This paper examines the practice implications of various state policies that provide publicly funded prenatal care to undocumented immigrants for health care workers who see undocumented patients. Data were collected through in-depth interviews with purposively sampled health care workers at safety net clinics in California, Maryland, Nebraska, and New York. Health care workers were asked about the process through which undocumented patients receive prenatal care in their health center and the ethical tensions and frustrations they encounter when providing or facilitating (...) this care under policy restrictions. Respondents discussed several professional practice norms as well as the ethical tensions they encountered when policy or institutional constraints prevented them from living up to professional norms. Using Nancy Berlinger's “workarounds” framework, this paper examines health care workers' responses to the misalignment of their professional norms and the policy restrictions in their state. These findings suggest that the prenatal policies in each state raise ethical and professional challenges for the health care workers who implement them. (shrink)

Given the potential dangers of unethical decisions in the workplace, it has become increasingly important for managers to hire, and promote into leadership positions, those who are morally inclined. Behavioral ethics research has contributed to this effort by examining an array of individual difference variables that play a role in morality. However, past research has focused mostly on direct causal effects and not so much on the processes through which different factors, especially those that are morality based, decrease unethical choices. (...) The purpose of the current research is to examine the process, which includes both subconscious and conscious decision pathways, through which moral attentiveness curbs unethical decision making at the individual level. The findings of a study employing about 200 participants and a cheating task reveal that both accurate ethical prototypes and moral awareness of the situation decreased unethical decisions, and moral attentiveness was found to be positively related to both of these constructs. In addition, having accurate ethical prototypes was found to be a partial mediator between perceptual moral attentiveness and less cheating, while moral awareness was found to be a partial mediator between reflective moral attentiveness and less cheating. The theoretical and practical implications of these findings are discussed. (shrink)

Mounting evidence suggests that endorsement of psychological continuity and the afterlife increases with age. This developmental change raises questions about the cognitive biases, social representations, and cultural input that may support afterlife beliefs. To what extent is there similarity versus diversity across cultures in how people reason about what happens after death? The objective of this study was to compare beliefs about the continuation of biological and psychological functions after death in Tanna, Vanuatu, and the United States. Children, adolescents, and (...) adults were primed with a story that contained either natural or supernatural cues. Participants were then asked whether or not different biological and psychological processes continue to function after death. We predicted that across cultures individuals would be more likely to endorse the continuation of psychological processes over biological processes and that a theistic prime would increase continuation responses regarding both types of process. Results largely supported predictions; U.S. participants provided more continuation responses for psychological than biological processes following both the theistic and non-theistic primes. Participants in Vanuatu, however, provided more continuation responses for biological than psychological processes following the theistic prime. The data provide evidence for both cultural similarity and variability in afterlife beliefs and demonstrate that individuals use both natural and supernatural explanations to interpret the same events. (shrink)

Enzymes that degrade nucleic acids are emerging as important players in the pathogenesis of inflammatory disease. This is exemplified by the recent identification of four genes that cause the childhood inflammatory disorder, Aicardi‐Goutières syndrome (AGS). This is an autosomal recessive neurological condition whose clinical and immunological features parallel those of congenital viral infection. The four AGS genes encode two nucleases: TREX1 and the hetero‐trimeric Ribonuclease H2 (RNase H2) complex. The biochemical activity of these enzymes was initially characterised 30 years ago (...) but a role in neurological inflammation was entirely unanticipated until they were found to be mutated in AGS. This has led to a hypothesis that accumulation of intracellular nucleic acids occurs as a consequence of mutation in these enzymes and triggers an inflammatory response through activation of innate immune pattern recognition receptors. ©2007 Wiley Periodicals, Inc BioEssays 30:833–842, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

