This provocation critiques the notion of long-term thinking and the claims of its proponents that it will help address failures in dominant conceptions of time, particularly in regard to environmental crises. Drawing on analyses of the Clock of the Long Now and Kim Stanley Robinson’s The Ministry for the Future, the article suggests that we be more wary of the concept’s use in what we might call chronowashing. Like the more familiar greenwashing, where environmental issues are hidden (...) by claims to be addressing the problem, the article explores how these examples of long-term thinking distract from extractivism, racism, and environmental injustice, making it harder to address the complexities involved. In particular, the article discusses examples where long-term thinking provides a veneer of environmental concern that actually disconnects from the work of building more equitable forms of relation. As a contrast, the article’s author asks: What is lost when we diagnose a problem as arising due to short-term thinking and propose long-term thinking as the solution? Against chronowashed environmental time, the author argues for more complex approaches that explicitly take into account the temporalities of inequality, political organization, ethical responsibilities and much else. The article engages with approaches to time that foreground the work needed to create time and move ethically within it, including Charles W. Mills’s white time and Kyle Powys Whyte’s kinship time. The author suggests that a stronger emphasis on the temporality of community, solidarity, and coalition—versus what James Hatley and Deborah Bird Rose have described as temporal narcissism—can better foreground the kinds of work that needs to be done, particularly by those with privilege. (shrink)

Long-term care is controversial because it involves foundational disputes. Some are moral-economic, bearing on whether the individual, the family, or the state is primarily responsible for long-term care, as well as on how one can establish a morally and financially sustainable long-term-care policy, given the moral hazard of people over-using entitlements once established, the political hazard of media democracies promising unfundable entitlements, the demographic hazard of relatively fewer workers to support those in need of (...) long-term care, the moral hazard to responsibility of shifting accountability to third parties, and the bureaucratic hazard of moving from individual and family choice to bureaucratic oversight. These disputes are compounded by controversies regarding the nature of the family (Is it to be regarded primarily as a socio-biological category, a fundamental ontological category of social reality, or a construct resulting from the consent of the participants?), as well as its legal and moral autonomy and authority over its members. As the disputes show, there is no common understanding of respect and human dignity that will easily lead out of these disputes. The reflections on long-term care in this issue underscore the plurality of moralities defining bioethics. (shrink)

UK law permits parents to use mitochondrial replacement to have genetically-related children without serious mitochondrial disease. However, long-term follow-up is required for each case. Whet...

In the thirty years since its discovery by Terje Lomo and Tim Bliss, Long Term Potentiation has become one of the most extensively studied topics in contemporary neuroscience. In LTP the strength of synapses between neurons is potentiated following brief but intense activation. LTP is thought to play a central role in learning and memory, though the exact nature of its role is less clear. In spite of years of research, there are many questions about LTP regarding its (...) functional relevance that remain unanswered - for example, is it a model of memory formation, or is the actual neural mechanism used by the brain to store information? This volume presents a state of the art account of LTP. It begins with lively accounts, by the scientists most closely involved, of the discovery of LTP and of the experiments that established its basic properties and induction mechanisms. Later contributions contain reviews and new research that cover the range of molecular, cellular, physiological and behavioural approaches to the study of LTP. Provocative, accessible, and authoritative, this book makes it clear why LTP continues in equal measure to puzzle and beguile neuroscientists today. Advance praise for Long Term Potentiation: 'This book provides a definitive overview of the development of ideas about synaptic plasticity and about the wide range of current research in this fascinating field.' Colin Blakemore, University of OxfordReadership: Neuroscientists from postgraduate level upwards. (shrink)

Electroencephalogram (EEG) recordings are increasingly used to evaluate patients with disorders of consciousness (DOC) or assess their prognosis outcome in the short-term perspective. However, there is a lack of information concerning the effectiveness of EEG in classifying long-term (many years) outcome in chronic DOC patients. Here we tested whether EEG operational architectonics parameters (geared towards consciousness phenomenon detection rather than neurophysiological processes) could be useful for distinguishing a very long-term (6 years) clinical outcome of DOC (...) patients whose EEGs were registered within 3 months post-injury. The obtained results suggest that EEG recorded at third month after sustaining brain damage, may contain useful information on the long-term outcome of patients in vegetative state: it could discriminate patients who remain in a persistent vegetative state from patients who reach a minimally conscious state or even recover a full consciousness in a long-term perspective (6 years) post-injury. These findings, if confirmed in further studies, may be pivotal for long-term planning of clinical care, rehabilitative programs, medical-legal decisions concerning the patients, and policy makers. (shrink)

