Recent and rapid technological developments on many fronts have created in our society some extremely difficult moral predicaments. Previous generations have not had to face the dilemmas posed by, for example, the availability of safe abortions, sperm banks and prostoglandins. They have not had to come to terms with an unchecked exploitation of natural resources heralding imminent ecological crisis, or, worst of all, with the recognition that only in this current generation have people the capacity to destroy themselves and their (...) environment. This book seeks to show how, and why, Seventh-day Adventism has addressed these moral issues, and that the ethical questions arising from these issues are especially relevant to the Adventist church and its development. Dr Pearson looks specifically at the moral decisions Adventists have made in the area of human sexuality, on such issues as contraception, abortion, the role and status of women, divorce and homosexuality, from the beginnings of the movement to 1985. He seeks to put such decision-making in perspective by providing the general social context in which it took place, and shows how Ellen White (whose charismatic leadership held the movement together in its first fifty years) has been a major source of moral authority in the Adventist church - her writings continuing to exercise authority in a contemporary society of turmoil and change. This important book, which conveys something of the general ethos of Adventism, is the first to investigate the ethics of the movement, ans so fill a notable gap in the literature. (shrink)

Seventh-day Adventists reformed movement: history and features of institutionalization in Ukraine. The article is devoted to consideration of specific processes of institualisation among the reformed Adventist movement in Ukraine. The feature of the process of institutionalization, ie the rise of the modern three different ASDR acting modern Ukrainian territories is analyzed.

Nurses’ religious beliefs influence their motivations and perspectives, including their practice of ethics in nursing care. When the impact of these beliefs is not recognized, great potential for unethical nursing care exists. Thus, this article examines how the theology of one religious tradition, Seventh-day Adventism (SDA), could affect nurses. An overview of SDA history and beliefs is presented, which explains why ‘medical missionary’ work is central to SDAs. Theological foundations that would permeate an SDA nurse’s view of the nursing (...) metaparadigm concepts of person, health, environment (i.e. community), and nursing (i.e. service) are presented. The ethical principles guiding SDA nurses (i.e. principled, case-based, and care ethics) and the implications of these theological foundations for nurses are noted in a case study. (shrink)

This article is a queer reading of the doctrine of miraculous conception and an exploration into how applying an intersex lens to these conception texts can liberate an intersex Jesus. In it, I explain the basics of intersex and otherwise queer theologies, before looking at sex difference in the New Testament through the figures of eunuchs, and conducting an intersex reading of Jesus’ conception and biology. I argue that, if we believe Mary to be a virgin at the moment of (...) Jesus’ conception, with no external male influence, then Jesus is necessarily a chromosomal ‘female’ (and therefore intersex, due to his ‘male’ physical appearance). I then discuss the ways in which his biology can transcend prescriptive roles of sex, mirroring how his social behaviour transcends prescriptive roles of gender. What this queer reading of Jesus can tell us relates to a gender-expansive view of deity – troubling rigid Church institutions by celebrating the breaking of binaries that constrain us. (shrink)

This article highlights how Internet and new media are experienced by Romanian Seventh-Day Adventist pastors in their ministry. What is the acceptance of Web 2.0 services for neo-Protestant pastors of the Seventh-Day Adventist Church, what uses of these technologies they make in their work, what is their mobilization for the appropriation of an innovative culture in the daily pastoral work, how these uses allow them to manage their religious activity, these are the main questions of a survey we (...) conducted in 2016 to shed light on uses of digital technologies by Romanian Seventh-Day Adventist pastors. (shrink)

This study analyzes two public speeches of two North-American Seventh-day Adventist women who oppose women’s ordination, in order to understand how they reconcile inequity perpetuated by their religious position that denigrates women. The two women in this study address the apparent disadvantage by reframing the issue and reordering their reality. Whereas one speaker creates other formidable sub-issues that make exclusion of women from church leadership imperative, the other speaker resorts to the elusive notion of female privilege. I demonstrate how (...) their discourse surrounding ministry and headship illuminates the fact that gender relations and religious convictions are ordered through permeable boundaries of arbitrary lexico-semantics. (shrink)

Ten years ago National Geographic magazine reported that the Loma Linda Seventh-day Adventist population is one of the communities in the world that lives longer and with a higher quality of life thanks in part to the biological benefits of a vegetarian diet. Along with National Geographic, other media outlets have reported since then that the Adventist religious community considers a plant-based diet a very important factor for a healthy lifestyle. Adventists have been promoting this type of diet (...) worldwide for more than 150 years. This article is an attempt to understand from a social-scientific perspective the origin of the importance they lend to diet and see whether this helps explain why approximately 150 years after the founding of the church, diet remains crucial for Adventists around the world. The conclusion proposed is that Adventists understood the adoption of a plant-based diet as a special divine instruction in order to nourish their new identity as a special people differentiated from the rest of society. This was possible through a desecularisation of diet that placed food in the moral category of the Adventist belief system.Keywords: Seventh-day Adventist Church; vegetarian diet; religion; health; desecularisation; identity. (shrink)

