Growth of the Hispanic consumer population in America is changing the marketplace landscape. Due to their considerable buying power, a better understanding of Hispanic consumer behavior has become a necessity. The marketing literature has examined issues regarding religiosity and attitude toward business in regards to consumer ethical beliefs as well as research differentiating consumers on the basis of ethnicity due to their inherently different religious principles. Therefore, the present study contributes to the existing consumer ethics literature by examining the roles (...) of religiosity and attitude toward business in determining consumer ethical beliefs. Furthermore, this study compares the relationships among religiosity, attitude toward business, and ethical beliefs at the sub-cultural level (i.e., between Hispanic and Anglo-American consumers). Survey data compare a sample of 187 predominately Catholic Hispanic consumers with a sample of 127 predominately protestant Anglo consumers. Results suggest a positive relationship between intrinsic religiousness and beliefs that questionable consumer activities are unethical. However, extrinsic religiousness does not impact consumer views as to the ethicality of consumer practices. Hispanics exhibit higher levels of extrinsic religiousness than Anglos, but no difference in terms of their intrinsic religiousness. Results also suggest that Hispanics have a more negative attitude toward business than Anglos do. Implications of these results are discussed. (shrink)

Which systems/organisms are conscious? New tests for consciousness (‘C-tests’) are urgently needed. There is persisting uncertainty about when consciousness arises in human development, when it is lost due to neurological disorders and brain injury, and how it is distributed in nonhuman species. This need is amplified by recent and rapid developments in artificial intelligence (AI), neural organoids, and xenobot technology. Although a number of C-tests have been proposed in recent years, most are of limited use, and currently we have no (...) C-tests for many of the populations for which they are most critical. Here, we identify challenges facing any attempt to develop C-tests, propose a multidimensional classification of such tests, and identify strategies that might be used to validate them. (shrink)

Dementia is a growing issue at the end of life that presents unique challenges for advance care planning. Advance directives are a useful and important component of end-of-life planning, but standard advance directives have less utility in cases of loss of capacity due to dementia. An advance directive designed to specifically address end-of-life issues in the setting of dementia can provide patients with increased autonomy and caregivers with improved information about the desires of the individual in question. The Dartmouth Dementia (...) Directive is a dementia-specific advance directive, available online, that seeks to address common concerns of individuals who are planning for dementia-related end-of-life care. This directive was piloted in a community-based workshop, which provided important details and perspective on the best use of dementia-specific advance directives in the greater population. (shrink)

ObjectiveStudies that examine disordered eating in samples of Asian individuals living in the United States frequently combine all individuals of Asian descent into a single group, which can obscure important differences between groups and their experiences of acculturation. The goal of the present study was to establish the relation of acculturation, internalization of appearance ideals, and religiosity as predicting body dissatisfaction and disordered eating in women of South and Southeast Asian descent.MethodWomen of SSEA descent aged 18–51 years completed a battery (...) of questionnaires that inquire about these variables. A path analysis was conducted with acculturation serving as the independent variable, religiosity and internalization of the thin ideal as mediators, and body dissatisfaction and disordered eating as dependent variables.ResultsDirect paths from acculturation to both body dissatisfaction and disordered eating were not significant. Thin ideal internalization completely accounted for the path from acculturation to both endogenous variables; whereas, religiosity did not significantly account for any indirect effect.DiscussionFor SSEA women, internalization of appearance ideals is a potentially greater risk factor for disordered eating than acculturation or religiosity. As this was an atemporal mediation analysis, more work needs to be done exploring predictors of internalization in this population and how that may impact the development of disordered eating. (shrink)

College students from small, medium, and large institutions with either a modified or no honor code were presented with cheating scenarios and asked to rate how dishonest they perceived the behavior to be and the likelihood that they would report it. No main effects were found for institution size or type of honor code. Student–faculty ratio was not correlated with responses to the cheating scenarios. Students from modified honor code schools perceived more severe punishments for cheating and understood the reporting (...) process better than students from non–honor code schools. Implications for modified honor code systems are discussed. (shrink)

