Total knee arthroplasty (TKA) is a commonly implemented elective surgical treatment for end-stage osteoarthritis of the knee, demonstrating high success rates when assessed by objective medical outcomes. However, a considerable proportion of TKA patients report significant dissatisfaction postoperatively, related to enduring pain, functional limitations, and diminished quality of life. In this conceptual analysis, we highlight the importance of assessing patient-centred outcomes routinely in clinical practice, as these measures provide important information regarding whether surgery and postoperative rehabilitation interventions have effectively remediated (...) patients’ real-world “quality of life” experiences. We propose a novel precision medicine approach to improving patient-centred TKA outcomes through the development of a multivariate machine-learning model. The primary aim of this model is to predict individual postoperative recovery trajectories. Uniquely, this model will be developed using an interdisciplinary methodology involving non-linear analysis of the unique contributions of a range of preoperative risk and resilience factors to patient-centred TKA outcomes. Of particular importance to the model’s predictive power is the inclusion of a comprehensive assessment of modifiable psychological risk and resilience factors that have demonstrated relationships with TKA and other conditions in some studies. Despite the potential for patient psychological factors to limit recovery, they are typically not routinely assessed preoperatively in this patient group, and thus can be overlooked in rehabilitative referral and intervention decision-making. This represents a research-to-practice gap that may contribute to adverse patient-centred outcomes. Incorporating psychological risk and resilience factors into a multivariate prediction model could improve the detection of patients at risk of sub-optimal outcomes following TKA. This could provide surgeons and rehabilitation providers with a simplified tool to inform postoperative referral and intervention decision-making related to a range of interdisciplinary domains outside their usual purview. The proposed approach could facilitate the development and provision of more targeted rehabilitative interventions on the basis of identified individual needs. The roles of several modifiable psychological risk and resilience factors in recovery are summarised, and intervention options are briefly presented. While focusing on rehabilitation following TKA, we advocate for the broader utilisation of multivariate prediction models to inform individually-tailored interventions targeting a range of health conditions. (shrink)

This article focuses on Guyanese efforts in the ​postcolonial present to address environmental issues that have become increasingly complex in the face of an awareness of climate change. It opens with an account of how the preservation of Indigenous forests contributes to international efforts to reduce carbon, while making visible the instability that the discovery of oil and gas reserves in the seabed might portend for the Guyanese economy. Specifically, the article examines how engineers have historically confronted settler-colonial discourses about (...) terra nullius unfold as they invest in sea defense. In doing so, the article foregrounds what engineers call slips—the slow or sudden displacement of a sea defense’s structural foundation. Slips are phenomena of energy conversion between land and sea. Rather than arguing for the claims of the pre-Anthropocene earth, the article suggests how many factors are in play in developing policy in the present, in an era of heightened awareness of the different forces in a changing climate. (shrink)

This article sets my own acquaintance with Asphodel in the context of her academic and life achievements. In this long life, she has both seen and influenced changes in the work of theology and social attitudes. Her own work has been seminal and inspiring. Her life has been as radical as her writing. The article draws on conversations with others of her acquaintance, as well as her writings. I end by honouring Asphodel as a gevirah, in scriptural terms.

Any philosophy of science ought to have something to say about the nature of mathematics, especially an account like constructive empiricism in which mathematical concepts like model and isomorphism play a central role. This thesis is a contribution to the larger project of formulating a constructive empiricist account of mathematics. The philosophy of mathematics developed is fictionalist, with an anti-realist metaphysics. In the thesis, van Fraassen's constructive empiricism is defended and various accounts of mathematics are considered and rejected. Constructive empiricism (...) cannot be realist about abstract objects; it must reject even the realism advocated by otherwise ontologically restrained and epistemologically empiricist indispensability theorists. Indispensability arguments rely on the kind of inference to the best explanation the rejection of which is definitive of constructive empiricism. On the other hand, formalist and logicist anti-realist positions are also shown to be untenable. It is argued that a constructive empiricist philosophy of mathematics must be fictionalist. Borrowing and developing elements from both Philip Kitcher's constructive naturalism and Kendall Walton's theory of fiction, the account of mathematics advanced treats mathematics as a collection of stories told about an ideal agent and mathematical objects as fictions. The account explains what true portions of mathematics are about and why mathematics is useful, even while it is a story about an ideal agent operating in an ideal world; it connects theory and practice in mathematics with human experience of the phenomenal world. At the same time, the make-believe and game-playing aspects of the theory show how we can make sense of mathematics as fiction, as stories, without either undermining that explanation or being forced to accept abstract mathematical objects into our ontology. All of this occurs within the framework that constructive empiricism itself provides the epistemological limitations it mandates, the semantic view of theories, and an emphasis on the pragmatic dimension of our theories, our explanations, and of our relation to the language we use. (shrink)

