Objective Moral distress is a complex phenomenon experienced by healthcare professionals. This study examined the relationships between key dimensions of Organizational Culture in Healthcare (OCHC)—perceived psychological safety, ethical climate, patient safety—and healthcare professionals’ perception of moral distress.Design Cross-sectional surveySetting Pediatric and adult critical care medicine, and adult hospital medicine healthcare professionals in the United States.Participants Physicians (n = 260), nurses (n = 256), and advanced practice providers (n = 110) participated in the study.Main outcome measures Three dimensions of OCHC were (...) measured using validated questionnaires: Olson’s Hospital Ethical Climate Survey, Agency for Healthcare Research and Quality’s Patient Safety Culture Survey, and Edmondson’s Team Psychological Safety Survey. The perception of moral distress was measured using the Moral Distress Amidst a Pandemic Survey. The hypothesized relationships between various dimensions were tested with structural equation modeling (SEM).Results Adequate model fit was achieved in the SEM: a root-mean-square error of approximation =0.072 (90% CI 0.069 to 0.075), standardized root mean square residual = 0.056, and comparative fit index =0.926. Perceived psychological safety (β= −0.357, p <.001) and patient safety culture (β = −0.428, p<.001) were negatively related to moral distress experience. There was no significant association between ethical climate and moral distress (β = 0.106, p = 0.319). Ethical Climate, however, was highly correlated with Patient Safety Culture (factor correlation= 0.82).Conclusions We used structural equation model to test a theoretical model of multi-dimensional organizational culture and healthcare climate (OCHC) and moral distress.Significant associations were found, supporting mitigating strategies to optimize psychological safety and patient safety culture to address moral distress among healthcare professionals. Future initiatives and studies should account for key dimensions of OCHC with multi-pronged targets to preserve the moral well-being of individuals, teams, and organizations. (shrink)

An experiment designed to test the highly speculative hypothesis of photon consciousness was executed. It was found that, within the accuracy attainable with the apparatus, there is no empirical justification for the hypothesis.

Emotion influences parameters of goal-directed whole-body movements in several ways. For instance, previous research has shown that approaching (moving toward) pleasant stimuli is easier compared to approaching unpleasant stimuli. However, some studies found that when emotional pictures are viewed for a longer time, approaching unpleasant stimuli may in fact be facilitated. The effect of viewing duration may have modulated whole-body approach movement in previous research but this has not been investigated to date. In the current study, participants initiated a step (...) forward after viewing neutral, high-arousal pleasant and high-arousal unpleasant stimuli. The viewing duration of the stimuli was set to seven different durations, varying from 100 to 4000 ms. Valence and arousal scores were collected for all stimuli. The results indicate that both viewing duration and the arousal of the stimuli influence kinematic parameters in forward gait initiation. Specifically, longer viewing duration, compared to shorter viewing duration, (a) diminished the step length and peak velocity in both neutral and emotional stimuli, (b) increased reaction time in neutral stimuli and, (c) decreased reaction time in pleasant and unpleasant stimuli. Strikingly, no differences were found between high-arousal pleasant and high-arousal unpleasant stimuli. In other words, the valence of the stimuli did not influence kinematic parameters of forward step initiation. Instead the arousal level (neutral: low; pleasant and unpleasant: high) explained the variance found in the results. The kinematics of forward gait initiation seemed to be reflected in the subjective arousal scores, but not the valence scores. So it seems arousal affects forward gait initiation parameters more strongly than valence. In addition, longer viewing duration seemed to cause diminished alertness, affecting GI parameters. These results shed new light on the prevailing theoretical interpretations regarding approach motivation in the literature, which warrants further examination in future research. (shrink)

RNA localization is a powerful strategy used by cells to localize proteins to subcellular domains and to control protein synthesis regionally. In germ cells, RNA targeting has profound implications for development, setting up polarities in genetic information that drive cell fate during embryogenesis. The frog oocyte offers a useful system for studying the mechanism of RNA localization. Here, we discuss critically the process of RNA localization during frog oogenesis. Three major pathways have been identified that are temporally and spatially separated (...) in oogenesis. Each pathway uses a different mechanism to effect RNA localization. In some cases, localization elements within the 3' untranslated region have been identified and have provided unique insights into the localization process. This important field is still in its infancy, however, and much remains to be learned. BioEssays 21:546–557, 1999. © 1999 John Wiley & Sons, Inc. (shrink)

