Social contracts are the mechanisms by which society legitimizes professions and grants them authority and autonomy to carry out their functions. The nursing profession is currently renegotiating its contract with society in a manner which clearly reflects a change from physician dominance, and emphasis on illness care to increased independent and autonomous functioning within a newly developing framework of nursing science which emphasizes health care. In return for their services, nurses are also negotiating for those benefits which historically they have (...) not received. These include legitimization of their newly acquired autonomous role functions, and adequate reimbursement mechanisms and structures. When the contemporary role of the nurse is fully legitimzed, the impact on contemporary society and health care is likely to be enormous. (shrink)

The theories or programs of research described in the chapters of this book move beyond the traditional evaluation model of prejudice, drawing on a broad range of theoretical ancestry to develop models of why, when, and how differentiated reactions to groups arise, and what their consequences might be. The chapters have in common a re-focusing of interest on emotion as a theoretical base for understanding differentiated reactions to, and differentiated behaviors toward, social groups. The contributions also share a focus on (...) specific interactional and structural relations among groups as a source of these differentiated emotional reactions. The chapters in the volume thus reflect a theoretical shift from an earlier emphasis on knowledge about ingroups and outgroups to a new perspective on prejudice in which socially-grounded emotional differentiation becomes a basis for social regulation. (shrink)

Bioethical decision‐making in pediatrics diverges from similar decisions in other medical domains because the young child is not an autonomous decision‐maker, while the teen is developing—and should be encouraged to develop—autonomy and decisional capacity. Thus the balance between autonomy and beneficence is fundamentally different in pediatrics than in adult medicine. While ethical dilemmas that reflect these fundamental issues are common, many pediatric physician and nursing training programs do not delve into the issues or offer specific training about how to deal (...) with borderline cases.To meet this need, the Children's Mercy Bioethics Center in Kansas City, Missouri, created a program specifically dedicated to serving practicing, experienced pediatric health professionals. Our students come from various professional disciplines: they are doctors, nurses, social workers, chaplains, lawyers, psychologists, counselors, and hospital administrators practicing in pediatrics. (shrink)

Over-time variability characterizes not only individual-level emotions, but also group-level emotions, those that occur when people identify with social groups and appraise events in terms of their implications for those groups. We discuss theory and research regarding the role of emotions in intergroup contexts, focusing on their dynamic nature. We then describe new insights into the causes and consequences of emotional dynamics that flow from conceptualizing emotions as based in group membership, and conclude with research recommendations.

We respond to a Letter to the Editor regarding "Principlism and contemporary ethical considerations for providers of transgender health care." We address criticisms by Castle & Klein (2024) of blatant fatphobia related to the ethical elements concerning BMI restrictions for gender-affirming surgery. Our response corrects several mischaracterizations of the article and clarifies our position. My co-authors and I remain focused on advocating for patient-centered, ethically sound, evidence-based, and equitable healthcare policies.

