Nurses are increasingly realising that they can offer relevant information and participate in decision-making involving ethical issues. However, inter-professional communications are frequently inadequate, and do not permit exchange of opinions. The consequences are often frustrating and upsetting for nurses whose care is affected by others' policies. This paper explores these issues using some clinical examples.

Principles of autonomy and self-determination have been upheld as vital to modern-day medical and ethical practice. However, the complexities of current health care and changes in the expectation of some patients and their families justify a review of such concepts. Their limitations and relativities may suggest that other descriptions of partnership and negotiated goal-setting, while based on respect for autonomy, reflect more modern and ideal multi-disciplinary practices. Discussion should extend beyond the 'classic' participants of patient and doctor to a more (...) realistic picture where other health carers are included. It is therefore apposite that other professional relationships are considered as they affect areas of doctors' and patients' responsibilities. Such partnership between members of the team may not be without problems and conflict, but the principle of negotiated agreements could result in more long-term harmony, and greater patient welfare. (shrink)

Although the condition known as synaesthesia is currently undergoing a scientific resurgence, to date the literature has largely focused on the heterogeneous nature of synaesthesia across individuals. In order to provide a better understanding of synaesthesia, however, general characteristics need to be investigated. Synaesthetic experiences are often described as occurring ‘internally’ or in the ‘mind’s eye’, which is remarkably similar to how we would describe our experience of visual mental imagery. We assessed the role of visual imagery in synaesthesia by (...) sampling a large group of synaesthetes and found that they report experiencing more vivid mental images than controls. These findings have important implications for our general understanding of synaesthesia and, in particular, emphasize the need to control for visual imagery in behavioural and neuroimaging paradigms. (shrink)

Language anomalies and left-hemisphere dysfunction are commonly reported in schizophrenia. Additional evidence also suggests differences in the integration of information between the hemispheres. Bilateral gain is the increase in accuracy and decrease in latency that occurs when identical information is presented simultaneously to both hemispheres. This study measured bilateral gain in controls and individuals with schizophrenia using a lexical-decision task where word or non-word judgements were made to letter strings presented in the left visual field , right visual field or (...) bilaterally . Language was not abnormally lateralized in the schizophrenia group. Controls exhibited the expected decrease in latency when words were presented bilaterally. This effect was not observed in the schizophrenia group who were actually disadvantaged in this condition. The lack of bilateral gain in schizophrenia is discussed as arising from differences in the connections between areas in each hemisphere that mediate language. (shrink)

Although telephone consultations are widely used in the delivery of healthcare, they are vulnerable to breaches of patient confidentiality. Current guidelines on telephone consultations do not address adequately the issue of confidentiality. In this paper, we propose a solution to the problem: a password system to control access to patient information. Authorised persons will be offered the option of selecting a password which they will use to validate their request for information over the telephone. This simple yet stringent method of (...) access control should improve security while allowing the continuing evolution of telephone consultations. (shrink)

The present study extends the study of individuals' ethical ideology withinthe context of marketing ethics issues. A national sample of marketing professionals participated. Respondents' ethical ideologies were classified as absolutists, situationists, exceptionists, or subjectivists using the Ethical Position Questionnaire (Forsyth, 1980). Respondents then answered questions about three ethically ambiguous situations common to marketing and sales. The results indicated that marketers' ethical judgments about the situations differed based on their ethical ideology, with absolutists rating the actions as most unethical. The findings (...) are consistent with those of two earlier studies that utilized samples of business students (Barnett et al., 1994, 1995). The results suggest that personal moral philosophy is an important influence on ethical decision making that should be considered in empirical studies of business ethics. The results also support the utility of the Ethical Position Questionnaire (Forsyth, 1980) as a means for researchers and practitioners to assess individuals' ethical ideology. (shrink)

Case presentations, esthetics, insurance considerations, communicable diseases, referral questions, dental phobia, and legal concerns all play a role in doctor-patient relationships. These topics, and many others, are the subject of this one-of-a-kind resource, designed to show dental students and practitioners how to approach patient relationships.

