The development of artificial intelligence (AI) in medicine raises fundamental ethical issues. As one example, AI systems in the field of mental health successfully detect signs of mental disorders, such as depression, by using data from social media. These AI depression detectors (AIDDs) identify users who are at risk of depression prior to any contact with the healthcare system. The article focuses on the ethical implications of AIDDs regarding affected users’ health-related autonomy. Firstly, it presents the (ethical) discussion of AI (...) in medicine and, specifically, in mental health. Secondly, two models of AIDDs using social media data and different usage scenarios are introduced. Thirdly, the concept of patient autonomy, according to Beauchamp and Childress, is critically discussed. Since this concept does not encompass the specific challenges linked with the digital context of AIDDs in social media sufficiently, the current analysis suggests, finally, an extended concept of health-related digital autonomy. (shrink)

The medical profession is observing a rising number of calls to action considering the threat that climate change poses to global human health. Theory-led bioethical analyses of the scope and weight of physicians’ normative duty towards climate protection and its conflict with individual patient care are currently scarce. This article offers an analysis of the normative issues at stake by using Korsgaard’s neo-Kantian moral account of practical identities. We begin by showing the case of physicians’ duty to climate protection, before (...) we succinctly introduce Korsgaard’s account. We subsequently show how the duty to climate protection can follow from physicians’ identity of being a healthcare professional. We structure conflicts between individual patient care and climate protection, and show how a transformation in physicians’ professional ethos is possible and what mechanisms could be used for doing so. An important limit of our analysis is that we mainly address the level of individual physicians and their practical identities, leaving out important measures to respond to climate change at the mesolevels and macrolevels of healthcare institutions and systems, respectively. (shrink)

Strategies for improving the explainability of artificial agents are a key approach to support the understandability of artificial agents’ decision-making processes and their trustworthiness. However, since explanations are not inclined to standardization, finding solutions that fit the algorithmic-based decision-making processes of artificial agents poses a compelling challenge. This paper addresses the concept of trust in relation to complementary aspects that play a role in interpersonal and human–agent relationships, such as users’ confidence and their perception of artificial agents’ reliability. Particularly, this (...) paper focuses on non-expert users’ perspectives, since users with little technical knowledge are likely to benefit the most from “post-hoc”, everyday explanations. Drawing upon the explainable AI and social sciences literature, this paper investigates how artificial agent’s explainability and trust are interrelated at different stages of an interaction. Specifically, the possibility of implementing explainability as a trust building, trust maintenance and restoration strategy is investigated. To this extent, the paper identifies and discusses the intrinsic limits and fundamental features of explanations, such as structural qualities and communication strategies. Accordingly, this paper contributes to the debate by providing recommendations on how to maximize the effectiveness of explanations for supporting non-expert users’ understanding and trust. (shrink)

This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...) ‘integrating’ empirical methods and ethical argument as a standard for research practice within empirical bioethics. (shrink)

Ce volume envisage l'amour en tant qu'objet polymorphe : Eros, Philia, Agapé, mais aussi Storgé. Les mots grecs rendent compte, du large spectre amoureux : amour romantique, amour sexuel, amour de soi, de l'autre, pour l'autre... des catégories qui placent les manifestations du sentiment amoureux dans un espace de contraintes et de possibilités qui relève du social et du discursif. Les travaux qui sont ici réunis s'attachent ainsi à interroger des genres artistiques et discursifs dans lesquels s'ancre l'amour, ils abordent (...) la littérature et le cinéma, mais aussi l'histoire, l'histoire des idées, la sociologie l'ethnologie ou la psychologie. Ces recherches mettent en avant que l'amour constitue une manière d'appréhender et d'expliquer le monde puisqu'on peut lire à travers lui les rapports qui définissent nos sociétés et qui le définissent à leur tour. (shrink)

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)

