Matrix degradation and tissue remodelling directed by matrix‐degrading proteases are activated in physiological situations such as wound healing and involution of the prostate, ovaries and uterus. Recently, other activities, in addition to the cleavage of matrix proteins, have been attributed to matrix proteases including the release of growth factors from the extracellular matrix and roles in the maturation of adipocytes. This review describes extracellular proteases, including MMPs, plasminogen and cathepsins involved in the tissue remodelling processes that occur in the breast (...) during pubertal mammary development and the mammary cycle of pregnancy, lactation and weaning. It particularly focuses on development and weaning, termed mammary gland involution, when the majority of remodelling occurs. It also brings together recent findings on the exciting new functions of matrix‐degrading proteases. BioEssays 27:894–903, 2005. © 2005 Wiley Periodicals, Inc. (shrink)

Nostalgia, a sentimental longing for one’s past, can serve as a resource for individuals coping with discomforting experiences. The experience of bereavement poses psychological and physical risks....

Mammalian sperm undergo discharge of a single, anterior secretory granule following their attachment to the zona pellucida surrounding the oocyte. This secretory discharge is known for historical reasons as the acrosome reaction. It fulfils a number of purposes and without it, sperm are unable to penetrate the zona pellucida and fuse with the oocyte. In this review, we focus on the role of the acrosome reaction in the development of fusion competence in sperm. Any naturally occurring membrane fusion has two (...) major sequential steps: a docking or adhesion step, in which two membranes adhere, and a fusion step, in which their lipid bilayers are destabilized and merged and a cellular compartment is either created or destroyed. Recent evidence suggests that there is an important role for oocyte integrins and sperm‐bound disintegrins in mammalian sperm/oocyte adhesion and fusion. The fusion mechanism employed by sperm remains poorly understood, however, and circumstantial evidence suggests it is more complex than the interaction between a single protein species and its target. Sperm/oocyte fusion is probably the most accessible eukaryotic model for intercellular fusion currently available, partly because it is temporally separated from gene expression. Elucidation of the mechanism of sperm/oocyte fusion may throw light on the mechanism of other intercellular fusions such as myoblast fusion, and the evolutionary relationship of intercellular membrane fusion to intracellular membrane fusion. (shrink)

In Book 2 of The Peloponnesian War, the ancient Greek historian Thucydides describes the Plague of Athens which killed an estimated 75,000 people in 430 BC, the second year of the war. Thucydides i...

The Central Bank of China is testing its Digital Currency Electronic Payment (DCEP) in the cities of Shenzhen, Suzhou, Chengdu and Xunan with the involvement of four large state-owned banks in the...

In three studies, we examined food as an elicitor of nostalgia. Study 1 participants visualised eating either a nostalgic or regularly consumed food. Study 2 participants visualised consuming 12 foods. Study 3 participants consumed 12 flavour samples. Following their food experiences, all participants responded to questions regarding the profile of food-evoked nostalgia (i.e. autobiographical relevance, arousal, familiarity, positive and negative emotions) and several psychological functions (i.e. positive affect, self-esteem, social connectedness, meaning in life). Study 2 and 3 participants also reported (...) their state nostalgia. Results revealed that food is a powerful elicitor of nostalgia. Food-evoked nostalgia has a similar contextual profile to previously examined elicitors, but is a predominantly positive emotional experience. Food-evoked nostalgia served multiple psychological functions and predicted greater state nostalgia. (shrink)

This collection of original essays, by some of the best known contemporary criminal law theorists, tackles a range of issues about the criminal law's 'special part' - the part of the criminal law that defines specific offences. One of its aims is to show the importance, for theory as well as for practice, of focusing on the special part as well as on the general part which usually receives much more theoretical attention. Some of the issues covered concern the proper (...) scope of the criminal law, for example how far should it include offences of possession, or endangerment? If it should punish only wrongful conduct, how can it justly include so-called 'mala prohibita', which are often said to involve conduct that is not wrongful prior to its legal prohibition? Other issues concern the ways in which crimes should be classified. Can we make plausible sense, for instance, of the orthodox distinction between crimes of basic and general intent? Should domestic violence be defined as a distinct offence, distinguished from other kinds of personal violence? Also examined are the ways in which specific offences should be defined, to what extent those definitions should identify distinctive types of wrongs, and the light that such definitional questions throw on the grounds and structures of criminal liability. Such issues are discussed in relation not only to such crimes as murder, rape, theft and other property offences, but also in relation to offences such as bribery, endangerment and possession that have not traditionally been subjects for in depth theoretical analysis. (shrink)

