Rousseau argued forcefully for the superiority of a life lived in accordance with “the simplest impulses of nature,” but his complex understanding of the relationship between humans and “nature” is rarely cited as a source of inspiration by those seeking to reform the human relationship with the natural world. We argue that the complexities of Rousseau's political thought illuminate important connections between his works and the programs put forth by deep ecology. In Part One, we explore the theoretical connections between (...) Rousseau's account of the human fall from nature and major works of radical environmentalism. In Part Two, we offer suggestions for a reconsideration of Rousseau's work that may illuminate the paradoxical political requirements of deep ecology's recommendations for a more ecological human life. We hope to illustrate howa careful reading of Rousseau'swork may serve as the basis for fruitful questioning of environmentalist thought. (shrink)

Rousseau argued forcefully for the superiority of a life lived in accordance with “the simplest impulses of nature,” but his complex understanding of the relationship between humans and “nature” is rarely cited as a source of inspiration by those seeking to reform the human relationship with the natural world. We argue that the complexities of Rousseau's political thought illuminate important connections between his works and the programs put forth by deep ecology. In Part One, we explore the theoretical connections between (...) Rousseau's account of the human fall from nature and major works of radical environmentalism. In Part Two, we offer suggestions for a reconsideration of Rousseau's work that may illuminate the paradoxical political requirements of deep ecology's recommendations for a more ecological human life. We hope to illustrate howa careful reading of Rousseau'swork may serve as the basis for fruitful questioning of environmentalist thought. (shrink)

Children in foster care are considered a “vulnerable population” in clinical care and research, with good reason. These children face multiple medical, psychological, and social risks that obligate the child welfare and healthcare systems to protect them from further harms. An unintended consequence of the “vulnerable population” designation for children in foster care is that it may impose barriers on tracking and studying their health that creates gaps in knowledge that are key to their receipt of medical care and good (...) outcomes. These gaps in knowledge have implications for justice, beneficence, and maleficence and serve to undermine “protection” of this population. Here we review the challenges of research regarding children in foster care, particularly medically complex children, and offer specific recommendations to include children in foster care in medical research. (shrink)

Approximately one in 10 children in foster care are medically complex and require intensive medical supervision, frequent hospitalization, and difficult medical decision making. Some of these children are in foster care because their parents cannot care for their medical needs; other parents are responsible for their child’s medical needs due to abuse or neglect. In either case, there can be uncertainty about the role that a child’s biological parents should play in making serious medical decisions. Here we highlight some of (...) the ethical challenges inherent in making these decisions for children in foster care, as seen through the lenses of a child welfare provider, an inpatient care physician, and a primary care pediatrician. (shrink)

Rousseau argued forcefully for the superiority of a life lived in accordance with "the simplest impulses of nature," but his complex (some would say contradictory) understanding of the relationship between humans and "nature" is rarely cited as a source of inspiration by those seeking to reform the human relationship with the natural world. We argue that the complexities of Rousseau's political thought illuminate important connections between his works and the programs put forth by deep ecology. In Part One, we explore (...) the theoretical connections between Rousseau's account of the human fall from nature and major works of radical environmentalism. In Part Two, we offer suggestions for a reconsideration of Rousseau's work that may illuminate the paradoxical political requirements of deep ecology's recommendations for a more ecological human life. We hope to illustrate how a careful reading of Rousseau's work may serve as the basis for fruitful questioning of environmentalist thought. (shrink)

Palliative care and medical-legal partnership are complementary disciplines dedicated to integrating care to treat the whole patient and intervening before a legal or medical issue is at a crisis point. In this paper, we discuss the founding and operations of the Yale Palliative Medical Legal Partnership, give examples of typical cases, explain special considerations in this area of law, and propose areas for further research.

Studies with humans have failed to produce evidence that any direct causal relation exists between the asymmetry of one function in an individual and the asymmetry of a different function in that individual. Without such evidence, factors external to an individual's nervous system, such as social interactions, may play crucial roles in explaining the directions of all asymmetries at all levels.