We argue for a perspective on bilingual heritage speakers as native speakers of both their languages and present results from a large-scale, cross-linguistic study that took such a perspective and approached bilinguals and monolinguals on equal grounds. We targeted comparable language use in bilingual and monolingual speakers, crucially covering broader repertoires than just formal language. A main database was the open-access RUEG corpus, which covers comparable informal vs. formal and spoken vs. written productions by adolescent and adult bilinguals with heritage-Greek, (...) -Russian, and -Turkish in Germany and the United States and with heritage-German in the United States, and matching data from monolinguals in Germany, the United States, Greece, Russia, and Turkey. Our main results lie in three areas. We found non-canonical patterns not only in bilingual, but also in monolingual speakers, including patterns that have so far been considered absent from native grammars, in domains of morphology, syntax, intonation, and pragmatics. We found a degree of lexical and morphosyntactic inter-speaker variability in monolinguals that was sometimes higher than that of bilinguals, further challenging the model of the streamlined native speaker. In majority language use, non-canonical patterns were dominant in spoken and/or informal registers, and this was true for monolinguals and bilinguals. In some cases, bilingual speakers were leading quantitatively. In heritage settings where the language was not part of formal schooling, we found tendencies of register leveling, presumably due to the fact that speakers had limited access to formal registers of the heritage language. Our findings thus indicate possible quantitative differences and different register distributions rather than distinct grammatical patterns in bilingual and monolingual speakers. This supports the integration of heritage speakers into the native-speaker continuum. Approaching heritage speakers from this perspective helps us to better understand the empirical data and can shed light on language variation and change in native grammars. Furthermore, our findings for monolinguals lead us to reconsider the state-of-the art on majority languages, given recurring evidence for non-canonical patterns that deviate from what has been assumed in the literature so far, and might have been attributed to bilingualism had we not included informal and spoken registers in monolinguals and bilinguals alike. (shrink)

Research in the field of Empirical Ethics (EE) uses a broad variety of empirical methodologies, such as surveys, interviews and observation, developed in disciplines such as sociology, anthropology, and psychology. Whereas these empirical disciplines see themselves as purely descriptive, EE also aims at normative reflection. Currently there is literature about the quality of empirical research in ethics, but little or no reflection on specific methodological aspects that must be considered when conducting interdisciplinary empirical ethics. Furthermore, poor methodology in an EE (...) study results in misleading ethical analyses, evaluations or recommendations. This not only deprives the study of scientific and social value, but also risks ethical misjudgement. (shrink)

Physicians frequently encounter situations in which their professional practice is intermingled with moral affordances stemming from other domains of the physician’s lifeworld, such as family and friends, or from general morality pertaining to all humans. This article offers a typology of moral conflicts ‘at the margins of professionalism’ as well as a new theoretical framework for dealing with them. We start out by arguing that established theories of professional ethics do not offer sufficient guidance in situations where professional ethics overlaps (...) with moral duties of other origins. Therefore, we introduce the moral theory developed by Christine M. Korsgaard, that centres around the concept of practical identity. We show how Korsgaard’s account offers a framework for interpreting different types of moral conflicts ‘at the margins of professionalism’ to provide either orientation for solving the conflict or an explanation for the emotional and moral burden involved in moral dilemmas. (shrink)

The umbrella-term ‘executive functions’ includes various domain-general, goal-directed cognitive abilities responsible for behavioral self-regulation. The influential unity and diversity model of EF posits the existence of three correlated yet separable executive domains: inhibition, shifting and updating. These domains may be influenced by factors such as socioeconomic status and culture, possibly due to the way EF tasks are devised and to biased choice of stimuli, focusing on first-world testees. Here, we propose a FREE test battery that includes two open-access tasks for (...) each of the three abovementioned executive domains to allow latent variables to be obtained. The tasks were selected from those that have been shown to be representative of each domain, that are not copyrighted and do not require special hardware/software to be administered. These tasks were adapted for use in populations with varying SES/schooling levels by simplifying tasks/instructions and using easily recognized stimuli such as pictures. Items are answered verbally and tasks are self-paced to minimize interference from individual differences in psychomotor and perceptual speed, to better isolate executive from other cognitive abilities. We tested these tasks on 146 early adolescents of both sexes and varying SES, because this is the age group in which the executive domains of interest become distinguishable and in order to confirm that SES effects were minimized. Performance was determined by Rate Correct Scores, which consider speed-accuracy trade-offs. Scores were sensitive to the expected improvement in performance with age and rarely/inconsistently affected by sex and SES, as expected, with no floor or ceiling effects, or skewed distribution, thus suggesting their adequacy for diverse populations in these respects. Using structural equation modeling, evidence based on internal structure was obtained by replicating the three correlated-factor solution proposed by the authors of the model. We conclude that the FREE test battery, which is open access and described in detail, holds promise as a tool for research that can be adapted for a wide range of populations, as well as altered and/or complemented in coming studies. (shrink)

