This paper examines the concept of ‘openness with patients’ from the stand-point of the limitations of biomedical ethics. Initially we review contemporary critiques of bioethics and, in particular, of principlism; we relate how other; somewhat neglected, forms of medical ethics can yield useful information and provide moral guidance. The main section of the paper then shows how a bioethical approach to openness misses the social context in our example, the viewpoints of patients; we present some of the increasing wealth of (...) research evidence which points towards patients wanting more information and a greater degree of openness. (shrink)

Prologue: love of children lost and found for teacher educators -- The seed of play -- The seed of hope -- The seed of imaginative voice -- The seed of change -- The seed of unmasking -- The seed of inner awareness -- The seed of freedom -- The seed of love.

A motivational system approach to avoidance behavior is presented. According to this approach, a motivational state increases the probability of relevant response patterns and establishes the appropriate or “ideal” consummatory stimuli as positive reinforcers. In the case of feeding motivation, for example, hungry rats are likely to explore and gnaw, and to learn to persist in activities correlated with the reception of consummatory stimuli produced by ingestion of palatable substances. In the case of defense motivation, fearful rats are likely to (...) flee or freeze, and to learn to persist in activities correlated with consummatory stimuli produced by flight from a dangerous place. Defense system activation is distinct from alarm reactions. The latter prepare the animal for probable noxious events, involve relatively intense negative affect and extinguish rapidly in situations where the noxious event no longer occurs. In contrast, defense system activation potentiates innate and modified defense reactions, thus preparing the animal for possible, but not necessarily probable, noxious events; it involves little or no negative affect and extinguishes very slowly when the noxious event no longer occurs. With these assumptions and the resulting model we attempt to resolve several long-standing problems in avoidance learning, including the low correlation between negative affect and avoidance performance, differential rates of extinction for avoidance performance and conditioned emotional responses, and evidence that some avoidance responses are much more easily learned than others. In addition, the model has implications for the study of parallels between appetitive and aversive motivation, sign tracking in aversive conditioning, and orientation of flight responses. Historical antecedents and alternative approaches are discussed. (shrink)

The cytokine interferon‐γ (IFN‐γ), initiates both cell cycle arrest and cell death in certain cell lines. Through a novel strategy of cell transfection with episomal vectors expressing antisense cDNAs, Deiss et al.(1.2) have demonstrated that it is possible to isolate genes that are required for the initiation of cell death by the cytokine IFN‐γ. This approach, referred to as TKO, for Technical Knock Out, has identified several genes whose activity appears to be essential for the induction of apoptosis by IFN‐γ (...) in HeLa cells. Interestingly, these genes appear to mediate IFN‐γ‐induced apoptosis in HeLa cells, but their inhibition by antisense does not ameliorate the anti‐proliferative effects of IFN‐γ in these cells. The clever strategy employed by these authors holds promise for others who wish to isolate genes required for other differentiative processes in cultured cell lines. (shrink)

Children deserve optimal medical care. Although prescription drugs play a prominent and essential role in pediatric health care delivery, health care providers often must make prescribing decisions for their young patients based on imperfect or absent safety and efficacy data for pediatric populations. Until relatively recently, the Food and Drug Administration made surprisingly little effort to improve the quality or quantity of clinical research data for this patient group. Despite recent agency efforts to improve the situation, only one-third of drugs (...) prescribed to children currently have been studied for safety and efficacy in pediatric populations. Moreover, recent agency initiatives to encourage pediatric drug research have generated mixed results and unintended consequences. The complex of issues surrounding the testing and prescribing of prescription drugs used for children will require that pharmaceutical companies, the FDA, and health care providers examine current practices, acknowledge their shortcomings, and consider cooperative, creative solutions. (shrink)

Der Vergleich einer modernen Rechts- und Gesellschaftstheorie anhand von Hayeks «Recht, Gesetz und Freiheit» mit einer postmodernen anhand Ladeurs «Der Staat gegen die Gesellschaft» fördert verblüffende Parallelen im Ausgangspunkt, der Argumentation und der Prognose respektive Diagnose einer institutionell bedingten postmodernen Krise von Staat und Gesellschaft zutage. Die Analyse der modernen Theorie ist zugleich eine umfassende und verständliche Einführung in von Hayeks Werk. Fundiert arbeitet die Schrift die Theorie als die in der Moderne gelegte Basis der postmodernen Gesellschaft heraus und gleicht (...) sie ab mit den Untersuchungen Ladeurs zur Postmoderne in dessen Streitschrift für die «Privatrechtsgesellschaft». Anknüpfend an den von beiden analog begründeten Weg in die Krise und die Wege zu ihrer Bewältigung zeigt die Autorin eine über diese Zeitspanne hinaus weisende kongruente liberale rechts-, staats- und gesellschaftspolitische Theorie auf. (shrink)

Paul Appelbaum and colleagues propose four models of informed consent to research that deploys whole genome sequencing and may generate incidental findings. They base their analysis on empirical data that suggests that research participants want to be offered incidental findings and on a normative consensus that researchers incur a duty to offer them. Their models will contribute to the heated policy debate about return of incidental findings. But in my view, they do not ask the foundational question, In the context (...) of genome sequencing, how much work can consent be asked to do? (shrink)