Traditional accounts hold that reference consists in a relation between the mind and an object; the relation is effected by a mental act and mediated by internal mental contents (internal representations). Contemporary theories as diverse as Fodor’s [Fodor, J.A., 1987. Psychosemantics: The Problem of Meaning in the Philosophy of Mind. MIT Press, Cambridge, MA] language of thought hypothesis, Dretske’s [Dretske, F., 1988. Explaining Behaviour: Reasons in a World of Causes. MIT Press, Cambridge, MA] informational semantics and Millikan’s [Millikan, R.G., 1984. (...) Language, Thought and Other Biological Categories: New Foundations for Realism. MIT Press, Cambridge, MA] teleosemantics share this act– content–object picture (which was also held by several early modern philosophers, in particular Locke). The core of the traditional view is the thesis that reference and intentionality are relational (‘thesis RR’). Although deeply problematic, RR is entrenched also in psychology, linguistics, cognitive science and Artificial Intelligence. Using for the most part arguments employed by Wittgenstein, we mount a case against RR and advance a deflationary account of reference and intentionality according to which neither is relational. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Plasminogen activator inhibitor‐1 (PAI‐1) is a physiological inhibitor of urokinase (uPA), a serine protease known to promote cell migration and invasion. Intuitively, increased levels of PAI‐1 should be beneficial in downregulating uPA activity, particularly in cancer. By contrast, in vivo, increased levels of PAI‐1 are associated with a poor prognosis in breast cancer. This phenomenon is termed the “PAI‐1 paradox”. Many factors are responsible for the upregulation of PAI‐1 in the tumor microenvironment. We hypothesize that there is a breast cancer (...) predisposition to a more aggressive stage when PAI‐1 is upregulated as a consequence of Metabolic Syndrome (MetS). MetS exerts a detrimental effect on the breast tumor microenvironment that supports cancer invasion. People with MetS have an increased risk of coronary heart disease, stroke, peripheral vascular disease and hyperinsulinemia. Recently, MetS has also been identified as a risk factor for breast cancer. We hypothesize the existence of the “PAI‐1 cycle”. Sustained by MetS, adipocytokines alter PAI‐1 expression to promote angiogenesis, tumor‐cell migration and procoagulant microparticle formation from endothelial cells, which generates thrombin and further propagates PAI‐1 synthesis. All of these factors culminate in a chemotherapy‐resistant breast tumor microenvironment. The PAI‐1 cycle may partly explain the PAI‐1 paradox. In this hypothesis paper, we will discuss further how MetS upregulates PAI‐1 and how an increased level of PAI‐1 can be linked to a poor prognosis. BioEssays 29:1029–1038, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Illness narratives invite practitioners to understand how biomedical and traditional health information is incorporated, integrated, or otherwise internalized into a patient’s own sense of self and social identity. Such narratives also reveal cultural values, underlying patterns in society, and the overall life context of the narrator. Most illness narratives have been examined from the perspective of European-derived genres and literary theory, even though theorists from other parts of the globe have developed locally relevant literary theories. Further, illness narratives typically examine (...) only the experience of illness through acute or chronic suffering (and potential recovery). The advent of biomedical disease prevention methods like post- and pre-exposure prophylaxis (PEP and PrEP) for HIV, which require daily pill consumption or regular injections, complicates the notion of an illness narrative by including illness prevention in narrative accounts. This paper has two aims. First, we aim to rectify the Eurocentrism of existing illness narrative theory by incorporating insights from African literary theorists; second, we complicate the category by examining prevention narratives as a subset of illness narratives. We do this by investigating several narratives of HIV prevention from informants enrolled in an HIV prevention trial in Kenya and Uganda in 2022. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

Inhalt: Vorwort von H.-M. Pawlowski / S. Smid / R. Specht - H.-M. Pawlowski: Probleme der Rechtsbegrundung im Staat der Glaubensfreiheit - V. Gerhardt: Selbstandigkeit und Selbstbestimmung. Freiheit bei Kant und Schelling - H. Folkers: Die durch Freiheit gebaute Stadt Gottes - W. E. Ehrhardt: Mythologie und Offenbarung der Freiheit - W. Bartuschat: Uber Spinozismus und menschliche Freiheit beim fruhen Schelling - C. Cesa: Schellings Kritik des Naturrechts - H. J. Sandkuhler: F. W. J. Schelling - Philosophie als (...) Seinsgeschichte und Anti-Politik - D. Losurdo: Von Louis Philippe bis Louis Bonaparte - R. Pettoello: Die Dialektik der menschlichen Freiheit als Emanzipation und als Abfall von Gott - H. Klenner: Schelling und die Rechtsphilosophie - S. Smid: Freiheit als Keim des Rechts - W. Schmied-Kowarzik: Freiheit - Recht - Geschichte - J. Simon: Die Wirklichkeit der Freiheit (Kant, Schelling, Hegel) - W. Schild: Die verstandlichen Schwierigkeiten des Rechtsdenkens mit dem Freiheitsbegriff - Personenregister. (shrink)