Levonorgestrel is widely used as emergency contraception, yet much confusion surrounds its use. Consensus statements and reviews typically attribute its efficacy to prefertilization mechanisms of action, such as suppression of ovulation and interference with cervical mucus or sperm function, yet studies do not rule out a postovulatory MOA. To yield greater clarity, the authors review recent scientific studies examining the MOAs of LNG-EC. They conclude that LNG-EC exerts minimal effects on cervical mucus and sperm function and that suppression of ovulation (...) is not the dominant MOA accounting for the contraceptive efficacy of LNG-EC. Luteal deficiencies and endometrial changes reported in the literature strongly suggest a postovulatory MOA when LNG-EC is given during the critical preovulatory period. National Catholic Bioethics Quarterly 13.4 : 677–716. (shrink)

BackgroundAlthough patient advocates have developed templates for standard consent forms, evaluating patient preferences for first in human (FIH) and window of opportunity (Window) trial consent forms is critical due to their unique risks. FIH trials are the initial use of a novel compound in study participants. In contrast, Window trials give an investigational agent over a fixed duration to treatment naïve patients in the time between diagnosis and standard of care (SOC) surgery. Our goal was to determine the patient-preferred presentation (...) of important information in consent forms for these trials.MethodsThe study consisted of two phases: (1) analyses of oncology FIH and Window consents; (2) interviews of trial participants. FIH consent forms were analyzed for the location(s) of information stating that the study drug has not been tested in humans (FIH information); Window consents were analyzed for the location(s) of information stating the trial may delay SOC surgery (delay information). Participants were asked about their preferred placement of the information in their own trial’s consent form. The location of information in the consent forms was compared to the participants’ suggestions for placement. Results34 [17 FIH; 17 Window] of 42(81%) cancer patients approached participated. 25 consents [20 FIH; 5 Window] were analyzed. 19/20 FIH consent forms included FIH information, and 4/5 Window consent forms included delay information. 19/20(95%) FIH consent forms contained FIH information in the risks section 12/17(71%) patients preferred the same. Fourteen (82%) patients wanted FIH information in the purpose, but only 5(25%) consents mentioned it there. 9/17(53%) Window patients preferred delay information to be located early in the consent, before the “Risks” section. 3/5(60%) consents did this.ConclusionsDesigning consents that reflect patient preferences more accurately is essential for ethical informed consent; however, a one-size fits all approach will not accurately capture patient preferences. We found that preferences differed for FIH and Window trial consents, though for both, patients preferred key risk information early in the consent. Next steps include determining if FIH and Window consent templates improve understanding. (shrink)

In her recent paper ‘The Epistemology of Propaganda’ Rachel McKinnon discusses what she refers to as ‘TERF propaganda’. We take issue with three points in her paper. The first is her rejection of the claim that ‘TERF’ is a misogynistic slur. The second is the examples she presents as commitments of so-called ‘TERFs’, in order to establish that radical (and gender critical) feminists rely on a flawed ideology. The third is her claim that standpoint epistemology can be used to establish (...) that such feminists are wrong to worry about a threat of male violence in relation to trans women. In Section 1 we argue that ‘TERF’ is not a merely descriptive term; that to the extent that McKinnon offers considerations in support of the claim that ‘TERF’ is not a slur, these considerations fail; and that ‘TERF’ is a slur according to several prominent accounts in the contemporary literature. In Section 2, we argue that McKinnon misrepresents the position of gender critical feminists, and in doing so fails to establish the claim that the ideology behind these positions is flawed. In Section 3 we argue that McKinnon’s criticism of Stanley fails, and one implication of this is that those she characterizes as ‘positively privileged’ cannot rely on the standpoint-relative knowledge of those she characterizes as ‘negatively privileged’. We also emphasize in this section McKinnon’s failure to understand and account for multiple axes of oppression, of which the cis/trans axis is only one. (shrink)

The Iowa Gambling Task (IGT) and the Soochow Gambling Task (SGT) are two experience-based risky decision-making tasks for examining decision-making deficits in clinical populations. Several cognitive models, including the expectancy-valence learning model (EVL) and the prospect valence learning model (PVL), have been developed to disentangle the motivational, cognitive, and response processes underlying the explicit choices in these tasks. The purpose of the current study was to develop an improved model that can fit empirical data better than the EVL and PVL (...) models and, in addition, produce more consistent parameter estimates across the IGT and SGT. Twenty-six opiate users (mean age 34.23; SD 8.79) and 27 control participants (mean age 35; SD 10.44) completed both tasks. Eighteen cognitive models varying in evaluation, updating, and choice rules were fit to individual data and their performances were compared to that of a statistical baseline model to find a best fitting model. The results showed that the model combining the prospect utility function treating gains and losses separately, the decay-reinforcement updating rule, and the trial-independent choice rule performed the best in both tasks. Furthermore, the winning model produced more consistent individual parameter estimates across the two tasks than any of the other models. (shrink)

