Two factors are discussed which have important implications for the issue of paternalism in the neonatal intensive care unit (NICU): the physician's role as advocate for the patient; and the range of typical responses of parents who learn that their neonate has a serious illness. These factors are pertinent to the task of identifying those actions which are paternalistic, as well as to the question of whether paternalism is justified. It is argued that certain behavior by physicians which is (...) often thought to be paternalistic is not in fact so. Furthermore, an argument in defense of paternalism which has largely been overlooked is presented. Examples are given to illustrate how paternalism actually arises in the NICU, and it is argued that paternalism is justified in some cases. (shrink)

. MAINTAINING DISCIPLINE IN DETAINEE OPERATIONS: A STUDY IN SMALL UNIT LEADERSHIP AND ETHICAL BEHAVIOR. Journal of Military Ethics: Vol. 11, No. 4, pp. 363-364. doi: 10.1080/15027570.2012.758409.

In “A new proof of the completeness of the Lukasiewicz axioms” Chang proved that any totally ordered MV-algebra A was isomorphic to the segment \}\) of a totally ordered l-group with strong unit A *. This was done by the simple intuitive idea of putting denumerable copies of A on top of each other. Moreover, he also show that any such group G can be recovered from its segment since \^*}\), establishing an equivalence of categories. In “Interpretation of (...) AF C *-algebras in Lukasiewicz sentential calculus” Mundici extended this result to arbitrary MV-algebras and l-groups with strong unit. He takes the representation of A as a sub-direct product of chains A i, and observes that \ where \. Then he let A * be the l-subgroup generated by A inside \. He proves that this idea works, and establish an equivalence of categories in a rather elaborate way by means of his concept of good sequences and its complicated arithmetics. In this note, essentially self-contained except for Chang’s result, we give a simple proof of this equivalence taking advantage directly of the arithmetics of the the product l-group \, avoiding entirely the notion of good sequence. (shrink)

Aim of this paper is to provide a self-contained presentation of the natural equivalence between MV-algebras and lattice-ordered abelian groups with strong unit.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

More than just a jail, Rikers has become a site of shifting discourse on punishment and justice in the United States. In the book Life and Death in Rikers Island, Homer Venters argues that the systematic failures of jails to provide appropriate safety and care constitute human rights violations and public health risks. The former chief medical officer and commissioner of correctional health services for the NYC Health and Hospitals system, Venters offers critical insight on the Rikers jail system. “Because (...) jails are chaotic and concealed from outside view,” he asserts, “we only become aware of them when very bad outcomes occur, such as deaths.” Life and Death's success lies in how it blends Venters's experiences on the ground as a health care professional with the empirical data he's been able to collect and analyze over the tenure of his career. According to Venters, all suicides, homicides, and accidental deaths in jail are jail attributable, as they reflect system‐wide failures in safety. (shrink)

Assisted reproductive technology has enabled thousands of infertile couples to experience the joys of parenthood. At various times, however, significant problems have come to light concerning the providing of infertility treatment in the United States. An early problem was misleading advertising by some infertility programs, particularly in regard to pregnancy success rates. This unacceptable activity suggested the need for more oversight of assisted reproductive technology and prompted the passage of a federal law requiring the reporting of success rates in a (...) standardized format. Another problem, one that was especially disturbing, was the transfer of preembryos to infertile women at the University of California, Irvine, without the consent of the progenitor couples. Disclosure of these events added fuel to the debate over whether assisted reproductive technology should be subject to greater governmental regulation. (shrink)

Assisted reproductive technology has enabled thousands of infertile couples to experience the joys of parenthood. At various times, however, significant problems have come to light concerning the providing of infertility treatment in the United States. An early problem was misleading advertising by some infertility programs, particularly in regard to pregnancy success rates. This unacceptable activity suggested the need for more oversight of assisted reproductive technology and prompted the passage of a federal law requiring the reporting of success rates in a (...) standardized format. Another problem, one that was especially disturbing, was the transfer of preembryos to infertile women at the University of California, Irvine, without the consent of the progenitor couples. Disclosure of these events added fuel to the debate over whether assisted reproductive technology should be subject to greater governmental regulation. (shrink)

In this paper we extend Mundici’s functor Γ to the category of monadic MV-algebras. More precisely, we define monadic ℓ -groups and we establish a natural equivalence between the category of monadic MV-algebras and the category of monadic ℓ -groups with strong unit. Some applications are given thereof.

In this paper we extend Mundici’s functor Γ to the category of monadic MV-algebras. More precisely, we define monadic ℓ-groups and we establish a natural equivalence between the category of monadic MV-algebras and the category of monadic ℓ-groups with strong unit. Some applications are given thereof.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

_Nietzsche's New Seas_ makes available for the first time in English a representative sample of the best recent Nietzsche scholarship from Germany, France, and the United States. Michael Allen Gillespie and Tracy B. Strong have brought together scholars from a variety of disciplines—philosophy, history, literary criticism, and musicology—and from schools of thought that differ both methodologically and ideologically. The contributors—Karsten Harries, Robert Pippin, Eugen Fink, Hans-Georg Gadamer, Kurt Paul Janz, Sarah Kofman, Jean-Michel Rey, and the editors themselves—take a new (...) approach to Nietzsche, one that begins with the claim that his enigmatic utterances can best be understood by examining the style or structure of his thought. (shrink)

In this paper we extend Mundici's functor? to the category of monadic MV- algebras. More precisely, we define monadic?- groups and we establish a natural equivalence between the category of monadic MV- algebras and the category of monadic?- groups with strong unit. Some applications are given thereof.

Strong Spirits, Kind Hearts is the first practical teacher resource to provide comprehensive coverage of all aspects of developing strong spirits and caring young people. It is focused on middle years’ students but most lessons can be adapted for older and younger students as well. This resource describes ways to incorporate emotional and spiritual supports into daily routines and interactions with students and provides ready-to-use activities, lessons and units that can be integrated into subject area teaching.

