Individuals with chronic pain often experience co-existing sleep problems and depression-related states. Chronic pain, sleep problems, and depression interrelate, and have been shown to exacerbate one another, which negatively impacts quality of life. This study explored the relationships between pain severity, pain interference, sleep quality, and depression among individuals with chronic pain. Secondly, we tested whether sleep quality may moderate the relationship between pain and depression. A cross-sectional survey was completed by 1,059 adults with non-malignant chronic pain conditions and collected (...) measures related to pain severity, pain interference, sleep quality, and depression. Multiple regression analyses found that pain severity, pain interference, and sleep quality are all significantly associated with depression. Secondly, moderated regression analyses revealed that sleep quality moderates the relationship between pain interference and depression among individuals with chronic pain such that good sleep quality attenuates the effect of pain interference on depression, and poor sleep quality amplifies the effect of pain interference on depression. These findings suggest that sleep quality may be a relevant therapeutic target for individuals with chronic pain and co-existing depression. (shrink)

On September 27, 2016 people across the world looked down at their buzzing phones to see the AP Alert: “Baby born with DNA from 3 people, first from new technique.” It was an announcement met with confusion by many, but one that polarized the scientific community almost instantly. Some celebrated the birth as an advancement that could help women with a family history of mitochondrial diseases prevent the transmission of the disease to future generations; others held it unethical, citing medical (...) tourism and consequences for the future of the therapy. The child in question was actually born a few months earlier on April 6, 2016, but the research was published a few months later in the October edition of Fertility and Sterility. The mother carries DNA that could have given the baby Leigh Syndrome, a severe neurological disorder characterized by psychomotor regression that typically results in death between ages two and three.[1] Also known as subacute necrotizing encephalomyelopathy, Leigh Syndrome is caused by genetic mutations in mitochondrial DNA, which causes defective oxidative phosphorylation. Because people with this condition cannot re-form ATP, “demyleniation, gliosis, necrosis, spongiosis, or capillary proliferation”[2] can occur, thereby producing bilateral lesions across the central nervous system. The 36-year-old mother previously had four miscarriages and successfully birthed two children, both of whom survived less than six years due to the syndrome. For religious reasons, the mother opted for Spindle Nuclear Transfer instead of Pronuclear Transfer,[3] which many religious organizations oppose because it entails the destruction of fertilized eggs.[4] In Pronuclear Transfer, both the parent and donor egg are fertilized. The parent’s nuclear material is then removed from the egg containing mutated mitochondria and inserted into the fertilized donor egg—from which the original nuclear material has been removed and destroyed. Spindle Nuclear Transfer, on the other hand, removes the mother’s nuclear material from the egg with unhealthy mitochondria, then implants it into a donor’s egg. The newly created egg is then fertilized with the father’s sperm. This Spindle Nuclear Transfer was performed in Mexico by a team of doctors led by Dr. John Zhang, the founder of the New Hope Fertility Center in New York City. In their report, the doctors outline that five oocytes were successfully reconstituted, four of which developed into blastocysts. Only one was euploid: containing 46 XY chromosomes. Researchers then biopsied that blastocyst and found that the transmission rate of maternal mtDNA was, “5.10 ± 1.11% and the heteroplasmy level for 8993T>G was 5.73%.”[5] This indicates that at the blastocyst stage, around five percent of the mitochondria are from the original maternal egg with the mutation for Leigh Syndrome. After birth, they biopsied different tissues and found that they had an average of less than 1.60 ± 0.92% of transmitted mtDNA from the original maternal egg. The baby is reportedly doing well and the team of doctors concluded that “[h]uman oocytes reconstituted by SNT are capable of producing a healthy live birth. SNT may provide a novel treatment option in minimizing pathogenic mtDNA transmission from mothers to their babies."[6] Even when considered theoretically, Spindle Nuclear Transfer is controversial. Many doctors believe that the risks at this stage of research are too great. Dr. Trevor Stammers, a bioethicist at St. Mary’s University in London, points out: “We do not yet have a clear picture of the interaction between nuclear DNA and mitochondria.”