Systematic study of the intersection of ethics consultation services and solid organ transplants and recipients can identify and illustrate ethical issues that arise in the clinical care of these patients, including challenges beyond resource allocation. This was a single-centre, retrospective cohort study of all adult ethics consultations between January 1, 2007, and December 31, 2017, at a large academic medical centre in the north-eastern United States. Of the 880 ethics consultations, sixty (6.8 per cent ) involved solid organ transplant, thirty-nine (...) (65.0 per cent) for candidates and twenty-one (35.0 per cent ) for recipients. Ethics consultations were requested for 4.3 per cent of heart, 4.9 per cent of lung, 0.3 per cent of liver, and 0.3 per cent of kidney transplant recipients over the study period. Nurses were more likely to request ethics consultations for recipients than physicians (80.0 per cent vs 20.0 per cent, p = 0.006). The most common reason for consultation among transplant candidates was discussion about intensity of treatment or goals of care after the patient was not or was no longer a transplant candidate. The most common reason for ethics consultation among transplant recipients was disagreement between transplant providers and patients/families/non-transplant healthcare professionals over the appropriate intensity of treatment for recipients. Very few consultations involved questions about appropriate resource allocation. Ethics consultants involved in these cases most often navigated communication challenges between transplant and non-transplant healthcare professionals and patients and families. (shrink)

Aggleton & Brown (A&B) propose that the hippocampal-anterior thalamic and perirhinal-medial dorsal thalamic systems play independent roles in episodic memory, with the hippocampus supporting recollection-based memory and the perirhinal cortex, recognition memory. In this commentary we discuss whether there is experimental support for the A&B model from studies of long-term memory in semantic dementia.

The aim of this article is to study the general and contextual issues related to prayers for the departed with a focus on the Evangelical Lutheran Church in Tanzania (ELCT). In 2012, the ELCT published a new hymnal, which included a number of prayers for those mourning their deceased friends and relatives, as well as prayers for the deceased individuals themselves. As a result of considerable criticism, this hymnal was replaced by a new edition in 2017, in which the prayers (...) for the departed were omitted. The article further scrutinises the historical and theological aspects of praying for the departed in Lutheranism. It studies examples of prayers for the dead in Lutheran churches in two other countries, Finland and Sweden, and relates these to the situation in the ELCT. (shrink)

The chromosome passenger complex (CPC) localizes to chromosomes and microtubules, sometimes simultaneously. The CPC also has multiple domains for interacting with chromatin and microtubules. Interactions between the CPC and both the chromatin and microtubules is important for spindle assembly and error correction. Such dual chromatin‐microtubule interactions may increase the concentration of the CPC necessary for efficient kinase activity while also making it responsive to specific conditions or structures in the cell. CPC‐microtubule dependent functions are considered in the context of the (...) first meiotic division. Acentrosomal spindle assembly is a process that depends on transfer of the CPC from the chromosomes to the microtubules. Furthermore, transfer to the microtubules is not only to position the CPC for a later role in cytokinesis; metaphase I error correction and subsequent bi‐orientation of bivalents may depend on microtubule associated CPC interacting with the kinetochores. (shrink)

Background: Financial conflict of interest in clinical research is an area of active debate. While data exist on the perspectives and roles of academic institutions, investigators, industry sponsors, and scientific journals, little is known about the perspectives of potential research participants.Methods: The authors surveyed potential research participants over the internet, using the Harris Interactive Chronic Illness Database. A potential research participant was defined by: self report of diagnosis by a health care professional and willingness to participate in clinical trials. Email (...) invitations were sent to 20 205 persons with coronary artery disease, breast cancer, or depression; a total of 6363 persons were screened; of these, 86% or 5478 met inclusion criteria and completed the survey. The outcome measures were respondents’ ratings on: importance of knowing conflict of interest information, whether its disclosure ought to be required, and its effect on willingness to participate—across seven widely discussed scenarios of financial conflicts of interest .Results: Majority responded that knowing conflict of interest information was “extremely” or “very” important; a larger majority felt financial conflicts of interest should be disclosed as part of informed consent . In all seven scenarios, a majority was still willing to participate but in some scenarios a sizable minority would be wary of participation. Respondents were more wary of individual than institutional conflicts of interest. Illness group and sociodemographic factors had modest effects and did not affect the main trends.Conclusions: The prevailing practice of non-disclosure of financial conflicts of interest in clinical research appears contrary to the values of potential research participants. (shrink)

