MYC is a transcription factor, which not only directly modulates multiple aspects of transcription and co‐transcriptional processing (e.g. RNA‐Polymerase II initiation, elongation, and mRNA capping), but also indirectly influences several steps of RNA metabolism, including both constitutive and alternative splicing, mRNA stability, and translation efficiency. As MYC is an oncoprotein whose expression is deregulated in multiple human cancers, identifying its critical downstream activities in tumors is of key importance for designing effective therapeutic strategies. With this knowledge and recent technological advances, (...) we now have multiple angles to reach the goal of targeting MYC in tumors, ranging from the direct reduction of MYC levels, to the dampening of selected house‐keeping functions in MYC‐overexpressing cells, to more targeted approaches based on MYC‐induced secondary effects. (shrink)

When participants make judgments about the onset of self-initiated movements they typically report the movement occurred earlier than it had [Obhi, S. S., & Haggard, P. . Free will and free won’t. American Scientific, 92, 358–365.]. One interpretation is that feed-forward processes lead to awareness of the movement prior to execution. Because individuals with autism experience reduced preparatory activity prior to a voluntary movement, the present study sought to determine whether these anticipatory biases are exhibited by persons with autism. Participants (...) watched a dot move in a circle and pressed the spacebar any time after one revolution. A tone either followed the participants’ voluntary movement or was computer generated. Participants in both groups made anticipatory judgements regarding movement initiation . When the movement and tone occurred together this anticipatory bias was also present, regardless of which event participants focused on. Individuals with autism appear to have access to a similar representation of voluntary movements, however this representation may be more variable. (shrink)

Federal guidelines require that informed consent be obtained from participants when they are enrolled in a research study. When conducting research with children, the guidelines utilize the term permission to describe parents' agreement to enroll their children in a study. The basic components of consent and permission are well described and identical, with the exception of the person for whom the decision to participate is being made. Beyond permission, when enrolling minor participants in research, affirmative agreement to participate in research (...) or assent must be obtained from the child participants themselves. The concept of children's assent to research, however, is poorly defined, resulting in inconsistency in its pursuit and, consequently, in its utility. The interface between cognitive development, emotional, and social development must be examined as it pertains to this special situation of decision making. For this process to meaningfully protect minors, the assent process must be clarified, decisions regarding parental veto power must be more convincingly justified, and researchers must be better educated and held accountable for the valid execution of this process. Strategies for implementing the assent process more effectively are presented. (shrink)

ABSTRACT Self-efficacy is the assessment of one’s capacity to perform tasks. Previous research has demonstrated that self-efficacy impacts ethical behavior and attitudes but its effect on ethical cognition and perceptions has not been studied. For the present study, participants analyzed an ethical dilemma after either high or low self-efficacy was induced. Participants analyzed the dilemma using one of two cognitive problem-solving techniques versus a third, control group, and what participants wrote about the problem was content-analyzed to determine how ethical cognition (...) is impacted by self-efficacy. Additionally, perceptions of the ethical problem were examined. Results revealed that differences in self-efficacy did not lead to changes in ethical cognition, but they did lead to changes in perceptions of ethical problems. Implications of these findings are discussed. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policy makers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.Advancing and protecting the public's health depends upon the coordination of actions by many, diverse partners. For effective public health preparedness, there must be effective coordination of legal tools and law-based strategies across local, state, tribal, and federal jurisdictions, and also across sectors such as public health, health care, emergency management, education, law enforcement, community design, and academia. (shrink)

Can the institutional systems that prepare Black nurse researchers question the ways their systemic pathways have impacted health equity knowledge development in nursing? We invite our readers to keep this question in mind and engage with our conversation as Black nurse researchers, scholars, educators, and clinicians. The purpose of our conversation, and this article, is to explore the transactional impact of knowledge development pathways and Black faculty retention pathways on the state of health equity knowledge in nursing today. Over a (...) series of conversations, we discuss the research exploitation of communities of color, deficit research funding, knowledge capitalization, the marginalization of diversity as a continuous process, a lack of sociocultural authority, and our thoughts on solutions. We conclude by using the wisdom of a generation to answer our initial question. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policy makers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.Advancing and protecting the public's health depends upon the coordination of actions by many, diverse partners. For effective public health preparedness, there must be effective coordination of legal tools and law-based strategies across local, state, tribal, and federal jurisdictions, and also across sectors such as public health, health care, emergency management, education, law enforcement, community design, and academia. (shrink)

