Life history theory predicts that exposure to high mortality in early childhood leads to faster and riskier reproductive strategies. Individuals who grew up in a high mortality regime will not overly wait until they find a suitable partner and form a stable union because premature death would prevent them from reproducing. Cox proportional hazard models were used to determine whether women who experienced sibling death during early childhood (0–5 years) reproduced earlier and were at an increased risk of giving birth (...) to an illegitimate child, with illegitimacy serving as a proxy for risky sexual behavior. Furthermore, we investigate whether giving birth out of wedlock is influenced by individual mortality experience or by more promiscuous sexual behavior that is clustered in certain families. Models are fitted on pedigree data from the eighteenth- and nineteenth-century Krummhörn population in Germany. The results show a relationship between sibling death in early childhood and the risk of reproducing out of wedlock, and reproductive timing. The risk of giving birth out of wedlock is linked to individual mortality experience rather than to family-level effects. In contrast, adjustments in connubial reproductive timing are influenced more by family-level effects than by individual mortality experience. (shrink)

The young adult novel is aimed at a carefully defined target market, often focused on a predictable range of issues. Where illness and death are the theme, the process of growing up is more dramatically defined. Young people who suffer or watch a family member suffer a serious illness find their stages of moral development disrupted, their values reorganized, and emerging sexual interests submerged under more insistent demands. The books discussed in this article are not formula novels, but complex tales (...) with interesting subplots and characters. Notable features common to them are as follows: 1) strategies of normalization, 2) abandonment and alienation, 3) unexpected emotions, 4) extra-familial support, 5) other people's problems, and 6) God, meaning, and hope. (shrink)

The growth of urban violence in Brazil, as in other countries, has led citizens to demand more severe and punitive measures to solve the problem of juvenile crime. One motion submitted to the Brazilian parliament, for instance, proposes to reduce the age of penal majority from 18 to 16 years. Our hypothesis is that popular opinions about this proposal are largely constrained by construal levels and psychological distance. Accordingly, we expect that the knowledge and proximity to the circumstances associated with (...) juvenile transgression will influence opinions about the proposal. To test this hypothesis, we evaluated how opinion against or for the proposal can be explained by psychological distance and moral development theory. We studied two samples, composed of people who do not have a deep experience with the subject and workers from a juvenile justice court. After collecting socio-demographic information from the subjects and their answer to moral dilemmas, the data was subjected to a multivariate analysis by multimodal logistic regression for socio-demographic characteristics, Kohlberg moral stages, and opinion on the reduction of APM as dependent variables. Our findings suggest that 1) opinion about the APM depends on psychological distance and 2) socioeconomic variables may influence the average construal level of adolescent transgressors in the public’s perspective. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Convention for Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Biomedicine: Convention on Human Rights and BiomedicineCouncil of EuropePreambleThe Member States of the Council of Europe, the other States and the European Community signatories hereto,Bearing in mind the Universal Declaration of Human Rights proclaimed by the General Assembly of the United Nations on 10 December 1948;Bearing in mind the (...) Convention for the Protection of Human Rights and Fundamental Freedoms of 4 November 1950;Bearing in mind the European Social Charter of 18 October 1961;Bearing in mind the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights of 16 December 1966;Bearing in mind the Convention for the Protection of Individuals with Regard to Automatic Processing of Personal Data of 28 January 1981;Bearing also in mind the Convention on the Rights of the Child of 20 November 1989;Considering that the aim of the Council of Europe is the achievement of a greater unity between its members and that one of the methods by which that aim is to be pursued is the maintenance and further realisation of human rights and fundamental freedoms;Conscious of the accelerating developments in biology and medicine;Convinced of the need to respect the human being both as an individual and as a member of the human species and recognising the importance of ensuring the dignity of the human being; [End Page 277]Conscious that the misuse of biology and medicine may lead to acts endangering human dignity;Affirming that progress in biology and medicine should be used for the benefit of present and future generations;Stressing the need for international co-operation so that all humanity may enjoy the benefits of biology and medicine;Recognising the importance of promoting a public debate on the questions posed by the application of biology and medicine and the responses to be given thereto;Wishing to remind all members of society of their rights and responsibilities;Taking account of the work of the Parliamentary Assembly in this field, including Recommendation 1160 (1991) on the preparation of a Convention on bioethics;Resolving to take such measures as are necessary to safeguard human dignity and the fundamental rights and freedoms of the individual with regard to the application of biology and medicine;Have agreed as follows:Chapter IGeneral provisionsArticle 1. (Purpose and object)Parties to this Convention shall protect the dignity and identity of all human beings and guarantee everyone, without discrimination, respect for their integrity and other rights and fundamental freedoms with regard to the application of biology and medicine.Each Party shall take in its internal law the necessary measures to give effect to the provisions of this Convention.Article 2. (Primacy of the human being)The interests and welfare of the human being shall prevail over the sole interest of society or science.Article 3. (Equitable access to health care)Parties, taking into account health needs and available resources, shall take appropriate measures with a view to providing, within their jurisdiction, equitable access to health care of appropriate quality. [End Page 278]Article 4. (Professional standards)Any intervention in the health field, including research, must be carried out in accordance with relevant professional obligations and standards.Chapter IIConsentArticle 5. (General rule)An intervention in the health field may only be carried out after the person concerned has given free and informed consent to it.This person shall beforehand be given appropriate information as to the purpose and nature of the intervention as well as on its consequences and risks.The person concerned may freely withdraw consent at any time.Article 6. (Protection of persons not able to consent)1. Subject to Articles 17 and 20 below, an intervention may only be carried out on a person who does not have the capacity to consent, for his or her direct benefit.2. Where, according to law, a minor does not have the capacity to consent to an intervention, the intervention may only be carried out with the authorisation of his or her representative or an authority or a person or... (shrink)