In this study we use dual process theory of self-regulation to develop a framework that outlines the mediating and moderating mechanisms explaining the relationship between leader emotional exhaustion and leadership style (transformational leadership and abusive supervision). Using Glomb et al.’s (2011) framework, we identify empathy and negative emotion as mediators that are of particular importance for leaders. In addition, we propose that leader mindfulness moderates these processes to improve leadership style. Using a time-lagged survey of leaders (N = 505) we (...) found that leader empathy and negative emotion mediated the relationships between emotional exhaustion and leadership style. Furthermore, we found that leader mindfulness significantly moderated the indirect effect of leader emotional exhaustion on leadership style through negative emotion. However, leader mindfulness did not moderate the relationship between emotional exhaustion and empathy. Theoretical and practical implications are discussed. (shrink)

This article argues that Maurice Merleau-Ponty advances a queer notion of love. In particular, I argue that his notion of love as an institution, as a hollow fueled by the imaginary dimension of existence, shows that love unhinges petrified ideals of gender. I suggest that the crucial insight to be found in Merleau-Ponty's account of love is that love is a lived openness that invites us to seek out new ways of being.

This article argues that Maurice Merleau-Ponty advances a queer notion of love. In particular, I argue that his notion of love as an institution, as a hollow fueled by the imaginary dimension of existence, shows that love unhinges petrified ideals of gender. I suggest that the crucial insight to be found in Merleau-Ponty's account of love is that love is a lived openness that invites us to seek out new ways of being.

Cell line immortalisation is a growing component of African genomics research and biobanking. However, little is known about the factors influencing consent to cell line creation and immortalisation in African research settings. We contribute to addressing this gap by exploring three questions in a sample of Xhosa participants recruited for a South African psychiatric genomics study: First, what proportion of participants consented to cell line storage? Second, what were predictors of this consent? Third, what questions were raised by participants during (...) this consent process? 760 Xhose people with schizophrenia and 760 controls were matched to sex, age, level of education and recruitment region. We used descriptive statistics to determine the proportion of participants who consented to cell line creation and immortalization. Logistic regression methods were used to examine the predictors of consent. Reflections from study recruiters were elicited and discussed to identify key questions raised by participants about consent. Approximately 40% of participants consented to cell line storage. The recruiter who sought consent was a strong predictor of participant’s consent. Participants recruited from the South African Eastern Cape, and older participants, were more likely to consent; both these groups were more likely to hold traditional Xhosa values. Neither illness nor education were significant predictors of consent. Key questions raised by participants included two broad themes: clarification of what cell immortalisation means, and issues around individual and community benefit. These findings provide guidance on the proportion of participants likely to consent to cell line immortalisation in genomics research in Africa, and reinforce the important and influential role that study recruiters play during seeking of this consent. Our results reinforce the cultural and contextual factors underpinning consent choices, particularly around sharing and reciprocity. Finally, these results provide support for the growing literature challenging the stigmatizing perception that people with severe mental illness are overly vulnerable as a target group for heath research and specifically genomics studies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Beastly Vagueness in Charles Sanders Peirce and Henry JamesMegan M. QuigleyIn 1878, Charles Sanders Peirce closed the first section of "How to Make our Ideas Clear"—an article that William James later declared a "birth certificate of Pragmatism"—on a strangely anecdotal note.1 Using what would become known as the pragmatic method to demolish the notion of Grand Ideas ("Our idea of anything is our idea of its sensible effects"), Peirce (...) also included a lesson from an "old German story":Many a man has cherished for years some vague shadow of an idea, too meaningless to be positively false; he has nevertheless, passionately loved it, has made it his companion by day and by night, and has given to it his strength and his life, leaving all other occupations for its sake, and in short has lived with it and for it, until it has become, as it were, flesh of his flesh and bone of his bone; and then he has waked up some morning to find it gone, cleaned vanished away like the beautiful Melusina of the fable, and the essence of his life gone with it. I have myself known such a man.(WCSP, p. 261)The story of the fled Melusina (a half-woman, half-serpent who gives birth to monsters) acts ostensibly as a warning against the danger inherent in "vague" ideas. "A vague shadow of an idea" can sap the life-blood out of a young man and, therefore, Peirce asserted, we must strive to be clear. But Peirce's anecdote did more than further his argument; it was an autobiographical aside—so personal, in fact, that he ordered the passage to be deleted in all future printings of his essay.Melusina was not just an allusion to a mythological figure; it was also a reference to the middle name of his wife, Harriet Melusina Fay. Since his schooldays, Peirce's friend and, later, wife, whom he called [End Page 362] "Zina," had been his constant companion and even the scribe for his fervent aspirations. Under the title "Theories of C. S. Peirce, 1854" she had transcribed his ambitious declaration: "My life is built upon a theory: and if this theory turns out false, my life will turn out a failure" (Brent, p. 51). By the mid 1870s, Peirce's theory, "passionately loved... his companion by day and by night," was finally being elucidated in his articles; however, Melusina herself had "cleaned vanished away," after two decades of intimacy, leaving Peirce in Paris to what his friend Henry James described as "a very lonely and dreary existence." Peirce's inclusion of an anecdote about his own loneliness—"I have myself known such a man"—is poignant even as it reveals his anger. Melusina is both a monster and "beautiful," and with her disappearance, Peirce has lost, "the essence of his life." The personal allusion also highlights the anxiety in the young Peirce's writing. What if his theories came to nothing, remained merely vague, and he lost his whole life and his wife to a misguided dedication? And how ironic would that be given that the idea itself aimed to explode the fallacy of grand ideas? Such an irony was not lost on his main companion during the winter of 1875, Henry James.In the following pages I aim to demonstrate that Charles S. Peirce's anxiety acted as a germ for the beast of John Marcher in James's late story, "The Beast in the Jungle." "More than any of Henry James's tales," Paul Lindholdt writes, "'The Beast in the Jungle,' has prompted source studies and psychoanalytic discussions by critics striving to identify" John Marcher.2 Eager to diagnose the relationship between Marcher and May Bartram, critics have sought both autobiographical and literary sources for Marcher's character.3 Strangely, however, no one has noted the connection between Peirce and Marcher, an omission that is especially odd given the critical attention directed at the relationship between the story and pragmatism. Since Richard Hocks's Henry James and Pragmatistic Thought highlighted the pragmatic tendencies of James's story and called Marcher the "anti-pragmatist" hero, "an epitome of William's... (shrink)