Human beings persist in an extraordinary range of ecological settings, in the process exhibiting enormous behavioural diversity, both within and between populations. People vary in their social, mating and parental behaviour and have diverse and elaborate beliefs, traditions, norms and institutions. The aim of this theme issue is to ask whether, and how, evolutionary theory can help us to understand this diversity. In this introductory article, we provide a background to the debate surrounding how best to understand behavioural diversity using (...) evolutionary models of human behaviour. In particular, we examine how diversity has been viewed by the main subdisciplines within the human evolutionary behavioural sciences, focusing in particular on the human behavioural ecology, evolutionary psychology and cultural evolution approaches. In addition to differences in focus and methodology, these subdisciplines have traditionally varied in the emphasis placed on human universals, ecological factors and socially learned behaviour, and on how they have addressed the issue of genetic variation. We reaffirm that evolutionary theory provides an essential framework for understanding behavioural diversity within and between human populations, but argue that greater integration between the subfields is critical to developing a satisfactory understanding of diversity. (shrink)

The earlier volume in this series dealt with two religions of Indian origin, namely, Buddhism and Jainism. The Indian religious scene, however, is characterized by not only religions which originated in India but also by religions which entered India from outside India and made their home here. Thus religious life in India has been enlivened throughout its history by the presence of religions of foreign origin on its soil almost from the very time they came into existence. This volume covers (...) three such religions—Zoraoastrianism, Judaism, and Islam. In the case of Zoraostianism, even its very beginnings are intertwined with India, as Zoroastrianism reformed a preexisting religion which had strong links to the Vedic heritage of India. This relationship took on a new dimension when a Zoroastrian community, fearing persecution in Persia after its Arab conquest, sought shelter in western India and ultimately went on to produce India’s pioneering nationalist in the figure of Dadabhai Naoroji ( 1825-1917), also known as the Grand Old Man of India. Jews found refuge in south India after the destruction of the Temple by the Romans in 70 C.E. and have remained a part of the Indian religious scene since then, some even returning to Israel after it was founded in 1948. Islam arrived in Kerala as soon as it was founded and one of the earliest mosques in the history of Islam is found in India. Islam differs from the previously mentioned religions inasmuch as it went on to gain political hegemony over parts of the country for considerable periods of time, which meant that its impact on the religious life of the subcontinent has been greater compared to the other religions. It has also meant that Islam has existed in a religiously plural environment in India for a longer period than elsewhere in the world so that not only has Islam left a mark on India, India has also left its mark on it. Indeed all the three religions covered in this volume share this dual feature, that they have profoundly influenced Indian religious life and have also in turn been profoundly influenced by their presence in India. (shrink)

The earlier volume in this series dealt with two religions of Indian origin, namely, Buddhism and Jainism. The Indian religious scene, however, is characterized by not only religions which originated in India but also by religions which entered India from outside India and made their home here. Thus religious life in India has been enlivened throughout its history by the presence of religions of foreign origin on its soil almost from the very time they came into existence. This volume covers (...) three such religions—Zoraoastrianism, Judaism, and Islam. In the case of Zoraostianism, even its very beginnings are intertwined with India, as Zoroastrianism reformed a preexisting religion which had strong links to the Vedic heritage of India. This relationship took on a new dimension when a Zoroastrian community, fearing persecution in Persia after its Arab conquest, sought shelter in western India and ultimately went on to produce India’s pioneering nationalist in the figure of Dadabhai Naoroji ( 1825-1917), also known as the Grand Old Man of India. Jews found refuge in south India after the destruction of the Temple by the Romans in 70 C.E. and have remained a part of the Indian religious scene since then, some even returning to Israel after it was founded in 1948. Islam arrived in Kerala as soon as it was founded and one of the earliest mosques in the history of Islam is found in India. Islam differs from the previously mentioned religions inasmuch as it went on to gain political hegemony over parts of the country for considerable periods of time, which meant that its impact on the religious life of the subcontinent has been greater compared to the other religions. It has also meant that Islam has existed in a religiously plural environment in India for a longer period than elsewhere in the world so that not only has Islam left a mark on India, India has also left its mark on it. Indeed all the three religions covered in this volume share this dual feature, that they have profoundly influenced Indian religious life and have also in turn been profoundly influenced by their presence in India. (shrink)

