Contexte : Dans les systèmes de santé universitaires complexes, les projets d’amélioration de la qualité (AQ) destinés à améliorer les soins et l’apprentissage prolifèrent, mais il existe des différences considérables quant à la manière dont ces projets sont supervisés sur le plan éthique, voire même s’ils le sont. À la suite d’un volume élevé de projets soumis à l’un de nos comités d’éthique de la recherche (CER), mais considérés comme n’étant pas de la recherche et donc non éligibles à un (...) examen, des questions ont commencé à se poser au sein de notre organisation sur la manière dont les dimensions éthiques des projets d’AQ pourraient être évaluées et sur les approbations institutionnelles qui pourraient être nécessaires pour garantir la conformité avec les normes émergentes. Méthodes : Une enquête environnementale à méthodes mixtes a conduit à une analyse quantitative rétrospective des projets d’AQ de notre organisation, associée à des consultations qualitatives approfondies avec le personnel, les médecins et les apprenants de l’ensemble de notre réseau de santé. Les exemptions de CER ont été analysées à l’aide de diagrammes d’exécution afin d’évaluer les volumes de base des projets d’AQ, et des analyses thématiques ont été menées sur les notes de terrain de 133 consultations avec les parties prenantes. Résultats : Au cours d’une période de 34 mois, 117 lettres d’exemption du CER ont été émises pour des projets d’AQ. Les consultations ont mis en évidence la nécessité d’un processus d’évaluation éthique clairement défini pour les projets d’AQ, de structures de gouvernance appropriées et de possibilités d’identifier et d’atténuer les risques. Les personnes interrogées ont également évoqué l’impératif éthique de mener des initiatives d’AQ. Le présent document explique comment ces thèmes ont contribué à l’élaboration et à la mise en place de notre comité d’examen de l’amélioration de la qualité (CEAQ). Conclusion : Depuis 2020, plus de 840 projets ont été examinés par notre CEAQ, dans le but d’atténuer les risques pour les patients, le personnel et les équipes de projet d’AQ dans l’ensemble de l’UHN. (shrink)

Brussen, Kerri Anne Children born through gamete donation can be genetically linked to one or neither parent. This article examines the practice of gamete donation, seeking to establish if there is cause for concern.

Brussen, Kerri Anne The selection of the sex of an unborn child brings to mind many thoughts: playing God, gender discrimination, imbalance in the male:female gender ratio, and a slippery slope that could lead to designer babies. Sex selection also raises the question of reproduction autonomy. These and other issues are explored in this article.

Brussen, Kerri Anne This article briefly examines the history and genetics of Down syndrome. Contemporary prenatal testing practices are described as is the effect of testing on the birth prevalence of children with Down syndrome. The analysis of a series of articles on families with a child with Down syndrome provides a touching insight into these families. It demonstrates that each person - including those with Down syndrome - make a unique and valuable contribution to their family and the world.

Brussen, Kerri Anne Adolescence and young adulthood are a time of change. It is also a time where there is an increased chance of being diagnosed with a mental illness. Professor Patrick McGorry has driven the agenda to transform the approach to youth mental health. This article is a review of the recommendations of McGorry and others within the mental health field on how best to care for our youth with a mental illness. We also briefly look at some of (...) the services offered by a Catholic agency. (shrink)

Brussen, Kerri Anne Ethically compromised vaccines are vaccines where the virus used in the manufacture of the vaccine has been cultured in a cell line developed from tissue grown from an aborted foetus. In Australia, an ethically compromised vaccine is the only vaccine available for Chicken pox (varicella), shingles (zoster), Hepatitis A, and Rubella (which is part of the MMR - measles, mumps, rubella - vaccine). The poliovirus vaccine component of Quadracel, available in Western Australia, is ethically compromised. However, the (...) poliovirus component of Infanrix-IPV is not ethically compromised and is used in all other Australian States and Territories. The rabies vaccine, Rabipur, is not ethically compromised and is the preferred option to Merieux Inactivated Rabies Vaccine (MIRV) which is an ethically compromised vaccine. This article lists the ethically compromised vaccines available in the various Australian States and Territories, and explains why they are ethically compromised. It also explains when and why vaccination should still be accepted even when the only available vaccine is ethically compromised. (shrink)

Brussen, Kerri Anne On 29 November 2012, one of the Standing Committees of the Commonwealth House of Representatives released a report on the prevention, diagnosis and management of Fetal Alcohol Spectrum Disorders in Australia. This article explores the findings and recommendations of this report. The Commonwealth parliamentary committee noted that FASD is a serious health issue in Australia. It therefore called for a National Plan of Action, education for health professionals, and public awareness campaigns to encourage women not to drink (...) when pregnant or when planning a pregnancy. Other recommendations included better management of FASD within education, disability services, and the criminal justice system. (shrink)

Brussen, Kerri Anne This article begins with a fictionalised account of a teenage party to celebrate a sporting club's end of season achievements. It then looks at some of the potential outcomes of the behaviours displayed and the longer term consequences.