The present review highlights an association between autism, Alzheimer disease , and fragile X syndrome . We propose a conceptual framework involving the amyloid-beta peptide , Abeta precursor protein , and fragile X mental retardation protein based on experimental evidence. The anabolic effect of the secreted alpha form of the amyloid-beta precursor protein may contribute to the state of brain overgrowth implicated in autism and FXS. Our previous report demonstrated that higher plasma sAPPalpha levels associate with more severe symptoms of (...) autism, including aggression. This molecular effect could contribute to intellectual disability due to repression of cell-cell adhesion, promotion of dense, long, thin dendritic spines, and the potential for disorganized brain structure as a result of disrupted neurogenesis and migration. At the molecular level, APP and FMRP are linked via the metabotropic glutamate receptor 5 . Specifically, mGluR5 activation releases FMRP repression of APP mRNA translation and stimulates sAPP secretion. The relatively lower sAPPalpha level in AD may contribute to AD symptoms that significantly contrast with those of FXS and autism. Low sAPPalpha and production of insoluble Abeta would favor a degenerative process, with the brain atrophy seen in AD. Treatment with mGluR antagonists may help repress APP mRNA translation and reduce secretion of sAPP in FXS and perhaps autism. (shrink)

SummaryThe writings of the very popular American poet Robert Frost (1874–1963) reveal an unusually specific and detailed knowledge of science. This was particularly evident among the poems of his penultimate volume, Steeple Bush, of 1947. Several of these poems confronted with basic insights issues raised by the period's ‘new physics’. Among those, especially Frost's epigram ‘A Wish to Comply’ wittily confronted an important epistemological difficulty in particle physics. Such science must induce a belief in the fundamental importance of entities invisible (...) to any physical human senses except those aided by complex apparatus used in abstruse experiments. Recondite scientific issues are confronted in other poems published in Steeple Bush such as ‘Skeptic’ (which meditates on the ‘red shift’ evidence for an expanding universe), but these poems are clearly derived from popular theoretical expositions, not practical experience. ‘A Wish to Comply’, on the other hand, clearly records an actual experience of a failed Millikan ‘oil drop’ experiment. This event evidently led to the poet to fake a report of his own observation of an electrically charged oil droplet, for reasons of social pressure. In meditating on these circumstances the epigram opens questions relating to scientific ‘systematic error’, the suppression, ‘trimming’ or ‘cooking’ of experimental data, and a bias toward confirmation of highly respected opinions. Although Frost did not live to know it, two of these questions have been latterly opened in regard to Millikan's own reports of his original oil drop experimental data. (shrink)

Recent influential criticisms attack the reputation of Thomas Harriot by citing the contents of his ethnographic and economic survey, A briefe and true report of the new found land of Virginia, first published in 1588. This interpretation makes Harriot, together with Shakespeare and others, agents of a colonialist project. But profound differences are indicated in the comparison of the relatively unbiased depiction and analysis by Harriot and his artist collaborator John White with the interpretations of America and Americans by some (...) of their contemporaries. A briefe and true report conveys, and John White's drawings support, insight into particular non-European features of the cultural and economic lives of the Algonquian peoples. On the contrary, Captain Arthur Barlowe's Discourse and the illustrations by Theodore de Bry for the 1600 edition of Harriot's book instance romanticizing, stereotyping, and unanalytic condescension very unlike Harriot's and White's. These differences prove the faultiness of the recent assessment. (shrink)

New Approaches to Monetary Economics brings together presentations of innovative research in the field of monetary economics. Much of this research develops and applies approaches to modelling financial intermediation, aggregate fluctuations, monetary aggregation and transactions-motivated monetary equilibrium. The contents of this volume comprise the proceedings of the second in a conference series entitled International Symposia in Economic Theory and Econometrics. This conference was held in 1985 at the IC2 Institute at the University of Texas at Austin. The symposia in this (...) series are sponsored by the IC2 Institute and the RGK Foundation. New Approaches to Monetary Economics, edited by Professors William A. Barnett and Kenneth J. Singleton, consists of five parts. Part I examines transactions-motivated monetary holding in general equilibrium; Part II, financial intermediation; Part III, monetary aggregation theory, Part IV, issues in aggregate fluctuation; and Part V, theoretical issues in the foundations of monetary economics and macroeconomics. (shrink)