BackgroundCommunity engagement within biomedical research is broadly defined as a collaborative relationship between a research team and a group of individuals targeted for research. A Community Advisory Board is one mechanism of engaging the community. Within genomics research CABs may be particularly relevant due to the potential implications of research findings drawn from individual participants on the larger communities they represent. Within such research, CABs seek to meet instrumental goals such as protecting research participants and their community from research-related risks, (...) as well as intrinsic goals such as promoting the respect of participants and their community. However, successful community engagement depends on the degree to which CABs legitimately represent and engage with communities targeted for research. Currently, there is little literature describing the use of CABs in genomics research taking place in developing countries, and even less in the field of genomics research relating to mental illness. The aim of this article is to describe and consider the contributions made by a researcher-driven, population-specific CAB in a genomics of schizophrenia research project taking place in South Africa, from the perspective of the research team.DiscussionFour broad discussion topics emerged during the CAB meetings namely: 1) informed consent procedures, 2) recruitment strategies, 3) patient illness beliefs and stigma experiences, and 4) specific ethical concerns relating to the project. The authors consider these discussions in terms of their contributions to instrumental and intrinsic goals of community engagement.SummaryThe CAB gave valuable input on the consent processes and materials, recruitment strategies and suggested ways of minimizing the potential for stigma and discrimination. All of these contributions were of an instrumental nature, and helped improve the way in which the research took place. In addition, and perhaps more importantly, the CAB made a unique and important contribution relating to intrinsic functions such as promoting the respect and dignity of research participants and their community. This was particularly evident in ensuring sensitivity and respect of the community’s traditional beliefs about schizophrenia and its treatment, and in this way promoting a respectful relationship between the research team and the participants. (shrink)

We investigated the ethical decision-making processes and intentions of 151 military personnel responding to 1 of 2 ethical scenarios drawn from the deployment experiences of military commanders. For each scenario, option choice and perspective affected decision-making processes. Differences were also found between the 2 scenarios. Results add to the emerging literature concerning operational ethical conflicts and highlight the complexity and challenge that often accompanies operational ethics.