Complex, multigenic biological traits are shaped by the emergent interaction of proteins being the main functional units at the molecular scale. Based on a phenomenological approach, algorithms for quantifying two different aspects of emergence were introduced (Wegner and Hao in Progr Biophys Mol Biol 161:54–61, 2021) describing: (i) pairwise reciprocal interactions of proteins mutually modifying their contribution to a complex trait (denoted as weak emergence), and (ii) formation of a new, complex trait by a set of n ‘constitutive’ proteins at (...) concentrations exceeding individual threshold values (strong emergence). The latter algorithm is modified here to take account of protein redundancy with respect to a complex trait (‘full redundancy’). Irreducibility is considered a necessary and sufficient criterion for strong biological emergence; if one constitutive protein is missing, or its concentration drops below the threshold the trait is lost. A definition based on ‘unpredictability’ is dismissed, because this criterion is irrelevant for the evolution of a complex trait, and apparent unpredictability may rather reflect our basic deficits in understanding unless we can provide an unequivocal proof for it. The phenomenological approach advocated here allows to identify hidden rules according to which strongly emergent traits may be organized. This is of high value for understanding the evolution of complex traits which seems to require the saltational advent of all constitutive proteins ‘in one turn’ to arrive at a functional trait providing for an improved fitness of the organism. Rather than being a purely random process, it may be guided by fundamental structural principles. (shrink)

Justification logics are special kinds of modal logics which provide a framework for reasoning about epistemic justifications. For this, they extend classical boolean propositional logic by a family of necessity-style modal operators “t : ”, indexed over t by a corresponding set of justification terms, which thus explicitly encode the justification for the necessity assertion in the syntax. With these operators, one can therefore not only reason about modal effects on propositions but also about dynamics inside the justifications themselves. We (...) replace this classical boolean base with Gödel logic, one of the three most prominent fuzzy logics, i.e. special instances of many-valued logics, taking values in the unit interval [0, 1], which are intended to model inference under vagueness. We extend the canonical possible-world semantics for justification logic to this fuzzy realm by considering fuzzy accessibility- and evaluation-functions evaluated over the minimum t-norm and establish strong completeness theorems for various fuzzy analogies of prominent extensions for basic justification logic. (shrink)

We develop a general algebraic and proof-theoretic study of substructural logics that may lack associativity, along with other structural rules. Our study extends existing work on substructural logics over the full Lambek Calculus [34], Galatos and Ono [18], Galatos et al. [17]). We present a Gentzen-style sequent system that lacks the structural rules of contraction, weakening, exchange and associativity, and can be considered a non-associative formulation of . Moreover, we introduce an equivalent Hilbert-style system and show that the logic associated (...) with and is algebraizable, with the variety of residuated lattice-ordered groupoids with unit serving as its equivalent algebraic semantics. Overcoming technical complications arising from the lack of associativity, we introduce a generalized version of a logical matrix and apply the method of quasicompletions to obtain an algebra and a quasiembedding from the matrix to the algebra. By applying the general result to specific cases, we obtain important logical and algebraic properties, including the cut elimination of and various extensions, the strong separation of , and the finite generation of the variety of residuated lattice-ordered groupoids with unit. (shrink)

Quine is routinely perceived as having changed his mind about the scope of the Duhem-Quine thesis, shifting from what has been called an 'extreme holism' to a more moderate view. Where the Quine of 'Two Dogmas of Empiricism' argues that “the unit of empirical significance is the whole of science” (1951, 42), the later Quine seems to back away from this “needlessly strong statement of holism” (1991, 393). In this paper, I show that the received view is incorrect. (...) I distinguish three ways in which Quine's early holism can be said to be wide-scoped and show that he has never changed his mind about any one of these aspects of his early view. Instead, I argue that Quine's apparent change of mind can be explained away as a mere shift of emphasis. (shrink)

Christianity in Africa owes its massive growth of the last 50 years to the Independent and Pentecostal/ charismatic churches. The relationships between these churches and the older mission-founded churches are strained. Ethnic and social factors contribute to the divisions. Christian unity in Africa will require conversion to Christ. The strong African tradition of communal life is destroyed by external forces and inter-African conflicts in which members of the same churches have fought one another. Healing is only possible through reconciliation, (...) which calls for conversion from the sin of breaking the community and neglecting the sanctity of human life. The Global Christian Forum offers a new model of working towards Christian unity, which may be particularly meaningful for Africa. (shrink)