[7] Others hold that faulty mitochondrial DNA can still be transferred during the procedure. Still more argue this technology could create problems because of germline modification.[8] Dr. Paul Knoepfler, a cell biologist at the UC Davis School of Medicine, explains: “Since this is uncharted territory and the children born from this technology would have heritable genetic changes, there are also significant unknown risks to future generations.”[9] However, proponents counter these arguments. They say the benefits outweigh the risks, as “mitochondrial replacement techniques [like Spindle Nuclear Transfer] would eliminate maternal transmission of mitochondrial disease… allowing a woman with a family history of mitochondrial diseases to ensure her children would not be affected.”[10] Additionally, experts say that no symptoms will occur if less than 20% of the transferred mitochondrial DNA is faulty.[11] And while opponents see potential germline modification as a problem, advocates answer that this could stop a family history of mitochondrial disease, which they deem a more serious concern. In this case specifically, however, there are more issues at hand. While the team of doctors did eliminate the possibility of germline modification by selecting a male embryo, there are other ethical concerns. Some argue that this case could be described as “medical tourism.” While New Hope Medical Clinic does maintain a branch in Mexico, Dr. Zhang stated that Mexico has “no rules.”[12] It is a country with underdeveloped regulations, making it difficult to confirm that doctors adhere to widely-held medical and ethical standards. Furthermore, while it is highly unlikely that the child will develop Leigh’s Syndrome, Dr. Dietrich Egli of the New York Stem Cell Foundation says the 5% mitochondrial transfer rate indicates that the technique “was not carried out well.”[13] He points to studies of embryos where the rate of mtDNA transfer was almost ten times lower. Spindle Nuclear Transfer is currently legal in the UK,[14] and many are hoping to see it legalized in the US, although Congress currently prohibits the FDA from considering applications that would entail trials in people.[15] While Dr. Zhang’s work is arguably revolutionary, many wonder if the manner in which this study was performed—in Mexico and with a high mitochondrial transfer rate—will impact the technology’s future in the US. Last week, Dr. Zhang presented the report to scientists gathered in Salt Lake City, saying that while science isn’t a race, it is “in a sense, a race for the family to find a cure, to find hope.”[16] Only time will tell if this study set back other families racing and hoping for a cure. References 1. "Leigh Syndrome." Genetics Home Reference, US National Library of Medicine, 25 Oct. 2016. Accessed 26 Oct. 2016. 2. McKusick, Victor A., and Ada Hamosh. "LEIGH SYNDROME; LS." Online Mendelian Inheritance in Man, Johns Hopkins University, 20 Jan. 2016. Accessed 30 Oct. 2016. 3. Zhang, J, H Liu, S Luo, A Chavez-Badiola, and Z Liu. "First live birth using human oocytes reconstituted by spindle nuclear transfer for mitochondrial DNA mutation causing Leigh syndrome." Fertility and Sterility, vol. 106, no. 3, 2016, pp. e375-76. Accessed 30 Oct. 2016. 4. Sample, Ian. "‘Three-parent’ babies explained: what are the concerns and are they justified?" The Guardian, 2 Feb. 2015. Accessed 30 Oct. 2016. 5. Zhang, et al. 6. Ibid. 7. Knapton, Sarah. "Three-parent babies: the arguments for and against." The Telegraph, 3 Feb. 2015. 8. Ibid. 9. Ibid. 10. "Mitochondrial Replacement Therapy FAQs." New York Stem Cell Foundation Research Institute, New York Stem Cell Foundation. Accessed 30 Oct. 2016. 11. Reardon, Sara. "‘Three-parent baby’ claim raises hopes — and ethical concerns." Nature, 28 Sept. 2016. Accessed 30 Oct. 2016. 12. Hamzelou, Jessica. "Exclusive: World’s first baby born with new “3 parent” technique." New Scientist, 27 Sept. 2016. Accessed 30 Oct. 2016. 13. Reardon, Sara. "‘Three-parent baby’ claim raises hopes — and ethical concerns." Nature, 28 Sept. 2016. Accessed 30 Oct. 2016. 14. "3-Person IVF: A Resource Page." Center for Genetics and Society, 24 Oct. 2016. Accessed 30 Oct. 2016. 15. Ritter, Malcolm. "Baby born with DNA from 3 people, first from new technique." Associated Press, 27 Sept. 2016. Accessed 30 Oct. 2016. 16. Chen, Daphne. "Controversy swirls around first three-parent baby." Deseret News, 19 Oct. 2016. Accessed 30 Oct. 2016. Works consulted Swetlitz, Ike. "FDA urged to approve ‘three-parent embryos,’ a new frontier in reproduction." STAT, 3 Feb. 2016. Accessed 30 Oct. 2016. (shrink)

I argue that Sider's view does succeed in accommodating the kind of maximization he is after, according to which the agent is required to maximize overall welfare with the single exception of his own welfare. I then argue that Splawn's argument highlights some interesting and important ways in which Sider's view fail to capture basic common-sense intuitions concerning the self-other asymmetry, but offer a different diagnosis of the source of the problem.