Professionalism is demonstrated through attitudes and behaviors. Medical education is concerned with teaching and evaluating it among students. It is often bioethicists who teach professionalism to medical students. Most bioethics curricula use lectures and group discussions to introduce principles and theories, but there is variation in number of credit and contact hours, placement in the curriculum and alongside which courses bioethics is placed), the extent of individual mentoring, and the emphasis placed on any particular philosophical approach. Bioethics curricula also vary (...) in whether and how explicitly and extensively they address topics, including professionalism, cultural competence, medical humanities, spirituality, death and dying, and community service, and in the number and topics of vignettes, controversies, assignments, and course activities. (shrink)

Background Despite decades of anti-racism and equity, diversity, and inclusion (EDI) interventions in academic medicine, medical racism continues to harm patients and healthcare providers. We sought to deeply explore experiences and beliefs about medical racism among academic clinicians to understand the drivers of persistent medical racism and to inform intervention design. Methods We interviewed academically-affiliated clinicians with any racial identity from the Departments of Family Medicine, Cardiac Sciences, Emergency Medicine, and Medicine to understand their experiences and perceptions of medical racism. (...) We performed thematic content analysis of semi-structured interview data to understand the barriers and facilitators of ongoing medical racism. Based on participant narratives, we developed a logic framework that demonstrates the necessary steps in the process of addressing racism using if/then logic. This framework was then applied to all narratives and the barriers to addressing medical racism were aligned with each step in the logic framework. Proposed interventions, as suggested by participants or study team members and/or identified in the literature, were matched to these identified barriers to addressing racism. Results Participant narratives of their experiences of medical racism demonstrated multiple barriers to addressing racism, such as a perceived lack of empathy from white colleagues. Few potential facilitators to addressing racism were also identified, including shared language to understand racism. The logic framework suggested that addressing racism requires individuals to understand, recognize, name, and confront medical racism. Conclusions Organizations can use this logic framework to understand their local context and select targeted anti-racism or EDI interventions. Theory-informed approaches to medical racism may be more effective than interventions that do not address local barriers or facilitators for persistent medical racism. (shrink)

This Handbook defines, illustrates, and challenges the field of environmental political theory. Through a broad range of approaches, it shows how scholars have used concepts, methods, and arguments from political theory and closely related disciplines to address contemporary environmental problems. Topics include the relationship of EPT to traditions of political thought; EPT conceptualizations of nature, the environment, community, justice, responsibility, rights, and flourishing; explorations of the structures that constrain or enable the achievement of environmental ends; and analyses of methods for (...) fostering environmental change. (shrink)

Professions typically formulate codes of ethics. Medical students are exposed to various codes and often are expected to recite some.

In 2005, President George Bush read John Barry’s The Great Influenza: The Story of the Deadliest Pandemic in History. After his experiences of 9/11 and Hurricane Katrina, Bush began the first White...

This paper examines a variety of social scientific studies purporting to demonstrate that transracial adoption is in the best interests of children. Finding flaws in these studies and the ethical and political arguments based upon such scientific findings, we argue for adoption practices and policies that respect the racial and ethnic identities of children of color and their communities of origin.