The book of Revelation contains rich imagery that has always aroused deep interest among Christian commentators. One of the most mysterious parts is Rev. 13, where the author wrote about the forces of evil fighting with God. John introduced the two main satanic forces – the beast from the sea and the beast from the earth. There is a unique interpretation in the Adventist Church that the beast from the earth (Rev. 13:11‑18) symbolizes the Protestant country of the USA. However, (...) the emergence and development of this interpretation in the Seventh-day Adventist Church has not received sufficient attention. This article traces the development and characterizes the interpretation of the beast from the earth (Rev. 13:11‑18) among Adventist pioneers. The first impetus for identifying the beast from the earth was the eschatological understanding of the Sabbath as a central issue in end-time events. Hermeneutic methods of Early Adventists were based on the principle of historicism, and they began to view Sunday as the mark of the beast from the sea (papacy) to be forcibly imposed by the beast from the land – the Protestant USA. G. W. Holt first stated that America would become an ally of the Antichrist and is a symbol of the beast from the earth. Other Adventists accepted this interpretation, which was confirmed in the visions of Ellen White. John Nevins Andrews made significant contributions to the biblical basis for the Adventist understanding of the beast from the earth. Building on his comments, John Loughborough, Uriah Smith, and Ellen White deepened and developed the arguments regarding the interpretation of the beast from the earth. Anticipation of the law on mandatory Sunday observance in the USA has become part of Adventist eschatology. Based on the apocalyptic prophecies of the book of Revelation, Adventists saw a future unification of Christendom in which US Protestantism would play a key role. (shrink)

The topic of the study is a component of modern scientific exploration that examines the role of the Seventh-day Adventist Church in building our multi-denominational society. In particular, the issue of determining the place and role of the Adventist Church in society and the state is important. However, today it is possible to unleash it only by summing up the accumulated experience in this field for the whole period of the history of Adventism in Ukraine. The problem (...) of state-confessional relations is important, but it has not been given sufficient importance in terms of theoretical research, which sometimes leads to gross errors in the construction of these relations, which is not beneficial to society. Thus, it is interesting for us to experience the emergence of relations between the state and the Adventist faith in the Ukrainian lands that were part of the Russian Empire, since that is when the formation of the Adventist Church in the domestic territories began. (shrink)

This paper discusses the nature and the status of inference to the best explanation. We outline the foundational role given IBE by its defenders and the arguments of critics who deny it any place at all ; argue that, on the two main conceptions of explanation, IBE cannot be a foundational inference rule ; sketch an account of IBE that makes it contextual and dependent on substantive empirical assumptions, much as simplicity seems to be ; show how that account (...) avoids the critics ' complaints and leaves IBE an important role ; and sketch how our account can clarify debates over IBE in arguments for scientific realism. (shrink)

In many applications of physics, boundary conditions have an essential role. The purpose of this paper is to examine from both a historical and philosophical perspective one such boundary condition, namely, the no-slip condition of fluid dynamics. The historical perspective is based on the works of George Stokes and serves as the foundation for the philosophical perspective. It is seen that historically the acceptance of the no-slip condition was problematic. Philosophically, the no-slip condition is interesting since the use of (...) the no-slip condition illustrates nicely the use of scientific models. But more importantly, both the use and justification of the no-slip condition illustrate clearly how theories can holistically approach the world through model construction. Further, since much of the debate over scientific realism occurs in the realm of models, a case is made that an understanding of the role of the no-slip condition has something to offer to this debate. (shrink)

Induced by intake of the psychedelic substances LSD, psilocybin, DMT and mescaline, psychedelic experiences have been extensively described by subjects as entailing a most unusual increase in the scope and quality of their consciousness. Accordingly, psychedelic experiences have been widely characterised as an “expansion of consciousness.” This article poses the following question, as yet unaddressed in contemporary philosophy and the tradition of phenomenology: to what exactly does “expansion of consciousness” refer as a general characterisation of psychedelic experiences, and what (...) class='Hi'>role might attention play therein? On the basis of Aron Gurwitsch’s phenomenology of attention, the following thesis is presented: (a) “expansion of consciousness” refers to a particular restructuration of consciousness in psychedelic experiences. (b) This occurs by means of certain extreme transformations in direction, scope, mode and degree of attention. In order to explicate this thesis, the characteristic features of psychedelic experiences that pertain to expansion of consciousness and attention are first systematically identified from a survey of subject reports. Second, it is demonstrated that the few previous attempts to understand expansion of consciousness in terms of attention as a filter/reducing-valve, spotlight or zoom-lens each fail to explain how consciousness is structured in psychedelic experiences. Third, it is argued that psychedelic expansion of consciousness is a general restructuration of consciousness by means of extreme attentional transformations. In conclusion, brief consideration is given to the question of whether psychedelic expansion of consciousness can have epistemic and ethical value for life. (shrink)

This essay argues that the "classical" or "standard" computation model of an enviroment of thought may hamstring the nascent cognitive science of religion by masking the ways in which the bare biological brain is prosthetically extended and embedded in the surrounding landscape. The motivation for distinsuishing between the problem-solving profiles of the basic brain and the brain-plus-scaffolding is that in many domains non-biological artifacts support and augment biological modes of computation - often allowing us to overcome some of the brain's (...) native computation limitations. The recognition that in some contexts not all of the relevant computational machinery fits inside the head suggests that we should reconsider the possible role and significance of material culture in religious cognition. More specifically, the broad spectrum of rituals, music, relics, scriptures, statues and buildings typically associated with religious traditions may be more than quaint ethnographic window dressing. Rather than thin cultural wrap arounds that decorate the real cognitive processes going on underneath, these elements could represent central components of the relevant machinery of religious thought. By introducing tangible features of the world that can be physically manipulated and tracked in real-time, for example, the cognitive scaffolding that religious material culture affords seems tailor-made for allowing people to exchange the intricate "off-line" problems that arise from dealing with invisible, counter-intuitive supernatural agents for the kinds of "on-line" cognitive tasks they are naturally good at doing. (shrink)