This paper examines parents experiences of medical decision-making and coping with having a critically ill baby in the Neonatal Intensive Care Unit (NICU) from a cross-cultural perspective (France vs. U.S.A.). Though parents experiences in the NICU were very similar despite cultural and institutional differences, each system addresses their needs in a different way. Interviews with parents show that French parents expressed overall higher satisfaction with the care of their babies and were better able to cope with the loss of (...) their child than American parents. Central to the French parents perception of autonomy and their sense of satisfaction were the strong doctor–patient relationship, the emphasis on medical certainty in prognosis versus uncertainty in the American context, and the sentimental work" provided by the team. The American setting, characterized by respect for parental autonomy, did not necessarily translate into full parental involvement in decision-making, and it limited the rapport between doctors and parents to the extent of parental isolation. This empirical comparative approach fosters a much-needed critique of philosophical principles by underscoring, from the parents perspective, the lack of emotional work" involved in the practice of autonomy in the American unit compared to the paternalistic European context. Beyond theoretical and ethical arguments, we must reconsider the practice of autonomy in particularly stressful situations by providing more specific means to cope, translating the impersonal language of rights" and decision-making into trusting, caring relationships, and sharing the responsibility for making tragic choices. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:EDWARD W. STRONG, 1901--1990 Edward W. Strong, one.of the founders and leaders of the Journal of the HistoryofPhilosophy,passed away on January 13, 199o, after a long struggle with cancer. Born in Dallas, Oregon in 19~ 1, he was eighty-eight years old when he died. He did his undergraduate studies at Stanford, receiving his B.A. in 1925. Then he went on to graduate studies at Columbia, where he (...) received a master's degree in 1927 and a Ph.D. in 1937. He taught at City College in New York from 1927 to 1932, and then began his long career at the University of California, Berkeley, where he remained for the rest of his academic life. During World War II, he became laboratory manager of the university's Radiation Laboratory (now called the Lawrence Berkeley Laboratory), which was part of the Manhattan Project to develop the atomic bomb. After the war, Strong became a full professor in 1947, chairman of the Sociology Department from 1946 to 1952, Associate Dean of the College of Letters and Sciences from 1947 to 1955, a leader of the Academic Senate and its Educational Policy Committee, and Chancellor of the Berkeley campus from 1961 to 1965.This was a period of very rapid growth for the campus as well as its most troubled time. When the student rebellion--the Free Speech Movement--broke out, Strong tried valiantly but unsuccessfully to preserve those academic values he felt most challenged. As the conflict wore on, he ceased to have the full support of his superiors, the President of the Universityand the Board of Regents, who negotiated a resolution with the students, the effects of which are still being felt at Berkeley and elsewhere in the United States. Some feel that Strong's position in the struggle that transformed American universities has not been properly understood, and that his role has been portrayed unfairly to enhance that of his superiors. In any event, he resigned as Chancellor and became Professor Emeritus in 1967. Strong developed his interest in the history of philosophy, history of science, and history of ideas at Columbia during its heyday as a center for such concerns, under the leadership of John Dewey and Frederick Woodbridge. He told me that he was also very much influenced by the historical interests of Morris Raphael Cohen, his senior colleague at City College. His dissertation, Proceduresand Methods,was, and still is, a basic study of the origin and development of modern science. (It was mentioned approvingly in an article by Ernst [9] 10 JOURNAL OF THE HISTORY OF PHILOSOPHY 29:1 JANUARY 1991 Cassirer, in 194o). In contrast to E. A. Burtt, whose MetaphysicalFoundationsof ModernPhysicalSciencestressed the philosophical and theological concerns of the early scientists, Strong emphasized the practical engineering concerns that were involved at the time. This led him to studies of Kepler, Galileo, and Newton, as well as to the scientific views of medieval thinkers, and modern views in the philosophy of science. Philosophically he was a naturalist, continuing the Columbia tradition. He was also very interested in Bergson's views, especially as they related to modern scientific ideas. He was the inspirer and founder of the History of Science discussion group at Berkeley, which became an important forum for creative research in this area. Strong was President of the American Philosophical Association in 1959. Because of the limited attention and concern given to the history of philosophy in most of the then-existing philosophicaljournals in America, the American Philosophical Association in 1957 approved in principle the establishment of a journal devoted to the history of philosophy, and appointed a committee of six members--Paul Kristeller, Gregory Vlastos, Richard McKeon, Julius Weinberg, John Goheen, and Edward Strong--to explore "ways and means to this end." Since all American philosophical journals at that time were published in the East and Midwest, Strong and Goheen were encouraged to try to establish the journal in the West. Strong has detailed the efforts to do this in his article, "The Founding of theJournal oftheHistoryofPhilosophy,"Journalof theHistoryofPhilosophy~5 (1987): 179-83. I first met Ed Strong at Trinity College, Dublin, in the summer of 1953, when I was a... (shrink)

In a previous paper-[17]-we characterized strong measure zero sets of reals in terms of a Ramseyan partition relation on certain subspaces of the Alexandroff duplicate of the unit interval. This framework gave only indirect access to the relevant sets of real numbers. We now work more directly with the sets in question, and since it costs little in additional technicalities, we consider the more general context of metric spaces and prove: 1. If a metric space has a covering (...) property of Hurewicz and has strong measure zero, then its product with any strong measure zero metric space is a strong measure zero metric space (Theorem 1 and Lemma 3). 2. A subspace X of a σ-compact metric space Y has strong measure zero if, and only if, a certain Ramseyan partition relation holds for Y (Theorem 9). 3. A subspace X of a σ-compact metric space Y has strong measure zero in all finite powers if, and only if, a certain Ramseyan partition relation holds for Y (Theorem 12). Then 2 and 3 yield characterizations of strong measure zeroness for σ-totally bounded metric spaces in terms of Ramseyan theorems. (shrink)

This book provides an important addition to the debate about the nature and normative basis for the United Kingdom's constitutional ordering. It combines a strong argument against moves to adopt forms of "legal constitutionalism" with a defence of the country's existing "political constitution", one sourced in the ideals of republican government. This critical review explores the structure of Tomkins' claims, and raises three questions about how they might apply to certain aspects of the United Kingdom's constitutional order: the place (...) of a republican United Kingdom in an increasingly integrated Europe; the place of the courts in a republican constitutional order; and the role of political parties in a republican parliament. (shrink)

The aim of this paper is to shed some light on understanding why companies adopt environmentally responsible behavior and what impact this adoption has on their performance. This is an empirical study that focuses on the United Nations (UN) Global Compact (GC) initiative as a Corporate Social Responsibility (CSR) mechanism. A survey was conducted among GC participants, of which 29 responded. The survey relies on the anticipated and actual benefits noted by the participants in the GC. The results, while not (...) conclusive, indicate that companies have more than one reason for adopting environmentally responsible behavior and that ethical and economic reasons co-exist. In terms of performance, the impact of participation in the GC seems to be particularly high in securing network opportunities and improved corporate image. The results indicate that companies that have participated many years in the GC, have submitted the most projects and have attended the most GC meetings also regard their CSR involvement as having had a strong, positive influence on their market performance. GC participation does not result in significant cost advantages, but this does not seem to have been regarded as a goal anyway. Costs seem to be affected to a␣large extent by existence of in-house research and␣development and the capability of developing environmentally sound technologies. Overall, the company receives both ethical and economic benefits from joining the GC. (shrink)

