With lost credibility, ratings, and circulation, journalism faces a crisis of conscience. One answer is participatory community journalism; journalists become activists on behalfofthe process of self-government. A veteran journalist and author of Agents of Power, Altschull questions the press's arrogance, its faith in objectivity, and its unvarying insistence on its First Amendment rights, and asks instead that the public interest be put ahead of the maximization of profit, that media help to mediate public issues, and that the public be (...) allowed to play a bigger role in the news decision making process. (shrink)

We are printing in its entirety the discussion document which sets out a code of professional conduct for nurses published by the Royal College of Nursing in November 1976 together with commentaries by the Assistant Secretary of the British Medical Association, a professor of nursing studies, student nurses and a lawyer. The image of the nurse is still that of one of Florence Nightingale's young ladies or of a member of a religious order who is wholly dedicated to caring for (...) the sick. Today, as this document and the comments upon it show, 'dedication' is still part of the motive which leads a man or woman to become a nurse but in addition, and this is where the public may be ignorant or choose to be ignorant, nursing offers a career where intellectual achievement and the satisfaction of a demanding job bring their proper financial reward and place in the professional community. We are grateful to the Royal College of Nursing for permission to publish this document. (shrink)

Evidence is summarized which indicates that the DNA loop anchoring proteins in chromosomes are effectively heterodimers that stack and are fastened into a bilaterally symmetrical array along the chromonemal axis. The evidence consists primarily of the observations made twenty five to thirty years ago on the pattern of sister chromatid exchanges and the way the DNA chains are sorted in the formation of diplochromosomes in cells that have undergone endoreduplication. The evidence indicates that each chain of DNA in the single (...) duplex, which is assumed to run the length of a chromosome, is anchored to a bilaterally symmetrical axis of heterodimers that sort the two original chains among the four derived chromatids of each diplochromosome in a very precise way. These observations are considered in the context of investigations on the nature of scaffold proteins and the loop anchorage sequences, as well as the advances being made on the nature of DNA binding proteins and the roles of topoisomerase II. (shrink)

ObjectivePhysical isolation measures, known as lockdown or shelter-in-place, experienced during coronavirus disease 2019 have the potential to cause psychological distress. This study was conducted to examine parents’ perceived stress and whether reports of rewards and challenges during lockdown impact stress.MethodsData were collected using a cross-sectional online survey in New South Wales, Australia, across the 4-week lockdown. The survey was completed by 158 parents of children aged under 6 years. Stress was measured using the short form of the Perceived Stress Scale. (...) Rewards and challenges were reported in response to two open-ended questions.ResultsThere was a weak negative correlation between PSS-4 scores and days in isolation, with parents who had spent longer in isolation reporting fewer stress symptoms. The relationship between time in isolation and stress was moderated by the degree to which parents described more rewards than challenges: parents who perceived high rewards and low challenges reported lower PSS-4 scores with more days in lockdown, whereas parents who perceived low rewards and high challenges reported higher PSS-4 scores with more days in lockdown. The moderation model examining associations between time in isolation and rewards ratio explained 13% of the variance in PSS-4 scores.ConclusionLockdowns are not uniformly or consistently negative experiences for parents. Identifying positive aspects of the experience may serve to buffer negative mental health risks across time. Understanding resilience strategies is critical for supporting current psychological wellbeing and to adequately prepare for future pandemic experiences. (shrink)

The participation of vulnerable patients in clinical research poses apparent ethical dilemmas. Depending on the nature of the vulnerability, their participation may challenge the ethical principles of autonomy, non-maleficence, or justice. On the other hand, non-participation may preclude the building of a knowledge base that is a prerequisite for defining the optimal clinical management of vulnerable patients. Such clinical uncertainty may also incur substantial economic costs. We present the participation of pre-menopausal women with atrial fibrillation in trials of novel oral (...) anticoagulant drugs as a case study. Due to their non-participation in pivotal trials, it is uncertain whether for them, the risks that are associated with these drugs are outweighed by the advantages compared with conventional treatment. We addressed the question whether research of this new class of drugs in this subgroup would be appropriate from both, an ethical as well an economic perspective. We used the method of specifying norms as a wider framework to resolve the apparent ethical dilemma, while incorporating the question whether research of oral anticoagulants in premenopausal women with atrial fibrillation can be justified on economic grounds. For the latter, the results of a value-of-information analysis were used. Further clinical research on NOACs in premenopausal women with atrial fibrillation can be justified on both, ethical and economic grounds. Addressing apparent ethical dilemmas by invoking a method such as specifying norms can improve the quality of public practical reasoning. As such, the method should also prove valuable to committees that have formally been granted the authority to review trial protocols and proposals for scientific research. (shrink)

