The existence of free will has been both an enduring presumption of Western culture and a subject for debate across disciplines for millennia. However, little empirical evidence exists to support the almost unquestioned assumption that, in general, Westerners endorse the existence of free will. The few studies that measure belief in free will have methodological problems that likely resulted in underestimating the true extent of belief. Recently, Rakos et al. (Behavior and Social Issues 17:20–39, 2008 ) found a stronger endorsement (...) of free will when demand characteristics were eliminated. The current study builds on this work by sampling incarcerated adolescents and adults, whose freedom to act is externally constrained. Belief in free will as well as attitudes toward punishment, self-esteem, and locus of control were measured. The results indicate that free will is strongly endorsed in Western society even when freedom to act is severely restricted. However, incarcerated adolescents endorsed free will to a slightly lesser extent than their nonincarcerated counterparts from Rakos et al. (Behavior and Social Issues 17:20–39, 2008 ), while incarcerated and nonincarcerated adults offered equally strong endorsements. The comparable endorsement by adults is consistent with the hypothesis that the belief in agency is an evolutionary adaptation. The small decrease found for incarcerated adolescents may reflect the interaction between developmental factors and the expression of an evolutionary adaptation. Additionally, incarcerated adolescents and adults associated beliefs in free will with viewing punishment as a means of deterrence, rehabilitation, and retribution. Incarcerated adults, but not incarcerated adolescents, associated beliefs in free will with greater self-esteem and with an external locus of control. Finally, though both incarcerated adults and adolescents endorsed free will strongly, the former manifested the belief by emphasizing free agentic choice whereas the latter focused on the personal responsibility that is interwoven with free choice. The implications of these findings are discussed in the context of evolutionary, cultural, and developmental factors. (shrink)

BackgroundHigh levels of moral distress in nursing professionals, of which oncology nurses are particularly prone, can negatively impact patient care, job satisfaction, and retention.Aim“Positive Attitudes Striving to Rejuvenate You: PASTRY” was developed at a tertiary cancer center to reduce the burden of moral distress among oncology nurses.Research DesignA Quality Improvement (QI) initiative was conducted using a pre- and post-intervention design, to launch PASTRY and measure its impact on moral distress of the nursing unit, using Hamric’s Moral Distress Scale–Revised (MDS-R.) This (...) program consisted of monthly 60-minute sessions allowing nurses to address morally distressing events and themes, such as clinicians giving “false hope” to patients or families. The PASTRY program sessions were led by certified clinicians utilizing strategies of discussion and mind-body practices.ParticipantsClinical nurses working on an adult leukemia/lymphoma unit.Ethical considerationsThis was a QI initiative, participation was voluntary, MDS-R responses were collected anonymously, and the institution’s Ethics Committee oversaw PASTRY’s implementation.FindingsWhile improvement in moral distress findings were not statistically significant, the qualitative and quantitative findings demonstrated consistent themes. The PASTRY program received strong support from nurses and institutional leaders, lowered the nursing unit’s moral distress, led to enhanced camaraderie, and improved nurses’ coping skills.DiscussionMeasurement of moral distress is innately challenging due to its complexity. This study reinforces oncology nurses have measurable moral distress. Interventions should be implemented for a safe and healing environment to explore morally distressing clinical experiences. Poor communication among multidisciplinary team members is associated with moral distress among nurses. Programs like PASTRY may empower nurses to build support networks for change within themselves and institutions.ConclusionThis QI initiative shows further research on moral distress reduction should be conducted to verify findings for statistical significance and so that institutional programs, like PASTRY, can be created. (shrink)

This chapter contains sections titled: Story Song Prayer.