25 leading contemporary theorists of criminal law tackle a range of foundational issues about the proper aims and structure of the criminal law in a liberal democracy. The challenges facing criminal law are many. There are crises of over-criminalization and over-imprisonment; penal policy has become so politicized that it is difficult to find any clear consensus on what aims the criminal law can properly serve; governments seeking to protect their citizens in the face of a range of perceived threats have (...) pushed the outer limits of criminal law and blurred its boundaries. To think clearly about the future of criminal law, and its role in a liberal society, foundational questions about its proper scope, structure, and operations must be re-examined. What kinds of conduct should be criminalized? What are the principles of criminal responsibility? How should offences and defences be defined? The criminal process and the criminal trial need to be studied closely, and the purposes and modes of punishment should be scrutinized. Such a re-examination must draw on the resources of various disciplines-notably law, political and moral philosophy, criminology and history; it must examine both the inner logic of criminal law and its place in a larger legal and political structure; it must attend to the growing field of international criminal law, it must consider how the criminal law can respond to the challenges of a changing world.Topics covered in this volume include the question of criminalization and the proper scope of the criminal law; the grounds of criminal responsibility; the ways in which offences and defences should be defined; the criminal process and its values; criminal punishment; the relationship between international criminal law and domestic criminal law. Together, the essays provide a picture of the exciting state of criminal law theory today, and the basis for further research and debate in the coming years. (shrink)

Michael A. Peters Beijing Normal UniversityDeclinism is back in fashion again. It is now a common and persistent source of historical reflection that has been a constant theme since the first Chris...

Drawing from both theoretical and empirical research, the literature on basic income (BI) is now voluminous, pronouncing both its merits and its limitations. Burgeoning research documents the impacts of un/conditional cash transfers and negative income tax programs, with many studies highlighting the effectiveness of these programs in reducing poverty, and improving a host of social, economic and health outcomes. We consider possible avenues for BI architecture to be adopted within Canada’s existing constellation of income security programs, to the benefit of (...) disadvantaged groups in society. Identifying key federal and provincial (i.e., Ontario) transfer and tax benefit programs, we highlight which programs might best be maintained or converted to a BI. While opponents decry the (alleged) exorbitant costs of BI schemes, we suggest that the existing approach not only produces an ineffective system—which actually engenders poverty and the health and social problems that accompany it—but an excessively costly one. (shrink)

Anticipated nostalgia is a new construct that has received limited empirical attention. It concerns the anticipation of having nostalgic feelings for one’s present and future experiences. In three...

One of the central issue of developmental biology concerns the molecular mechanisms whereby a multipotent cell gives rise to distinct differentiated progeny. Differences between specialised cell types reflect variations in their patterns of gene expression. The regulation of transcription initiation is an important control point for gene expression and it is, therefore, not surprising that transcription factors play a pivotal role in mammalian development and differentiation.Haemopoiesis offers a uniquely tractable system for the study of lineage commitment and differentiation. The importance (...) of transcription factor in the normal regulation of haemopoiesis is underlined by the frequency with which transcription factors are targeted by leukaemogenic mutations. Studies of the function and regulation of haemopoietic transcription factors, especially those expressed in lineage‐restricted patterns, should greatly increase our understanding of the molecular control of haemopoiesis. In this review we have focused on insights provided by recent studies of the GATA and SCL proteins. (shrink)