Brussen, Kerri Anne In 2002, euthanasia became legal in the Netherlands. Since then, the Groningen Protocol has been endorsed, allowing infanticide for disabled babies. More recently, a citizen's initiative is being prepared to propose to the Dutch government that people should be allowed to legally terminate their life if they consider it completed. The slippery slope in the Netherlands appears to be well lubricated.

Using 16 in-depth interviews drawn from a larger sample of Black/white biracial individuals, this article explores how gender shapes the microlevel process of racial identity construction. Skin color stratification within the Black community, combined with a low rate of marriageable men and high rates of interracial marriages among the most educated and affluent Black men, has created a social context that differentiates the interactional experiences of biracial men and women. The findings highlight the need for more complex theoretical conceptualizations of (...) how gender shapes the way that women negotiate their racial identities in post-Civil Rights America. (shrink)

Brussen, Kerri Anne In February 2009, the National Health and Medical Research Council (NHMRC) issued revised guidelines to help reduce the health risks from alcohol consumption. This report summarises these guidelines. Above all, it discusses the change of thought in these guidelines based on a greater understanding of the need to reduce both the immediate as well as the lifetime risks of alcohol consumption.

Brussen, Kerri Anne The National Health and Medical Research Council released a new set of dietary guidelines on 18 February 2013, to help ensure that Australians continue to make healthy food choices based on the best available scientific evidence. Unlike the 2003 guidelines which were based on nutrients, these guidelines are based on food and food groups. The guidelines encourage the consumption of a varied diet and physical exercise. They also encourage the limiting of energy-dense nutrient-poor food. By making these (...) food choices, we can help to reduce our risk of diet-related disease. (shrink)

Brussen, Kerri Anne Sex Cells, written by Rene Almeling, describes the commercial market that has emerged in the United States for human eggs and sperm. Almeling examines how agendas that are economically, biologically and culturally driven have lead to distinctly different practices within egg agencies and sperm banks. Further, she observes how these practices subsequently shape an individual's perception of the commodification of human gametes.

Brussen, Kerri Anne A patent provides the exclusive legal right to a person or company to regulate the distribution, manufacture or use of their invention. This paper examines some of the issues surrounding Gene Patents. Although there is a drive to abolish Gene Patents, we argue that refined and clearly defined regulation would continue to support medical research, avoid exploitation, and be of benefit to public health.

Brussen, Kerri Anne This paper is a brief history of suicide, euthanasia, and physician assisted suicide in the United States of America which aims to provide an understanding of the continued and persistent effort in the USA to legalise physician assisted suicide. Oregon and Washington State Dying with Dignity Laws are reviewed as examples of legalised physician assisted suicide.

Occupying a space in-between conventional scholarship and imaginative storytelling, The University in Crumbs: A Register of Things Seen and Heard is an experimental work that dramatizes the everyday life of the academy.

_From Knowledge to Beatitude _is a collection of original essays on the intersection between Christian theology and spiritual life primarily in the twelfth and thirteenth centuries, especially in the Parisian School of St. Victor, which honors the influential work of Grover A. Zinn, Jr. Written by distinguished scholars from various fields of medieval studies, these essays range from the study of the exegetical school of twelfth-century St. Victor and medieval glossed Bibles to the medieval cultural reception of women visionaries, preachers, (...) and crusaders. Although focused on St. Victor, they provide analyses of Christian themes up to the modern period. A common thread is Zinn’s careful attention to the connections between medieval spirituality and biblical studies, the origin of these ideas, and their lasting influence in Christian culture. The essays take us from Hugh of St. Victor’s foundation—material culture—to the “beatitude” of a wider understanding of Victorine culture and its lasting legacy. This volume is a fitting tribute to a generous scholar, teacher, and mentor. It will appeal to historians, scholars of religion and theology, and art historians. "_From Knowledge to Beatitude_ serves a need and fills an important gap in the Victorine tradition, the history of medieval exegesis, and medieval studies. The volume also honors the contributions of Grover Zinn, an important medieval scholar and teacher. It serves as a model for doing research and generalizing in the field of medieval studies and demonstrates how the last generation and the current generation of medieval scholars have plowed through difficult primary and secondary sources to make the medieval traditions clear." —_Philip Krey, Lutheran Theological Seminary at Philadelphia_. (shrink)

