In February 2010, the American Psychiatric Association (APA) launched their DSM-5 website with details about the development of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The APA invited “the general public” to review the draft diagnostic criteria and provide written comments and suggestions. This revision marks the first time the APA has solicited public review of their diagnostic manual. This article analyzes reported speech on the DSM-5 draft diagnostic criteria for the classification Posttraumatic Stress (...) Disorder. It demonstrates how textual standardization facilitates the cultural portability of the DSM-5 diagnostic criteria such that a community of speakers beyond the borders of the APA come to be seen as exemplary speakers, writers, and revisers of the professional style. Furthermore, analysis shows how co-authoring practices recontextualize the “voice” and persona of putative patient reported speech on Criterion D2. As a consequence of textual standardization, spoken discourse becomes recontextualized as the product of scientific inquiry and the organization of psychiatric knowledge. (shrink)

Research has shown that a majority of employed women experience sexual harassment and suffer negative repercussions because of it; yet only a minority of these women label their experiences “sexual harassment.” To investigate how people identify sexual harassment, in-depth interviews were conducted with 18 waitpeople in restaurants in Austin, Texas. Most respondents worked in highly sexualized work environments. Respondents labeled sexual advances as sexual harassment only in four specific contexts: when perpetrated by someone who exploited their powerful position for personal (...) sexual gain; when the perpetrator was of a different race/ethnicity than the victim—typically a minority man harassing a white woman; when the perpetrator was of a different sexual orientation than the victim—typically a gay man harassing a straight man; or when violence or the threat of violence was used. The authors argue that the hegemonic norms of acceptable sexual activity privilege heterosexual relationships, legitimize institutionalized forms of sexual exploitation in the workplace, and may protect assailants of the same race and sexual orientation as their victims from charges of sexual harassment. (shrink)

Health care professionals use strategies during the physical examination to stay in control of their feelings, the behaviors of their patients, and to avoid allegations of sexual misconduct. To investigate how health care practitioners desexualize physical exams, the authors conducted 70 in-depth interviews with physicians and nurses. Three desexualizing strategies were general ones, used by both male and female health care providers, and were employed regardless of the characteristics of the patients: engaging in conversation and nonsexual joking, meeting the patient (...) clothed before the exam, and using medical rather than colloquial terms. Six strategies were used only in specific contexts or were used primarily by men or women. These gendered strategies include using a chaperone, objectifying the patient, empathizing with the patient, joking about sex, threatening the patient, and looking professional. The authors conclude that desexualizing the exam is gendered and, in some contexts, sexualized. Using certain strategies bolsters stereotypes about gender and heterosexual relationships in the hospital. (shrink)

The proto-code of ethics and conduct for European nurse directors was developed as a strategic and dynamic document for nurse managers in Europe. It invites critical dialogue, reflective thinking about different situations, and the development of specific codes of ethics and conduct by nursing associations in different countries. The term proto-code is used for this document so that specifically country-orientated or organization-based and practical codes can be developed from it to guide professionals in more particular or situation-explicit reflection and values. (...) The proto-code of ethics and conduct for European nurse directors was designed and developed by the European Nurse Directors Association’s (ENDA) advisory team. This article gives short explanations of the code’ s preamble and two main parts: Nurse directors' ethical basis, and Principles of professional practice, which is divided into six specific points: competence, care, safety, staff, life-long learning and multi-sectorial working. (shrink)

Engaging citizens with digital technology to co-create data, information and knowledge has widely become an important strategy for informing the policy response to COVID-19 and the ‘infodemic’ of misinformation in cyberspace. This move towards digital citizen participation aligns well with the United Nations’ agenda to encourage the use of digital tools to enable data-driven, direct democracy. From data capture to information generation, and knowledge co-creation, every stage of the data lifecycle bears important considerations to inform policy and practice. Drawing on (...) evidence of participatory policy and practice during COVID-19, we outline a framework for citizen ‘e-participation’ in knowledge co-creation across every stage of the policy cycle. We explore how coupling the generation of information with that of social capital can provide opportunities to collectively build trust in institutions, accelerate recovery and facilitate the ‘e-society’. We outline the key aspects of realising this vision of data-driven direct democracy by discussing several examples. Sustaining participatory knowledge co-creation beyond COVID-19 requires that local organisations and institutions incorporate adaptive learning mechanisms into their operational and governance structures, their integrated service models, as well as employing emerging social innovations. (shrink)

The results of an exploratory study examining the role of trust in stakeholder satisfaction are reported. Customers, stockholders, and employees of financial institutions were surveyed to identify management behaviors that lead to stakeholder satisfaction. The factors critical to satisfaction across stakeholder groups are the timeliness of communication, the honesty and completeness of the information and the empathy and equity of treatment by management.