Using fMRI, we investigated how right temporal lobe gliomas affecting the posterior superior temporal sulcus alter neural processing observed during speech perception and production tasks. Behavioural language testing showed that three pre-operative neurosurgical patients with grade 2, grade 3 or grade 4 tumours had the same pattern of mild language impairment in the domains of object naming and written word comprehension. When matching heard words for semantic relatedness (a speech perception task), these patients showed under-activation in the tumour infiltrated right (...) superior temporal lobe compared to 61 neurotypical participants and 16 patients with tumours that preserved the right postero-superior temporal lobe, with enhanced activation within the (tumour-free) contralateral left superior temporal lobe. In contrast, when correctly naming objects (a speech production task), the patients with right postero-superior temporal lobe tumours showed higher activation than both control groups in the same right postero-superior temporal lobe region that was under-activated during auditory semantic matching. The task dependent pattern of under-activation during the auditory speech task and over-activation during object naming was also observed in eight stroke patients with right hemisphere infarcts that affected the right postero-superior temporal lobe compared to eight stroke patients with right hemisphere infarcts that spared it. These task-specific and site-specific cross-pathology effects highlight the importance of the right temporal lobe for language processing and motivate further study of how right temporal lobe tumours affect language performance and neural reorganisation. These findings may have important implications for surgical management of these patients, as knowledge of the regions showing functional reorganisation may help to avoid their inadvertent damage during neurosurgery. (shrink)

While the literature in business ethics abounds with philosophical analyses, perspectives from religious thinkers are curiously underrepresented. What religious analysis has occured has often been moralistic in tone, more fit to the pulpit than the classroom or the boardroom. In the three essays that follow, presented originally at a panel at the Annual Meeting of the American Academy of Religion in 1989, ethicists from the Protestant, Roman Catholic, and Jewish traditions analyze a case study familiar to many who teach and (...) research in business ethics - the Consolidated Foods Case. Each author shows how a particular religious tradition might react to the case. The authors show how insights from their traditions would affect corporation's moral deliberations about policy. Specific policy recommendations are offered to CEO John Bryan. (shrink)

The effects of research ethics training on medical students' attitudes about clinical research are examined. A preliminary randomized controlled trial evaluated 2 didactic approaches to ethics training compared to a no-intervention control. The participant-oriented intervention emphasized subjective experiences of research participants. The criteria-oriented intervention emphasized specific ethical criteria for analyzing protocols. Compared to controls, those in the participant-oriented intervention group exhibited greater attunement to research participants' attitudes related to altruism, trust, quality of relationships with researchers, desire for information, hopes about (...) participation and possible therapeutic misconception, importance of consent forms, and deciding quickly about participation. The participant-oriented group also agreed more strongly that seriously ill people are capable of making their own research participation decisions. The criteria-oriented intervention did not affect learners' attitudes about clinical research, ethical duties of investigators, or research participants' decision making. An empathy-focused approach affected medical students' attunement to research volunteer perspectives, preferences, and attributes, but an analytically oriented approach had no influence. These findings underscore the need to further examine the differential effects of empathy-versus analytic-focused approaches to the teaching of ethics. (shrink)

This book is written primarily for psychology and education students whose programs include a course in child psychology, child development, or theories of development. The text may also be used to supplement courses on child development organized thematically or chronologically. Instructors of graduate courses in child development may wish to consider this text as a primary synthesis containing more source material and source citations than others of its kind. The primary aim of the book is to describe what developmental theories (...) are, what they can do, where they come from, how they work, and how they can be used to explain human nature. (shrink)

While the literature in business ethics abounds with philosophical analyses, perspectives from religious thinkers are curiously underrepresented. What religious analysis has occured has often been moralistic in tone, more fit to the pulpit than the classroom or the boardroom. In the three essays that follow, presented originally at a panel at the Annual Meeting of the American Academy of Religion in 1989, ethicists from the Protestant, Roman Catholic, and Jewish traditions analyze a case study familiar to many who teach and (...) research in business ethics — the Consolidated Foods Case. Each author shows how a particular religious tradition might react to the case. The authors show how insights from their traditions would affect corporation's moral deliberations about policy. Specific policy recommendations are offered to CEO John Bryan. (shrink)

Ethical issues are pivotal to the practice of psychiatry. Anyone involved in psychiatric practice and mental healthcare has to be aware of the range of ethical issues relevant to their profession. An increased professional commitment to accountability, in parallel with a growing "consumer" movement has paved the way for a creative engagement with the ethical movement. The bestselling 'Psychiatric Ethics' has carved out a niche for itself as the major comprehensive text and core reference in the field, covering a range (...) of complex ethical dilemmas which face clinicians and researchers in their everyday practice. This new edition takes a fresh look at recent trends and developments at the interface between ethics and psychiatric practice. Coming ten years after the third edition, the editors have observed several emerging aspects of psychiatric practice requiring coverage, as a result, 5 new chapters have been added, including cutting edge topics - such as neuroethics. All other chapters have been fully revised and updated. The book will continue to be essential reading for psychiatrists, psychologists, other mental health professionals, and bioethicists, as well as of interest to policy makers, managers and lawyers. (shrink)