Disordered sleep is strongly linked to future depression, but the reasons for this link are not well understood. This study tested one possibility – that poorer sleep impairs emotion regulation, which over time leads to increased depressive symptoms. Our sample contained individuals with a wide range of depression symptoms, who were followed clinically over six months and reassessed for changes in depressive symptom levels. As predicted, maladaptive ER mediated both cross-sectional and prospective relationships between poor sleep quality and depression symptoms. (...) In contrast, an alternative mediator, physical activity levels, did not mediate the link between sleep quality and depression symptoms. Maladaptive ER may help explain why sleep difficulties contribute to depression symptoms; implications for interventions are discussed. (shrink)

A collection of original comics engaging fundamental issues in medical ethics, including patient autonomy, informed consent, unconscious bias, mandated reporting of suspected abuse, confidentiality, medical mistakes, surrogate decision-making, and futility.

This essay explores key concerns surrounding “coming out” as a person with illness and addresses important professional and social considerations for those who are closeted in various kinds of illness. Using central tenets of Queer Theory and Disability and Cultural Studies as a theoretical base, I examine the politics of coming out in the specific context of my lived experience during the 2002 NEH Summer Institute, “Medicine, Literature, and Culture” While such an environment might foster unusual candor about personal illness (...) experience, I discovered that the choice to come out as a person with chronic, non-infectious disease (Inflammatory Bowel Disease) was nevertheless complicated in interesting ways. (shrink)

This review summarizes the empirical ethical decision-making (EDM) research in business published between 2012 and 2022. Utilizing Rest's (Moral development: advances in research and theory, Praeger, New York, 1986) four-step model for EDM and Jones' (Acad Manag Rev, 16(2): 366-395, 1991) theory of moral intensity, 85 articles, resulting in 388 findings, were analyzed. Empirical findings in awareness, intent, judgment, and behavior were categorized by their application to individual and organizational factors resulting in the application of 624 and 62 factors, respectively. (...) A maturing of the research environment is seen through the need for grouping individual factors into themes, essentially forming new connections within EDM research. This article prioritizes new factors and themes, such as bad behaviors, customers and selling, fantasy and imagination, and negative experiences. Additionally, new research in reoccurring themes such as demographics, feelings, personality, and power have elements that were seen in prior reviews but are more nuanced in the current. Furthermore, this quinary review discusses the evolution of EDM research highlighting the relationships studied and modifiers and mediators used. These themes help shape the landscape of EDM research by illustrating the intersectionality of variables. This article advances the understanding of how these foundational models are being nuanced to understand more deeply the EDM process. A call for future research incorporating intersectionality, the continued pursuit of complex relationships, longitudinal research, and major societal and organizational movements is included. Research into the effects of underrepresented demographics such as gender identity, veteran status, and ability is suggested. Furthermore, we question whether Rest (1986) and Jones' (1991) models are inherently Western and if comparing outcomes with a decolonialized research method might give insight into EDM. We present this latest 10-year collection of EDM empirical research based on Rest (1986) and Jones (1991) as a tool for new and future scholars to utilize in their research endeavors. (shrink)

BackgroundResearchers are working to identify dynamic factors involved in the shift from behavioral initiation to maintenance—factors which may depend on behavioral complexity. We test hypotheses regarding changes in factors involved in behavioral initiation and maintenance and their relationships to behavioral frequency over time, for a simple vs. complex behavior.MethodsData are secondary analyses from a larger RCT, in which young adult women, new to both behaviors, were randomly assigned to take daily calcium or to go for a daily, brisk walk, for (...) 4-weeks. Factors were measured weekly. Multi-level modeling evaluated their change over time. Bivariate correlations and multiple regression determined the relationships between factors and the subsequent-week behavioral frequency.FindingResults were partly in-line with expectations, in that individuals’ intentions and self-efficacy predicted initial behavioral engagement for both behaviors, and habit strength increased for both behaviors, becoming a significant predictor of behavioral frequency in later weeks of the study in some analyses. However, results depended on whether the outcome was self-reported or objectively measured and whether analyses were bivariate or multivariate.DiscussionThe factors theorized to play a role in behavioral maintenance started to develop, but only habit strength predicted behavioral frequency by study-end, for both behaviors. Differences in initiation and maintenance between behaviors of differing complexity may not be as stark as theorized, but longer follow-up times are required to evaluate maintenance factors. (shrink)

