We previously showed that the illusory sense of ownership and agency over a moving body in immersive virtual reality can trigger subjective and physiological reactions on the real subject’s body and, therefore, an acute improvement of cognitive functions after a single session of high-intensity intermittent exercise performed exclusively by one’s own virtual body, similar to what happens when we actually do physical activity. As well as confirming previous results, here, we aimed at finding in the elderly an increased improvement (...) after a longer virtual training with similar characteristics. Forty-two healthy older subjects completed a parallel-group randomized controlled trial including an adapted version of the virtual training previously used: while sitting, participants observed the virtual body in a first-person perspective or a third-person perspective performing 20 min of virtual high-intensity intermittent exercise. This was repeated twice a week for 6 weeks. During the vHIE, we measured the heart rate and administered questionnaires to evaluate illusory body ownership and agency. Before the beginning of the intervention, immediately after the first session of vHIE, and at the end of the entire intervention, we evaluated the cognitive performance at the Stroop task with online recording of the hemodynamic activity over the left dorsolateral prefrontal cortex. While we confirm previous results regarding the virtual illusion and its physiological effects, we did not find significant cognitive or neural improvement immediately after the first vHIE session. As a novelty, in the 1PP group only, we detected a significant decrease in the response time of the Stroop task in the post-intervention assessment compared to its baseline; coherently, we found an increased activation on left dorsolateral prefrontal cortex after the entire intervention. While the current results strengthen the impact of the virtual full-body illusion and its physiological consequences on the elderly as well, they might have stronger and more established body representations. Perhaps, a longer and increased exposure to those illusions is necessary to initiate the cascade of events that culminates to an improved cognitive performance. (shrink)

In this paper, we analyse the relation between the use of environmental data in contemporary health sciences and related conceptualisations and operationalisations of the notion of environment. We consider three case studies that exemplify a different selection of environmental data and mode of data integration in data-intensive epidemiology. We argue that the diversification of data sources, their increase in scale and scope, and the application of novel analytic tools have brought about three significant conceptual shifts. First, we discuss the EXPOsOMICS (...) project, an attempt to integrate genomic and environmental data which suggests a reframing of the boundaries between external and internal environments. Second, we explore the MEDMI platform, whose efforts to combine health, environmental and climate data instantiate a reframing and expansion of environmental exposure. Third, we illustrate how extracting epidemiological insights from extensive social data collected by the CIDACS institute yields innovative attributions of causal power to environmental factors. Identifying these shifts highlights the benefits and opportunities of new environmental data, as well as the challenges that such tools bring to understanding and fostering health. It also emphasises the constraints that data selection and accessibility pose to scientific imagination, including how researchers frame key concepts in health-related research. (shrink)

Background:Ethical conflict is a barrier to decision-making process and is a problem derived from ethical responsibilities that nurses assume with care. Intensive care unit nurses are potentially exposed to this phenomenon. A deep study of the phenomenon can help prevent and treat it.Objectives:This study was aimed at determining the frequency, degree, level of exposure, and type of ethical conflict among nurses working in the intensive care units.Research design:This was a descriptive cross-sectional research.Participants and research context:In total, 382 nurses working (...) in the intensive care units in Iranian hospitals were selected using the random sampling method. Data were collected using the Ethical Conflict in Nursing Questionnaire-Critical Care Version (Persian version).Ethical considerations:This study was approved by the Medical Research Ethics Committee. Ethical considerations such as completing the informed consent form, ensuring confidentiality of information, and voluntary participation were observed.Findings:The results showed that the average level of exposure to ethical conflict was 164.39 ± 79.06. The most frequent conflict was related to “using resources despite believing in its futility,” with the frequency of at least once a week or a month (68.6%, n = 262). The most conflictive situation was violation of privacy (76.9%, n = 294). However, the level of exposure to ethical conflict according to the theoretical model followed was the situation of “working with incompetent staff.” The most frequently observed type of conflict was moral dilemma.Conclusion:The moderate level of exposure to ethical conflict was consistent with the results of previous studies. However, the frequency, degree, and type of ethical conflict were different compared to the results of other studies. Recognizing ethical conflict among intensive care unit nurses can be useful as it allows to consolidate those measures that favor low levels of ethical conflict, design appropriate strategies to prevent ethical conflicts, and improve the nursing work environment. (shrink)

This paper reports the results of a systematic review conducted on articles examining the effects of daytime electric light exposure on alertness and higher cognitive functions. For this, we selected 59 quantitative research articles from 11 online databases. The review protocol was registered with PROSPERO. The results showed that both short-wavelength dominant light exposure and higher intensity white light exposure induced alertness. However, those influences depended on factors like the participants’ homeostatic sleep drive and the time (...) of day the participants received the light exposure. The relationship between light exposure and higher cognitive functions was not as straightforward as the alerting effect. The optimal light property for higher cognitive functions was reported dependent on other factors, such as task complexity and properties of control light. Among the studies with short-wavelength dominant light exposure, ten studies reported beneficial effects on simple task performances, and four studies on complex task performances. Four studies with higher intensity white light exposure reported beneficial effects on simple task performance and nine studies on complex task performance. Short-wavelength dominant light exposure with higher light intensity induced a beneficial effect on alertness and simple task performances. However, those effects did not hold for complex task performances. The results indicate the need for further studies to understand the influence of short-wavelength dominant light exposure with higher illuminance on alertness and higher cognitive functions. (shrink)

Moral distress is a fundamental problem in the nursing profession that affects nurses. Critical care nurses are more susceptible to this problem due to the nature of their work. Moral distress may, in turn, lead to several undesirable consequences. This study aimed to determine the relationship between moral distress and intention to leave the ward among critical care nurses. This descriptive-correlational study was conducted by census method on all eligible nurses who worked in Coronary Care Unit and Intensive Care Unit (...) of AhVaz hospitals, Iran. Data was collected by Corley’s moral distress questionnaire and a researcher-made questionnaire to investigate the intention to leave the ward. Questionnaires were completed through self-report and data were analyzed using a t-test and Pearson correlation coefficient. The results showed that there was a direct association between moral distress and intension to leave the ward in critical care nurses. Also, the intensity of moral distress and the intention to leave the ward were significantly higher in ICU nurses. Given the high exposure of critical care nurses with moral distress and its association with leaving the ward, it seems that devising strategies to reduce or control moral distress and its negative consequences are necessary, particularly in ICU nurses. (shrink)

It is currently assumed that exposure to an artificial blue-enriched light enhances human alertness and task performance, but recent research has suggested that behavioural effects are influenced by the basal state of arousal. Here we tested whether the effect of blue-enriched lighting on vigilance performance depends on participants’ arousal level. Twenty-four participants completed four sessions (blue-enriched vs. dim light x low vs. high arousal) at 10 pm on four consecutive days, following a repeated-measures design. Participants’ arousal was manipulated parametrically (...) through the execution of a cycling task at two intensities (low vs. moderate), and was checked by monitoring their heart rate. On each session, distal and proximal skin temperatures were recorded as a neuroergonomic index of vigilance, while participants performed a 20-min psychomotor vigilance task (PVT) under either blue-enriched light or dim light conditions. The Positive and Negative Affect Schedule (PANAS), Karolinska Sleepiness Scale (KSS) and Borg Rating of Perceived Exertion Scale (RPE) were used to measure subjective psychological state. The results showed that the exercise-induced manipulation of arousal produced robust alerting effects in most measures, while the lighting manipulation only attenuated subjective sleepiness and enhanced positive affect, but it did not influence behaviour or physiology. Acute exposure to a blue-enriched light was practically ineffective when the arousal level was over baseline. The present research favoured the use of acute physical exercise over acute exposure to blue-enriched lighting in order to boost humans’ alertness when necessary, as in work settings where maintaining optimal levels of attention is difficult (shift work, night-work, vigilance tasks) and necessary to prevent human error and accidents. (shrink)