In this paper I critically evaluate Ronald Dworkin's attempt in Life's Dominion to understand sacred value as a form of intrinsic value which is grounded in investment. I argue that there are two problems with Dworkin's conception of intrinsic value. First, it does not allow him to distinguish, as he must, between incremental and sacred values. Secondly, sacred value qua intrinsic value is not the kind of value which can be grounded in investment. I argue that both of these problems (...) are an implication of a realist conception of intrinsic value. Nevertheless, investment does seem to play a role in our judgements about intrinsic value and in light of this I aim to develop an alternative account of intrinsic value whichcan make sense of this. (shrink)

There has been considerable recent debate about prostitution in Europe that reflects concerns about health, employment and human rights. Legal changes are being introduced in many countries. We focus on two examples in order to discuss the likely implications. A new law in The Netherlands is normalizing aspects of the sex industry through decriminalizing both workers and businesses. In Sweden, on the other hand, prostitution is considered to be a social problem, and a new law criminalizes the purchasers of sexual (...) services in an attempt to reduce demand. Both reforms appear to have had their desired effect at one level; in The Netherlands, health and safety regulations will be introduced as in any other job, and EU sex workers gain full social, legal and employment rights; in Sweden there was initially a tenfold decrease in the numbers of women working visibly on the streets, and some workers have left the industry. However, in both countries, the new legislation has also driven some sex work underground. Many sex workers are excluded by the Dutch system and move underground to become effectively invisible to the authorities. In Sweden sex workers and their clients also become less visible in order that the latter can avoid sanction. Social and economic changes, such as increased migration and the growing use of the Internet will also render the sex industry less visible both to state regulation and to health care workers. The major problems of prostitution for the workers remain exploitation, stigma, abuse and criminalization. These are not unique to the industry, and can only be tackled effectively by the self-organization of sex workers into unions and rights groups, along with full decriminalization. An alternative vision is promised through self-organization and anti-racist actions by sex workers in Germany; normalization and workers’ rights are tackled alongside training programmes for those seeking alternatives. Policy makers throughout Europe would do well to look at their experience and not simply at the clash of legal reforms. (shrink)

BackgroundCommunity engagement is increasingly promoted as a marker of good, ethical practice in the context of international collaborative research in low-income countries. There is, however, no widely agreed definition of community engagement or of approaches adopted. Justifications given for its use also vary. Community engagement is, for example, variously seen to be of value in: the development of more effective and appropriate consent processes; improved understanding of the aims and forms of research; higher recruitment rates; the identification of important ethical (...) issues; the building of better relationships between the community and researchers; the obtaining of community permission to approach potential research participants; and, the provision of better health care. Despite these diverse and potentially competing claims made for the importance of community engagement, there is very little published evidence on effective models of engagement or their evaluation.MethodsIn this paper, drawing upon interviews with the members of a Community Advisory Board on the Thai-Myanmar border, we describe and critically reflect upon an approach to community engagement which was developed in the context of international collaborative research in the border region.Results and conclusionsDrawing on our analysis, we identify a number of considerations relevant to the development of an approach to evaluating community engagement in this complex research setting. The paper also identifies a range of important ways in which the Community Advisory Board is in practice understood by its members to have morally significant roles and responsibilities beyond those usually associated with the successful and appropriate conduct of research. (shrink)

In many applications of physics, boundary conditions have an essential role. The purpose of this paper is to examine from both a historical and philosophical perspective one such boundary condition, namely, the no-slip condition of fluid dynamics. The historical perspective is based on the works of George Stokes and serves as the foundation for the philosophical perspective. It is seen that historically the acceptance of the no-slip condition was problematic. Philosophically, the no-slip condition is interesting since the use of (...) the no-slip condition illustrates nicely the use of scientific models. But more importantly, both the use and justification of the no-slip condition illustrate clearly how theories can holistically approach the world through model construction. Further, since much of the debate over scientific realism occurs in the realm of models, a case is made that an understanding of the role of the no-slip condition has something to offer to this debate. (shrink)

This article addresses the role of social media fragments in the return of fascist politics It argues that beside or contrary to a conscious collective intelligence emerging through the internet, a collective unconscious has seized the political space, delegitimatizing modern institutions of documentary truth based on evidence, method, and the institutional construction of facts.

ABSTRACT Although dominant discourses of various kinds are frequently reproduced on talk radio, the fundamentally collaborative nature of the medium also means that it is able to serve as a channel through which to challenge these discourses. Using Critical Discourse Analysis, this article examines how neoliberal ideology structures discussions around ‘service delivery protest’ on South African talk radio, and explores some of the roles that talk radio is, and is not, able to play in constructing resistance to neoliberal ideology. Our (...) analysis yielded two discourses, namely: naturalisation of the commodification of everyday life, and market over welfare – both of which seemed to cohere with neoliberal frameworks and rationalities in different ways. We conclude by suggesting how radio can be used to denaturalise neoliberalism’s impulse towards making common sense conditions that enable economic oppression and exploitation. (shrink)

This chapter contains sections titled: Notes.