The purpose of this paper is to examine the various guidelines presented in the literature for instituting an ethics curriculum and to empirically study their effectiveness. Three questions are addressed concerning the trainability of ethics material and the proper integration and implementation of an ethics curriculum. An empirical study then tested the effect of ethics training on moral awareness and reasoning. The sample consisted of two business classes, one exposed to additional ethics curriculum (experimental), and one not exposed (control). For (...) the experimental group, ethics exercises and discussion relevant to each topic were completed. Findings suggested gender differences such that, relative to other groups, women in the experimental group showed significantly improved moral awareness and decision-making processes. An explanation of the underlying cognitive processes is presented to explain the gender effect. (shrink)

This study documents and characterizes a phenomenon in naturally‐occurring conversation which I have termed interactional reconstruction. Interactional reconstruction involves retroactive reinterpretation of an earlier utterance (or set of utterances) on the basis of a more recent utterance (or set of utterances). This work is meant to serve two functions: first, to enrich our theories of human communication; and second, to explore directions and implications for theories of meaning and discourse modeling within cognitive science.

SummaryCross-sectional studies in Australia and the Philippines and a longitudinal prospective study in a selected Australian sample of breast-feeding mothers have shown that basal serum prolactin concentrations are elevated during 15–21 months of lactational amenorrhoea.A predictive model of serum PRL levels and return of cyclic ovarian activity during full breast-feeding, partial breast-feeding and weaning has been developed from the results of breast-feeding behaviour and serum PRL, gonadotrophin and oestradiol measurements in 34 mothers breast-feeding on demand for a mean of 67 (...) weeks.Breast-feeding patterns influence serum PRL levels. Important factors during full breast-feeding are the age of the baby, the longest interval between feeds at night and total 24-hr suckling time, and following the introduction of supplements, the mean interval between feeds, together with the total 24-hr suckling time and the number of solid supplements per day.The precise mechanisms whereby breast-feeding regulates cyclic ovarian activity remain unknown. Gonadotrophin secretion appears to be quantitatively normal, but qualitative changes, secondary to altered hypothalamic activity, may be the most important factor. A direct inhibitory effect of PRL on ovarian follicular development and steroidogenesis remains possible.Ovulation with a normal luteal phase is probable for 30% of breast-feeding mothers before the first menses, but is unlikely before 6 months, provided breast-feeding is frequent day and night.Measurement of serum PRL is a sensitive index of the return of menstruation and fertility during lactation in the population studied. (shrink)

Why is female violence a taboo? We suggest that both men and women actively contribute to the creation of this stigma. Men may benefit because nonaggressive women may make better mothers and be more faithful and fertile. Females may benefit by downplaying their aggressive nature because they will be perceived as more valuable mates and because they will be more accepted within female social groups.

Creativity and civil courage are major dimensions of an intellectual's authority and contribute towards the enrichment of democracy. This book develops a sociological account of civil courage and creative behaviour in order to enhance our understanding of the nature of intellectuals' involvement in society. Barbara A. Misztal employs both theoretical-analytic and empirical components to develop a typology of intellectuals who have shown civil courage and examines the biographies of twelve Nobel Peace Prize laureates, including Elie Wiesel, Andrei Sakharov and (...) Linus C. Pauling, to illustrate acts of courage which have embodied the values of civil society. She advances our understanding of the nature of intellectuals' public involvement and their contribution to social well-being. In the current climate of fear and insecurity, as governments are forced to deal with issues of increasing complexity, this is a pioneering sociological book with a highly original approach. (shrink)

We critique the distinction Byrne makes between strong causes and enabling conditions, and its implications, on both theoretical and empirical grounds. First, we believe that the difference is psychological, not logical. Second, we disagree that there is a strict Third, we disagree that it is easier for people to generate causes than counterfactuals.

The theme of this special issue is Post-truth. No doubt it was my exasperation with the terminological state of our collective situation that incited me in the spring of 2017 to settle upon it. What, exactly, does the hyphenated couplet mean or to what does it refer? What is its significance or sense? How is it being used, by whom, for what purpose, and with what consequences—for whom? And if, as was being asserted on nearly every side, we currently find (...) ourselves in post-truth, how might we ever get out, presuming we may one day want as much? The original contributions by Sarah Burgess, James Crosswhite, Jason David Myres, Bradford Vivian, and Eric King Watts published herein go a long way toward answering these... (shrink)

The nuclear DNA of eukaryotes is organized into a series of loops each topologically anchored by elements of the nuclear matrix. Evidence is reviewed which indicates that the anchorage points of the loops are formed by transcriptionally active genes and that individual loops function as replicons. The data suggests a specific model for coupling of DNA replication and transcription in eukaryotes.

This paper examines the concept of ‘openness with patients’ from the stand-point of the limitations of biomedical ethics. Initially we review contemporary critiques of bioethics and, in particular, of principlism; we relate how other; somewhat neglected, forms of medical ethics can yield useful information and provide moral guidance.The main section of the paper then shows how a bioethical approach to openness misses the social context in our example, the viewpoints of patients; we present some of the increasing wealth of research (...) evidence which points towards patients wanting more information and a greater degree of openness.Finally we put forward that a principlist’s objection to active encouragement of openness might be based on the risk of infringing upon the ‘right not to know’. We reject this by arguing how rights can be trumped. (shrink)