IntroductionLifestyle modifications are part of comprehensive treatment plans to help manage the symptoms of pre-existing chronic conditions. However, behavior change is notoriously difficult as patients often lack the necessary support. The present manuscript outlines the development of a Green Health Prescription pathway that was designed to link patients with appropriate lifestyle interventions and to support attendance. Strengths, Weaknesses, Opportunities, and Threats analysis was undertaken in three focus groups to highlight areas of strength and weakness within the proposed pathway prior to (...) delivery. The SWOT analyses revealed that the pathway was supported by all three focus groups. Weaknesses and threats were identified including sustainability of nature-based interventions in terms of funding, the need to connect patients with appropriate interventions based on their physical and mental health needs, and the requirement to have a “one-stop shop” for information to ensure that the pathway was accessible for all service-users and healthcare professionals. Results were addressed and considered throughout the development of the pathway.DiscussionThe Green Health Prescription pathway was launched in 2019 and gave patients the ability to receive a prescription from a healthcare professional, community service, or to self-refer. The pathway allows patients to contact a consultant, via a telephone service, who is trained to match them with a programme that the patient believes will be enjoyable and that fits their treatment needs. Data collection to assess the efficacy of the pathway is ongoing. (shrink)

Development and targeting efforts by academic organizations to effectively promote research integrity can be enhanced if they are able to collect reliable data to benchmark baseline conditions, to assess areas needing improvement, and to subsequently assess the impact of specific initiatives. To date, no standardized and validated tool has existed to serve this need. A web- and mail-based survey was administered in the second half of 2009 to 2,837 randomly selected biomedical and social science faculty and postdoctoral fellows at 40 (...) academic health centers in top-tier research universities in the United States. Measures included the Survey of Organizational Research Climate (SORC) as well as measures of perceptions of organizational justice. Exploratory and confirmatory factor analyses yielded seven subscales of organizational research climate, all of which demonstrated acceptable internal consistency (Cronbach’s α ranging from 0.81 to 0.87) and adequate test–retest reliability (Pearson r ranging from 0.72 to 0.83). A broad range of correlations between the seven subscales and five measures of organizational justice (unadjusted regression coefficients ranging from 0.13 to 0.95) document both construct and discriminant validity of the instrument. The SORC demonstrates good internal (alpha) and external reliability (test–retest) as well as both construct and discriminant validity. (shrink)

This article presents data from the Growing up with Media study related to the implementation of a risk reduction protocol that resulted in three groups of youth: low-risk youth (no flags), youth flagged because of violence involvement and not clinically referred; and flagged youth who were referred to a team clinician due to additional risk considerations. Data are from 3,979 US youth 14–15 years of age recruited through social media between October 2018-August 2019. Four in ten youth were flagged for (...) review. Findings suggest that this methodology of identifying and reviewing cases appears to be working as intended: Not only did referred youth have more flags than non-referred youth, but post-hoc analyses suggested that these youth also had higher rates of psychosocial problems (e.g., non-victimization adversity, substance use, and depressed mood). The implementation of a risk reduction protocol such as the one described in this article adds a layer of human subject protection beyond the more standard list of websites and hotlines provided to all participants in most studies. This protocol leads the way for future studies to recreate a similar process to address concerning responses collected from survey research. (shrink)

As clinical trials end, little is understood about how participants exiting from clinical trials approach decisions related to the removal or post-trial use of investigational brain implants, such as deep brain stimulation (DBS) devices. This empirical bioethics study examines how research participants experience the process of exit from research at the end of clinical trials of implanted neural devices. Using a modified grounded theory study design, we conducted semi-structured, in-depth interviews with 16 former research participants from clinical trials of DBS (...) and responsive neurostimulation (RNS). Open-ended questions elicited motivations for joining the trial, understanding of study procedures at the time of initial informed consent, the process of exiting from research, and decisions about device removal or post-trial device use. Thematic analysis identified categories related to: limited preparedness for the end of research participation, straightforwardness of decisions to explant or keep the device, reconciling with the end of research participation, reconciling post-trial expectations, and achieving a sense of closure after exit from research. A preliminary theoretical model describes contextual factors influencing the process and experience of exit from research. Experiences of clinical trial participants should guide research practices to enhance the ethical design and conduct of clinical trials in DBS and other brain devices. (shrink)