A common and driving assumption in agricultural research is that the introduction of research trials, new practices and innovative technologies will result in technology adoption, and will subsequently generate benefits for farmers and other stakeholders. In Lao PDR, the potential benefits of introduced technologies have not been fully realised by beneficiaries. We report on an analysis of a survey of 735 smallholder farmers in Southern Lao PDR who were questioned about factors that influenced their decisions to adopt new technologies. In (...) this study, we have constructed measures or states of adoption which identify key elements of an adoption decision-making nexus. Analysis was conducted to statistically group explanatory factors of adoption. The key explanatory factors represented attributes of the farmer, the factors considered when undertaking production decisions and elements of the agricultural value chain that present as opportunities or constraints. We describe the combination of farmer’s personal attributes, perceptions of the value chain, and the introduction of new technologies by external actors as an “agricultural research value chain”, where agricultural research activities intervene to derive greater benefits for local farmers. A generalised linear model, via Poisson regression analysis on the identified explanatory factors, was applied to explore how they influence adoption measures and we found several significant relationships. (shrink)

Recent data indicate that under a specific posthypnotic suggestion to circumvent reading, highly suggestible subjects successfully eliminated the Stroop interference effect. The present study examined whether an optical explanation could account for this finding. Using cyclopentolate hydrochloride eye drops to pharmacologically prevent visual accommodation in all subjects, behavioral Stroop data were collected from six highly hypnotizables and six less suggestibles using an optical setup that guaranteed either sharply focused or blurred vision. The highly suggestibles performed the Stroop task when naturally (...) vigilant, under posthypnotic suggestion not to read, and while visually blurred; the less suggestibles ran naturally vigilant, while looking away, and while visually blurred. Although visual accommodation was precluded for all subjects, posthypnotic suggestion effectively eliminated Stroop interference and was comparable to looking away in controls. These data strengthen the view that Stroop interference is neither robust nor inevitable and support the hypothesis that posthypnotic suggestion may exert a top-down influence on neural processing. (shrink)

In C. elegans and D. melanogaster, specialized sites have an important role in meiotic recombination. Recent evidence has shown that these sites in C. elegans have a role in synapsis. Here we compare the initiation of synapsis in organisms with specialized sites and those without. We propose that, early in prophase, synapsis requires an initiator to overcome inhibitory factors that function to prevent synaptonemal complex (SC) formation between nonhomologous sequences. These initiators of SC formation can be stimulated by crossover sites, (...) possibly other types of recombination sites and also specialized sites where recombination does not occur. BioEssays 29: 217–226, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Virtuousness refers to the pursuit of the highest aspirations in the human condition. It is characterized by human impact, moral goodness, and unconditional societal betterment. Several writers have recently argued that corporations, in addition to being concerned with ethics, should also emphasize an ethos of virtuousness in corporate action. Virtuousness emphasizes actions that go beyond the “do no harm” assumption embedded in most ethical codes of conduct. Instead, it emphasizes the highest and best of the human condition. This research empirically (...) examines the buffering and amplifying effects of virtuousness in organizations. The study hypothesizes that virtuousness has a positive effect on organizations because amplifying dynamics make subsequent virtuous action more likely, and buffering dynamics reduce the harmful effects of downsizing. The study reveals that two types of virtuousness – tonic and phasic – are associated with these effects. (shrink)

It is often alleged that liberalism and nationalism are mutually antagonistic in theory and practice. Max Weber is a good example, the dominant interpretation maintains, as his political thought betrays its liberal foundation by embracing an ardent nationalism that was popular in Wilhelmine Germany. Weber was, in short, a nationalist, and thus illiberal, political thinker. Against this conventional wisdom I argue that Weber's liberal nationalism cannot be placed squarely in the authoritarian, ethnic tradition of German nationalism, and its idiosyncrasy becomes (...) evident once Weber's twofold political project of revivifying a robust civil society while imbuing it with the spirit of public citizenship is foregrounded more clearly. Thus recast, Weber's political thought reveals a strong affinity with that of Tocqueville and Mill, especially in their similar concern with moral personality and political maturity in a mass democracy. (shrink)