We examine metonymy at psycho- and neurolinguistic levels, seeking to adjudicate between two possible processing implementations. We compare highly conventionalized systematic metonymy to lesser-conventionalized circumstantial metonymy. Whereas these two metonymy types differ in terms of contextual demands, they each reveal a similar dependency between the named and intended conceptual entities. We reason that if each metonymy yields a distinct processing time course and substantially non-overlapping preferential localization pattern, it would not only support a two-mechanism view but would suggest that conventionalization (...) acts as a linguistic categorizer. By contrast, a similar behavior in time course and localization would support a one-mechanism view and the inference that conventionalization acts instead as a modulator of contextual felicitousness, and that differences in interpretation introduced by conventionalization are of degree, not of kind. Results from three paradigms: self-paced reading, event-related potentials, and functional magnetic resonance imaging, reveal the following: no main effect by condition for either metonymy type immediately after the metonymy trigger, and a main effect for only the Circumstantial metonymy one word post-trigger ; a N400 effect across metonymy types and a late positivity for Circumstantial metonymy ; and a highly overlapping activation connecting the left ventrolateral prefrontal cortex and the left dorsolateral prefrontal cortex. Altogether, the pattern observed does not reach the threshold required to justify a two-mechanism system. Instead, the pattern is more naturally understood as resulting from the implementation of a generalized referential dependency mechanism, modulated by degree of context dependence/conventionalization, thus supporting architectures of language whereby “lexical” and “pragmatic” meaning relations are encoded along a cline of contextual underspecification. (shrink)

Much of the recent AI-LLM literature has been apocalyptic in pointing out the risks of AI technology, “mitigating the risk of extinction from AI should be a global priority alongside other societal...

Presents a plethora of approaches to developing human potential in areas not conventionally addressed. Organized in two parts, this international collection of essays provides viable educational alternatives to those currently holding sway in an era of high-stakes accountability.

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing p...

In Greek mythology, the Chimera is a fire-breathing monster with three heads: one of a lion, one of a horned goat, and one of a powerful dragon. Of similar construction is the presence of three structures in US society, whiteness, patriarchy, and capitalism, which are overwhelmingly represented, valued, and espoused when examining areas of progress, i.e., family income, poverty rates, high school and college graduation rates, and home ownership. This modern American three-headed beast controls, manipulates, and permeates all aspects of (...) US society irrespective of class, culture, or gender. Using critical race theory and critical whiteness studies, this critically interpretive parable draws from the ways in which whiteness, patriarchy, and capitalism function in social, cultural, economic, and educational spheres. The parable tells the story of Sue Libertad and analyzes how this metaphorical Chimera, despite its ubiquity, silently permeates all aspects of her life. Not until a tragic outbreak occurs, does the hegemony of this chimera erodes and Sue. (shrink)

Epigenetic research has brought several important technological achievements, including identifying epigenetic clocks and signatures, and developing epigenetic editing. The potential military applications of such technologies we discuss are stratifying soldiers’ health, exposure to trauma using epigenetic testing, information about biological clocks, confirming child soldiers’ minor status using epigenetic clocks, and inducing epigenetic modifications in soldiers. These uses could become a reality. This article presents a comprehensive literature review, and analysis by interdisciplinary experts of the scientific, legal, ethical, and societal issues (...) surrounding epigenetics and the military. Notwithstanding the potential benefit from these applications, our findings indicate that the current lack of scientific validation for epigenetic technologies suggests a careful scientific review and the establishment of a robust governance framework before consideration for use in the military. In this article, we highlight general concerns about the application of epigenetic technologies in the military context, especially discrimination and data privacy issues if soldiers are used as research subjects. We also highlight the potential of epigenetic clocks to support child soldiers’ rights and ethical questions about using epigenetic engineering for soldiers’ enhancement and conclude with considerations for an ethical framework for epigenetic applications in the military, defense, and security contexts. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

Broadening participation in early science, technology, engineering and math learning outside of school is important for families experiencing poverty. We evaluated variations of the Teaching Together STEM pre-kindergarten program for increasing parent involvement in STEM learning. This informal STEM, family engagement program was offered in 20 schools where 92% of students received free/reduced lunch. The core treatment included a series of family education workshops, text messages, and family museum passes. The workshops were delivered at school sites by museum outreach educators. (...) We randomly assigned schools to business-as-usual control or one of three additive treatment groups. Using an additive treatment design, we provided the core program in Treatment A, we added take-home STEM materials in Treatment B, and added materials + parent monetary rewards in Treatment C. The primary outcome was parent involvement in STEM. There were no significant impacts of any treatment on parent involvement; however, the groups that added take-home materials had larger effect sizes on parent involvement at posttest and later, kindergarten follow-up. Adding parent monetary rewards only produced short-term improvements in parent involvement that faded at follow-up. We discuss implications for other community-sponsored family engagement programs focused on informal STEM learning, including considering characteristics of families who were more versus less likely to attend. These null findings suggest that alternatives to in-person family education workshops should be considered when parents are experiencing poverty and have competing demands on their time. (shrink)

Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)

Background Nurses experienced intense ethical and moral challenges during the COVID-19 pandemic. Our 2020 qualitative parent study of frontline nurses’ experiences during the COVID-19 pandemic identified ethics as a cross-cutting theme with six subthemes: moral dilemmas, moral uncertainty, moral distress, moral injury, moral outrage, and moral courage. We re-analyzed ethics-related findings in light of refined definitions of ethics concepts. Research aim To analyze frontline U.S. nurses’ experiences of ethics during the COVID-19 pandemic. Research design Qualitative analysis using a directed content (...) methodology. Participants and research context The study included 43 nurses from three major metropolitan academic medical centers and one community hospital in the northeastern, mid-Atlantic, midwestern, and western United States. Ethical considerations Participant privacy and data confidentiality were addressed. Findings Moral dilemmas arose from many situations, most frequently related to balancing safety and patient care. Moral uncertainty commonly arose from lacking health information or evidence about options. Moral distress occurred when nurses knew the right thing to do, but were prevented from doing so, including with end-of-life issues. Moral injury (accompanied by suffering, shame, or guilt) occurred after doing, seeing, or experiencing wrongdoing, often involving authority figures. Nurses expressed moral outrage at events and people within and outside healthcare. Despite difficult ethical situations, some nurses exemplified moral courage, sometimes by resisting policies they perceived as preventing compassionate care, guided by thinking about what was best for patients. Discussion This content analysis of ethics-related subthemes revealed conceptual characteristics and clarified distinctions with corresponding exemplars. Conceptual clarity may inform responses and interventions to address ethical quandaries in nursing practice. Conclusions Ethics education in nursing must address the moral dilemmas of pandemics, disasters, and other crises. Nurses need time and resources to heal from trying to provide the best care when no ideal option was available. (shrink)

This collection of papers by prominent feminist thinkers advances the positive feminist project of remapping the moral by developing theory that acknowledges the diversity of women.

_341_ _Objectives: _In patients with multivessel disease both the detection of the culprit lesion and the exact allocation are important preconditions for sufficient treatment and improved outcome. In a vessel based approach the combination of quantitative coronary angiography and fractional flow reserve measured by a pressure wire should be advantageous compared to myocardial SPECT, as morphological and functional information is delivered simultaneously. Therefore our aim was to evaluate MS in the detection and allocation of hemodynamically significant stenoses obtained by the (...) combined gold standard QCA plus FFR in patients with multivessel disease. _Methods: _FFR and QCA of 95 vessels in 80 patients have been evaluated. Hemodynamically significant target lesions were defined as intermediate stenoses between 50 and 75% with an FFR. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Roadmap Needed:How to Help Parents Navigate the Worst Day of Their LivesCheryl KilpatrickOn January 14, 2010, our 3–year–old daughter, Maggie, was rushed to an emergency room at a satellite medical center. I am an occupational therapist and was actually scheduled to work at a hospital that day. I was wearing my purple scrubs. Maggie had been showing “strange” symptoms all week that I thought might be a sign that (...) she was getting a cold or the flu. She had been extremely tired, having morning headaches and ataxia (balance problems). When I dropped Maggie off at preschool the morning of January 14, 2010 she began to have trouble using her left arm. The teacher noticed that her smile was crooked. I did a quick neurological assessment and saw that her [End Page E9] left arm was much weaker than her right arm. I thought to myself, “My kid looks as if she is having a stroke. But she is only 3–years–old. This doesn’t make any sense.” The teacher gave me a look as if to say, “Are you going to take Maggie to the hospital or am I going to have to do it?” I just stood there. I suppose I was in the first stages of shock. I turned to the teacher and said, “We are going to the hospital.”As we walked toward the ER admissions desk I was surprised to see that we were the only people in the waiting area. It didn’t take long before we were called into the examination room. The ER doctor did a neurological assessment on Maggie like I had done only 30 minutes earlier and said that a CAT scan was needed. He thought that we would most likely be transferred to a local children’s hospital. The CAT scan revealed that Maggie had a large mass in her thalamus. I just looked at the ER doctor and said, “Just tell me what I need to do and I will do it.” No tears, no screams, no emotion. I just went into “mommy mode” and made sure that my child felt safe every step of the way. My husband was on his way home from a business trip when I called to tell him the news. He had no idea what he would find when he finally got to us.As expected, we were transported by ambulance to the local children’s hospital. I remember sitting in the front seat with the driver and feeling like this was all a dream. It was all very surreal. Maggie calmly chatted with the EMS personnel in the back of the ambulance as if nothing was happening. I had no idea how our lives would change once we reached the hospital. This ride to the hospital began our journey into uncharted territory. Nothing in my life had prepared me for what was about to happen.We arrived at the children’s hospital around 11:00 a.m. As we walked into ER department, I could feel the eyes of the ER staff following us. I turned to look at them and they smiled. The look on their faces told me that something was very wrong with my daughter. I felt like we were a sideshow at the carnival. I hated those looks. I didn’t want their smiles. I wanted to know what was happening. I wanted information.My husband arrived about an hour after our arrival. He walked into the room and found his little girl looking very spacey and unable to walk to him without falling. When Maggie and I stepped out into the hallway to find the restroom, I turned to look back into the room and saw my husband with his face in his hands. He was crying. I was not. I was still in “mommy mode” or just plain shock. I knew that my daughter was not well. But then again, neither was I. I was not crying. I was not screaming. I was numb. What I needed was someone to take my “emotional pulse.”We waited patiently in that small room watching the hours pass by as each doctor came... (shrink)

