BackgroundExposure to early life stress is alarmingly prevalent and has been linked to the high rates of depression documented in adolescence. Researchers have theorized that ELS may increase adolescents’ vulnerability or reactivity to the effects of subsequent stressors, placing them at higher risk for developing symptoms of depression.MethodsWe tested this formulation in a longitudinal study by assessing levels of stress and depression during the COVID-19 pandemic in a sample of adolescents from the San Francisco Bay Area who had been characterized (...) 3–7 years earlier with respect to exposure to ELS and symptoms of depression.ResultsAs expected, severity of ELS predicted levels of depressive symptoms during the pandemic [r = 0.26, p = 0.006], which were higher in females than in males [t = −3.56, p < 0.001]. Importantly, the association between ELS and depression was mediated by adolescents’ reported levels of stress, even after controlling for demographic variables.ConclusionsThese findings underscore the importance of monitoring the mental health of vulnerable children and adolescents during this pandemic and targeting perceived stress in high-risk youth. (shrink)

Ethical reasoning and decision-making may be thought of as 9professional skills9, and in this sense are as relevant to efficient clinical practice as the biomedical and clinical sciences are to the diagnosis of a patient9s problem. Despite this, however, undergraduate medical programmes in ethics tend to focus on the teaching of bioethical theories, concepts and/or prominent ethical issues such as IVF and euthanasia, rather than the use of such ethics knowledge (theories, principles, concepts, rules) to clinical practice. Not surprisingly, many (...) students and clinicians experience considerable difficulty in using what they know about ethics to help them make competent ethical decisions in their day-to-day clinical practice. This paper describes the development of a seminar programme for teaching senior medical students a more systematic approach to ethical reasoning and analysis and clinical decision-making. (shrink)

Aim To ascertain the quantity and nature of gifts and items provided by the pharmaceutical industry in Australia to medical specialists and to consider whether these are appropriate in terms of justifiable ethical standards, empirical research and views expressed in the literature.

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)

Concerned with criticizing representational theories of knowledge by developing alternative concepts of knowing and communicating, Ian Angus and Lenore Langsdorf bring together eight essays that are united by a common theme: the convergence of philosophy and rhetoric. In the first chapter, Angus and Langsdorf illustrate the centrality of critical reasoning to the nature of questioning itself, arguing that human inquiry has entered a "new situation" where "the convictions and orientations that have traditionally marked the separation of rhetoric and philosophy—the concern (...) for truth and the focus on persuasion—have begun to converge on a new space that can be defined through the central term _discourse._"_ _In these essays, this convergence of rhetoric and philosophy is addressed as it presents itself to a variety of interests that transcend the traditional boundaries of these fields. The two editors, Raymie E. McKerrow, Michael J. Hyde and Craig R. Smith, James W. Hikins and Kenneth S. Zagacki, Calvin O. Schrag and David James Miller, and Richard L. Lanigan map this new space, recognizing that such mapping "simultaneously _constitutes _the territory mapped.". (shrink)

The use of cost-benefit analysis (CBA) in environmental decision-making and the contingent valuation (CV) technique as input into traditional CBA to elicit environmental values in monetary terms has stimulated an extensive debate. Critics have questioned the appropriateness of both the method and the technique. Some alternative suggestions for the elicitation of environmental values are based on a social process of deliberation. However, just like traditional economic theory, these alternative approaches may be questioned on their implicit value judgements regarding the legitimacy (...) of the social-political organisation of the process of value elicitation. Instead of making assumptions a priori, research efforts should be focused on the processes by which actual public attitudes and preferences towards the environment can best be elicited and fed into environmental or other public policy decision-making. In the study presented in this paper, support was found for both the individual WTP based approach and a participatory social deliberation approach to inform the environmental decision-making process, suggesting that a combination of both approaches is most appropriate. (shrink)

This volume contains 17 articles on various aspects of Islamic thought in the Middle East and in Southeast Asia. The first 9 articles concentrate especially on the Qur’ān and its exegesis, Kalām and Sufism; the second 8 articles deal with Javanese Islam, and with Islam and modernity in Southeast Asia.

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Buddhisms and Deconstructions considers the connection between Buddhism and Derridean deconstruction, focusing on the work of Robert Magliola. Fourteen distinguished contributors discuss deconstruction and various Buddhisms—Indian, Tibetan, and Chinese —followed by an afterword in which Magliola responds directly to his critics.