Gossip is ubiquitous. Gossip allows important rules to be clarified and reinforced, and it allows individuals to keep track of their social networks while strengthening their bonds to the group. The purpose of this study is to decipher the nature of gossip and how it relates to friendship connections. To measure how gossip relates to friendship, participants from men’s and women’s collegiate competitive rowing teams noted their friendship connections and their tendencies to gossip about each of their teammates. Using social (...) network analysis, we found that the crew members’ friend group connectedness significantly correlated with their positive and negative gossip network involvement. Higher connectedness among friends was associated with less involvement in spreading negative gossip and/or being a target of negative gossip. More central connectedness to the friend group was associated with more involvement in spreading positive gossip and/or being a target of positive gossip. These results suggest that the spread of both positive and negative gossip may influence and be influenced by friendship connections in a social network. (shrink)

Cultural effects can influence the results of causal genetic analyses, such as Mendelian randomisation, but the potential influences of culture on genotype–phenotype associations are not currently well understood. Different genetic variants could be associated with different phenotypes in different populations, or culture could confound or influence the direction of the association between genotypes and phenotypes in different populations.

Prior research supports the learnability of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Alternative Model of Personality Disorders. However, researchers have yet to compare novice ratings on the AMPD’s Level of Personality Functioning Scale and the 25 pathological personality traits with expert ratings. Furthermore, the AMPD has yet to be examined with the idiographic Shedler-Westen Assessment Procedure. We compared the aggregated AMPD clinical profile of a group of psychology doctoral students who learned the AMPD to high levels (...) of reliability to that of an expert rater using the crucible of the classical case of “Madeline G.” Examination of AMPD and SWAP ratings of “Madeline G.” revealed excellent overall concordance but suggests that novice raters tend to perceive lower levels of personality impairment. (shrink)

All forms of beauty create appeal or enticement with moral significance. Sublime beauty draws one into a deep relationship that properly promotes the good and true. Parents tend to experience such beauty in their children, as eloquently described in works such as the 14th-century poem ‘The Pearl’, and they see this even when their children are desperately ill or dying. The experience of beauty in one’s child creates or reinforces the morality of caring. Unfortunately, at the end of modernity, the (...) framing of beauty as only instrumental and subjective generally works against any recognition of dignity or respect for the very small pediatric patient. Practitioners who believe in the intrinsic value and dignity of persons as general concepts should recognize parental drawing toward their children as a particularization of a transcendental value. (shrink)

Sociocultural norms against women can contribute to promoting intimate partner violence (IPV) and shape women's decision to disclose IPV. A cross‐cultural analysis of the existing literature is needed to present an overview of the influences of sociocultural norms on women's decisions regarding the disclosure of IPV across different cultural contexts. The purpose of the review was to synthesize published quantitative, qualitative, and mixed methods (MMs) studies to identify known sociocultural norms across different cultures that may influence women's decision to disclose (...) IPV. The Whittemore and Knafl framework, Rayyan software, and PRISMA flow diagram were used. Databases included APA PsycInfo, CINAHL, PubMed, SocINDEX, and Women's Studies International. The quality of studies was assessed by the MMs appraisal tool. A total of 15 research articles written in English and published in peer‐reviewed journals were included. Main categories emerged: (1) stigma surrounding IPV disclosure, victimization, and divorce; (2) gender roles; (3) preserving family honor; and (4) Children's well‐being and future. A one‐size‐fits‐all approach is not adequate for women who are considering disclosing IPV. Findings underscore that regardless of residing in individualistic countries, those sociocultural norms related to traditional gender roles and gender inequality are still important barriers to the disclosure of IPV among women with collectivist roots. (shrink)