This paper presents the manner in which the DNA, the molecule of life, was discovered. Unlike what many people, even biologists, believe, it was Johannes Friedrich Miescher who originally discovered and isolated nuclein, currently known as DNA, in 1869, 75 years before Watson and Crick unveiled its structure. Also, in this paper we show, and above all demonstrate, the serendipity of this major discovery. Like many of his contemporaries, Miescher set out to discover how cells worked by means of studying (...) and analysing their proteins. During this arduous task, he detected an unexpected substance of unpredicted properties. This new substance precipitated when he added acid to the solution and it dissolved again when adding alkali. Unexpectedly and by a mere fluke, Miescher was the first person to obtain a DNA precipitate. The paper then presents the term serendipity and discusses how it has influenced the discovery of other important scientific milestones. Finally, we address the question of whether serendipitous discoveries can be nurtured and what role the computer could play in this process. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Martin Heidegger and OntologyEmmanuel Levinas (bio)The prestige of Martin Heidegger 1 and the influence of his thought on German philosophy marks both a new phase and one of the high points of the phenomenological movement. Caught unawares, the traditional establishment is obliged to clarify its position on this new teaching which casts a spell over youth and which, overstepping the bounds of permissibility, is already in vogue. For once, (...) Fame has picked one who deserves it and, for that matter, one who is still living. Anyone who has studied philosophy cannot, when confronted by Heidegger’s work, fail to recognize how the originality and force of his achievements, stemming from genius, are combined with an attentive, painstaking, and close working-out of the argument—with that craftsmanship of the patient artisan in which phenomenologists take such pride. In this study, it is important for us to understand, above all, the true intentions of our author, to illuminate what he thinks really needs to be said, and to surmise what is most critical for him.To get to the heart of Heidegger’s system, it seems fitting to begin with a problem that is generally familiar. We choose the problem of knowledge, a deeper understanding of which takes us to the very threshold of Heidegger’s thought. For this problem, central to modern philosophy, is one of the main obstacles of modern philosophy that Heidegger wishes to surmount. Neo-Kantianism, which takes knowledge as the philosophical problem of the first rank, is the movement against which Heidegger rebels with all his strength. We have, thus, every chance of gaining access to his thought by the main door, so to speak. Once inside the system we will try to trace its outlines, 2 reserving, for a second part of our work, the determination of Heidegger’s place in the history of ideas, especially in the phenomenological movement, as well as of his relations with the philosopher to whom he owes so much—Edmund Husserl. 31In its most general form, the problem of the theory of knowledge has a critical significance. It consists in delineating a domain where knowledge can be certain and in determining the criteria for the legitimate scope of knowledge. But this problem, as normal and as simple as it may appear, has deeper roots. That knowledge should need a criterion at all presupposes that truth is not identical to all that is known and that the course [End Page 11] of things can fail to correspond with the course of thought. “How does knowledge correspond to being?” is a more profound formulation of the problem of knowledge.But we are not going to touch anymore on the primordial phenomenon that generates the problem. The problem of correspondence between thing and thought presupposes a free activity of thought and its isolation in relation to the object. It is precisely this presupposition which renders their harmony and even their contact problematic. “How does the subject take leave of itself to attain the object?” is what the problem of knowledge, in the last analysis, boils down to. Its true source is thus the concept of “subject” as elaborated by modern philosophy. The cogito presided over the subject’s birth. The cogito was the affirmation of the privileged nature of the subject’s immanent sphere, of its unique place in existence; hence, the cogito was the specificity of the subject’s connection to the rest of reality, the sui generis nature which opens up the passage from immanence to transcendence, the passage from ideas contained in the thinking substance to 4 their “formal existence.”The concept of the subject, understood as a substance having a specific position in the entire domain of being, presents us with difficulties of two kinds. First, how do we understand this leave-taking from the self which the thinking substance brings about and which displays an entirely original aspect? Indeed, we could say that thought, in reaching out toward objects, does not actually take leave of itself, since its objects—considered as ideas and contents of thought—are, in a certain sense, already within it. In order to make sense of this paradox, Descartes... (shrink)

There are important ethical issues to be examined before launching any public health intervention, particularly when targeting vulnerable groups. The aim of this article is to identify and discuss ethical concerns that may arise when intervening for health behavior change among adolescents identified as overweight. These concerns originate from an intervention designed to capacitate adolescents to increase self-determined physical activity. Utilizing an ethical framework for prevention of overweight and obesity, we identified three ethical aspects as particularly significant: the (...) attribution of responsibility for health behavior, liberty to choose, and the effect on the participants’ psychosocial well-being. It is discussed whether and how measures can be taken to deal with these aspects. It seems evident that the ethical aspects are mainly concerned with the vulnerability of adolescents identified as overweight. However, we claim that when individual feedback and counseling is provided, tailored interventions have a unique potential to empower adolescents to make ethically anchored decisions about their own health behavior. (shrink)

There are important ethical issues to be examined before launching any public health intervention, particularly when targeting vulnerable groups. The aim of this article is to identify and discuss ethical concerns that may arise when intervening for health behavior change among adolescents identified as overweight. These concerns originate from an intervention designed to capacitate adolescents to increase self-determined physical activity. Utilizing an ethical framework for prevention of overweight and obesity, we identified three ethical aspects as particularly significant: the (...) attribution of responsibility for health behavior, liberty to choose, and the effect on the participants’ psychosocial well-being. It is discussed whether and how measures can be taken to deal with these aspects. It seems evident that the ethical aspects are mainly concerned with the vulnerability of adolescents identified as overweight. However, we claim that when individual feedback and counseling is provided, tailored interventions have a unique potential to empower adolescents to make ethically anchored decisions about their own health behavior. (shrink)

Connecting with peers online to overcome social isolation has become particularly important during the pandemic-related school closures across many countries. In the context of contact restrictions, feelings of isolation and loneliness are more prevalent and the regulation of these negative emotions to maintain a positive well-being challenges adolescents. This is especially the case for those individuals who might have a high need to belong and difficulties in emotional competences. The difficult social situation during contact restrictions, more time for online (...) communication and maladaptive emotion regulation might lead to aggressive communication patterns in the form of cyberbullying perpetration. In an online study with N = 205 adolescents aged 14–19, we assessed the frequency of online and offline contacts, need to belong, emotion regulation problems, feelings of loneliness, and cyberbullying perpetration as predictors of adolescents’ well-being. In particular, we explored whether cyberbullying perpetration might function as a maladaptive strategy to deal with feelings of loneliness and therefore predicts well-being. This effect was expected to be stronger for those with a higher need to belong and with higher emotion regulation problems. Results of a hierarchical regression analysis revealed that well-being was significantly predicted by less emotion regulation difficulties, less feeling isolated and more cyberbullying perpetration. We also tested whether the need to belong or emotion regulation problems moderated the association between cyberbullying and well-being. While the results for emotion regulation problems were not significant, the moderation effect for the need to belong was significant: For students with a high need to belong, well-being was more strongly related to cyberbullying perpetration than for students with a medium need to belong. For students with a low need to belong, cyberbullying was not significantly associated with well-being. That cyberbullying perpetration predicted well-being positively is rather surprising in the light of previous research showing negative psychosocial outcomes also for cyberbullying perpetrators. The moderation analysis provides a hint at underlying processes: In times of distance learning and contact restrictions, cyberbullying may be a way of coming into contact with others and to regulate loneliness maladaptively. (shrink)

