Millum and Bromwich provide a thorough and thoughtful analysis of what is required for sufficient informed consent, offering distinct conceptualizations of the ethical requirements of disclo...

The increasing complexity of human subjects research and its oversight has prompted researchers, as well as institutional review boards, to have a forum in which to discuss challenging or novel ethical issues not fully addressed by regulations. Research ethics consultation services provide such a forum. In this article, we rely on the experiences of a national Research Ethics Consultation Collaborative that collected more than 350 research ethics consultations in a repository and published 18 challenging cases with accompanying ethical commentaries to (...) highlight four contexts in which REC can be a valuable resource. REC assists: 1) investigators before and after the regulatory review; 2) investigators, IRBs, and other research administrators facing challenging and novel ethical issues; 3) IRBs and investigators with the increasing challenges of informed consent and risk/benefit analysis; and 4) in providing flexible and collaborative assistance to overcome study hurdles, mediate conflicts within a team, or directly engage with research participants. Institutions that have established, or plan to establish, REC services should work to raise the visibility of their service and engage in open communication with existing clinical ethics consult services as well as the IRB. While the IRB system remains the foundation for the ethical review of research, REC can be a valuable service for investigators, regulators, and research participants aligned with the goal of supporting ethical research. (shrink)

Clinical ethics consultants provide a range of services in hospital settings and in teaching environments. Training to achieve the skills needed to meet the expectations of employers comes in various forms, ranging from on-the-job training to formal fellowship training programs. We surveyed graduates of clinical ethics fellowships to evaluate their self-reported preparedness for their first job after fellowship training. The results indicated several areas of need, including greater exposure to program-building skills, quality improvement skills, and approaches to working with members (...) of higher administration. These data will be of use to educators as well as to fellows who advocate for elements of training in preparation for their first position. (shrink)

The sixteen essays in Gender Struggles address a wide range of issues in gender struggles, from the more familiar ones that, for the last thirty years, have been the mainstay of feminist scholarship, such as motherhood, beauty, and sexual violence, to new topics inspired by post-industrialization and multiculturalism, such as the welfare state, cyberspace, hate speech, and queer politics, and finally to topics that traditionally have not been seen as appropriate subjects for philosophizing, such as adoption, care work, and the (...) home. (shrink)

Children’s understanding of status and group norms influence their expectations about social encounters. However, status is multidimensional and children may perceive status stratification differently across multiple status dimensions. The current study investigated the effect of status level and norms on children’s expectations about intergroup affiliation in wealth and popularity contexts. Participants were randomly assigned to hear two scenarios where a high- or low-status target affiliated with opposite-status groups based on either wealth or popularity. In one scenario, the group expressed an (...) inclusive norm. In the other scenario, the group expressed an exclusive norm. For each scenario, children made predictions about children’s expectations for a target to acquire social resources. Novel findings indicated that children associated wealth status to some extent, but they drew stronger inferences from the wealth dimension than from the popularity dimension. In contrast to previous evidence that children distinguish between high- and low-status groups, we did not find evidence to support this in the context of the current study. In addition, norms of exclusion diminished children’s expectations for acquiring social resources from wealth and popularity groups but this effect was more pronounced between wealth groups. We found age differences in children’s expectations in regards to norms, but not in regards to status. The implications of how these effects, in addition to lack of effects, bear on children’s expectations about acquiring resources are discussed. (shrink)

René Girard developed his theory largely as a response to what he saw as Freud's profound discovery, namely, a recognition that violence and conflict are at the root of all social relations. Girard, however, rejected Freud's psychology of the autonomous subject and his emphasis on the family of origin dynamics in favor of the intersubjective experience of mimetic desire occurring between persons anywhere at any age. With imitation of others as the guiding theoretical principle of mimetic theory, Girard placed psychological (...) movement in the relational realm and developed a psychology of interdividuality that offers a convincing account of the contagious rivalry that either directly or tacitly flows through much human... (shrink)

