Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria, there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, (...) the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients. (shrink)

Somites are transient structures which represent the most overt segmental feature of the vertebrate embryo. The strict temporal regulation of somitogenesis is of critical developmental importance since many segmental structures adopt a periodicity based on that of the somites. Until recently, the mechanisms underlying the periodicity of somitogenesis were largely unknown. Based on the oscillations of c-hairy1 and lunatic fringe RNA, we now have evidence for an intrinsic segmentation clock in presomitic cells. Translation of this temporal periodicity into a spatial (...) periodicity, through somite formation, requires Notch signaling. While the Hox genes are certainly involved, it remains unknown how the metameric vertebrate axis becomes regionalized along the antero–posterior (AP) dimension into the occipital, cervical, thoracic, lumbar, and sacral domains. We discuss the implications of cell division as a clock mechanism underlying the regionalization of somites and their derivatives along the AP axis. Possible links between the segmentation clock and axial regionalization are also discussed. (shrink)

Chow's monograph exhibits four prototypical symptoms of psychology's enduring scientific crisis: it equates empirical science with statistical analysis; it settles for qualitative rather than quantitative theories; it ignores the role of ecological validity in the generalizability of theories; and it puts rigid adherence to arbitrary but documentable rules over critical thinking about the meaning of results.

: This article describes a psychological test of Hull's (1988) theory of science as an evolutionary process by seeing if it can account for how scientists sometimes remember and cite the scientific literature. The conceptual adequacy of Hull's theory was evaluated by comparing it to Bartlett's (1932) seminal theory of human remembering. Bartlett found that remembering is an active, reconstructive process driven by a schema that biases recall in the direction of proto- typicality and personal involvement. This account supports Hull's (...) theory of science because it shows that the characteristics of reconstructive remembering are consistent with the generic properties of an evolutionary process. The empirical adequacy of Hull's theory was evaluated by comparing the predictions made from this evolutionary viewpoint against evidence from the history of science. Six cases studies of well-known psychological experiments that had been subject to repeated miscitation errors were collected and reviewed. All six case studies revealed a systematic pattern of distortions that is consistent with the schema-induced biases of reconstructive remembering. These findings support Hull's claim that science is an evolutionary process with scientists as interactors, scientific beliefs as replicators, and schemata as means for that replication. (shrink)

Abstract(1) The miscitations of seminal experiments in the base rate literature adds to the existing database of systematic miscitations of wellknown psychological experiments. These miscitations may be caused by a process of reconstructive remembering. (2) Representative design should be the methodological core of Koehler's call for ecologically valid research. This approach can benefit both basic and applied research.

This study investigated the perceptions and attitudes of ICU nurses towards the ‘do not resuscitate’ (DNR) decision and changes in their nursing activities after implementation of the DNR decision in South Korea. A data survey was conducted in South Korea between August and October 2008, with a convenience sample of 252 ICU nurses who had more than one year of clinical experience. The data were collected via a self-administered questionnaire. Most of the nurses perceived the necessity of the DNR decision (...) in cases where there would be no chance of patient recovery despite massive efforts. Very few of the nurses' activities changed, either passively or actively, after implementation of the DNR decision. Moreover, the findings of this research provide suggestions for the future direction of the DNR decision and ethical nursing guidelines in South Korea. Further investigations are needed for the development of decision-making skills and intervention guidelines for end-of-life nursing. (shrink)

Im Jahre 1998 verblüfften Andy Clark und David Chalmers die philosophische Gemeinschaft mit der so genannten These des erweiterten Geistes, die im Kern besagt, dass kognitive Systeme nicht-biologische Komponenten enthalten können und sich damit über die Grenzen biologischer Organismen hinaus erstrecken können. Die These wird seitdem nicht nur von Philosophen, sondern auch von Kognitions- und Neurowissenschaftlern intensiv und kontrovers diskutiert. In den Beiträgen, die in dem vorliegenden ersten deutschsprachigen Band zur These des erweiterten Geistes versammelt sind, werden u.a. die folgenden (...) Fragen behandelt: Was soll es heißen, dass der Geist nicht (nur) im Kopf ist? In welchem Sinne könnte er erweitert sein, und welche Möglichkeiten der Erweiterung gibt es? Welche Zusammenhänge bestehen zwischen Geist und Kognition sowie zwischen Kopplung und Konstitution? Was genau besagt der von Clark und Chalmers vorgebrachte aktive Externalismus? Welche Bedeutung hat die These des erweiterten Geistes für repräsentationalistische und für funktionalistische Theorien des Geistes sowie für Theorien kollektiver Intentionalität und sozialer Kognition? Welche Anwendungen der These könnte es geben? (shrink)