“Ambivalence” is the key word in much of this book; “comic” [is the book’s] most obscure and I think absolutely without use value. I don’t know what B[urke] means by “comic,” as a matter of fact. I wonder if he does, and could define it briefly. Readers of Kenneth Burke are well aware of the importance of comedy and its associated cluster of concepts in his work: comic, comic frame, comic attitude, comic corrective. This cluster of terms figures prominently in (...) his 1937 book Attitudes Toward History, most notably in two key passages that scholars turn to time and again. In the first, from the “Poetic Categories” section of the book, Burke explains how different genres serve as guides for how to act in the... (shrink)

WQ.1 “Independent men and women, in independent homes, leading separate and independent lives, with full freedom to form and dissolve relations, and with perfectly equal opportunities to happiness, development, and love.” I leave out the word “rights,” doubtful I can use it without being misunderstood. Perhaps I can succeed in dispensing with its use altogether. This ideal, so stated, is attractive to me and completely in harmony with my idea of the course in life which will best further human happiness. (...) WQ.2 I am not sure that I quite understand Victor’s position in regard to the number of.. (shrink)

Mastery imagery has been shown to be associated with more positive cognitive and emotional responses to stress, but research is yet to investigate the influence of mastery imagery ability on imagery’s effectiveness in regulating responses to acute stress, such as competition. Furthermore, little research has examined imagery’s effectiveness in response to actual competition. This study examined (a), whether mastery imagery ability was associated with stress response changes to a competitive stress task, a car racing computer game, following an imagery intervention, (...) and (b), the effects of different guided imagery content on pre-task cognitive and emotional responses. In Session 1, 78 participants (M age = 20.03 years, SD = 1.28) completed ratings of pre-task anxiety intensity and direction, confidence, and perceived control. Imagery ability was also assessed before completing the task. In Session 2, participants were randomly allocated to an imagery condition (positive mastery, negative mastery, relaxation) or control group (no imagery) before completing the task and outcome measures again. For the negative mastery group, greater positive mastery imagery ability was associated with greater perceived control and perceiving anxiety as more facilitative. Furthermore, mastery imagery ability moderated the relationship between anxiety intensity and direction. Altogether, results suggest that positive mastery imagery ability may act as a potential buffer against the effects of negative images. (shrink)

Under some circumstances, individuals are willing to engage in unethical behaviors that benefit another entity. In this research we advance the unethical pro-organizational behavior construct by showing that individuals also have the potential to behave unethically to benefit their supervisors. Previous research has not examined if employees engage in unethical acts to benefit an entity that is separate from oneself and if they will conduct these acts to benefit a supervisor. Our research helps to address these gaps. We also demonstrate (...) that unethical behavior to benefit a supervisor, what we term unethical pro-supervisor behavior, is more likely to occur if individuals are more (versus less) identified with their organization or supervisor. That is, feeling a sense of oneness with one’s organization or supervisor can result in employees engaging in unethical behavior to help their supervisor. Further, this positive relationship is weakened if the employee possesses higher levels of moral identity. We test our hypotheses with a two-part laboratory study, a field study, and a time-lagged field study. Theoretical and practical implications of this work are discussed. (shrink)

Many of those teaching at the intersection of medicine and the humanities are siloed within institutional spaces. This essay recounts the teaching of Sarah Manguso’s The Two Kinds of Decay to students across different academic contexts and considers what we can learn when we put classrooms in conversation with each other. This essay argues for the value of texts like Manguso’s, which explicitly hold the narrating subject and form of illness narrative up for critical examination. The authors call for (...) more collaborative teaching, which has special resonance in the health humanities, where conversations already depend on bridging disciplines and listening to the stories others can tell. (shrink)

Plato's thought evolves from the epistemology of the Meno, Phaedo, and Republic to the Combined Doctrine of the Theaetetus. The Combined Doctrine maintains that both Forms and certain objects rooted in perception are objects of knowledge. Dialectic results in apprehension of the Good, and consequently of being, which brings about a permanent change in a person's state of mind enabling one to know what one previously believed. The Combined Doctrine resolves the paradoxes of the refutations of the Theaetetus. It turns (...) out that the difference between true belief and knowledge for Plato amounts to difference in states of mind. (shrink)