Identity Economics provides an important and compelling new way to understand human behavior, revealing how our identities--and not just economic incentives--influence our decisions. In 1995, economist Rachel Kranton wrote future Nobel Prize-winner George Akerlof a letter insisting that his most recent paper was wrong. Identity, she argued, was the missing element that would help to explain why people--facing the same economic circumstances--would make different choices. This was the beginning of a fourteen-year collaboration--and of Identity Economics. The authors explain how (...) our conception of who we are and who we want to be may shape our economic lives more than any other factor, affecting how hard we work, and how we learn, spend, and save. Identity economics is a new way to understand people's decisions--at work, at school, and at home. With it, we can better appreciate why incentives like stock options work or don't; why some schools succeed and others don't; why some cities and towns don't invest in their futures--and much, much more. Identity Economics bridges a critical gap in the social sciences. It brings identity and norms to economics. People's notions of what is proper, and what is forbidden, and for whom, are fundamental to how hard they work, and how they learn, spend, and save. Thus people's identity--their conception of who they are, and of who they choose to be--may be the most important factor affecting their economic lives. And the limits placed by society on people's identity can also be crucial determinants of their economic well-being. (shrink)

Identity Economics provides an important and compelling new way to understand human behavior, revealing how our identities--and not just economic incentives--influence our decisions. In 1995, economist Rachel Kranton wrote future Nobel Prize-winner George Akerlof a letter insisting that his most recent paper was wrong. Identity, she argued, was the missing element that would help to explain why people--facing the same economic circumstances--would make different choices. This was the beginning of a fourteen-year collaboration--and of Identity Economics. The authors explain how (...) our conception of who we are and who we want to be may shape our economic lives more than any other factor, affecting how hard we work, and how we learn, spend, and save. Identity economics is a new way to understand people's decisions--at work, at school, and at home. With it, we can better appreciate why incentives like stock options work or don't; why some schools succeed and others don't; why some cities and towns don't invest in their futures--and much, much more. Identity Economics bridges a critical gap in the social sciences. It brings identity and norms to economics. People's notions of what is proper, and what is forbidden, and for whom, are fundamental to how hard they work, and how they learn, spend, and save. Thus people's identity--their conception of who they are, and of who they choose to be--may be the most important factor affecting their economic lives. And the limits placed by society on people's identity can also be crucial determinants of their economic well-being. (shrink)

Introduction: Screen-based and mobile technology has grown at an unprecedented rate. However, little is understood about whether increased screen-use affects executive functioning, the range of mental processes that aid goal attainment and facilitate the selection of appropriate behaviors. To examine this, a systematic review was conducted.Method: This systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A comprehensive literature search was conducted using Web of Science, MEDLINE, PsycINFO and Scopus databases to identify (...) articles published between 2007 and March 2020, examining the use of mobile technologies on aspects of EF in healthy adults aged 18–35 years. In total 6079 articles were screened by title, and 39 screened by full text. Eight eligible papers were identified for inclusion. Our methods were pre-registered on the PROSPERO international prospective register of systematic reviews.Results: A total of 438 participants were included across the eight studies. Five of the eight studies examined more than one EF. Five studies measured inhibition, and four studies measured decision-making. Smartphone use was negatively associated with inhibition and decision-making. Working memory performance was found to be improved by increased time engaging in video games and by refraining from smartphone use prior to bedtime. Quality assessments indicated high risk of methodological biases across the studies and a low quality of evidence for determining the relationship between technology use and executive functioning.Conclusions: This review highlights the scarcity of the literature in this area. It presents a call for rigorous and objective research to further our understanding of the impact of mobile technology on different aspects of executive function. (shrink)

Over the last century, droughts have caused more deaths internationally than any other weather- or climate-related disaster. Like other natural disasters, droughts cause significant changes in the environment that can lead to negative health outcomes. As droughts are becoming more frequent and intense with climate change, public health systems need to address impacts associated with these events. Partnering with federal and local entities, we evaluated the state of knowledge of drought and health in the United States through a National Drought (...) and Public Health Summit and a series of subsequent regional workshops. The intended outcome was to develop public health strategies for implementing activities to better support and prepare public health systems for future droughts. The information gathered from this work identified multiple policy and law options to address the public health issues associated with drought. These policy recommendations include the use of public health emergency declarations for drought events, increased usage of preparedness evaluations for drought emergencies, and engagement of drought and climate experts in state and local risk assessments. As drought events are projected to increase in frequency and magnitude with climate change, taking policy action now will help decrease the health impacts of drought and save lives. (shrink)