Se efectuó un estudio en dos fases: una observacional descriptiva y otra correlacional, para caracterizar psicológicamente al niño y adolescente con Retinosis Pigmentaria y su familia, en el Centro Provincial que atiende a este paciente en la ciudad de Camagüey. El estudio se hizo aplicando una encuesta elaborada a los efectos del trabajo y una batería de pruebas psicológicas para niños y otra para adolescentes. Se realizó un muestreo intencional puro, no probabilístico de 41 pacientes. Las Pruebas Psicológicas aplicadas fueron: (...) Encuesta, Dibujo Libre, Rotter, Wechller Bellevue, Test Gráfico de la Familia para ambos grupos e Historietas de Madelaine Thomas, 3 Alegrías, 3 Roñas y 3 Miedos para niños y Técnica de los 10 Deseos, Inventario de Problemas Juveniles, Escala de Autovaloración de Dembo Rubinstein, para los adolescentes. A todas las madres de los pacientes se les aplicó el Cuestionario FFSIL para determinar su funcionamiento familiar. En lo metodológico, se realizaron modificaciones a las pruebas psicológicas, adaptándolas al entorno sociocultural cubano. Se reportaron hallazgos típicos explicables por el tipo de enfermedad. Como resultado de este estudio, se confirmó lo expuesto por otros autores que más que la enfermedad misma, lo que influye en su formación personológica es el proceso de socialización que se efectúe An study was made to characterize psychologically the childs and adolescent suffering from pigmentary retinosis and their family, in the Provincial Center that assists those patients in Camagüey. The study was carried out applying a battery of psychological tests for children and another for adolescents. The applied Psychological Tests were: interviews, Free Drawing, Rotter, Graphic Test of the Family for both groups and Comics of Madelaine Thomas, 3 Happiness, 3 Dirts and 3 Fears for children and Technique of the 10 Desires, Inventory of Juvenile Problems and the Scale of Dembo Rubinstein, for the adolescents. Methodological modifications to the psychological tests were carried out, adapting them to the Cuban sociocultural environment. Accountable typical discoveries were reported by the illness type. As results of this study, the most important fact for the patients' personalities is the socialization process. (shrink)

In previous decades, numerous involvements of adolescents in deviant behavior have been increasing, and previous researchers examined different variables that may influence these phenomena. This study was designed to look for the possible predictors of deviant behavior, as well as its association with family satisfaction and personality traits. The study was conducted on 1500 participants ages 12–19 years old from selected schools in Nueva Ecija. The researchers used the Deviant Behavior Variety Scale by Sanches et al.. It consists of (...) 19 items of a variety of deviant action such as thefts, drug and alcohol consumption, verbal and physical aggression, possession of weapons, vandalism, truancy, lies and defiance of authority, and selling drugs among adolescents. Out of 1500 samples, 1227 met the criteria for the deviant behavior scale. Descriptive and Inferential statistics such as Mean, sd, frequency, percentage, Regression analysis, Pearson-correlation, and Mann Whitney U test were used to analyze this study. The research found that there are differences in levels of deviant behavior among sexes. Results showed that female participants have higher tendency to engage in minor infractions of deviant acts, while males had a higher rate of participation in severe infractions of deviant acts. Moreover, there is a negative/inverse association between family satisfaction and deviant behavior. This implies that respondents who participate more in deviant behaviors are found to be less satisfied with their family life, while respondents who participate less in deviant behavior are more satisfied in their family life. Lastly, the current study found that personality trait-agreeableness is found to be the best predictor of deviant behavior among adolescents. (shrink)

Many therapists can attest to the fact that adolescents can be difficult and frustating clients-problems are seldom well defined, clearly delineated symptoms are more exception than the rule, and troubling situations often involve the entire family. Gestalt therapist Mark McConville draws on his more than twenty years of professional experience to offer clinicians an effective model for understanding and treating adolescents. He outlines the Developmental Tasks Model, which describes adolescents' struggles, "temporary insanity," and ultimately, triumph of development. (...) He clearly demonstrates that the Gestalt therapeutic model bridges the theoretical and clinical gap, and offers an indepth exploration of the various aspects of clinical work. _Adolescence_ offers valuable nuts-and-bolts advice on initiating therapy with adolescents who are not yet ready to do the self-reflective, exploratory work. In addition, the book examines the therapeutic method of engaging and cultivating the adolescent's emerging inner world. With perception and sensitivity, McConville explains how the clinician can guide the adolescent in the very personal and subjective process of birthing and existential self. The book details the process of the creative reorganization of the self during adolescence and explores the changes that take place in the adolescent's relationships with peers, parents, and others in the adult world. The author also tracks the interplay of intrapsychic and interpersonal boundary development and shows how this interplay manifests itself in relationships and evolves from early through late adolescence. The Gestalt model of therapy allows the clinician to make sense of the confusion of the adolescent world and map out the multiple possibilities of clinical interventions. (shrink)

Many therapists can attest to the fact that adolescents can be difficult and frustating clients-problems are seldom well defined, clearly delineated symptoms are more exception than the rule, and troubling situations often involve the entire family. Gestalt therapist Mark McConville draws on his more than twenty years of professional experience to offer clinicians an effective model for understanding and treating adolescents. He outlines the Developmental Tasks Model, which describes adolescents' struggles, "temporary insanity," and ultimately, triumph of development. (...) He clearly demonstrates that the Gestalt therapeutic model bridges the theoretical and clinical gap, and offers an indepth exploration of the various aspects of clinical work. _Adolescence_ offers valuable nuts-and-bolts advice on initiating therapy with adolescents who are not yet ready to do the self-reflective, exploratory work. In addition, the book examines the therapeutic method of engaging and cultivating the adolescent's emerging inner world. With perception and sensitivity, McConville explains how the clinician can guide the adolescent in the very personal and subjective process of birthing and existential self. The book details the process of the creative reorganization of the self during adolescence and explores the changes that take place in the adolescent's relationships with peers, parents, and others in the adult world. The author also tracks the interplay of intrapsychic and interpersonal boundary development and shows how this interplay manifests itself in relationships and evolves from early through late adolescence. The Gestalt model of therapy allows the clinician to make sense of the confusion of the adolescent world and map out the multiple possibilities of clinical interventions. (shrink)

En la actualidad se habla de la anomalía dentomaxilofacial como una enfermedad inherente a la civilización, cuya prevalencia varia en las distintas partes del mundo, el alto índice se relaciona a la heterogeneidad genética. Estas anomalías tienen una etiología multifactorial donde intervienen diversos factores internos o externos, que provocan variabilidad en su forma de presentación; cada una tiene características muy particulares y diversos grados de complejidad a la hora de ser tratadas, sin embargo poseen un aspecto común, afectan por lo (...) general la estética y la psiquis de los pacientes que las padecen. Con el objetivo de determinar afectaciones psicológicas en niños y adolescentes con anomalías dentomaxilofaciales se realizó un estudio no experimental descriptivo transversal. Se ejecutó en dos etapas y se emplearon métodos empíricos la recolección de la información a través de interrogatorio y examen clínico, incluido el Test Auto reporte vivencial para determinar la afectación psicológica del niño o adolescente. Se evidenció que los adolescentes resultaron ser afectados psicológicamente en presencia de anomalías de origen dentario. Presently, while prevalence varies in different parts of the world, dentomaxillofacial anomaly is regarded as a disease of our civilization. Its high rate is related to genetic heterogeneity. These anomalies have a multifactorial etiology since various internal or external factors that cause variability in its presentation are involved. Each of these anomalies has unique characteristics and varying degrees of complexity when being treated. However, they have a common feature: they usually affect the aesthetics and psyche of patients who suffer from them. In order to determine the psychological effects of dentomaxillofacial anomalies in children and adolescents, a non-experimental, descriptive, cross-sectional study was conducted. It was carried out in two stages and empirical methods were used for collecting information through interview and clinical examination, including Experiential Self-Report to determine the psychological effects in the child or adolescent. Through this study, adolescents were found to be affected psychologically in the presence of anomalies of dental origin. (shrink)