It is often overlooked that, in addition to the integrity of protein‐coding sequences (PCSs), human health is crucially linked to the normal expression of genes by cis‐regulatory sequences (CRSs). These CRSs often lie at some considerable distance from the PCSs whose expression they control and often within other genes. The resulting gene interdigitation can make long‐range CRS identification and characterisation difficult. We propose that the need to conserve long‐range CRSs in cis with their target PCSs through evolution, in combination with (...) gene interdigitation and co‐regulation of many genes by individual CRSs, has contributed to the persistence of conserved synteny blocks between diverse species. We further hypothesise that examination of the varying extents of synteny blocks between multiple species in combination with phylogenetic footprinting to find CRSs might provide important clues to the existence of crucial functional CRS–PCS linkages. Identifying CRS–PCS linkages crucial to human health will lead to a better understanding of how their disruption by CRS mutation or chromosome translocation might contribute to many distressing human diseases. BioEssays 26:1217–1224, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Moral imagination is a central component of moral agency and person‐centred care. Becoming moral agents who can sustain attention on patients and their families through their illness and suffering involves imagining the other, what moral possibilities are available, what choices to make, and how one wants to be. This relationship between moral agency, moral imagination, and personhood can be effaced by a focus on task‐driven technical rationality within the multifaceted challenges of contemporary healthcare. Similarly, facilitating students' moral agency can also (...) be obscured by the task‐driven technical rationality of teaching. The development of moral agency requires deliberate attention across the trajectory of nursing education. To prepare nursing students for one practice challenge, workplace violence, we developed a multimodal education intervention which included a simulated learning experience (SLE). To enhance the realism and consistency of the educational experience, 11 nursing students were trained as simulated participants (SP). As part of a larger study to examine knowledge acquisition and practice confidence of learners who completed the SLE, we explored the experience of being the SP through interviews and a focus group with the SP students. The SP described how their multiple performances contributed to imagining the situation ‘on both sides’ prompting empathy, a reconsideration of their moral agency, and the potential to prevent violence in the workplace beyond technical rational techniques, such as verbal de‐escalation scripts. The empirical findings from the SP prompted a philosophical exploration into moral imagination. We summarise the multimodal educational intervention and relevant findings, and then, using Johnson's conception of moral imagination and relevant nursing literature, we discuss the significance of the SP embodied experiences and their professional formation. We suggest that SLEs offer a unique avenue to create pedagogical spaces which promote moral imagination, thereby teaching for moral agency and person‐centred care. (shrink)

'The Battle of the Gods and Giants Redux' is a collection of 14 original essays in early modern philosophy by leading scholars in the field presented in honour of Thomas M. Lennon.

In recent decades, there has been increasing interest in (re)connecting people with nature to foster sustainability outcomes. There is a growing body of evidence suggesting a relationship between connection with nature and pro-environmental behaviors. Connection with nature has often been conceptualized as a unidimensional construct, and although recent evidence suggests that it is multidimensional, there is ongoing debate regarding the dimensions that make up connection with nature. Existing multidimensional connection with nature instruments capture similar dimensions, yet they are lengthy and (...) may not have practical application in real-world contexts. This research sought to clarify the dimensions of connection with nature and to develop and validate an abbreviated yet multidimensional connection with nature instrument—the CN-12. Analyses of two large datasets revealed three dimensions of connection with nature—identity, experience, and philosophy. Results suggested that the CN-12 and its three dimensions are positively correlated with: (1) environmental and altruistic values; (2) time spent in nature; and (3) a range of pro-environmental behaviors. Results also suggested that the CN-12 and its three dimensions are stable over time and are positively correlated with two existing multidimensional connection with nature instruments, the Nature Relatedness (NR) Scale and Environmental Identity (EID) Scale. The utility of the CN-12 for exploring human connections with nature and the role of fostering connection with nature to increase engagement in pro-environmental behaviors are discussed. (shrink)

Wilson et al. focus on one class of AGL tasks: the cognitively demanding task of detecting non‐adjacent dependencies (NADs) among items. They provide a typology of the different types of NADs in natural languages and in AGL tasks. A range of cues affect NAD learning, ranging from the variability and number of intervening elements to the presence of shared prosodic cues between the dependent items. These cues, important for humans to discover non‐adjacent dependencies, are also found to facilitate NAD learning (...) in several nonhuman animal species. (shrink)