After Rachel E. Burke briefly introduces the essays presented with a focus on our contemporary relationship to modern subjectivity, Mieke Bal will make the case for the sense of presentness on an affective and sensuous level in Munch’s paintings and Flaubert’s writing by selecting a few topics and cases from the book Emma and Edvard Looking Sideways: Loneliness and the Cinematic, published by the Munch Museum in conjunction with the exhibition Emma & Edvard. It is this foregrounded presentness that (...) not only produces the ongoing thematic relevance of these works, but more importantly, the sense-based conceptualism that declares art and life tightly bound together. If neither artist eliminated figuration in favour of abstraction, they had a good reason for that. Art is not a representation of life, but belongs to it, illuminates it and helps us cope with it by sharpening our senses. As an example, a few paintings will clarify what I mean by the noun-qualifier “cinematic” and how that aesthetic explains the production of loneliness. (shrink)

Background Previous research on informed consent for research in psychiatric patients has centered on disorders that affect comprehension and appreciation of risks. Little has been written about consent to research in those subjects with Borderline Personality Disorder, a prevalent and disabling condition. Discussion Despite apparently intact cognition and comprehension of risks, a borderline subject may deliberately choose self-harm in order to fulfill abnormal psychological needs, or due to suicidality. Alternatively, such a subject may refuse enrollment due to transference or the (...) desire to harm him or herself. Such phenomena could be precipitated or prevented by the interpersonal dynamics of the informed consent encounter. Summary Caution should be exercised in obtaining informed consent for research from subjects with Borderline Personality Disorder. A literature review and recommendations for future research are discussed. (shrink)

Individual differences and polysemy have rich literatures in cognitive linguistics, but little is said about the prospect of individual differences in polysemy. This article reports an investigation that sought to establish whether people vary in the senses of a polysemous word that they find meaningful, and to develop a novel methodology to study polysemy. The methodology combined established tools: sentence-sorting tasks, a rarely used statistical model of inter-participant agreement, and network visualisation. Two hundred and five English-speaking participants completed one of (...) twelve sentence-sorting tasks on two occasions, separated by a delay of two months. Participants varied in how similarly they sorted the sentences as compared to other participants, and mean agreement across all 24 tasks did not meet an established threshold of acceptable agreement. Between the two test phases, inter-participant agreement varied to a significant but trivial degree. Networks generated for each dataset varied in the degree to which they captured all participants’ responses. This variation correlated with inter-participant agreement. The data collectively suggest that word senses may be subject to individual differences, as is the case in other linguistic phenomena. The methodology proved replicable and has a promise as a useful tool for studying polysemy. (shrink)

Natural and supernatural explanations are used to interpret the same events in a number of predictable and universal ways. Yet little is known about how variation in diverse cultural ecologies influences how people integrate natural and supernatural explanations. Here, we examine explanatory coexistence in three existentially arousing domains of human thought: illness, death, and human origins using qualitative data from interviews conducted in Tanna, Vanuatu. Vanuatu, a Melanesian archipelago, provides a cultural context ideal for examining variation in explanatory coexistence due (...) to the lack of industrialization and the relatively recent introduction of Christianity and Western education. We argue for the integration of interdisciplinary methodologies from cognitive science and anthropology to inform research on explanatory coexistence. (shrink)

The 21st Century Cures Act is a major act of legislation that contains numerous changes to drug and device regulation. The House of Representatives passed the Act after considerable interest group lobbying, but the bill and the key changes made during its drafting remain controversial. Using publicly disclosed records of written comments on the bill, we reviewed the key areas of lobbying activity and the compromises made in the final text. We focused on legislative provisions relating to management of the (...) National Institutes of Health, incentives for medical product development, and approval standards for new drugs and devices. By the end of the first comment period, the Committee received 118 comments. Most respondents were patient organizations, professional societies, and pharmaceutical and device companies. Overall, the majority of public comments were positive, although public health and consumer organizations were underrepresented in the number of submitted comments. As the legislative process continued, the draft bill underwent several changes relating to NIH funding, market exclusivity provisions, and scrutiny of regulatory evidentiary standards. Understanding the key statutory provisions and how they have evolved could help patients, researchers, and advocates make more informed comments on the bill and future health care legislation. (shrink)

