This study expands the application of deonance theory into organizations’ upper echelons by examining how CEOs imprinted with a sense of duty can influence managerial decision-making. We hypothesize an imprint of bounded autonomy, an ought-force that constrains their decision-making and understanding of behavioral freedom, influences duty-bound CEOs to self-report errors in past financial reporting. We test deonance theory propositions of instrumentality for behavioral expansion, namely loss avoidance and gain attainment, related to institutional ownership concentration and CEO equity ownership. We use (...) CEOs that are graduates of U.S. service academies as a proxy for duty-bound executives and find firms they lead are more likely to issue a financial restatement to correct a previous reporting error. This finding is robust to alternate explanations such as being error-prone, earnings management, auditor oversight, and risk behaviors. We also find evidence that deonance may be subject to behavioral expansion. The likelihood of issuing a restatement decreases as institutional ownership concentration and CEO equity ownership increases. This study shows imprinted deonance within the C-suite influences important organizational outcomes. (shrink)

Corporate governance scholarship focuses on executive malfeasance, specifically its antecedents and consequences. Academic efforts primarily focus on prevention while practitioners are often left to hold firms and executives (including directors) accountable through a variety of sanctions. Even so, executive malfea­sance still occurs even in the face of the vast resources used to monitor, control, and penalize firms and executives. In this paper, we posit equity markets do not adequately penalize firms for inaccurate earnings reports. Using a sample of 129 firms (...) identified by the U.S. General Accounting Office for reporting fraudulent earnings in 10K filings, we found support for our assertion. Consequently, the one party who may benefit but escape accountability is firm shareholders. Moreover, we find little empirical evidence that the subset of firms sanctioned by the SEC is penalized more heavily than the full sample by markets at the time they report and correct their 10K filings. Our results raise serious questions whether such mana­gerial opportunism can be eradicated given the apparent lack of consequences in equity markets for investors. We also question whether the SEC is able to discern between fraud and error in financial reporting and its implications. (shrink)

Corporate governance scholarship focuses on executive malfeasance, specifically its antecedents and consequences. Academic efforts primarily focus on prevention while practitioners are often left to hold firms and executives (including directors) accountable through a variety of sanctions. Even so, executive malfea­sance still occurs even in the face of the vast resources used to monitor, control, and penalize firms and executives. In this paper, we posit equity markets do not adequately penalize firms for inaccurate earnings reports. Using a sample of 129 firms (...) identified by the U.S. General Accounting Office for reporting fraudulent earnings in 10K filings, we found support for our assertion. Consequently, the one party who may benefit but escape accountability is firm shareholders. Moreover, we find little empirical evidence that the subset of firms sanctioned by the SEC is penalized more heavily than the full sample by markets at the time they report and correct their 10K filings. Our results raise serious questions whether such mana­gerial opportunism can be eradicated given the apparent lack of consequences in equity markets for investors. We also question whether the SEC is able to discern between fraud and error in financial reporting and its implications. (shrink)

This chapter describes the Danish church, with the focus centered primarily on its life during the years 1835 to 1855 when Søren Kierkegaard was productive. The beginnings of the church up to 1835 are briskly examined, and then contributions of Jacob Peter Mynster, Nicolai Frederik Severin Grundtvig, and Hans Lassen Martensen are delineated. These three figures have been chosen because of their importance both for the Danish church and for Kierkegaard. The chapter ends with a few comments on some creative (...) thinkers who find in Kierkegaard's critique a resource for critically reforming the church so that it might more appropriately serve its intended purpose. At points in the chapter, the analysis utilizes the Kierkegaardian categories of the objective and the subjective. (shrink)

This article examines three early writings of Hans L. Martensen, Søren Kierkegaard’s teacher and the target of his criticisms. The writings focus respectively on self-consciousness, mysticism, and freedom. They each make important claims about religion, and together they disclose the young Martensen’s systematic understanding of the epistemological, mystical, and moral-ethical dimensions of human experience as shaped by the representations of Christian faith and life. The analysis reveals an agile thinker, whose creative philosophical and theological ideas are the product of imaginative (...) speculation growing out of passionate religiosity. Some connections will be drawn from these essays to the writings of Søren Kierkegaard. (shrink)

This volume examines the Kierkegaard-Martensen relationship, establishing ways in which the speculative theologian Martensen was a source for Kierkegaards thought. Kierkegaard's relationship with Martensen was multidimensional and volatile.