Few medieval pilgrims' guides were written in English; even fewer were illuminated. This chapter examines Oxford, Queen's College, MS 357, a manuscript made in England in the late fifteenth century, which possesses both qualities. The manuscript contains a variety of texts written in Latin and English including pilgrims' guides, prayers to be said at holy sites in Palestine, travellers' tales, and descriptions of miracles that have taken place at shrines. It is also exuberantly illuminated. The miniatures begin with an Annunciation (...) and end with Christ in Judgment. These two images form the parentheses around the others in the manuscript, which depict sites in the Holy Land. The miniatures and decoration unite the disparate texts, turning them into a scale model of salvation history and providing a prompt to virtual pilgrimage. (shrink)

IntroductionThere is a paucity of clinical guidelines for the routine assessment of maladaptive reproductive grief reactions in outpatient primary care and OB-GYN settings in the United States. Because of the disenfranchised nature of perinatal grief reactions, many clinicians may be apt to miss or dismiss a grief reaction that was not identified in the perinatal period. A significant number of those experiencing a reproductive loss exhibit signs of anxiety, depression, or post-traumatic stress disorder. Reproductive losses are typically screened for and (...) recorded numerically as part of a woman’s well-visit intake, yet this process often fails to identify patients emotionally troubled by a prior pregnancy loss.Materials and MethodsA summative content analysis of 164 recent website blogs from female participants who self-reported having experienced a miscarriage or abortion in their lifetime was conducted. The narratives were reviewed for details regarding the time span between the pregnancy loss and the composition of the blog post. The stories were analyzed for subsequent relationship problems and detrimental mental health conditions. Maladaptive reactions were contrasted for those that indicated a greater than 12 months’ time-lapse and those who had not.ResultsMore than a third of the women reported in the narrative that at least one year or more had passed since experiencing the miscarriage or abortion. For those women, the median time span between the loss and composing the blog was 4 years with a range of 47 years. Mental health conditions attributed to the reproductive loss by those who reported longer bereavement times included subsequent relationship problems, substance misuse, depression, suicidal ideation, and PTSD. The percent of reported maladaptive issues was more than double for those who reported that a year or more had passed since the loss of the pregnancy.DiscussionGrief reactions following the loss of a pregnancy may be prolonged or delayed for several months which can contribute to adverse biopsychosocial outcomes. Recognition and treatment of maladaptive grief reactions following a pregnancy loss are critical. Screening methods should be enhanced for clinicians in medical office settings to help identify and expedite the appropriate mental health assistance. (shrink)

Volume 20, Issue 4, May 2020, Page 116-118.

FOREWORD. Gilbert Gottlieb and the Developmental Point of View. I. INTRODUCTION. 1. Developmental Systems, Nature-Nurture, and the Role of Genes in Behavior and Development: On the Legacy of Gilbert Gottlieb. 2. Normally Occurring Environmental and Behavioral Influences on Gene Activity: From Central Dogma to Probabilistic Epigenesis. II. THEORETICAL FOUNDATIONS FOR THE DEVELOPMENTAL STUDY OF BEHAVIOR AND GENETICS. 3. Historical and Philosophical Perspectives on Behavioral Genetics and Developmental Science. 4. Development and Evolution Revisited. 5. Probabilistic Epigenesis and Modern Behavioral and Neural (...) Genetics. 6. The Roles of Environment, Experience, and Learning in Behavioral Development. 7. Contemporary Ideas in Physics and Biology in Gottlieb’s Psychology. III. EMPIRICAL STUDIES OF BEHAVIORAL DEVELOPMENT AND GENETICS. 8. Behavioral Development during the Mother-Young Interaction in Placental Mammals: The Development of Behavior in the Relationship with the Mother. 9. Amniotic Fluid as an Extended Milieu Interieur. 10. Developmental Effects of Selective Breeding for an Infant Trait. 11. Emergence and Constraint in Novel Behavioral Adaptations. 12. Nonhuman Primate Research Contributions to Understanding Genetic and Environmental Influences on Phenotypic Outcomes across Development. 13. Interactive Contributions of Genes and Early Experience to Behavioural Development: Sensitive Periods and Lateralized Brain and Behaviour. 14. Trans-Generational Epigenetic Inheritance. 15. The Significance of Non-Replication of Gene-Phenotype Associations. 16. Canalization and Malleability Reconsidered: The Developmental Basis of Phenotypic Stability and Variability. IV. APPLICATIONS TO DEVELOPMENT. 17. Gene-Parenting Interplay in the Development of Infant Emotionality. 18. Genetic Research in Psychiatry and Psychology: A Critical Overview. 19. On the Limits of Standard Quantitative Genetic Modeling of Inter-Individual Variation: Extensions, Ergodic Conditions and a New Genetic Factor Model of Intra-Individual Variation. 20. Songs My Mother Taught Me: Gene-Environment Interactions, Brain Development and the Auditory System: Thoughts on Non-Kin Rejection, Part II. 21. Applications of Developmental Systems Theory to Benefit Human Development: On the Contributions of Gilbert Gottlieb to Individuals, Families, and Communities. (shrink)