Using the dual-route reading model as a framework, this study investigated the following research questions on Hangul reading: Which orthographic units influence the reading performance of Korean-speaking children? In addition, do the influential units change as the children grow up? To answer these questions, we tested the effects of age, frequency, lexicality, and two types of length—the numbers of letters and syllable blocks —and the interactions of these factors in the reading performance of Korean-speaking preschool and primary school children from (...) first to third grade. Regarding reading latencies, there was a significant three-way interaction of age × lexicality × length regardless of the type of length. This interaction indicated that, for words only, the interaction between age and length was significant. Accordingly, the length effect decreased as children’s age increased. When reading latencies for words were analyzed with a mixed-effect model consisting of three factors—age, frequency, and length—neither a main effect of syllable block length nor an interaction of syllable block length with age was significant. In contrast, the interaction of age × letter length in word reading latencies remained significant. The length effect was smaller as children’s age increased. In addition, the frequency effect was significant and interacted significantly with age. The frequency effect increased as children’s age increased. In conclusion, significant frequency effects indicate that Korean-speaking children use the lexical process in addition to the non-lexical process when reading Hangul words. Importantly, as children grow up, a larger orthographic unit, that is, words, is more strongly related to reading performance, whereas the influence of the smaller orthographic unit, that is, letters, decreases. (shrink)

Every day in the United States 17 people die waiting for an organ transplant. The waiting list for organs, which now contains the names of 82,000 people, has more than tripled in the last 10 years. The U.S. policy on who can donate an organ is based both on previous consent of the potential donor and on the consent of the donor's family. This foundation greatly limits the number of potential donors. Spain is the world's leader in providing organs to (...) its population, and the underlying principle of their policy on donors in presumed consent. That is, those people who have not expressly opposed donating their organs are considered eligible for donation. This policy, along with a plan of public education and a strong infrastructure for organ procurement, is what has enhanced their donor rates. Spain is not alone: other countries have seen the benefits of presumed consent and the limits of opt-in systems. The United States must put to use the experiences of these countries to stem the tide of organ shortage and give new life to those desperately awaiting organs. a. (shrink)

Culture has been identified as a significant determinant of ethical attitudes of business managers. This research studies the impact of culture on the ethical attitudes of business managers in India, Korea and the United States using multivariate statistical analysis. Employing Geert Hofstede's cultural typology, this study examines the relationship between his five cultural dimensions (individualism, power distance, uncertainty avoidance, masculinity, and long-term orientation) and business managers' ethical attitudes. The study uses primary data collected from 345 business manager participants of Executive (...) MBA programs in selected business schools in India, Korea and the United States using Hofstede's Value Survey Module (94) and an instrument designed by the researchers to measure respondents' ethical attitudes (attitudes toward business ethics in general and toward twelve common questionable practices in particular). Results indicate that national culture has a strong influence on business managers' ethical attitudes. In addition to national culture, respondents' general attitudes toward business ethics are related to their personal integrity; their attitudes toward questionable business practices are related to the external environment and gender, as well as to their personal integrity. A strong relationship exists between cultural dimensions of individualism and power distance and respondents' ethical attitudes toward certain questionable practices. The analysis of the relationship between cultural dimensions of masculinity, uncertainty avoidance and long-term orientation and respondents' ethical attitudes toward questionable practices produced mixed results, likely due to the lack of notable differences in cultural dimension scores among the countries surveyed. (shrink)

This study deals with teachers’ language use as it is manifested in community-based heritage-language classes. Specifically, it focuses on the functions of students’ dominant variety when harnessed by teachers for the purposes of teaching their ethnic language. Empirical investigation was conducted at two Chinese community schools in the United Kingdom and data demonstrate that students’ L1 was utilised naturally and systematically by teachers to facilitate students’ L2 learning. Various L1 facilitative functions were identified and these generally accord well with functions (...) recorded in other studies. In addition, this study underlines the potentially unique characteristics of community-based heritage-language education: while the target variety of students is routinely the native variety of teachers, teachers struggle to explain new linguistic information in Mandarin because of students’ low proficiency while they concurrently struggle with at least some elements of students’ native or dominant variety. Teachers explained that the fact that students’ dominant language of English is a global language makes their use of it all the more likely. Teachers demonstrated a strong tendency to feel ill-prepared for their language teaching role. There is thus a clear need for heritage-language teachers to receive training that is sociolinguistically informed. This training should emphasise the potential utility of exploiting students’ full linguistic repertoires by drawing in particular on the crosslinguistic similarities and differences between the varieties of which students are cognisant. Teacher-training programmes that promote such awareness may well hold the key to better heritage-language education which will continue to have a crucial role in maintaining and developing minority community languages. (shrink)

BackgroundOne of the next frontiers in HIV research is focused on finding a cure. A new priority includes people with HIV (PWH) with non-AIDS terminal illnesses who are willing to donate their bodies at the end-of-life (EOL) to advance the search towards an HIV cure. We endeavored to understand perceptions of this research and to identify ethical and practical considerations relevant to implementing it.MethodsWe conducted 20 in-depth interviews and 3 virtual focus groups among four types of key stakeholders in the (...) United States (PWH, biomedical HIV cure researchers, HIV clinicians, and bioethicists) to obtain triangulated viewpoints because little was known about the ethics of this topic. Each group was queried as to ethical considerations, safeguards, and protections for conducting HIV cure-related research at the EOL to ensure this research remains acceptable.ResultsAll four key stakeholder groups generally supported HIV cure-related research conducted at the EOL because of the history of altruism within the PWH community and the potential for substantial scientific knowledge to be gained. Our informants expressed that: (1) Strong stakeholder and community involvement are integral to the ethical and effective implementation, as well as the social acceptability of this research; (2) PWH approaching the EOL should not inherently be considered a vulnerable class and their autonomy must be respected when choosing to participate in HIV cure-related research at the EOL; (3) Greater diversity among study participants, as well as multi-disciplinary research teams, is necessitated by HIV cure-related research at the EOL; (4) The sensitive nature of this research warrants robust oversight to ensure a favorable risk/benefit balance and to minimize the possibility of therapeutic misconception or undue influence; and (5) Research protocols should remain flexible to accommodate participants’ comfort and needs at the EOL.ConclusionBecause of the ethical issues presented by HIV cure-related research at the EOL, robust ethical safeguards are of utmost importance. The proposed ethical and practical considerations presented herein is a first step in determining the best way to maximize this research’s impact and social value. More much inquiry will need to be directed towards understanding context-specific and cultural considerations for implementing EOL HIV cure research in diverse settings. (shrink)