Long-term potentiation (LTP) is operationally defined as a long-lasting increase in synaptic efficacy following high-frequency stimulation of afferent fibers. Since the first full description of the phenomenon in 1973, exploration of the mechanisms underlying LTP induction has been one of the most active areas of research in neuroscience. Of principal interest to those who study LTP, particularly in the mammalian hippocampus, is its presumed role in the establishment of stable memories, a role consistent with descriptions of memory (...) formation. Other characteristics of LTP, including its rapid induction, persistence, and correlation with natural brain rhythms, provide circumstantial support for this connection to memory storage. Nonetheless, there is little empirical evidence that directly links LTP to the storage of memories. In this target article we review a range of cellular and behavioral characteristics of LTP and evaluate whether they are consistent with the purported role of hippocampal LTP in memory formation. We suggest that much of the present focus on LTP reflects a preconception that LTP is a learning mechanism, although the empirical evidence often suggests that LTP is unsuitable for such a role. As an alternative to serving as a memory storage device, we propose that LTP may serve as a neural equivalent to an arousal or attention device in the brain. Accordingly, LTP may increase in a nonspecific way the effective salience of discrete external stimuli and may thereby facilitate the induction of memories at distant synapses. Other hypotheses regarding the functional utility of this intensely studied mechanism are conceivable; the intent of this target article is not to promote a single hypothesis but rather to stimulate discussion about the neural mechanisms underlying memory storage and to appraise whether LTP can be considered a viable candidate for such a mechanism. (shrink)

The aim of this study was to explore ethically problematic situations in the long-term nursing care of elderly people. It was assumed that greater awareness of ethical problems in caring for elderly people helps to ensure ethically high standards of nursing care. To obtain a broad perspective on the current situation, the data for this study were collected among elderly patients, their relatives and nurses in one long-term care institution in Finland. The patients (n=10) were interviewed, (...) while the relatives (n=17) and nurses (n=9) wrote an essay. Interpretation of the data was based on qualitative content analysis. Problematic experiences were divided into three categories concerning patients’ psychological, physical and social integrity. In the case of psychological integrity, the problems were seen as being related to treatment, self-determination and obtaining information; for physical integrity, they were related to physical abuse and lack of individualized care; and for social integrity, to loneliness and social isolation. This study provided no information on the prevalence of ethical problems. However, it is clear from the results that patient integrity warrants more attention in the nursing care of elderly patients. (shrink)

Purpose This paper aims to formalize long-term trajectories of human civilization as a scientific and ethical field of study. The long-term trajectory of human civilization can be defined as the path that human civilization takes during the entire future time period in which human civilization could continue to exist. -/- Design/methodology/approach This paper focuses on four types of trajectories: status quo trajectories, in which human civilization persists in a state broadly similar to its current state into (...) the distant future; catastrophe trajectories, in which one or more events cause significant harm to human civilization; technological transformation trajectories, in which radical technological breakthroughs put human civilization on a fundamentally different course; and astronomical trajectories, in which human civilization expands beyond its home planet and into the accessible portions of the cosmos. -/- Findings Status quo trajectories appear unlikely to persist into the distant future, especially in light of long-term astronomical processes. Several catastrophe, technological transformation and astronomical trajectories appear possible. -/- Originality/value Some current actions may be able to affect the long-term trajectory. Whether these actions should be pursued depends on a mix of empirical and ethical factors. For some ethical frameworks, these actions may be especially important to pursue. (shrink)

The American system of long‐term care is disorganized and expensive. Obtaining care for a loved one is a confusing and difficult journey. When it comes to paying for that care, a bit over half who receive care are supported at least partially by insurance, and those with no insurance pay entirely out of pocket. The costs are exorbitant. What makes the system function is reliance on unpaid family members, who care for their loved ones often at considerable cost (...) to themselves.As the baby boom generation ages, this creaky system will become increasingly dysfunctional, and a likely shortage of caregivers will be at the heart of the difficulties. The supply of unpaid family caregivers will become limited, as the ratio of people in the category of ages forty‐five to sixty‐four compared to those who are eighty and older shrinks from just above seven to one in 2010 to just above four to one in 2030. Paid caregivers will be needed to take up the slack, yet they are poorly paid, work under very difficult conditions, and receive little respect from the health care system. In this essay, I discuss the circumstances facing these paid home‐care workers and a possible path forward, illustrating the current problems by drawing on interviews I conducted for a book‐length study published in 2017. (shrink)