Early last year, the GenEthics Consortium (GEC) of the Washington Metropolitan Area convened at George Washington University to consider a complex case about genetic testing for Alzheimer disease (AD). The GEC consists of scientists, bioethicists, lawyers, genetic counselors, and consumers from a variety of institutions and affiliations. Four of the 8 co-authors of this paper delivered presentations on the case. Supplemented by additional ethical and legal observations, these presentations form the basis for the following discussion.

Schizophrenia is a severe mental illness, which affects sense of identity. While the ability to have a coherent vision of the self relies partly on its reciprocal relationships with autobiographical memories, little is known about how memories ground “self-images” in schizophrenia. Twenty-five patients with schizophrenia and 25 controls were asked to give six autobiographical memories related to four self-statements they considered essential for defining their identity. Results showed that patients’ self-images were more passive than those of controls. Autobiographical memories underlying (...) self-images were less thematically linked to these self-images in patients. We also found evidence of a weakened sense of self and a deficient organization of autobiographical memories grounding the self in schizophrenia. These abnormalities may account for the poor cohesiveness of the self in schizophrenia. (shrink)

This title includes the following features: Presents a comprehensivediscussion of the central issues of psychiatric ethics, defining and exploringeach of these issues; Contains essential readings for each of these central issues, providing in onevolume readings that would otherwise be difficult to obtain; Includes introductory essays that provide a comprehensive overview of eachissue, efficiently and effectively organizing the reader's approach to theselected readings; Draws on the success of the well-known and respected 'PsychiatricEthics'.

In lieu of an abstract, here is a brief excerpt of the content:Instinct of Nature: Natural Law, Synderesis, and the Moral SenseRobert A. Greene“Instinct is a great matter.”—Sir John FalstaffThis essay traces the evolution of the meaning of the expression instinctus naturae in the discussion of the natural law from Justinian’s Digest through its association with synderesis to Francis Hutcheson’s theory of the moral sense. The introduction of instinctus naturae into Ulpian’s definition of the natural law by Isidore of Seville (...) in the seventh century posed a problem of definition for medieval commentators. Some said that it meant a universal and providential natura naturans; some defined it as the urge to self and species preservation in animals, degenerating in man into sensual and shameful impulses; some advanced the humanistic and paradoxical notion that it referred to a unique exercise of human reason in coming to know the natural law. The contemporaneous revival in the twelfth century of St. Jerome’s puzzling new term “synderesis,” and its gradual definition as the immediate apprehension of the first practical moral principles of the natural law, brought the two terms into proximity and loose association.A half-century later St. Bonaventure made explicit what had remained latent in the thinking of Thomas Aquinas by relocating synderesis in the affective rather than the intellectual part of man’s nature. Accordingly the moral discoveries of synderesis came to be spoken of as not only non-discursive but instinctive in nature—apprehensions for which no reason could be given, apprehensions somehow rooted in affective human experience. During the bilingual early modern period an increasingly secularized, internalized, and reified instinctus [End Page 173] naturae, together with its abbreviated vernacular cognate, “instinct,” came to serve as a substitute and synonym for the obsolescent synderesis. Edward Herbert’s attention to instinctus naturae in his De Veritate (1624), Sir Matthew Hale’s speculations about the place of rational instinct in the natural law, and Francis Hutcheson’s theory of a moral sense all exemplify this semantic legacy.The first entry in Justinian’s Digest has had a disproportionate influence on later speculation about the natural law. It begins a chapter that gives pride of place to general definitions of justice, law, jus naturale and jus gentium, and it is drawn from the writings of the Roman jurisconsult Domitius Ulpianus (d. 223), whose work constitutes forty percent of the Digest. Ulpian defines the natural law, with insistent repetition, as that which nature has taught to, or is common to, all animals:Jus naturale is that which nature has taught to all animals; for it is not a law specific to mankind but is common to all animals—land animals, sea animals, and the birds as well. Out of this comes the union of man and woman [male and female] which we call marriage, and the procreation of children, and their rearing. So we can see that the other animals, wild beasts included, are rightly understood to be acquainted with this law. Jus gentium, the law of the nations, is that which all human peoples observe. That it is not coextensive with natural law can be grasped easily, since this latter is common to all animals whereas jus gentium is common only to human beings among themselves. 1Justinian’s compilers gave Ulpian’s definition striking prominence at the beginning of the Digest and then in the same short chapter quoted the incompatible and more traditional definitions of his contemporaries Gaius and Paulus. They confined the operation of the natural law to mankind and spoke of reason as its source. 2 The compilers had been charged to eliminate just such conflicts; yet here at the very outset they set a conundrum that perplexed commentators [End Page 174] and invited explanation from Isidore of Seville to Hugo Grotius. Their selection of quotations suggests that as lawyers they regarded such general definitions as “for legal purposes no more than ornament to discussion.” 3 For those of a more speculative bent, however, the dilemmas could not have been more fundamental. How was the natural law to be defined in relation to those appetitive and self-preservative urges that man seemed to share with animals? Or did the term law apply only... (shrink)