Medical and public health professionals recommend wearing face masks to combat the spread of the coronavirus disease of 2019. While the majority of people in the United States support wearing face masks as an effective tool to combat COVID-19, a smaller percentage declared the recommendation by public health agencies as a government imposition and an infringement on personal liberty. Social media play a significant role in amplifying public health issues, whereby a minority against the imposition can speak loudly, perhaps using (...) tactics of verbal aggression taking the form of toxic language. We investigated the role that toxicity plays in the online discourse around wearing face masks. Overall, we found tweets including anti-mask hashtags were significantly more likely to use toxic language, while tweets with pro-mask hashtags were somewhat less toxic with the exception of #WearADamnMask. We conclude that the tensions between these two positions raise doubt and uncertainty around the issue, which make it difficult for health communicators to break through the clutter in order to combat the infodemic. Public health agencies and other governmental institutions should monitor toxicity trends on social media in order to better ascertain prevailing sentiment toward their recommendations and then apply these data-driven insights to refine and adapt their risk communication messaging toward mask wearing, vaccine uptake, and other interventions. (shrink)

This paper examines how the Harper Government of Canada shut down both debate about threats and research into environmental risk, a strategy that Canadian scientists characterized as the “death of evidence.” Based on interviews with scientists who research risks to the marine environment, we explore the shifting relationship between science and the Canadian government by tracing the change in the mode of risk calculation supported by the Harper administration and the impact of this change. Five themes emerged from the interviews: (...) erosion of science research capacity, resulting limitations in understanding risk, declining influence on policy and regulation, redirection of public science funds to support the private sector, and the need to broaden the science knowledge base. The Canadian death of evidence controversy represents a challenge to science and technology studies scholars who wish to maintain a critical and reflexive perspective on the scientific enterprise without supporting attacks on evidence. While subsequent Canadian governments may simply return science to an unreflexively privileged knowledge status, we view this as equally damaging to broad risk calculation and democratic science. We suggest instead that a broader gathering of matters of concern will always be essential to risk assessment. (shrink)

Objective: To assess the adequacy of the process of informed consent for surgical patients at the University Hospital of the West Indies. Method: The study is a prospective, cross-sectional, descriptive study. 210 patients at the University Hospital of the West Indies were interviewed using a standardised investigator-administered questionnaire, developed by the authors, after obtaining witnessed, informed consent for participation in the study. Data were analysed using SPSS V.12 for Windows. Results: Of the patients, 39.4% were male. Of the surgical procedures, (...) 68.6% were scheduled, 7.6% urgent and 23.8% emergency, 35.2% were minor and 64.8% major. Information imparted/received was acceptable in 40% of cases, good in 24% and inadequate (unacceptable) in 36% of cases. Almost all (97.6%) patients stated that they understood why an operation was planned and 93.3% thought that they had given informed consent. Most (95.2%) thought that they had free choice and made up their own mind. A quarter (25.2%) of all patients were told that it was mandatory for them to sign the form. There was a discussion of possible side effects and complications in 56.7% of patients. Conclusions: This study clearly indicates that surgical patients at the University Hospital of the West Indies feel that they have given informed consent. However, it also suggests that more information should be given to patients for consent to be truly informed. (shrink)