Background: The demand for autonomy in medical decision making is increasing among Korean people, but it is not well known why some people prefer autonomy in decision making but others do not. Research objectives: The aim of this study was to determine the extent to which Korean adults wished to exercise autonomy in the process of decision making regarding end-of-life treatment and to determine whether economic issues and family functioning, in particular, were associated with preferences for participation in decision making (...) in Korean people. Research design: This study was a cross-sectional correlational study using a survey. Participants and research context: Data were collected using structured questionnaires from 354 patients or their families who visited ambulatory departments at two general hospitals in South Korea, recruited by the proportionate quota sampling method. Data analysis was performed using multinomial logistic regression analyses. Ethical considerations: The study was approved by the hospitals’ directors and the ethics committee of Kyungpook National University Hospital. Written informed consent was given by all participants. Findings: A majority of Korean people wanted to make autonomous decisions regarding treatment at the end of life. Preferences for autonomous decision making regarding end-of-life treatment, rather than relying on family, showed a significant increase in association with poor family functioning and low income. Discussion: Results of this study suggested the necessity for development of alternatives to a dominant traditional “family-centered” approach in Korean people, in order to enhance end-of-life decision making for people who wish to take an active role in the decision-making process. Conclusion: Healthcare providers need to examine not only patients’ preferred decision-making style but also any reasons for their choice, in particular, family conflict and financial burden. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

But with the member of a Nonconforming or self-made religious community, how different! The sectary's eigene grosse Erfindungen, as Goethe calls them,—the precious discoveries of himself and his friends for expressing the inexpressible and defining the undefinable in peculiar forms of their own,—cannot but, as he has voluntarily chosen them and is personally responsible for them, fill his whole mind. He is zealous to do battle for them and affirm them; for in affirming them, he affirms himself, and that is (...) what we all like. Matthew Arnold. (shrink)

A simple model for the description of atomic and ionic species with spectra exhibiting a quantum defect is solved using the Lie algebra su(1, 1). The quantum defect of bound states is related to the phase shift of scattering states. The resonances are discussed in terms of the nonunitary representations of this algebra.

A total of 1918 loci, detected by the hybridization of 938 expressed sequence tag unigenes from 26 Triticeae cDNA libraries, were mapped to wheat homoeologous group 4 chromosomes using a set of deletion, ditelosomic, and nulli-tetrasomic lines. The 1918 EST loci were not distributed uniformly among the three group 4 chromosomes; 41, 28, and 31% mapped to chromosomes 4A, 4B, and 4D, respectively. This pattern is in contrast to the cumulative results of EST mapping in all homoeologous groups, as reported (...) elsewhere, that found the highest proportion of loci mapped to the B genome. Sixty-five percent of these 1918 loci mapped to the long arms of homoeologous group 4 chromosomes, while 35% mapped to the short arms. The distal regions of chromosome arms showed higher numbers of loci than the proximal regions, with the exception of 4DL. This study confirmed the complex structure of chromosome 4A that contains two reciprocal translocations and two inversions, previously identified. An additional inversion in the centromeric region of 4A was revealed. A consensus map for homoeologous group 4 was developed from 119 ESTs unique to group 4. Forty-nine percent of these ESTs were found to be homoologous to sequences on rice chromosome 3, 12% had matches with sequences on other rice chromosomes, and 39% had no matches with rice sequences at all. Limited homology was found between wheat ESTs on homoeologous group 4 and the Arabidopsis genome. Forty-two percent of the homoeologous group 4 ESTs could be classified into functional categories on the basis of blastX searches against all protein databases. (shrink)

Background Rapid ethical access to personal health information to support research is extremely important during pandemics, yet little is known regarding patient preferences for consent during such crises. This follow-up study sought to ascertain whether there were differences in consent preferences between pre-pandemic times compared to during Wave 1 of the COVID-19 global pandemic, and to better understand the reasons behind these preferences. Methods A total of 183 patients in the pandemic cohort completed the survey via email, and responses were (...) compared to the distinct pre-pandemic cohort ; all were patients of a large Canadian cancer center. The survey covered broad versus study-specific consent; opt-in versus opt-out contact approach; levels of comfort sharing with different recipients; perceptions of commercialization; and options to track use of information and be notified of results. Four focus groups were subsequently conducted to elucidate reasons motivating dominant preferences. Results Patients in the pandemic cohort were significantly more comfortable with sharing all information and biological samples, sharing information with the health care institution, sharing information with researchers at other hospitals, sharing PHI provincially, nationally and internationally compared to the pre-pandemic cohort. Discomfort with sharing information with commercial companies remained unchanged between the two cohorts. Significantly more pandemic cohort patients expressed a wish to track use of PHI, and to be notified of results. Thematic analysis uncovered that transparency was strongly desired on outside PHI use, particularly when commercialization was involved. Conclusions In pandemic times, patients were more comfortable sharing information with all parties, except with commercial entities, where levels of discomfort remained unchanged. Focus groups identified that the ability to track and receive results of studies using one’s PHI is an important way to reduce discomfort and increase trust. These findings meaningfully inform wider discussions on the use of personal health information for research during global crises. (shrink)