This article considers Beauvoir’s gesture towards fraternité at the end of The Second Sex (1949) by focusing on her fleeting characterisation of this future as ‘an androgynous world’. Generally, either Beauvoir’s call for fraternité is dismissed as an erasure of sexual difference and is thus seen to be politically bankrupt, or fraternité is understood to realise sexual difference. This latter reading suggests that androgyny plays no role in Beauvoir’s solution to women’s oppression, while the other view often sees it as (...) one effect of fraternité. This article takes a different position by arguing that Beauvoir affirms sexual difference and commits to an androgynous future. The article argues that androgyny is an affective mood that is constitutive of an openness in the field of possibility for living sexual difference. Consequently, androgyny plays not only a central role in fraternité, but also gestures to a future beyond dimorphic sexual difference. (shrink)

Recent judicial rulings and changes in federal and state legislation have given for-profit corporations a growing list of rights and constitutional protections, including the right to practice religion free from many types of federal or state restriction. In this paper, we highlight the implications of these developments using Rawls’ Theory of Justice to explore the consequences of for-profit corporate religious freedom for consumers and employees. We identify preliminary principles to spark a discussion as to how expanding religious freedom for businesses (...) and fair access to goods and services can coexist in the for-profit marketplace. (shrink)

This article suggests that Simone de Beauvoir's The Second Sex offers an important contribution to a feminist phenomenology of temporality. In contrast to readings of The Second Sex that focus on the notion of “becoming” as the main claim about the relation between “woman” and time, this article suggests that Beauvoir's discussion of temporality in volume II of The Second Sex shows that Beauvoir understands the temporality of waiting, or a passive present, to be an underlying structure of women's existence (...) and subordination. Accordingly, I argue that Beauvoir does not see “woman” as a mere becoming, as that which unfolds in time, but instead understands becoming a woman to be realized as lived time. As such, Beauvoir's account shows that gender and temporality are deeply entangled, and thus she challenges the classic phenomenological account of temporality as a general, given structure of human existence. More specifically, I argue that her account shows how a particular experience of time is an underlying structure of sexual objectification, a claim that expands on the feminist phenomenological claim that a particular relation to space becomes a way in which women take up and negotiate their own subordination and objectification. (shrink)

This research examined the role of thought suppression in the formation of mental blocks. In Experiment 1, participants were asked to generate a series of creative associates for two target words after initially suppressing a word that was semantically related to one of the two target words. Participants produced fewer responses, and experienced a greater sensation of being mentally blocked, when attempting to produce associates for the target word that was semantically related to the suppressed word. In Experiment 2, participants (...) either thought about or suppressed a series of words prior to completing a word fragment completion task. Each word either corresponded exactly to one of the word fragment solutions or resembled one of the solutions but was slightly different in its orthographic properties . Participants performed most poorly on the items for which they had initially suppressed negative primes. (shrink)

The recognition of the similarities between Roman epic poetry and historiography have led to valuable studies such as Joseph’s analysis of the relationship between Lucan’s Bellum Civile and Tacitus’ Histories. Traces of Lucan’s Bellum Civile can also be observed in Tacitus’ Annals 1 and 2, causing the beginning of Tiberius’ reign to look like a civil war in the making. The charismatic Germanicus sits with a supportive army on the northern frontier, much like Caesar, causing fear for Tiberius at Rome. (...) Germanicus denies his chance to become the next Caesar and march on the city, but he exhibits other similarities with Lucan’s Caesar, including an association with Alexander the Great. Although at some points Germanicus seems to be repeating the past and reliving episodes experienced by Caesar in Bellum Civile, he prevents himself from fully realizing a Caesarian fate and becoming Lucan’s bad tyrant. The similar images, events, and themes presented by both authors create messages that reflect experiences from the authors’ own lives during dangerous times. (shrink)

