We give a sharper version of a theorem of Rosický, Trnková and Adámek [13], and a new proof of a theorem of Rosický [12], both about colimits in categories of structures. Unlike the original proofs, which use category-theoretic methods, we use set-theoretic arguments involving elementary embeddings given by large cardinals such as $\alpha$-strongly compact and $C^{(n)}$-extendible cardinals.

Reconstructive allografts using Vascularized Composite Allotransplantation are providing individuals living with upper limb loss and facial disfigurement with new opportunities for a sensate, esthetically acceptable, and functional alternative to current treatment strategies. Important research attention is being paid to how best to assess and screen candidates for VCA, measure optimal patient outcomes, and support patient adherence to lifelong behaviors and medical regimens. Far less attention, however, has been dedicated to the team science required for these complex VCA teams to form, (...) prepare, and provide the highest quality clinical and psychosocial care to those receiving VCA. VCA teams are unique in that they require specialized team members whose scope of practice may not otherwise overlap. The team also needs to constantly negotiate balancing patient safety with multiple risks throughout the transplant process. This study aimed to elucidate the team science needed for this highly innovative and complex area of medicine. Using in-depth qualitative interviews with 14 VCA team members and observations at team meetings, we found that careful consideration of team composition, team structure, and organizational commitment influences team performance and patient outcomes, but that to be efficient and truly effective, teams need to commit to developing processes that foster collaboration. These processes are action-oriented, strategic and interpersonal. Dedication and commitment to team science allows teams to manage conflict under stress and exercise ways to leverage strengths to provide optimal performance or patient psychosocial and clinical outcomes. This study can provide insight into quality improvement efforts for VCA teams and guidance for other transplant programs that wish to consider expansion into VCA. (shrink)

On the Contemplative Life is known for its depiction of a philosophical group of Jewish men and women known as the 'Therapeutae'. Yet the reasons for their depiction have been little understood. In the first commentary on the treatise in English for over 100 years, the social, cultural and political background of the times in which Philo lived are shown to be crucial in understanding Philo's purposes. As Alexandrian Jews were vilified and attacked, Philo went to Rome to present the (...) case for his community, faced with intense opposition. Side-stepping direct confrontation, Philo here cleverly presents the Therapeutae as the pinnacle of excellence, most especially in their communal meal, while ridiculing his accusers in a stinging parody of a festive banquet. (shrink)

The goals of vascular composite allotransplantation for hand are to maximize functional status and psychosocial wellbeing and to improve quality of life. Candidates are carefully vetted by transplant programs through an extensive evaluation process to exclude those patients with contraindications and to select those that are most likely to attain functional or quality of life benefit from transplant. Patient choice for any treatment, however, requires that candidates be able to understand the risks, benefits, and alternatives before choosing to proceed. This (...) study aimed to understand patients’ knowledge and perceptions about treatment options for hand loss, including hand transplant. This study will be used to inform a standardized education approach and develop conversation aids for use by clinicians and patients throughout the treatment decision process. Ten individuals who had experienced hand amputation or had congenital limb loss were interviewed to better understand previous and current decisions about treatment, experiences in adjusting to their treatment, and perceptions about hand VCA. From this qualitative interview data, four findings emerged: knowledge and education around VCA as a treatment option; adaptation of individuals with limb loss; fear of risk associated with transplantation; issues of aging and overuse injuries to existing limbs. Results suggests that there is opportunity for expanding education about all treatment options for patients with new loss, long-term loss, and congenital limb loss. Establishing a baseline of knowledge about all options–prosthetics, rehabilitative strategies, and VCA—can help patients evaluate their values and goals of treatment. Issues associated with aging, including overuse and injury, and adaptability over the life course should be included in considerations about treatment choices. Data indicate the need for routinely assessing patient preferences about treatment choice so patients can plan for their future as they adapt and age and as technology for treatments change. To assure that thorough information is provided for current and future decision-making, education about treatment choices and selection procedures for VCA should be standardized. (shrink)

The 'Therapeutae' were a Jewish group of ascetic philosophers who lived outside Alexandria in the middle of the first century CE. They are described in Philo's treatise De Vita Contemplativa and have often been considered in comparison with early Christians, the Essenes, and the Dead Sea Scrolls. But who were they really? This study focuses particularly on issues of history, rhetoric, women, and gender in a wide exploration of the group, and comes to new conclusions about the 'Therapeutae' and their (...) relationship with the Jewish allegorical school of exegesis in Alexandria. The volume includes a new translation of De Vita Contemplativa. (shrink)