Throughout the biological and biomedical sciences there is a growing need for, prescriptive ‘minimum information’ (MI) checklists specifying the key information to include when reporting experimental results are beginning to find favor with experimentalists, analysts, publishers and funders alike. Such checklists aim to ensure that methods, data, analyses and results are described to a level sufficient to support the unambiguous interpretation, sophisticated search, reanalysis and experimental corroboration and reuse of data sets, facilitating the extraction of maximum value from data sets (...) them. However, such ‘minimum information’ MI checklists are usually developed independently by groups working within representatives of particular biologically- or technologically-delineated domains. Consequently, an overview of the full range of checklists can be difficult to establish without intensive searching, and even tracking thetheir individual evolution of single checklists may be a non-trivial exercise. Checklists are also inevitably partially redundant when measured one against another, and where they overlap is far from straightforward. Furthermore, conflicts in scope and arbitrary decisions on wording and sub-structuring make integration difficult. This presents inhibit their use in combination. Overall, these issues present significant difficulties for the users of checklists, especially those in areas such as systems biology, who routinely combine information from multiple biological domains and technology platforms. To address all of the above, we present MIBBI (Minimum Information for Biological and Biomedical Investigations); a web-based communal resource for such checklists, designed to act as a ‘one-stop shop’ for those exploring the range of extant checklist projects, and to foster collaborative, integrative development and ultimately promote gradual integration of checklists. (shrink)

ABSTRACT:A wide range of research uses patterns of genetic variation to infer genetic similarity between individuals, typically referred to as genetic ancestry. This research includes inference of human demographic history, understanding the genetic architecture of traits, and predicting disease risk. Researchers are not just structuring an intellectual inquiry when using genetic ancestry, they are also creating analytical frameworks with broader societal ramifications. This essay presents an ethics framework in the spirit of virtue ethics for these researchers: rather than focus on (...) rule following, the framework is designed to build researchers’ capacities to react to the ethical dimensions of their work. The authors identify one overarching principle of intellectual freedom and responsibility, noting that freedom in all its guises comes with responsibility, and they identify and define four principles that collectively uphold researchers’ intellectual responsibility: truthfulness, justice and fairness, anti-racism, and public beneficence. Researchers should bring their practices into alignment with these principles, and to aid this, the authors name three common ways research practices infringe these principles, suggest a step-by-step process for aligning research choices with the principles, provide rules of thumb for achieving alignment, and give a worked case. The essay concludes by identifying support needed by researchers to act in accord with the proposed framework. (shrink)

New coverage of the recent wars in Afghanistan and Iraq, and the ensuing public education campaigns by the Department of Veterans Affairs and private veterans advocacy groups combine to call the public's attention to the many potential mental health problems associated with traumatic event exposure. Indeed, since 2001, Operation Iraqi Freedom and Operation Enduring Freedom combat and peacekeeping missions have been characterized by high levels of exposure to acts of extreme violence, with often gruesome effects. Less publically discussed is the (...) fact that a surprisingly large number of United States civilians also report exposure to traumatic events, such as severe interpersonal violence, natural disasters, and serious automobile accidents. In fact, approximately 70% of randomly sampled respondents indicated that they have experienced an incident characterized by significant perceived life threat at some point during their lives. (shrink)

The arguments presented in this comprehensive collection have important implications for the philosophy of mind and the study of consciousness.

The Ontology for Biomedical Investigations (OBI) is an ontology that provides terms with precisely defined meanings to describe all aspects of how investigations in the biological and medical domains are conducted. OBI re-uses ontologies that provide a representation of biomedical knowledge from the Open Biological and Biomedical Ontologies (OBO) project and adds the ability to describe how this knowledge was derived. We here describe the state of OBI and several applications that are using it, such as adding semantic expressivity to (...) existing databases, building data entry forms, and enabling interoperability between knowledge resources. OBI covers all phases of the investigation process, such as planning, execution and reporting. It represents information and material entities that participate in these processes, as well as roles and functions. Prior to OBI, it was not possible to use a single internally consistent resource that could be applied to multiple types of experiments for these applications. OBI has made this possible by creating terms for entities involved in biological and medical investigations and by importing parts of other biomedical ontologies such as GO, Chemical Entities of Biological Interest (ChEBI) and Phenotype Attribute and Trait Ontology (PATO) without altering their meaning. OBI is being used in a wide range of projects covering genomics, multi-omics, immunology, and catalogs of services. OBI has also spawned other ontologies (Information Artifact Ontology) and methods for importing parts of ontologies (Minimum information to reference an external ontology term (MIREOT)). The OBI project is an open cross-disciplinary collaborative effort, encompassing multiple research communities from around the globe. To date, OBI has created 2366 classes and 40 relations along with textual and formal definitions. The OBI Consortium maintains a web resource providing details on the people, policies, and issues being addressed in association with OBI. (shrink)