The scientific study of consciousness emerged as an organized field of research only a few decades ago. As empirical results have begun to enhance our understanding of consciousness, it is important to find out whether other factors, such as funding for consciousness research and status of consciousness scientists, provide a suitable environment for the field to grow and develop sustainably. We conducted an online survey on people’s views regarding various aspects of the scientific study of consciousness as a field of (...) research. 249 participants completed the survey, among which 80% were in academia, and around 40% were experts in consciousness research. Topics covered include the progress made by the field, funding for consciousness research, job opportunities for consciousness researchers, and the scientific rigor of the work done by researchers in the field. The majority of respondents (78%) indicated that scientific research on consciousness has been making progress. However, most participants perceived obtaining funding and getting a job in the field of consciousness research as more difficult than in other subfields of neuroscience. Overall, work done in consciousness research was perceived to be less rigorous than other neuroscience subfields, but this perceived lack of rigor was not related to the perceived difficulty in finding jobs and obtaining funding. Lastly, we found that, overall, the global workspace theory was perceived to be the most promising (around 28%), while most non-expert researchers (around 22% of non-experts) found the integrated information theory (IIT) most promising. We believe the survey results provide an interesting picture of current opinions from scientists and researchers about the progresses made and the challenges faced by consciousness research as an independent field. They will inspire collective reflection on the future directions regarding funding and job opportunities for the field. (shrink)

Ethics courses are most commonly evaluated using reaction measures. However, little is known about the specific types of reaction data being collected and how these reaction data relate to improvements in trainee performance. Using a sample of 381 ethics training sessions, major reaction data categories were identified. Content and course satisfaction were the most frequently collected types of reaction criteria. Furthermore, content relevance and course satisfaction showed strong, positive relationships with performance criteria, whereas content satisfaction demonstrated a moderate, negative relationship. (...) These results and future directions for ethics training evaluation are discussed. (shrink)

To address growing concerns about academic integrity, college students (n?=?758) at honor system and non-honor system institutions were presented with eight scenarios to determine the influence of an honor system on their perceptions of and responses to academic dishonesty. Main effects for honor code status emerged. Students from traditional honor system schools considered the behaviors to be more dishonest, and were more likely to respond that they would report the incident when compared to students attending modified and non-honor system institutions. (...) Findings suggest traditional honor systems, with specific rules and regulations in place, are more effective at cultivating academic integrity among students; modified honor systems may not be as effective as previous research suggests. (shrink)

This chapter contains sections titled: I'm an Mammal, I'm a Reptile, I'm a Tree! Asanas as Earth Democracy in Practice Yogis for the Earth.