Psychopathy refers to a range of complex behaviors and personality traits, including callousness and antisocial behavior, typically studied in criminal populations. Recent studies have used self-reports to examine psychopathic traits among noncriminal samples. The goal of the current study was to examine the underlying factor structure of the Self-Report of Psychopathy Scale–Short Form (SRP-SF) across complementary samples and examine the impact of gender on factor structure. We examined the structure of the SRP-SF among 2,554 young adults from three undergraduate samples (...) and a high-risk young adult sample. Using confirmatory factor analysis, a four-correlated factor model and a four-bifactor model showed good fit to the data. Evidence of weak invariance was found for both models across gender. These findings highlight that the SRP-SF is a useful measure of low-level psychopathic traits in noncriminal samples, although the underlying factor structure may not fully translate across men and women. (shrink)

IntroductionThere is a paucity of clinical guidelines for the routine assessment of maladaptive reproductive grief reactions in outpatient primary care and OB-GYN settings in the United States. Because of the disenfranchised nature of perinatal grief reactions, many clinicians may be apt to miss or dismiss a grief reaction that was not identified in the perinatal period. A significant number of those experiencing a reproductive loss exhibit signs of anxiety, depression, or post-traumatic stress disorder. Reproductive losses are typically screened for and (...) recorded numerically as part of a woman’s well-visit intake, yet this process often fails to identify patients emotionally troubled by a prior pregnancy loss.Materials and MethodsA summative content analysis of 164 recent website blogs from female participants who self-reported having experienced a miscarriage or abortion in their lifetime was conducted. The narratives were reviewed for details regarding the time span between the pregnancy loss and the composition of the blog post. The stories were analyzed for subsequent relationship problems and detrimental mental health conditions. Maladaptive reactions were contrasted for those that indicated a greater than 12 months’ time-lapse and those who had not.ResultsMore than a third of the women reported in the narrative that at least one year or more had passed since experiencing the miscarriage or abortion. For those women, the median time span between the loss and composing the blog was 4 years with a range of 47 years. Mental health conditions attributed to the reproductive loss by those who reported longer bereavement times included subsequent relationship problems, substance misuse, depression, suicidal ideation, and PTSD. The percent of reported maladaptive issues was more than double for those who reported that a year or more had passed since the loss of the pregnancy.DiscussionGrief reactions following the loss of a pregnancy may be prolonged or delayed for several months which can contribute to adverse biopsychosocial outcomes. Recognition and treatment of maladaptive grief reactions following a pregnancy loss are critical. Screening methods should be enhanced for clinicians in medical office settings to help identify and expedite the appropriate mental health assistance. (shrink)

ABSTRACTRumination has long been considered a verbal thought process, though emerging evidence suggests that some individuals dwell on maladaptive imagery. This series of studies evaluated imagery and verbal thought during experimentally induced rumination and distraction. In Study 1, imagery and verbal thought during rumination resulted in similar increases in negative affect. Greater imagery during distraction, on the other hand, was associated with greater decreases in negative affect while verbal thought was not related to affect change. Given that greater verbal thought (...) was reported in the rumination condition and greater imagery was reported in the distraction condition, Study 2 evaluated whether the rumination/distraction induction was confounded by concurrent induction of imagery or verbal thought. The rumination prompts induced both rumination and verbal thought and the distraction prompts induced both distraction and imagery. Using a revised induction, Study 3 tested whether imagery and verbal t... (shrink)

The increasing incidence of ‘trafficking’ has added an incontestably disturbing dimension to the contestable nature of a ‘non-trafficked’ UK sex industry. Men who buy sex remain under-researched, though some studies have indicated ambivalence within men's attitudes. This study combines a critical discursive psychology in support of dialogical self theory. Secondary data, from prominent UK media resources, were analysed using Edley's method of combining ‘interpretative repertoires’, ‘ideological dilemmas’ and ‘subject positions’. Contrasting discursive practices indicative of wider ideological conflict were found. Discursive (...) concepts were ‘mapped’ onto Hermans and Hermans-Konopka's ‘I-positions’ to explore how these potentially dilemmatic positions might be understood in terms of identity production. The function of ‘uncertainty’, particularly salient with the increasing complexity of globalisation, was considered a factor in how men's identities might be limited by the current discursive space. A ‘dialogical’ model of self is introduced as a framework for understanding how men who buy sex might take up new, inclusive, positions. A corollary is reflected upon; that researchers, activists and buyers alike, who remain ideologically inflexible, may be sustaining the conditions for coercion through their contribution to the discursive conflict. The synthesis of discursive and dialogical analytical tools is recommended for investigating the production of selves in contested spaces. (shrink)

Clinical trials for acute conditions such as myocardial infarction and stroke pose challenges related to informed consent due to time limitations, stress, and severe illness. Consent processes shou...