The landscape of the Sundarbans today is a product of two countervailing forces: conversion of wetland forests to cropland vs. sequestration of the forests in reserves to be managed for long-term sustained yield of wood products. For two centures, land-hungry peasants strove to transform the native tidal forest vegetation into an agroecosystem dominated by paddy rice and fish culture. During the colonial period, their reclamation efforts were encouraged by landlords and speculators, who were themselves encouraged by increasingly favorable (...) state policies (land grants, tax incentives, cadastral surveys, and eventually colonization projects and subsidized irrigation) designed by revenue officials to maximize the rate of transformation of wetland forest to taxable agricultural land.In the late nineteenth century, as the rate of agricultural conversion increased, the colonial Forest Department succcessfully sought to preserve large areas of the remaining Sundarbans tidal forest by giving them legal status as Reserved or Protected Forests. These forests were intensively managed to provide a sustainable supply of timber and firewood for the increasing population of southern Bengal. Institutionalization of conflicting policies by the Revenue and Forest Departments reflected the escalating needs for both food and forest products as the colony grew. Today, supplies of some economically valuable trees have been depleted, and some mammals are locally extinct (although the Bengal tiger remains), but government policy in both Bangladesh and India now favors use of the Sundarbans as forest rather than its transformation to agricultural land. Further expansion of cropland to meet the grain demands of the burgeoning Bengali population in both nations has largely taken place outside the boundaries of the Sundarbans. Overexploitation of these forests for wood products remains a possibility, but large-scale clearing for rice paddies is unlikely under present policies. (shrink)

Although nurses in almost every long-term care facility face daily challenges involving issues related to residents' sexual lives, guidelines for ethically supporting sexual activity are rare and inadequate. A decision-making framework was developed to guide care providers in responding to the sexual expression of residents in long-term care. The framework recommends that nurses should weigh the documented substantial benefits of having a sexual life against harm to the resident and others, and against offence to others. This (...) article illustrates the use of this ethical decision-making framework by using the example of nurses supporting a resident's expression of his sexuality. It is suggested that nurses use this framework to guide their practice when related ethical issues arise. (shrink)

This paper consists in a critical review of Peter Goldie's book, The Emotion. A Philosophical Exploration (Oxford: Oxford University Press, 2000). Goldie is right to distinguish between long-term emotions and emotional experiences. And he is also right to reject the view that emotions are reducible to 'feelingless' states plus some extra feelings. However, Goldie's own account in terms of "feeling towards" is problematic. Goldie would have been better advised to claim that emotional experiences are necessarily emotional representations of (...) something as being F (disgusting, attractive, admirable, etc.), that is, that emotional experiences are apprehensions or representations of evaluative features. (shrink)

BackgroundScientific literature on posttraumatic growth after terrorist attacks has primarily focused on persons who had not been directly exposed to terrorist attacks or persons who had been directly exposed to them, but who were assessed few months or years after the attacks.MethodsWe examined long-term PTG in 210 adults directly exposed to terrorist attacks in Spain a mean of 29.6 years after the attacks. The participants had been injured by a terrorist attack or were first-degree relatives of people who (...) had been killed or injured by a terrorist attack. They completed diagnostic measures of emotional disorders and measures of PTSD and depression symptomatology, optimism, and PTG.ResultsMultiple regression analyses revealed gender differences and a positive linear relationship between PTG and cumulative trauma after the terrorist attack. Some PTG dimensions were significantly associated with PTSD symptomatology, these associations being linear, not curvilinear. However, PTG was not associated with depression symptomatology, diagnosis of emotional disorders, age, elapsed time since the attack, or optimism. In comparison with survivors assessed 18 years after the 1995 Oklahoma City bombing, Spanish victims of terrorism showed higher levels of appreciation of life, but lower levels of relating to others and spiritual change.ConclusionThe findings underscore the influence of gender on PTG and provide support to the hypothesis that some emotional distress may be a necessary condition of PTG. Future studies on PTG after terrorist attacks should take into consideration the characteristics of the terrorist attack itself and the contexts of violence and threat in which it occurred. The political, social, and cultural characteristics of the community affected by it and the profile and characteristics of other traumatic events suffered after the attack should also be taken into account in further research. (shrink)