There is increasing global pressure to ensure that pregnant women are responsibly and safely included in clinical research in order to improve the evidence base that underpins healthcare delivery during pregnancy. One supposed barrier to inclusion is the assumption that pregnant women will be reluctant to participate in research. There is however very little empirical research investigating the views of pregnant women. Their perspective on the benefits, burdens and risks of research is a crucial component to ensuring (...) effective recruitment. The Research In Pregnancy Ethics study set out to ascertain the views of pregnant women about research participation using an inductive thematic analysis. We conducted semi-structured interviews with 20 women who had participated in a double-blind randomised placebo controlled trial in Wellington while pregnant. Our results show that at least some pregnant women recognise the value and importance of research during pregnancy. The women we interviewed were deeply invested in the research process and outcomes. Key motivations for participating were altruism, playing a valuable civic role and the importance of research. The main perceived burdens related to inconvenience and time commitment. For some women, possible randomization to the placebo arm was regarded as a burden or disadvantage. (shrink)

Pregnant adolescents have a higher risk of poor maternal and fetal outcomes, particularly in the setting of concomitant maternal alcohol and other drug (AOD) use. Despite numerous programmes aimed at reducing overall teen pregnancy rates and the recognition of AOD use as a risk factor for unintended pregnancy in adolescents, interventions targeting this specific group have been sparse. In adult drug-using women, financial incentives for contraception have been provided but are ethically controversial. This article explores whether a (...) trial could ethically employ monetary incentives in adolescents with AOD use to promote the use of long-acting reversible contraception (LARC), with special attention to the relevant distinctions between adults and adolescents. We conclude that a trial of incentives to promote LARC in this patient population is ethically permissible if the incentives are small, are tied to completion of an educational activity to minimise the quick fix temptation and potential for non-attendance to the risks and benefits of LARC and are provided only to the adolescent after an assessment of her reasoning to rule out coercion (eg, by guardians) as motivation. Information about treatment for AOD use and follow-up care in case of problems with the contraceptive or desire for removal should also be provided. Before implementing such a trial, qualitative research with input from providers, potential patients and their parents should be conducted to inform the programme's specific structure. (shrink)

A hypothetical scenario is presented in which a female patient is admitted to a private hospital to undergo a mastectomy and breast reconstruction. The surgeons and anaesthetists conducting the different procedures charge three times the medical aid rates. When the patient asks what the co-payments are likely to be, she is informed by the doctors’ accounts section that they can only provide this information after each procedure. The patient’s medical scheme also advises her that it cannot determine the likely co-payments (...) unless she completes the assessment form sent to her. The form requires her to include the costs reflected against the relevant ICD10 codes. The patient cannot complete the form because the doctors’ accounts sections have not informed her about the proposed procedures and the likely costs of each. This article builds on a previous article discussing doctors’ overarching responsibility to disclose medical treatment costs in advance. The present article outlines the legal requirements in the South African Constitution, the National Health Act and the Health Professions Act, and refers to the Promotion of Access to Information Act and Consumer Protection Act. Similar to the earlier article, this article addresses the ethical requirements of the Health Professions Council of South Africa and the internationally recognised biomedical ethical principles. Furthermore, it also refers to the National Patients Charter, the government’s policy document on health care services. (shrink)

Bullying often results in negative coping in victims, including an increased consumption of alcohol. Recently, however, an increase in alcohol use has also been reported among perpetrators of bullying. The factors triggering this pattern are still unclear. We investigated the role of empathy in the interaction between bullying and alcohol use in an adolescent sample (IMAGEN) at age 13.97 (±0.53) years (baseline (BL), N = 2165, 50.9% female) and age 16.51 (±0.61) years (follow-up 1 (FU1), N = 1185, 54.9% female). (...) General empathic distress served as a significant moderator of alcohol use in perpetrators (F9, 493 = 17.978, p < 0.01), which was specific for males and FU1. Male perpetrators, who are generally less sensitive to distress, might thus be more vulnerable to alcohol abuse. (shrink)

In New Zealand, there are adolescents who are at risk of pregnancy and who do not want to become pregnant, but are not using contraception. Cost and other barriers limit access to contraception. To address the gap between contraceptive need and contraceptive access, this paper puts forward the concept of proactive contraception provision, where adolescents are offered contraceptives directly. To strengthen the case for proactive contraception provision, this paper addresses a series of potential objections. One is that (...) such a programme would cause harm; another that such a programme would not have sufficient benefit. In rebutting these objections, the conclusion is reached that proactive contraception provision is a model worth pursuing as a means of meeting the needs of the New Zealand adolescent population and may be of interest more widely. (shrink)

I have been teaching qualitative research in education at The Hebrew University of Jerusalem for some years now. I have a sense that dealing with the issues of research methodology is of importance if we do indeed consider anthropology and qualitative methods to have something to contribute to improve the world in which we live. I write this rather short note out of a commitment to empirical research in the social sciences, emphasizing that which is observed and experienced, and recognizing (...) the complexity of studying that which is human. I reflect on my experience as a learner looking for ways to understand educational practice through methods able to capture its complexity. I then reflect on my experience as a teacher of anthropology and education, and consider the problems I encounter when trying to share my trade with my students. I hint at the potential connection between the political organizations within which we evolve and the paradigmtic perspectives which seem to become an obstacle in overcoming traditional empirical perspectives in the social sciences in general and in education in particular. Last, I consider multiple literacies as tools which might help us realize the problems mentioned and emphasize that these do not belong only in the world outside but also inside our immediate academic settings. (shrink)

Purpose of the articleThe presented study introduces the psychological factors which influence the creative development of young people in their families, especially from psychological position - acquired of birh of order - point of view. The study presents basic theoretical theses of birth orders´concept, as A. Adler and his followers introduced into psychological literature; it also brings information from empirical researches about the groups of five positions´ birth order: first-born, send-born, middle-born, youngest and parents´only children in relation to their psychological (...) characteristics. The second part is dedicated to issue of birth order in relation to creativity, intelligence and personality traits of 153 adolescents - students of the last year of high school who passed the exams for the artistic - technical study at the Faculty of Architecture with the average age 18.32 years. Methodology/methods The creativity was identified by Urban’s Test of Creative Thinking and Torrance Test of Creative Thinking. The intelligence was identified by the nonverbal Test of General Abilities. The Slovak version of NEO FFI Inventory was used for the measuring of five personality dimensions. The anamnestic data were obtained from our Questionnaire of the Family Constellation. The results were statistically processed by means of ANOVA SPSS program. The inter-group differences based on the birth-order were tested by the one-way ANOVA method as well as two-way analysis by ANOVA method and by T-test. Scientific aim The aim of the study was to find out in what kind of families live the gifted students, what are intersexual differences in creativity, intelligence, personality traits and in what birth order live the gifted adolescents, what are their typical personality traits and also the specifics of their creativity and the level of intelligence. Findings The research results on the sample of 153 adolescents showed that higher performances in the fluency and flexibility of thinking in the Torrance Creativity Test showed the women in comparison to men. The results indicate that the birth order differentiates the groups of gifted adolescents in the personality dimension openness to experience and agreeableness. Highly creative adolescents have ascribed themselves more often characteristics connected with creativity.The findings are comented as to the implications for the role of the creativity in both sexes and for the composition research sample and for research methods too. The other findings dealing with the specifics of creativity will be more broadly discussed in the study. (shrink)

