First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

IntroductionHead and neck cancer diagnosis and treatment can be a significant life trauma. Some HNC survivors experience post-traumatic growth, which has been linked with better health-related quality-of-life. Empirical research on PTG, and theoretical models, point to the importance of being able to purposely make sense of the traumatic experience. Intrusive rumination, by contrast, is linked to poorer outcomes. This study explored HNC survivors’ experiences of rumination.MethodsTwenty HNC survivors between 9 months and 5 years post-diagnosis were recruited. They had a range (...) of HNC sub-types and cancer treatments. Participants underwent a semi-structured interview about their cancer diagnosis and treatment. Reflexive thematic analysis identified themes and sub-themes around rumination.ResultsFour themes with linked subthemes on the content and process of rumination were identified. Theme 1 was rumination and worry related to diagnosis. Here, survivors discussed how the HNC diagnosis and plans for treatment had dominated their initial thoughts. Theme 2 was processing the trauma of HNC. This theme reflected rumination on the traumatic experience of diagnosis and treatment and how the participant was reacting to it. Theme 3 was considering the impact. This theme encompassed retrospective thinking and comparisons between the participant now versus the early days after diagnosis. Theme 4 was continued rumination. This theme included ongoing intrusive and distressing rumination about the trauma and impact of cancer. Those who expressed ongoing rumination revisited fears or returned to negative experiences.ConclusionThis study uniquely describes the nature and content of rumination following HNC. Early intrusive rumination is common and may reflect perceptions of cancer as an existential threat. Over time, rumination can become more reflective and move towards deliberate meaning-making. Some HNC survivors may benefit from interventions to reduce barriers to this transition. The content of distressing and difficult to control rumination helps to identify those who may benefit from more directed psychological support. (shrink)

Catherine Malabou in The New Wounded develops a general theory of trauma by extending her account of destructive plasticity to the realm of post-traumatic stress disorder. “The new wounded,” she claims, “all come together around a single fact: the radical rupture that trauma introduces in the psyche”. This rupture is demonstrated by an affective fissure, which renders traumatized persons emotionally and socially mute, and a temporal fissure, which punctures subjects’ relationships to their pasts, thus tearing them from any sociohistorical context. (...) Malabou’s new wounded are marked by extreme indifference and a new, unrecognizable identity created ex nihilo with total absence at its center; at times she... (shrink)

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

Martin B. Peterson argues that the social experiment analysis improperly shifts our focus onto the rhetorical dimension of debates over technology, which is ‘clearly irrelevant’ to the ‘traditional...

What is one who takes normativity seriously to do if normativity can neither be discovered lurking out there in the world independently of us nor can it be sufficiently grasped from a merely explanatory perspective? One option is to accept that the normative challenge cannot be met and to retreat to some form of moral skepticism. Another possibility has recently been proposed by Christine Korsgaard in The Sources of Normativity where she aims to develop an account of normativity which is (...) grounded in autonomy. Furthermore, she argues that on her account reasons are "essentially public" and that this captures how it is that we can obligate one another. In this paper I argue that there is a serious tension between her account of normativity and the publicity of reasons-namely, that if reasons are essentially public, then it is not possible for individuals to legislate laws for themselves. However, I then argue that if we revise her conception of normativity such that it is understood to involve collective rather than individual legislation that it may then be possible to account for interpersonal reasons. (shrink)

In popular image, Jesus as friend is sentimentalized, but not so in the Fourth Gospel. Jesus gave his life in love for others and always spoke and acted boldly—marks of friendship in the cultural world of the New Testament.

The cyclical nature of the church's timekeeping means that the sacred story begins anew at Advent, inviting the church to place the coming of the Christ child in a cosmic context in which even time is redefined by God's anticipated in-breaking into the world. Advent is the season of new beginnings and new hopes in its anticipation of the dawning of God's new age.

Internet-based health research is increasing, and often offers financial incentives but fraudulent behavior by participants can result. Specifically, eligible or ineligible individuals may enter the study multiple times and receive undeserved financial compensation. We review past experiences and approaches to this problem and propose several new strategies. Researchers can detect and prevent Internet research fraud in four broad ways: through the questionnaire/instrument ; through participants' non-questionnaire data and seeking external validation through computer information,, and 4) through study design. These approaches (...) each have pros and cons, and raise ethical, legal, and logistical questions, given that ethical tensions can emerge between preserving the integrity of research vs. protecting the privacy and confidentiality of study respondents. While past discussions concerning the ethics of online research have tended to focus on the participants' ability to trust the researchers, needs now arise to examine researchers' abilities to trust the participants. This analysis has several critical implications for future practice, policy, and research. (shrink)