Bacterial populations are heterogeneous, which in many cases can provide a selective advantage during changes in environmental conditions. In some instances, heterogeneity exists at the genetic level, in which significant allelic variation occurs within a population seeded by a single cell. In other cases, heterogeneity exists due to phenotypic differences within a clonal, genetically identical population. A variety of mechanisms can drive this latter strategy. Stochastic fluctuations can drive differential gene expression, but heterogeneity in gene expression can also be driven (...) by environmental changes sensed by individual cells residing in distinct locales. Utilizing multiple single cell approaches, workers have started to uncover the extent of heterogeneity within bacterial populations. This review will first describe several examples of phenotypic and genetic heterogeneity, and then discuss many single cell approaches that have recently been applied to define heterogeneity within bacterial populations. (shrink)

In summaries of “best practices” for pedagogy, one typically encounters enthusiastic advocacy for metacognition. Some researchers assert that the body of evidence supplied by decades of education studies indicates a clear pedagogical imperative: that if one wants their students to learn well, one must implement teaching practices that cultivate students’ metacognitive skills. -/- In this dissertation, I counter that education research does not impose such a mandate upon instructors. We lack sufficient and reliable evidence from studies that use the appropriate (...) research design to validate the efficacy of metacognitive skill-building interventions (not just evaluate their relationship to learning outcomes). I argue that improved academic outcomes following these interventions aren’t necessarily mediated by increased metacognitive skills; rather, enhanced student performance can be accounted for by other factors that accompany metacognitive training, particularly the explicit provision of domain-specific knowledge. -/- On the way to this conclusion, I elaborate some complications and controversies surrounding “metacognition.” This is a sprawling and nebulous construct, which makes generalizations about its pedagogical value dubious from the outset. Moreover, it is unclear the extent to which the end goal of metacognitive skill-building (cognitive self-mastery, involving knowledge of and control over our own minds) is even possible, given our mental architecture; some cognitive scientists allege that we are subject to phenomenological illusions which make this seem more achievable than it actually is. -/- I also attempt to provide an account of how metacognitive skill-building could receive glowing endorsements from educators and education researchers, even though its conceptual and empirical underpinnings are flimsy. The error theory I offer identifies two major factors that may foster belief in the efficacy of metacognitive training: goalpost-shifting around the objective of such efforts, and motivated reasoning in defense of the desirable conclusion that educators can significantly reshape students’ minds and unlock their intellectual potential through simple pedagogical interventions. (shrink)

We explored the frequency with which typical adults make Theory of Mind attributions, and under what circumstances these attributions occur. We used an experience sampling method to query 30 typical adults about their everyday thoughts. Participants carried a Personal Data Assistant that prompted them to categorize their thoughts as Action, Mental State, or Miscellaneous at approximately 30 pseudo-random times during a continuous 10-h period. Additionally, participants noted the direction of their thought and degree of socializing at the time of inquiry. (...) We were interested in the relative frequency of ToM and how prominent they were in immediate social exchanges. Analyses of multiple choice answers suggest that typical adults: spend more time thinking about actions than mental states and miscellaneous things, exhibit a higher degree of own- versus other-directed thought when alone, and make mental state attributions more frequently when not interacting than while interacting with others . A significant 3-way interaction between thought type, direction of thought, and socializing emerged because action but not mental state thoughts about others occurred more frequently when participants were interacting with people versus when alone; whereas there was an increase in the frequency of both action and mental state attributions about the self when participants were alone as opposed to socializing. A secondary analysis of coded free text responses supports findings 1–3. The results of this study help to create a more naturalistic picture of ToM use in everyday life and the method shows promise for future study of typical and atypical thought processes. (shrink)