Virtual reality enables individuals to be exposed to naturalistic environments in laboratory settings, offering new possibilities for research in human neuroscience and treatment of mental disorders. We used VR to study psychological, autonomic and postural reactions to heights in individuals with varying intensity of fear of heights. Study participants were immersed in a VR of an unprotected open-air elevator platform in an urban area, while standing on an unstable ground. Virtual elevation of the platform elicited robust and reliable psychophysiological (...) activation including increased distress, heart rate, and electrodermal activity, which was higher in individuals suffering from fear of heights. In these individuals, compared with individuals with low fear of heights, the VR height exposure resulted in higher velocity of postural movements as well as decreased low-frequency body sway oscillations. This indicates that individuals with strong fear of heights react to heights with maladaptive rigidity of posture due to increased weight of visual input for balance control, while the visual information is less reliable at heights. Our findings show that exposure to height in a naturalistic VR environment elicits a complex reaction involving correlated changes of the emotional state, autonomic activity, and postural balance, which are exaggerated in individuals with fear of heights. (shrink)

Three experimental studies are reported in which we tested the prediction that negative emotion elicits the social sharing of the emotional experience. In two experiments, participants arrived at the laboratory with a friend and then viewed one of three film excerpts (nonemotional, moderate emotion, or intense emotion) alone. Afterwards, the participants who saw the film had an opportunity to interact with the friend and their conversation was recorded. In both experiments participants who had seen the intense emotion excerpt engaged in (...) significantly more social sharing than did participants in the other two conditions. A third experiment extended the investigation to social sharing in everyday life and replicated the previous results. Nonemotional explanations of the effects observed were also ruled out. Results are discussed in the context of the relation between emotional intensity and amount of social sharing. (shrink)

Research on parasocial interactions and parasocial relationships refers back to a tradition of 50 years. However, research on both phenomena still suffers from overlapping definitions and resulting measurements that do not distinguish between PSI and PSR. The present study presents a post-exposure measurement tool that aims to measure PSI instead of PSR. It is derived from a theoretical model that specifically focuses on PSI. Psychometric analyses indicate the tool's high usability. It is capable of displaying both the intensity (...) and the dimensionality of PSI. It can be applied to measure both positive and negative PSI across all TV formats, without changing the item wording. In sum, the PSI-Process-Scales may offer a valuable alternative for researchers in the field, specifically if they want to assess parasocial processes that take place throughout TV exposure. (shrink)

Stellen Kondome einen potenten Schutz sowohl vor HIV als auch von anderen sexuell übertragbaren Infektionen (STIs) dar, und besteht außerdem ein barrierefreier Zugang zur HIV-Postexpositionsprophylaxe (PEP) (z. B. nach Kondom-Fatigue), muss präzise sondiert werden, wann die sich zunehmend etablierende HIV-Präexpositionsprophylaxe (PrEP) die bessere Wahl darstellt. Vor dem Hintergrund einer generalisierten everyone at risk-Annahme über MSM wird die PrEP zunehmend zu einem standard of care. Zwar kann kein Zweifel daran bestehen, dass dies für bestimmte MSM mit einem bestimmten Risikoprofil wünschenswert ist. (...) Es ist aber von Variabilitäten (z. B. casual condomless sex versus random condomless sex) auszugehen, die zur Vermeidung einer unverhältnismäßigen Medikalisierung berücksichtigt werden müssen. Im Spannungsfeld von hochpotenter HIV-Prävention und Medikalisierung insbesondere von Männern, die Sex mit Männern praktizieren, soll im Sinn einer Güterabwägung gefragt werden, wann genau eine PrEP (dauerhaft oder on demand) mehr Vorteile und weniger Nachteile bietet als der Gebrauch von Kondom oder PEP. Dazu gehört ein Fokus auf den aktuellen Stand der klinischen Forschung und ein Fokus auf die medizinethische Debatte. Die Medizingeschichte der Prävention und der HIV-Erkrankung erweist sich dabei als relevanter Erörterungszusammenhang für die weitgehend noch ausstehende ethische Untersuchung der PrEP. Methodisch basiert diese Arbeit auf einer Auswertung der interdisziplinären Fachliteratur über die HIV-Präexpositionsprophylaxe im Besonderen und über HIV-Prävention im Allgemeinen. Basierend auf den PRISMA (Prefered Reporting Items for Systematic Reviews and Meta-Analyses) Guidelines wurden aus der Datenbank PubMed/MEDLINE solche Studien ausgewählt, die die aktuelle klinische Praxis der PrEP oder eine medizinethische Diskussion der PrEP zum Gegenstand haben. Auf der Basis dieser Literatur erfolgt eine diskursive Erörterung und Abwägung der verfügbaren Pros und Cons zur PrEP. Präventionsmaßnahmen treten regelmäßig als ambivalente Instrumente der Gesundheitsförderung zwischen Liberalisierung und Restringierung des Individuums hervor. Insgesamt bietet daher die PrEP on demand gegenüber der kontinuierlichen PrEP im Sinne der Personalisierung die Option einer individuellen Anpassung an konkretes Risikoverhalten. Auch im Sinne einer Güterabwägung hat die PrEP gewichtige Vorteile gegenüber der kontinuierlichen PrEP und gegenüber einer PEP, wenn kein dauerhaft gleichhohes Risiko vorliegt. In dieser medizinethischen Untersuchung wird darauf hingewiesen, dass es sich bei MSM um eine heterogene Gruppe handelt, deren individuelles Sexualverhalten eine ebenfalls individualisierte HIV-Präventions-Strategie benötigt. Diese Studie argumentiert daher für ein stark personalisiertes decision making bei möglicher Indikation für eine PrEP bei MSM. Damit soll ein wesentlicher Faktor zur Vermeidung einer Medikalisierung von MSM dargestellt werden. (shrink)

Considerable interest has long existed in two separate phenomena of considerable social interest, namely children’s early exposure to employment outside of any organizational, legislative, or collective bargaining protection, and teenage smoking. We used data from a large national survey to address possible direct and indirect links between children’s early employment intensity and smoking because of significant long-term implications of the link between work and well-being in a vulnerable population. Fifth to ninth grade children’s informal employment intensity was (...) related to both smoking history and smoking intent, and these effects were partially mediated by the amount of weekly spending money and self-esteem. The number of one’s parents and friends who smoke separately moderated the relationships between self-esteem and weekly spending money, and smoking behavior. These findings illustrate the complex consequences of young children’s exposure to early employment, and emphasize the need for research on the ethical implications of pre- and early teenagers who are employed outside of the formal employment context. (shrink)