In lieu of an abstract, here is a brief excerpt of the content:Anonymous Temporality and Gender:Rereading Merleau-PontyMegan M. BurkeThis Essay Provides a Feminist reading of Merleau-Ponty’s notion of anonymity in order to show that it is a critical resource for a feminist account of gender. For Merleau-Ponty, anonymity is a structure of temporality that is prior to the cogito; it is a time that actualizes the reflective self. It gestures away from ontological commitments rooted in presence and calls attention to (...) how senses inform and actualize one’s reflective experience, which illuminates how it is that certain habits become sedimented or deeply rooted into the structure of one’s lived experience. As such, anonymity provides a useful framework for understanding how and in what ways gender normativity is taken up and resisted in experience. Yet feminist readings of Merleau-Ponty and anonymity are divided. On the one hand, there is a strong criticism of his work in general and anonymity in particular and, on the other hand, there is an effort to recuperate aspects of his project, including anonymity. Four examples can help frame this disparate feminist reception of his work:1. Merleau-Ponty neglects sexual difference. For example, Elizabeth Grosz suggests, “Merleau-Ponty leaves out—indeed, is unable to address—the questions of sexual difference, the question of what kind of human body he is discussing, what kind of perceptual functions, and what kind of sexual desire result from the sexual morphology and particularity of the subject” (Grosz 1994, 10). [End Page 138]2. Anonymity neglects sexual difference. Shannon Sullivan is representative of this point, claiming, “Merleau-Ponty’s notion of the anonymous or impersonal body … leads one to overlook” difference; “Merleau-Ponty fails to realize” difference; “He is wrong” (Sullivan 2001, 71).3. Anonymity illuminates sexual difference. For Silvia Stoller “[W]ith the help of Merleau-Ponty … sexual difference presupposes an anonymous sexuality which underlies gender identifications,” making anonymity important to a phenomenological account of sexual difference (Stoller 2013).4. Merleau-Ponty’s account of embodied subjectivity provides insight into the lived experience of femininity. Feminist analyses of female body comportment, such as those of Iris Marion Young and Sandra Bartky, suggest that gender is a process of sedimentation (Young 1990; Bartky 1990). More specifically, they suggest gender becomes a lived experience through the repetition of particular behaviors and actions such that they become a deeply habituated part of one’s being in the world.While the feminist criticisms of Merleau-Ponty are important insofar as they caution against the acceptance of universal claims about existence, they also overlook anonymity’s relationship to time. Given that Merleau-Ponty’s characterization of anonymity is temporal through and through, this oversight is problematic. Without an account of anonymity as a kind of temporality, we miss the value of anonymity and the further insight that can be drawn from it in relation to gender. In what follows, then, I propose a solution to the disparate reception of his work. I suggest that reading anonymity as a structure of temporality illuminates how gender is taken up in lived experience. And, I suggest that anonymity can provide a strong account of gender normativity when one understands the parallels between sedimentation and anonymity with respect to temporality. By showing the strong connection between sedimentation and anonymous temporality, I suggest that it is ontologically and politically helpful to understand gender as a lived time.In the first section of this paper, I will address the main criticisms of anonymity provided by Shannon Sullivan and Luce Irigaray, while also paying attention to those from Elizabeth Grosz, Judith Butler, and Beata Stawarska. For Sullivan, Grosz, and Butler, Merleau-Ponty’s anonymous body is a neutral body, a body that fails to account for gender differences. Irigaray and Stawarska suggest that anonymity is the mark of patriarchy, making ethical and ontological solipsism fundamental to Merleau-Ponty’s work. In each of these cases, anonymity provides nothing useful for and is, in fact, a detriment to feminist projects.In the second section of this paper, I turn to Stoller’s positive reading of anonymity. For Stoller, anonymity is a political and ethical resource that challenges gender norms because it can allow for transformation in... (shrink)

In their target article, Conley et al. (2023) appropriately highlight the ongoing conceptual and practical opacity of public engagement (PE) in the translation of human gene editing (HGE) (Conley e...

Driving is central to adult independence and autonomy; yet most autistic young adults do not acquire driver’s licenses. It is important to understand barriers to achieving this milestone for autistic adults. Differences in negative affect and emotion dysregulation associated with autism may interfere with managing difficult driving situations. The current study compared perceived driving difficulty, emotion dysregulation, and negative affect in emerging drivers with and without autistic traits, and investigated how emotion dysregulation and negative affect relate to perceived DD. We (...) expected greater perceived DD, emotion dysregulation, and negative affect in participants with AT and a positive correlation of perceived DD with both emotion dysregulation and negative affect in the whole sample. Thirty-seven adolescents and young adults self-reported perceived DD in 15 scenarios and completed the Difficulty in Emotion Dysregulation Scale and the Depression, Anxiety, and Stress Scale. Autistic participants scored significantly higher on mean perceived DD, DERS Impulse subscale, DASS total and DASS Stress subscale scores. Perceived DD positively correlated with the DERS and DASS total scores, all DASS subscales, and DERS Nonacceptance, Goals, and Impulse subscales across the whole sample. The findings highlight the roles of emotion dysregulation and negative affect in perceived DD in emerging drivers with AT. In particular, emotional stress and impulsivity may map onto mechanisms of over-reactivity to negative affect and explain why autistic people perceive particular situations as difficult when driving. Implications and directions for future research are discussed. (shrink)

This qualitative study describes the lived experience of physicians who work in communities that have experienced a public mass shooting. Semi-structured interviews were conducted with seventeen physicians involved in eight separate mass casualty shooting incidents in the United States. Four major themes emerged from constant comparative analysis: The psychological toll on physicians: “I wonder if I'm broken”; the importance of and need for mass casualty shooting preparedness: “[We need to] recognize this as a public health concern and train physicians to (...) manage it”; massive media attention: “The media onslaught was unbelievable”; and commitment to advocacy for a public health approach to firearm violence: “I want to do whatever I can to prevent some of these terrible events.”. (shrink)

