Selected as Outstanding Academic Book by Choice magazine.

A dialogue between virtue and care ethics is formed as a step towards meeting Pellegrino's challenge to create a more comprehensive moral philosophy. It is also a dialogue between nursing and medicine since each practice draws on the Greek Virtue Tradition and the Judeo-Christian Tradition of care differently. In the Greek Virtue Tradition, the point of scrutiny lies in the inner character of the actor, whereas in the Judeo-Christian Tradition the focus is relational, i.e. how virtues are lived out in (...) specific relationships, particularly unequal relationships where vulnerability of one of the members is an issue. In a care ethic relational qualities such as attunement rather than inner qualities are the point of scrutiny. A dialogue between these two traditions makes it possible to consider the relational virtues and skills of openness and responsiveness that are required for a respectful meeting of the other. (shrink)

Sex determination in most organisms involves a simple binary fate choice between male or female development; the outcome of this decision has profound effects on organismal biology, biochemistry and behaviour. In the nematode C. elegans, there is also a binary choice, either male or hermaphrodite. In C. elegans, distinct genetic pathways control somatic and germline sexual cell fate. Both pathways share a common set of globally acting regulatory genes; however, germline-specific regulatory genes also participate in the decision to make male (...) or female gametes. The determination of sexual fate in the germline of the facultative hermaphrodite poses a special problem, because first sperm then oocytes are produced. It has emerged that additional layers of post-transcriptional regulation have been imposed to modulate the activities of the global sex-determining genes, tra-2 and fem-3; the balance between these activities is crucial in controlling sexual cell fate in the hermaphrodite germline. BioEssays 23:596–604, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

Offering a format that is significantly different than that offered by other books, Ethical Health Care beings by asking what is meant by health and how it is achieved. The book then proceeds to explore with care and context the nature of the relationship between patients and clinicians, health care providers and the societies in which they inhabit, and finally the relationship between the health care enterprise and the international community. By emphasizing the ethical issues that arise in the broad (...) quest to foster human health, and appreciating that health is not primarily a function of medical interventions, Ethical Health Care introduces students to problems such as the international distribution of pharmaceuticals and the dangers of reemerging infections. To a far greater extent than is done traditionally, Ethical Health Care provides an interdisciplinary perspective to bioethics, relying heavily upon the teachings of economics, law, and public health. (shrink)

A multiracial, socioeconomically diverse sample of 45 lesbians describe power relations in both satisfactory and problematic health care encounters with physicians. Whether doctors act in solidarity or dominate them is pivotal to lesbians' health care experiences. Solidarity means compassionate competence, empowering information exchange, and negotiated action. Domination takes form in the withholding of information, doomsaying, defensive dismissals, sexist comments, body sculpting, reproductive regulation, and bodily transgression.

Traditionally, developmental psychology has been characterized by two approaches, one predominantly social and the other, cognitive. Despite this separatism, develop-mentalists have expressed the need for a better understanding of how these two facets of the person interact - a need for a better account of development within the person as a whole. However, such an integration has been difficult given the incompatibility of underlying assumptions guiding these two areas of inquiry. James Mark Baldwin's integration of social and cognitive development into (...) one theory highlights the utility of historical analyses for further progress in the field. In this paper, Baldwin's dialectical theory of personal growth is placed in historical context, highlighting similarities and differences between his approach and that taken by Piaget, and the legacy of his theory in current theory and research. The importance of self, the development of knowledge in the context of social relationships and the function of imitation are emphasized. (shrink)

This landmark volume articulates and develops the argument that new directions in sociocultural theory are needed in order to address important issues of identity, agency, and power that are central to understanding literacy research and literacy learning as social and cultural practices. With an overarching focus on the research process as it relates to sociocultural research, the book is organized around two themes: conceptual frameworks and knowledge sources. *Part I, “Rethinking Conceptual Frameworks,” offers new theoretical lenses for reconsidering key concepts (...) traditionally associated with sociocultural theory, such as activity, history, community, and the ways they are conceptualized and under-conceptualized within sociocultural theory. *Part II, “Rethinking Knowledge and Representation,” considers the tensions and possibilities related to how research knowledge is produced, represented, and disseminated or shared—challenging the locus of authority in research relationships, asking who is authorized to be a legitimate knowledge source, for what purposes, and for which audiences or stakeholders. Employing the lens of “critical sociocultural research,” this book focuses on the central role of language and identity in learning and literacy practices. It is intended for scholars, researchers, and graduate students in literacy education, social and cultural psychology, social foundations of education, educational anthropology, curriculum theory, and qualitative research in education. (shrink)