Mass vaccination has been a successful public health strategy for many contagious diseases. The immunity of the vaccinated also protects others who cannot be safely or effectively vaccinated—including infants and the immunosuppressed. When vaccination rates fall, diseases like measles can rapidly resurge in a population. Those who cannot be vaccinated for medical reasons are at the highest risk of severe disease and death. They thus may bear the burden of others' freedom to opt out of vaccination. It is often asked (...) whether it is legitimate for states to adopt and enforce mandatory universal vaccination. Yet this neglects a related question: are those who opt out, where it is permitted, morally responsible when others are harmed or die as a result of their decision? In this article, we argue that individuals who opt out of vaccination are morally responsible for resultant harms to others. Using measles as our main example, we demonstrate the ways in which opting out of vaccination can result in a significant risk of harm and death to others, especially infants and the immunosuppressed. We argue that imposing these risks without good justification is blameworthy and examine ways of reaching a coherent understanding of individual moral responsibility for harms in the context of the collective action required for disease transmission. Finally, we consider several objections to this view, provide counterarguments and suggest morally permissible alternatives to mandatory universal vaccination including controlled infection, self-imposed social isolation and financial penalties for refusal to vaccinate. (shrink)

Empirical research with young people in Finland, Germany, Spain and Britain was carried out as part of the BIOCULT project funded by the European Union. The project focused on their attitudes to biotechnology and, in particular, the formation of arguments about risk and safety. This paper looks at the responses of 14–18 year olds to a story about the so called anti-obesity gene, in the form of advice to a friend who is taking it. The majority advised against taking it (...) with some differences by gender and country. Most reservations were on grounds of safety and the feeling that ‘natural’ ways to lose weight are better: A minority questioned the idea of striving for a ‘perfect’ body. The types of arguments used by the young people reveal underlying perspectives on the place of human beings in the world and whether they have a right to manipulate nature and their own bodies. (shrink)

Dr de Zulueta articulates some important and commonly held concerns about the anonymised screening programme for HIV in pregnant women, which is one of a number of such programmes that are current. However, in my view, many of these concerns reflect a failure to understand two key distinctions.In both these regards, there is a danger of putting up a “straw man” for challenge. In this commentary, I wish to pick up some of these issues to help to resolve the (...) apparent ethical tensions that Dr de Zulueta has set out.Firstly, the unlinked seroprevalence surveillance programmes, including that on pregnant women, comprise research studies that are designed to inform policy and practice, as well as individual decision making. They are not screening for the purpose of clinical care. The anonymisation is a procedural research tool, which enables the studies to be done in a way that does not undermine consent or individual autonomy. The ethical standards and duties expected of professionals are thus, in this specific regard, those that relate to the conduct of clinical research. That research is evidently designed to improve the quality of clinical care as a result of the information and insight gained. The duty of care is to apply the results of properly conducted and valid research in order to improve clinical practice on behalf of the individuals receiving care, in this case the mother and unborn child. The research conducted, in this case by a particular form of screening procedure, is not the same as a screening procedure done for clinical purposes to identify individuals who could benefit from an intervention. The ethical debate must therefore focus on the purpose in applying the procedure, not on the procedure itself, regardless of intent.Secondly, it is vital to distinguish, in debating such …. (shrink)

The WHO recently made news by apparently advising couples in Zika affected areas to delay pregnancy. On closer inspection, however, it is not so clear what advice was actually being offered in their interim guidance regarding the prevention of the sexual transmission of Zika. In this paper, we lay out a framework for considering the ethical issues that arise in the context of advising and use it to evaluate the WHO guidance. We argue that advising is not merely an informative (...) act. The choices that agencies make in how and whom they advise are ethical choices with practical implications; these choices change not only how people ought to think about their options but also how they indeed ought to act. While we focus on these interim guidance updates from the WHO, the framework we provide can shed light more generally on the ethical issues surrounding advising in other public health contexts. (shrink)

What was the process by which an antiquity found on the streets of Rome became the subject of a Renaissance engraving? How did engraving preserve the memory of such antiquities as they vanished into the homes of private collectors, were plundered or destroyed? This article focuses on Marcantonio Raimondis Lion Hunt to explore the relationship between ancient sculpture and the medium of print in Raphaels Rome.

Although prior research has demonstrated that switching schools poses a risk for academic and behavioral functioning among adolescents, relatively little is known about their emotional adjustment, or how it affects emotional well-being. Moreover, the cumulative effects of multiple risk and protective factors on their emotional well-being are even less covered in the existing literature. Guided by a risk and resilience ecological framework, the current study compared emotional well-being, operationalized as positive affect and negative affect, between adolescents who had (...) switched schools and their non-switch counterparts, and examined the direct and interactive effects of teacher autonomy support and two facets of grit (i.e., perseverance and consistency) on emotional well-being in both groups. A propensity score matching analysis was used to balance the two groups in terms of sociodemographic characteristics (i.e., age, gender, and socioeconomic status). A total of 371 adolescents who had switched schools and 742 non-switch counterparts aged from 13 to 18 years were involved in this study. Results indicated that adolescents who had switched schools reported higher levels of negative affect than their non-switch counterparts. Moreover, for adolescents who had switched schools, those who possessed higher levels of perseverance had a significantly negative association between teacher autonomy support and negative affect; however, the corresponding association was independent of perseverance for their non-switch counterparts. The current findings indicate that switching schools is a disadvantage for adolescents’ emotional states. However, teacher autonomy support and perseverance can protect adolescents who switch schools as critical stress-buffering factors against these negative feelings. (shrink)

ABSTRACT The objective of the study was to identify future lawyers’ and physicians’ views on testing children for Huntington’s disease (HD) against parents’ wishes. After receiving general information about HD, patient autonomy and confidentiality, law students and advanced medical students were shown an interview with a mother suffering from HD who is opposed to informing and testing her two children (aged 10 and 16) for HD. Students then filled out questionnaires concerning their agreement with testing. No significant differences were found (...) between medical and law students or between students from different courses concerning the adolescent son. Three quarters of students thought that he should be told about his mother’s disease, and 91% thought the adolescent son should have the opportunity of genetic testing for HD for himself. However, significant differences were found concerning the 10‐year old son, with 44% of law students and 30% of medical students in favour of testing the child for HD. Students raised some important ethical issues in their elective comments. In conclusion, we found highly positive attitudes towards informing a 16‐year old of his mother’s HD and offering to test him. These attitudes were not in tune with guidelines. Students did not consider several practical and ethical issues of genetic testing of children and adolescents. Specific education should ensure that attitudes are based on sufficiently detailed knowledge about all aspects of genetic testing of children to discourage pressures on persons at risk of HD. (shrink)