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

Calhoun’s critical sociology relies not only on engagements with Habermas, Bourdieu and Taylor, but also on the middle range empirical traditions of American sociology. Through a review of his recent work on cosmopolitanism and globalization, community and solidarity, and public spaces and sociology, I propose that his search to explain different ways in which solidarity is developed offers a robust sociological foundation for the development of the most appropriate intellectual formation, and institutional sequel, to the emancipatory project that undergirds (...) critical theory’s hope and commitment. At the same time, we all need to rethink how both critical theory and more empirical sociologies can help us recognize the issues and agencies most vital for the address of contemporary cultural, social and biophysical needs. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Protecting Human Research SubjectsThe Office for Protection from Research RisksJoan Paine Porter (bio)The office for Protection from Research Risks (OPRR), located within the National Institutes of Health, has two divisions: Human Subject Protections and Animal Welfare. This article will address the overall responsibilities and current projects relating to human subject protections.OPRR implements the Department of Health and Human Services' (HHS) regulations for the protection of human subjects (45 CFR (...) 46 (1991)). These regulations fulfill the responsibilities set forth in the Public Health Service (PHS) Act with regard to institutional review boards (IRB) and other protections for human subjects involved in biomedical and behavioral research conducted or supported by HHS. The PHS Act also mandates a program to clarify ethical issues in biomedical research involving human subjects and to address violations of the rights of human subjects of research (P.L. 99-158 (1985)).OPRR staff negotiate assurances of compliance with institutions conducting Federally-supported research involving human subjects. The assurances describe the policies and procedures each institution will follow to fulfill the requirements of the regulations, including specific IRB composition and functions.In addition, OPRR cosponsors with the Food and Drug Administration and awardee institutions a series of regional workshops that address human subject protections issues. These are attended by IRB members, institutional officials, research investigators, and others involved with human subject protections.Current ActivitiesNumerous activities are underway in OPRR. The following describes only a few of the initiatives and studies aimed at helping develop policies and procedures to protect human subjects of research."Points to Consider" DocumentsOPRR is currently working with the National Center for Human Genome Research (NCHGR) to develop a "points to consider" document for IRBs and others involved in large genetic pedigree studies. Many questions have emerged [End Page 279] on topics such as how subjects should be recruited, with whom information should be shared about others in the family, social risks of disclosure in employment and insurance, the circumstances and timing of informing subjects about study results, and involvement of children. OPRR and NCHGR hope to assemble a group this fall to review and refine the points that are now being developed jointly. A conference in South Carolina organized by the American Association for Advancement in the Sciences entitled "Project on the Ethical and Legal Implications of Genetic Testing," helped generate advice, and identified some of the more controversial issues in design and conduct of genetic research that involves large groups of family members.Another "points to consider" effort concerns enrollment of women and minorities in research. The PHS has established a policy that members of these groups must be included in research projects unless there are valid scientific justifications for their exclusion which can be made on a project by project basis (ADAMHA/NIH Policy 1990; NIH/ADAMHA Policy 1990). OPRR has commissioned several scholarly papers to help in developing "points to consider" for IRBs as they balance issues of equitable selection of subjects and protection of these selected individuals. Concerns about enrolling women of childbearing age in research that may be harmful to a fetus, and liability issues frequently dominate discussion in this area. The papers will address ethical, legal, and statistical aspects of enrollment of minorities and women as well as provide a description of various practices and roles of IRBs in addressing goals of fair selection of participants and appropriate protections.OPRR is also working with the PHS Panel on Women, Adolescents and Children to produce a document, also in the form of "points to consider" guidance, concerning enrollment of children who are wards of the state in HIV-related research. Subpart D of the regulations for the protection of human subjects (45 CFR 46) specifically addresses research involving children who are wards of the state, including the special protections that must be provided. State and local officials who have authority to enroll foster care children in research have indicated a desire to obtain advice in this area.The IRB GuidebookA major project that is now being completed under contract to the Poynter Center at Indiana University is the IRB Guidebook. It will revise and expand the current IRB Guidebook produced in the 1980s... (shrink)

This paper advances a novel conception of the child’s best interest in regard to pediatric surgeries that do not promote the preventive or therapeutic health needs of children, or elective pediatric surgeries (EPS). First, children’s capacity for decision-making is examined, and the best decision-making model for EPS is identified as the Best Interest Standard. What follows is a discussion of the interests of children in the context of EPS, the correlation of fundamental interests to rights, and guidelines for weighing children’s (...) competing interests. Next, the rights and duties of parents as proxy decision makers are considered. Finally, a reinterpretation of the Best Interest Standard is proposed, identifying as paramount a child’s ability to make elective medical decisions for herself when she reaches maturity. (shrink)