The nature–nurture controversy has been with us since it was first outlined by Plato and Aristotle. Nobody likes it anymore. All reasonable scholars today agree that genes and environment interact to determine complex cognitive outcomes. So why does the controversy persist? First, it persists because it has practical implications that cannot be postponed (i.e., what can we do to avoid bad outcomes and insure better ones?), a state of emergency that sometimes tempts scholars to stake out claims they cannot defend. (...) Second, the controversy persists because we lack a precise, testable theory of the process by which genes and the environment interact. In the absence of a better theory, innateness is often confused with (1) domain specificity (outcome X is so peculiar that it must be innate), (2) species specificity (we are the only species who do X, so X must lie in the human genome), (3) localization (outcome X is mediated by a particular part of the brain, so X must be innate), and (4) learnability (we cannot figure out how X could be learned, so X must be innate). We believe that an explicit, plausible theory of interaction is now around the corner, and that many of the classic maneuvers to defend or attack innateness will soon disappear. In the interim, some serious errors can be avoided if we keep these confounded issues apart. That is the major goal of this chapter: not to attack innateness but to clarify what claims about innateness are (and are not) about. (shrink)

Graduates of doctoral programs are expected to be competent at designing and conducting research independently. Given the level of research competence needed to successfully conduct research, it is important that assessors of doctoral programs have a reliable and validated tool for measuring and tracking perceived research competence among their students and graduates. A high level of research competence is expected for all Ph.D. graduates worldwide, in addition to in all disciplines/fields. Moreover, graduates of Ph.D. programs may complete their studies in (...) one country but then obtain a research position in another country, emphasizing the need to ensure that all doctoral programs are fostering similar levels of research competence. Thus, the purpose of this study was to gather additional evidence for validity and reliability of the Research Competence scale. Specifically, we sought to extend the findings of by adapting the scale, translating it to other languages, and applying the tool with a sample of early stage researchers. Our findings provide initial evidence that the adapted PR-Comp is appropriate for use in three languages and across a variety of disciplines/programs of study. (shrink)

The American Journal of Bioethics, Volume 12, Issue 6, Page 35-37, June 2012.

Under some circumstances, individuals are willing to engage in unethical behaviors that benefit another entity. In this research we advance the unethical pro-organizational behavior construct by showing that individuals also have the potential to behave unethically to benefit their supervisors. Previous research has not examined if employees engage in unethical acts to benefit an entity that is separate from oneself and if they will conduct these acts to benefit a supervisor. Our research helps to address these gaps. We also demonstrate (...) that unethical behavior to benefit a supervisor, what we term unethical pro-supervisor behavior, is more likely to occur if individuals are more identified with their organization or supervisor. That is, feeling a sense of oneness with one’s organization or supervisor can result in employees engaging in unethical behavior to help their supervisor. Further, this positive relationship is weakened if the employee possesses higher levels of moral identity. We test our hypotheses with a two-part laboratory study, a field study, and a time-lagged field study. Theoretical and practical implications of this work are discussed. (shrink)

Venturing into novel terrain poses physical risks to a female and her offspring. Females have a greater tendency to avoid physical harm, while males tend to have larger range sizes and often outperform females in navigation-related tasks. Given this backdrop, we expected that females would explore a novel environment with more caution than males, and that more-cautious exploration would negatively affect navigation performance. Participants explored a novel, large-scale, virtual environment in search of five objects, pointed in the direction of each (...) object from the origin, and then navigated back to the objects. We found that females demonstrated more caution while exploring as reflected in the increased amounts of pausing and revisiting of previously traversed locations. In addition, more pausing and revisiting behaviors led to degradation in navigation performance. Finally, individual levels of trait harm avoidance were positively associated with the amount of revisiting behavior during exploration. These findings support the idea that the fitness costs associated with long-distance travel may encourage females to take a more cautious approach to spatial exploration, and that this caution may partially explain the sex differences in navigation performance. (shrink)