A review of the stakeholder literature reveals that the concept of "normative core" can be applied in three main ways: philosophical justification of stakeholder theory, theoretical governing principles of a firm, and managerial beliefs/values influencing the underlying narrative of business. When considering the case of Wall Street, we argue that the managerial application of normative core reveals the imbedded nature of the fact/value dichotomy. Problems arise when the work of the fact/value dichotomy contributes to a closed-core institution. We make the (...) distinction between open- and closed-core institutions to show how in the case of the closed-core, ethical decision-making is viewed by the institution as a separate domain from the core business of the institution. The resulting blind spot stifles meaningful exchanges with stakeholders attempting to address the need for reform. We suggest in conclusion that ethical considerations are less about casting a value judgment and more about creating a process for meaningful conversation throughout an institution and its stakeholders. (shrink)

Every living entity requires the capacity to defend against viruses in some form. From bacteria to plants to arthropods, cells retain the capacity to capture genetic material, process it in a variety of ways, and subsequently use it to generate pathogen-specific small RNAs. These small RNAs can then be used to provide specificity to an otherwise non-specific nuclease, generating a potent antiviral system. While small RNA-based defenses in chordates are less utilized, the protein-based antiviral invention in this phylum appears to (...) have derived from components of the same ancestral small RNA machinery. Based on recent evidence, it would seem that RNase III nucleases have been reiteratively repurposed over billions of years to provide cells with the capacity to recognize and destroy unwanted genetic material. Here we describe an overview of what is known on this subject and provide a model for how these defenses may have evolved. RNase III nuclease domains are widely used in an array of RNA metabolic functions as well as antiviral defenses. Here, we review their current usage as well as provide insight into how these domains may have shaped all major antiviral pathways over the course of evolution. (shrink)

The authors meta-analytically examined the relationship between intrinsic religiosity and internal locus of control. Thirty-seven independent samples, comprising 9,924 participants, yielded an average effect size of r =.06, which was small, but significant, indicating a positive correlation between intrinsic religiosity and internal locus of control. Moderation analyses showed a significant trend of effects becoming weaker over time. The judged religiousness of samples significantly predicted the strength of the correlation, such that more religious samples showed stronger effect sizes.

Sport is viewed as an arena for positive life skill development, including leadership development. In 2015, the NFHS launched an online Captain’s Leadership Training Course. The main purpose of this study was to examine the effectiveness of the course in improving leadership knowledge and ability. An electronic survey was sent to a sample of athletes, ages 13–19 in eight United States states who had completed the NFHS course within the last 3–18 months. Most athletes completed the course based upon their (...) coach’s recommendation. The course was viewed to be moderately to very useful in helping them in preparing to be a team captain. Participants believed the course to be very to extremely effective in building their knowledge on motivation, communication, decision making, peer modeling, team cohesion and problem solving strategies. Canonical correlation analyses showed that athletes who felt they were more reflective tended to rate the effectiveness of the course lower than their peers. Additionally, analyses did not show any clear demographic characteristics that distinguished between perceptions of the effectiveness of the course, showing the value found in the course was high with all types of scholastic athletes. Athletes felt the course could be improved most in the area of learning how to manage conflict with their peers and coaches. Future research in scholastic leadership should seek to understand the impact of the course prospectively across a high school sport season. (shrink)

To call attention to and motivate action on ethical issues in business or society, messengers often criticize groups for wrongdoing and ask these groups to change their behavior. When criticizing target groups, messengers frequently identify and express concern about harm caused to a victim group, and in the process address a target group by criticizing them for causing this harm and imploring them to change. However, we find that when messengers criticize a target group for causing harm to a victim (...) group in this way—expressing _singular concern_ for the victim group—members of the target group infer, often incorrectly, that the messenger views the target group as less moral and unworthy of concern. This inferred lack of moral concern reduces criticism acceptance and prompts backlash from the target group. To address this problem, we introduce _dual concern_ messaging—messages that simultaneously communicate that a target group causes harm to a victim group and express concern for the target group. A series of several experiments demonstrate that dual concern messages reduce inferences that a critical messenger lacks moral concern for the criticized target group, increase the persuasiveness of the criticism among members of the target group, and reduce backlash from consumers against a corporate messenger. When pursuing justice for victims of a target group, dual concern messages that communicate concern for the victim group _as well as_ the target group are more effective in fostering openness toward criticism, rather than defensiveness, in a target group, thus setting the stage for change. (shrink)