Language's intentional nature has been highlighted as a crucial feature distinguishing it from other communication systems. Specifically, language is often thought to depend on highly structured intentional action and mutual mindreading by a communicator and recipient. Whilst similar abilities in animals can shed light on the evolution of intentionality, they remain challenging to detect unambiguously. We revisit animal intentional communication and suggest that progress in identifying analogous capacities has been complicated by (i) the assumption that intentional (that is, voluntary) production (...) of communicative acts requires mental-state attribution, and (ii) variation in approaches investigating communication across sensory modalities. To move forward, we argue that a framework fusing research across modalities and species is required. We structure intentional communication into a series of requirements, each of which can be operationalised, investigated empirically, and must be met for purposive, intentionally communicative acts to be demonstrated. Our unified approach helps elucidate the distribution of animal intentional communication and subsequently serves to clarify what is meant by attributions of intentional communication in animals and humans. (shrink)

We are extremely grateful for the insightful and thought-provoking commentaries on our feature article.1 We have distilled four themes emerging from the commentaries, and we would also like to address one misunderstanding of our argument that has appeared. In our article, we explicitly acknowledge that major decisions relevant for climate protection take place at the mesolevels and macrolevels of healthcare, a point raised again in some of the commentaries.2–4 Climate protection is a societal issue, and we thank these authors for (...) the concrete proposals of potential models to guide action. Yet, to us, it still makes sense to reflect simultaneously on the responsibilities that physicians have themselves. Without wanting to put the main responsibility on them, we argue it is important to start thinking about the scope of action that physicians actually have (or not have). As we have argued the need for climate action comes ever more into focus of society, we wanted to explore whether the professional ethics of the medical professionals needs to be amended. Our argument is that this is the case, based on the reasons that climate change has a big health impact while simultaneously the health system has a strong climate impact. Based on the World Medical Association (WMA) Declaration of Geneva the focus on the individual patient is clear, but this and other important codices do also include a public health perspective. The (model) Professional Code for Physicians in Germany, for example, states in its first article that ‘Physicians serve the health of …. (shrink)

This qualitative study investigated the personal and professional stances of 40 health and social care professionals confronted with assisted suicide of older persons living in nursing homes or supported by social welfare or home care and support services in French-speaking Switzerland. Requests of assisted suicide triggered questions with regard to the professional mission, the quality of accompaniment, values, and ethical principles. Four types of stances emerged from the analysis performed according to the principles of the grounded theory: favorable in principle, (...) professional compromise, personal compromise, and opposed in principle. Each stance results from the combination of several dimensions: personal or professional concordance or compatibility with assisted suicide; implication in, and impact of, the process; appreciation of the process; and satisfaction with the resources at disposal. The differentiated stances adopted by professionals depend largely on their way of interpreting their mission, deontology, and the relationship to the older person. (shrink)

In teacher education, students have to link theoretical knowledge from educational studies or other academic fields with classroom experiences in formal settings such as triadic mentoring conversations. Students make this link through verbal activities, which are the heart of our analysis. Students produce complex discourses in which they position themselves, refer to multiple types of knowledge, describe and analyse their practicum. Considering that discourse analysis enlightens professional development processes, we study what prospective teachers (PTs) learn in a specific moment of (...) formal mentoring conversations that is a presentation of problematic issues. We compare the evolution of these presentations for two PTs. Through an utterer centred approach, we focus on three key elements: positioning adopted by PTs regarding the content of their sayings and their discussion partners; the way they integrate the theoretical concepts in their discourse; and the way they put in words working experiences and specific internship events. These elements enlighten the process of self-building and building of professional knowledge. Our results point out that in these « in between » settings, preservice teachers produce two kinds of discourse: academic and professional. (shrink)