War and Border Crossings brings together renowned scholars to address some of the most pressing problems in public policy, international affairs, and the intercultural issues of our day. Contributors from widely varying disciplines discuss cross-cultural ethical issues and international topics ranging from American international policy and the invasion and occupation of Iraq to domestic topics such as immigration, the war on drugs, cross-cultural bioethics and ethical issues involving American Indian tribes. The culture clashes discussed in these essays raise serious questions (...) about what principles ought to inform the negotiating of conflicts in order to achieve, or at least approach, outcomes that are fundamentally just, fair, responsible, and ethical. (shrink)

Online education has become an essential component of education. Thus, several factors, such as the student’s learning strategy and motivation, generally contribute to their academic success. This study investigates the relationship between learning strategies, motivation, and online learning environment among 150 first-year college students. Employing correlational design, the statistical findings of the study reveal that the r coefficient of 0.59 indicates a moderate positive correlation between the variables. The p-value of 0.00, which is less than 0.05, leads to the decision (...) to reject the null hypothesis. Hence, a significant relationship exists between learning strategies, motivation, and the online learning environment. (shrink)

Because no single person or group holds knowledge about all aspects of research, mechanisms are needed to support knowledge exchange and engagement. Expertise in the research setting necessarily includes scientific and methodological expertise, but also expertise gained through the experience of participating in research and/or being a recipient of research outcomes. Engagement is, by its nature, reciprocal and relational: the process of engaging research participants, patients, citizens and others brings them closer to the research but also brings the research closer (...) to them. When translating research into practice, engaging the public and other stakeholders is explicitly intended to make the outcomes of translation relevant to its constituency of users. In practice, engagement faces numerous challenges and is often time-consuming, expensive and ‘thorny’ work. We explore the epistemic and ontological considerations and implications of four common critiques of engagement methodologies that contest: representativeness, communication and articulation, impacts and outcome, and democracy. The ECOUTER methodology addresses problems of representation and epistemic foundationalism using a methodology that asks, “How could it be otherwise?” ECOUTER affords the possibility of engagement where spatial and temporal constraints are present, relying on saturation as a method of ‘keeping open’ the possible considerations that might emerge and including reflexive use of qualitative analytic methods. This paper describes the ECOUTER process, focusing on one worked example and detailing lessons learned from four other pilots. ECOUTER uses mind-mapping techniques to ‘open up’ engagement, iteratively and organically. ECOUTER aims to balance the breadth, accessibility and user-determination of the scope of engagement. An ECOUTER exercise comprises four stages: engagement and knowledge exchange; analysis of mindmap contributions; development of a conceptual schema ; and feedback, refinement and development of recommendations. ECOUTER refuses fixed truths but also refuses a fixed nature. Its promise lies in its flexibility, adaptability and openness. ECOUTER will be formed and re-formed by the needs and creativity of those who use it. (shrink)

Music can reduce stress and anxiety, enhance positive mood, and facilitate social bonding. However, little is known about the role of music and related personal or cultural variables in maintaining wellbeing during times of stress and social isolation as imposed by the COVID-19 crisis. In an online questionnaire, administered in 11 countries, participants rated the relevance of wellbeing goals during the pandemic, and the effectiveness of different activities in obtaining these goals. Music was found to be the most effective activity (...) for three out of five wellbeing goals: enjoyment, venting negative emotions, and self-connection. For diversion, music was equally good as entertainment, while it was second best to create a sense of togetherness, after socialization. This result was evident across different countries and gender, with minor effects of age on specific goals, and a clear effect of the importance of music in people's lives. Cultural effects were generally small and surfaced mainly in the use of music to obtain a sense of togetherness. Interestingly, culture moderated the use of negatively valenced and nostalgic music for those higher in distress. (shrink)