This article describes the long-term trends in marital status mortality differences in the Netherlands using a unique dataset relating to the period 1850–1970. Poisson regression analysis was applied to calculate relative mortality risks by marital status. For two periods, cause-of-death by marital status could be used. Clear differences in mortality by marital status were observed, with strongly increasing advantages for married men and women and a relative increase in the mortality of widowed compared with non-married people. Excess mortality (...) among single and formerly married men and women was visible in many cause-of-death categories, and this became more widespread during the last decades of the nineteenth century. Hypotheses are formulated that might explain why married men and women underwent a stronger decrease in mortality up until the end of World War II. (shrink)

The mere presence of irrelevant external stimuli results in interference with the fidelity of details retrieved from long-term memory (LTM). Recent studies suggest that distractibility during LTM retrieval occurs when the focus of resource-limited, top-down mechanisms that guide the selection of relevant mnemonic details is disrupted by representations of external distractors. We review findings from four studies that reveal distractibility during episodic retrieval. The approach cued participants to recall previously studied visual details when their eyes were closed, or (...) were open and irrelevant visual information was present. The results showed a negative impact of the distractors on the fidelity of details retrieved from LTM. An fMRI experiment using the same paradigm replicated the behavioral results and found that diminished episodic memory was associated with the disruption of functional connectivity in whole-brain networks. Specifically, network connectivity supported recollection of details based on visual imagery when eyes were closed, but connectivity declined in the presence of visual distractors. Another experiment using auditory distractors found equivalent effects for auditory and visual distraction during cued recall, suggesting that the negative impact of distractibility is a domain-general phenomenon in LTM. Comparisons between older and younger adults revealed an aging-related increase in the negative impact of distractibility on retrieval of LTM. Finally, a new study that compared categorization abilities between younger and older adults suggests a cause underlying age-related decline of visual details in LTM. The sum of our findings suggests that cognitive control resources, although limited, have the capability to resolve interference from distractors during tasks of moderate effort, but these resources are overwhelmed when additional processes associated with episodic retrieval, or categorization of complex prototypes, are required. (shrink)

Conducting nursing research in long-term care facilities and with samples of older people requires careful attention to research ethics and the ethical conduct of the study. This review analysed the research ethics of the empirical studies that focus on older people in long-term care settings as research participants. Articles (n = 66) focussing on older people in long-term care settings as research informants were retrieved from an electronic search of MEDLINE (1990 to February 2012) (...) using the MESH terms ‘Nursing’ AND ‘Long-term care’ (578 citations) and ‘Institutionalization’ and ‘Nursing’ (89 citations). Ethical approval procedure was reported in more than half of the studies (58%) and informed consent in two-thirds of the studies (70%). Ethical issues in data collection were described in most of the articles, but only a few reported ethics in problem statement, reporting or presenting implications. There is a need to focus on reporting research ethics and procedures in empirical research on vulnerable people. (shrink)

Shors & Matzel's target article is a thought-provoking attempt to reconceptualise long-term potentiation as an attentional or arousal mechanism rather than a memory storage mechanism. This is incompatible with the facts of the neurobiology of attention and of the behavioural neurophysiological properties of hippocampal neurons.

Conducting nursing research in long-term care facilities and with samples of older people requires careful attention to research ethics and the ethical conduct of the study. This review analysed the research ethics of the empirical studies that focus on older people in long-term care settings as research participants. Articles (n = 66) focussing on older people in long-term care settings as research informants were retrieved from an electronic search of MEDLINE (1990 to February 2012) (...) using the MESH terms ‘Nursing’ AND ‘Long-term care’ (578 citations) and ‘Institutionalization’ and ‘Nursing’ (89 citations). Ethical approval procedure was reported in more than half of the studies (58%) and informed consent in two-thirds of the studies (70%). Ethical issues in data collection were described in most of the articles, but only a few reported ethics in problem statement, reporting or presenting implications. There is a need to focus on reporting research ethics and procedures in empirical research on vulnerable people. (shrink)

Book reviewed in this article: Long Term Care: Principles, Programs and Policies. By Rosalie A. Kane and Robert L. Kane. Long Term Health Care: providing a Spectrum of Services to the Aged. By Philip W. Brickner, Anthony J. Lechich, Roberta Lipsman, and Linda K. scharer.

