A multiracial, socioeconomically diverse sample of 45 lesbians describe power relations in both satisfactory and problematic health care encounters with physicians. Whether doctors act in solidarity or dominate them is pivotal to lesbians' health care experiences. Solidarity means compassionate competence, empowering information exchange, and negotiated action. Domination takes form in the withholding of information, doomsaying, defensive dismissals, sexist comments, body sculpting, reproductive regulation, and bodily transgression.

Sex determination in most organisms involves a simple binary fate choice between male or female development; the outcome of this decision has profound effects on organismal biology, biochemistry and behaviour. In the nematode C. elegans, there is also a binary choice, either male or hermaphrodite. In C. elegans, distinct genetic pathways control somatic and germline sexual cell fate. Both pathways share a common set of globally acting regulatory genes; however, germline-specific regulatory genes also participate in the decision to make male (...) or female gametes. The determination of sexual fate in the germline of the facultative hermaphrodite poses a special problem, because first sperm then oocytes are produced. It has emerged that additional layers of post-transcriptional regulation have been imposed to modulate the activities of the global sex-determining genes, tra-2 and fem-3; the balance between these activities is crucial in controlling sexual cell fate in the hermaphrodite germline. BioEssays 23:596–604, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

Offering a format that is significantly different than that offered by other books, Ethical Health Care beings by asking what is meant by health and how it is achieved. The book then proceeds to explore with care and context the nature of the relationship between patients and clinicians, health care providers and the societies in which they inhabit, and finally the relationship between the health care enterprise and the international community. By emphasizing the ethical issues that arise in the broad (...) quest to foster human health, and appreciating that health is not primarily a function of medical interventions, Ethical Health Care introduces students to problems such as the international distribution of pharmaceuticals and the dangers of reemerging infections. To a far greater extent than is done traditionally, Ethical Health Care provides an interdisciplinary perspective to bioethics, relying heavily upon the teachings of economics, law, and public health. (shrink)

Traditionally, developmental psychology has been characterized by two approaches, one predominantly social and the other, cognitive. Despite this separatism, develop-mentalists have expressed the need for a better understanding of how these two facets of the person interact - a need for a better account of development within the person as a whole. However, such an integration has been difficult given the incompatibility of underlying assumptions guiding these two areas of inquiry. James Mark Baldwin's integration of social and cognitive development into (...) one theory highlights the utility of historical analyses for further progress in the field. In this paper, Baldwin's dialectical theory of personal growth is placed in historical context, highlighting similarities and differences between his approach and that taken by Piaget, and the legacy of his theory in current theory and research. The importance of self, the development of knowledge in the context of social relationships and the function of imitation are emphasized. (shrink)

This landmark volume articulates and develops the argument that new directions in sociocultural theory are needed in order to address important issues of identity, agency, and power that are central to understanding literacy research and literacy learning as social and cultural practices. With an overarching focus on the research process as it relates to sociocultural research, the book is organized around two themes: conceptual frameworks and knowledge sources. *Part I, “Rethinking Conceptual Frameworks,” offers new theoretical lenses for reconsidering key concepts (...) traditionally associated with sociocultural theory, such as activity, history, community, and the ways they are conceptualized and under-conceptualized within sociocultural theory. *Part II, “Rethinking Knowledge and Representation,” considers the tensions and possibilities related to how research knowledge is produced, represented, and disseminated or shared—challenging the locus of authority in research relationships, asking who is authorized to be a legitimate knowledge source, for what purposes, and for which audiences or stakeholders. Employing the lens of “critical sociocultural research,” this book focuses on the central role of language and identity in learning and literacy practices. It is intended for scholars, researchers, and graduate students in literacy education, social and cultural psychology, social foundations of education, educational anthropology, curriculum theory, and qualitative research in education. (shrink)

Selected as Outstanding Academic Book by Choice magazine.

Gap junction intercellular communication channels permit the exchange of small regulatory molecules and ions between neighbouring cells and coordinate cellular activity in diverse tissue and organ systems. These channels have short half‐lives and complex assembly and degradation pathways. Much of the recent work elucidating gap junction biogenesis has featured the use of connexins (Cx), the constituent proteins of gap junctions, tagged with reporter proteins such as Green Fluorescent Protein (GFP) and has illuminated the dynamics of channel assembly in live cells (...) by high‐resolution time‐lapse microscopy. With some studies, however, there are potential short‐comings associated with the GFP chimeric protein technologies. A recent report by Gaietta et al., has highlighted the use of recombinant proteins with tetracysteine tags attached to the carboxyl terminus of Cx43, which differentially labels ‘old’ and ‘new’ connexins thus opening up new avenues for studying temporal and spatial localisation of proteins and in situ trafficking events.1 BioEssays 24:876–880, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