This rich and varied collection of essays addresses some of the most fundamental human questions through the lenses of philosophy, literature, religion, politics, and theology. Peter Augustine Lawler and Dale McConkey have fashioned an interdisciplinary consideration of such perennial and enduring issues as the relationship between nature and history, nature and grace, reason and revelation, classical philosophy and Christianity, modernity and postmodernity, repentance and self-limitation, and philosophy and politics.

What kind of thing is a psychiatric disorder? At present, this is the central question in the philosophy of psychiatry. Answers tend toward one of two opposing views: realism, the view that psychiatric disorders are natural kinds, and constructivism, the view that disorders are products of classificatory conventions. The difficulties with each are well rehearsed. One compelling third-way solution, developed by Peter Zachar, holds that disorders are practical kinds. Proponents of this view are left with the difficult task of (...) explaining what makes practical kinds practical. Kendler, Zachar, and Craver have recently developed a new third-way solution, according to which psychiatric disorders are mechanistic property cluster kinds. This account, already influential in the philosophy of psychiatry, holds that the usefulness of psychiatric kinds is explained by the stability of multilevel mechanisms that generate psychiatric symptoms. We argue that this account, like any that purports to address the central question in the philosophy of psychiatry without first attending carefully to the nature of psychiatry and the difference between its constituent scientific and philosophical parts, will ultimately be committed to untenable views about the nature of psychiatric science, the aims and limitations of scientific inquiry and mechanistic explanations, and the role of values in psychiatry. (shrink)

This article considers some different views of fairness and whether they conflict with the use of a version of Cost Effectiveness Analysis (CEA) that calls for maximizing health benefits per dollar spent. Among the concerns addressed are whether this version of CEA ignores the concerns of the worst off and inappropriately aggregates small benefits to many people. I critically examine the views of Daniel Hausman and Peter Singer who defend this version of CEA and Eric Nord among others (...) who criticize it. I come to focus in particular on the use of CEA in allocating scarce resources to the disabled. (shrink)

One of the important questions discussed by philosophers of technology has to do with the moral significance of artefacts in human life. While many philosophers agree that artefacts do have moral significance attached to them, opinions vary as to how it is to be construed. In this paper we deal with the approach of the influential Dutch philosopher of technology Peter Paul Verbeek. He criticizes traditional ethical theories for assuming that whatever relevancy artefacts have for morality is entirely dependent (...) on human beings, since artefacts are mere passive instruments of human agency. In contrast, he develops a view of moral agency that includes artefacts and that ascribes moral agency to human-technology hybrids rather than to humans as such. The goal of this paper is to elucidate Verbeek’s account of moral agency and evaluate it. We also deal with his views on post phenomenology and mediation underlying this account. Although the general gist of our paper is expository, we point out to several problems for Verbeek’s account. (shrink)

The classic, influential essay in 'descriptive metaphysics' by the distinguished English philosopher.

The species-specific organizational property of speech is a continual mouth open-close alternation, the two phases of which are subject to continual articulatory modulation. The cycle constitutes the syllable, and the open and closed phases are segments framescontent displays that are prominent in many nonhuman primates. The new role of Broca's area and its surround in human vocal communication may have derived from its evolutionary history as the main cortical center for the control of ingestive processes. The frame and content components (...) of speech may have subsequently evolved separate realizations within two general purpose primate motor control systems: (1) a motivation-related medial system, including anterior cingulate cortex and the supplementary motor area, for self-generated behavior, formerly responsible for ancestral vocalization control and now also responsible for frames, and (2) a lateral system, including Broca's area and surround, and Wernicke's area, specialized for response to external input (and therefore the emergent vocal learning capacity) and more responsible for content. (shrink)