Adults are skilled at using language to construct/negotiate identity and to signal affiliation with others, but little is known about how these abilities develop in children. Clearly, children mirror statistical patterns in their local environment (e.g., Canadian children using zed instead of zee), but do they flexibly adapt their linguistic choices on the fly in response to the choices of different peers? To address this question, we examined the effect of group membership on 7‐ to 9‐year‐olds' labeling of objects in (...) a trivia game, exploring whether they were more likely to use a particular label (e.g., sofa vs. couch) if members of their “team” also used that label. In a preregistered study, children (N = 72) were assigned to a team (red or green) and were asked during experimental trials to answer questions—which had multiple possible answers (e.g., blackboard or chalkboard)—after hearing two teammates and two opponents respond to the same question. Results showed that children were significantly more likely to produce labels less commonly used by the community (i.e., dispreferred labels) when their teammates had produced those labels. Crucially, this effect was tied to group membership, and could not be explained by children simply repeating the most recently used label. These findings demonstrate how social processes (i.e., group membership) can guide linguistic variation in children. (shrink)

'Since the middle of the twentieth century,' writes Elizabeth Johnson, 'there has been a renaissance of new insights into God in the Christian tradition. On different continents, under pressure from historical events and social conditions, people of faith have glimpsed the living God in fresh ways. It is not that a wholly different God is discovered from the One believed in by previous generations. Christian faith does not believe in a new God but, finding itself in new situations, (...) seeks the presence of God there. Aspects long-forgotten are brought into new relationships with current events, and the depths of divine compassion are appreciated in ways not previously imagined.' This book sets out the fruit of these discoveries. The first chapter describes Johnson's point of departure and the rules of engagement, with each succeeding chapter distilling a discrete idea of God. Featured are transcendental, political, liberation, feminist, black, Hispanic, interreligious, and ecological theologies, ending with the particular Christian idea of the one God as Trinity. >. (shrink)

The nursing metaparadigm, as described by Fawcett in 1984, includes human, health, nursing, and the environment, all of which support theory development by giving direction to our focus as a scientific body. Nursing scientists make their mark in biotechnological applications, mobile health, informatics, and human factors research. We give voice to the patient through design feedback and incorporating technological advancements in our evolving nursing knowledge; however, we have not formally acknowledged technology in our metaparadigm. To continue patient‐centered care in this (...) age where machines are enmeshed in daily human life, we propose technology must be a domain of the metaparadigm to continue advancing nursing science and knowledge. In this paper, we propose a separate domain of technology within the metaparadigm to challenge nurses to consider approaches within their research and practice of how technology will impact patient care and their personal development within the profession. A technology‐specific domain within the metaparadigm also is a signal to other bodies of science of our willingness and ability to run at pace with novel, exciting new discoveries while adding our perspective. Nurses may become active agents in novel developments rather than passive adopters, continuing our legacy of patient advocacy through new knowledge generation. Emerging and continuing nurse leadership has set the stage for the next era of nurse‐led innovation and technology development, which provides an opportunity to embed technology as a core aspect of the nursing metaparadigm. (shrink)

Banking scandals, accounting fraud, product recalls, and environmental disasters, their associated reputational effects as well as company response strategies have been well reported in the literature. Reported crises and scandals typically involve one focal company for example BP and the 2010 Deepwater Horizon accident. As business practices change and company supply chains become more complex and interlinked, there is a greater risk of collective crises where multiple companies are associated with the same scandal. We argue that companies are likely to (...) behave differently in a group setting compared to when faced with a crisis individually. Using an inductive approach, we examine the case of the Rana Plaza building collapse. We find that organizations with a history of similar crises adopt defensive strategies and communicate much later compared to organizations which adopt accommodative strategies. Contrary to the individual case, in a collective crisis accommodative strategies result in more negative reputational damage and a higher burden of responsibility. We propose that the relationship between crisis response strategy and organization reputation is moderated by the crisis setting. We extend the logic of crisis management and corporate reputation to incorporate the case of a collective crisis. (shrink)

Advocates of biomimicry encourage a new industrial paradigm that ostensibly leaves behind the crude violence of Francis Bacon, the domination of nature-as-machine, and a history of toxic production processes that have given rise to a present and coming climate crisis. As part of a broader trend towards the conceptualization and development of a ‘bioeconomy’, we argue here that biomimicry produces ‘nature’ in new ways. At face value, these new approaches to valuing nature may seem less violent and exploitative. Yet, new (...) natures can and are tortured in new ways. We argue that biomimicry produces ‘nature’ through well-worn logics of resource enclosure and privatization, focusing upon two fundamental shifts in how nonhuman life is figured and put to work: the production of nature as intellectual property ; the production of nature as an active subject. (shrink)