After 40 years of attributing high rates of physician career dissatisfaction, attrition, alcoholism, divorce and suicide to ‘burnout’, there is growing recognition that these outcomes may instead be caused by moral injury. This has led to a debate about the relative diagnostic merits of these two terms, a recognition that interventions designed to treat burnout may be ineffective, and much perplexity about how—if at all—this changes anything. The current research seeks to develop the construct of moral injury outside military contexts, (...) generate more robust validity tests and more fully describe and measure the experiences of persons exposed to moral harms. Absent from the literature is a mechanism through which to move from the collective moral injury experience of physicians to a systematic change in the structure of medical practice. To address this, after providing a brief history, definitions and contrasts between burnout, moral distress and moral injury, we review the interplay of moral and ethical codes in the context of moral injury. We conclude by suggesting that professional associations can potentially prevent moral injury by providing protections for physicians within their codes of ethics. There are no data in this work. (shrink)

Theory of mind competence and knowledge of emotions were studied longitudinally in a sample of preschoolers aged 3 (n=263) and 4 (n=244) years. Children were assessed using standard measures of theory of mind and emotion knowledge. Three competing hypotheses were tested regarding the developmental associations between children's theory of mind abilities and their knowledge of emotions. First, that an understanding of emotion develops early and informs children's understanding of others’ thinking. Alternatively, having a basic theory of mind may help children (...) learn about emotions. Third, that the two domains are separate aspects of children's social cognitive skills such that each area develops independently. Results of hierarchical regressions supported the first hypothesis that early emotion understanding predicts later theory-of-mind performance, and not the reverse. (shrink)

There have been calls for mandatory vaccination legislation to be introduced into the UK in order to tackle the national and international rise of vaccine-preventable disease. While some countries have had some success associated with mandatory vaccination programmes, the Royal College of Paediatrics and Child Health insist this is not a suitable option for the UK, a country which has seen historical opposition to vaccine mandates. There is a lack of comprehensive data to demonstrate a direct link between mandatory vaccination (...) legislation and increased uptake. While there are examples whereby there has been an improvement, some studies suggest that comparable results can be obtained by strongly recommending vaccinations instead. The RCPCH insist that healthcare workers are ideally placed to engage and inform parents to make every interaction a ‘vaccine opportunity’. This paper calls for a principled, rational approach to interpretations of autonomy which underpin parental informed consent. MacLean’s concept of mutual persuasion could be a vehicle to ensuring parents are suitably informed of both the material risks associated with vaccine choices and to consider the rationality of their decisions, while ultimately upholding parental autonomy. It is argued that this, alongside infrastructural improvement, could create a more sustainable, long-term improvement in childhood vaccination rates in the UK than mandatory vaccination. (shrink)

Lapses in ethical conduct by those in corporate and public authority worldwide have given business researchers and practitioners alike cause to re-examine the antecedents to personal ethical values. We explore the relationship between ethical values and an individual’s long-term orientation or LTO, defined as the degree to which one plans for and considers the future, as well as values traditions of the past. Our study also examines the role of work ethic and conservative attitudes in the formation of a person’s (...) long-term orientation and consequent ethical beliefs. Empirically testing these hypothesized relationships using data from 292 subjects, we find that long-term perspectives on tradition and planning indeed engender higher levels of ethical values. The results also support work ethic’s role in fostering tradition and planning, as well as conservatism’s positive association with planning. Additionally, we report how tradition and planning mediate the influence of conservatism and work ethic on the formation of ethical values. Limitations of the study and future research directions, as well as implications for business managers and academics, are also discussed. (shrink)