Background: The intrauterine hearing experience differs from the extrauterine hearing exposure within a neonatal intensive care unit (NICU) setting. Also, the listening experience of a neonate drastically differs from that of an adult. Several studies have documented that the sound level within a NICU exceeds the recommended threshold by far, possibly related to hearing loss thereafter. The aim of this study was, firstly, to precisely define the dynamics of sounds within an incubator and, secondly, to give clinicians and caregivers (...) an idea about what can be heard “inside the box.” Methods: Audio recordings within an incubator were conducted at the Pediatric Simulation Center of the Medical University Vienna. They contained recorded music, speech and synthesized sounds. To understand the dynamics of sounds around and within the incubator the following stimuli were used: broadband noise with decreasing sound level in ten steps of 6 dB, sine waves (62.5, 125, 250, 500, 1000, 2000, 4000, 8000 and 16000 Hz), logarithmic sweep (Chirp) over the frequency band 20 Hz to 21 kHz, singing male voice, singing and whispering female voice. Results: Our results confirm a protective effect of the incubator from noises above 500 Hz in conditions of “no-flow” and show almost no protective effect of an incubator cover. We, furthermore, observed a strong boost of low frequencies below 125 Hz within the incubator, as well as a notable increase of higher frequency noises with open access doors, a significant resonant effect of the incubator, and a considerable masking effect of the respiratory support against any other source of noise or sound stimulation even for “low-flow” conditions. Conclusion: Our study reveals high noise levels of air supply at high flow rates and the boost of low frequencies within the incubator. Education of medical staff and family members as well as modifications of the physical environment should aim at reducing noise exposure of preterm infants in the incubator. Audiovisual material is provided as supplementary material. (shrink)

Previous research suggests that social anxiety symptoms are maintained and intensified by inflexible emotion regulation (ER). Therefore, we examined whether trait-level social anxiety moderates ER flexibility operationalised at both between-person (covariation between variability in emotional intensity and variability in strategy use across occasions) and within-person (associations between emotional intensity and strategy use on a given day) levels. In a sample of healthy college-aged adults (N = 185, Mage = 21.89), we examined overall and emotion-specific intensities (shame, guilt, anxiety, (...) anger, sadness) and regulatory strategies (i.e. experiential avoidance, expressive suppression, and rumination) in response to each day’s most emotionally intense event over 6 days. During the study period, we found a positive association between variability in emotional intensity and variability of experiential avoidance in individuals with lower, rather than higher, levels of trait social anxiety after controlling for key covariates (i.e. gender, personality traits, and stress exposure). However, we did not find evidence for the moderating role of trait social anxiety in ER flexibility assessed at within-person levels. Our findings highlight the need to delineate dynamic ER flexibility across everyday events. (shrink)

We show that true colors as defined by Chevreul (1839) produce unsuspected simultaneous brightness induction effects on their immediate grey backgrounds when these are placed on a darker (black) general background surrounding two spatially separated configurations. Assimilation and apparent contrast may occur in one and the same stimulus display. We examined the possible link between these effects and the perceived depth of the color patterns which induce them as a function of their luminance contrast. Patterns of square-shaped inducers of a (...) single color (red, green, blue, yellow, or grey) were placed on background fields of a lighter and a darker grey, presented on a darker screen. Inducers were always darker on one side of the display and brighter on the other in a given trial. The intensity of the grey backgrounds varied between trials only. This permitted generating four inducer luminance contrasts, presented in random order, for each color. Background fields were either spatially separated or consisted of a single grey field on the black screen. Experiments were run under three environmental conditions: dark-adaptation, daylight, and rod-saturation after exposure to bright light. In a first task, we measured probabilities of contrast, assimilation, and no effect in a three-alternative forced-choice procedure (background appears brighter on the ‘left’, on the ‘right’ or the ‘same’). Visual adaptation and inducer contrast had no significant influence on the induction effects produced by colored inducers. Achromatic inducers produced significantly stronger contrast effects after dark-adaptation, and significantly stronger assimilation in daylight conditions. Grouping two backgrounds into a single one was found to significantly decrease probabilities of apparent contrast. Under the same conditions, we measured probabilities of the inducers to be perceived as nearer to the observer inducers. These, as predicted by Chevreul’s law of contrast, were determined by the luminance contrast of the inducers only, with significantly higher probabilities of brighter inducers to be seen as nearer, and a marked asymmetry between effects produced by inducers of opposite sign. Implications of these findings for theories which attempt to link simultaneous induction effects to the relative depth of object surfaces in the visual field are discussed. (shrink)

Why are negative emotions so central in art reception far beyond tragedy? Revisiting classical aesthetics in the light of recent psychological research, we present a novel model to explain this much discussed (apparent) paradox. We argue that negative emotions are an important resource for the arts in general, rather than a special license for exceptional art forms only. The underlying rationale is that negative emotions have been shown to be particularly powerful in securing attention, intense emotional involvement, and high memorability, (...) and hence is precisely what artworks strive for. Two groups of processing mechanisms are identified that conjointly adopt the particular powers of negative emotions for art's purposes. The first group consists of psychological distancing mechanisms that are activated along with the cognitive schemata of art, representation, and fiction. These schemata imply personal safety and control over continuing or discontinuing exposure to artworks, thereby preventing negative emotions from becoming outright incompatible with expectations of enjoyment. This distancing sets the stage for a second group of processing components that allow art recipients to positively embrace the experiencing of negative emotions, thereby rendering art reception more intense, more interesting, more emotionally moving, more profound, and occasionally even more beautiful. These components include compositional interplays of positiveandnegative emotions, the effects of aesthetic virtues of using the media of (re)presentation (musical sound, words/language, color, shapes) on emotion perception, and meaning-making efforts. Moreover, our Distancing-Embracing model proposes that concomitant mixed emotions often help integrate negative emotions into altogether pleasurable trajectories. (shrink)

There is the world of ideas and the world of practice; the French are often for sup pressing the one and the English the other; but neither is to be suppressed. -Matthew Arnold The Function of Criticism at the Present Time From its inception, bioethics has confronted the need to reconcile theory and practice. At first the confrontation was purely intellectual, as writers on ethical theory (within phi losophy, theology, or other humanistic disciplines) turned their attention to topics from the (...) world of medical practice. Recently the confrontation has grown more intense. The ap pointment of clinical ethicists in hospitals and other health care settings is an accelerating trend in North America. Concomitantly, those institutions involved in training peo ple in clinical ethics have added organized exposure to the world of practice, in the form of placement requirements, to the normal academic course load. In common with other dis ciplines, bioethics has begun to see clinical training as a con dition of didactic theory and apprenticeship. (shrink)

A common picture of evolution by natural selection sees it as a process through which organisms change so that they become better adapted to their environment. However, agents do not merely respond to the challenges their environments pose. They modify their environments, filtering and transforming the action of the environment on their bodies A beaver, in making a dam, engineers a stream, increasing both the size of its safe refuge and reducing its seasonal variability. Beavers, like many other animals, are (...) ecological engineers. They act to modify the physical challenges posed by their environment. Nests, burrows and other shelters reduce the impacts of adverse weather and of other agents. Animal also modify their exposure to biological risks. Hygienic behaviour reduces the impact of disease. Intensive grooming; moving to new roosts; using a. (shrink)