Anthony Giddens’ theory of structuration is a theory of social action, which claims that society should be understood in terms of action and structure; a duality rather than two separate entities. This paper introduces some of the central characteristics of structuration theory, presenting a conceptual framework that helps to explore how people produce the systems and structures that shape their practice. By understanding how people produce and reproduce structures, then there is the potential for changing them. Criticisms that have been (...) raised about the theory are introduced, followed by examples of how the theory might be useful to nursing research. Structuration theory can be employed to explore how nurses produce, reproduce, and transform nursing practice through social interaction across time and space. (shrink)

Postural reflexes are essential for locomotion and postural stability, and may play an important role in the etiology of chronic back pain. It has recently been theoretically predicted, and with the help of unilateral perturbations of the trunk experimentally confirmed that the sensorimotor control must lower the reflex amplitude for increasing reflex delays to maintain spinal stability. The underlying neuromuscular mechanism for the compensation of postural perturbations, however, is not yet fully understood. In this study, we applied unilateral and bilateral (...) sudden external perturbations to the trunk of healthy subjects and measured the muscular activity and the movement onset of the trunk. We found that the onset of the trunk muscle activity is prior to, or coincident with, the onset of the trunk movement. Additionally, the results of our experiments imply that the muscular response mechanism integrates distant sensory information from both sides of the body. These findings rule out a simple monosynaptic stretch reflex in favor of a more complex polysynaptic postural reflex mechanism to compensate postural perturbations. Moreover, the previously predicted negative correlation between reflex delay and reflex gain was also confirmed for bilateral perturbations. (shrink)

The language $L_A(\Finv)$ is formed by adding the quantifier $\Finv x$ , "few x", to the infinitary logic L A on an admissible set A. A complete axiomatization is obtained for models whose universe is the set of ordinals of A and where $\Finv x$ is interpreted as there exist A-finitely many x. For well-behaved A, every consistent sentence has a model with an A-recursive diagram. A principal tool is forcing for $L_A(\Finv)$.

The language $L_A$ is formed by adding the quantifier $\Finv x$ , "few x", to the infinitary logic L A on an admissible set A. A complete axiomatization is obtained for models whose universe is the set of ordinals of A and where $\Finv x$ is interpreted as there exist A-finitely many x. For well-behaved A, every consistent sentence has a model with an A-recursive diagram. A principal tool is forcing for $L_A$.

Fowers et al. recently made a general argument for virtues as the characteristics necessary for individuals to flourish, given inherent human limitations. For example, people can flourish by developing the virtue of friendship as they navigate the inherent human dependency on others. This general argument also illuminates a pathway to flourishing during the COVID-19 pandemic, the risks of which have induced powerful fears, exacerbated injustices, and rendered life and death decisions far more common. Contexts of risk and fear call for (...) the virtue of courage. Courage has emerged more powerfully as a central virtue among medical personnel, first responders, and essential workers. Longstanding inequalities have been highlighted during the pandemic, calling for the virtue of justice. When important personal and public health decisions must be made, the central virtue of practical wisdom comes to the fore. Wise decisions and actions incorporate the recognition of relevant moral concerns and aims, as well as responding in fitting and practical ways to the specifics of the situation. Practicing courage, justice, and practical wisdom illuminates a path to flourishing, even in a pandemic. (shrink)

In this study, we elaborate connections among gender, structure, and practice to suggest how social structural relations shape social sexual practice and, in the process, reshape gender relations. Using survey data from a study of a community mobilization intervention, we investigate the connection between institutional arrangements and condom use practice in sexual encounters with commercial clients and intimate partners among 410 women engaged in sex trade in a semiurban town in southern India. Multinomial logistic regression analysis uncovers the effects of (...) 16 measures of gendered structural relations in three contexts—livelihood resources, household circumstances, and community mobilization intervention priorities. We compare women who practice either consistent or inconsistent condom use with both clients and partners with a reference group of women who practice consistent condom use with clients but not with partners. Results reveal the importance of household and community relations for consistent safer sex practice over and above the organization of sex trade. Our analysis advances gender theory in two interrelated ways: We contribute to gender theorizing in the implementation of health interventions, and to gender change more generally by thinking through possibilities emerging from recursive influences between reordered institutional configurations and altered expectations in interaction. (shrink)