Digitalisierung und Technik bestimmen heute maßgeblich das sozialgesellschaftliche Miteinander. Dies betrifft eher traditionsorientierte Strukturen in Religion und Kultur ebenso wie progressive Bereiche in Medizin und Pflege. Technik erweist sich nicht länger als ein bloßes Instrument des Wandels, sondern treibt den Wandel an, gibt ihm Richtung. Der Mensch wird dabei zunehmend zum Passagier einer Entwicklung, die er immer seltener überblickt. Umso wichtiger ist es daher, eine strukturierte und kontextsensible Auseinandersetzung mit Chancen und Risiken technischer Möglichkeiten vorzunehmen. Interdisziplinäre Beiträge aus Theologie, Pflege (...) und Ethik geben Einblicke in ein breitgefächertes Themenfeld, das die Frage nach dem Selbstverständnis des Menschen in einer transformativen Gesellschaft stellt. Sie bieten Orientierung und Argumentationshilfen und tragen bei zu einer Sprachfähigkeit »Sozialer Verantwortung«, die zwischen analoger und digitaler Welt verbindet. (shrink)

Sexual exploitation and abuse (SEA) by United Nations (UN) peacekeepers causes severe physical and psychological consequences. Where SEA leads to pregnancy and childbirth, peacekeepers typically absolve themselves of their paternal responsibilities and paternity suits are largely unsuccessful. The lack of support for peacekeeper-fathered children (PKFC) tarnishes the image of the UN who fails to implement a victim-centred approach to SEA. Analysing shortcomings in the provision of support, this article presents an evaluation of the UN’s accountability system from the perspective of (...) PKFC families. In-depth interviews with thirty-five PKFC and sixty mothers demonstrate local barriers to child support and paternity claims in eastern Democratic Republic of Congo. We discuss PKFC’s need for assistance and their mothers’ attempts to navigate an opaque international legal system. The findings cast light on their limited access to UN subsidies and offer recommendations to better implement existing UN goals of justice and victim-oriented policies. (shrink)

BackgroundBiobanking biospecimens and consent are common practice in paediatric research. We need to explore children and young people’s (CYP) knowledge and perspectives around the use of and consent to biobanking. This will ensure meaningful informed consent can be obtained and improve current consent procedures.MethodsWe designed a survey, in co-production with CYP, collecting demographic data, views on biobanking, and consent using three scenarios: 1) prospective consent, 2) deferred consent, and 3) reconsent and assent at age of capacity. The survey was disseminated (...) via the Young Person’s Advisory Group North England (YPAGne) and participating CYP’s secondary schools. Data were analysed using a qualitative thematic approach by three independent reviewers (including CYP) to identify common themes. Data triangulation occurred independently by a fourth reviewer.ResultsOne hundred two CYP completed the survey. Most were between 16–18 years (63.7%, N = 65) and female (66.7%, N = 68). 72.3% had no prior knowledge of biobanking (N = 73).Acceptability of prospective consent for biobanking was high (91.2%, N = 93) with common themes: ‘altruism’, ‘potential benefits outweigh individual risk’, 'frugality', and ‘(in)convenience’.Deferred consent was also deemed acceptable in the large majority (84.3%, N = 86), with common themes: ‘altruism’, ‘body integrity’ and ‘sample frugality’. 76.5% preferred to reconsent when cognitively mature enough to give assent (N = 78), even if parental consent was previously in place. 79.2% wanted to be informed if their biobanked biospecimen is reused (N = 80).ConclusionProspective and deferred consent acceptability for biobanking is high among CYP in the UK. Altruism, frugality, body integrity, and privacy are the most important themes. Clear communication and justification are paramount to obtain consent. Any CYP with capacity should be part of the consenting procedure, if possible. (shrink)