Wilson et al. focus on one class of AGL tasks: the cognitively demanding task of detecting non‐adjacent dependencies (NADs) among items. They provide a typology of the different types of NADs in natural languages and in AGL tasks. A range of cues affect NAD learning, ranging from the variability and number of intervening elements to the presence of shared prosodic cues between the dependent items. These cues, important for humans to discover non‐adjacent dependencies, are also found to facilitate NAD learning (...) in several nonhuman animal species. (shrink)

The contribution of this book to the field of reconciliation is both theoretical and practical, recognizing that good theory guides effective practice and practice is the ground for compelling theory. Using a Girardian hermeneutic as a starting point, a new conceptual Gestalt emerges in these essays, one not fully integrated in a formal way but showing a clear understanding of some of the challenges and possibilities for dealing with the deep divisions, enmity, hatred, and other effects of violence.

The contribution of this book to the field of reconciliation is both theoretical and practical, recognizing that good theory guides effective practice and practice is the ground for compelling theory. Using a Girardian hermeneutic as a starting point, a new conceptual Gestalt emerges in these essays, one not fully integrated in a formal way but showing a clear understanding of some of the challenges and possibilities for dealing with the deep divisions, enmity, hatred, and other effects of violence. By situating (...) discourse about reconciliation within the context of Girardian thought, it becomes clear that like Peter who vowed he would never deny Jesus but ended up doing it three times any of us is susceptible to the siren call of angry resentment and retaliation. It is with a profound awareness of the power of violence that the emergence of mimetic discourse around reconciliation takes on particular urgency.". (shrink)

There couldn't be a more appropriate method for illustrating the dynamics of psychoanalysis than the vehicle of story. In this book, Kerry L. Malawista, Anne J. Adelman, and Catherine L. Anderson share amusing, poignant, and sometimes difficult stories from their personal and professional lives, inviting readers to explore the complex underpinnings of the psychoanalytic profession and its esoteric theories. Through their narratives, these practicing analysts show how to incorporate psychodynamic concepts and identify common truths at the root of shared (...) experience. Their approach demystifies dense material and the emotional consequences of deep clinical work. The book covers psychodynamic theory, the development of ideas, various techniques, the challenges of treatment, and the experiences of trauma and loss. Each section begins with a brief memoir by one of the authors and leads into a discussion of related concepts. Overall the text follows a developmental trajectory, opening with stories from early childhood and concluding with present encounters. The result is a unique approach enabling the absorption of psychodynamic concepts as they unfold across the life span. (shrink)

The National Center for Biomedical Ontology is now in its seventh year. The goals of this National Center for Biomedical Computing are to: create and maintain a repository of biomedical ontologies and terminologies; build tools and web services to enable the use of ontologies and terminologies in clinical and translational research; educate their trainees and the scientific community broadly about biomedical ontology and ontology-based technology and best practices; and collaborate with a variety of groups who develop and use ontologies and (...) terminologies in biomedicine. The centerpiece of the National Center for Biomedical Ontology is a web-based resource known as BioPortal. BioPortal makes available for research in computationally useful forms more than 270 of the world's biomedical ontologies and terminologies, and supports a wide range of web services that enable investigators to use the ontologies to annotate and retrieve data, to generate value sets and special-purpose lexicons, and to perform advanced analytics on a wide range of biomedical data. (shrink)

This paper proposes a reformulation of the treatment of boundaries, at parts and aggregates of entities in Basic Formal Ontology. These are currently treated as mutually exclusive, which is inadequate for biological representation since some entities may simultaneously be at parts, boundaries and/or aggregates. We introduce functions which map entities to their boundaries, at parts or aggregations. We make use of time, space and spacetime projection functions which, along the way, allow us to develop a simple temporal theory.

Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations (...) by providing reminders to ethics consultants about process steps that are important for most patient-centered ethics consultations, (2) to create consistency in the ethics consultation process across the medical system, and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist, it was distributed to 46 ethics consultants. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities, a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants’ perceptions regarding the three aims listed above. Of the 25 survey respondents, 11 self-reported as experts in ethics consultation, nine perceived themselves to have mid-level expertise, and five self-reported as novices. The majority (68 percent) of all respondents, regardless of expertise, believed that the checklist could be a “helpful” or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system, utilized a small sample size, and used self-reported quality outcome measures. Despite these limitations, to the authors’ knowledge this is the first investigatation of the use of a checklist systematically to improve quality in ethics consultation. Importantly, our findings shed light on ways this checklist can be used to improve ethics consultation, including its use as an educational tool. The authors hope to test the checklist with consultants in other healthcare systems to explore its usefulness in different healthcare environments. (shrink)

As late-1990s developments in higher education suggest that a concept of a university will continue to be redefined, this text looks at the past, present and possible future changes in the nature of universities.