BackgroundCritical to conducting high quality research is the ability to attract and retain participants, especially for longitudinal studies. Understanding participant experiences and motivators or barriers to participating in clinical research is crucial. There are limited data on healthy participant experiences in longitudinal research, particularly in low- and middle-income countries. This study aims to investigate quantitatively participant experiences in a South African birth cohort study.MethodsMaternal participant experience was evaluated by a self-administered survey in the Drakenstein Child Health Study, a longitudinal birth (...) cohort study investigating the early life determinants of child health. Pregnant mothers, enrolled during the second trimester, were followed through childbirth and the early childhood years. Satisfaction scores were derived from the participant experience survey and quantitatively analyzed; associations between satisfaction scores and sociodemographic variables were then investigated using a linear regression model.ResultsData were included from 585 pregnant mothers, who had participated in the study for a median time of 16 months. Overall participant satisfaction was high and associated with increased attendance of study visits. Reasons for participating were a belief that involvement would improve their health, their child’s health or the health of family and friends. Potential reasons for leaving the study were inconvenience, not receiving clinical or study results, and unexpected changes in study visits or procedures. Variables associated with higher overall satisfaction scores were no prior participation in research, higher socioeconomic status, less intensive follow-up schedules and having experienced stressful life events in the past year.ConclusionsSatisfaction scores were high and associated with increased visit attendance. Participants’ perceived benefits of study participation, most notably the potential for an improvement in the health of their child, were a significant motivator to enroll and remain in the study. The consistent theme of perceived health benefits as a motivator to join and remain in the study raises the question of whether participation in research results in actual improvements in health. (shrink)

This article examines the regalist reforming critique and the curial defence of papal temporal dominion in the eighteenth-century Italian peninsula. The discussion examines the little-explored links between the justification for papal supremacy in the Church and the historico-theological defence of its theocratic rule. The refusal of the Curia to grant reform gave rise to a radical reforming movement which produced some astoundingly bitter anti-curial polemics little known outside Italian studies, but of some significance in the history of political thought.

A study of 513 executives researched decisions involving ethics, relationships and results. Analyzing personal values, organization role and level, career stage, gender and sex role with decisions in ten scenarios produced conclusions about both the role of gender, subjective values, and the other study variables and about situational relativity, gender stereotypes, career stages, and future research opportunities.

. The seemingly disparate systems of philosophical Taoism and modern biological science are compared. A surprising degree of similarity is found in their views on death, reversion , complementary interactions of dichotomous systems, and the place of humans in the universe. The thesis is advanced that these similarities arise quite naturally, since both systems base their knowledge upon objective observation of natural phenomena. Substantial differences between the two systems are recognized and examined regarding verbal argument, machinery, and experimentation. The Taoists' (...) relationship to Chinese alchemy and the biologists' to technology are claimed to mitigate their attitudes toward experimentation. (shrink)

Interest in subjective values and decision responses are investigated empirically, including statistically testing the predictive relationships between subjective values, other independent variables such as level and area of executive responsibility, and decision responses.

Being a healthcare professional in both paediatric and adult hospitals will mean being exposed to human tragedies and stressful events involving conflict, misunderstanding, and moral distress. There are a number of different structured approaches to reflection and discussion designed to support healthcare professionals process and make sense of their feelings and experiences and to mitigate against direct and vicarious trauma. In this paper, we draw from our experience in a large children’s hospital and more broadly from the literature to identify (...) and analyse four established approaches to facilitated reflective discussions. Each of the four approaches seeks to acknowledge the stressful nature of health professional work and to support clinicians from all healthcare professions to develop sustainable skills so they continue to grow and thrive as health professionals. Each approach also has the potential to open up feelings of uncertainty, frustration, sorrow, anguish, and moral distress for participants. We argue, therefore, that in order to avoid unintentionally causing harm, a facilitator should have specific skills required to safely lead the discussion and be able to explain the nature, scope, safe application, and limits of each approach. With reference to a hypothetical but realistic clinical case scenario, we discuss the application and key features of each approach, including the goals, underpinning theory, and methods of facilitation. (shrink)