Background Individuals who were maltreated during childhood are faced with increased risks for developing various psychological symptoms that are particularly resistant to traditional treatments. This pilot study investigated the effects of a mindfulness based behavioral intervention for young adults with a childhood maltreatment history. Methods This study looked at self-report psychological questionnaires from 20 subjects (5 males) before and after a mindfulness-based behavioral intervention, compared to 18 subjects (6 males) in the waiting list control group (age range 22–29); all subjects (...) experienced mild-to-moderate childhood maltreatment. We analyzed changes in stress, anxiety, depression, mindfulness and self-compassion related to the intervention with linear mixed effects models; we also analyzed the relationships among questionnaire score changes with partial correlation analyses and mediation analysis. Results Linear mixed effects model analyses revealed significant group by time interaction on stress ( p p p p p p r = 0.578, p = 0.001), which negatively correlated with changes in depression ( r = −0.374, p = 0.05) and anxiety ( r = −0.395, p p r = −0.674, p r = −0.580, p r = −0.544, p Conclusion Our results suggest that, to some extent, the mindfulness-based intervention can be helpful for improving self-compassion and psychological health among young adults with a childhood maltreatment history. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT02447744. (shrink)

Childbearing is an increasingly complicated matter, which has evolved significantly over the past several decades. Treatment options for infertility have expanded. Prenatal testing and treatment have led to an evolution in obstetrical decision-making, wherein the risks and benefits to the fetus and future child are better understood and more strongly considered in medical management of the pregnant woman. Obstetrics appears to be increasingly interventional; one in three babies in the United States is now born by cesarean section. Neonatal intensive care (...) has markedly improved outcomes for premature babies. A pregnant woman may now be presented with many options— obstetrician or midwife, home or hospital delivery, choices among prenatal testing and monitoring, early induction of labor, cesarean delivery. Health care professionals face similar decisions with regard to what they recommend and the boundaries of safe and responsible care they should make available. Preterm Babies, Fetal Patients, and Childbearing Choices, by John D. Lantos and Diane S. Lauderdale, provides an excellent overview of the available information relevant to these questions. (shrink)

Research monography about the works of famous Mongolian writer, scholar B. Rinchen.

Spiritual Theology's journey through these last decades shows an itinerary of development, the fruit of which is an ever more solid identity. This book seeks to present a perspective in that itinerary and in tune with the signs of our times: on one hand, militant secularism and, on the other, a widespread, concrete resurgence of experiences of transcendence. In this sense, the author is presenting a path of study organized around five concepts: presence, mystery, transcendence, lived experience, and transformation. In (...) effect, the inner transformation worked by the Presence of Mystery leaves a new knowing, in which the relationship with reality is renewed, since it has expanded and dilated beyond sensible perception, opening the subject up to an unlimited and real horizon of transcendence. The awareness of perceiving a 'greater reality' within reality leaves an emotional resonance that teaches a new way of feeling and reacting in the face of sensibly perceived reality. (shrink)

This book focuses upon the perennial question of the existence and nature of an obligation to obey the law. Leading writers have, at one time or another, emphasized considerations such as gratitude, 'divine ordering, ' prudence, contract, autonomy, and utility in seeking to justify, or to deny any justification for, some sort of obligation to obey the positive law. The book provides relevant selections from a sampling of the historical approaches to legal obligation taken by writers such as Plato, Augustine, (...) Aquinas, Hobbes, Locke, Hume, Rousseau, Thoreau, Bentham, Marx and Engels, and Martin Luther King, Jr. These classical discussions are augmented by critical questions and commentary, by independent discussions of the question of legal obligation by a wide range of contemporary writers, and by relevant judicial cases discussing matters such as conscientious objection and civil disobedience. (shrink)

The famous 1893 Chicago World’s Fair celebrated the dawn of corporate capitalism and a new Machine Age with an exhibit of the world’s largest engine. Yet the noise was so great, visitors ran out of the Machinery Hall to retreat to the peace and quiet of the Japanese pavilion’s Buddhist temples and lotus ponds. Thus began over a century of the West’s turn toward an Asian aesthetic as an antidote to modern technology. From the turn-of-the-century Columbian Exhibition to the latest (...) Zen-inspired designs of Apple, Inc., R. John Williams charts the history of our embrace of Eastern ideals of beauty to counter our fear of the rise of modern technological systems. In a dazzling work of synthesis, Williams examines Asian influences on book design and department store marketing, the commercial fiction of Jack London, the poetic technique of Ezra Pound, the popularity of Charlie Chan movies, the architecture of Frank Lloyd Wright, and the design of the latest high-tech gadgets. Williams demonstrates how, rather than retreating from modernity, writers, artists, and inventors turned to traditional Eastern technê as a therapeutic means of living with—but never abandoning—Western technology. (shrink)