This paper seeks to contribute to the debate around sustainability by proposing the need for an ecocentric stance to sustainability that reflexively embeds humans in—rather than detached from—nature. We argue that this requires a different way of thinking about our relationship with our world, necessitating a engagement with the sociomaterial world in which we live. We develop the notion of ecocentrism by drawing on insights from sociomateriality studies, and show how radical-reflexivity enables us to appreciate our embeddedness and responsibility for (...) sustainability by bringing attention to the interrelationship between values, actions and our social and material world. We examine the implications of an ecocentric radically reflexive approach to sustainability for management education. (shrink)

Research on multiple relationships by practicing psychologists has typically presumed the presence of a professional relationship and focused on the ethicality of subsequent, nonprofessional relationships. Instead, this study focused on the question of what, exactly, constitutes the professional relationship in the first place. Practicing psychologists and undergraduates responded to vignettes portraying various early stages of interaction between a therapist and a prospective client. Participants' responses indicated that determinations of professional relationship establishment, and the ethicality of subsequent nonprofessional relationships, depended upon (...) the degree of engagement. Some differences emerged between perceptions by professionals and nonprofessionals. Ethical and professional implications are discussed. (shrink)

Theories of perception have traditionally dismissed the sense of smell as a notoriously variable and highly subjective sense, mainly because it does not easily fit into accounts of perception based on visual experience. So far, philosophical questions about the objects of olfactory perception have started by considering the nature of olfactory experience. However, there is no philosophically neutral or agreed conception of olfactory experience: it all depends on what one thinks odors are. We examine the existing philosophical methodology for addressing (...) our sense of smell: on the one hand appeals to phenomenology that focus on the experiential dimensions of odor perception and on the other approaches that look at odor sources and their material dimensions. We show that neither strategy provides enough information to account for the human sense of smell and argue that the inclusion of the missing dimension of biology, with its concern for the function (or functions) of olfaction, provides the means to develop a satisfactory and empirically informed philosophy of smell. (shrink)

This paper investigates the effect of the countervailing forces within organizations of formal systems that direct employees toward ethical acts and informal systems that direct employees toward fraudulent behavior. We study the effect of these forces on deception, a key component of fraud. The results provide support for an interactive effect of these formal and informal systems. The effectiveness of formal systems is greater when there is a strong informal “push” to do wrong; conversely, in the absence of a strong (...) push to do wrong, the strength of formal systems has little impact on fraudulent behavior. These results help to explain why the implementation of formal systems within organizations has been met with mixed results and identifies when formal systems designed to promote ethical behavior will be most efficacious. (shrink)

This essay begins with the impossibility of thinking back, or at least of conscious memory, and the need to fix on a fragment, before unconscious memory may emerge as inscription. I then follow the intuition of a link, contained in the cover image of Malcolm Bowie's book Freud, Proust, Lacan: Theory as Fiction, between fictions which theorize and the apparition of the feminine as a haunting incompleteness. It is suggested that such apparitions may be read — like the image in (...) Plato's chora, as read by Pierre Fédida — as a surviving trace, hovering phantom-like between reminiscence and existence. As such, the image might be seen not only as the impensé of theory, producing in texts auratic moments which condense signifiers of present encounter and lost memory trace, but furthermore as the unthinkable feminine negative of masculine pursuit, returning us quite simply to a nodal point of silent gazing. (shrink)

Glowacki defines peace as harmonious relationships between groups maintained without the threat of violence, where groups can be anything from families to nation states. However, defining such contentious concepts like “peace” and “groups” is a difficult task, and we discuss the implications of Glowacki's definitions for understanding intergroup relationships and their evolutionary history.

This book explores how Paul Tillich's systematic theology, focusing on the concepts of being and reason can benefit nonhuman animals, while also analysing how taking proper account of nonhuman animals can prove immensely beneficial. The author first explains the body of Tillich's system, examining reason and revelation, life and the spirit, and history and the kingdom of God. The second section undertakes a critical analysis of Tillichian concepts and their adequacy in relation to nonhuman animals, addressing topics such as Tillich's (...) concept of 'technical reason' and the multidimensional unity of life. The author concludes by discussing the positive concepts in Tillich's systematic theology with respect to nonhuman animals and creation, including the concept of universal salvation and Tillich's interpretation of nonhuman animals and the Fall in Genesis. (shrink)