BackgroundSarcomas are a diverse group of neoplasms that vary greatly in clinical presentation and responsiveness to treatment. Given the differences in the sites of involvement, rarity, and treatment modality, a multidisciplinary approach is required. Previous literature suggests patients with sarcoma suffer from poorer quality of life especially physical and functional wellbeing. Adolescent and young adult patients are an underrepresented population in cancer research and have differing factors influencing QoL.MethodsRetrospective analysis of Young Adult patients enrolled in the Sarcoma Tissue Repository at (...) University of Iowa. QoL was assessed using the self-report FACT-G questionnaire at enrollment and 12 months post-diagnosis; overall scores and the 4 wellbeing subscales were calculated. Linear mixed effects models were used to measure the association between the rate of change in FACT-G subscale scores and baseline clinical, comorbidity, and treatment characteristics.Results49 patients were identified. 57.1% of patients had a malignancy involving an extremity. Mean FACT-G scores of overall wellbeing improved from baseline to 12 months. Social and emotional wellbeing did not differ significantly between baseline and 12 months. Physical wellbeing and functional wellbeing scores improved from baseline to 12 months. No difference was seen for FACT-G overall scores for age, sex, laterality, marital status, performance status, having children, clinical stage, limb surgery, chemotherapy, or tumor size. A difference was demonstrated in physical wellbeing scores for patients with baseline limitation compared to those with no baseline limitation. A difference was demonstrated in social wellbeing based on anatomical site.ConclusionYoung adults with sarcoma treated at a tertiary center had improvements in overall reported QoL at 12 months from diagnosis. Overall baseline QoL scores on FACT-G were lower than the general adult population for YA patients with sarcoma but at 12 months became in line with general population norms. The improvements seen merit further investigation to evaluate how these change over the continuum of care. Quality of life changes may be useful outcomes of interest in sarcoma trials. (shrink)

This is an abridged, paperback edition of Peter le Huray and James Day's invaluable anthology of writings concerned with the role of music in eighteenth- and early-nineteenth-century aesthetics. This volume retains all the most important and significant items from the original hardcover edition. Over fifty writers are represented here, including such major figures as Rousseau, Kant, Schlegel, Schopenhauer and Hegel, and the useful introductions and biographical details of the original are also retained. The aesthetic literature of the period is (...) profuse but this carefully edited volume offers a balanced selection which illuminates the ways people experienced music and how they came to an understanding in particular of the new music of their day. (shrink)

Intimacies and domestic lives -- Reproduction.

Abductive reasoning is central to reconstructing the past in the geosciences. This paper outlines the nature of the abductive method and restates it in Bayesian terms. Evidence plays a key role in this working method and, in particular, traces of the past are important in this explanatory framework. Traces, whether singularly or as groups, are interpreted within the context of the event for which they have evidential claims. Traces are not considered as independent entities but rather as inter-related pieces (...) of information concerning the likelihood of specific events. Exemplification of the use of such traces is provided by dissecting an example of their use in the environmental reconstruction of mountain climate. (shrink)

Ever feel concerned that you may not achieve your career goals, or feel worried about where your life is going? Such examples may reflect the experience of status anxiety, that is, concerns that one may be stuck or not able to move up in life, or worries that one may be too low in standing compared to society’s standards. Status anxiety is believed to be exacerbated by economic inequality and negatively affect well-being. While job satisfaction is an important determinant of (...) well-being, no research has examined whether status anxiety can also help explain people’s satisfaction with their jobs. We tested whether status anxiety differs from other organizational constructs and uniquely relates to job satisfaction among full-time working adults. In a pilot study we found that status anxiety is separate from the concept of job insecurity (e.g.,, perceived threat of job loss). Results of our main study also indicated that higher status anxiety significantly predicted lower job satisfaction beyond several other indicators of organizational attitudes (job insecurity, occupational self-efficacy, distributive, procedural, and interactional justice), as well as the tendency to seek status and several background factors (e.g., income, education, perceived socioeconomic status). We discuss the unique role of status anxiety in job satisfaction and the implications of this research to our understanding of status concerns as well as organizational attitudes and policies. (shrink)

We propose that distinct leadership competencies differ in their development over time. Extending the integrative model of leader development (Day, Harrison, & Halpin, 2009), we further propose that leader identity will form complex relationships with leadership competencies over time. To test these propositions, we use longitudinal data (i.e., five month, four measurement points) of the 80 in total high-potential executives in a corporate leadership development program. We find significant difference in the initial levels and changes of eight distinct leadership competencies. (...) We also find that leader identity relates to the development of certain – but not all -- leadership competencies. Finally, we demonstrate the importance of developing leadership competencies by linking them to career advancement (i.e., job promotion). These findings are discussed in light of their theoretical and practical implications. (shrink)

The purpose of this study is to examine the topic of older people in the world from the perspective of the Social Teaching of the Church. As explained in Christifideles Laici , the Catholic Church believes that the laity is summoned to pave the way for the arrival of God’s Kingdom, and people who are at an advanced age should still respond to God’s calling through their own unique way of contribution. In Familiaris Consortio it is emphasized that the Church (...) should help older people manifest their roles both in families and religious groups. Although it is mentioned in these two apostolic exhortations that older people are blessed with wisdom, it is not explained as they actually acquire such a blessing. In order to address this issue and elaborate on the meaning of older people’s wisdom, Grün’s theory on the nature of older people’s wisdom and where such a blessing comes from is made reference to in this study. Moreover, it is emphasized in the apostolic exhortation of Familiaris Consortio that older people are often marginalized in today’s industrialized and urbanized society and neglected in their families, while also enduring psychological and/or physical pain. Addressing this issue, the value of older people’s work and their unshirkable missions and duties are explained in the present study by examining the nature and value of man’s work as mentioned in Laborem Exercens . Sen’s “capability approach” is also utilized in the present study as a way to examine older people’s values and the deprivation of their capability, allowing an in-depth analysis of this topic. The findings of this study reveal that Grün’s theory of older people’s wisdom being shaped by their life-experiences is significantly complementary to the messages on older people in Christifideles Laici and Familiaris Consortio . While Sen’s capability approach does not offer a complete set of values or cultural system that solves this problem, the approach of “civilization of love” proposed in the Social Teaching of the Church is very useful in helping one contemplate on the problems faced by older people around the world. (shrink)