Multiple scholars and institutions have asked what distinguishes public health research from public health practice. Most often, they ask in order to have a clear definition of what one does in various public health settings to assess oversight and/or regulation of human subjects research. More importantly, however, whether something is considered public health research or public health practice has real ethical implications in terms of the general moral considerations at stake and the obligations of public health researchers/practitioners to the populations (...) they serve or study.Numerous examples in recent history of research ethics, including the Kennedy Krieger Lead Abatement Study and EPA’s Children’s Environmental Exposure Research Study, suggest that an exploration of the ethics of public health, or more generally population-based research, may be warranted. Although we acknowledge that there are important ethical issues to consider in the implementation of public health practice, we leave that discussion for other authors. (shrink)

First Published in 1993. Routledge is an imprint of Taylor & Francis, an informa company.

Clinical trials are a central mechanism in the production of medical knowledge. They are the gold standard by which such knowledge is evaluated. They are widespread both in the United States and internationally; a National Institute of Health database reports over 106,000 active industry and government-sponsored trials (National Institutes of Health n.d.). They are an engine of the economy. The work of trials is complex; multiple people with diverse interests working across multiple settings simultaneously participate in them, and they are (...) underwritten by multiple organizational structures and diverse funding mechanisms. In the past several years, concern about the ethics of clinical trials has spiked dramatically .. (shrink)

: Catholic teaching has no moral difficulties with research on stem cells derived from adult stem cells or fetal cord blood. The ethical problem comes with embryonic stem cells since their genesis involves the destruction of a human embryo. However, there seems to be significant promise of health benefits from such research. Although Catholic teaching does not permit any destruction of human embryos, the question remains whether researchers in a Catholic institution, or any researchers opposed to destruction of human embryos, (...) could participate in research on cultured embryonic stem cells, or whether a Catholic institution could use any therapy that ultimately results from such research. This position paper examines how such research could be conducted legitimately in a Catholic institution by using an ethical analysis involving a narrative context, the nature of the moral act, and the principle of material cooperation, along with references to significant ethical assessments. It also offers tentative guidelines that could be used by a Catholic institution in implementing such research. (shrink)

: This response to the preceding article by Gastmans, Dierckx de Casterle, and Schotsmans challenges the notion of "good care" as the ultimate goal of nursing practice, explores further the possible goals of nursing and how they may be identified, and presents six elements of professional caring along with their related virtues and moral obligations.

In 2013, one year after the enactment of the landmark Mental Health Act, a small team of psychiatrists, psychologists, and statisticians from the University of Ghana Medical School began a controversial field-based randomized-control trial entitled "Joining Forces" at the Mount Horeb prayer camp. Located about 45 minutes outside of Accra, Mt. Horeb is one of the largest and best known prayer camps in Ghana. It is an Evangelical Pentecostal organization whose mission is to "set free those held captive by Satan (...) through a ministry of fasting and prayer". Mount Horeb had a well-documented track record of human... (shrink)

While political and ethical philosophers today are familiar with critiques of confinement in both critical prison studies and critical animal studies, The Ethics of Captivity is unusual in that it brings these critiques of incarceration together, bridging human and nonhuman animal liberation movements. While Lisa Guenther’s recent book, Solitary Confinement: Social Death and Its Afterlives, also critiques the mass incarceration of both human and nonhuman animals, it is far more common to see human and animal liberation movements opposed on this (...) issue, as when the incarceration of humans is deplored for treating those individuals like animals. As Guenther argues, however, this humanistic language is... (shrink)

The brain matters. Says the opening line from Victoria Pitts-Taylor’s The Brain’s Body: Neuroscience and Corporeal Politics. On the face of it, the human brain matters inasmuch as it is the body’s central information processing organ; the CEO that presides over many of our executive bodily functions. But the brain matters beyond the ways in which it has biologically evolved and currently processes information. The brain also matters in social thought, as neuroscientific research has historically informed widespread perceptions of (...) certain bodies and persons at the social and institutional level. Moreover, the brain is embodied, and bodies accrue social and political meanings beyond what they represent at the level... (shrink)

In this paper, I propose a solution to Fitch’s paradox that draws on ideas from Edgington (Mind 94:557–568, 1985), Rabinowicz and Segerberg (1994) and Kvanvig (Noûs 29:481–500, 1995). After examining the solution strategies of these authors, I will defend the view, initially proposed by Kvanvig, according to which the derivation of the paradox violates a crucial constraint on quantifier instantiation. The constraint states that non-rigid expressions cannot be substituted into modal positions. We will introduce a slightly modified syntax and semantics (...) that will help underline this point. Furthermore, we will prove results about the consistency of verificationism and the principle of non-omniscience by model-theoretical means. Namely, we prove there exists a model of these principles, and delineate certain constraints they pose on a structure in which they are true. (shrink)

"[This book is] an... examination of how we can respond to suffering, live our fullest lives, and remain open to the full spectrum of our human experience"--Amazon.com.