Relatives’ presence in connection with cardiopulmonary resuscitation and sudden death at the intensive care unit Within Norwegian intensive care units it is common to focus on the needs of the next of kin of patients undergoing end‐of‐life care. Offering emotional and practical support to relatives is regarded as assisting them in the initial stages of their grief process. It has also become usual to encourage relatives to be present at the time of death of close relatives. How can dignified (...) end‐of‐life care coexist with the sometimes turbulent and dramatic character of intensive care in the highly technological environment of intensive care units? This paper describes a case study based on an incident that took place at the intensive care unit (ICU) of Trondheim University Hospital, Norway, in which the relatives of a newly deceased patient voiced unusually strong dissatisfaction with the way they were excluded in connection with cardiopulmonary resuscitation (CPR). The next of kin's criticism highlights an important paradox as well as a degree of inconsistency in lifesaving and end‐of‐life care at the ICU. I argue that an investigation of the multiple identities within medical practice can illuminate the potential for clashes between lifesaving and end‐of‐life care, as described and analysed in this paper. (shrink)

Strong evidence shows that exposure and engagement with the natural world not only improve human wellbeing but can also help promote environmentally friendly behaviors. Human-nature relationships are at the heart of global agendas promoted by international organizations including the World Health Organization’s “One Health” and the United Nations “Ocean Decade.” These agendas demand collaborative multisector interdisciplinary efforts at local, national, and global levels. However, while global agendas highlight global goals for a sustainable world, developing science that directly addresses these (...) agendas from design through to delivery and outputs does not come without its challenges. In this article, we present the outcomes of international meetings between researchers, stakeholders, and policymakers from the United Kingdom and Brazil. We propose a model for interdisciplinary work under such global agendas, particularly the interface between One Health and the UN Ocean Decade and identify three priority research areas closely linked to each other: human-nature connection, conservation-human behavior, and implementation strategies. We also discuss a number of recommendations for moving forward. (shrink)

Because of the declining fiscal capabilities of the German welfare state and the resulting reductions in social services provided by the government, increasing attention has been given to the voluntary social engagement of businesses, often referred to as corporate citizenship. In that context, scholars and politicians alike have pointed to the United States as a country with a strong corporate citizenship culture and advocated a transatlantic transfer of the respective practices. Against this background, it is the first aim of (...) this paper to examine the socio‐economic environment for corporate citizenship in both countries. Second, it will be investigated if corporate citizenship is really practiced more widely in the United States than in Germany and what forms of corporate citizenship are used by businesses. For that purpose, the corporate citizenship activities of the 100 largest companies in the United States and Germany each will be analyzed. Results show that more US than German companies undertake corporate citizenship activities and apply a wider variety of different forms. The possibilities for a transatlantic transfer are limited because of the differences in the cultural and political systems of both countries. (shrink)

Approximately 15% of couples are affected by infertility worldwide. Subsequently, the use of assisted reproductive technologies is becoming increasingly popular, including the use of donor eggs, sperm and embryos. Despite ongoing ethical debate surrounding gamete donation, this is now a widely accepted practice in Western countries. Assisted reproductive technology is becoming more commonly utilised within the Muslim population; however, gamete donation remains a relatively controversial and taboo topic within this religion. Interestingly, there are significant differences in beliefs between Sunni and (...) Shi’a Muslims. Whilst Sunni Islam absolutely forbids the use of third-party reproductive assistance, Shi’a Islam is somewhat more lenient towards this practice. Reproductive tourism has therefore become prevalent in Shi’a Middle Eastern countries that permit the use of donor gametes in assisted reproductive technologies; however, this continues to evoke a strong bioethical debate, particularly around sperm donation. With the increased influx of reproductive tourism, this is beginning to weaken the regional Sunni Islam ban on the use of donor technologies, questioning the morality of their current beliefs. Consideration of religious beliefs is also crucial for patient-centred care in UK patients treated by the National Health Service for fertility issues. Of note, there is a lack of non-Caucasian donors in the United Kingdom. Reproductive tourism is also becoming increasingly common in the United Kingdom and needs to be considered in terms of future patient management in delivering good obstetric care. (shrink)