Organisations face an increasingly competitive and uncertain global environment, after recent experience of unparalleled technological advances and political shifts. Increased dependence on Information Technology (IT) will require appropriate human resource strategies, to develop individuals who will be capable of operating successfully within new organisational structures, with reduced management layers and a requirement for teamworking.This paper presents a university-industry based partnership, revolving around a final year Group Consultancy project, in which undergraduate students work with an external client on a live problem. (...) The project involves the use ofaction research methodology, where academic ideas are applied in the ‘real’ world of business. This is described in the context of group projects, which examine thelegacy system problems faced by three multi-national organisations. (shrink)

The COVID-19 pandemic has exacerbated levels of stress and anxiety for P-12 teachers around the globe. The present study aims to understand teachers’ emotional experiences and feelings of burnout during the pandemic, and how individual or contextual factors intersect with different facets of their emotional experiences. Using a sequential explanatory mixed methods design, we collected and examined survey and interview data from teachers in the southeastern United States. The structural equation model confirmed the relationships among the following latent variables: negative (...) emotion, emotion regulation, autonomy support, burnout, and teacher enthusiasm. Qualitative findings provide further insight in the contextualized nature of these relationships and how they play out across various schools and districts. (shrink)

If funding allocation is an indicator of a field’s priorities, then the priorities of the field of bioethics are misaligned because they perpetuate injustice. Social justice mandates priority for the factors that drive systematic disadvantage, which tend not to be the areas supported by funding within academic bioethics. Current funding priorities violate social justice by overemphasizing technologies that aim to enhance the human condition without addressing underlying structural inequalities grounded in racism, and by deemphasizing areas of inquiry most frequently pursued (...) by Scholars of Color. This lack of attention to upstream determinants of health in bioethics research perpetuates a gap in the resources needed to understand the experiences of communities disproportionately experiencing poor health, which is itself a form of epistemic injustice. Both social and epistemic injustices are apparent in the impact of these funding priorities on people of color, both in the public and in the bioethics community. (shrink)

The “public charge” rule is a long-standing immigration policy that seeks to determine the likelihood that a prospective immigrant will become dependent on the government for subsistence. When the Trump administration sought to expand the criteria that would count against an applicant for permanent residency to include public benefits historically excluded from the calculation, thousands of commenters wrote to oppose or support the proposed changes. This paper explores the moral and practical reasons commenters provided for their position on the public (...) charge rule and considers the value of the public comment process for immigration, health, and social policy. (shrink)

Through engagement with key informants and review of ethical theories applicable to refugee policy, this paper examines the ethical and policy considerations that policy-level stakeholders believe should factor into setting the refugee resettlement ceiling. We find that the ceiling traditionally has been influenced by policy goals, underlying values, and practical considerations. These factors map onto several ethical approaches to resettlement. There is significant alignment between U.S. policy interests and ethical obligations toward refugees. We argue that the refugee ceiling should be (...) restored to historical norms, and that there exists a corresponding obligation to counter negative public perceptions about refugees and the costs of resettlement. (shrink)

For many young Americans, access to credit has become critical to completing a college education and embarking on a successful career path. Young people increasingly face the trade-off of taking on debt to complete college or foregoing college and taking their chances in the labor market without a college degree. These trade-offs are gendered by differences in college preparation and support and by the different labor market opportunities women and men face that affect the value of a college degree and (...) future difficulties they may face in repaying college debt. We examine these new realities by studying gender differences in the role of debt in the pivotal event of graduating from college using the 1997 cohort of the National Longitudinal Survey of Youth. In this article, we find that women and men both experience slowing and even diminishing probabilities of graduating when carrying high levels of debt, but that men drop out at lower levels of debt than do women. We conclude by theorizing that high levels of debt are one of the mechanisms that sort women and men into different positions in the social stratification system. (shrink)