ObjectivePatient involvement is used to describe the inclusion of patients as active participants in healthcare decision-making and research. This study aimed to investigate incoming year 1 medical (MBChB) students’ attitudes and opinions regarding patient involvement in this context.MethodsWe established a staff–student partnership to formulate the design of an online research survey, which included Likert scale questions and three short vignette scenarios designed to probe student attitudes towards patient involvement linked to existing legal precedent. Incoming year 1 medical students (n=333) were (...) invited to participate in the survey before formal teaching commenced.ResultsSurvey data (49 participants) indicate that students were broadly familiar with, and supportive of, patient involvement in medical treatment. There was least support for patient involvement in conducting (23.9%), contributing to (37.0%) or communicating research (32.6%), whereas there was unanimous support for patients choosing treatment from a selection of options (100%).ConclusionIncoming members of the medical profession demonstrate awareness of the need to actively involve patients in healthcare decision-making but are unfamiliar with the utility and value of such involvement in research. Further empirical studies are required to examine attitudes to patient involvement in healthcare. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Christ Who Meets Us in the Sacraments:The Influence of St. Ambrose on the tertia pars of St. Thomas's Summa theologiaeDamian Day O.P.IntroductionThe recent increased interest in St. Thomas Aquinas and the Fathers of the Church has produced a number of excellent studies of the Angelic Doctor's understanding of the authority of the Fathers and his use of them.1 In this article, I hope to contribute to the ongoing (...) study of Aquinas and the Fathers by examining how Thomas employs St. Ambrose in the tertia pars of his Summa theologiae [ST]. Thomas's use of Ambrose has received little detailed [End Page 103] attention. One of Leo Elders's last contributions to the study of Aquinas and the Fathers provided an overview of Ambrose's presence in Thomas's writings.2 I hope to expand upon Elders's work of cataloging and describing Thomas's numerous citations of Ambrose—Thomas names Ambrose over eleven hundred times in his writings3—by making a particular argument about Thomas's Christological and sacramental use of Ambrose. While Elders gives an excellent summary of where Ambrose appears in Thomas's corpus, he does not connect Thomas's use of Ambrose in his treatises on Christ and the Eucharist. I argue that Thomas's citations of Ambrose in the tertia pars help him develop an understanding of the Incarnation that supports his sacramental realism, especially emphasizing contact with Christ in the Eucharist.4Much recent reflection on the Eucharist has sought to deemphasize the substantial presence of Christ and emphasize his presence in other ways. Michael C. McGuckian, for example, argues that the Western emphasis on Christ's presence in the Blessed Sacrament has damaged the understanding of participation in the heavenly liturgy and obscured other ways in which Christ is present, such as in the bishop presiding and the proclamation of the word. He claims that "those other presences surpass the presence in the elements in their personal quality, their dynamic force and their effect on our [End Page 104] spirits and are not to be undervalued."5 Looking at Thomas and Ambrose, we will see that Christ's substantial presence in the Eucharist is preeminently personal, dynamic, and efficacious for our spirits. Colman O'Neill's masterful work of sacramental realism, Meeting Christ in the Sacraments, provides an entrée into such a study. The title derives from Ambrose. In his work A Defense of the Prophet David to Theodosius Augustus, Ambrose reflects on Psalm 51. Suddenly, in the middle of confessing his sins, David foresees the cleansing sacrament of baptism. In prophetic wonder, he cries out, "face-to-face you have shown yourself to me, Christ; I have discovered you in your sacraments."6 Even prior to their institution, David prophetically glimpses what the sacraments of the Old Law prefigure. In this vision, David sees "no longer in shadow, nor in figure, nor in type," but meets Christ in his sacraments.7 For Ambrose, the sacraments are real encounters with Christ. As O'Neill puts it, "Christ, who was worshipped from afar, comes near and touches the believer; and at his touch power goes out from him."8 For [End Page 105] Thomas, too, one meets Christ in the sacraments.9 While all the sacraments apply the merits of his Passion,10 the Eucharist is the locus par excellence for meeting Christ, since the whole Christ is there contained.11 The encounter is both personal and powerful.While the language of meeting or encountering Christ in the sacraments may seem to echo modern phenomenological philosophy, Thomas grounds the encounter in a realism of the Incarnation.12 His treatment of the encounter with Christ in the sacraments flows from his treatment of the Incarnation.13 Guy-Thomas Bedouelle summed up O'Neill's approach, which reflects Thomas's, as simply stressing, again and again, "that sacramental realism implies that the Church draws its life from the dynamism of the Incarnation itself."14 I argue that Thomas, in drawing his sacramental realism from the Incarnation, employs Ambrose as a key authority. First, I examine Thomas's knowledge and use of Ambrose's works. Second, I... (shrink)

ABSTRACTThis study examines the types of verbal, pictorial, and multimodal metaphors in the genre of sex education picture books for young children in Mainland China. Although being an educational discourse genre that is essentially concerned with transmitting scientific facts, sex education picture books employ a range of metaphors that categorize and construe the biological knowledge of human reproduction in a way that not only facilitates young children’s understanding of scientific concepts but also instills in them particular values and moralities that (...) are socioculturally conditioned. An examination of the source domains from which the metaphors are drawn and the target domains onto which the metaphors are mapped reveals three types of metaphor, namely, personification, domestication, and cross-experience metaphors. The analysis of seven sex education picture books for pre-school children suggests that these types of metaphor are used purposefully for addressing pedagogical as well as ideological con... (shrink)

In this study, we explore the relationship between perceived CEO greed and workplace safety. Drawing on insights from the social psychology literature, we theorize that CEOs are cognizant that their perceived greed has implications for how observers respond to failures in workplace safety. Our theorizing points to a somewhat counterintuitive positive relationship between perceived CEO greed and workplace safety. Consistent with our theorizing, we find that the relationship is attenuated when the CEO is insulated from how observers respond to firm (...) conduct and is amplified when the CEO’s characteristics have a larger impact on how observers respond to adverse firm-level events. We contribute to business ethics research on executive greed, on the relationship between CEO traits and (ir)responsible corporate conduct, and on the antecedents of workplace safety. (shrink)