In this paper, we show that the question of the relative importance of innate characteristics and institutional arrangements in explaining human difference was vehemently contested in Britain during the first half of the nineteenth century. Thus Sir Francis Galton’s work of the 1860s should be seen as an intervention in a pre-existing controversy. The central figure in these earlier debates—as well as many later ones—was the philosopher and economist John Stuart Mill. In Mill’s view, human nature was fundamentally shaped by (...) history and culture, factors that accounted for most mental and behavioral differences between men and women and among people of different classes, nationalities, and races. Indeed, Mill’s whole program of social reform depended on the assumption that human differences were not fixed by nature. To identify the leading figures in these disputes about difference and the concrete context in which they occurred, we explore three debates in which Mill played a key role: over the capacities and rights of women, the viability of peasant proprietorship in India and Ireland, and the status of black labor in Jamaica. The last two draw our attention to the important colonial context of the nature–nurture debate. We also show that ideas that for us seem of a piece were not always linked for these earlier thinkers, nor did views on innateness necessarily have the political correlates that we now take for granted. (shrink)

Over the past seventy-five years, the UN has evolved significantly, often in response to geopolitical dynamics and new waves of thinking. In some respects, the UN has registered remarkable achievements, stimulating a wide range of multilateral treaties, promoting significant growth of human rights, and at times playing a central role in containing and preventing large-scale armed conflict. As part of the special issue on “The United Nations at Seventy-Five: Looking Back to Look Forward,” this essay argues that the organization (...) has been the most impactful in three areas: producing, shaping, and driving key ideas, particularly on development and rights; generating such effective operational agencies as UNICEF and the World Food Program; and, especially in the immediate post–Cold War period, addressing major conflict risks through the Security Council. Since then, however, the UN has struggled to meet emerging challenges on many fronts and been increasingly hampered by internal ossification and institutional sprawl as well as internecine dysfunction. The twenty-first century has confronted the UN with further challenges relating most notably to climate change; to risks arising from new technologies; and to the increasingly fraught relationships between China, Russia, and the United States. If the past seventy-five years can offer one lesson, it is that new thinking and new ideas will need to drive the organization to evolve still further and faster, or else risk irrelevance. (shrink)

This paper discusses ways in which empirical research investigating sexual networks can further understanding of the transmission of HIV in London, using information from a 24-month period of participant observation and 53 open-ended, in-depth interviews with eighteen men and one woman who have direct and indirect sexual links with each other. These interviews enabled the identification of a wider sexual network between 154 participants and contacts during the year August 1994-July 1995. The linked network data help to identify pathways of (...) transmission between individuals who are HIV+ and those who are HIVolderyounger’ men, and with male prostitutes. There appears to be considerable on-going transmission of HIV in London. The majority of participants reported having had unprotected anal and/or vaginal sex within a variety of relationships. The implications of these findings for policies designed to prevent the transmission of HIV are discussed. (shrink)

Background:Moral distress occurs when constraints prevent healthcare providers from acting in accordance with their core moral values to provide good patient care. The experience of moral distress in nurses might be magnified during the current Covid-19 pandemic.Objective:To explore causes of moral distress in nurses caring for Covid-19 patients and identify strategies to enhance their moral resiliency.Research design:A qualitative study using a qualitative content analysis of focus group discussions and in-depth interviews. We purposively sampled 31 nurses caring for Covid-19 patients in (...) the acute care units within large academic medical systems in Maryland and New York City during April to June 2020.Ethical considerations:We obtained approval from the Institutional Review Board at the University of Maryland, Baltimore.Results:We identified themes and sub-themes representative of major causes of moral distress in nurses caring Covid-19 patients. These included (a) lack of knowledge and uncertainty regarding how to treat a new illness; (b) being overwhelmed by the depth and breadth of the Covid-19 illness; (c) fear of exposure to the virus leading to suboptimal care; (d) adopting a team model of nursing care that caused intra-professional tensions and miscommunications; (e) policies to reduce viral transmission (visitation policy and PPE policy) that prevented nurses to assume their caring role; (f) practicing within crisis standards of care; and (g) dealing with medical resource scarcity. Participants discussed their coping mechanisms and suggested future strategies.Discussion/Conclusion:Our study affirms new causes of moral distress related to the Covid-19 pandemic. Institutions need to develop a supportive ethical climate that can restore nurses’ moral resiliency. Such a climate should include non-hierarchical interdisciplinary spaces where all providers can meet together as moral peers to discuss their experiences. (shrink)