Chapter 1 First Person Access to Mental States. Mind Science and Subjective Qualities -/- Abstract. The philosophy of mind as we know it today starts with Ryle. What defines and at the same time differentiates it from the previous tradition of study on mind is the persuasion that any rigorous approach to mental phenomena must conform to the criteria of scientificity applied by the natural sciences, i.e. its investigations and results must be intersubjectively and publicly controllable. In Ryle’s view, philosophy (...) of mind needs to adopt an antimentalist stance to achieve this aim. Antimentalism not only definitively rejects the idea that mind is a substance separated from the body, it also denies that mental phenomena radically differ from physical phenomena by virtue of several unique features. Most problematically, mental phenomena have a conscious character (mental states are related to specific qualitative feelings) and are accessible only to the first-person (only the subject knows directly what s/he is experiencing inside his/her mind). Ryle takes a strong stance on antimentalism going so far as to maintain that an approach to mind which aims to meet the criteria of scientificity set by the natural sciences must avoid any reference to internal, unobservable mental states. In his view (which is considered a specifically philosophical version of psychological behaviorism and also addresses questions put forward in psychological research), mental states can be redescribed in terms of behavioral dispositions. In this chapter, we address the historical roots of the antimentalist view and analyze its relation to the later tradition of research on mind. We show that, compared to the antimentalist stance, functionalism and cognitivism take a step back when they maintain that direct reference to mental states is necessary since mental states cause and therefore explain human behavior. This step backwards is often interpreted as a return to mentalism. However, this is only partially true. Indeed, we suggest that these later traditions retain one important element of Ryle’s antimentalism, i.e. the idea that mental states must be uniquely identified using external and publicly observable criteria, while excluding any reference to introspection and those qualitative dimensions of a mental state, which are accessible only to the first-person. According to the perspective we put forward, this epistemological stance has continued to influence contemporary research on mind and current philosophical and psychological theories which both tend to exclude the subjective qualities of human experience from their accounts of how the mind works. The issue we raise here is whether this is legitimate or whether subjective qualities do play a role with respect to the way our mind works. The conclusion of this chapter anticipates the argument the book makes in in favor of this latter position, starting from a particular angle, i.e. the problem of how we categorize concepts related to our internal states. -/- Chapter 2 The Misleading Aspects of the Mind/Computer Analogy. The Grounding Problem and the Thorny Issue of Propriosensitive Information -/- Abstract. After the crisis of behaviorism, cognitivism and functionalism became the predominant models in the field of psychology and of philosophy, respectively. Their success is mainly due to the new key they use for interpreting mental processes: the mind/computer analogy. On the basis of this analogy, mental operations are seen as cognitive processes based on computations, i.e. on manipulations of abstract symbols which are in turn understood as informational unities (representations). This chapter identifies two main problems with this model. The first is how these symbols can relate to and communicate with perception and thus allow us to identify and classify what we perceive through the senses. Here we limit ourselves to presenting this issue in relation to the classical symbol grounding problem originally put forward by Harnad on the basis of Searle’s Chinese room argument. An attempt to address the problem raised here will be made in chap. 3. The second point we discuss in relation to the mind/computer analogy concerns the idea of information it fosters. Indeed, following this analogy, information is something available in the external world which can be captured by the senses and transmitted to the central system without being influenced or modified by the procedures of transmission. This perspective does not take into account that – unlike computers – in living beings information is acquired by means of the body. As Ulric Neisser has already pointed out, the body is itself an informational source that provides us with additional sensory experience that influences (modifies or complements) the information extracted from the external world by the senses. To develop this line of analysis and to determine exactly what information is provided by the body and how this might influence cognition, we examine Sherrington’s and Gibson’s positions. Moving on from their views, we qualify bodily information in terms of ‘proprioception’. We use ‘proprioception’ in a broad sense to describe any kind of experience we have of our internal states (including postural information as well as sensations related to the general state of the body and its parts). Following Damasio’s and Craig’s studies, we further elaborate this position, arguing that living beings are equipped with an internal propriosensitive monitoring system which maps all the changes that constantly occur in our body and that give us perceptual (‘proprioceptive’ or propriosensitive) information about what happens inside us. Moreover, relying on Goldie’s and Ratcliffe’s view, we show that emotional information can also be considered as a form of ‘proprioception’ which contributes to determining everything we perceive. This analysis leads us to the second main thesis of this book: ‘proprioception’ is a form of internal perception and it is an essential component of the sensory information we can access and use for all cognitive purposes. -/- Chapter 3 Semantic Competence from the Inside: Conceptual Architecture and Composition -/- Abstract. Concepts are essential constituents of thought: they are the instruments we use to categorize our experience, i.e. to classify things and group them together in homogeneous sets. Here we define concepts as the internal mental information (representations) that allows us, among other things, to master words in natural language. By analyzing the way in which individuals master word meanings we explore a number of hypotheses regarding the nature of concepts. Following Diego Marconi’s research, we differentiate between two kind of abilities that underpin lexical competence – so-called ‘referential’ and ‘inferential competence’ – and we suggest that, in order to support these abilities, concepts must also include two corresponding kinds of information, i.e. inferential and referential information. We point out that the most widely used and acknowledged theories of concepts do not make this distinction, instead broadly characterizing the information used for categorization in terms of propositionally described feature lists. However, we show that while feature lists can explain inferential competence, they do not account for referential competence. To address the issue of referential competence we examine Ray Jackendoff’s hypothesis that to account for the possibility of linking perceptual and conceptual information we need to assume the existence of a (visual) representation that encodes the geometric and topological properties of objects and bridges the gap between the percept and the concept. Furthermore, we analyze the extension of this work by Jesse Prinz who introduced the notion of a proxytype, a perceptual representation of a class of objects that incorporates structural and parametric information related to their appearance. However, as we point out, proxytypes can only explain the relationship between perception and concepts with respect to instances that can be perceived through the senses and that belong to the same class by virtue of their physical similarity. We suggest that this notion be extended to include larger conceptual classes. To accomplish this, we further develop Mark Johnson, George Lakoff and Jean Mandler’s idea of a schematic image and argue that conceptual representations include a perceptual schema. Perceptual schemata are non-linguistic, structured experiential gestalts (patterns or maps) that make use of information taken from all sensory modalities, including body perception. They accomplish a quasi-conceptual function: they allow us to recognize and to classify different instances. In this work, we hypothesize that perceptual schemata are an essential component of concepts, but not identical to them. Instead, we suggest that concepts include both perceptual and propositional information with perceptual schemata providing the ‘perceptual core concept’ that grounds related propositional information. -/- Chapter 4 In the Beginning There Were Categories. The Bodily Origin of Prelinguistic Categorical Organization: The Example of Folkbiological Taxonomies -/- Abstract. Studies of categorization in psychology and the cognitive sciences have made use of the notions of ‘category’ and ‘concept’ without precisely defining what is meant by either; in fact, often these terms have been used as synonyms, making it difficult to address specific issues related to conceptual development. This chapter begins by discussing the definitions of, as well as the distinctions between, ‘categories’ and ‘concepts’ in the classical philosophical tradition (Aristotle, Kant and Husserl). We introduce our view of categories with reference to Husserl. Categorization is defined as the way in which our experience is originally (pre-linguistically) organized in a passive and fully unconscious manner on the basis of universal structuring principles. Conceptualization is explained as a later process in which the earlier categorical macro-classes are further subdivided into more specific and detailed sets; this later process also relies on linguistic learning and exposure to culture. On the basis of Ray Jackendoff, Jean Mandler, George Lakoff and Mark Johnson’s work, we hypothesize that categorization is a two-step process that begins with the formation of homogeneous sets of entities partitioned into regions that describe the ontological boundaries of the objects that humans perceive (categories) and continues at a later stage with the development of more specific classifications (concepts). In this chapter, we mainly address three related issues: Why should we assume that there is categorical organization which precedes the development of a conceptual system? How do categories and concepts relate to each other? Shall we hypothesize that categories are innate or that they are formed before concepts on the basis of information and organizational structure available at a very early developmental stage? We show that categorical partitions are necessary for categorization and, following Mandler, that the general categories we form at an early age do not match our adult superordinate concepts. As for the third issue, we argue that there might be no need to assume that categories are innately present in the human mind, since their formation can be explained – at least in certain cases – by basic mechanisms that work on body (propriosensitive) information. This hypothesis will not be discussed in general, but in relation to a particularly relevant example of categorical partition, i.e. the folk-biological dichotomy between ANIMATE/INANIMATE. This is compared with other dichotomies that derive from it, but are not directly categorical such as LIVING/NON-LIVING and BIOLOGICAL/NON-BIOLOGICAL. -/- Chapter 5 Internal States: From Headache to Anger. Conceptualization and Semantic Mastery -/- Abstract. Here we ask if we can also apply the distinction between referential and inferential competence we introduced in Chapter 3 to words that do not refer to things that are perceived using the external senses, especially to words/concepts that denote bodily experiences (such as pain, thirst, hunger, etc.) or emotions. We introduce and discuss the hypothesis that – even though such words/concepts do not refer to intersubjectively identifiable entities in the external world – they do have a kind of referent that can be accessed via direct perception, more specifically ‘proprioception’, as we have defined it in terms of all propriosensitive information we can consciously access. In the first part of the chapter, we specifically consider terms denoting bodily experiences such as ‘pain’ or ‘hunger’ and argue that their referents are identified and classified from a first-personal point of view on the basis of four main characteristics: their specific intensity, their localization in the body, their co-occurrence with other signals and above all their specific qualitative sensations. Emotions are addressed in the second part of the chapter. We suggest that there is a continuity between bodily experiences and emotions. In particular, we argue for a perceptual theory of emotions in line with that proposed by James and Lange at the end of the 19th century and developed more recently by authors such as Damasio (see also chap. 2§5, §6). The hypothesis we put forward is that the referential information that supports the categorization of emotions and therefore also our mastery of terms referring to emotions consists in the perception (i.e. the ‘proprioception’) of those bodily states and changes in bodily states which constitute our emotional experience. In the context of this discussion we examine some objections to this line of reasoning that arise from a cognitivist perspective and following authors such as Oatley, Johnson-Laird and Frijda, we distinguish between basic emotions that can be identified and classified solely on the basis on how they feel and complex emotions whose identification and classification additionally depends on cognitive factors. To describe how emotions are identified and classified on the basis of how they feel, we rely on Marcel and Lambie’s distinction between an ‘emotion state’ and an ‘emotion experience’. Both notions indicate kinds of feelings that we consciously experience. However, they describe first-order and second order emotion awareness respectively. The emotion state is the feeling we have of the bodily states and changes that occur when we are experiencing an emotion, while the emotion experience is the fully developed and integrated emotion we both experience and are, with reflection, aware of experiencing. On the basis of this differentiation, we also show that the same characteristics that aid in the identification and classification of bodily experiences (specific qualitative sensations; somatic localization; specific intensity; presence/absence of specific concomitant sensations) can also be used for the identification and classification of emotions – at least basic emotions. In the last two sections of the chapter we present some clinical evidence on the semantic competence of people who suffer from Alexithymia and Autism Spectrum Disorder which supports the conclusions of our preceding analyses. -/- Chapter 6 The ‘Proprioceptive’ Component of Abstract Concepts -/- Abstract. In this chapter, we address the issue of whether the mastery of abstract words requires only inferential knowledge and thus, if the concepts that support the mastery of abstract words include only linguistic information. We start by differentiating the notions of ‘abstract’ and ‘general’ which are often erroneously confused. We then identify a strict definition of abstract, as contrasted with ‘concrete’, that applies to words or concepts whose referent cannot be experienced by the senses. We argue that abstract words/concepts would be better described as theoretical, because they are usually conceived as structured sets of inferential knowledge expressed linguistically; that is, as small theories. Pointing out parallels with Carnap’s analysis of this issue in philosophy of science, we hypothesize that words/concepts denoting non-observable entities are not all ‘equally theoretical’, because their link to sensory experience can be stronger or weaker. We revive the distinction, inspired by Quine, between theoretical and intertheoretical concepts/words. This distinction relies on the fact that the former – unlike the latter – retains a strong, although indirect, connection with perception. In Quine’s discussion, perception is understood uniquely in terms of observability, i.e. of external sensory experience. Here we argue, however, that bodily, ‘proprioceptive’ (i.e. propriosensitive) experience can also serve to referentially ground theoretical (i.e. abstract) concepts/words. We frame this issue using the example of the theoretical concept ‘freedom’ and Lakoff’s hypothesis that this concept is developed on the basis of bodily information. We contrast this with the example of ‘democracy’ which more closely resembles an intertheoretical concept/word. Furthermore, we show that one of the classical views put forward in psycholinguistic research to explain how abstract concepts are mentally represented – i.e. Paivio’s Dual Coding Theory – points in the same direction as our analysis. The same is true of Barsalou’s work suggesting that we use internal information to understand at least some abstract words. To sustain this position, we put forward two lines of evidence: the first comes from psycholinguistic studies while the second examines deficits of semantic competence exhibited by people with Autism Spectrum Disorder. On the basis of our analysis, we put forward a classification that distinguishes between different kinds of concreteness and different degrees of abstraction: concepts/words referring to body experiences and basic emotions are described as analogous to concrete concepts/words because they are grounded in perceptual (i.e. propriosensitive) experience, while abstract concepts/words are considered more or less abstract depending on whether they are intratheoretical (and rely entirely on inferential information) or theoretical (and are partially grounded in perceptual – or more often in propriosensitive perceptual – information). In the last section of the chapter we consider two scales that have been used in psycholinguistic research to measure the degree of concreteness vs. abstractness of words and we show that – used conjointly – they can provide a measure of the internal vs. external grounding of specific words. (shrink)