Cowan assumes that chunk-based capacity limits are synonymous with the essence of a “specialized STM mechanism.” In a single experiment, we measured the capacity, or span, of long-term memory and found that it, too, corresponds roughly to the magical number 4. The results imply that a chunk-based capacity limit is not a signature characteristic of remembering over the short-term.

Background: In prior reports, we described the design and initial performance of a fully implantable, bi-directional neural interface system for use in deep brain and other neurostimulation applications. Here we provide an update on the chronic, long-term neural sensing performance of the system using traditional 4-contact leads and extend those results to include directional 8-contact leads.Methods: Seven ovine subjects were implanted with deep brain stimulation leads at different nodes within the Circuit of Papez: four with unilateral leads in (...) the anterior nucleus of the thalamus and hippocampus; two with bilateral fornix leads, and one with bilateral hippocampal leads. The leads were connected to either an Activa PC+S® or Percept PC°ledR deep brain stimulation and recording device. Spontaneous local field potentials, evoked potentials, LFP response to stimulation, and electrode impedances were monitored chronically for periods of up to five years in these subjects.Results: The morphology, amplitude, and latencies of chronic hippocampal EPs evoked by thalamic stimulation remained stable over the duration of the study. Similarly, LFPs showed consistent spectral peaks with expected variation in absolute magnitude dependent upon behavioral state and other factors, but no systematic degradation of signal quality over time. Electrode impedances remained within expected ranges with little variation following an initial stabilization period. Coupled neural activity between the two nodes within the Papez circuit could be observed in synchronized recordings up to 5 years post-implant. The magnitude of passive LFP power recorded from directional electrode segments was indicative of the contacts that produced the greatest stimulation-induced changes in LFP power within the Papez network.Conclusion: The implanted device performed as designed, providing the ability to chronically stimulate and record neural activity within this network for up to 5 years of follow-up. (shrink)

Long-term potentiation is one of the most extensively studied forms of neuroplasticity and is considered the strongest candidate mechanism for memory and learning. The use of event-related potentials and sensory stimulation paradigms has allowed for the translation from animal studies to non-invasive studies of LTP-like synaptic plasticity in humans. Accumulating evidence suggests that synaptic plasticity as measured by stimulus-specific response modulation is reduced in neuropsychiatric disorders such as major depressive disorder, bipolar disorders and schizophrenia, suggesting that impaired synaptic (...) plasticity plays a part in the underlying pathophysiology of these disorders. This is in line with the neuroplasticity hypothesis of depression, which postulate that deficits in neuroplasticity might be a common pathway underlying depressive disorders. The current study aims to replicate and confirm earlier reports that visual stimulus-specific response modulation is a viable probe into LTP-like synaptic plasticity in a large sample of healthy adults. Further, this study explores whether impairments in LTP-like synaptic plasticity is associated with self-reported subclinical depressive symptoms and stress in a healthy population. Consistent with prior research, the current study replicated and confirmed reports demonstrating significant modulation of visual evoked potentials following visual high-frequency stimulation. Current results further indicate that reduced LTP-like synaptic plasticity is associated with higher levels of self-reported symptoms of depression and perceived stress. This indicate that LTP-like plasticity is sensitive to sub-clinical levels of psychological distress, and might represent a vulnerability marker for the development of depressive symptoms. (shrink)

Subjects classified visible 2-digit numbers as larger or smaller than 55. Target numbers were preceded by masked 2-digit primes that were either congruent (same relation to 55) or incongruent. Experiments 1 and 2 showed prime congruency effects for stimuli never included in the set of classified visible targets, indicating subliminal priming based on long-term semantic memory. Experiments 2 and 3 went further to demonstrate paradoxical unconscious priming effects resulting from task context. For example, after repeated practice classifying 73 (...) as larger than 55, the novel masked prime 37 paradoxically facilitated the “larger” response. In these experiments task context could induce subjects to unconsciously process only the leftmost masked prime digit, only the rightmost digit, or both independently. Across 3 experiments, subliminal priming was governed by both task context and long-term semantic memory. (shrink)

Do neurobiologists aim to discover natural kinds? I address this question in this chapter via a critical analysis of classification practices operative across the 43-year history of research on long-term potentiation. I suggest that this 43-year history supports the idea that the structure of scientific practice surrounding LTP research has remained an obstacle to the discovery of natural kinds as philosophers of science have traditionally conceived them.