This article provides an analysis of theories of metaphor, tracing how far those which have dominated Western thought until the past few decades are reflective of the definitions within which writers from Classical Greece were working. It is shown how, during the Middle Ages and beyond, in particular since the seventeenth century, definitions of metaphor which emphasised ‘literal’ and ‘figurative’ levels of meaning have led to serious misconceptions concerning its nature and function in the attempts of human beings to conceptualise (...) and make sense of their experiences. A discussion of these misconceptions is provided in some detail and traditional definitions are shown to have distorted the deeper insights held by classical writers, such as Aristotle, Demetrius and Longinus. The article continues with descriptive analyses of the mistaken nature of definitions of metaphor which confine it to creative, poetic forms of discussion. It is shown that conventional speech utterances comprise simple metaphors to a large extent and how these provide an immensely important base from which education could help pupils extend and enrich both their thought and language. This could be done by teaching them ways of interpreting the novel, poetic metaphors of others and how to create their own. (shrink)

The need for education in moral values is increasingly being recognised today, but how is it to be conducted in schools? In particular we consider the appropriateness or otherwise of a teacher assuming the role of a neutral chairperson in discussion.Advocacy of such a stance is especially associated with Lawrence Stenhouse who saw neutrality as a procedural device in order to empower students’ own involvement. We point out many of the insights of Stenhouse's approach, but also some of its disadvantages (...) which subtly encourage a popularist form of relativism.We suggest the substitution of procedural neutrality with a different approach, that of critical affirmation. Here the teacher advocates a stance alongside everyone else. This, however, is done in a way that affirms pupils, and their right to personal views, whilst subjecting all views, including the teacher's own, to a close scrutiny, especially regarding implications for the views of others. (shrink)

This article attempts to answer the question: What makes the Roman constitution "by far the best," as Cicero claims in De republica? Following Polybius, Cicero analyses the Roman constitution as a mixed constitution, which both regard as the best type of constitution. Cicero, however, does not merely impute the best type of constitution to the Romans. He elevates the Roman constitution above all other mixed constitutions as the single best constitution. In rivalry with Plato, he constructs a model of the (...) Roman constitution as an exemplum that can unite the Romans in a common purpose. The constitution is distinguished by two main features: a fair system of cooperation among the whole citizen body and wise guidance by individual leaders. The moral unity of this constitution sets it apart from all other mixed constitutions. (shrink)

This editorial explains why we are launching Research Integrity and Peer Review, a new open-access journal that will provide a home to research on ethics, reporting, and evaluation of research. We discuss how the idea to launch this journal came about and identify the gaps in knowledge where we would like to encourage more research and interdisciplinary discussion. We are particularly keen to receive submissions presenting actual research that will increase our understanding and suggest potential solutions to issues related to (...) peer review, study reporting, and research and publication ethics. (shrink)

In his recent work exploring the role of science in democratic societies Kitcher claims that scientists ought to have a prominent role in setting the agenda for and limits to research. Against the backdrop of the claim that the proper limits of scientific inquiry is John Stuart Mill’s Harm Principle , he identifies the limits of inquiry as the point where the outcomes of research could cause harm to already vulnerable populations. Nonetheless, Kitcher argues against explicit limitations on unscrupulous research (...) on the grounds that restrictions would exacerbate underlying social problems. I show that Kitcher’s argument in favor of dissuading inquiry through conventional standards is problematic and falls prey to the same critique he offers in opposition to official bans. I expand the conversation of limiting scientific research by recognizing that the actions that count as ‘science’ are located in the space between ‘thinking’ and ‘doing’. In this space, we often attempt to balance freedom of research, as scientific speech, against the disparate impact citizens might experience in light of such research. I end by exploring if such disparate impact justifies limiting research, within the context of the United States, under Title VII of the Civil Rights Act of 1964 or under international human rights standards more generally. (shrink)