Neoliberal cultural frames of individual choice inform mothers’ accounts of why they refuse state-mandated vaccines for their children. Using interviews with 25 mothers who reject recommended vaccines, this article examines the gendered discourse of vaccine refusal. First, I show how mothers, seeing themselves as experts on their children, weigh perceived risks of infection against those of vaccines and dismiss claims that vaccines are necessary. Second, I explicate how mothers see their own intensive mothering practices—particularly around feeding, nutrition, and natural living—as (...) an alternate and superior means of supporting their children’s immunity. Third, I show how they attempt to control risk through management of social exposure, as they envision disease risk to lie in “foreign” bodies outside their networks, and, therefore, individually manageable. Finally, I examine how these mothers focus solely on their own children by evaluating—and often rejecting—assertions that their choices undermine community health, while ignoring how their children benefit from the immunity of others. By analyzing the gendered discourse of vaccines, this article identifies how women’s insistence on individual maternal choice as evidence of commitment to their children draws on and replicates structural inequality in ways that remain invisible, but affect others. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Phenomenological Interviews and Tourette'sThe authors report no conflicts of interest.We appreciate the responses from the two clinicians, Efron and Mathieson. We agree with their reminder about the holistic nature of clinician's engagement (mood, sociality, and work life) and with their emphasis on patient-reported outcome measures, although this is not quite what we did in our interviews. As has recently been recognized in section 24 of the Victorian Mental Health (...) and Well-being Act (to provide a local Australian example), patients and caregivers' "lived experience makes them valuable leaders and active partners in the mental health and wellbeing service system."1In this paper, however, our aim was both more modest and immodest: modest, in that we aimed to work with those "leaders and active partners" to generate a more adequate account of lived experience in concert with behavioral symptomatology; immodest, in that we wondered how the lived experience of Tourette syndrome (TS) aligned (or not) with some of the commonly ascribed features of the condition. Although phenomenology as a discipline does not own lived experience, of course, it is more systematically treated in this tradition, starting with elaborations of Erlebnis.Efron and Mathieson note that older patients are more likely to describe urges or premonitory urges (PUs). This raises the priming question: Has greater exposure to and involvement in medical concepts and treatments transformed the nature of their self-report, or has it provided them with more phenomenological skills, enabling them to pick out discrete parts of experience? Or perhaps they have just been exposed more frequently to the experience over time? We address some related issues below, in our reply to Fernandez, where we outline our interview techniques more fully.They end by noting that the aim of comprehensive behavioral intervention for tics is to become attentive to PUs to better block tics. This is complex and understudied. In principle, becoming aware of something cognitively and experientially can foreground or even perhaps induce that experience. Conversely, from the TS scholarship, we know that attending to urges in certain ways (e.g., via acceptance training) can also reduce perceived urge frequency and intensity (see Gev et al., 2016). We would welcome further work on this link between attention and experience in TS. [End Page 49]Response to FernandezBecause our paper was partly framed around Fernandez' own work on phenomenological psychopathology, we welcome his invitation to provide further "inspiration and guidance" for other phenomenological researchers conducting empirical studies, who may also be dealing with the challenge posed by "narrative habits." When an interviewee uses well-worn medicalized terms to describe their experience, it is not clear whether these descriptions genuinely reveal or rather occlude the experience in question. There are sometimes, perhaps often, second-person phenomenological 'tells' regarding interviewees genuinely re-evoking an experience, but for interviewers it still raises the question of how to prompt alternative and potentially more accurate descriptions of experience.Because of this challenge, we purposely did not use the term "urge" or "premonitory urge" (PU) in our interview questions. Instead, we asked about (and used the broader term of) "experiences" that may occur prior, during, or after ticcing, without assuming that there are such experiences in the first place. We guided interviewees to evoke the memory of a specific, singular tic event (a tic token; see Curtis-Wendlandt 2020, 2023). Once a memory of such an event had been identified, we asked interviewees the following three lead questions:1. What, if anything, did you experience during this tic?2. What, if anything, did you experience before this tic?3. What, if anything did you experience after this tic?The temporal framing of these questions counters common trends and assumptions in the scholarship, which has focused heavily on pre-tic experiences, with little attention given to post-tic experiences (reduced to notions of "relief" and barely investigated), and even less to experiential explorations of the tic itself. Our catalogue of supporting questions sought to elicit fine-grained descriptions of evoked/recalled experiences along sensory and cognitive-affective dimensions:•. Did you see anything before, during, or after this tic? If so, what did you see?•. Did you hear anything... (shrink)