Positive emotions are highly valued and frequently sought. Beyond just being pleasant, however, positive emotions may also lead to long-term benefits in important domains, including work, physical health, and interpersonal relationships. Research thus far has focused on the broader functions of positive emotions. According to the broaden-and-build theory, positive emotions expand people’s thought–action repertoires and allow them to build psychological, intellectual, and social resources. New evidence suggests that positive emotions—particularly gratitude—may also play a role in motivating individuals to engage in (...) positive behaviors leading to self-improvement. We propose and offer supportive evidence that expressing gratitude leads people to muster effort to improve themselves via increases in connectedness, elevation, humility, and specific negative states including indebtedness. (shrink)

This is the first article in a two-part series describing subject and family perspectives from the central thalamic deep brain stimulation for the treatment of traumatic brain injury using the Medtronic PC + S first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury, with subjects who were deemed capable of providing voluntary informed consent. In this article, we report on interviews conducted prior to surgery wherein we asked participants about their experiences recovering from (...) brain injury and their perspectives on study enrollment and participation. We asked how risks and benefits were weighed, what their expectations and fears were, and how decisions were reached about trial participation. We found that informed consent and enrollment decisions are fraught. Subjects and families were often split, with subjects more focused on putative benefits and families concerned about incremental risk. Both subjects and families viewed brain injury as disruptive to personal identity and relationships. As decisions were made about study enrollment, families struggled with recognizing the re-emergent agency of subjects and ceding decision-making authority to subjects who had previously been dependent upon them for protection and guidance. Subjects and family members reported a hope for the relief of cognitive disabilities, improved quality of life, normalization of interpersonal interactions, and a return to work or school as reasons for study participation, along with altruism and a desire to advance science. Despite these aspirations, both subjects and families appreciated the risks of the intervention and did not suffer from a therapeutic misconception. A second essay to be published in the next issue of Cambridge Quarterly of Healthcare Ethics—Clinical Neuroethics will describe interviews conducted after surgery, the effects of cognitive restoration for subjects, families, and challenges presented to the social structures they will call upon to support them through recovery. This subsequent article will be available online prior to its formal publication in October 2023. (shrink)

The emergence of the “4th Industrial Revolution,” i.e. the convergence of artificial intelligence, the Internet of Things, advanced materials, and bioengineering technologies, could accelerate socioeconomic insecurities and anxieties or provide beneficial alternatives to the status quo. In the post-Covid-19 era, the entities that are best positioned to capitalize on these innovations are large firms, which use digital platforms and big data to orchestrate vast ecosystems of users and extract market share across industry sectors. Nonetheless, these technologies also have the potential (...) to democratize ownership, broaden political-economic participation, and reduce environmental harms. We articulate the potential sociotechnical pathways in this high-stakes crossroads by analyzing cellular agriculture, an exemplary 4th Industrial Revolution technology that synergizes computer science, biopharma, tissue engineering, and food science to grow cultured meat, dairy, and egg products from cultured cells and/or genetically modified yeast. Our exploration of this space involved multi-sited ethnographic research in both the cellular agriculture community and alternative economic organizations devoted to open source licensing, member-owned cooperatives, social financing, and platform business models. Upon discussing how these latter approaches could potentially facilitate alternative sociotechnical pathways in cellular agriculture, we reflect upon the broader implications of this work with respect to the 4th Industrial Revolution and the enduring need for public policy reform. (shrink)