The purpose of this study is to examine whether United States -style regulatory intervention to encourage whistle-blowing can be immediately effective if transplanted into another country with a distinctly different historical cultural background and institutional system. A total of 98 U.S. and 84 German accountants participated in a laboratory experiment relating to a case of financial statement fraud. The provision of anti-retaliation protection and monetary rewards for whistle-blowing were manipulated and participants were asked to assume the role of an internal (...) auditor. We hypothesize and find that the provision of anti-retaliation protection and monetary rewards encourage U.S. accountants to blow the whistle. In contrast, among German accountants, where their country features a historical fear and distrust of whistle-blowers, U.S.-style regulatory interventions are less effective. Together, our findings provide strong support for the theory of path-dependence, suggesting that whistle-blowing regulation should not be uniformly transplanted without due consideration of the unique history and culture of a country. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Future Directions for Oversight of Stem Cell Research in the United States: An UpdateMary A. Majumder (bio) and Cynthia B. Cohen (bio)On 9 March 2009, President Barack Obama (2009a) signed an executive order revoking the statement issued by President George W. Bush during a televised speech in August 2001, in which the latter had sharply restricted the scope of federally funded human embryonic stem cell (hESC) research to cell (...) lines derived (without federal funding) prior to 9:00 P.M. EDT on 9 August 2001. Action by President Obama to remove the cut-off date had been expected. It came as a surprise, however, that he gave authority to determine the scope of eligible research to the Director of the National Institutes of Health (NIH), referencing only general concerns of responsibility, scientific worth, and legality.1 This contrasted not only with the approach of former President Bush, but also with that of former President Clinton, who had expressed personal opposition to the creation of embryos for research and had a distinction between hESCs derived from embryos created for research and those derived from spare embryos enshrined in NIH policy.President Obama’s remarks upon signing the executive order give some insight into the thinking behind his approach. Implicit in them are the views that earlystage human embryos outside the womb do not have full moral status and that the destruction of human embryos in the effort to care for and ease the suffering of human beings who do have full moral status does not devalue human life. The President also stressed that the decision to pursue hESC research reflected not only his opinion, but also a broad social consensus. He concluded with strong ethical commitments on two fronts:We will develop strict guidelines, which we will rigorously enforce, because we cannot ever tolerate misuse or abuse. And we will ensure that our government never opens the door to the use of cloning for human reproduction. It is dangerous, profoundly wrong, and has no place in our society, or any society.(Obama 2009b)The specific guarantee that President Obama gave against government support for the development of cloning techniques for human reproductive purposes made his silence on the use of cloning for research seem significant. Comments he had made in the course of the campaign (Obama 2008) suggested that he would affirm [End Page 195] the Clinton-era policy of limiting federal funding to hESCs derived from spare embryos. Did this silence mean that President Obama was opening the door to federal funding of research cloning when and if scientists might manage that feat?2009 NIH GuidelinesThe answer to this question and several others came on 17 April, when Raynard Kington, the acting director of NIH, released Draft NIH Guidelines for Human Stem Cell Research (NIH 2009), developed by an NIH Stem Cell Task Force, along with a request for public comment within 30 days of their publication in the Federal Register.2 The 2009 Draft Guidelines exclude from federal funding the derivation of hESCs, a restriction mandated by the reenactment of the Dickey-Wicker Amendment as part of the 2009 Omnibus Appropriations Act (Public Law 111-8, Division F, Title V, § 509). The 2009 Draft Guidelines also exclude the use of hESCs derived from embryos created for research purposes, and so represent a refusal to open the funding door as broadly as the NIH interpretation of the Dickey-Wicker Amendment might allow, at least for the time being.It appears that the drafters used as their starting point the 2000 NIH Guidelines for Research Using Human Pluripotent Stem Cells (NIH 2000) dating from the Clinton Administration, rather than more recent guidelines from the National Academy of Sciences (National Research Council 2005; 2007; 2008) and other private bodies. Both the format and content of the 2000 and 2009 NIH efforts are similar, making the departures in the latter stand out in high relief. We highlight departures related to informed consent to embryo donation, creation of human-nonhuman chimeras, and the role of an NIH task force, updating our original comment (Cohen and Majumder 2009).Informed Consent to Embryo DonationThe 2009 NIH Draft Guidelines require that certain statements... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Future Directions for Oversight of Stem Cell Research in the United StatesCynthia B. Cohen (bio) and Mary A. Majumder (bio)Human pluripotent stem cell research, meaning research into cells that can multiply indefinitely and differentiate into almost all the cells of the body, has become a minefield in which science, ethics, and politics have collided over the last decade in the United States. President Barack Obama entered this highly charged (...) territory when he indicated during his campaign that once in office he would issue an executive order expanding federally funded human embryonic stem cell (hESC) research and introduce rigorous oversight of it (Obama 2008a & b). Candidate Obama stated that he would require that the hESC lines involved were derived with donor consent from early embryos that otherwise would be discarded following in vitro fertilization (IVF) treatment. However, in contrast with the policy of President George W. Bush, he would do so without regard to the date of their derivation. He added that he would call upon the director of the National Institutes of Health (NIH) to develop guidelines for federally funded hESC and other pluripotent stem cell research that would draw from the guidelines developed in 2005 by the National Academies of Science (NAS) for privately funded research (National Research Council 2005).A similar policy was written into the 2008 version of the Stem Cell Research Enhancement Act, which reiterates the policy enunciated in earlier versions of this bill, passed twice by the Congress but vetoed by President Bush each time (House of Representatives, 110th Congress 2008).1 Depending on how one reads the 2008 version of the act, it could also apply in certain respects to hESC research that is not federally funded. We proceed on the assumption that the act applies at least to federally funded stem cell research. Therefore, it appears that the president or the Congress, or both, will approve of an expanded policy of federal funding of hESC research, as well as other forms of human pluripotent stem cell research. [End Page 79]This policy would make the guidelines developed by a committee appointed by NAS, a prestigious private body of American scientists and related experts, the primary basis for the development of new federal guidelines for oversight of hESC research in the United States. This would have certain advantages in that those familiar with the relevant scientific issues are likely to address them accurately and stem cell investigators are apt to accept restrictions on their research written by fellow scientists and ethics and policy experts whom they perceive as strong supporters of stem cell research. However, it also would have certain disadvantages. Chief among these is that the NAS committee appointed to write guidelines for this research, in its concern to see stem cell science move forward after a period in which many scientists and others maintained that it had been unduly restricted, might have overlooked or deferred consideration of some pressing ethical and policy issues. We maintain that this is the case—although we also maintain that the NAS guidelines provide a responsible foundation for developing NIH guidelines for stem cell research. Consequently, we propose that an NIH task force charged by the director of NIH with writing new guidelines for hESC and other stem cell research should revise and expand the NAS guidelines in ways that we propose below, as well as others that it considers necessary, and make it obligatory for those seeking federal funding of such research to follow these new guidelines.We highlight certain areas in which an ethical case can be made for strengthening the existing NAS guidelines and certain areas in which more fundamental ethical reflection—and building on that, additional guideline/policy development—seems warranted. Among the sections of the NAS guidelines that need clarification and reworking, we include those regarding consent to embryo donation, which provide one of their central focuses, and the development of human-nonhuman chimeras, which they address relatively briefly. In addition, we maintain that new guidelines need to be written to address the nascent ethical and policy issues raised by the possibility that human gametes will be induced from pluripotent stem cells in the next few years and that... (shrink)