The moral doctrine of Hobbes, in many ways the most interesting of our major British philosophers, is, I think, commonly seen in a false perspective which has seriously obscured its real affinities. This is, no doubt, largely due to the fact that most modern readers begin and end their study of Hobbes's ethics with the Leviathan , a rhetorical and, in many ways, a popular Streitschrift published in the very culmination of what looked at the time to be a permanent (...) revolution, and do not pay such attention to the more calmly argued statements of the same doctrine contained in the Elements of Law , circulated before the outbreak of the Civil War, or the De Cive. (shrink)

The scale and asymmetry of commercial technology firms’ power over people through data, combined with the increasing involvement of the private sector in public governance, means that increasingly, people do not have the ability to opt out of engaging with technology firms. At the same time, those firms are increasingly intervening on the population level in ways that have implications for social and political life. This creates the potential for power relations of domination, and demands that we decide what constitutes (...) the legitimacy to act on the public. Business ethics and private law are not designed to answer these questions, which are primarily political. If people have lost the right to disengage with commercial technologies, we may need to hold the companies that offer them to the same standards to which we hold the public sector. This paper first defines the problem and demonstrates that it is significant and widespread, and then argues for the development of an overarching normative framework for what constitutes non-domination with regard to digital technologies. Such a framework must involve a nuanced idea of political power and accountability that can respond not only to the legality of corporate behaviour, but to its legitimacy. (shrink)

Social categories play a central role in inquiry. Some authors have argued that social categories can only play this role because they have a particular metaphysical status, such as a connection to natural kinds or to comparatively joint-carving properties. This reflects the broadly realist idea that categories that play important roles in inquiry do so for metaphysical reasons. In this paper I argue that such metaphysical views of social categories cannot accommodate ‘empty’ social categories, cases in which social categories that (...) cannot have the metaphysical features attributed to them by such accounts still play a central role in inquiry. I defend an alternative approach: context-dependent naturalness, an analogue of metaphysical naturalness that concerns context-dependent, rather than metaphysical, structure. (shrink)

Following an extensive review of the moral intensity literature, this article reports the findings of two studies (one between-subjects, the other within-subject) that examined the effect of manipulated and perceived moral intensity on ethical judgment. In the between-subjects study participants judged actions taken in manipulated high moral intensity scenarios to be more unethical than the same actions taken in manipulated low moral intensity scenarios. Findings were mixed for the effect of perceived moral intensity. Both probable magnitude of consequences (a factor (...) consisting of magnitude of consequences, probability of effect, and temporal immediacy) and social consensus had a significant effect; proximity did not. In the within-subject study manipulated moral intensity had a significant effect on ethical judgment, but perceived moral intensity did not. Regression of ethical judgment on age, gender, major, and the three perceived moral intensity factors was significant between-subjects, but not within-subject. Ethical judgment was found to be a more robust predictor of intention than perceived moral intensity using a within-subject design. (shrink)

A half-century of Rawls interpreters have overemphasized economic equality in A Theory of Justice, slighting liberty—the central value of liberalism—in the process. From luck-egalitarian readings of Rawls to more recent claims that Rawls was a “reticent socialist,” these interpretations have obscured Rawls’s identity as a philosopher of freedom. They have also obscured the perhaps surprising fact that Rawlsian liberties (basic and non-basic) restrain and even undermine that same economic equality. As I will show in this article, such undermining occurs in (...) three areas: first, in the lexical priority of the basic liberties; second, in the (underappreciated) role played by free and competitive markets in Rawls’s theory; and third, in the structure and functioning of Rawls’s preferred economic institutions, viz., liberal socialism and property-owning democracy. (shrink)

This essay discusses the difference between the concepts of multiculturalism and interculturalism, both concepts which are current on the Canadian scene. It argues that the difference between the two is not so much a matter of the concrete policies, but concerns rather the story that we tell about where we are coming from and where we are going. In some ways, we could argue that interculturalism is more suitable for certain European countries.