BackgroundImportant sex and gender differences have been found in research on diabetes complications and treatment. Reporting on whether and how sex and gender impact research findings is crucial for developing tailored diabetes care strategies. To analyze the extent to which this information is available in current diabetes research, we examined original investigations on diabetes for the integration of sex and gender in study reporting.MethodsWe examined original investigations on diabetes published between January 1 and December 31, 2015, in the top five (...) general medicine journals and top five diabetes-specific journals (by 2015 impact factor). Data were extracted on sex and gender integration across seven article sections: title, abstract, introduction, methods, results, discussion, and limitations.ResultsWe identified 155 original investigations on diabetes, including 115 randomized controlled trials (RCTs) and 40 observational studies. Sex and gender were rarely incorporated in article titles, abstracts and introductions. Most methods sections did not describe plans for sex/gender analyses; 47 (30.3%) articles described plans to control for sex/gender in the analysis and 12 (7.7%) described plans to stratify results by sex/gender. While most articles (151, 97.4%) reported the sex/gender of study participants, only 10 (6.5%) of all articles reported all study outcomes separately by sex/gender. Discussion of sex-related issues was incorporated into 21 (13.5%) original investigations; however, just 1 (0.6%) discussed gender-related issues. Comparison by journal type (general medicine vs. diabetes specific) yielded only minor differences from the overall integration results. In contrast, RCTs performed more poorly on multiple sex/gender assessment metrics compared to observational studies.ConclusionsSex and gender are poorly integrated in current diabetes original investigations, suggesting that substantial improvements in sex and gender data reporting are needed to inform the evidence to support sex- and gender-specific diabetes care. (shrink)

Background Community advisory boards have expanded beyond high-income countries and play an increasing role in low- and middle-income country research. Much research has examined CABs in HICs, but less is known about CABs in LMICs. The purposes of this scoping review are to examine the creation and implementation of CABs in LMICs, including identifying frequently reported challenges, and to discuss implications for research ethics. Methods We searched five databases for publications describing or evaluating CABs in LMICs. Two researchers independently (...) reviewed articles for inclusion. Data related to the following aspects of CABs were extracted from included publications: time, country, financial support, research focus, responsibilities, and challenges. Thematic analyses were used to summarize textual data describing challenges. Results Our search yielded 2005 citations, 83 of which were deemed eligible for inclusion. Most studies were published between 2010 and 2017. Upper-middle-income countries were more likely to have studies describing CABs, with South Africa, China, and Thailand having the greatest numbers. The United States National Institutes of Health was the main source of financial support for CABs. Many CABs focused on HIV research. Thirty-four studies reported how CABs influenced the informed consent process for clinical trials or other aspects of research ethics. CAB responsibilities were related to clinical trials, including reviewing study protocols, educating local communities about research activities, and promoting the ethical conduct of research. Challenges faced by CABs included the following: incomplete ethical regulations and guidance; limited knowledge of science among members of communities and CABs; unstable and unbalanced power relationships between researchers and local communities; poor CAB management, including lack of formal participation structures and absence of CAB leadership; competing demands for time that limited participation in CAB activities; and language barriers between research staff and community members. Several challenges reflected shortcomings within the research team. Conclusions Our findings examine the formation and implementation of CABs in LMICs and identify several ethical challenges. These findings suggest the need for further ethics training among CAB members and researchers in LMICs. (shrink)

The peculiarities of the philosophy and practices of realization of the principles of a healthy way of life by the Seventh-day Adventist Church in Ukraine are considered. It has been established that the social and cultural changes caused by Ukraine’s independence have contributed to the opening of sanatoriums, boarding houses, and health centers by Adventist believers. It has been stated that since 1991, Adventists have generally conducted short-term health programs and exhibitions, but over time have shifted to the (...) Western system of providing services based on permanent health facilities. The philosophy and practices of the Church's implementation of a healthy lifestyle are outlined Seventh-day Adventists in Ukraine in the context of the work of medical, sanatorium and health facilities that belong directly to this religious organization. The practical novelty of the study is based on interviews with health care managers who were directly involved in the establishment of health facilities and the implementation of various Adventist health programs. It was found that representatives of other Protestant and Orthodox denominations who visited the recreation centers changed their minds about Adventism and Adventists, which, in turn, contributed to the creation of an atmosphere of religious tolerance and tolerance for each other. The activities of the inspected health centers, sanatoriums and boarding houses mainly carry out the mission of the Seventh-day Adventist Church, and the performers (staff) see their contribution to the service of God in the prevention of diseases and rehabilitation of patients. In addition, in the institutions we have studied, special attention is paid to teaching about the principles of a healthy lifestyle, proper nutrition, hydrotherapy and more. It is determined that the process of implementing health programs is based on the principles of Christian ethics, which managers and staff try to follow, seeing it as fulfilling Christ’s mission on earth, especially in the field of restoring and preventing the health of sanatorium visitors. (shrink)

Introduction: There is significant overlap in the type of structural language impairments exhibited by children with autism spectrum disorder and children with attention deficit hyperactivity disorder. This similarity suggests that the cognitive impairment contributing to the structural language deficits in ASD and ADHD may be shared. Previous studies have speculated that procedural memory deficits may be the shared cognitive impairment. The procedural deficit hypothesis argues that language deficits can be explained by differences in the neural structures underlying the procedural memory (...) network. This hypothesis is based on the premise that the neural structures comprising the procedural network support language learning. In this study, we aimed to test the PDH in children with ASD, ADHD, and typical development.Methods: One hundred and sixty-three participants : 91 with ASD, 26 with ADHD, and 46 with TD, completed standardized measures of cognitive and language ability as well as structural magnetic resonance imaging. We compared the structural language abilities, the neural structures underlying the procedural memory network, and the relationship between structural language and neural structure across diagnostic groups.Results: Our analyses revealed that while the structural language abilities differed across ASD, ADHD, and TD groups, the thickness, area, and volume of the structures supporting the procedural memory network were not significantly different between diagnostic groups. Also, several neural structures were associated with structural language abilities across diagnostic groups. Only two of these structures, the inferior frontal gyrus, and the left superior parietal gyrus, are known to be linked to the procedural memory network.Conclusions: The inferior frontal gyrus and the left superior parietal gyrus, have well-established roles in language learning independent of their role as part of the procedural memory system. Other structures such as the caudate and cerebellum, with critical roles in the procedural memory network, were not associated with structural language abilities across diagnostic groups. It is unclear whether the procedural memory network plays a fundamental role in language learning in ASD, ADHD, and TD. (shrink)