Contemporary theories of self-consciousness typically begin by dividing experiences of the self into types, each requiring separate explanation. The stereotypical case of an out of body experience may be seen to suggest a distinction between the sense of oneself as an experiencing subject, a mental entity, and a sense of oneself as an embodied person, a bodily entity. Point of view, in the sense of the place from which the subject seems to experience the world, in this case is tied (...) to the sense of oneself as a mental entity and seems to be the ‘real’ self. Closer reading of reports, however, suggests a substantially more complicated picture. For example, the ‘real’ self that is experienced as separate from the body in an OBE is not necessarily experienced as disembodied. Subjects may experience themselves as having two bodies. In cases classed as heautoscopy there is considerable confusion regarding the apparent location of the experiencing subject; is it the ‘real mind’ in the body I seem to be looking out from, or is it in the body that I see? This suggests that visual point of view can dissociate from the experience of one’s own “real mind” or experience of self-identification. I provide a tripartite distinction between the sense of ownership, the sense of embodiment and the sense of subjectivity to better describe these experiences. The phenomenology of OBEs suggests that there are three distinct forms of self-consciousness which need to be explained. (shrink)

Infants, children, adolescents, and pregnant and lactating women have been described as groups with special needs. Regardless of diet chosen, these groups are at higher risk for nutritional deficiencies than adult males. Vegan diets can be safely used by these groups if foods, and in some instances supplements, are selected which provide a healthful and nutritionally adequate diet. Guidelines have been developed for those choosing to follow vegan diets. In many instances vegan diets offer health benefits. Studies of (...) vegans are limited by factors such as heterogeneity of diets, the size and extent of this type of study, and difficulty in subject identification. There is a scarcity of studies of newer vegetarians who are often more mainstream than the vegetarians of the 1960s and 1970s. In some instances this has led to assumptions about today's vegans which are based on out-dated information. Thorough scientific studies of today's vegetarians, especially of those in groups with special needs, are needed. (shrink)

Various cases of conjoined twinning have been presented as problems for the animalist view that we are animals. In some actual and possible cases of human dicephalus that have been discussed in the literature, it is arguable that there are two persons but only one human animal. It is also tempting to believe that there are two persons and one animal in possible instances of craniopagus parasiticus that have been described. Here it is argued that the animalist can admit that (...) these are cases in which human persons are not animals, without forfeiting the title “animalist.” It is also shown that this is not only an option but also a well-motivated and plausible option for the animalist. Seeing this requires getting clear on what the word “we” should be thought to include in the animalist's claim that we are animals. Here animalism is defended against twinning objections by figuring out how to view the scope of the animalist's identity claim. (shrink)

The present study examined British children’s and adolescents’ individual and perceived group evaluations of a challenger when a member of one’s own group excludes a British national or an immigrant newcomer to the school from participating in a group activity. Participants included British children and adolescents, who were inducted into their group and heard hypothetical scenarios in which a member of their own group expressed a desire to exclude the newcomer from joining their activity. Subsequently, participants heard that (...) another member of the ingroup challenged the exclusionary act by stating that they should be inclusive. Children’s and adolescents’ individual evaluations of the bystander who challenged the social exclusion of an immigrant peer were more positive than their perceived group evaluations, recognizing that groups are often exclusionary. Only adolescents but not children differed in their individual and perceived group evaluations in the social exclusion of British peers. When the newcomer was an immigrant peer, adolescents were more likely to evaluate the challenger positively in both their individual and perceived group evaluations compared to children. Further, children, compared to adolescents, were more likely to reason about social and group norms to justify their evaluations only when the excluded peer was an immigrant but not when the excluded peer was British. Adolescents were more likely to reason about fairness, rights, and equality. The findings indicate that exclusionary group norms surrounding immigrants begin in childhood. Interventions that focus on changing group norms to be more inclusive could be effective in reducing prejudicial attitudes toward immigrants in childhood. (shrink)

Background: Adolescence is a period with physical, psychological, biological, intellectual, and social changes in which there is usually little perception of risk. COVID-19 has generated constant situations of change and uncertainty worldwide. During the pandemic, the acquisition of preventive behaviors has been relevant. Various studies carried out with adults associate risk perception and the implementation of preventive behaviors with knowledge about the COVID-19 and with age, but there are not many studies with adolescents. Therefore, the objective is to validate, (...) in Spanish, the questionnaire of the knowledge, attitudes, risk perceptions, and practices of adolescents toward the pandemic, and analyze it according to sociodemographic characteristics.Method: This study was a descriptive cross-sectional study, which included adolescents between the ages of 12–18. First, a translation and a back-translation of the questionnaire were performed. The questionnaire was presented in several high schools chosen by convenience sampling and following a non-probabilistic snowball sampling. Reliability and validity analyses were then carried out and the relationships between the different sociodemographic variables were analyzed.Results: The reliability of the questionnaire is acceptable. Knowledge was higher in women, and in those with a higher level of education; and were lower in those who lived in smaller towns, as well as in those who had a member of their family receiving financial aid. In terms of attitudes and risk perceptions, younger adolescents had higher scores, and those who had a member of their family receiving financial aid, lower.Conclusion: The questionnaire is a reliable tool in the Spanish adolescent population. Knowledge was influenced by gender, place of residence, level of education, and financial aid. Attitudes and risk perceptions were influenced by age and financial aid. For practices, no predictors were found. In general, adolescents scored lower on knowledge about COVID-19, but they scored higher on COVID-19 safety practices. (shrink)

Objectives: Young people who are concerned that consultations may not remain confidential are reluctant to consult their doctors, especially about sensitive issues. This study sought to identify issues and concerns of adolescents, and their parents, in relation to confidentiality and teenagers’ personal health information.Setting: Recruitment was conducted in paediatric dermatology and general surgery outpatient clinics, and on general surgery paediatric wards. Interviews were conducted in subjects’ own homes.Methods: Semistructured interviews were used for this exploratory qualitative study. Interviews were carried (...) out with 11 young women and nine young men aged 14–17. Parents of 18 of the young people were interviewed separately. Transcripts of tape recorded interviews provided the basis for a framework analysis.Results: Young women were more concerned than young men, and older teenagers more concerned than younger teenagers, about people other than their general practitioner having access to their health information. Young people with little experience of the healthcare system were less happy than those with greater knowledge of the National Health Service for non-medical staff to access their health information. As they grow older, adolescents become increasingly concerned that their health information should remain confidential.Conclusion: Young people’s willingness to be open in consultations could be enhanced by doctors taking time to explain to them that their discussion is completely confidential. Alternatively, if for any reason confidentiality cannot be assured, doctors should explain why. (shrink)

Are there clergy who don’t believe in God? Certainly there are former clergy who fall in this category. Before making their life-wrenching decisions, they were secret nonbelievers. Who knows how many like-minded pastors discover that they simply cannot take this mortal leap from the pulpit and then go on to live out their ministries in secret disbelief? What is it like to be a pastor who doesn’t believe in God? John Updike gave us a moving account in his brilliant novel, (...) In the Beauty of the Lilies, which begins with the story of Reverend Wilmot, a Lutheran minister whose life is shattered by his decision to renounce the pulpit in the face of his mounting disbelief. But that is fiction and Wilmot’s period of concealment is short-lived. What is it like to be a pastor who stays the course, in spite of sharing Wilmot’s disbelief? (shrink)