Twentieth-century ideologies, from liberalism to fascism, are rooted in humanism—the faith in the sovereignty of human reason and potential that grew out of Renaissance thought and discovery. This special issue asks if it is true that all vestiges of humanism have been dismantled, or whether humanism has taken on new forms. Have new versions of historical analysis and cultural studies reanimated humanist themes? What is posthumanism? These essays examine relationships among structuralism, poststructuralism, and the subject; explore the challenge of anticolonialist (...) critique to the coherence of antihumanism; reconsider the canon of antihumanists such as Heidegger and Foucault, and broach the intractable problems posed by efforts to comprehend the Holocaust, the camps, and ethnic cleansing. _Contributors_. Athena Athanasiou, Etienne Balibar, Mara de Gennaro, Carolyn J. Dean, Brady Thomas Heiner, Lynne Joyrich, Jacques Lezra. (shrink)

In reconsidering the question of sexual difference, Weed offers a fresh perspective on what is at stake for critical reading in the neoliberal university.

In the period 1800–1870, French physicians approached psychic illness (Philippe Pinel’s “neurosis”) within competing “cerebralist” and “visceralist” frameworks. Cerebralism, which dominated the specialty of mental medicine, sought the origins of psychic illness in lesions of the brain and central nervous system. “Visceralism,” upheld by generalists, clung to the view of the ancients that psychic disorder was seated in the abdominal viscera. The distinction enjoyed credibility thanks to widespread acceptance of Xavier Bichat’s “two lives” doctrine, which demarcated functions of the central (...) and the “vegetative” nervous systems. Once the “two lives” conception was undercut after midcentury, cerebralists sought to draw disturbances of appetite, digestion, and eating within the domain of the central nervous system. This essay suggests that historical study of “hysterical anorexia” and related disease entities that displaced “neuroses of the stomach” has overemphasized sociocultural determinants to the neglect of the internal dynamics of biomedical science. (shrink)

If truth is not unproblematic, then neither is it inaccessible. And, telling the truth is decidedly a political act. "From the viewpoint of politics, truth has a despotic character," declared Hannah Arendt, in her essay, "Truth and Politics." "Unwelcome opinion can be argued with, rejected, or compromised upon," she goes on, "but unwelcome facts possess an infuriating stubbornness that nothing can move except plain lies." Moreover, at this late date in the twentieth century, we know that social justice is impossible (...) unless intellectuals tell the truth. This is a lesson which Vaclav Havel, the Czech playwright turned politician, teaches as well as anyone. In "The Power of the Powerless," his classic essay on the intellectual's role in opposing totalitarianism, he observes that: "Under the orderly surface of the life of lies... there slumbers the hidden sphere of life in its real aims, of its hidden openness to truth.". (shrink)

(1999). The Statesman and the Ophthalmologist: Gladstone and Magnus on the Evolution of Human Colour Vision, One Small Episode of the Nineteenth-century Darwinian Debate. Annals of Science: Vol. 56, No. 1, pp. 25-45.

This response draws on Saba Mahmood's work on Muslim subjectivities in order to consider how Stalnaker's conceptualization of virtue might be applied to non-Confucian sources. I argue that when applied cross-culturally, Stalnaker's revised definition of “skillful virtue” raises normative and metaethical questions about what counts as a skill versus a mere bodily practice, the process by how skill is acquired, and how we can both allow for the ambiguity of skills and continue to make constructive arguments about them.

The claim that God is a person or personal is, perhaps, one of the most fundamental claims which religious believers make about God. In Hinduism, Brahma, Vishnu and Shiva are represented in person-like form. In the Hebrew Bible/Old Testament God walks in the Garden of Eden , experiences emotions , and converses with human beings . In the New Testament, God communicates with his people, usually by means of angels or visions , and retains the ability to speak audibly, as (...) he does to Paul on the Damascus road . And, in the Qur'an, Allah is said to have a face and two hands , to see, and to sit on a throne . Many believers today would still claim that, among other things which God can do, he loves those who believe in him and responds to their prayers. -/- In this article, I consider several ways in which God has been understood to be a person or personal and argue that, if God’s person-like characteristics must be understood in a metaphorical sense, we cannot draw a clear line between a personal God and an impersonal Absolute. (shrink)

