Social contracts are the mechanisms by which society legitimizes professions and grants them authority and autonomy to carry out their functions. The nursing profession is currently renegotiating its contract with society in a manner which clearly reflects a change from physician dominance, and emphasis on illness care to increased independent and autonomous functioning within a newly developing framework of nursing science which emphasizes health care. In return for their services, nurses are also negotiating for those benefits which historically they have (...) not received. These include legitimization of their newly acquired autonomous role functions, and adequate reimbursement mechanisms and structures. When the contemporary role of the nurse is fully legitimzed, the impact on contemporary society and health care is likely to be enormous. (shrink)

The theories or programs of research described in the chapters of this book move beyond the traditional evaluation model of prejudice, drawing on a broad range of theoretical ancestry to develop models of why, when, and how differentiated reactions to groups arise, and what their consequences might be. The chapters have in common a re-focusing of interest on emotion as a theoretical base for understanding differentiated reactions to, and differentiated behaviors toward, social groups. The contributions also share a focus on (...) specific interactional and structural relations among groups as a source of these differentiated emotional reactions. The chapters in the volume thus reflect a theoretical shift from an earlier emphasis on knowledge about ingroups and outgroups to a new perspective on prejudice in which socially-grounded emotional differentiation becomes a basis for social regulation. (shrink)

The theories or programs of research described in the chapters of this book move beyond the traditional evaluation model of prejudice, drawing on a broad range of theoretical ancestry to develop models of why, when, and how differentiated reactions to groups arise, and what their consequences might be. The chapters have in common a re-focusing of interest on emotion as a theoretical base for understanding differentiated reactions to, and differentiated behaviors toward, social groups. The contributions also share a focus on (...) specific interactional and structural relations among groups as a source of these differentiated emotional reactions. The chapters in the volume thus reflect a theoretical shift from an earlier emphasis on knowledge about ingroups and outgroups to a new perspective on prejudice in which socially-grounded emotional differentiation becomes a basis for social regulation. (shrink)

Bioethical decision‐making in pediatrics diverges from similar decisions in other medical domains because the young child is not an autonomous decision‐maker, while the teen is developing—and should be encouraged to develop—autonomy and decisional capacity. Thus the balance between autonomy and beneficence is fundamentally different in pediatrics than in adult medicine. While ethical dilemmas that reflect these fundamental issues are common, many pediatric physician and nursing training programs do not delve into the issues or offer specific training about how to deal (...) with borderline cases.To meet this need, the Children's Mercy Bioethics Center in Kansas City, Missouri, created a program specifically dedicated to serving practicing, experienced pediatric health professionals. Our students come from various professional disciplines: they are doctors, nurses, social workers, chaplains, lawyers, psychologists, counselors, and hospital administrators practicing in pediatrics. (shrink)

Significant associations have been found between specific human leukocyte antigen (HLA) alleles and organ transplant rejection, autoimmune disease development, and the response to infection. Traditional searches for disease associations have conventionally measured risk associated with the presence of individual HLA alleles. However, given the high level of HLA polymorphism, the pattern of amino acid variability, and the fact that most of the HLA variation occurs at functionally important sites, it may be that a combination of variable amino acid sites shared (...) by several alleles (shared epitopes) are better descriptors of the actual causative genetic variants. Here we describe a novel approach to genetic association analysis in which genes/proteins are broken down into smaller sequence features and then variant types defined for each feature, allowing for independent analysis of disease association with each sequence feature variant type. We have used this approach to analyze a cohort of systemic sclerosis patients and show that a sequence feature composed of specific amino acid residues in peptide binding pockets 4 and 7 of HLA-DRB1 explains much of the molecular determinant of risk for systemic sclerosis. (shrink)

Over-time variability characterizes not only individual-level emotions, but also group-level emotions, those that occur when people identify with social groups and appraise events in terms of their implications for those groups. We discuss theory and research regarding the role of emotions in intergroup contexts, focusing on their dynamic nature. We then describe new insights into the causes and consequences of emotional dynamics that flow from conceptualizing emotions as based in group membership, and conclude with research recommendations.