Focal brain metabolic effects detected by proton magnetic resonance spectroscopy (MRS) in obsessive-compulsive disorder (OCD) represent prospective indices of clinical status and guides to treatment design. Sampling bilateral pregenual anterior cingulate cortex (pACC), anterior middle cingulate cortex (aMCC), and thalamus in 40 adult patients and 16 healthy controls, we examined relationships of the neurometabolites glutamate+glutamine (Glx), creatine+phosphocreatine (Cr), and choline-compounds (Cho) with OCD diagnosis and multiple symptom types. The latter included OC core symptoms (Yale-Brown Obsessive-Compulsive Scale - YBOCS), depressive symptoms (...) (Montgomery-Åsberg Depression Rating Scale - MADRS), and general functioning (Global Assessment Scale - GAS). pACC Glx was 9.7% higher in patients than controls. Within patients, Cr and Cho correlated negatively with YBOCS and MADRS, while Cr correlated positively with the GAS. In aMCC, Cr and Cho correlated negatively with MADRS, while Cr in thalamus correlated positively with GAS. These findings present moderate support for glutamatergic and cingulocentric perspectives on OCD. Based on our prior metabolic model of OCD, we offer one possible interpretation of these group and correlational effects as consequences of a corticothalamic state of elevated glutamatergic receptor activity alongside below-normal glutamatergic transporter activity. (shrink)

Bioethics, Volume 36, Issue 5, Page 535-546, June 2022.

The AI and Society discourse has previously drawn attention to the ways that digital systems embody the values of the technology development community from which they emerge through the development and deployment process. Research shows how this effect leads to a particular treatment of gender in computer systems development, a treatment which lags far behind the rich understanding of gender that social studies scholarship reveals and people across society experience. Many people do not relate to the narrow binary gender options (...) of male or female, and many people express their gender identity in much richer ways than the sex/gender binary female/woman and male/man Boolean terms will allow. We ask: are “born-digital” gendered datasets in digital systems experienced as marginalising by those who express their identity beyond the male/female binary? Case Study: Ireland. To answer this universal question, this paper presents the findings of an empirical case study of people in Ireland with diverse gender identities and expressions, and their experiences with public data systems and new technologies. In spite of great social changes in Ireland which have led to constitutional change in favour of LGBTQI + people, born-digital systems were experienced by respondents as embodying socio-cultural values which were no longer accepted in society at large. For many of the respondents, digital technologies routinely marginalise them in all kinds of ways. These systems keep alive violence and oppression long after civil rights have been enshrined in constitutional law. This study is just one example of the way assumptions about digital are disengaged from society-at-large. It is a call to arms to all who are passionate about socially-responsible technology. (shrink)

This paper is one of four interrelated action papers resulting from the 2008 National Summit on Legal Preparedness for Obesity Prevention and Control. Summit participants engaged in discussions on the current state of the law with respect to obesity, nutrition and food policy, physical activity, and physical education. Participants also identified gaps in the law at all jurisdictional levels and relevant to numerous sectors and disciplines that have a stake in obesity prevention and control.The companion paper, “Assessment of Laws and (...) Legal Authorities for Obesity Prevention and Control,”identified numerous laws and policies enacted to target the three domains of healthy lifestyles, healthy places, and healthy societies. That paper identified several gaps in the law that require attention and action. This paper addresses those gaps and presents applicable laws and legal authorities that public health professionals and lawyers can consider to implement to close the gaps. (shrink)

This chapter examines the romanitas of the Codex Amiatinus. It suggests that the choice of uncial script in Northumbria in the 660s and 670s was a political act and that the association of uncial script with Rome and the papal mission acted as a challenge to insular liturgical gospel-book traditions in Northumbria. The chapter analyses the romanitas of Wearmouth-Jarrow, assuming that Bishop Wilfrid's romanitas aimed to demonstrate to the Northumbrians the superiority of Rome over Iona and of St. Peter over (...) Columba. (shrink)

This volume is a collection of 16 essays, old and new, relating history and exegesis in the writings of Bede and Adomnán, and in the lives of Thomas Becket. The first part consists of seven studies of Bede's writings, notably his biblical commentaries and his Ecclesiastical History. Two of the essays are published here for the first time. The five studies in the second part, devoted to Adomnán, discuss his life of Saint Columba (the Vita Columbae) and his guide to (...) the Holy Places (De locis sanctis). One essay ('The Bible as Map'), published posthumously, compares his presentation of a major theme, the earthly and heavenly Jerusalem, with the approach adopted by Bede. The third section consists of two essays on the lives of Thomas Becket that were composed shortly after his death. They examine, in the context of patristic exegesis, the biblical images invoked in the texts in order to show how the saint's biographers understood the complex relationship between hagiography and history. With the exception of the Jarrow Lecture on Bede and the essays on Becket, the studies in both parts were published originally in edited books, some of them now hard to come by. (shrink)