In 1952, two well-known characters called ‘A’ and ‘B’ met for the first time to argue about the Identity of Indiscernibles (Black, 1952). A argued that the principle is true, and B that it is false. By all accounts A took a bit of a beating and came out worst-off. Forty-three years later John O’Leary-Hawthorne offered a response on behalf of A that looked as if it would work so long as A was willing to accept the universal-bundle theory of (...) substance (Hawthorne, 1995). In 1997, A and B met again (Zimmerman, 1997). A took Hawthorne’s advice and revealed himself as a universal-bundle theorist. But B was well-prepared, and once more A took a beating. Since then Gonzalo Rodriguez-Pereyra (2004) has put the boot in, offering further criticism of A’s position. In recent years A has been rather quiet, leaving B to reign as the undisputed champion. However, it turns out that A is down, but not out. And now it’s time for A’s revenge. (shrink)

In this article I present a theory of what it is to be fair. I take my cue from Broome’s well known 1990 account of fairness. Broome’s basic thesis is that fairness is the proportional satisfaction of claims, and with this I am in at least partial agreement. But neither Broome nor anyone else (so far as I know) has laid down a theory of precisely what one must do in order to be fair. The theory offered here does just (...) this. (shrink)

This chapter treats in roughly chronological order ten Lutheran theologians other than Rudolf Bultmann and Paul Tillich, who were examined in the previous chapter. All of these figures can be discussed in relation to their reception of Søren Kierkegaard's writings, even though the level of appropriation of Kierkegaard varies significantly. They include German national Lutheran theologians Karl Holl, Friedrich Gogarten, Paul Althaus, and Emanuel Hirsch, Scandinavian Lutheran theologians Anders Nygren, Knud Løgstrup, Regin Prenter, and Gustaf Wingren, and contemporary German Lutheran (...) theologians Wolfhart Pannenberg and Eberhard Jüngel. The chapter attempts to identify distinctive characteristics of each thinker and their connections to Kierkegaard. (shrink)

The second volume of Hegel’s Lectures on the Philosophy of Religion emphasizes the pulsating particularities that distinguish the religions of history from one another. This volume discloses Hegel’s philosophical theology to be an open system whose concepts, as Jon Stewart points out, are no mere abstractions but principles concretely instantiated in the real world. This article first reviews key analytical notions used in investigating religions, with the notion of freedom being the most important. Next are examined two models of the (...) God-world relation that have gained significant attention in the secondary literature on Hegel: pantheism, which affirms God as the substantial power in all things, and panentheism, which affirms all things as being in God. The essay’s final portion turns to a third model of the God-world relation, pantransentheism, which affirms that all things are being transformed in God. There I offer a very abbreviated gesture towards a Hegelian pantransentheism. (shrink)

What are Eric Mullis’s contributions to a pragmatist philosophy of dance? First, the work brings attention to aspects of dance in regional and religious contexts and to a selection of religious dance practices not typically addressed in the literature of dance philosophy, thus adding to the current scope of dance studies. This book’s main strength with respect to pragmatist philosophies is its efforts to apply existing theories of pragmatism to aspects of dance in a particular regional setting. This task is (...) accomplished with three aspects of the research: ecological study of Pentecostal dance, pragmatism in a selection of its manifestations with connections to philosophies of dance, and performance. In the final chapter, the scope is broadened with summary references to alternative theories of dance philosophy and their interdisciplinary relations to dance studies using pragmatist philosophies. The remainder of this essay examines selection of past and current studies that inform the state of dance philosophy with the aim of gathering a broader perspective on the state of dance philosophy. While there is no established long-term tradition of dance philosophy, a generation of twentieth-century scholars—Cohen, Arnheim, Sparshott, Goodman, Van Camp, Banes, Carroll, McFee, Foster, and Fraleigh, among others—has advanced recent philosophical discussion of dance. Joining these are contemporary writers on philosophy of dance, such as Anna Pakes. (shrink)