This is the second paper in a two-part series describing subject and family perspectives from the CENTURY-S (CENtral Thalamic Deep Brain Stimulation for the Treatment of Traumatic Brain InjURY-Safety) first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury (msTBI). To participate, subjects were independently assessed to formally establish decision-making capacity to provide voluntary informed consent. Here, we report on post-operative interviews conducted after a successful trial of thalamic stimulation. All five msTBI subjects met (...) a pre-selected primary endpoint of at least a 10% improvement in completion time on Trail-Making-Test Part B, a marker of executive function. We describe narrative responses of subjects and family members, refracted against that success. Interviews following surgery and the stimulation trial revealed the challenge of adaptation to improvements in cognitive function and emotional regulation as well as altered (and restored) relationships and family dynamics. These improvements exposed barriers to social reintegration made relevant by recoveries once thought inconceivable. The study’s success sparked concerns about post-trial access to implanted devices, financing of device maintenance, battery replacement, and on-going care. Most subjects and families identified the need for supportive counseling to adapt to the new trajectory of their lives. (shrink)

People may exhibit two kinds of modifications when demonstrating action for others: modifications to facilitate bottom‐up, or sensory‐based processing; and modifications to facilitate top‐down, or knowledge‐based processing. The current study examined actors' production of such modifications in action demonstrations for audiences that differed in their capacity for intentional reasoning. Actors' demonstrations of complex actions for a non‐anthropomorphic computer system and for people (adult and toddler) were compared. Evidence was found for greater highlighting of top‐down modifications in the demonstrations for the (...) human audiences versus the computer audience. Conversely, participants highlighted simple perceptual modifications for the computer audience, producing more punctuated and wider ranging motions. This study suggests that people consider differences in their audiences when demonstrating action. (shrink)

We are grateful to Friesen and colleagues for drawing attention to the tension between the protection of populations that may experience vulnerability with their inclusion in research (Friesen et a...

: In this brief commentary, we reflect on the recent study by Siminoff, Burant, and Youngner of public attitudes toward "brain death" and organ donation, focusing on the implications of their findings for the rules governing from whom organs can be obtained. Although the data suggest that many seem to view "brain death" as "as good as dead" rather than "dead" (calling the dead donor rule into question), we find that the study most clearly demonstrates that understanding an individual's definition (...) of death is neither a straightforward task nor a good predictor of views about donation. Reflecting on the implications for ongoing debates over the dead donor rule, we suggest that perhaps it is not a change in policy that is warranted, but rather a change in the priorities that have garnered such intense focus on this issue within the field of bioethics. (shrink)

Humans routinely modify their walking speed to adapt to functional goals and physical demands. However, damage to the central nervous system often results in abnormal modulation of walking speed and increased risk of falls. There is considerable interest in treatment modalities that can provide safe and salient training opportunities, feedback about walking performance, and that may augment less reliable sensory feedback within the CNS after injury or disease. Fully immersive virtual reality technologies show benefits in boosting training-related gains in walking (...) performance; however, they lack views of the real world that may limit functional carryover. Augmented reality and mixed reality head-mount displays provide partially immersive environments to extend the virtual reality benefits of interacting with virtual objects but within an unobstructed view of the real world. Despite this potential advantage, the feasibility of using MR-HMD visual feedback to promote goal-directed changes in overground walking speed remains unclear. Thus, we developed and evaluated a novel mixed reality application using the Microsoft HoloLens MR-HMD that provided real-time walking speed targets and augmented visual feedback during overground walking. We tested the application in a group of adults not living with disability and examined if they could use the targets and visual feedback to walk at 85%, 100%, and 115% of each individual’s self-selected speed. We examined whether individuals were able to meet each target gait speed and explored differences in accuracy across repeated trials and at the different speeds. Additionally, given the importance of task-specificity to therapeutic interventions, we examined if walking speed adjustment strategies were consistent with those observed during usual overground walking, and if walking with the MR-HMD resulted in increased variability in gait parameters. Overall, participants matched their overground walking speed to the target speed of the MR-HMD visual feedback conditions. The percent inaccuracy was approximately 5% across all speed matching conditions and remained consistent across walking trials after the first overall walking trial. Walking with the MR-HMD did not result in more variability in walking speed, however, we observed more variability in stride length and time when walking with feedback from the MR-HMD compared to walking without feedback. The findings offer support for mixed reality-based visual feedback as a method to provoke goal-specific changes in overground walking behavior. Further studies are necessary to determine the clinical safety and efficacy of this MR-HMD technology to provide extrinsic sensory feedback in combination with traditional treatments in rehabilitation. (shrink)