Objective: To determine whether a moral reasoning exercise can improve response quality to surveys of healthcare priorities Methods: A randomised internet survey focussing on patient age in healthcare allocation was repeated twice. From 2574 internet panel members from the USA and Canada, 2020 (79%) completed the baseline survey and 1247 (62%) completed the follow-up. We elicited respondent preferences for age via five allocation scenarios. In each scenario, a hypothetical health planner made a decision to fund one of two programmes identical (...) except for average patient age (35 vs 65 years). Half of the respondents (intervention group) were randomly assigned to receive an additional moral reasoning exercise. Responses were elicited again 7 weeks later. Numerical scores ranging from –5 (strongest preference for younger patients) to +5 (strongest preference for older patients); 0 indicates no age preference. Response quality was assessed by propensity to choose extreme or neutral values, internal consistency, temporal stability and appeal to prejudicial factors. Results: With the exception of a scenario offering palliative care, respondents preferred offering scarce resources to younger patients in all clinical contexts. This preference for younger patients was weaker in the intervention group. Indicators of response quality favoured the intervention group. Conclusions: Although people generally prefer allocating scarce resources to young patients over older ones, these preferences are significantly reduced when participants are encouraged to reflect carefully on a wide range of moral principles. A moral reasoning exercise is a promising strategy to improve response quality to surveys of healthcare priorities. (shrink)

Logical and moral arguments have been made for the organizational importance of ethos or virtuousness, in addition to ethics and responsibility. Research evidence is beginning to provide, empirical support for such normative claims. This paper considers the relationship between ethics and ethos in contemporary organizations by summarizing emerging findings that link virtuousness and performance. The effect of virtue in organizations derives from its buffering and amplifying effects, both of which are described.

It is shown that the jet mechanism derivable from the Lorentz deformation picture leads to a nearly constant average jet transverse momentum. It is pointed out that this is consistent with the high-energy experimental data. It is pointed out further that this result strengthens the physical basis for the minimal time-energy uncertainty combined covariantly with Heisenberg's space-momentum uncertainty relation.

Well-being is topic of perennial concern. It has been of significant interest to scholars across disciplines, culture, and time. But like morality, conceptions of well-being are deeply shaped and influenced by one's particular social and cultural context. We ought to pursue, therefore, a cross-cultural understanding of well-being and moral psychology by taking seriously reflections from a variety of moral traditions. This book develops a Confucian account of well-being, considering contemporary accounts of ethics and virtue in light of early Confucian thought (...) and philosophy. Its distinctive approach lies in the integration of Confucian moral philosophy, contemporary empirical psychology, and contemporary philosophical accounts of well-being. Richard Kim organizes the book around four main areas: the conception of virtues in early Confucianism and the way that they advance both individual and communal well-being; the role of Confucian ritual practices in familial and communal ties; the developmental structure of human life and its culmination in the achievement of sagehood; and the sense of joy that the early Confucians believed was central to the virtuous and happy life. (shrink)

Kim examines the fundamental tenets of Immanuel Kant’s theory of morality structural-methodological point of view to highlight the activities of reason vis-à-vis the blind forces of brute nature. The study provides new perspective on Kant's thought to benefit studies of epistemology, modern philosophy, moral theory and philosophy, and ethics.

The main purpose of this study was to validate a scale to examine the moral sensitivity of Korean nurses. A pre-existing scale, the Moral Sensitivity Questionnaire (MSQ), developed by Lützén, was used after deletion of three items. The reliability and validity of the scale were examined by using Cronbach’s alpha and factor analysis, respectively. According to the results, reliability of the scale was adequate but its construct validity was not fully supported. Through discussion on evidence of validity, five subconstructs emerged. (...) In particular, unlike the factor structure of the MSQ, two subconstructs, patient-oriented care and professional responsibility, were newly extracted. It was assumed that the other three MSQ subconstructs, conflict, meaning and benevolence (expressed as nurses being ethically good), would not be sensitive to cultural background. Given these findings, interpretations about the meaning of moral sensitivity of Korean nurses are discussed. (shrink)