A comprehensive and systematic reconstruction of the philosophy of Charles S. Peirce, perhaps America's most far-ranging and original philosopher, which reveals the unity of his complex and influential body of thought. We are still in the early stages of understanding the thought of C. S. Peirce (1839-1914). Although much good work has been done in isolated areas, relatively little considers the Peircean system as a whole. Peirce made it his life's work to construct a scientifically sophisticated and logically rigorous philosophical (...) system, culminating in a realist epistemology and a metaphysical theory ("synechism") that postulates the connectedness of all things in a universal evolutionary process. In The Continuity of Peirce's Thought, Kelly Parker shows how the principle of continuity functions in phenomenology and semeiotics, the two most novel and important of Peirce's philosophical sciences, which mediate between mathematics and metaphysics. Parker argues that Peirce's concept of continuity is the central organizing theme of the entire Peircean philosophical corpus. He explains how Peirce's unique conception of the mathematical continuum shapes the broad sweep of his thought, extending from mathematics to metaphysics and in religion. He thus provides a convenient and useful overview of Peirce's philosophical system, situating it within the history of ideas and mapping interconnections among the diverse areas of Peirce's work. This challenging yet helpful book adopts an innovative approach to achieve the ambitious goal of more fully understanding the interrelationship of all the elements in the entire corpus of Peirce's writings. Given Peirce's importance in fields ranging from philosophy to mathematics to literary and cultural studies, this new book should appeal to all who seek a fuller, unified understanding of the career and overarching contributions of Peirce, one of the key figures in the American philosophical tradition. (shrink)

In this article, we extend the well-known ‘agreeing-to-disagree’ and ‘no-trade’ results from economics and game theory to international relations. We show that two rational countries should never agree to go to war when war is inefficient and when rationality is common knowledge. We argue that this result might provide one possible explanation for the empirical finding, often referred to as the ‘democratic peace’, that modern democracies rarely go to war with one another. We propose that the informational properties of pluralistic (...) institutions (as opposed to oligarchies or dictatorships) lead to better decision-making by democracies and that democracies are therefore more likely to be the rational actors necessary for the ‘no-war’ result. We discuss empirical evidence in support of this proposition. (shrink)

Organizational ethics—defined as the alignment of an institution’s practices with its mission, vision, and values—is a growing field in health care not well characterized in empirical literature. To capture the scope and context of organizational ethics work in United States healthcare institutions, we conducted a nationwide convenience survey of ethicists regarding the scope of organizational ethics work, common challenges faced, and the organizational context in which this work is done. In this article, we report substantial variability in the structure of (...) organizational ethics programs and the settings in which it is conducted. Notable findings included disagreement about the activities that comprise organizational ethics and a lack of common metrics used to assess organizational ethics activities. A frequently cited barrier to full engagement in these activities was poor institution-wide understanding about the role and function of organizational ethics resources. These data suggest a tension in the trajectory of organizational ethics’ professionalization: while some variability is appropriate to the field’s relative youth, inadequate attention to definitions of organizational ethics practice and metrics for success can impede discussions about appropriate institutional support, leadership context, and training for practitioners. (shrink)

Hastings Center Report, Volume 52, Issue 2, Page 49-57, March‐April 2022.

Dealing with challenging topics like race and gender in the classroom can be a daunting task. Even when we mean well and try hard, we can easily make mistakes that can have serious consequences for our students, especially those in targeted or oppressed groups. Whether or not we explicitly discuss race and gender in our classes, well-meaning professors and students who believe in equality and social justice often commit racist and sexist microaggressions, which are words and actions that, generally unintentionally, (...) convey racist and sexist messages. These microaggressions have a negative impact on students, and impede their learning process. In this paper, I will explain what microaggressions are and why they happen, in order to help prevent them from occurring. I will also examine ways of effectively managing them when they do occur. (shrink)

Spatial asymmetries are an intriguing feature of directed attention. Recent observations indicate an influence of temperament upon the direction of these asymmetries. It is unknown whether this influence generalises to visual orienting behaviour. The aim of the current study was therefore to explore the relationship between temperament and measures of spatial orienting as a function of target hemifield. An exogenous cueing task was administered to 92 healthy participants. Temperament was assessed using Carver and White's (1994) Behavioural Inhibition System and Behavioural (...) Activation System (BIS/BAS) scales. Individuals with high sensitivity to punishment and low sensitivity to reward showed a leftward asymmetry of directed attention when there was no informative spatial cue provided. This asymmetry was not present when targets were preceded by spatial cues that were either valid or invalid. The findings support the notion that individual variations in temperament influence spatial asymmetries in visual orienting, but only when lateral targets are preceded by a non-directional (neutral) cue. The results are discussed in terms of hemispheric asymmetries and dopamine activity. (shrink)

This article elaborates on Putnam's ''discrete behavioral states'' model of dissociative identity disorder (Putnam, 1997) by proposing the involvement of the orbitalfrontal cortex in the development of DID and suggesting a potential neurodevelopmental mechanism responsible for the development of multiple representations of self. The proposed ''orbitalfrontal'' model integrates and elaborates on theory and research from four domains: the neurobiology of the orbitalfrontal cortex and its protective inhibitory role in the temporal organization of behavior, the development of emotion regulation, the development (...) of the self, and experience-dependent reorganizing neocortical processes. The hypothesis being proposed is that the experience-dependent maturation of the orbitalfrontal cortex in early abusive environments, characterized by discontinuity in dyadic socioaffective interactions between the infant and the caregiver, may be responsible for a pattern of lateral inhibition between conflicting subsets of self-representations which are normally integrated into a unified self. The basic idea is that the discontinuity in the early caretaking environment is manifested in the discontinuity in the organization of the developing child's self. (shrink)

Previous research has demonstrated that reversing the contrast of the eye region, which includes the eyebrows, affects the N170 ERP. To selectively assess the impact of just the eyes, the present study evaluated the N170 in response to reversing contrast polarity of just the iris and sclera in upright and inverted face stimuli. Contrast reversal of the eyes increased the amplitude of the N170 for upright faces, but not for inverted faces, suggesting that the contrast of eyes is an important (...) contributor to the N170 ERP. (shrink)

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)