Commodification is a broad and crosscutting issue that spans debates in ethics (from prostitution to global market practices) and bioethics (from the sale of body parts to genetic enhancement). There has been disagreement, however, over what constitutes commodification, whether it is happening, and whether it is of ethical import. This chapter focuses on one area of the discussion in bioethics – the commodification of human tissue – and addresses these questions – about the characteristics of commodification, its pervasiveness, and ethical (...) significance – in order to clarify and map the commodificatory debate. The chapter does this in three parts. First, it defines commodification as the shift from “persons” to “things” and from “relationships” to services for “contract.” Second, using examples of kidney and gamete sale and commercial surrogacy, it argues that commodification is rife in bioethics. Third, it contends that commodification is an ethical problem for three key reasons: First, because it leads to exploitation; second, because some things should not be for sale; and third, because it damages social goods. The chapter concludes that commodification and commodificatory practices should be resisted. (shrink)

Conscientious objections (CO) can be disruptive in a variety of ways and may disadvantage patients and colleagues who must step-in to assume care. Nevertheless, nurses have a right and responsibility to object to participation in interventions that would seriously harm their sense of integrity. This is an ethical problem of balancing risks and responsibilities related to patient care. Here we explore the problem and propose a nonlinear framework for exploring the authenticity of a claim of CO from the perspective of (...) the nurse and of those who must evaluate such claims. We synthesized the framework using Rest’s Four Component Model of moral reasoning along with tenets of the International Council of Nursing’s (ICN) Code of Ethics for Nurses and insights from relevant ethics and nursing ethics literature. The resulting framework facilitates evaluating potential consequences of a given CO for all involved. We propose that the framework can also serve as an aid for nurse educators as they prepare students for practice. Gaining clarity about the sense in which the concept of conscience provides a defensible foundation for objecting to legally, or otherwise ethically, permissible actions, in any given case is critical to arriving at an ethical and reasonable plan of action. (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)

The negative impact of adverse experiences in childhood on neurodevelopment is well documented. Less attention however has been given to the impact of variations in “normative” parenting behaviors. The influence of these parenting behaviors is likely to be marked during periods of rapid brain reorganization, such as late childhood. The aim of the current study was to investigate associations between normative parenting behaviors and the development of structural brain networks across late childhood. Data were collected from a longitudinal sample of (...) 114 mother-child dyads, recruited from low socioeconomic areas of Melbourne, Australia. At the first assessment parenting behaviors were coded from two lab-based interaction tasks and structural magnetic resonance imaging scans of the children were performed. At the second assessment, approximately 18 months later MRI scans were repeated. Cortical thickness was extracted from T1-weighted images using FreeSurfer. Structural covariance networks were constructed from partial correlations of CT estimates between brain regions and estimates of network efficiency and modularity were obtained for each time point. The change in these network measures, from Time 1 to Time 2, was also calculated. At Time 2, less positive maternal affective behavior was associated with higher modularity, while negative maternal affective behavior was not related. No support was found for an association between local or global efficacy and maternal affective behaviors at Time 2. Similarly, no support was demonstrated for associations between maternal affective behaviors and change in network efficiency and modularity, from Time 1 to Time 2. These results indicate that normative variations in parenting may influence the development of structural brain networks in late childhood and extend current knowledge about environmental influences on structural connectivity in a developmental context. (shrink)

Morality can help guide behavior and facilitate relationships. Although moral judgments by autistic people are similar to neurotypical individuals, many researchers argue that subtle differences signify deficits in autistic individuals. Moral foundation theory describes moral judgments in terms of differences rather than deficits. The current research, aimed at assessing autistic individuals’ moral inclinations using Haidt’s framework, was co-designed with autistic community members. Our aim was to describe autistic moral thinking from a strengths-based perspective while acknowledging differences that may pose interpersonal (...) challenges among autistic youth. We assessed 25 autistic and 23 neurotypical children’s moral judgments using the Moral Foundations Questionnaire for Kids. We used semi-structured interviews and qualitative analysis with a subset of participants to describe children’s moral reasoning. Analyses suggested that autistic and neurotypical children make similar judgments about moral transgressions across all five moral foundations. General linear mixed modeling showed that the greatest predictor of recommending punishment was how bad children deemed moral transgressions to be. We also found a trend that autistic children were more likely to recommend punishment for harmless norms violations than were neurotypical children. Future research could use longitudinal methods to understand the development of moral judgments among autistic and neurotypical children. (shrink)