What sets off the termination of analysis and psychodynamic therapy from the variety of endings that enter into all human relationships? So asks Herbert J. Schlesinger in _Endings and Beginnings: On Terminating Psychotherapy and Psychoanalysis_, a work of remarkable clarity, conceptual rigor, and ingratiating readability. Schlesinger situates termination - which he understands, variously, as a phase of treatment, a treatment process, and a state of mind - within the family of "beginnings and endings" that permeate one another throughout the (...) course of therapy. For Schlesinger, therapeutic endings cannot be aligned with the final phase of treatment; ending-phase phenomena are ongoing accompaniments of therapeutic work. They occur whenever patients achieve some portion of their treatment goals and supervene when therapy stagnates. Small wonder that an assessment of the patient's relationship to time and capacity to end therapy are key aspects of diagnostic evaluation. By linking beginning and ending phases not to the chronology of treatment but to the patient’s experience of it, Schlesinger brings revivifying insight to a host of psychodynamic concepts. Nor does he shy away from a trenchant critique of the instrumental “medical model” of psychiatric and psychotherapeutic training, which militates against the therapeutic exploration of treatment endings. Schlesinger's exemplification of how to begin treatment from the point of view of ending; his sensitive delineation of the mid-treatment "ending" crises characteristic of "vulnerable patients"; his richly woven case vignettes illustrating various "ending" contingencies and permutations - these inquiries are gems of pragmatic clinical wisdom. _Endings and Beginnings_ distills lessons learned over the course of a half century of practicing, teaching, and supervising psychotherapy and psychoanalysis and is a gift to the profession. (shrink)

Considering that getting along in civil society is based on the expectation that people will do what they say they will do, i.e., essentially live up to their explicit or implicit promises, it is amazing that so little scientific attention has been given to the act of promising. A great deal of research has been done on the moral development of children, for example, but not on the child’s ability to make and keep a promise, one of the highest moral (...) achievements. What makes it possible developmentally, cognitively, and emotionally to make a promise in the first place? And on the other hand, what compels one to keep a promise when there seems to be no personal advantage in doing so, and even when harm can be predicted? How do we know when a promise is offered seriously to be taken at face value, and how do we understand that another is only a polite gesture, not to be taken seriously? In _Promises, Oaths, and Vows: On the Psychology of Promising_, Herbert Schlesinger addresses these questions, drawing on the literature of moral development in children; the psychotherapy of a patient who regularly broke promises that were unnecessary in the first place; those who were regarded as "promising youngsters" who did not fulfill their "promise"; and those who feared making a promise, a commitment, or a threat out of fear that, once made, the utterance would take on a life of its own and could never be taken back. Furthermore, he illustrates his conclusions by examining the widespread use of promising in classical literature, such as Greek drama and the plays of Shakespeare, as well as the motivating and reifying power of the promise in Western religious traditions. With a style honed over the penning of two previous books, Schlesinger once again produces a work grounded in a firm analytic sensibility, but which also retains the wit and candor of the seasoned analyst. His seminal investigation of this all but neglected topic in the clinical literature is as timely as it is scholarly, and – with the title firmly in mind – _Promises, Oaths, and Vows_ is assured to be a worthy addition to any clinician’s library and a provoking investigation into Nietzsche’s notion of man as "the animal who makes promises.". (shrink)

In this paper certain basic assumptions about causation will be made explicit and then an attempt will be made to show, on the basis of those assumptions, that causation must be supplemented by an extra-causal operation of a selective nature. It is hoped that our assumptions will have in their own right a certain general acceptability, but since assumptions or “postulate sets”, whether antecedently acceptable or not are usually chosen for the purpose of proving something already deemed desirable, a word (...) should be said as to why it was thought desirable to argue for selectivity. (shrink)

Here is a simple, clear, useful proof that quantum mechanics contradicts Einstein, Podolsky, and Rosen's local realistic assumptions. It is a variant of the powerful argument first worked out by Daniel Mordechai Greenberger, Michael A. Horne, and Anton Zeilinger. This version uses the eigenstates of two orthogonal spin components for three spin-1/2 particles. No operator or matrix algebra is necessary. A novel discussion of the background and history serves to introduce this proof and to place it in the context of (...) Danny's work. (shrink)

The mind as a whole escapes objective studies because belief in mind- independent reality is self-contradictory and by definition excludes subjective experience (awareness, 'consciousness') from reality. The mind's center therefore vanishes in studies which imply exclusive objectivism or empiricism. This conceptual difficulty can be counteracted by acknowledging that all mental and world structures arise within an unstructured origin- and-matrix for knowledge-structures and beliefs. The mind's structure is thus at the center of reality. Use of such a zero-structure reference can also (...) help to clarify some related conceptual difficulties and to bridge the gap between the 'two cultures'. (shrink)