Empirical evidence suggests that while people hold the capacity to control their data in high regard, they increasingly experience a loss of control over their data in the online world. The capacity to exert control over the generation and flow of personal information is a fundamental premise to important values such as autonomy, privacy, and trust. In healthcare and clinical research this capacity is generally achieved indirectly, by agreeing to specific conditions of informational exposure. Such conditions can be openly (...) stated in informed consent documents or be implicit in the norms of confidentiality that govern the relationships of patients and healthcare professionals. However, with medicine becoming a data-intense enterprise, informed consent and medical confidentiality, as mechanisms of control, are put under pressure. In this paper we explore emerging models of informational control in data-intense healthcare and clinical research, which can compensate for the limitations of currently available instruments. More specifically, we discuss three approaches that hold promise in increasing individual control: the emergence of data portability rights as means to control data access, new mechanisms of informed consent as tools to control data use, and finally, new participatory governance schemes that allow individuals to control their data through direct involvement in data governance. We conclude by suggesting that, despite the impression that biomedical big data diminish individual control, the synergistic effect of new data management models can in fact improve it. (shrink)

The teikei movement is a Japanese version of the alternative food movement, which emerged around the late 1960s and early 1970s. Similar to now well-known Community Supported Agriculture, it is a farmer-consumer partnership that involves direct exchanges of organic foods. It also aims to build a community that coexists with the natural environment through mutually supportive relationships between farmers and consumers. This article examined the history of the teikei movement. The movement began as a reaction to negative impacts of mechanized (...) and chemically intensive agriculture promoted by the Japanese government. The movement experienced a rapid expansion in the early 1980s, and then gradually declined thereafter. The organic market expansion and certification system intersected with both cultural and gender role changes, impacting the teikei movement negatively. Consequently, the membership of teikei consumer groups has shrunk. Furthermore, the March 2011 Fukushima Daiichi nuclear power plant accident caused unprece dented damage to organic farmers in the affected regions. Despite the scientific uncertain about the safety level of radiation exposure, the organic farmers and the teikei consumer groups managed the situation and found a way to inspect radiation contamination. They did so with the support by networking with other teikei-related actors. This response to the nuclear power plant accident suggests that although the level of embeddedness presumably varies among teikei actors, ethics guided by the teikei principles are effective in forging a resilient partnership between farmers and consumers and in keeping the teikei system alive as an agent for social change. (shrink)

Background Ethical conflict is a problem with negative consequences, which can compromise the quality and ethical standards of the nursing profession and it is a source of stress for health care practitioners’, especially for nurses. Objectives The main aim of this study was to analyze Spanish critical care nurses’ level of exposure to ethical conflict and its association with sociodemographic, occupational, and COVID-19–related variables. Research Design, Participants, and Research context: This was a quantitative cross-sectional descriptive study conducted among 117 (...) nurses working in critical care units. Data collection tools were sociodemographic, occupational, and COVID-19–related questionnaires and previously validated Spanish version of Ethical Conflict in Nursing Questionnaire-Critical Care Version. Ethical Considerations We obtained permission from the Ethics Committee and participants' informed consent. Findings Data indicates a moderate level of exposure to ethical conflicts. The most frequent ethical conflicts were related to situations about "treatment and clinical procedures." The most intensity of ethical conflicts was related to situations about "treatment and clinical procedures" and "dynamics of the service and working environment." No statistical significance was identified between the socio-demographic variables and level of exposure to ethical conflicts. However, for critical care nurses working in ICU, nurses with perceived worked stress had a higher level of exposure to ethical conflicts. Likewise, critical care nurses whose family/friends were infected with COVID-19 had a higher level of exposure. Conclusions Critical care nurses experience a moderate level of exposure to ethical conflicts which is consistent with the results of previous studies. A deeper understanding of ethical conflicts in conflictive situations allows recognition of the situations that occur in everyday clinical practice, identification of the ethical conflicts, and facilitation of the nurses working in the challenging clinical situation. (shrink)

Both ethicists and lawyers accept that a provider – be it a researcher or a clinician – should provide sufficient information for a reasonable person to make an informed decision about whether they wish to go ahead with the proposed intervention or treatment.1 They are bound to do so both because they have an ethical responsibility to preserve the individual’s autonomous decision making, and, in many countries, because the law obliges them to. In this month’s issue of the JME, three (...) articles tackle ethical issues relating to consent in different contexts. Overarching these analyses is the pragmatic question of whether the process of taking consent in itself might alter the outcomes, and whether, in doing so, it can undermine the initial therapeutic or research goal – so creating another ethical question of what to prioritise. Psilocybin is entering Phase III trials to evaluate its effect on treatment resistant depression and cancer related depression and anxiety; earlier trials have shown sustained symptom reduction in these populations. Smith and Sisti examine whether a form of enhanced consent is ethically required for these drugs.2 They explore how to adequately consent for ‘therapeutic touch’ in a future altered state; the rare but significant mental health risks including trauma re-exposure; and the potential for a personality change given the intense experiences which many subjects have reported. They illustrate the potential for personality change with an example regarding the spiritual experiences which can occur with serotonergic psychedelics, and suggest that ‘agnostic or atheist patients may take the development of a newfound sense of spirituality or belief in God to …. (shrink)