Research is increasingly recognised as a key component of medical curricula, offering a range of benefits including development of skills in evidence-based medicine. The literature indicates that experienced academic supervision or mentoring is important in any research activity and positively influences research output. The aim of this project was to investigate the human research ethics experiences and knowledge of three groups: medical students, and university academic staff and clinicians eligible to supervise medical student research projects; at two Australian universities. Training (...) in research ethics was low amongst academic staff and clinicians eligible to supervise medical student research. Only two-thirds of academic staff and students and less than half of clinicians surveyed indicated that specific patient consent was required for a doctor to include patient medical records within a research publication. There was limited awareness of requirements for participant information and consent forms amongst all groups. In the case of clinical trials, fewer clinicians and students than academics indicated there was a requirement to obtain consent. Awareness of the ethics committee focus on respect was low across all groups. This project has identified significant gaps in human research ethics understanding among medical students, and university academic staff and clinicians. The incorporation of research within medical curricula provides the impetus for medical schools and their institutions to ensure that academic staff and clinicians who are eligible and qualified to supervise students’ research projects are appropriately trained in human research ethics. (shrink)

The Institute of Medicine reporting on the quality of health care in America recommends six aims for achieving the health care system we could have. Together with the Institute for Healthcare Improvement Triple Aim initiative, a framework has emerged to challenge providers, educators, and policymakers to remake the health care system according to specific objectives: to provide care that is safe, effective, patient-centered, timely, efficient, and equitable to more people at a price we can afford. Complicating this mission of better (...) prevention and better care at a lower cost is a daunting demographic: January of 2011 marked the month and year that the first of the baby boomers turned 65. The U.S. Census Bureau in May 2010 projected the number of Americans of this age and over to reach 88 million by 2050, more than double the current figure of 40.2 million. Parekh and Barton forecast in stark detail what it will be like to address these burgeoning numbers of older Americans with comorbidities, including the fact that over 20% of the population currently experiences at least two chronic medical conditions. (shrink)

Imagine a telephone conversation between a presidential aide and a wealthy supporter, shortly after news breaks that the president plans to veto a bill that the supporter strongly favors. The nervous aide opens with “I'm calling to let you know that the president regrets his, uh, his decision…” The supporter's hopes rise at the intimation that the president changed his mind. But when the aide continues: “… did not meet with your apparel, I mean, your approval,” the crestfallen (and, perhaps, (...) former) supporter realizes that the president is sorry merely about the impact of his decision, not the decision itself. The aide's utterance seems to mean one thing at first, but something entirely different in the end. Unintentional verbal about‐faces of this kind are common in everyday language use – the outspoken owner of an American baseball team recently said that she regretted her remarks offended many people – yet listeners rarely notice the miscues, the wealthy supporter notwithstanding. This is one of the chief motivations behind the psycholinguistic study of language use. (shrink)

Volume 19, Issue 10, October 2019, Page 99-101.