Plasminogen activator inhibitor‐1 (PAI‐1) is a physiological inhibitor of urokinase (uPA), a serine protease known to promote cell migration and invasion. Intuitively, increased levels of PAI‐1 should be beneficial in downregulating uPA activity, particularly in cancer. By contrast, in vivo, increased levels of PAI‐1 are associated with a poor prognosis in breast cancer. This phenomenon is termed the “PAI‐1 paradox”. Many factors are responsible for the upregulation of PAI‐1 in the tumor microenvironment. We hypothesize that there is a breast cancer (...) predisposition to a more aggressive stage when PAI‐1 is upregulated as a consequence of Metabolic Syndrome (MetS). MetS exerts a detrimental effect on the breast tumor microenvironment that supports cancer invasion. People with MetS have an increased risk of coronary heart disease, stroke, peripheral vascular disease and hyperinsulinemia. Recently, MetS has also been identified as a risk factor for breast cancer. We hypothesize the existence of the “PAI‐1 cycle”. Sustained by MetS, adipocytokines alter PAI‐1 expression to promote angiogenesis, tumor‐cell migration and procoagulant microparticle formation from endothelial cells, which generates thrombin and further propagates PAI‐1 synthesis. All of these factors culminate in a chemotherapy‐resistant breast tumor microenvironment. The PAI‐1 cycle may partly explain the PAI‐1 paradox. In this hypothesis paper, we will discuss further how MetS upregulates PAI‐1 and how an increased level of PAI‐1 can be linked to a poor prognosis. BioEssays 29:1029–1038, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

BackgroundThe ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines are widely endorsed but compliance is limited. We sought to determine whether journal-requested completion of an ARRIVE checklist improves full compliance with the guidelines.MethodsIn a randomised controlled trial, manuscripts reporting in vivo animal research submitted to PLOS ONE (March–June 2015) were randomly allocated to either requested completion of an ARRIVE checklist or current standard practice. Authors, academic editors, and peer reviewers were blinded to group allocation. Trained reviewers performed outcome adjudication (...) in duplicate by assessing manuscripts against an operationalised version of the ARRIVE guidelines that consists 108 items. Our primary outcome was the between-group differences in the proportion of manuscripts meeting all ARRIVE guideline checklist subitems.ResultsWe randomised 1689 manuscripts (control: n = 844, intervention: n = 845), of which 1269 were sent for peer review and 762 (control: n = 340; intervention: n = 332) accepted for publication. No manuscript in either group achieved full compliance with the ARRIVE checklist. Details of animal husbandry (ARRIVE subitem 9b) was the only subitem to show improvements in reporting, with the proportion of compliant manuscripts rising from 52.1 to 74.1% (X2 = 34.0, df = 1, p = 2.1 × 10−7) in the control and intervention groups, respectively.ConclusionsThese results suggest that altering the editorial process to include requests for a completed ARRIVE checklist is not enough to improve compliance with the ARRIVE guidelines. Other approaches, such as more stringent editorial policies or a targeted approach on key quality items, may promote improvements in reporting. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

Traditional accounts hold that reference consists in a relation between the mind and an object; the relation is effected by a mental act and mediated by internal mental contents (internal representations). Contemporary theories as diverse as Fodor’s [Fodor, J.A., 1987. Psychosemantics: The Problem of Meaning in the Philosophy of Mind. MIT Press, Cambridge, MA] language of thought hypothesis, Dretske’s [Dretske, F., 1988. Explaining Behaviour: Reasons in a World of Causes. MIT Press, Cambridge, MA] informational semantics and Millikan’s [Millikan, R.G., 1984. (...) Language, Thought and Other Biological Categories: New Foundations for Realism. MIT Press, Cambridge, MA] teleosemantics share this act– content–object picture (which was also held by several early modern philosophers, in particular Locke). The core of the traditional view is the thesis that reference and intentionality are relational (‘thesis RR’). Although deeply problematic, RR is entrenched also in psychology, linguistics, cognitive science and Artificial Intelligence. Using for the most part arguments employed by Wittgenstein, we mount a case against RR and advance a deflationary account of reference and intentionality according to which neither is relational. (shrink)