The wilderness is one of the most widely recognized sources of transcendent emotion. Various recent studies have demonstrated nature’s power to induce intense emotions. The study at hand will generate conceptual and operational definitions of sublime emotion toward nature. Taking into consideration the recent research on feelings of awe, an instrument is devised to measure sublime emotion toward nature. The proposed scale’s reliability and validity is tested in a sample of 280 participants from the general population of Madrid. Results show (...) that sublime emotion was defined by two conceptual components: awe, and inspiring energy, both obtained using the computer program FACTOR. After reliability and validity analysis, the Sublime Emotion toward Nature (SEN) scale included 18 items, distributed into awe (6 items, α =.881) and inspiring energy (12 items, α=.933). Awe was defined by feelings of fear, threat, vulnerability, fragility, and respect for nature, which is perceived as vast, powerful, and mysterious. Inspiring energy was defined by feelings of vitality, joy, energy, oneness, freedom, eternity, and harmony with the universe. The SEN is an adequate instrument to measure transcendent emotions provoked by direct wilderness exposure or memory thereof. (shrink)

This paper examines gradients of attention in relation to aesthetic appreciation. My main claim is that we should leave open the possibility that aesthetic response might be triggered by stimulations taking place far from the centre of one’s focused attention. In support of this claim I first discuss the notion of ‘periphery of attention’ and the challenges that it poses to contemporary psychological theories of aesthetics. I provide four criteria for differentiating between several types of attentional processes and then proceed (...) to single out the characteristics of non-focal types of attention processes with varying intensity such as pre-attentive processing, the mere exposure effect and psychic overtones. Finally, I reassess the periphery of attention in the light of its relation to aesthetic appreciation. I hold that given certain constraints such as repeated exposure, perceptual learning, encoding in long-term memory, and possibility of retrieval, subdued, inconspicuous forms of stimulation can elicit aesthetic responses. (shrink)

Background This paper describes the design, implementation, and process outcomes from three public deliberations held in three tribal communities. Although increasingly used around the globe to address collective challenges, our study is among the first to adapt public deliberation for use with exclusively Indigenous populations. In question was how to design deliberations for tribal communities and whether this adapted model would achieve key deliberative goals and be well received.Methods We adapted democratic deliberation, an approach to stakeholder engagement, for use with (...) three tribal communities to respect tribal values and customs. Public deliberation convenes people from diverse backgrounds in reasoned reflection and dialogue in search of collective solutions. The deliberation planning process and design were informed by frameworks of enclave deliberation and community-based participatory research, which share key egalitarian values. The deliberations were collaboratively designed with tribal leadership and extensive partner input and involvement in the deliberations. Each deliberation posed different, locally relevant questions about genomic research, but used the same deliberation structure and measures to gauge the quality and experience of deliberation.Results A total of 52 individuals participated in the deliberations across all three sites. Deliberants were balanced in gender, spanned decades in age, and were diverse in educational attainment and exposure to health research. Overall, the deliberations were positively evaluated. Participant perceptions and external observer datasets depict three deliberations that offered intensive conversation experiences in which participants learned from one another, reported feeling respected and connected to one another, and endorsed this intensive form of engagement.Conclusion The adapted deliberations achieved key deliberative goals and were generally well received. Limitations of the study are described. (shrink)

Recently, it has been argued that the use of Big Data transforms the sciences, making data-driven research possible and studying causality redundant. In this paper, I focus on the claim on causal knowledge by examining the Big Data project EXPOsOMICS, whose research is funded by the European Commission and considered capable of improving our understanding of the relation between exposure and disease. While EXPOsOMICS may seem the perfect exemplification of the data-driven view, I show how causal knowledge is necessary (...) for the project, both as a source for handling complexity and as an output for meeting the project’s goals. Consequently, I argue that data-driven claims about causality are fundamentally flawed and causal knowledge should be considered a necessary aspect of Big Data science. In addition, I present the consequences of this result on other data-driven claims, concerning the role of theoretical considerations. I argue that the importance of causal knowledge and other kinds of theoretical engagement in EXPOsOMICS undermine theory-free accounts and suggest alternative ways of framing science based on Big Data. (shrink)

This study focuses on a set of dreams related to the September 11, 2001 terrorist attacks and their aftermath, using content analysis and cognitive psychology to explore the interweaving of external public catastrophe and internal psychological processes. The study tests several recent claims in contemporary dream research, including the central image theory of Hartmann [Hartmann, E., & Basile, R. . Dream imagery becomes more intense after 9/11/01. Dreaming, 13, 61–66; Hartmann, E., & Brezler, T. . A systematic change in dreams (...) after 9/11/01. Sleep, 31, 213–218], the media exposure factor postulated by Propper [Propper, R. E., Stickgold, R., Keeley, R., & Christman, S. D. . Is television traumatic? Dreams, stress, and media exposure in the aftermath of September 11, 2001. Psychological Science, 18, 334–340], the continuity hypothesis of Domhoff [Domhoff, W. G. . Finding meaning in dreams: A quantitative approach. New York: Plenum], the cognitive and metacognitive approach of Kahan [Kahan, T. L. . Consciousness in dreaming: A metacognitive approach. In K. Bulkeley , Dreams: A reader on the religious, cultural, and psychological dimensions of dreaming . New York: Palgrave], and the threat simulation theory of Revonsuo [Revonsuo, A. . The reinterpretation of dreams: An evolutionary hypothesis of the function of dreaming. Behavioral and Brain Sciences, 23, 877–901]. Our findings suggest the terrorist attacks had a tangible impact on the content of many people’s dreams, but did not fundamentally alter the cognitive processing features of their dreaming. The 9/11 attacks affected what they dreamed about, but not the way they dreamed. (shrink)

The COVID-19 pandemic has brought the long-standing public health practice of contact tracing into the public spotlight. While contact tracing and case investigation have been carefully designed to protect privacy, the huge volume of tracing which is being carried out as part of the pandemic response in the United States is highlighting potential concerns around privacy, legality, and equity. Contact tracing during the pandemic has gained particular attention for the new use of digital technologies—both on the consumer side in the (...) form of Exposure Notification applications, and for public health agencies as digital case management software systems enable massive scaling of operations. While the consumer application side of digital innovation has dominated the news and academic discourse around privacy, people are likely to interact more intensively with public health agencies and their use of digital case management systems. Effective use of digital case management for contact tracing requires revisiting the existing legal frameworks, privacy protections, and security practices for management of sensitive health data. The scale of these tools and demands of an unprecedented pandemic response are introducing new risks through the collection of huge volumes of data, and expanding requirements for more adept data sharing among jurisdictions. Public health agencies must strengthen their best practices for data collection and protection even in the absence of comprehensive or clear guidance. This requires navigating a difficult balance between rigorous data protection and remaining highly adaptive and agile. (shrink)