The article attempts to address the issue of nudity and eroticism in stage and screen versions of Shakespeare’s plays. Elizabethan theatrical conventions and moral and political censorship of the English Renaissance did not allow for an explicit presentation of naked bodies and sexual interactions on stage; rather, these were relegated to the verbal plane, hence the bawdy language Shakespeare employed on many occasions. Conventions play a significant role also in the present-day, post-1960s and post-sexual revolution era, whereby human sexuality (...) in Western culture is not just alluded to, but discussed and presented in an open manner. Consequently, nudity on stage and screen in versions of Shakespeare’s plays has become more marked and outspoken. Indeed, in both filmic and TV productions as well as stage performances directors and actors more and more willingly have exposed human body and sexuality to the viewer/spectator. My aim is to look at such instances from the perspective of realism and realistic conventions that the three media deploy and the effect nudity/sex can have on the recipient. The conclusion is that theatre is most conventional and stark realism and directness of the message need to be carefully dosed. Similarly to the theatre, television, more specifically television theatre, is, too, a most direct genre, as television is inherently a live medium, the broadcasts of which occur here and now, in the present tense. Film is markedly different from the two previous forms of art: it is narrated in the past tense, thus creating a distance between what is shown and the viewer, and allowing for more literalness. Naturally, particular cases discussed in the article go beyond these rather simple divisions. (shrink)

Historically, studies of the role of endogenous hormones in developmental differentiation of the sexes have suggested that mammalian sexual differentiation is mediated primarily by testicular androgens, and that exposure to androgens in early life leads to a male brain as defined by neuroanatomy and behavior. The female brain has been assumed to develop via a hormonal default mechanism, in the absence of androgen or other hormones. Ovarian hormones have significant effects on the development of a sexually dimorphic cortical structure, (...) the corpus callosum, which is larger in male than in female rats. In the females, removal of the ovaries as late as Day 16 increases the cross-sectional area of the adult corpus callosum. Treatment with low-dose estradiol starting on Day 25 inhibits this effect. Female callosa are also enlarged by a combination of daily postnatal handling and exogenous testosterone administered prior to Day 8. The effects of androgen treatment are expressed early in development, with males and testosterone-treated females having larger callosa than control females as early as Day 30. The effects of ovariectomy do not appear until after Day 55. These findings are more consistent with other evidence of a later sensitive period for ovarian feminization as compared to androgenic masculinization. (shrink)

Hobbes could not have written Paradise Lost: the longest of his few references to the story of Adam and Eve drains their relationship of drama and complexity; most aspects of human sexuality he addresses only in classifying them as off limits because of their indecency, neglecting topics in some respects germane to the clarification of his philosophy; and his original English verse amounts to one line for each of that epic's twelve books. This short poem nonetheless represents an intriguing persuasion (...) to love written in his extreme old age. Moreover, his treatment of “LUST” in The Elements of Law takes a significantly non-judgmental form by the standards of his time, though not marking so substantial an innovation as Simon Blackburn takes it to be. Most importantly, the anti-puritanical thrust of Hobbes's attack on Presbyterian preachers in Behemoth again illustrates his capacity for entertaining—however briefly—an essentially uncensorious view of human sexuality, this time in conjunction with a critique of sexual repression, as imposed by those clergymen in their role as spiritual advisers, that sheds invaluable light on the self-consciously scandalous libertinism of younger contemporaries often identified in his own day and since as “Hobbists”. (shrink)