Causation is a core feature of human cognition and language. How children learn about intricate causal meanings is yet unresolved. Here, we focus on how children learn verbs that express causation. Such verbs, known as lexical causatives (e.g., break and raise), lack explicit morphosyntactic markers indicating causation, thus requiring that the child generalizes the causal meaning from the context. The language addressed to children presumably plays a crucial role in this learning process. Hence, we tested whether adults adapt their use (...) of lexical causatives to children when talking to them in day-to-day interactions. We analyzed naturalistic longitudinal data from 12 children in the Manchester corpus (spanning from 20 to 36 months of age). To detect semantic generalization, we employed a network approach with semantics learned from cross-situational contexts. Our results show an increasing trend in the expansion of causative semantics, observable in both child speech and child-directed speech. Adults consistently maintain somewhat more intricate causative semantic networks compared to children. However, both groups display evolving patterns. Around 28–30 months of age, children undergo a reduction in the degree of causative generalization, followed by a slightly time-lagged adjustment by adults in their speech directed to children. These findings substantiate adults' adaptation in child-directed speech, extending to semantics. They highlight child-directed speech as a highly adaptive and subconscious teaching tool that facilitates the dynamic processes of language acquisition. (shrink)

Free games that are monetized by selling virtual items, such as cosmetic microtransactions for one’s avatar, seem to offer a better gaming experience to paying players. To experimentally explore this phenomenon, the effects of character customization with cosmetic microtransactions on objective and self-estimated player performance, subjective identification with the avatar, fun and the players’ perceived competence were examined in the game League of Legends. This study introduces a new laboratory-based, experimental task to objectively measure within-game player performance. Each participant performed (...) this game-based task in two different conditions: With a character that was customized using a provided set of cosmetic microtransactions and with a default character. Results showed that customization increased subjective identification with the player character. However, objective performance measures were unaffected by this manipulation although the novel experimental approach provided reliable performance results. Additionally, identification was positively related to perceived competence, fun, and self-estimated performance. Implications for the design of cosmetic microtransactions and their influence on competitive gaming are discussed. (shrink)

This paper reviews the main pricing policies in Latin American countries, discussing their shortcomings. It also gives an overview of the most common pricing and reimbursement policies in Europe and describes in detail three well-established approaches — international price referencing, value-based pricing, including setting up of health technology assessment, and generic and biosimilar policies — building on country examples.

In language evolution research, the use of computational and experimental methods to investigate the emergence of structure in language is exploding. In this review, we look exclusively at work exploring the emergence of structure in speech, on both a categorical level, and a combinatorial level. We show that computational and experimental methods for investigating population-level processes can be effectively used to explore and measure the effects of learning, communication and transmission on the emergence of structure in speech. We also look (...) at work on child language acquisition as a tool for generating and validating hypotheses for the emergence of speech categories. Further, we review the effects of noise, iconicity and production effects. (shrink)

Cognitive Science, Volume 46, Issue 2, February 2022.

Becoming productive with grammatical categories is a gradual process in children's language development. Here, we investigated this transition process by focusing on Turkish causatives. Previous research examining spontaneous and elicited production of Turkish causatives with familiar verbs attested the onset and early stages of productivity at ages 2 to 3 (Aksu-Koç & Slobin, 1985; Nakipoğlu, Uzundag, & Sarıgül, 2021). So far, however, we know very little about children's understanding of causatives with novel verbs. In the present study, we asked: (a) (...) When does the generalization of causative morphology in a novel context emerge? and (b) What role does child-directed input play in this development? To answer the first question, we conducted comprehension-judgment experiments with children aged 2;6–6;11 using pseudo-verbs (Study 1 & 2). Results showed that children preferred the Turkish causative suffix -DIr over an unrelated or no suffix to denote caused events earliest at age 4;10. To answer the second question, we analyzed child-directed speech from a longitudinal corpus of Turkish language acquisition (Study 3). Results showed that when addressing children younger than age 3, caregivers used the -DIr suffix with little variation considering the overall variability of verbs they could utter. Overall, these findings suggest that productivity with morphological causatives in a novel context emerges in a later stage of acquisition. This later development might partly be accounted for by the insufficient variation of morphological causatives in the early input. (shrink)