Many Western countries have introduced market principles in healthcare. The newly introduced financial instrument of “care-intensity packages” in the Dutch long-term care sector fit this development since they have some characteristics of a market device. However, policy makers and care providers positioned these instruments as explicitly not belonging to the general trend of marketisation in healthcare. Using a qualitative case study approach, we study the work that the two providers have done to fit these instruments to their organisations (...) and how that enables and legitimatises market development. Both providers have done various types of work that could be classified as market development, including creating accounting systems suitable for markets, redefining public values in the context of markets, and starting commercial initiatives. Paradoxically, denying the existence of markets for long-term care and thus avoiding ideological debates on the marketisation of healthcare has made the use of market devices all the more likely. Making the market invisible seems to be an operative element in making the market work. Our findings suggest that Dutch long-term care reform points to the need to study the ‘making’ rather than the ‘liberalising’ of markets and that the study of healthcare markets should not be confined to those practices that explicitly label themselves as such. (shrink)

The type I CaM-sensitive adenylyl cyclase is in a position to integrate signals from multiple inputs, consistent with the requirements for mediating long term potentiation (LTP). Biochemical and genetic evidence supports the idea that this enzyme plays an important role inc LTP. However, more work is needed before we will be certain of the role that CaM-sensitive adenylyl cyclases play in LTP.

Directive 36 of the Ethical and Religious Directives for Catholic Health Care Services gives guidance to health care professionals on the reactive administration of contraceptives to women in instances of isolated rape. This paper examines the moral permissibility of long-term proactive contraceptive use in instances of repeated marital rape by comparing it to the moral permissibility of reactive contraceptive use in cases of isolated rape found in directive 36.

The relationships between several Hofstede’s cultural dimensions and prosocial behavior at national level have been investigated by some studies. Yet the roles of indulgence versus restraint (IVR) and long-term versus short-term orientation (LTO), two newly established cultural dimensions, have received insufficient interest. This study was aimed to investigate whether the World Giving Index (WGI), a national level measure of prosocial behavior (including donating, volunteering, and helping a stranger) provided by Gallup, was affected by IVR and LTO. The (...) results suggested a positive link between IVR and WGI, and a negative link between LTO and helping a stranger. Culture values can in a great extend account for why prosocial behavior varies across countries. Further analysis revealed interactions among IVR, LTO, and individualism versus collectivism (IND). Simple slope analyses found that: (1) a higher level of IND could enhance the positive influence of IVR on prosocial behavior; (2) a lower level of IND could weaken the negative impact of LTO on prosocial behavior; (3) a higher level of IVR could weaken the negative effect of LTO on prosocial behavior. (shrink)

Do neurobiologists aim to discover natural kinds? I address this question in this chapter via a critical analysis of classification practices operative across the 43-year history of research on long-term potentiation (LTP). I argue that this 43-year history supports the idea that the structure of scientific practice surrounding LTP research has remained an obstacle to the discovery of natural kinds.

Background Concepts of health have been widely discussed in the philosophy and ethics of medicine. Parallel to these theoretical debates, numerous empirical research projects have focused on subjective concepts of health and shown their significance for individuals and society at various levels. Only a few studies have so far investigated the concepts of health of non-professionals and professionals involved in long-term home care and discussed these empirical perspectives regarding moral responsibilities. Objectives To identify the subjective concepts of the (...) health of non-professionals (care recipients, informal caregivers) and professionals (registered nurses) involved in long-term home care and to discuss them against the background of existing normative guidelines addressing non-professionals and professionals’ responsibilities and rights concerning health. Research design A qualitative design was chosen to explore subjective concepts of health. Data were collected by semi-structured interviews; content analysis was applied according to Mayring. Participants and research context Twenty-eight interviews were conducted with non-professionals and professionals in long-term home care arrangements in Northern Germany. Ethical considerations Ethics approval was obtained from the Institutional Review Board at the University Medicine Greifswald (BB123/16). Findings Non-professionals and professionals consider health as a capability that enables them to participate in social activities and live their own lives according to their preferences. The former regard health particularly as a feeling and an attitude, the latter as the absence of disease with a focus on mental and emotional well-being. Both groups highlight the unsurpassable value of health and the personal responsibility for it. Discussion Normative guidelines applicable to practice in long-term home care discuss responsibilities and rights unevenly and raise several problems regarding non-professionals and professionals’ subjective concepts of health. Conclusion Individuals’ concepts of health are relevant for the subsequent interpretation of rights and responsibilities and should, thus, be reflected upon to address health-related needs effectively. (shrink)