Background No previous study has provided evidence for the scope and frequency of ethical dilemmas for paediatric nurses. It is essential to understand this to optimise patient care and tailor ethics support for nurses. Research aim The aim of this study was to explore the scope of nurses’ ethical dilemmas in a paediatric hospital and their engagement with the hospital clinical ethics service. Research design This study used a cross-sectional survey design. Participants and research context Paediatric nursing staff in a (...) tertiary paediatric centre in Australia completed an online survey asking about their exposure to a range of ethical dilemmas and their knowledge of the clinical ethics service. Analysis used descriptive and inferential statistics. Ethical considerations Ethical approval was granted from the hospital research committee. The survey was anonymous, and no identifying details of participants were collected. Results Paediatric nurses experienced a wide range of ethical dilemmas frequently, both in the intensive care and general areas. Knowledge and use of the clinical ethics service was poor and the most frequent challenge for nurses in managing dilemmas was feeling powerless. Conclusion There is a need to recognise the moral burden of ethical dilemmas for paediatric nurses in order to foster ethical sensitivity, and to provide adequate support to improve care and mitigate nursing moral distress. (shrink)

High noise levels may have an adverse effect on the normal cochlea function and lead to significant hearing loss. Clinically, exposure to high intensity impulse noise produces a wide range of audiometric effects which may result in long term or even irreversible symptoms. Nevertheless, there is sometimes a spontaneous rebound recovery of the auditory function. This phenomenon was previously studied in the vision, another sensory function. It was called the visual survival attractor.In view of the importance that the (...) sensory organs have for the brain, and in particular in its function of recognising and dealing with its environment, it was interesting to know whether this survival attractor concept already described for vision occurs more generally in all the sensory functions. With this in mind we present here the results of a new study, this time on hearing. (shrink)

From a leading figure in the field of psychotherapy, this new book is the first dedicated to the topic of the fear of contamination. The fear of contamination is the driving force behind compulsive washing, the most common manifestation of obsessive compulsive disorder. It is one of the most extraordinary of all human fears. People who have an abnormally elevated fear of contamination over-estimate the probability and the potential seriousness of becoming contaminated. They believe that they are more susceptible than (...) other people to contamination. People who labour under the illusion that they are particularly vulnerable to contamination are persistently anxious, excessively vigilant and highly avoidant. The fear is complex, powerful, probably universal, easily provoked, intense, and difficult to control. Usually it is caused by physical contact with a contaminant and spreads rapidly and widely. When a person feels contaminated it drives a strong urge to remove the contamination, usually by washing. The fear and subsequent urges over-ride other behaviour. A fear of contamination can also be established mentally and without physical contact. The fear can arise after exposure to violation, physical or non-physical, and from self-contamination. The book starts by defining the disorder, before considering the various manifestations of this fear, examining both mental contamination and contact contamination, and feelings of disgust. Most significantly, it develops a theory for how this problem can be treated, providing clinical guidelines - based around cognitive behavioural techniques. (shrink)

Airway mucin secretion is important pathophysiologically and as a model of polarized epithelial regulated exocytosis. We find the trafficking protein, SNAP23, selectively expressed in secretory cells compared with ciliated and basal cells of airway epithelium by immunohistochemistry and FACS, suggesting that SNAP23 functions in regulated but not constitutive epithelial secretion. Heterozygous SNAP23 deletant mutant mice show spontaneous accumulation of intracellular mucin, indicating a defect in baseline secretion. However mucins are released from perfused tracheas of mutant and wild-type mice at the (...) same rate, suggesting that increased intracellular stores balance reduced release efficiency to yield a fully compensated baseline steady state. In contrast, acute stimulated release of intracellular mucin from mutant mice is impaired whether measured by a static imaging assay 5 min after exposure to the secretagogue ATP or by kinetic analysis of mucins released from perfused tracheas during the first 10 min of ATP exposure. Together, these data indicate that increased intracellular stores cannot fully compensate for the defect in release efficiency during intense stimulation. The lungs of mutant mice develop normally and clear bacteria and instilled polystyrene beads comparable to WT mice, consistent with these functions depending on baseline secretion that is fully compensated. (shrink)

ABSTRACTThis study examines whether a firm's ownership form has any influence on its social performance. Conventional wisdom suggests that public corporations are more susceptible to corruption and socially irresponsible behavior than privately owned corporations because of the intense short‐term profit maximization pressure from shareholders and the lack of sufficient monitoring mechanisms. This study introduces an alternate perspective in thinking about the relationship between ownership form and corporate social responsibility. This study reasons that public corporations are more likely to become socially (...) responsible because of their greater exposure to external influence and greater dependence on external actors with diverse interests. Using a panel data on the pollution management practices of 118 industrial facilities over a 13‐year period, this study shows that public corporations were indeed subject to greater external pressure to reduce pollution, and the pressure led to consistently stronger environmental performance. (shrink)

Intentional weight loss can increase health risk in the long‐term, despite short‐term benefits, because human adipose tissue is widely contaminated with various lipophilic environmental contaminants, especially persistent organic pollutants (POPs). Recently, chronic exposure to low POPs has emerged as a new risk factor for common metabolic diseases and cardiovascular diseases. The amount of POPs released from adipocytes to the circulation increases during weight loss, thereby increasing POPs exposure of other critical organs. Possible harmful effects due to release of (...) POPs during weight loss are opposite to those usually expected from losing weight. It is speculated that this tradeoff can explain recent puzzling findings on intensive weight loss. The presence of POPs in adipose tissue adds a challenge to weight management and an optimal strategy of weight management needs to consider both fat mass and dynamics of POPs. (shrink)

We show how metagenomic analysis of the human gut antibiotic resistome, compared across large populations and against environmental or agricultural resistomes, suggests a strong anthropogenic cause behind increasing antibiotic resistance in bacteria. This area has been the subject of intense and polarized debate driven by economic and political concerns; therefore such recently available insights address an important need. We derive and compare antibiotic resistomes of human gut microbes from 832 individuals from ten different countries. We observe and describe significant differences (...) between samples from these countries in the gut resistance potential, in line with expectations from antibiotic usage and exposure in medical and food production contexts. Our results imply roles for both of these sources in increased resistance among pathogens in recent history. In contrast, other available metadata such as age, body mass index, sex, or health status have little effect on the antibiotic resistance potential of human gut microbes.Also watch the Video Abstract. (shrink)

This study examines the impact of non-executive employee stock ownership plans (ESOP) on corporate environmental engagement. We show that granting ESOPs to non-executive employees promotes greater corporate ecological engagement from the perspectives of environmental protection expenditures, environmental information disclosure quality, and environmental, social, and governance (ESG) ratings. ESOPs unite members in a common interest, empowering them to put pressure on management to reduce carbon emissions, which benefits their physical wellbeing and increases their residual interest in long-term corporate wealth. Further, our (...) analysis reveals that companies investing in environmental protection forgo short-term profit as a consequence of high initial costs, while increasing long-term firm value. These positive effects are attributable to ESOP schemes with higher employee subscription rates, those granted to a larger number of non-executive employees, and those with longer validity periods of ownership, whose incentive effect is sufficiently powerful to offset the free-rider problem. In addition, the impact of ESOPs is more pronounced in companies with greater media exposure, those confronting intense labor market competition, and those in heavily polluting industries. Fundamentally, our study provides novel evidence of the incentive effect of ESOPs on corporate environmental engagement and of stakeholder dynamics driving the implementation of carbon reduction strategies. (shrink)