Dance is proposed as the most representative of somaesthetic arts in Thinking Through the Body: Essays in Somaesthetics and other writings of Richard Shusterman. Shuster- man offers a useful, but incomplete approach to somaesthetics of dance. In the examples provided, dance appears as subordinate to another art form or as a means to achieving bodily excellence. Missing, for example, are accounts of the role of dance as an independent art form, how somaesthetics would address differences in varying approaches to dance, (...) and attention to the viewer’s somaesthetic dance experience. Three strategies for developing new directions for dance somaesthetics are offered here: identify a fuller range of applications of somaesthetics to dance as an independent art form ; develop somaesthetics for a wider range of theatre dance ; and relate somaesthetics to more general features of dance necessary for understanding the roles of the choreographer/dancer and the viewer. (shrink)

Can identity itself be vague? Can there be vague objects? Does a positive answer to either question entail a positive answer to the other? In this paper we answer these questions as follows: No, No, and Yes. First, we discuss Evans’s famous 1978 argument and argue that the main lesson that it imparts is that identity itself cannot be vague. We defend the argument from objections and endorse this conclusion. We acknowledge, however, that the argument does not by itself establish (...) either that there cannot be vague objects or that there cannot be identity statements that are indeterminate for ontic reasons. And we further acknowledge that it does not by itself establish that there cannot be identity statements that are indeterminate in virtue of the existence of vague objects. We then go on to argue that, despite this, one who believes in vague objects cannot endorse Evans’s argument. To establish this we offer supplementary arguments that show that if vague objects exist then identity is vague, and that if identity is vague then vague objects exist. Finally we draw attention to an argument parallel to that of Evans’s, but safer, which can be employed against the putative ontic indeterminacy in identity of vague objects which can be differentiated by identity-free properties. (shrink)

Peter Redpath is a distinguished historian of philosophy. He believes that the best way to acquire a philosophical education is through the study of philosophy’s history. Because he is convinced that ideas have consequences, he holds that the history of philosophy illuminates important events in history. Philosophy is a necessary condition for sound education, which, in turn, is a necessary condition for cultural and political leadership. Hence, the way educators and leaders shape culture reflects the effects of philosophy on culture. (...) In light of this background, it is possible to discern in Redpath’s account of the history of philosophy a corresponding philosophy of history. This emerges as he explains how philosophers have produced changes in thinking that have profound consequences for the culture at large. Some of these changes, many of them significant, have been positive, but others have been disastrous. Much of Redpath’s philosophy of history diagnoses what went wrong in the history of philosophy so as to indicate why modern culture suffers considerable disorder. The good news is that Redpath’s philosophy of history prescribes ways to correct Western Civilization’s current malaise. (shrink)

Porpora offers an a priori argument for the conclusion that there are infinitely many thoughts that it is physically possible for us to think. That there should be such an a priori argument is astonishing enough. That the argument should be simple enough to teach to a first-year undergraduate class in about 20 min, as Porpora’s is, is more astonishing still. Porpora’s main target is Max Tegmark’s recent argument for the claim that if current physics is right, then there are (...) mental duplicates of us in far flung regions of the Universe. His argument is directed against Tegmark’s assumption that mental facts supervene upon physical facts. So, if Porpora’s argument is sound then not only is Tegmark’s argument unsound, but physicalism is also false. So, Porpora’s argument is powerful indeed. Who would have thought that a simple a priori argument, together with the physical facts, could solve the issue of whether physicalism is true?. Not I. In this paper I take a closer look at Porpora’s argument and show that it is fallacious. I also consider the other reasons Porpora gives for thinking there are infinitely many thinkable thoughts and find them similarly lacking. (shrink)

In this paper I argue against Mark Jago’s recent suggestion that ordinary knowers can move from knowledge of essence to knowledge of metaphysical necessity.

Open peer commentary on the article “A Defence of Starmaking Constructivism: The Problem of Stuff” by Bin Liu. Abstract: I provide a brief account of key elements in Nelson Goodman’s starmaking constructivist philosophy and comment on Bin Liu’s defense of Goodman in the context of contemporary constructivist philosophy.