. This paper examines the association between long-term compensation and corporate social responsibility for 90 publicly traded Canadian firms. Social responsibility is considered to include concerns for social factors and the environment, 564-578; Kane, E. J., 341-359). Long-term compensation attempts to focus executives efforts on optimizing the longer term, which should direct their attention to factors traditionally associated with socially responsible executives. As hypothesized, we found a significant relationship between the long-term compensation and (...) total CSR weakness as well as the product/environmental weakness dimension of CSR. In addition, we found a marginally significant relationship between long-term compensation and total corporate responsibility. Our findings are that executives long-term compensation is associated with a firms environmental actions, and that firms that utilize long-term compensation are more likely to mitigate product/environment weaknesses than those that do not. Implications for practice and research are discussed. (shrink)

Subliminal primes are assumed to produce weaker and short-lived effects on subsequent behavior compared to clearly visible primes. However, this difference in priming effect may be due to differences in signal strength, rather than level of awareness. In the present study we manipulated prime discriminability by using metacontrast masks and pseudomasks, while keeping the prime strength equal. This manipulation resulted in large differences in discriminability of the primes. However, both immediate response priming and long-term response priming was equal (...) for the poorly discriminable and well discriminable primes, and equal for groups that differed markedly in terms of how well they could discriminate the primes. Our findings imply that discriminability of information is independent of both the immediate and long-term effects that information can have on behavior. (shrink)

The purpose of this commentary is to present and respond to the gap that currently exists in providing culturally inclusive residential long-term care options for Indigenous peoples in Ontario. After presenting statistics regarding the Indigenous population and long-term care options, we argue that we have an ethical responsibility to offer more culturally inclusive long-term care.

Since the onset of the latest United States (U.S.) recession (beginning in December 2007), the U.S. economy has been posting high unemployment levels consistently exceeding 8 percent. Of specific interest, the U.S. Department of Labor, Bureau of Labor Statistics (BLS), reports on a specific subset of the U.S. unemployed: the long‐term unemployed, defined as those who are unemployed for 27 weeks and over. Since December 2009, the share of the long‐term unemployed of the total U.S. unemployed (...) has exceeded 40 percent (through April 2012), the highest level since 1948 when data was first collected. A phenomenon of this recession is an alleged public bias by American private sector employers against hiring the long‐term unemployed, or even simply those unemployed. While the authors support the removal of discrimination against the unemployed in job advertisements, they cannot support the larger notion of including those who are unemployed as a protected class of employees. Becoming or being unemployed is a state that one can change, and based on the lack of research on how widespread this discrimination is (beyond anecdotal stories or limited research surveys), they believe that extending protection under equal employment opportunity legislation would be overreaching and inappropriate at this time. (shrink)

It has become common in medical ethics to discuss difficult cases in terms of the principles of respect for autonomy, beneficence, nonmaleficence, and justice. These moral concepts or principles serve as maxims that are suggestive of appropriate clinical behavior. Because this language evolved primarily in the acute care setting, I consider whether it is in need of supplementation in order to be useful in the long-term care setting. Through analysis of two typical cases involving residents of long- (...) class='Hi'>term care facilities, I argue for the additional principles of candor and responsibility for narrative integrity. (shrink)