In spite of these efforts in the 1920s and 1930s to initiate ongoing research on contraception, the subject of birth control remained a problem of concern primarily to the social activist rather than to the research scientist or practicing physician.80 In the 1930s, as has been shown, American scientists turned to the study of other aspects of reproductive physiology, while American physicians, anxious to eliminate the moral and medical dangers of contraception, only reluctantly accepted birth control as falling within their (...) professional domain.As a result, the problem of cheap, effective, and safe contraception was not solved by these earliest attempts. Consideration of the subject was initiated afresh by private philanthropy after World War II, sparked by a new wave of interest in population studies.81 Summarizing such efforts to support research in the reproductive sciences, a recent Ford Foundation study has noted: “To initiate and sustain serious research in the reproductive sciences has required for more than half a century concerted effort by interested individuals and private organizations, mainly from outside the mainstreams of the biomedical research community.”82The early laboratory research on chemical contraception described in this paper was but one important outcome of the concerted effort made by reformers in the 1920s to eliminate a variety of social problems thought to derive from excessive fertility. Scientific arguments and expertise were employed to advocate reform as well as to define the appropriate solution to such social problems. Scientists were recruited as advocates for the movement, but they were also employed as researchers in laboratory investigations sponsored by these same reformers.Sponsors of these early laboratory studies noted the difficulty of obtaining first-class investigators.83 The routine analyses necessary for such research, as well as the traditional scientific aversion to applied problems, provide only a partial explanation for this response. The real difficulty lay in recruiting investigators to a field that had previously been taboo. Once opened up — first as socially relevant, and finally as scientifically sound — there was much interest in this area, and the appeal to researchers of the scientific issues surrounding fertility and reproduction soon surpassed that of the reforming value of birth control.A survey of the kinds of experimental investigations sponsored by birth control advocates indicates the range of physiological problems explored by contraceptive research. The most definitive work was done on the efficacy and safety of spermicides, but the potential of other contraceptive methods was also examined. Investigators attempted to develop spermatoxins that would effectively immunize women against sperm, and they also tried to elucidate the mechanism of hormonal control of reproduction. In fact, speculations about the possible hormonal manipulation of fertility were expressed at the Seventh International Birth Control Conference held in Zurich in 1930.84In the 1920s, clinical studies were undertaken to assess the effectiveness of the various birth control methods. Laboratory investigators complemented this work by screening spermicides for safety and testing for their ability to kill sperm. There were a variety of birth control preparations on the market, but no one really knew whether these were effective or even safe.85 Although the physiology of other major organ systems was well advanced, the scientific study of reproductive physiology and contraceptive technology was clearly in its infancy in this period. Routine analyses simply could not be conducted, because the fundamental research establishing baselines had not yet been done. Scientists used this fact to redirect attention to basic research on reproduction.Laboratory research on contraception indicated important unexplored areas for physiological investigation. Social activists, who had encouraged prominent scientists to become interested in both the social value and the genetic implications of birth control, found these investigators revising the goals of their research. The biologists had formed their own network and had begun to seek out funding, reformulating the justification for sponsorship of further investigations. The eugenic motivations underlying these studies, which had initially made them theoretically attractive to biologists, were gradually eroded. Concern with “human evolution” ceded its place to interest in physiological mechanisms. Crew and others began to note that the use of biological theory to justify essentially political decisions had serious limitations. Biologists had become uncomfortable with those very arguments which had originally captured their interest. Recognition of the potential political abuse wrought by applying scientific principles to society was expressed by Crew just one year after the Zurich meeting. Referring to previous assessments of the role of sex in reproduction, he generalized: “In the past the biologist has justified feudalism, Manchester Liberalism, socialism and every other type of social organization and political programme by reference to selected biological phenomena.”86 By 1932 Crew had also begun to question the biological logic of regulated breeding, and had made it clear to his American sponsor that there was no simple correspondence between the practice of birth control and the genetic improvement of the human race.87Biologists further began to recognize, however, that although the hopeful genetic solution to human problems was probably an illusion, contraception still remained one tangible means to alleviate, human misery. Some laboratory scientists, like Crew, acknowledged the applicability of their own particular skills to this problem. For a few brief years, social needs and scientific goals were mutually supportive and closely intertwined. But as laboratory researchers gained interest in the study of reproduction and established their own priorities in this field, they temporarily withdrew from the arena of debate over birth control as an important mechanism for social reform.With the rise of Hitler, the genetic arguments for birth control rapidly lost their appeal. But by that time the scientific problem of how to achieve effective contraception had entered the professional consciousness. Both physicians and scientists began to be aware of birth control as a subject within their domain of expertise, although outside the principal focus of their research. Scientific discussion of birth control permanently altered from a question of justification to a problem of method: How could one achieve reliable and safe contraception? This had been Sanger's and Dickinson's goal from the beginning. Laboratory scientists had indeed been persuaded to undertake this work; this research had in turn affected biologists' perceptions of the whole field of reproductive physiology, encouraging further study of reproductive mechanisms. The promise of new knowledge provided for continued funding of this research, despite the caution by scientists that the social benefits would not be as immediate or as far-reaching as advocates and they themselves had first argued.The activities of birth control activists and their supporting agencies, and the financial backing of private contributors and foundations, notably the Rockefeller philanthropies, provided an important new stimulus to the development of research on the biology of reproduction in the late 1920s and early 1930s. Biologists were able to claim an enlarged realm of issues for scientific study through their activities as advocates and as investigators for the birth control movement. At the same time, they promised as-yet-undiscovered possibilities for regulating human reproduction once its physiology was understood. The knowledge and control that they promised lay in understanding the whole reproductive cycle — not merely in evaluating the toxic effects of presumptive spermicides.Chemical spermicides never summoned the interest of scientists as the contraceptive pill was to do, yet that research did reinforce the widespread perceptions of scientific research as essential to social reform. Spermicide investigations focused research efforts in reproductive biology by challenging traditional taboos, defining problems for further study, and providing laboratory investigators the opportunity to assert the social and scientific value of their own skills. Crew echoed this attitude as he observed in 1934:Man has turned from the adventurous conquest of his environment to the conquest of himself. To-day is the day of biological invention, eagerly used for the control of the undesirable and the unwanted. Sex and reproduction are no longer hedged around by myth and taboo; they are no longer accepted as mysteries that defy understanding. They are matters inviting examination and explanation; they are regarded as expressions of physico-chemical forces, the nature of which is to be displayed. It is accepted that when knowledge is sufficient, control will be absolute, and, though knowledge is not yet sufficient, readers... must be persuaded to the view that this will not always be so.88The synergism between reproductive biology and social needs has been temporary and sporadic, but recurring, since the 1920s. Scientific research programs have clearly been influenced by issues raised by public debate. Nevertheless, reproductive biologists have continued to assert their own professional goals. For the most part, they have rejected problems without inherent scientific interest and have spurned applied research except as it has had a direct bearing on current research themes. This attitude, apparent among American and British investigators in the 1930s, created the intellectual context for the invention and acceptance of the technically sophisticated oral contraceptive pill. It did not foster the production and improvement of the simple, safe, effective, and cheap vaginal contraceptive desired by early birth control advocates. (shrink)