Among the objections to the implementation of what I will call "genome editing in human reproduction" is that it does not address any unmet medical need, and therefore fails to meet an important criterion for introducing an unproven procedure with potentially adverse consequences. To be clear: what I mean by GEHR is the use of any one of a number of related biological techniques, such as the CRISPR-Cas9 system, deliberately to modify a functional sequence of DNA in a cell of (...) a human embryo, so that the modified sequence is replicated in the cells of a resulting child and may, without further intervention, be passed on to that child's biological descendants. It is... (shrink)

In terms of Aristotle's intellectual virtues, the process of clinical reasoning and the discipline of clinical medicine are often construed as techne (art), as episteme (science), or as an amalgam or composite of techne and episteme. Although dimensions of process and discipline are appropriately described in these terms, I argue that phronesis (practical reasoning) provides the most compelling paradigm, particularly of the rationality of the physician's knowing and doing in the clinical encounter with the patient. I anchor this argument, moreover, (...) in Pellegrino's philosophy of medicine as a healing relationship, oriented to the end of a right and good healing action for the individual patient. (shrink)

The outbreak of the novel coronavirus pandemic, otherwise known as COVID-19 brought about the use of new terminologies—new lexical items such as social distancing, self-isolation, and lockdown. In developed countries, basic social amenities to support these are taken for granted; this is not the case in West African countries. Instead, those suggested safeguards against contracting COVID-19 have exposed the infrastructural deficit in West African countries. In addition, and more profoundly, these safeguards against the disease have distorted the traditional community-individuality balance. (...) The enforcement of social distancing, self-isolation, and lockdown has made it impossible for West Africans to drift to their ancestral homes and villages, as is usually the case in times of crisis, with attendant consequences for communal life and traditional burial rites. This could be one of the reasons why some COVID-19 patients are escaping from isolation centres, since to die in such centres violates their bodily integrity at an ontological level. (shrink)

I expressed agreement with Unger's view of the essential\nnature of personal identity, but dissented from what I took\nto be his view of the value we attach to its preservation;\nsaying, for example, that, in common, I think with many\nothers, I would prefer being replaced or succeeded' by a\nnumerically distinct continuator' with "qualitatively"\nidentical memories and mental and physical characteristics\nto surviving as the "numerically" identical person with\nsevere impairment of memory and abilities.

This paper examines how people in West Africa are reacting to the Ebola virus disease, an epidemic presently prevalent in the region. Certain lifestyle changes are suggested. Additionally, the heart of the paper focuses on the request by governments to be allowed access to experimental drugs, such as Zmapp and TKM-Ebola, for their infected populations. The author argues that granting such a request would circumvent research ethics procedures, which could potentially constitute significant risk to users of the drugs. The Pfizer (...) Kano meningitis trial of 1996 is cited as an example to buttress how unapproved drugs could prove fatal. (shrink)

The Frame/Content theory deals with how and why the first language evolved the present-day speech mode of programming syllable “Frame” structures with segmental “Content” elements. The first words are considered, for biomechanical reasons, to have had the simple syllable frame structures of pre-speech babbling, and were perhaps parental terms, generated within the parent–infant dyad. Although all gestural origins theories have iconicity as a plausible alternative hypothesis for the origin of the meaning-signal link for words, they all share the problems of (...) how and why a fully fledged sign language, necessarily involving a structured phonology, changed to a spoken language. (shrink)

An action-oriented perspective changes the role of an individual from a passive observer to an actively engaged agent interacting in a closed loop with the world as well as with others. Cognition exists to serve action within a landscape that contains both. This chapter surveys this landscape and addresses the status of the pragmatic turn. Its potential influence on science and the study of cognition are considered (including perception, social cognition, social interaction, sensorimotor entrainment, and language acquisition) and its impact (...) on how neuroscience is studied is also investigated (with the notion that brains do not passively build models, but instead support the guidance of action). A review of its implications in robotics and engineering includes a discussion of the application of enactive control principles to couple action and perception in robotics as well as the conceptualization of system design in a more holistic, less modular manner. Practical applications that can impact the human condition are reviewed (e.g., educational applications, treatment possibilities for developmental and psychopathological disorders, the development of neural prostheses). All of this foreshadows the potential societal implications of the pragmatic turn. The chapter concludes that an action-oriented approach emphasizes a continuum of interaction between technical aspects of cognitive systems and robotics, biology, psychology, the social sciences, and the humanities, where the individual is part of a grounded cultural system. (shrink)