BackgroundAustralian health and medical research funders support substantial research efforts, and incentives within grant funding schemes influence researcher behaviour. We aimed to determine to what extent Australian health and medical funders incentivise responsible research practices.MethodsWe conducted an audit of instructions from research grant and fellowship schemes. Eight national research grants and fellowships were purposively sampled to select schemes that awarded the largest amount of funds. The funding scheme instructions were assessed against 9 criteria to determine to what extent they incentivised (...) these responsible research and reporting practices: publicly register study protocols before starting data collection, register analysis protocols before starting data analysis, make study data openly available, make analysis code openly available, make research materials openly available, discourage use of publication metrics, conduct quality research, collaborate with a statistician, and adhere to other responsible research practices. Each criterion was answered using one of the following responses: “Instructed”, “Encouraged”, or “No mention”.ResultsAcross the 8 schemes from 5 funders, applicants were instructed or encouraged to address a median of 4 of the 9 criteria. Three criteria received no mention in any scheme. Importantly, most incentives did not seem strong as applicants were only instructed to register study protocols, discourage use of publication metrics and conduct quality research. Other criteria were encouraged but were not required.ConclusionsFunders could strengthen the incentives for responsible research practices by requiring grant and fellowship applicants to implement these practices in their proposals. Administering institutions could be required to implement these practices to be eligible for funding. Strongly rewarding researchers for implementing robust research practices could lead to sustained improvements in the quality of health and medical research. (shrink)

BackgroundMulti-centre studies generally cost more than single-centre studies because of larger sample sizes and the need for multiple ethical approvals. Multi-centre studies include clinical trials, clinical quality registries, observational studies and implementation studies. We examined the costs of two large Australian multi-centre studies in obtaining ethical and site-specific approvals.MethodsWe collected data on staff time spent on approvals and expressed the overall cost as a percent of the total budget.ResultsThe total costs of gaining approval were 38 % of the budget for (...) a study of 50 centres (mean cost AUD $6960 per site) and 2 % for a study of 11 centres (mean cost AUD $2300 per site). Seventy-five and 90 % of time was spent on repeated tasks, respectively, and many time-consuming tasks, such as reformatting documents, did nothing to improve the study design or participant safety.ConclusionsImprovements have been made to the ethical approval application system, but more gains could be made without increasing risks of harm to research participants. We propose that ethical review bodies and individual sites publish statistics on how long they take to process approvals which could then be nationally benchmarked. (shrink)

Michael A. PetersBeijing Normal University, Beijing, PR China;There is an ecology of bad ideas, just as there is an ecology of weeds– Gregory Bateson (1972, p. 492)While there are classical anteced...

Law plays a critical role in all stages of a public health emergency, providing an infrastructure for planning, response, and recovery efforts. A growing body of research has underscored the potential for certain types of state laws, such as those granting liability protections to responders, to influence the public health workforce's participation in emergency responses. It is therefore especially important to focus on particular state-level laws that may be associated with individuals' increased or decreased willingness to respond. We conducted a (...) systematic identification and analysis of specific state emergency preparedness laws that may affect individuals' willingness to respond and offer recommendations for policymakers seeking to promote more effective responses to public health emergencies. (shrink)

Law plays a critical role in all stages of a public health emergency, including planning, response, and recovery. Public health emergencies introduce health concerns at the population level through, for example, the emergence of a novel infectious disease. In the United States, at the federal, state, and local levels, laws provide an infrastructure for public health emergency preparedness and response efforts: they grant the government the ability to officially declare an emergency, authorize responders to act, and facilitate interjurisdictional coordination. Law (...) is perhaps most visible during an emergency when the president or a state's governor issues a disaster declaration establishing the temporal and geographic parameters for the response and making financial and other resources available. This legal authority has increasingly been used during the last decade. (shrink)