The patient wished to receive an experimental drug that she was instrumental in developing. After her diagnosis, she had investigated treatments that might help her condition and discovered that a specific compound could be beneficial. To further the development of this potential drug, she obtained preclinical data, founded a company, and sought investment from venture capitalists. The company was about to begin phase I testing, but the clinical trial had not yet opened. In addition, she would not have been a (...) candidate for the study, as it excluded patients with advanced disease. To be able to administer this drug to her, the patient's team of oncologists was in the process of drafting an individual patient investigational new drug application, including the protocol for the drug's delivery, to the Food and Drug Administration. The company developing the drug had preliminarily agreed to provide it. This protocol was also under review by the institutional review board of the university, and the ethics committee was consulted to determine whether she should receive the drug. (shrink)

The ethical recruitment of participants with neurological disorders in clinical research requires obtaining initial and ongoing informed consent. The purpose of this study is to characterize barriers faced by research personnel in obtaining informed consent from research participants with neurological disorders and to identify strategies applied by researchers to overcome those barriers. This study was designed as a web-based survey of US researchers with an optional follow-up interview. A subset of participants who completed the survey were selected using a stratified (...) purposeful sampling strategy and invited to participate in an in-depth qualitative interview by phone or video conference. Data were analyzed using a mixed methods approach, including content analysis of survey responses and thematic analysis of interview responses. Over 1 year, 113 survey responses were received from US research personnel directly involved in obtaining informed consent from participants in neurological research. Frequently identified barriers to informed consent included: cognitive and communication impairments (e.g. aphasia), unrealistic expectations of research participants, mistrust of medical research, time constraints, literacy barriers, lack of available social support, and practical or resource-related constraints. Strategies to enhance informed consent included: involving close others to support participant understanding of study-related information, collaborating with more experienced research personnel to facilitate training in obtaining informed consent, encouraging participants to review consent forms in advance of consent discussions, and using printed materials and visual references. Beyond conveying study-related information, researchers included in this study endorsed ethical responsibilities to support deliberation necessary to informed consent in the context of misconceptions about research, unrealistic expectations, limited understanding, mistrust, and/or pressure from close others. Findings highlight the importance of training researchers involved in obtaining informed consent in neurological research to address disease-specific challenges and to support the decision-making processes of potential research participants and their close others. (shrink)

We examine ethical considerations in access to facial transplantation (FT), with implications for promoting health equity. As a form of vascularised composite allotransplantation, FT is still considered innovative with a relatively low volume of procedures performed to date by a small number of active FT programmes worldwide. However, as numbers continue to increase and institutions look to establish new FT programmes, we anticipate that attention will shift from feasibility towards ensuring the benefits of FT are equitably available to those in (...) need. This manuscript assesses barriers to care and their ethical implications across a number of considerations, with the intent of mapping various factors relating to health equity and fair access to FT. Evidence is drawn from an evolving clinical experience as well as published scholarship addressing several dimensions of access to FT. We also explore novel concerns that have yet to be mentioned in the literature. (shrink)

Strange Tools foregoes stolid conventions of professional philosophy, laudably broadening the book’s appeal to accommodate a popular audience. However, Noë’s manner of glossing over complex issues about art does not necessarily render these topics intelligible to philosophical novices. Instead, his oversimplifications will tend to confirm naïve notions that art is straightforward – a common misconception that a foray into philosophy of art ought to dispel, not corroborate.