In the course of demographic change, the proportion of older people in many countries is rising continuously and more and more people are experiencing a long time together as a couple. In old age, subjective wellbeing and health aspects are associated with partners’ satisfaction with couple relationship. The need for couple counseling in old age is growing in parallel with demographic developments. However, empirical studies on couple therapy with older people in long-term couple relationships exist to date (...) only to a limited extent. The present contribution deals with this knowledge gap. In an explanative two phases design, research has been conducted with long-term couples in couple counseling of which we would like to present here the central qualitative study. The aim is to be able to describe details of these factors. Older couples who have lived in long-term couple relationships were interviewed after using standardized questionnaires concerning the individual and couple-related stress factors and problems at the beginning and the end of their couple counseling process. Five couples from this study were the interviewees for the following study. The couples were interviewed separately. In this interview study and central part of this contribution, the stress factors, problem areas and coping processes of the older couples were examined. The results serve as a suggestion for further research and can only be interpreted with caution due to the small sample of five case studies: The central results of the study are summarized in a circular process model and are discussed in the light of relevant theoretical approaches. The culmination of massive chronic and acute strains and losses associated with feelings of excessive demands and desperation gave rise to emotional alienation of the partners. In the course of couple therapy, the partners mutually opened their thoughts and emotions and modified their previous dysfunctional pattern of interaction. Thus, emotional and physical rapprochement of the partners was fostered with the effect that subjective load of the partners and dissatisfaction of the couple relationship decreased, and subjective emotional wellbeing increased. To prevent negative emotions and destructive conflicts with their spouse, some of the interviewed partners actively used avoidance strategies in couple interactions. Upon completion of couple therapy changes in the couple relationships appeared instable as soon as overcharging stress factors occurred again. The results suggest that an approach to couple therapy for older people in long-term couple relationships should prioritize emotional safeness and attachment in couple relationship to facilitate constructive conflict management. The couple therapy process should emphasize emotion regulation strategies based on age-related strengths and consider age-related vulnerabilities. Moreover, long-term couples may benefit from catamnestic consultation appointments to consolidate the developed changes. (shrink)

Ruchkin et al. make a strong claim about the neural substrates of active information. Some qualifications on that conclusion are: (1) Long-term memories and neural substrates activated for perception of information are not the same thing; (2) humans are capable of retaining novel information in working memory, which is not long-term memory; (3) the content of working memory, a dynamically bound representation, is a quantity above and beyond the long-term memories activated, or the activity (...) in perceptual substrates. (shrink)

This paper proposes a revised Theory of Moves (TOM) to analyze matrix games between two players when payoffs are given as ordinals. The games are analyzed when a given player i must make the first move, when there is a finite limit n on the total number of moves, and when the game starts at a given initial state S. Games end when either both players pass in succession or else a total of n moves have been made. Studies are (...) made of the influence of i, n, and S on the outcomes. It is proved that these outcomes ultimately become periodic in n and therefore exhibit long-term predictable behavior. Efficient algorithms are given to calculate these ultimate outcomes by computer. Frequently the ultimate outcomes are independent of i, S, and n when n is sufficiently large; in this situation this common ultimate outcome is proved to be Pareto-optimal. The use of ultimate outcomes gives rise to a concept of stable points, which are analogous to Nash equilibria but consider long-term effects. If the initial state is a stable point, then no player has an incentive to move from that state, under the assumption that any initial move could be followed by a long series of moves and countermoves. The concept may be broadened to that of a stable set. It is proved that every game has a minimal stable set, and any two distinct minimal stable sets are disjoint. Comparisons are made with the results of standard TOM. (shrink)

Background Licensed nurses working in long-term care facilities experience ethical challenges if not resolved can lead to moral distress. There is a lack of an English-language validated tool to adequately measure moral distress in the long-term care setting. Aims To describe the modification and psychometric evaluation of the Moral Distress Questionnaire. Methods Instrument development and psychometric evaluation. Internal consistency using Cronbach’s α to establish reliability was conducted using SPSS version 27.0 while SPSS Amos version 27.0 was (...) used to perform a confirmatory factor analysis of the Moral Distress Questionnaire Participants A national sample of US-licensed nurses who provided direct resident care in long-term care settings were recruited via a targeted sampling method using Facebook from 7 December 2020 to 7 March 2021. Ethical Consideration The study was approved by the university’s human research protection program. Informed consent was provided to all participants. Results A total of 215 participants completed the surveys. Confirmatory analysis indicated that the 21-item scale with a 4-factor structure for the Moral Distress Questionnaire model met the established criteria and demonstrates an acceptable model fit (CMIN/DF = 2.0, CFI = 0.82, TLI = 0.77, RMSEA = 0.07). Factor loadings for each item depict a moderate to a strong relationship (range 0.36–0.70) with the given underlying construct. Cronbach’s α coefficient was 0.87 for the overall scale and 0.60–0.74 for its subscales which demonstrate good reliabilities. Discussion This is the first English-language validated tool to adequately measure moral distress in the long-term care setting experienced by US long-term care nurses. This reliable and well-validated tool will help identify moral distress situations experienced by US long-term care nurses. Conclusion The modified 21-item English version of the Moral Distress Questionnaire is reliable tool that demonstrates good psychometric properties to validly measure sources of moral distress among direct resident care nurses. (shrink)