In this paper, we provide a new framework for understanding infant-feeding-related maternal guilt and shame, placing these in the context of feminist theoretical and psychological accounts of the emotions of self-assessment. Whereas breastfeeding advocacy has been critiqued for its perceived role in inducing maternal guilt, we argue that the emotion women often feel surrounding infant feeding may be better conceptualized as shame in its tendency to involve a negative self-assessment—a failure to achieve an idealized notion of good motherhood. Further, we (...) suggest, both formula-feeding and breastfeeding mothers experience shame: the former report feeling that they fail to live up to ideals of womanhood and motherhood, and the latter transgress cultural expectations regarding feminine modesty. The problem, then, is the degree to which mothers are vulnerable to shame generally, regardless of infant feeding practices. As an emotion that is less adaptive and potentially more damaging than guilt, shame ought to be the focus of resistance for both feminists and breastfeeding advocates, who need to work in conjunction with women to oppose this shame by assisting them in constructing their own ideals of good motherhood that incorporate a sense of self-concern. (shrink)

As the coronavirus pandemic continues apace in the United States, the dizzying amount of data being generated, analyzed and consumed about the virus has led to calls to proclaim this the first ‘data-driven pandemic’. But at the same time, it seems that this plethora of data has not meant a better grasp on the reality of the pandemic and its effects. Even as we have the potential to digitally track and trace nearly every single individual who has contracted the virus, (...) we have no idea exactly how many people have had the virus, been hospitalized, or died because of it, largely due to a confluence of factors, particularly active obfuscation and mismanagement by public authorities and misinformation spread through social media and right-wing media channels. But beyond these dynamics, there also lies the less nefarious ways that the everyday, subjective practices of data collection, analysis and visualization have the potential to themselves produce these very same dynamics where data is at once valorized and ignored, preeminent and completely useless. That is, the pandemic has revealed only the general inadequacy of our data infrastructures and assemblages to solving pressing social issues, but also the more general shift towards a ‘post-truth’ disposition in contemporary social life. But, as this paper argues, it would be a mistake to see the centrality of data as being somehow the opposite from the larger post-truth apparatus, as the two are instead fundamentally intertwined and co-produced. (shrink)

This article identifies a prevalent strand of feminist writing on beauty and aesthetic surgery and explores some of the contradictions and inconsistencies inscribed within it. In particular, we concentrate on three central feminist claims: that living in a misogynist culture produces aesthetic surgery as an issue predominantly concerning women; that pain - both physical and psychic - is a central conceptual frame through which aesthetic surgery should be viewed; and that aesthetic surgery is inherently a normalizing technology. Engaging with these (...) ‘myths’, we explore the tensions uncovered through a historical analysis of the practices of aesthetic surgery as well as the challenges to feminist claims offered by post-feminism. In particular we seek to destabilize the connection in feminist writing between beauty and passivity. We argue that through aesthetic references to denigrated black and working-class bodies, young women may mobilize aesthetic surgeries to reinscribe active sexuality on the feminine body. (shrink)

From the foundation of self-determination theory and existing literature on forms of power, we empirically explored relationships between followers’ perceptions of their leader’s use of various forms of power, followers’ self-reported motivational outlooks, and followers’ favorable work intentions. Using survey data collected from two studies of working professionals, we apply path analysis and hierarchical multiple regression to analyze variance among constructs of interest. We found that followers’ perceptions of hard power use by their leaders (i.e., reward, coercive, and legitimate power) (...) was often related to higher levels of sub-optimal motivation in followers (i.e., amotivation, external regulation, and introjected regulation). However, followers who perceived their leaders used soft power (i.e., expert, referent, and informational power) often experienced higher levels of optimal motivation (i.e., identified regulation and intrinsic motivation), but further investigation of soft power use is warranted. The quality of followers’ motivational outlooks was also related to intentions to perform favorably for their organizations. (shrink)

Although what language users in different cultures say about their own language has long been recognized as of potential interest, its theoretical importance to the study of language has typically been thought to be no more than peripheral. Theorizing Language is the first book to place the reflexive character of language at the very centre both of its empirical study and of its theoretical explanation. Language can only be explained as a cultural product of the reflexive application of its own (...) creative powers to construct, regulate, and give conceptual form to objects of understanding. Language is itself, first and foremost, an object of cultural understanding. Theoretical analyses of language which have neglected its reflexive character, or simply taken its effects for granted, merely impose their own artificial structures on their analytical object. The first part of this book discusses the consequences of neglecting this reflexive character for the technical concepts and methods which are used in analysing different types of communicational phenomena. In the second part, normativity - a crucial aspect of language's reflexive nature - is examined. The book's third and final part focuses on particular issues in the history of linguistic thought which bear witness to the rhetoric of language theorizing as a reflexive form of inquiry. (shrink)