The purpose of this paper is to suggest that the current conversation about the relationship between capitalism and the poor assumes a story about business that is shopworn and outmoded. There are assumptions about business, human behavior, and language that are no longer useful in the twenty first century. Business needs to be understood as how we cooperate together to create value and trade. It is fundamentally about creating value for stakeholders. Human beings are not solely self-interested, but driven by (...) meaning, purpose, and the ability to cooperate. And, language is best understood as a tool, rather than a source of representation. Business and capitalism with these new assumptions can be realized by large and small businesses as not just about money and profits but as the creation of meaning within a prophetic framework. (shrink)

While the phenomenon of ‘moral distress’ has been of interest to the nursing community since Jameton first described it in 1984, moral distress is now understood to effect healthcare professionals...

The Survey of Organizational Research Climate (SORC) is a validated tool to facilitate promotion of research integrity and research best practices. This work uses the SORC to assess shared and individual perceptions of the research climate in universities and academic departments and relate these perceptions to desirable and undesirable research practices. An anonymous web- and mail-based survey was administered to randomly selected biomedical and social science faculty and postdoctoral fellows in the United States. Respondents reported their perceptions of the research (...) climates at their universities and primary departments, and the frequency with which they engaged in desirable and undesirable research practices. More positive individual perceptions of the research climate in one’s university or department were associated with higher likelihoods of desirable, and lower likelihoods of undesirable, research practices. Shared perceptions of the research climate tended to be similarly predictive of both desirable and undesirable research practices as individuals’ deviations from these shared perceptions. Study results supported the central prediction that more positive SORC-measured perceptions of the research climate were associated with more positive reports of research practices. There were differences with respect to whether shared or individual climate perceptions were related to desirable or undesirable practices but the general pattern of results provide empirical evidence that the SORC is predictive of self-reported research behavior. (shrink)

We present a one per cent measurement of the cosmic distance scale from the detections of the baryon acoustic oscillations in the clustering of galaxies from the Baryon Oscillation Spectroscopic Survey, which is part of the Sloan Digital Sky Survey III. Our results come from the Data Release 11 sample, containing nearly one million galaxies and covering approximately 8500 square degrees and the redshift range 0.2 < z < 0.7. We also compare these results with those from the publicly released (...) DR9 and DR10 samples. Assuming a concordance Λ cold dark matter cosmological model, the DR11 sample covers a volume of 13 Gpc3 and is the largest region of the Universe ever surveyed at this density. We measure the correlation function and power spectrum, including density-field reconstruction of the BAO feature. The acoustic features are detected at a significance of over 7σ in both the correlation function and power spectrum. Fitting for the position of the acoustic features measures the distance relative to the sound horizon at the drag epoch, rd, which has a value of rd,fid = 149.28 Mpc in our fiducial cosmology. We find DV = at z = 0.32 and DV = at z = 0.57. At 1.0 per cent, this latter measure is the most precise distance constraint ever obtained from a galaxy survey. Separating the clustering along and transverse to the line of sight yields measurements at z = 0.57 of DA = and H =. Our measurements of the distance scale are in good agreement with previous BAO measurements and with the predictions from cosmic microwave background data for a spatially flat CDM model with a cosmological constant. © 2014 The Author Published by Oxford University Press on behalf of the Royal Astronomical Society. (shrink)

In recent years, the phenomenon of moral distress has been critically examined—and for a good reason. There have been a number of different definitions suggested, some that claimed to be consistent with the original definition but in fact referred to different epistemological states. In this paper, we re‐examine moral distress by exploring its relationship with moral agency. We critically examine three conceptions of moral agency and argue that two of these conceptions risk placing nurses' values at the center of moral (...) action when it ought to be the patient's values that shape nurses' obligations. We propose that the conception of moral agency advanced by Aimee Milliken which re‐centers patient values, should be more broadly accepted within nursing. We utilize a case example to demonstrate a situation in which the values of a patient's parents (surrogates) justifiably constrained nurses' moral agency, creating moral distress. Through an examination of constraints on nurse agency in this case, we illustrate the problematic nature of ‘narrow' moral distress and the value of re‐considering moral distress. Finally, we provide an action‐oriented proposal identifying mediating steps that we argue have utility for nurses (and other healthcare professionals) to mediate between experiences of narrow moral distress and the exercise of moral agency. (shrink)