In this article, I will investigate Sartre's claims regarding need as an element of the human condition, and I will compare them to the analysis of need found in the works of Marx and of Herbert Marcuse. These comparisons will raise important questions, such as: given the cultural diversity of experiences of need, is Sartre justified in speaking of needs common to all humans? Are these human needs to be considered permanent fixtures, or do they change historically? And, how might (...) this affect their status as fundamental and truly human? Finally, is it even possible for us to recognize our real human needs, and to distinguish them from artificially created and alienated false "needs," while we exist in what Sartre identifies as the current state of subhumanity? (shrink)

O artigo tem como objetivo recolocar a literatura infantil produzida por autoras e autores afro-brasileiros na história crítica da literatura infantil brasileira, com vistas a reescrever essa trajetória e colaborar com a formação de leitores de literatura com bases antirracistas e tecida na afropoética. Neste texto enfoco prioritariamente Gonçalves Crespo (1846-1883) e sua obra Contos para nossos filhos (1896), mas amplio o debate para outros autores afrodescendentes como João do Rio (1881-1921), Ildelfonso Juvenal (1894-1965) e Mestre Didi (1917-2013) e a (...) autora Ruth Guimarães (1920-2014) como precursores e integrantes da fundação da literatura infantil e juvenil brasileira. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Editors' Introduction to the Special Issue on the Translational Work of BioethicsElizabeth Lanphier and Larry R. ChurchillRecent essays in Perspectives and Biology and Medicine, including "Can Clinical Ethics Survive Climate Change" by Andrew Jameton and Jessica Pierce and "Ethical Maxims for a Marginally Inhabitable Planet" by David Schenck and Larry R. Churchill, both appearing in the Autumn 2021 issue, inspired conversations between us, among our colleagues, and with various (...) contributors to this symposium. We asked of ourselves and each other: where can, should, or must bioethics as a field go to make what bioethicists know and publish about in the academic literature relevant to public policy decisions, health and technological innovation, and a general public? In other words, where do we, practically speaking, go with our bioethical insights and discoveries to make a tangible impact on issues like climate change—though that is only one of the various topics that the authors in this symposium tackle.This translational work of connecting scholarly innovation back to overt practical innovation is often peripheral to academic bioethics. It is not the work the academy typically recognizes in its credit system. Yet this translational work is becoming a critical, central duty of bioethics for the 21st century, while the kinds of work the academy most valorizes may be the least important at this time. In particular, the need for translational initiatives is increasingly evident as pandemics linger into a new normal, the long history and ongoing impacts of racism become even more evident at institutional levels, and the devastating health implications of global warming emerge. [End Page 515]Bioethicists function in privileged proximity to the deleterious effects of failed health and social policy, as well the interplay between seemingly personal health choices, such as those related to diet or lifestyle, and inequitable conditions that impact the options available to individuals and groups. We are increasingly distressed by what we see from this privileged window into health. The COVID-19 pandemic has made preexisting social and policy inequities impacting health impossible to ignore. At the same time, the patterns of carbon pollution portend health crises of unprecedent severity and magnitude in the near future—and will likely deepen inequities and disparities already occurring between those most contributing to, and those most harmed by, climate change.As a field, bioethics has, since its start, been at the intersection of theory and practice. But it is not sufficient for the field to reside passively at this crossroads. The field must be constantly innovating new byways and highways, new offshoots from existing pathways and connector roads between them, that build out both the theory and practice of bioethics in a mutually innovative relationship to each other. Bioethics does not make sense without attention to the real-world practices and the lived realities of health and care. The practical engagement is what deepens and enriches theory, in ways that are more responsive to the real world in which bioethicists toil. But it also is not enough to merely contribute to the body of bioethics scholarship. The translational bioethics we envision is also about using novel theories and concepts to actively shape practices and realities; it is a bioethics in which theory and practices mutually influence each other, each reaching out to generate and change the other.This collection of essays, drawn from a diverse number of scholars, offers several promising paths forward. The essays were written in the spring of 2022, two years into the COVID-19 pandemic, two years after the murder of George Floyd and international attention to the movement for Black lives, and for the most part in the weeks just prior to a set of US Supreme Court decisions with enormous impacts on health, including the June 24 Dobbs v. Jackson Women's Health Organization and the June 30 West Virginia v. EPA decisions.The authors are diverse in age, spheres of work, discipline, sex, race, and ethnicity. They expand our vision for what bioethics can and should be. While we have grouped the essays by subject matter, most of the pieces speak to the field as a whole and invite cross-fertilization. We hope readers will find new ideas, old ideas... (shrink)