Surprisingly little is known about what ancient Confucian thinkers struggled with in their own social and political contexts and how these struggles contributed to the establishment and further development of classical Confucian political theory. Leading scholar of comparative political theory, Sungmoon Kim offers a systematic philosophical account of the political theories of Mencius and Xunzi, investigating both their agreements and disagreements as the champions of the Confucian Way against the backdrop of the prevailing realpolitik of the late Warring States period. (...) Together, they contributed to the formation of Confucian virtue politics, in which concerns about political order and stability and concerns about moral character and moral enhancement are deeply intertwined. By presenting their political philosophies in terms of constitutionalism, Kim shows how they each developed the ability to authorize the ruler's legitimate use of power in domestic and interstate politics in ways consistent with their distinctive accounts of human nature. (shrink)

The current research tested the idea that it is the cultural fit of emotions, rather than certain emotions per se, that predicts psychological well-being. We reasoned that emotional fit in the domains of life that afford the realization of central cultural mandates would be particularly important to psychological well-being. We tested this hypothesis with samples from three cultural contexts that are known to differ with respect to their main cultural mandates: a European American ( N = 30), a Korean ( (...) N = 80), and a Belgian sample ( N = 266). Cultural fit was measured by comparing an individual’s patterns of emotions to the average cultural pattern for the same type of situation on the Emotional Patterns Questionnaire ( De Leersnyder et al., 2011 ). Consistent with our hypothesis, we found evidence for “universality without uniformity”: in each sample, psychological well-being was associated with emotional fit in the domain that was key to the cultural mandate. However, cultures varied with regard to the particular domain involved. Psychological well-being was predicted by emotional fit (a) in autonomy-promoting situations at work in the U.S., (b) in relatedness-promoting situations at home in Korea, and (c) in both autonomy-promoting and relatedness-promoting situations in Belgium. These findings show that the experience of culturally appropriate patterns of emotions contributes to psychological well-being. One interpretation is that experiencing appropriate emotions is itself a realization of the cultural mandates. (shrink)

We analyse the tensions in a hybrid collaboration and how these are mitigated using boundary-spanning community impact, leading to compatibility between distinctive institutional logics. Our qualitative longitudinal study undertaken during 2011–2016 involved reviewing literature and archival data, key informant interviews, workshop and focus groups. We analysed common themes within the data, relating to our two research questions concerning how and why hybrids collaborate, and how resulting tensions are mitigated. The findings suggest a viable model of service delivery termed hybridized collaboration (...) in which the inherent tensions from different institutional logics do not prevent success. Paradoxically, multiple logics are a basis for the partnership’s existence, but the ability to achieve different and occasionally conflicting aims simultaneously can be difficult, resulting in tensions. We offer two novel insights. First, we highlight how social enterprise hybrids collaborate locally and in multi-organizational relationships. We found that the initial opportunity to collaborate was catalysed by the existence of shared objectives. Pre-existing relationships between organizations, and the existence of synergistic capabilities also influence the choice of partners. Secondly, we identify how tensions arise, and are mitigated via several factors including the pre-existing relationships, allowing for regular “spaces of negotiation” between collaborators, the shared social mission, community social impact, the resulting public relations, and shared resources and knowledge. (shrink)

Background: Visual technologies are central to youth culture and are often the preferred communication means of adolescents. Although these tools can be beneficial in fostering relations, adolescents’ use of visual technologies and social media also raises ethical concerns. Aims: We explored how school public health nurses identify and resolve the ethical challenges involved in the use of visual technologies in health dialogues with adolescents. Research design: This is a qualitative study utilizing data from focus group discussions. Participants and research context: (...) We conducted focus group discussions using two semi-structured discussion guides with seven groups of public health nurses (n = 40) working in Norwegian school health services. The data were collected during January and October 2016. Discussions were audio recorded, transcribed, and coded into themes and subthemes using systematic text condensation. Ethical considerations: The leader of the public health nursing service who agreed to provide access for the study and the Norwegian Center for Research Data that reviewed and approved the study. All participants gave informed consent. Findings: In adolescents’ use of visual materials with public health nurses, ethical concerns were raised regarding suicide ideations, socially unacceptable content, violation of privacy, and presentations of possible child neglect. The nurses utilized their professional knowledge and experience when identifying and navigating these ethical dilemmas; they resolved ethical uncertainties through peer discussion and collaboration with fellow nurses and other professionals. Discussion: We discussed the findings in light of Annemarie Mol’s interpretation of the ethics of care. Mol expands the notion of ethical care to include the action of technologies. Conclusion: Although the increasing use of visual technologies offered benefits, school nurses faced ethical challenges in health dialogues with adolescents. To address and navigate these ethical issues, they relied on their experience and caring practices based on their professional ethics. Uncertainties were resolved through peer dialogue and guidance. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)