Various studies have shown a decrease in well-being and an increase in mental health problems during the COVID-19 pandemic; however, only a few studies have explored fear, depression, and well-being cross-culturally during this time. Accordingly, we present the results of a cross-cultural study that compares these mental health scores for German and South African students, compares the correlations among them, and identifies COVID-19 fear, well-being, and depression predictors. German and South African societies differ from each other socio-culturally, politically, and economically. (...) Their university systems also differ to a large extent. University students in both countries completed the Fear of COVID-19 Scale, the World Health Organization-Five Well-Being Index, and the Patient Health Questionnaire-9. Welch’s t-test, correlation, and multiple regression analyses were performed. German students were found to have statistically lower levels of COVID-19 fear and depression, but lower levels of general well-being than South African students. In both samples, fear of COVID-19 was negatively correlated with well-being and positively associated with female gender and depression. Additionally, female gender, depression, and lower well-being were identified as predictors of COVID-19 fear in both samples. The findings indicate that the fear of COVID-19 is associated with and varies according to gender, depression, and well-being across cultures, and that the difference in the intensity of fear between German and South African students may be partly explained by cultural and contextual differences. These findings can create a deeper understanding of the pandemic’s impact on student communities and may be used by mental health practitioners and researchers to develop and apply culture-specific interventions. (shrink)

Eating disorders (EDs) are characterized by marked cognitive distortions and maladaptive schemas. Cognitive models of EDs highlight the direct impact of cognitive dysfunctions on eating-related disturbances, insofar as specific cognitive contents such as thoughts about diet rules and food or loss of control may trigger disturbed eating behavior. Moreover, early maladaptive schemas that reflect perfectionist standards and relate to achievement and performance seem to be associated with disturbed eating, e.g. via their impact on situation-specific appraisals. However, so far, no study (...) has investigated these assumptions. Hence, the present study sought to demonstrate whether and how cognitive content exerts an impact on eating behavior in daily life, and whether maladaptive core schemas impact the occurrence of binge eating via dysfunctional ED cognitions in eating-related contexts. N = 29 females with Bulimia Nervosa (BN), n = 31 females with Binge Eating Disorder (BED) and n = 30 female controls without EDs (NC) participated in the study. All participants received a handheld computer for a 48-hour period to capture antecedents of disturbed eating behavior in daily life. Event-sampling (meals, binge eating, purging, stressful situations) and signal-sampling (five times a day) methods were applied. EMA included a short questionnaire to assess dysfunctional cognitions and level of craving and to capture information about situational contexts. Early maladaptive schemas were assessed using a short version of the Young Schema Questionnaire at baseline. The main results showed specific patterns of dysfunctional eating-related cognitions for BED and BN. Binge eating was predicted by thoughts about loss of control (positively) and dietary restraint (negatively). For meal situations, no significant differences between the two ED groups emerged. All three domains exerted indirect effects on craving via thoughts about ‘eating/loss of control’, whereas neither a direct nor an indirect effect emerged regarding thoughts about ‘dietary restraint’. These results fit well with previous studies and support cognitive models of EDs; schema therapeutic approaches may be a valuable contribution to enhance treatment of EDs. Further studies should explore whether the findings from emerging adulthood can be generalized to younger age groups. (shrink)