Hundreds of millions of people around the world are unable to meet their needs on their own, and do not receive adequate protection or support from their home states. These people, if they are to be provided for, need assistance from the international community. If we are to meet our duties to these people, we must have ways of knowing who should be eligible for different forms of relief. One prominent proposal from scholars and activists has been to classify all (...) who are unable to meet their basic needs on their own as ‘refugees’, and to extend to them the sorts of protections established under the United Nations Refugee Convention. Such an approach would expand the traditional refugee definition significantly. Unlike most academic commentators discussing this issue, I reject calls for an expanded refugee definition, and instead defend the core elements of the definition set out in the 1967 Protocol to the United Nations Refugee Convention. Using the tools of moral and political philosophy, I explain in this article how the group picked out by this definition has particular characteristics that make refugee protection distinctly appropriate for it. While many people in need of assistance can be helped ‘in place’, in their home countries, or by providing a form of temporary protected status to them, this is not so, I show, of convention refugees. The group picked out by the UN refugee definition is a normatively distinct group to whom we owe particular duties, duties we can only meet by granting them refuge in a safe country. Additionally, there are further practical reasons why a broader refugee definition may lead to problems. Finally, I argue that rejecting the call for a broader definition of refugees will better help us meet our duties to those in need than would an expanded definition. (shrink)

Background South Africa is likely to be the first country in the world to host an adolescent HIV vaccine trial. Adolescents may be enrolled in late 2007. In the development and review of adolescent HIV vaccine trial protocols there are many complexities to consider, and much work to be done if these important trials are to become a reality. Discussion This article sets out essential requirements for the lawful conduct of adolescent research in South Africa including compliance with consent (...) requirements, child protection laws, and processes for the ethical and regulatory approval of research. Summary This article outlines likely complexities for researchers and research ethics committees, including determining that trial interventions meet current risk standards for child research. Explicit recommendations are made for role-players in other jurisdictions who may also be planning such trials. This article concludes with concrete steps for implementing these important trials in South Africa and other jurisdictions, including planning for consent processes; delineating privacy rights; compiling information necessary for ethics committees to assess risks to child participants; training trial site staff to recognize when disclosures trig mandatory reporting response; networking among relevant ethics commitees; and lobbying the National Regulatory Authority for guidance. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.4 (2003) 369-372 [Access article in PDF] Unity of Agency and Volition:Some Personal Reflections Stephen Weiner The issues of unity of agency, self-as-narrative, and more generally, volition are highly personal to me. Indeed, I would say I have frequently been obsessed with them. I am 52 years old, and date the onset of my psychiatric symptoms—my long-term misery—very specifically: 11:00 pm Pacific Standard Time, August (...) 28, 1965. At almost precisely that time, I started obsessing that I was homosexual and, in fact, turning into a girl. Within days, derealization followed: for instance, the houses in my neighborhood seemed one-dimensional—they seemed as though they were painted, as though I could stick my hand or an object through them. Colors seemed less bright as well—but I hardly had words for all this at the time: it was an overwhelmingly preverbal feeling, but I found some words for it.I was also depressed, and knew I was depressed—that is, I was worried, had trouble sleeping, and had suicidal thoughts and feelings. Within weeks, I asked my parents if I could see a psychiatrist, and I did. I remember asking my psychiatrist if he ever thought about the possibility that everything might be an illusion, and he quoted the refrain from "Row, Row, Row Your Boat": "merrily, merrily, merrily, merrily, life is but a dream." But just asking him produced a chilling feeling that he did not exist and, largely for this reason, I did not mention unreality feelings again to therapists for another 20 years.So, like Dr. Wells' patient Edward, described by James Phillips (2003), I was in trouble; like Edward, I was starting to construct a narrative. I started feeling that I had "to tell my story" at about this time—before then, I had not felt a need to do that. That may be partly because young children take life for granted (at least, I did), and it may be partly because suffering, by its very nature, demands explanation; both reasons were probably operating—certainly, both my parents told me years later that I had seemed emotionally distressed as a child, and my mother told they would have given me Ritalin if it had been available. So, to other people (my parents and my teachers) I was mentally ill in some sense, and I have some pretty clear memories of what I now recognize as depression, especially in the second and third grades; but I did not think of myself as sick and I did not think of myself as suffering—and I did not experience the duality (at least) of selves that I started to experience almost immediately in August 1965.Phillips further points out that the "future Edward" could look back in his narrative, at a later age, and reconstruct his history either as someone with a continuing mental illness, or as someone who had attained a secure, healthy adulthood and saw his experience as adolescent pain in the service of ultimate adult health and integration. I see my story, I am sorry to report, as [End Page 369] one of unremitting basic pain but with the positive dimension that I was able to go on, obtain a good education, work a good deal in my adult life, and father a child. But my narrative—and am I not, as a highly verbal person, almost constrained to think of my life as a narrative?—has been one, as Phillips (following Kleinman) realizes, of suffering. It is, above all else, an illness narrative. I find the approach of J. Melvin Woody (2003)—of privileging performing and performing arts and spatial metaphors over story—less relevant and true to myself, although I see no reason to argue with Mary's preference for such forms. It may be that the temporal discontinuities she has experienced predispose her to see herself in such terms—may, in fact, necessitate doing so. I am not exactly sure why, but it probably has to do with acting, with trying on and performing one role... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.4 (2003) 369-372 [Access article in PDF] Unity of Agency and Volition:Some Personal Reflections Stephen Weiner The issues of unity of agency, self-as-narrative, and more generally, volition are highly personal to me. Indeed, I would say I have frequently been obsessed with them. I am 52 years old, and date the onset of my psychiatric symptoms—my long-term misery—very specifically: 11:00 pm Pacific Standard Time, August (...) 28, 1965. At almost precisely that time, I started obsessing that I was homosexual and, in fact, turning into a girl. Within days, derealization followed: for instance, the houses in my neighborhood seemed one-dimensional—they seemed as though they were painted, as though I could stick my hand or an object through them. Colors seemed less bright as well—but I hardly had words for all this at the time: it was an overwhelmingly preverbal feeling, but I found some words for it.I was also depressed, and knew I was depressed—that is, I was worried, had trouble sleeping, and had suicidal thoughts and feelings. Within weeks, I asked my parents if I could see a psychiatrist, and I did. I remember asking my psychiatrist if he ever thought about the possibility that everything might be an illusion, and he quoted the refrain from "Row, Row, Row Your Boat": "merrily, merrily, merrily, merrily, life is but a dream." But just asking him produced a chilling feeling that he did not exist and, largely for this reason, I did not mention unreality feelings again to therapists for another 20 years.So, like Dr. Wells' patient Edward, described by James Phillips (2003), I was in trouble; like Edward, I was starting to construct a narrative. I started feeling that I had "to tell my story" at about this time—before then, I had not felt a need to do that. That may be partly because young children take life for granted (at least, I did), and it may be partly because suffering, by its very nature, demands explanation; both reasons were probably operating—certainly, both my parents told me years later that I had seemed emotionally distressed as a child, and my mother told they would have given me Ritalin if it had been available. So, to other people (my parents and my teachers) I was mentally ill in some sense, and I have some pretty clear memories of what I now recognize as depression, especially in the second and third grades; but I did not think of myself as sick and I did not think of myself as suffering—and I did not experience the duality (at least) of selves that I started to experience almost immediately in August 1965.Phillips further points out that the "future Edward" could look back in his narrative, at a later age, and reconstruct his history either as someone with a continuing mental illness, or as someone who had attained a secure, healthy adulthood and saw his experience as adolescent pain in the service of ultimate adult health and integration. I see my story, I am sorry to report, as [End Page 369] one of unremitting basic pain but with the positive dimension that I was able to go on, obtain a good education, work a good deal in my adult life, and father a child. But my narrative—and am I not, as a highly verbal person, almost constrained to think of my life as a narrative?—has been one, as Phillips (following Kleinman) realizes, of suffering. It is, above all else, an illness narrative. I find the approach of J. Melvin Woody (2003)—of privileging performing and performing arts and spatial metaphors over story—less relevant and true to myself, although I see no reason to argue with Mary's preference for such forms. It may be that the temporal discontinuities she has experienced predispose her to see herself in such terms—may, in fact, necessitate doing so. I am not exactly sure why, but it probably has to do with acting, with trying on and performing one role... (shrink)