The author identifies and discusses the most important elements of Étienne Gilson’s thought which emanate out of his articulation and defense of the Western Creed. To the question: why Gilson, why now?, the author offers a following answer: because we need to champion the Western Creed, defend philosophical realism, rightly interpret the history of philosophy, correctly comprehend Christian philosophy, and show that modernist and postmodernist systems are arbitrary. The author maintains that Gilson delivers us with the realist philosophy of the (...) human person, shows us the undeniable advantages of philosophical realism, and formulates an original notion of Christian philosophy which appreciates that genuine philosophy is non-systematic in its nature, and that it can expose the failure of modernist philosophies that strive to be systems. (shrink)

The underlying skepticism of ancient Greek culture made it unreceptive of philosophy. It was the Catholic Church that embraced philosophy. Still, Étienne Gilson reminds us in Reason and Revelation in the Middle Ages that some early Christians rejected philosophy. Their rejection was based on fideism: the view that faith alone provides knowledge. Philosophy is unnecessary and dangerous, fideists argue, because (1) anything known by reason can be better known by faith, and (2) reason, on account of the sin of pride, (...) seeks to replace faith. To support this twofold claim, fideists, like Tertullian and Tatian, quote St. Paul. However, a judicious interpretation of St. Paul’s remarks shows that he does not object to philosophy per se but to erroneous philosophy. This interpretation is reinforced by St. Paul’s own background in philosophy and by his willingness to engage intellectuals critical of Christianity in the public square. The challenge of fideism brings up the interesting question: what would Jesus himself say about the discipline of philosophy? Could it be that Jesus himself was a philosopher (as George Bush once declared)? As the fullness of wisdom and intelligence, Jesus certainly understood philosophy, although not in the conventional sense. But surely, interpreting his life through the lens of fideism is unconvincing. Instead, an appreciation of his innate philosophical skills serves better to understand important elements of his mission. His perfect grasp of how grace perfects nature includes a philosophy of the human person. This philosophy grounded in common-sense analysis of human experience enables Jesus to be a profound moral philosopher. Specifically, he is able to explain the principles of personal actualization. Relying on ordinary experience, where good philosophy must start, he narrates moral lessons—parables—that illumine difficulties regarding moral responsibility and virtue. These parables are accessible but profound, showing how moral understanding must transcend Pharisaical legalism. Additionally, Jesus’ native philosophical power shows in his ability to explain away doctrinal confusions and to expose sophistical traps set by his enemies. If fideism is unconvincing, and if the great examples of the Patristics, the Apostles, and Jesus himself show an affinity for philosophy, then it is necessary to conclude that Christianity is a rational religion. Accordingly, the history of Christian culture is arguably an adventure in faith and reason. Since God is truth and the author of all truths, there is nothing in reality that is incompatible with Christian teaching. As John Paul II explains effectively in the encyclical, Fides et Ratio, Christianity is a religion that is rational and can defend itself. This ability to marshal a defense makes Christianity a religion for all seasons. (shrink)

The underlying skepticism of ancient Greek culture made it unreceptive of philosophy. It was the Catholic Church that embraced philosophy. Still, Étienne Gilson reminds us in Reason and Revelation in the Middle Ages that some early Christians rejected philosophy. Their rejection was based on fideism: the view that faith alone provides knowledge. Philosophy is unnecessary and dangerous, fideists argue, because (1) anything known by reason can be better known by faith, and (2) reason, on account of the sin of pride, (...) seeks to replace faith. To support this twofold claim, fideists, like Tertullian and Tatian, quote St. Paul. However, a judicious interpretation of St. Paul’s remarks show that he does not object to philosophy per se but to erroneous philosophy. This interpretation is reinforced by St. Paul’s own background in philosophy and by his willingness to engage intellectuals critical of Christianity in the public square. The challenge of fideism brings up the interesting question: what would Jesus himself say about the discipline of philosophy? Could it be that Jesus himself was a philosopher (as George Bush once declared)? As the fullness of wisdom and intelligence, Jesus certainly understood philosophy, although not in the conventional sense. But surely, interpreting his life through the lens of fideism is unconvincing. Instead, an appreciation of his innate philosophical skills serves better to understand important elements of his mission. His perfect grasp of how grace perfects nature includes a philosophy of the human person. This philosophy grounded in common-sense analysis of human experience enables Jesus to be a profound moral philosopher. Specifically, he is able to explain the principles of personal actualization. Relying on ordinary experience, where good philosophy must start, he narrates moral lessons—parables—that illumine difficulties regarding moral responsibility and virtue. These parables are accessible but profound, showing how moral understanding must transcend Pharisaical legalism. Additionally, Jesus’ native philosophical power shows in his ability to explain away doctrinal confusions and to expose sophistical traps set by his enemies. If fideism is unconvincing, and if the great examples of the Patristics, the Apostles, and Jesus himself show an affinity for philosophy, then it is necessary to conclude that Christianity is a rational religion. Accordingly, the history of Christian culture is arguably an adventure in faith and reason. Since God is truth and the author of all truths, there is nothing in reality that is incompatible with Christian teaching. As John Paul II explains effectively in the encyclical, Fides et Ratio, Christianity is a religion that is rational and can defend itself. This ability to marshal a defense makes Christianity a religion for all seasons. (shrink)