Examining variation in reasoning about sustainability between diverse populations provides unique insight into how group norms surrounding resource conservation develop. Cultural institutions, such as religious organizations and formal schools, can mobilize communities to solve collective challenges associated with resource depletion. This study examined conservation beliefs in a Western industrialized (Austin, Texas, USA) and a non‐Western, subsistence agricultural community (Tanna, Vanuatu) among children, adolescents, and adults (N = 171; n = 58 7–12‐year‐olds, n = 53 13–17‐year‐olds, and n = 60 18–68‐year‐olds). (...) Participants endorsed or rejected four types of justifications for engaging in land and animal conservation: sustainability, moral, religious, or permissible. In both populations, participants endorsed sustainability justifications most frequently. Religious justifications increased with age in Tanna and decreased with age in Austin. Tannese participants were also more likely to endorse multiple justifications for conservation than Austin participants. Data across all justification types show a main effect of age in both communities; endorsement of conservation decreased with age in Austin, but increased with age in Tanna. Across age groups, participants were more likely to endorse the conservation of animals than land in Austin, yet equally as likely to endorse the conservation of land and animals in Tanna. Overall, these results reveal similarities and differences in the beliefs that support the conservation of natural resources across populations. (shrink)

The Netherlands does not have any specific legislation pertaining to human biological materials and data collection by biobanks. Instead, these issues are governed by a patchwork of laws, codes of practices, and other ethical instruments, where special emphasis is given to the right to privacy and self-determination. While draft legislation for biobanking was scheduled to enter into force in 2007, as of mid-2015 such legislation was still under consideration, with the intent that it would focus particularly on individual self-determination, the (...) interests of research, the use of bodily materials collected by biobanks for criminal law purposes, and dilemmas around results that are clinically relevant for biobank participants. Under the current framework, the amount of privacy protection afforded to data is linked to its level of identifiability. International sharing of personal data to non-EU/European Economic Area countries is allowed if these countries provide adequate protection. (shrink)

When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (n (...) = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p. (shrink)

The possible integration of genomic sequencing (including whole‐genome and whole‐exome sequencing) into the three contexts addressed in this special report—state‐mandated screening programs, clinical care, and direct‐to‐consumer services—raises related but distinct legal issues. This essay will outline the legal issues surrounding the integration of genomic sequencing into state newborn screening programs, parental rights to refuse and access sequencing for their newborns in clinical and direct‐to‐consumer care, and privacy‐related legal issues attending the use of sequencing in newborns.

Dorfman et al. (2024) make a significant empirical contribution to a growing body of literature pertaining to issues of futility in psychiatry. The authors acknowledge that their survey methodologi...

Perceived control in contingency learning is linked to psychological wellbeing with low levels of perceived control thought to be a cause or consequence of depression and high levels of control considered to be the hallmark of mental healthiness. However, it is not clear whether this is a universal phenomenon or whether the value that people ascribe to control influences these relationships. Here we hypothesize that values affect learning about control contingencies and influence the relationship between perceived control and symptoms of (...) mood disorders. We tested these hypotheses with European university samples who were categorized as endorsing (or not) values relevant to control - individualist and collectivist values. Three online experimental contingency learning studies (N1 = 127, N2 = 324, N3 = 272) were carried out. Evidence suggested that individualist values influenced basic learning processes via an effect on learning about the context in which events took place. Participants who endorsed individualist values made control judgments that were more in line with an elemental associative learning model, whilst those who were ambivalent about individualist values made judgments that were more consistent with a configural process. High levels of perceived control and individualist values were directly associated with increased euphoric symptoms of bipolar disorder, and such values completely mediated the relation between perceived control and symptoms. The effect of low perceived control on depression was moderated by collectivist values. Anxiety created by dissonance between values and task may be a catalyst for developing mood symptoms. Conclusions are that values play a significant intermediary role in the relation between perceived control and symptoms of mood disturbance. (shrink)