This book describes the adventures in Russia of Samuel Bentham, the brother of the famous law-reformer, Jeremy Bentham. Shipbuilder, technical expert and inventor, his talents were employed for several years in serving the government of Catherine II, involving him in activities both in peace and war, and in extensive travel through the Russian Empire. The Russian court, war against the Turks, commercial enterprise in Siberia, are a few of the themes illuminated by his correspondence which forms the basis for this (...) book. (shrink)

Koriat & Goldsmith propose that the correspondence metaphor captures the essence of everyday memory research. We suggest that correspondence is often not at issue because objective assessments of everyday events are frequently lacking. In these cases, other questions arise, such as how individuals evaluate the validity of memories and the significance they attach to those evaluations.

Current research into the molecular biology of blood‐clotting factors suggests that the basis of inherited bleeding disorders may soon be understood. In addition, the expression of cloned genes for the factors in mammalian cell lines provides the hope of pure factors being available for replacement therapy, uncontaminated with the causative agents for Hepatitis and Acquired Immune Deficiency Syndrome (AIDS), identified in the blood products at present available. The recent findings on the molecular biology of several of the key blood clotting (...) genes are described here. (shrink)

De Neys proposed a “switch” model to address what he argued to be lacuna in dual-process theory, in which he theorized about the processes that initiate and terminate analytic thinking. We will argue that the author neglected to acknowledge the abundant literature on metacognitive functions, specifically, the meta-reasoning framework developed by Ackerman and Thompson (2017), that addresses just those questions.

PurposeIn addition to data transforming the insurance sector from within, insurance consumers and their behaviour has transformed significantly over the past 20 years from traditional retail to, predominantly, online trading. Data are a fundamental part of how the sector operates, and the use of data in insurance is constantly evolving. This paper aims to explore consumer perceptions about digital privacy and their subsequent motivations to disclose personal data for insurance purposes.Design/methodology/approachThe study uses an exploratory research approach based on in-depth interviews (...) to generate metathemes to provide an understanding of consumer perceptions about digital privacy and data sharing in the insurance sector.FindingsConsumers were extrinsically motivated to disclose data by financial reward and convenience; however, subsequent intrinsic motivations may be an influence on the initial motivations. Consumers perceived transactions as “fair” if they received the expected rewards, retained control of the data, and the data was not unilaterally used to their detriment. Concern for privacy was generally low, provided antecedent conditions were met.Research limitations/implicationsAs the study uses an exploration for discovery approach, the main limitation of this study is its small sample. However, this research aimed to identify metathemes and issues that may be the focus of future research in this area and is, therefore, not proposing to suggest strong conclusions and definitive answers.Originality/valueThis paper presents the first empirical research to examine data privacy issues in the UK insurance context. It contributes to knowledge in the areas of motivation, applied ethics and online consumer behaviour in general. (shrink)

Spontaneous mutations that perturb myelination occur in a range of species including man, and together with engineered mutations have been used to study disease, normal myelination and axon/glial inter‐relationships. Only a minority of the currently defined mutations have an apparently simple pathogenesis due to lack of a functional protein. Mutations in the myelin basic protein gene lead to a lack of protein, resulting in changes in the structure of myelin, which can be rescued by transgenic complementation. The pathogenesis of autosomal (...) dominant and X‐linked mutations affecting either oligodendrocytes or Schwann cells is more complex. Point mutations may act in a dominant negative manner and gene dosage is clearly linked to phenotypic change. Mutations in regulatory genes, such as those encoding transcription factors, can also disturb myelination by selected cell types. Other less‐well studied and unexpected consequences of myelin mutations, such as seizures in mutations affecting genes expressed in Schwann cells and axonal changes associated with dysmyelination, are also considered. With the major developments in gene mapping and cloning it is now relevant to study mutations in a variety of species with the real prospect of defining their molecular basis. Examples are given of unusual, but potentially useful, uncharacterised mutations in dog and bovine. (shrink)

There is nothing more humbling to one’s inner moral compass than to realize that you do not initially know what is right or wrong! I found myself in just such a situation after reading the above case. Much has been written, both in the professional literature and the popular media, about the “Ashley Treatment” since Gunther and Diekema published their article in 2006. It is unclear if others in the United States or around the world have, to any significant degree, (...) adopted growth attenuation therapy and/or surgical intervention for children with severe neurological compromise, but the case quoted above suggests that hospital ethics committees may also be struggling with these decisions. An informal survey of pediatric endocrinologists, mentioned in a recent article on the topic, claims that many physicians are facing this dilemma as well. (shrink)

I would like to present the details of an actual case from my own experience over which I, along with the family, have agonized. I think this case brings into focus some of the unique issues in perinatal medicine where multiple patients, some real and some potential, can enter into a single decision. I hope that through this presentation others may gain insight into the complexities of applied ethics in perinatal medicine.