If contemporary philosophers of science could transcend the skepticism that seems to have become obligatory in modern epistemologies, they could restore a comprehensive vision of science that would be a boon to science and scientific education. Science is not mere knowledge. Science is knowledge of something that is necessary and universal because its causes are understood. This was Aristotle’s conception of science (epistēmē), a conception which includes knowledge of substances and the first ontological principles of things. St. Thomas Aquinas refined (...) this understanding of science in a way that, perhaps surprisingly, has escaped the notice of many Thomists, especially the way St. Thomas understands physical substance to be a generic universal grounding necessary relations for some of its accidents. The recovery of Aristotle’s and St. Thomas’s conception of science would in no way threaten contemporary empirical science. Instead, it would explain how empirical science complements the ontology of science. (shrink)

Pummer : 43–77, 2014) ingeniously wraps together issues from the personal identity literature with issues from the literature on desert. However, I wish to take issue with the main conclusion that he draws, namely, that we need to rethink the following principle: Desert.: When people culpably do very wrong or bad acts, they deserve punishment in the following sense: at least other things being equal they ought to be made worse off, simply in virtue of the fact that they culpably (...) did wrong—even if they have repented, are now virtuous, and punishing them would benefit no one. :43–77, 2014: 43–44) Pummer offers an argument that is intended to show that this principle, along with widely-held views about personal identity, entails an inconsistent triad of propositions. I agree. But I think Pummer's argument attacks a straw man. I believe that no-one holds Desert, at least as it is stated, and that once the principle is stated correctly it is easy to see that no inconsistent triad follows from it. So, Desert does not need rethinking. It just needs to be stated correctly. (shrink)

In ‘Ramseyan Humility’ Lewis presents the Permutation Argument for quidditism. As he presents it the argument is simple enough, but once one digs beneath its surface, and attempts to understand it in strictly Lewisian terms, difficulties arise. The fundamental difficulty is that, as he presents it, the argument only seems to be sound if one rejects views that Lewis explicitly holds. One aim of this paper is to clarify the argument to show that one can make sense of it in (...) strictly Lewisian terms. In so doing I clarify Lewis’s view, clearly lay out the commitments that Lewis has, and define quidditism in strictly Lewisian terms. However, I also have a secondary aim. Lewis accepts that quidditism entails a form of scepticism, that he calls ‘Humility’. However, by an extension of the permutation argument I show that quidditism entails a form of scepticism, that I call ‘Diffidence’, that is far more wide-reaching than Humility. (shrink)

In this note I firstly give a formulation of Berkeleyean Idealism in modern anti‐realist terms. Secondly, I supply a reading of Berkeley that serves to do three things: 1. It makes clear that the formulation of the position in modern terms is acceptable. 2. It offers a revealing insight into the reasons why Berkeley accepted the position. 3. It allows us to see that these reasons are, in fact, bad ones.

In his book Modal Logic as Metaphysics, Williamson argues that the traditional actualist‐possibilist debate should be abandoned as hopelessly unclear and that we should get on with the clearer contingentism‐necessitism debate. We think that Williamson’s pessimism is not warranted by the brief arguments he gives. In this paper, we explain why and provide a clear formulation of the traditional actualist‐possibilist debate.

Perry Hendricks has recently argued that endorsing the divine hiddenness objection to the existence of God ‘eliminates’ or ‘does away with’ all de jure objections to theism. So, he says, anyone who endorses the divine hiddenness objection must ‘reject’ any de jure objection. ‘And this,’ he says, ‘means that the argument from divine hiddenness is costly for atheists’. However, although Hendricks's argument is an interesting one, it does not establish any of these things, at least on any natural understanding of (...) his claims. (shrink)