This study examines how the leading beverage company handles the strategic paradox between its core business and the social issue of obesity. A discursive analysis reveals how the organization does embrace a social goal related to obesity but not the paradoxical tension between this goal and its core business. The analysis further shows how the tension, along with the responsibility for the social goal, is projected outside the organization. This response is underpinned by the paradoxical constructions of consumers and the (...) concept of obesity in the organization’s communication. Based on these findings, I outline a new type of process for projection, one of the defensive mechanisms recognized in the literature. The findings increase our understanding of defensive responses to organizational paradoxes and help distinguish between different kinds of strategic paradoxes. They also highlight the need to further open up the complexity and multiplicity of strategic paradoxes related to corporate sustainability. (shrink)

The artist's house is a prism through which to view not only the artistic practice of its inhabitant, but also to apprehend broader developments in sculpture and contemporary art in relation to domestic architecture and interior space. Based on a series of interviews and site visits with living artists about the role of their home in relation to their work, Kirsty Bell looks at the house as receptacle, vehicle, model, theater, or dream space. In-depth analyses of these contemporary examples—including (...) Jorge Pardo, Mirosław Bałka, Danh Vo, Gregor Schneider, Frances Stark, Marc Camille Chaimowicz, Dominique Gonzalez-Foerster, Paweł Althamer, Mark Leckey, Monika Sosnowska, Gabriel Orozco, Rirkrit Tiravanija, and Andrea Zittel—are contextualized by key artists of the twentieth century such as Kurt Schwitters, Alice Neel, Edward Krasiński, Carlo Mollino, and Louise Bourgeois. A two-way flow from the domestic arena to the exhibition space becomes apparent, in which the everyday has a significant role to play in the merging of such developments as installation art, relational aesthetics, expanded collage, and performance art. (shrink)

Conceptual combination performs a fundamental role in creating the broad range of compound phrases utilised in everyday language. This article provides a novel probabilistic framework for assessing whether the semantics of conceptual combinations are compositional, and so can be considered as a function of the semantics of the constituent concepts, or not. While the systematicity and productivity of language provide a strong argument in favor of assuming compositionality, this very assumption is still regularly questioned in both cognitive science and philosophy. (...) Additionally, the principle of semantic compositionality is underspecifi ed, which means that notions of both "strong" and "weak" compositionality appear in the literature. Rather than adjudicating between different grades of compositionality, the framework presented here contributes formal methods for determining a clear dividing line between compositional and non-compositional semantics. In addition, we suggest that the distinction between these is contextually sensitive. Compositionality is equated with a joint probability distribution modeling how the constituent concepts in the combination are interpreted. Marginal selectivity is introduced as a pivotal probabilistic constraint for the application of the Bell/CH and CHSH systems of inequalities. Non-compositionality is equated with a failure of marginal selectivity, or violation of either system of inequalities in the presence of marginal selectivity. This means that the conceptual combination cannot be modeled in a joint probability distribution, the variables of which correspond to how the constituent concepts are being interpreted. The formal analysis methods are demonstrated by applying them to an empirical illustration of twenty-four non-lexicalised conceptual combinations. (shrink)