Omnipresent calls for more women in university administration assume these women will prioritize using resources and power to increase female representation, especially in STEM fields where women are most underrepresented. However, empirical evidence is lacking for systematic differences in female versus male administrators’ attitudes. Do female administrators agree on which strategies are best, and do men see things differently? To answer this question, we explored United States college and university administrators’ opinions regarding policies, strategies, and structural changes in their organizations (...) designed to increase women professors’ representation and retention in STEM fields. A comprehensive review of past research yielded a database of potentially-effective, recommended policies (e.g., increasing emphasis on teaching, service, and administration during promotion reviews; stopping the tenure clock for childbearing; providing on-campus childcare; couples-hiring; sharing tenure lines; having more women chair search committees; setting gender quotas for promotion). A survey based on these recommended policies was sent to provosts, deans, associate deans, and department chairs of STEM fields at 96 public and private research universities (formerly called R1s) across the U.S. These administrators were asked to rate the quality and feasibility of each recommended policy; 474 provided data, of which 334 contained complete numerical data used in the analyses, so our results are based on a large, geographically diverse group of administrators at research universities. Our data revealed that female administrators perceived the 44 strategies to be higher in quality overall than did male administrators--but not higher in feasibility--with 9 policies perceived differently when rated by women versus men administrators, after imposing conservative statistical controls. There was broad general agreement on the relative rankings of the 44 policies in terms of their perceived quality. Overall, our national survey of U.S. administrators supported the assertion that placing women in administrative roles creates greater emphasis on the importance of enacting policies to attract and retain women in STEM. Topics of disagreement between women and men regarding strategy quality are important focuses of future policy and planning, because female administrators may have insights into how to retain women professors that male administrators do not share. (shrink)

A data provenance framework is subject to security threats and risks, which increase the uncertainty, or lack of trust, in provenance information. Information assurance is challenged by incomplete information; one cannot exhaustively characterize all threats or all vulnerabilities. One technique that specifically incorporates a probabilistic notion of uncertainty is subjective logic. Subjective logic allows belief and uncertainty, due to incomplete information, to be specified and operated upon in a coherent manner. A mapping from the standard definition of information assurance to (...) a more quantitative subjective logic framework is suggested with a focus on the specific application of data provenance. Finally, specific consideration is given to the notion of uncertainty within subjective logic and its relation to information entropy. Information entropy is an alternative measure of uncertainty and a fundamental relationship is hypothesized between uncertainty in subjective logic and entropy. (shrink)

© 2016 Regents of the University of California.The Review summarizes much of particle physics and cosmology. Using data from previous editions, plus 3,062 new measurements from 721 papers, we list, evaluate, and average measured properties of gauge bosons and the recently discovered Higgs boson, leptons, quarks, mesons, and baryons. We summarize searches for hypothetical particles such as supersymmetric particles, heavy bosons, axions, dark photons, etc. All the particle properties and search limits are listed in Summary Tables. We also give numerous (...) tables, figures, formulae, and reviews of topics such as Higgs Boson Physics, Supersymmetry, Grand Unified Theories, Neutrino Mixing, Dark Energy, Dark Matter, Cosmology, Particle Detectors, Colliders, Probability and Statistics. Among the 117 reviews are many that are new or heavily revised, including those on Pentaquarks and Inflation. The complete Review is published online in a journal and on the website of the Particle Data Group. The printed PDG Book contains the Summary Tables and all review articles but no longer includes the detailed tables from the Particle Listings. A Booklet with the Summary Tables and abbreviated versions of some of the review articles is also available. (shrink)

When a disaster occurs, adults over age 65 may be disproportionately impacted due to sensory deficits, chronic health conditions, diminished social support and isolation, and financial limitations. Although older adults comprised approximately 15 percent of the New Orleans population, they accounted for over 70 percent of the fatalities associated with Hurricane Katrina in 2005. Disasters can also impact older adults’ morbidity, as a disaster may disrupt established habits and routines and result in removal from a familiar environment, promoting disorientation. This (...) may raise particular challenges for older adults with mental and physical co-morbidities, and subsequently for their formal and informal caregivers.While some older adults may need care for physical health problems following a disaster, mental health needs are often overlooked or unmet. One study of Hurricane Katrina survivors found that, compared to older adults, middle-aged individuals were twice as likely to have received mental health services in the eight months after the hurricane. (shrink)