The focus here will be on the tension between architecture’s symbolic role and its function as a space to house and present art. ‘Symbolic’ refers both to a building as an aesthetic or sculptural form and secondly to its role in expressing civic identity. ‘Function’ refers to the intended purpose or practical use apart from its role as a form of art. As an art form, it serves important symbolic purposes; its practical purposes are linked to serving individual and community (...) functions requiring the delineation of space. In the present context of museum architecture, certain museum buildings are more likely to be seen as a sculptural object than as functioning buildings. The reasons for this development derive in part from unresolved issues pertaining to the respective roles of symbolic and practicalfunction as is seen in the analysis of architecture provided by G. W. F. Hegel, Rudolf Arnheim and Nelson Goodman. The vocabularies of contemporary architects such Frank Gehry and Santiago Calatrava do not follow the abstract geometrical patterns of Le Corbusier or Louis Kahn who envisioned a universal vocabulary of architectural forms derived from industrial technical forms that underscored Modernist conventions in architecture.By looking at this issue in the contexts provided by the theoretical discussions of Hegel, Arnheim and Goodman, it is possible to see more clearly the importance of examining with a critical eye the relative place of symbolism and function in museum architecture, and to question whether current museum practice has gone astray in allowing the sculptural symbolism to become the dominant element. When either its symbolic or its practical aspects are out of balance the result is sure to be unsatisfactory architecture. If the past is a reliable guide, it works best when the symbolic (sculptural) and the practical in architecture are worked out in harmony with each other. (shrink)

Utopias from ancient times to the present have come and gone. They remain as a part of literary, philosophical and historical texts and communal practices. Yet this subject has never ceased to inspire contemporary minds as well. My aim in this paper is to consider the communities known as favelas that have formed on the edges of the Brazilian city of Rio de Janeiro as a contemporary form of utopian community. The paper begins with a brief analysis of the concept (...) of utopia. Then follows a discussion of the Favela as an urban utopia as seen from the perspective of Latin American philosopher Enrique Dussel’s philosophy of liberation as represented in his book, The Philosophy of Liberation. The remainder of the paper will consider in what sense the Favela settlements can be understood as a form of utopia. Among additional sources for this paper, I will refer to the research on the favelas by such scholars as Janice Perlman and Catalytic Communities. Other sources will include art projects in the favelas, the novel and film City of God made on site, and photographs of Miguel Rio Branco taken in the Favelas. All of these artists’ representations reflectactual experiences of life in the Favelas. An underlying question throughout will be the role that art might play in understanding utopias. (shrink)

In the 1960s, there were efforts to move broadcast television in the direction of the experimental video art by altering television's conventional format. Fred Barzyk, in his role as a producer and director at WGBH-TV in Boston, was uniquely positioned to act as a link between television and experimental video artists who normally would not have had access to the technology available at a major broadcast facility. As the leading innovator in the beginnings of video art, the Korean American Nam (...) June Paik (1932-2006) deserves special mention. His work bridges the worlds of art, video technology, and television. The video works of Nan June Paik, Amy Greenfield, Peter Campus, Feng Meng Bo, Elizabeth Sussman and other video artists are considered in this essay as key contributors to the development of video art. The selection is based on my experience with the artists cited. Despite video art's growing popularity among contemporary artists in the 1970s and beyond, the museums were slow to acknowledge this development. One of the problems was deciding where, among the existing museum collections, to locate video art. In its 50 some years of history, video art has enjoyed a remarkable success in its artistic innovations while undergoing changes in formats virtually at the speed of rapid advances in electronic visual technology. Ironically, the legacy of creative television set in motion by Barzyk and his generation has been largely coopted by the television broadcasting industry, which mainly serves as a platform for mass media advertising. (shrink)

In this article I reply to Thomas Schramme's argument that there are no good reasons for the prohibition of severe forms of voluntary non‐therapeutic body modification. I argue that on paternalistic assumptions there is, in fact, a perfectly good reason.

RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

Host-microbiome interactions (HMIs) are critical for the modulation of biological processes and are associated with several diseases, and extensive HMI studies have generated large amounts of data. We propose that the logical representation of the knowledge derived from these data and the standardized representation of experimental variables and processes can foster integration of data and reproducibility of experiments and thereby further HMI knowledge discovery. A community-based Ontology of Host-Microbiome Interactions (OHMI) was developed following the OBO Foundry principles. OHMI leverages established (...) ontologies to create logically structured representations of microbiomes, microbial taxonomy, host species, host anatomical entities, and HMIs under different conditions and associated study protocols and types of data analysis and experimental results. (shrink)