Nursing practice invites nurses to embody caring practices that meet, comfort and empower vulnerable others. Such a practice requires a commitment to meeting and helping the other in ways that liberate and strengthen and avoid imposing the will of the caregiver on the patient. Being good and acting well (phronesis) occur in particular situations. A socially constituted and embodied view of agency, as developed by Merleau‐Ponty, provides an alternative to Cartesian and Kantian views of agency. A socially constituted, embodied view (...) of agency is less mechanistic and less deterministic than Descartes' and Kant's radical separation of mind and body, and more responsive and generative than Kant's vision of moral agency as constituted by autonomous choice makers who are uninfluenced by emotion. The role of emotion in perception and judgement is explored in this paper. Distinctions between techne and phronesis are drawn. The role of emotion in market relationships and procedural ethics drawn for the abstract, general other are strategies for exchange of goods and services, but these same market relationships are dependent on well‐functioning nonmarket relations of noncalculated giving and receiving. (shrink)

Gap junction intercellular communication channels permit the exchange of small regulatory molecules and ions between neighbouring cells and coordinate cellular activity in diverse tissue and organ systems. These channels have short half‐lives and complex assembly and degradation pathways. Much of the recent work elucidating gap junction biogenesis has featured the use of connexins (Cx), the constituent proteins of gap junctions, tagged with reporter proteins such as Green Fluorescent Protein (GFP) and has illuminated the dynamics of channel assembly in live cells (...) by high‐resolution time‐lapse microscopy. With some studies, however, there are potential short‐comings associated with the GFP chimeric protein technologies. A recent report by Gaietta et al., has highlighted the use of recombinant proteins with tetracysteine tags attached to the carboxyl terminus of Cx43, which differentially labels ‘old’ and ‘new’ connexins thus opening up new avenues for studying temporal and spatial localisation of proteins and in situ trafficking events.1 BioEssays 24:876–880, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious (...) wrongdoing by physicians. (shrink)

BackgroundResponsive neurostimulation has been utilized as a treatment for intractable epilepsy. The RNS System delivers stimulation in response to detected abnormal activity, via leads covering the seizure foci, in response to detections of predefined epileptiform activity with the goal of decreasing seizure frequency and severity. While thalamic leads are often implanted in combination with cortical strip leads, implantation and stimulation with bilateral thalamic leads alone is less common, and the ability to detect electrographic seizures using RNS System thalamic leads is (...) uncertain.ObjectiveThe present study retrospectively evaluated fourteen patients with RNS System depth leads implanted in the thalamus, with or without concomitant implantation of cortical strip leads, to determine the ability to detect electrographic seizures in the thalamus. Detailed patient presentations and lead trajectories were reviewed alongside electroencephalographic analyses.ResultsAnterior nucleus thalamic leads, whether bilateral or unilateral and combined with a cortical strip lead, successfully detected and terminated epileptiform activity, as demonstrated by Cases 2 and 3. Similarly, bilateral centromedian thalamic leads or a combination of one centromedian thalamic alongside a cortical strip lead also demonstrated the ability to detect electrographic seizures as seen in Cases 6 and 9. Bilateral pulvinar leads likewise produced reliable seizure detection in Patient 14. Detections of electrographic seizures in thalamic nuclei did not appear to be affected by whether the patient was pediatric or adult at the time of RNS System implantation. Sole thalamic leads paralleled the combination of thalamic and cortical strip leads in terms of preventing the propagation of electrographic seizures.ConclusionThalamic nuclei present a promising target for detection and stimulation via the RNS System for seizures with multifocal or generalized onsets. These areas provide a modifiable, reversible therapeutic option for patients who are not candidates for surgical resection or ablation. (shrink)