This essay considers medieval sewing in light of Austin's speechact theory. Analysing manuscripts, relics, indulgences, and even a bishop's mitre, the article argues that stitching was a way to enact, or intensify, the ritual purpose of objects, whether that was ceremonial, devotional, or authoritative. Whereas a speech act functions by its utterance, stitches act by forming visible and often ceremonious attachments between materials in order to aggrandise, embellish, assert and layer author ity, or swathe an object in textiles as if (...) it were a relic. _German_ Dieser Essay betrachtet mittelalterliches Nähen im Licht von Austins Sprechakttheorie. Indem er Manuskripte, Reliquien, Ablässe und sogar die Mitra eines Bischofs analysiert, argumentiert der Artikel, dass Nähen eine Weise war, den rituellen Gebrauch der Objekte einzusetzen oder zu intensivieren – ob es sich nun um zeremonielle, devotionale, oder autoritative Zwecke handelte. Während ein Sprechakt durch seine Äußerung agiert, handeln Nähstiche, indem sie sichtbare und oft feierliche Verbindungen zwischen Materialien schaffen, um Autorität zu steigern, zu verschönern, zu behaupten und zu schichten – oder um einen Gegenstand in Textilien zu hüllen, als handelte es sich um eine Reliquie. (shrink)

This essay considers medieval sewing in light of Austin's speechact theory. Analysing manuscripts, relics, indulgences, and even a bishop's mitre, the article argues that stitching was a way to enact, or intensify, the ritual purpose of objects, whether that was ceremonial, devotional, or authoritative. Whereas a speech act functions by its utterance, stitches act by forming visible and often ceremonious attachments between materials in order to aggrandise, embellish, assert and layer author ity, or swathe an object in textiles as if (...) it were a relic. (shrink)

Every so often a book comes along that transforms one’s perspective on a major development in the history of science. Kenneth Caneva’s is one of them. Built upon decades of immersion in the primary...

(1987). An Ethnography of AESA: A Collective Insider's Perspective on the Organization (AESA Presidential Address--1986) Educational Studies: Vol. 18, No. 3, pp. 359-373.

In Western industrialized countries, women report using health services, and certain medications, more often than do men. Often, analyses are based on data that exclude objective measures of morbidity and that come from cross-sectional surveys, which precludes the use of socioeconomic covariates that are endogenous to seeking care. Here, differences in objective cognitive and physical function, as well as differences in reporting on illness, propensity to seek care, and socioeconomic resources are expected to account for differences in care-seeking behaviour among (...) women and men. This model is applied to the question of medication use in Ismailia, Egypt, using two waves of survey data and in-home tests of physical function from 896 adults aged 50 years and older. The results show that women use medications more often than do men, and that differences between women and men in reported morbidity and disability, observed cognitive and physical function, and economic resources account for womens and men’s care-seeking behaviour in later life. (shrink)

Can moments of spiritual atonement (the Holy Grail Experience) be explained away as heightened awareness and other more mundane worldly phenomena? The author posits that part of the puzzle can be accounted for by the following factors: hypnotic phenomena such as time distortion, time orientation, fantasy proneness, absorption and a movement from dissociation to association. Knowledge about sensory modalities, internal dialogues and peripheral sensing, and about meditation and awareness, may also help to verbalise this magical moment of “grace”. Writings on (...) conversion experiences and mysticism may also assist us in investigating this phenomenon, when time stands still, and when for brief moments in life we become absorbed in the wonderment of life at its zenith - a taste of eternity. Contextual elements of prior social isolation and sensory deprivation are investigated as possible contributions to this unique phenomenon. In this conceptual article, the author explores the Holy Grail experience from both spiritual and secular viewpoints. Indo-Pacific Journal of Phenomenology , Volume 6, Edition 1 May 2006. (shrink)

Nearly $2 trillion is spent annually in the U.S. treating chronic illness — yet accessibility to quality health care services in rural communities for the chronically ill and dying remains problematic. Unique barriers present special challenges to a meaningful discussion of and subsequent strategies for addressing these issues in the context of increasingly scarce resources.