Animal and human studies suggest that parenting style is transmitted from one generation to the next. The hypotheses of this study were that a mother’s rearing experiences would predict her own parenting resources and current maternal mood, motivation to care for her offspring, and relationship with her parents would underlie this association. In a subsample of 201 first-time mothers participating in the longitudinal Maternal Adversity, Vulnerability and Neurodevelopment project, we assessed a mother’s own childhood maltreatment and rearing experiences using the (...) Childhood Trauma Questionnaire and the Parental Bonding Instrument. At 6 months postpartum, mothers completed questionnaires on parenting stress, symptoms of depression, maternal motivation, and current relationship with their own parents. The sample consisted of mostly high socioeconomic status mothers recruited from Montréal or Hamilton, Canada, with an age range from 18 to 43 years. More severe maltreatment and less supportive rearing by the mother’s parents predicted increased parenting stress at 6 months. These associations were mediated through distinct psychosocial pathways: maltreatment on parenting stress through symptoms of depression ; maternal rearing on parenting stress through maternal motivation and symptoms of depression ; and paternal rearing on parenting stress through current relationship with the father. Maternal rearing experiences predict a mother’s own parenting resources though distinct psychosocial pathways, including depressed mood, maternal motivation, and social support. (shrink)

Dicer is a key player in microRNA (miRNA) and RNA interference (RNAi) pathways, processing miRNA precursors and doublestranded RNA into ~21-nt-long products ultimately triggering sequence-dependent gene silencing. Although processing of substrates in vertebrate cells occurs in the cytoplasm, there is growing evidence suggesting Dicer is also present and functional in the nucleus. To address this possibility, we searched for a nuclear localization signal (NLS) in human Dicer and identified its C-terminal double-stranded RNA binding domain (dsRBD) as harboring NLS activity. We (...) show that the dsRBD-NLS can mediate nuclear import of a reporter protein via interaction with importins β, 7, and 8. In the context of full-length Dicer, the dsRBD-NLS is masked. However, duplication of the dsRBD localizes the full-length protein to the nucleus. Furthermore, deletion of the N-terminal helicase domain results in partial accumulation of Dicer in the nucleus upon leptomycin B treatment, indicating that CRM1 contributes to nuclear export of Dicer. Finally, we demonstrate that human Dicer has the ability to shuttle between the nucleus and the cytoplasm. We conclude that Dicer is a shuttling protein whose steady-state localization is cytoplasmic. (shrink)

In depicting five “spheres of morality” occupied by physicians Doernberg and Troug provide an impressive analysis on physicians’ various commitments and role conflicts which are excellently illustr...

Die Notwendigkeit guter Arzt-Patienten-Kommunikation für eine angemessene Behandlung und für die Ausübung der Patientenselbstbestimmung ist bekannt. In interkulturell-mehrsprachigen Situationen, in denen ein kommunikationsintensiver Aushandlungsprozess besonders notwendig ist, erhält die Qualität der Verständigung besondere Bedeutung, so dass der Einsatz qualifizierter Dolmetschender hier ethisch geboten ist. Er stellt Ärzte und Ärztinnen, aber auch die Dolmetschenden vor besondere, ethisch zu reflektierende Herausforderungen. Sind zudem keine qualifizierten Dolmetschenden einsetzbar, müssen Ärzte und Ärztinnen in schwierigen ethischen Abwägungsprozessen eine Entscheidung über das weitere Vorgehen treffen. Diese (...) beiden Themen finden in der medizinethischen Literatur bisher wenig Beachtung. Anhand von Erkenntnissen aus der Forschung u. a. zum Gesprächsdolmetschen werden im Folgenden zentrale ethische Herausforderungen eines Dolmetschereinsatzes herausgearbeitet. Diskutiert werden der Bedarf sprachlicher Unterstützung, der drohende Ausschluss von Patientinnen und Patienten in gedolmetschten Gesprächen, die Beachtung der für das Dolmetschen geltenden berufsethischen Prinzipien, die Gewährleistung der Vertraulichkeit sowie die Konsequenzen interkulturellen Vermittelns. Des Weiteren wird für Ärzte und Ärztinnen, die unter nicht-idealen Bedingungen ohne qualifizierte Dolmetschende agieren müssen, erstmals ein strukturierter argumentativer Rahmen vorgestellt. Es werden neun Bewertungskriterien vorgeschlagen, anhand derer in einem Abwägungsprozess über die Eignung einer Person zum (spontanen) Dolmetschen entschieden werden kann. (shrink)