Availability of external funding influences the viability and structure of scientific fields. In the 1980s, structural changes in the manner in which external funds became available started to have an impact on materials science and engineering in the United States. These changes colluded with the search for a disciplinary identity of this research field inside the university. The solutions that arose were intended to find a mediating structure between external demands and resources and disciplinary orientation. Interviews with seventeen scientists in (...) seven universities revealed the impact in local university settings. The rise of research centers as new organizational units in universities can be linked to two periods. In the 1960s, expensive instruments stimulated unit formation; in the 1980s, the increase in application-related funding forced new administrative ways. It is shown that organizational changes also have an impact on disciplinary identity as witnessed by a strong increase in interdisciplinary materials Ph.D.s awarded. (shrink)

Colonization of public education—the process by which schools are overwhelmed and penetrated by non-educational imperatives—is usually believed to be caused by capitalism and the hegemonic ideological structures it produces. In this paper I argue that in the case of the United States an additional mechanism produces strong colonizing effects: the institution of local control. In the context of contemporary institutional conditions, local control is the lynch-pin for the production of socio-economic segregation, cumulative disadvantages, and the mythology of popular control (...) disguising the growing control of public schooling through unaccountable bureaucracies and private corporations. (shrink)

Although present research shows that ambitious corporate sustainability objectives improve employee engagement in business organizations, there is scarcity of research showing how employees engage in corporate sustainability objectives and become autonomous sustainability thinkers. We suggest that a strong, individual level of psychological ownership of corporate sustainability is a precondition for the development of sustainability thinking, and examine the factors that influence the emergence of such feelings of ownership. Our qualitative study, based on 29 interviews conducted in seven Finnish local (...) business units from three different technology-oriented multinational enterprises (MNEs), shows that several key factors can have contradictory effects, both strengthening and hindering the routes to psychological ownership of corporate sustainability. While these contradictory effects may potentially lead to confusion among employees, our findings may help managers to avoid pitfalls in developing a more sustainability-oriented organizational culture. Moreover, by applying the theory of psychological ownership, our study contributes to the business sustainability research by providing new theoretical opportunities to understand the process of how individuals may become engaged in enhancing business sustainability. (shrink)

The United States Government does not mandate that US based firms follow US social and environmental law in foreign markets. However, because many developing countries do not have strong human rights, labor, and environmental laws, many multinationals have adopted voluntary corporate responsibility initiatives to self-regulate their overseas social and environmental practices. This article argues that voluntary actions, while important, are insufficient to address the magnitude of problems companies confront as they operate in developing countries where governance is often inadequate. (...) The United States can do more to ensure that its multinationals act responsibly everywhere they operate. First, policymakers should define the social and environmental responsibilities of global companies. They must consistently make their expectations for global business clear – and underscore that this objective can often be accomplished without mandates. Second, the US should closely examine the policies that undermine global Corporate Social Responsibility (CSR) and address the many conflicting signals sent by policymakers. Third, the President should make the US government a CSR model by examining how to use its purchasing power to promote human rights. Finally, the US government should require pension funds to report on the social and environmental consequences of their investments. In these ways, Americans can mind our business – and thus make sure that US based firms do not undermine social and environmental progress when they operate in the developing world. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Future Directions for Oversight of Stem Cell Research in the United StatesCynthia B. Cohen (bio) and Mary A. Majumder (bio)Human pluripotent stem cell research, meaning research into cells that can multiply indefinitely and differentiate into almost all the cells of the body, has become a minefield in which science, ethics, and politics have collided over the last decade in the United States. President Barack Obama entered this highly charged (...) territory when he indicated during his campaign that once in office he would issue an executive order expanding federally funded human embryonic stem cell (hESC) research and introduce rigorous oversight of it (Obama 2008a & b). Candidate Obama stated that he would require that the hESC lines involved were derived with donor consent from early embryos that otherwise would be discarded following in vitro fertilization (IVF) treatment. However, in contrast with the policy of President George W. Bush, he would do so without regard to the date of their derivation. He added that he would call upon the director of the National Institutes of Health (NIH) to develop guidelines for federally funded hESC and other pluripotent stem cell research that would draw from the guidelines developed in 2005 by the National Academies of Science (NAS) for privately funded research (National Research Council 2005).A similar policy was written into the 2008 version of the Stem Cell Research Enhancement Act, which reiterates the policy enunciated in earlier versions of this bill, passed twice by the Congress but vetoed by President Bush each time (House of Representatives, 110th Congress 2008).1 Depending on how one reads the 2008 version of the act, it could also apply in certain respects to hESC research that is not federally funded. We proceed on the assumption that the act applies at least to federally funded stem cell research. Therefore, it appears that the president or the Congress, or both, will approve of an expanded policy of federal funding of hESC research, as well as other forms of human pluripotent stem cell research. [End Page 79]This policy would make the guidelines developed by a committee appointed by NAS, a prestigious private body of American scientists and related experts, the primary basis for the development of new federal guidelines for oversight of hESC research in the United States. This would have certain advantages in that those familiar with the relevant scientific issues are likely to address them accurately and stem cell investigators are apt to accept restrictions on their research written by fellow scientists and ethics and policy experts whom they perceive as strong supporters of stem cell research. However, it also would have certain disadvantages. Chief among these is that the NAS committee appointed to write guidelines for this research, in its concern to see stem cell science move forward after a period in which many scientists and others maintained that it had been unduly restricted, might have overlooked or deferred consideration of some pressing ethical and policy issues. We maintain that this is the case—although we also maintain that the NAS guidelines provide a responsible foundation for developing NIH guidelines for stem cell research. Consequently, we propose that an NIH task force charged by the director of NIH with writing new guidelines for hESC and other stem cell research should revise and expand the NAS guidelines in ways that we propose below, as well as others that it considers necessary, and make it obligatory for those seeking federal funding of such research to follow these new guidelines.We highlight certain areas in which an ethical case can be made for strengthening the existing NAS guidelines and certain areas in which more fundamental ethical reflection—and building on that, additional guideline/policy development—seems warranted. Among the sections of the NAS guidelines that need clarification and reworking, we include those regarding consent to embryo donation, which provide one of their central focuses, and the development of human-nonhuman chimeras, which they address relatively briefly. In addition, we maintain that new guidelines need to be written to address the nascent ethical and policy issues raised by the possibility that human gametes will be induced from pluripotent stem cells in the next few years and that... (shrink)