The focus of this study was to analyze the content, distribution, and comparative genome relationships of 996 chromosome bin-mapped expressed sequence tags accounting for 2266 restriction fragments on the homoeologous group 3 chromosomes of hexaploid wheat. Of these loci, 634, 884, and 748 were mapped on chromosomes 3A, 3B, and 3D, respectively. The individual chromosome bin maps revealed bins with a high density of mapped ESTs in the distal region and bins of low density in the proximal region of the (...) chromosome arms, with the exception of 3DS and 3DL. These distributions were more localized on the higher-resolution group 3 consensus map with intermediate regions of high-mapped-EST density on both chromosome arms. Gene ontology classification of mapped ESTs was not significantly different for homoeologous group 3 chromosomes compared to the other groups. A combined analysis of the individual bin maps using 537 of the mapped ESTs revealed rearrangements between the group 3 chromosomes. Approximately 232 of the consensus mapped ESTs matched sequences on rice chromosome 1 and revealed large- and small-scale differences in gene order. Of the group 3 mapped EST unigenes ∼21 and 32% matched the Arabidopsis coding regions and proteins, respectively, but no chromosome-level gene order conservation was detected. (shrink)

Ten nurses at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in ethically difficult situations in surgical units. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. The main theme in the narratives was being close to and moved by the suffering of patients and relatives. The nurses' responsibility for patients and relatives was expressed as a commitment to act, and they needed to ask themselves (...) whether their responsibility had been fulfilled, that nothing had been left undone, overlooked or neglected, before they could leave the unit. When there was confirmation by the patients, relatives, colleagues and themselves that the needs of patients and relatives had been attended to in a morally and professionally satisfying manner, this increased the nurses' confidence and satisfaction in their work, and their strength to live with the burden of being in ethically difficult situations. (shrink)

The traditional medical epistemology, resting on a biomedical paradigmatic monopoly, fails to display an adequate representation of medical knowledge. Clinical knowledge, including the complexities of human interaction, is not available for inquiry by means of biomedical approaches, and consequently is denied legitimacy within a scientific context. A gap results between medical research and clinical practice. Theories of knowledge, especially the concept of tacit knowing, seem suitable for description and discussion of clinical knowledge, commonly denoted the art of medicine. A metaposition (...) allows for inquiry of clinical knowledge, inviting an expansion of the traditional medical epistemology, provided that relevant criteria for scientific knowledge within this field are developed and applied. The consequences of such approaches are discussed. (shrink)

Background The aim of this study was to explore the ethical challenges in surgery from the surgeons' point of view and their experience of being in ethically difficult situations. Methods Five male and five female surgeons at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in such situations. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. Results No differences in ethical reasoning between male and (...) female surgeons were found. They reasoned in both action and relational ethical perspectives. Surgeons focused on their relationships with patients and colleagues and their moral self in descriptions of the ethical challenges in their work. Dialogue and personal involvement were important in their relationships with patients. The surgeons emphasized the importance of open dialogue, professional recognition, and an inclusive and accepting environment between colleagues. Conclusion The surgeons are personally challenged by the existential realities of human life in their relationships with patients. They realized that ethical challenges are an inherent part of performing surgery and of life itself, and say that they have to learn to "live with" these challenges in a way that is confirmed both socially and by their inner moral self. This means accepting their personal and professional limitations, being uncertain, being fallible, and being humble. Living with the ethical challenges of surgery seems to contribute to the surgeons' confidence and vulnerability in their professional identity. (shrink)

This paper takes a critical perspective on corporate social responsibility and examines the ways in which an industry organization discursively manages the relationship between the industry and its stakeholders in a situation where the legitimacy of the industry is called into question. Drawing on the literature on organizational narcissism and sensemaking the paper develops the construct of narcissistic CSR orientation and empirically elaborates on three defensive rhetorical strategies through which the organization makes sense of the accountability and responsibility of the (...) industry for the negative societal effects of their business. The paper advances knowledge in the field of critical CSR by proposing a new framework for critically examining organization-stakeholder relationships and organizational responses to stakeholder demands in contexts where the interests of organizations are in conflict with the public good. (shrink)

This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they (...) are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different countries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a “bottom-up” perspective might give healthcare personnel opportunities to think and reflect more than a “top-down” perspective. A “bottom-up” approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a “top-down” approach risks removing such moral responsibility. (shrink)