Three studies using the Dreyfus model of skill acquisition were conducted over a period of 21 years. Nurses with a range of experience and reported skill-fulness were interviewed. Each study used nurses’ narrative accounts of actual clinical situations. A subsample of participants were observed and interviewed at work. These studies extend the understanding of the Dreyfus model to complex, underdetermined, and fast-paced practices. The skill of involvement and the development of moral agency are linked with the development of expertise, and (...) change as the practitioner becomes more skillful. Nurses who had some difficulty with understanding the ends of practice and difficulty with their skills of interpersonal and problem engagement did not progress to the level of expertise. Taken together, these studies demonstrate the usefulness of the Dreyfus model for understanding the learning needs and styles of learning at different levels of skill acquisition. (shrink)

An alternative to objectifying approaches to understanding Post-traumatic Stress Disorder grounded in hermeneutic phenomenology is presented. Nurses who provided care for soldiers injured in the Iraq and Afghanistan wars, and sixty-seven wounded male servicemen in the rehabilitation phase of their recovery were interviewed. PTSD is the one major psychiatric diagnosis where social causation is established, yet PTSD is predominantly viewed in terms of the usual neuro-physiological causal models with traumatic social events viewed as pathogens with dose related effects. Biologic models (...) of causation are applied reductively to both predisposing personal vulnerabilities and strengths that prevent PTSD, such as resiliency. However, framing PTSD as an objective disease state separates it from narrative historical details of the trauma. Personal stories and cultural meanings of the traumatic events are seen as epiphenomenal, unrelated to the understanding of, and ultimately, the therapeutic treatment of PTSD. Most wounded service members described classic symptoms of PTSD: flashbacks, insomnia, anxiety etc. All experienced disturbance in their sense of time and place. Rather than see the occurrence of these symptoms as decontextualized mechanistic reverberations of war, we consider how these symptoms meaningfully reflect actual war experiences and sense of displacement experienced by service members. (shrink)

Currently, Nursing Education draws on a commonly taken‐for‐granted folk psychology of a representational view of how the mind works and how human beings learn. Descartes' representational view of the mind strongly influences pedagogies, theories of learning, curricula, and approaches to testing nursing knowledge and more broadly in academia. A representational view of the mind holds that perception occurs in the mind only through representations in the mind through ideas, concepts, templates and schema. Situated, embodied, and socially embedded cognition is presented (...) as a counter view to a representational view of the mind. (shrink)

_Employment and Employee Rights_ addresses the issue of rights in the workplace. Although much of the literature in this field focuses on employee rights, this volume considers the issue from the perspective of both employees and employers. Considers the rights of both employees and employers. Discusses the moral and legal landscape and traditional assumptions about right in employment. Investigates arguments for guaranteeing rights, particularly for employees, which are derived from relational, developmental, and economic bases. Explores new dimensions of employment including (...) a model that incorporates growing workplace diversity, builds upon our understanding of the legal landscape, and expands upon our justifications for recognizing and protecting rights. (shrink)

Although the right to health is universal, many nations that honor it fail to do so in the case of non-citizen immigrants. In this essay, we argue that the reasons typically given for not extending the right to health to immigrants are without merit and that there are good reasons for nations to protect, respect and fulfill the health right of all immigrants. Contrary to the standard view, we argue that health can be understood as a global public good. Two (...) important points follow: because health is non-excludable and non-rivalrous, it is in the health interests of nations to respect, protect and fulfill immigrants’ right to health. Furthermore, meeting the health needs of immigrants is an important way for receiving nations to meet the duties that may be generated by the benefits they incur as a result of health’s global public good dimension, thus ensuring that receiving nations are not free riders. We then argue that because citizens and immigrants dwell together, nations have duties of solidarity to immigrants with respect to health. Using the insights of social psychology, we show that solidarity among diverse people is both a reasonable expectation and a morally desirable one. (shrink)

The societal and ethical impacts of emerging technological and business systems cannot entirely be foreseen; therefore, management of these innovations will require at least some ethicists to work closely with researchers. This is particularly critical in the development of new systems because the maximum degrees of freedom for changing technological direction occurs at or just after the point of breakthrough; that is also the point where the long-term implications are hardest to visualize. Recent work on shared expertise in Science & (...) Technology Studies (STS) can help create productive collaborations among scientists, engineers, ethicists and other stakeholders as these new systems are designed and implemented. But collaboration across these disciplines will be successful only if scientists, engineers, and ethicists can communicate meaningfully with each other. The establishment of a trading zone coupled with moral imagination present one method for such collaborative communication. (shrink)