Throughout the Old Testament, the stories, laws, and songs not only teach a way of life that requires individuals to be moral, but they demonstrate how. In biblical studies, character ethics has been one of the fastest-growing areas of interest. Whereas ethics usually studies rules of behavior, character ethics focuses on how people are formed to be moral agents in the world. This book presents the most up-to-date academic work in Old Testament character ethics, covering topics throughout the Torah, the (...) Prophets, and the Writings, in addition to the use of the Bible in the modern world. In addition to Carroll and Lapsley, contributors are Denise M. Ackermann, Cheryl B. Anderson, Samuel E. Balentine, William P. Brown, Walter Brueggemann, Thomas B. Dozeman, Bob Ekblad, Jose Rafael Escobar R., Theodore Hiebert, Kathleen O'Connor, Dennis T. Olson, J. David Pleins, Luis R. Rivera Rodriguez, J. J. M. Roberts, and Daniel L. Smith-Christopher. (shrink)

It has long been known that there exists a relationship between British analytic philosophy and American pragmatism.1 Recently, however, Cheryl Misak gave this story a new twist. Her 2016 book Camb...

This case describes an adolescent in a crisis of a chronic medical condition whose situation is complicated by substance abuse and mental illness. D. Micah Hester provides an analytic approach, teasing apart the multiple layers of medical, developmental, and moral issues at hand and describing possible responses and outcomes. Amy T. Campbell examines existing legal guidelines for adolescent decision making, arguing that greater space exists for clinical discretion in these matters than commonly thought. Cheryl D. Lew discusses the development (...) of agency in adolescent patients, the ideal of autonomous decision making in the context of impairment and chronic illness, and the obligation of healthcare teams to examine an adolescent patient’s decisions in relation to her identity. (shrink)

The Bible has influenced contemporary culture both positively and negatively. The present volume is a collection of papers that were discussed at an international colloquium on the use of the Bible in Ethics in the Department of Biblical Studies at the University of Sheffield in April 1995. Participants came from many parts of the world and from different backgrounds, and the papers reflect their varied interests and the contexts in which they work. The contributors, in addition to the three editors, (...) are John Barton, Bruce Birch, Mark Brett, Mark Chapman, David Clines, Philip Davies, Cheryl Exum, Stephen Fowl, Norman Gottwald, John Haldane, Walter Houston, Sharon Ringe, Chrisopher Rowland, Lisa Sowle Cahill and Gerald West. (shrink)