BackgroundDepression is a serious mental disorder often accompanied by emotional and physiological disorders. Visceral fat index is the current standard method in the evaluation of visceral fat deposition. In this study, we explored the association between VAI and depression in the American population using NHANES data.MethodsA total of 2,577 patients were enrolled for this study. Data were collected through structured questionnaires. Subgroup analysis for the relationship between VAI and depression was evaluated using multivariate regression analysis after adjustment for potential confounding (...) factors.ResultsFor every 1 unit increase in VAI, the clinical depression increased by 14%. High VAI scores increased the highest risk of developing depression. Subgroup analysis demonstrated a strong and stable association between VAI and the development of depression.ConclusionOur study showed that depressive symptoms are associated with a high ratio of visceral adiposity index after controlling confounding factors. (shrink)

The general-case glass ceiling hypothesis states that not only is it more difficult for women than for men to be promoted up levels of authority hierarchies within workplaces but also that the obstacles women face relative to men become greater as they move up the hierarchy. Gender-based discrimination in promotions is not simply present across levels of hierarchy but is more intense at higher levels. Empirically, this implies that the relative rates of women being promoted to higher levels compared to (...) men should decline with the level of the hierarchy. This article explores this hypothesis with data from three countries: the United States, Australia, and Sweden. The basic conclusion is that while there is strong evidence for a general gender gap in authority—the odds of women having authority are less than those of men—there is no evidence for systematic glass ceiling effects in the United States and only weak evidence for such effects in the other two countries. (shrink)

Professionals in environmental fields engage with complex problems that involve stakeholders with different values, different forms of knowledge, and contentious decisions. There is increasing recognition of the need to train graduate students in interdisciplinary environmental science programs in these issues, which we refer to as “social ethics.” A literature review revealed topics and skills that should be included in such training, as well as potential challenges and barriers. From this review, we developed an online survey, which we administered to faculty (...) from 81 United States colleges and universities offering IESPs. Respondents overwhelmingly agreed that IESPs should address values in applying science to policy and management decisions. They also agreed that programs should engage students with issues related to norms of scientific practice. Agreement was slightly less strong that IESPs should train students in skills related to managing value conflicts among different stakeholders. The primary challenges to incorporating social ethics into the curriculum were related to the lack of materials and expertise for delivery, though challenges such as ethics being marginalized in relation to environmental science content were also prominent. Challenges related to students’ interest in ethics were considered less problematic. Respondents believed that social ethics are most effectively delivered when incorporated into existing courses, and they preferred case studies or problem-based learning for delivery. Student competence is generally not assessed, and respondents recognized a need for both curricular materials and assessment tools. (shrink)

Background: Theoretically, the principle of justice is strong in healthcare priorities both nationally and internationally. Research, however, has indicated that questions can be raised as to how this principle is dealt with in clinical intensive care. Objective: The objective of this article is to examine how significant others may affect the principle of justice in the medical treatment and nursing care of intensive care patients. Method: Field observations and in-depth interviews with physicians and nurses in intensive care units (ICU). (...) Emphasis was placed on eliciting the underlying rationale for prioritisations in clinical intensive care with particular focus on clinicians’ considerations when limiting ICU treatment. Results: Significant others could induce an unintentional discrimination of ICU patients. Family members who were demanding received more time and attention for both the patient and themselves. Patients’ and families’ status and position and/or an interesting medical diagnosis seemed to govern the clinicians’ priorities of patients and families—consciously as well as unconsciously. The clinicians emphasised that patient information given through families was important. However, patients’ preferences and values conveyed to clinicians through their families were not always taken seriously. This even applied in cases with very serious prognoses and an explicit patient wish to forego life-prolonging treatment. Conclusion: The principle of justice was violated when qualified attention was given to significant others, and through this also to patients. Attention given to significant others was influenced by the healthcare workers’ professional and personal values, attitudes and interests. (shrink)

This article examines the political controversy in the United States surrounding a new process for the disposition of human remains, alkaline hydrolysis. AH technologies use a heated solution of water and strong alkali to dissolve tissues, yielding an effluent that can be disposed through municipal sewer systems, and brittle bone matter that can be dried, crushed, and returned to the decedent’s family. Though AH is legal in eight US states, opposition to the technology remains strong. Opponents express concerns (...) about public health and safety and about the dignity of our mortal remains. Proponents focus on AH’s environmental benefits over cremation and earth burial, aligning the technology with the “green burial” movement. Drawing from historical sources, Science, Technology, and Society literature, interviews with funeral professionals, industry literature, and various media sources, this article examines four prominent conceptions of the dead human body as they are deployed by various funeral stakeholders seeking to exercise authority over the dead human body, to influence the trajectory of AH technology in the United States, and to chart a course for US deathcare culture in the twenty-first century. (shrink)

Background There is considerable variation in the functionality of bioethical services in different institutions and countries for children in hospital, despite new challenges due to increasing technology supports for children with serious illness and medical complexity. We aimed to understand how bioethics services address bioethical concerns that are increasingly encountered in paediatric intensive care. Methods A qualitative descriptive design was used to describe clinician’s perspectives on the functionality of clinical bioethics services for paediatric intensive care units. Clinicians who were members (...) of formal or informal clinical bioethics groups, or who were closely involved with the process of working through ethically challenging decisions, were interviewed. Interviews took place online. Resulting transcripts were analysed using thematic analysis. Results From 33 interviews, we identified four themes that described the functionality of bioethics services when a child requires technology to sustain life: striving for consensus; the importance of guidelines; a structure that facilitates a time-sensitive and relevant response; and strong leadership and teamwork. Conclusions Clinical bioethics services have the potential to expand their role due to the challenges brought by advancing medical technology and the increasing options it brings for treatment. Further work is needed to identify where and how bioethics services can evolve and adapt to fully address the needs of the decision-makers in PICU. (shrink)