BackgroundResponsive neurostimulation has been utilized as a treatment for intractable epilepsy. The RNS System delivers stimulation in response to detected abnormal activity, via leads covering the seizure foci, in response to detections of predefined epileptiform activity with the goal of decreasing seizure frequency and severity. While thalamic leads are often implanted in combination with cortical strip leads, implantation and stimulation with bilateral thalamic leads alone is less common, and the ability to detect electrographic seizures using RNS System thalamic leads is (...) uncertain.ObjectiveThe present study retrospectively evaluated fourteen patients with RNS System depth leads implanted in the thalamus, with or without concomitant implantation of cortical strip leads, to determine the ability to detect electrographic seizures in the thalamus. Detailed patient presentations and lead trajectories were reviewed alongside electroencephalographic analyses.ResultsAnterior nucleus thalamic leads, whether bilateral or unilateral and combined with a cortical strip lead, successfully detected and terminated epileptiform activity, as demonstrated by Cases 2 and 3. Similarly, bilateral centromedian thalamic leads or a combination of one centromedian thalamic alongside a cortical strip lead also demonstrated the ability to detect electrographic seizures as seen in Cases 6 and 9. Bilateral pulvinar leads likewise produced reliable seizure detection in Patient 14. Detections of electrographic seizures in thalamic nuclei did not appear to be affected by whether the patient was pediatric or adult at the time of RNS System implantation. Sole thalamic leads paralleled the combination of thalamic and cortical strip leads in terms of preventing the propagation of electrographic seizures.ConclusionThalamic nuclei present a promising target for detection and stimulation via the RNS System for seizures with multifocal or generalized onsets. These areas provide a modifiable, reversible therapeutic option for patients who are not candidates for surgical resection or ablation. (shrink)

State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious (...) wrongdoing by physicians. (shrink)

Buddhist philosophy asserts that human suffering is caused by ignorance regarding the true nature of reality. According to this, perceptions and thoughts are largely fabrications of our own minds, based on conditioned tendencies which often involve problematic fears, aversions, compulsions, etc. In Buddhist psychology, these tendencies reside in a portion of mind known as Store consciousness. Here, I suggest a correspondence between this Buddhist Store consciousness and the neuroscientific idea of stored synaptic weights. These weights are strong synaptic connections built (...) in through experience. Buddhist philosophy claims that humans can find relief from suffering through a process in which the Store consciousness is transformed. Here, I argue that this Buddhist 'transformation at the base' corresponds to a loosening of the learned synaptic connections. I will argue that Buddhist meditation practices create conditions in the brain which are optimal for diminishing the strength of our conditioned perceptual and behavioural tendencies. (shrink)

_Employment and Employee Rights_ addresses the issue of rights in the workplace. Although much of the literature in this field focuses on employee rights, this volume considers the issue from the perspective of both employees and employers. Considers the rights of both employees and employers. Discusses the moral and legal landscape and traditional assumptions about right in employment. Investigates arguments for guaranteeing rights, particularly for employees, which are derived from relational, developmental, and economic bases. Explores new dimensions of employment including (...) a model that incorporates growing workplace diversity, builds upon our understanding of the legal landscape, and expands upon our justifications for recognizing and protecting rights. (shrink)

_Management Ethics_ is a highly accessible and concise introduction to issues and key problems in the area of management ethics. Examines the obligations that managers have to their various stakeholders: employees, customers, shareholders, and the community Looks at topics at the cutting edge of business ethics, including the ethics of supply chain management, as well as dealing with the press and non governmental agencies Considers the concepts of sustainability and triple bottom line accounting Includes chapters on stimulating the manager's moral (...) imagination and promoting a unique theory of ethical leadership. (shrink)

Although the right to health is universal, many nations that honor it fail to do so in the case of non-citizen immigrants. In this essay, we argue that the reasons typically given for not extending the right to health to immigrants are without merit and that there are good reasons for nations to protect, respect and fulfill the health right of all immigrants. Contrary to the standard view, we argue that health can be understood as a global public good. Two (...) important points follow: because health is non-excludable and non-rivalrous, it is in the health interests of nations to respect, protect and fulfill immigrants’ right to health. Furthermore, meeting the health needs of immigrants is an important way for receiving nations to meet the duties that may be generated by the benefits they incur as a result of health’s global public good dimension, thus ensuring that receiving nations are not free riders. We then argue that because citizens and immigrants dwell together, nations have duties of solidarity to immigrants with respect to health. Using the insights of social psychology, we show that solidarity among diverse people is both a reasonable expectation and a morally desirable one. (shrink)

Background: Despite the expansion of ethics consultation services, questions remain about the aims of clinical ethics consultation, its methods and the expertise of those who provide such services.Objective: To describe physicians’ expectations regarding the training and skills necessary for ethics consultants to contribute effectively to the care of patients in intensive care unit .Design: Mailed survey.Participants: Physicians responsible for the care of at least 10 patients in ICU over a 6-month period at a 921-bed private teaching hospital with an established (...) ethics consultation service. 69 of 92 eligible physicians responded.Measurements: Importance of specialised knowledge and skills for ethics consultants contributing to the care of patients in ICU; need for advanced disciplinary training; expectations regarding formal-training programmes for ethics consultants.Results: Expertise in ethics was described most often as important for ethics consultants taking part in the care of patients in ICU, compared with expertise in law , religious traditions , medicine and conflict-mediation techniques . When asked about the formal training consultants should possess, however, physicians involved in the care of patients in ICU most often identified advanced medical training as important.Conclusions: Although many physicians caring for patients in ICU believe ethics consultants must possess non-medical expertise in ethics and law if they are to contribute effectively to patient care, these physicians place a very high value on medical training as well, suggesting a “medicine plus one” view of the training of an ideal ethics consultant. As ethics consultation services expand, clear expectations regarding the training of ethics consultants should be established. (shrink)