We think less than we think. My thesis moves from this suspicion to show that standard accounts of intentional action can't explain the whole of agency. Causalist accounts such as Davidson's and Bratman's, according to which an action can be intentional only if it is caused by a particular mental state of the agent, don't work for every kind of action. So-called automatic actions, effortless performances over which the agent doesn't deliberate, and to which she doesn't need to pay attention, (...) constitute exceptions to the causalist framework, or so I argue in this thesis. Not all actions are the result of a mental struggle, painful hesitation, or the weighting of evidence. Through practice, many performances become second nature. Think of familiar cases such as one's morning routines and habits: turning on the radio, brushing your teeth. Think of the highly skilled performances involved in sport and music: Jarrett's improvised piano playing, the footballer's touch. Think of agents' spontaneous reactions to their environment: ducking a blow, smiling. Psychological research has long acknowledged the distinctiveness and importance of automatic actions, while philosophy has so far explained them together with the rest of agency. Intuition tells us that automatic actions are intentional actions of ours all the same (I have run a survey which shows that this intuition is widely shared): not only our own autonomous deeds for which we are held responsible, but also necessary components in the execution and satisfaction of our general plans and goals. But do standard causal accounts deliver on the intentionality of automatic actions? I think not. Because, in automatic cases, standard appeals to intentions, beliefs, desires, and psychological states in general ring hollow. We just act: we don't think, either consciously or unconsciously. On the reductive side, Davidson's view can't but appeal to, at best, unconscious psychological states, the presence and causal role of which is, I argue, inferred from the needs of a theory, rather than from evidence in the world. On the non-reductive side, Bratman agrees, with his refutation of the Simple View, that we can't just attach an intention to every action that we want to explain. But Bratman’s own Single Phenomenon View, appealing to the mysterious notion of 'motivational potential', merely acknowledges the need for refinement without actually providing one. So I propose my own account of intentional action, the 'guidance view', according to which automatic actions are intentional: differently from Davidson and Bratman, who only offer necessary conditions in order to avoid the problem of causal deviance, I offer a full-blown account: E's phi-ing is intentional if and only If phi-ing is under E's guidance. This account resembles one developed by Frankfurt, with the crucial difference that Frankfurt – taking 'acting with an intention' and 'acting intentionally' to be synonymous – thinks that guidance is sufficient only for some movement being an action, but not for some movement being an intentional action. I argue that, on the other hand, Frankfurt's concept of guidance can be developed so that it is sufficient for intentional action too. In Chapter One I present and defend my definition of ‘automatic action’. In Chapter Two I show that such understanding of automatic actions finds confirmation in empirical psychology. In Chapter Three I show that Davidson's reductive account of intentional action does not work for automatic actions. In Chapter Four I show that the two most influential non-reductive accounts of intentional action, the Simple View and Bratman's Single Phenomenon View, don't work either. And in Chapter Five I put forward and defend my positive thesis, the 'guidance view'. Also, in the Appendix I present the findings of my survey on the intentionality of automatic actions. (shrink)

To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effect. A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on "Death and Dying" was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on "Decisions near the End of Life". Practitioners accept the relevance of concepts widely disparaged (...) by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/withdrawing treatment. Within the UK nurses' group a "rationalist" axis of respondents who describe themselves as having "no religion" are closer to the bioethics consensus on withholding and withdrawing treatment. Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners. (shrink)

_"A stimulating history of how the imagination interacted with its sibling psychological faculties—emotion, perception and reason—to shape the history of human mental life."—_The __Wall Street Journal__ To imagine—to see what is not there—is the startling ability that has fueled human development and innovation through the centuries. As a species we stand alone in our remarkable capacity to refashion the world after the picture in our minds. Traversing the realms of science, politics, religion, culture, philosophy, and history, Felipe Fernández-Armesto reveals the (...) thrilling and disquieting tales of our imaginative leaps—from the first _Homo sapiens_ to the present day. Through groundbreaking insights in cognitive science, Fernández-Armesto explores how and why we have ideas in the first place, providing a tantalizing glimpse into who we are and what we might yet accomplish. Unearthing historical evidence, he begins by reconstructing the thoughts of our Paleolithic ancestors to reveal the subtlety and profundity of the thinking of early humans. A masterful paean to the human imagination from a wonderfully elegant thinker, _Out of Our Minds_ shows that bad ideas are often more influential than good ones; that the oldest recoverable thoughts include some of the best; that ideas of Western origin often issued from exchanges with the wider world; and that the pace of innovative thinking is under threat. (shrink)

Objectives—To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effectDesign, subjects and setting–A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on “Death and Dying” was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on “Decisions near the End of Life”.Results–Practitioners accept the relevance of concepts widely (...) disparaged by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/ withdrawing treatment. Within the UK nurses' group a “rationalist” axis of respondents who describe themselves as having “no religion” are closer to the bioethics consensus on withholding and withdrawing treatment.Conclusions—Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners. (shrink)

Parental consent poses challenges to needed research with adolescents who identify as lesbian, gay, bisexual, transgender, queer and/or questioning (LGBTQ+) and are at heightened risk for negative health outcomes. Obtaining parental consent in studies focused on LGBTQ+ issues can prove arduous if adolescents have not yet disclosed their identity or have unsupportive guardians. Institutional Review Boards (IRBs) may be hesitant to grant waivers of parental consent, yet research suggests that studies requiring parental consent deter the participation of (...) class='Hi'>adolescents who identify as LGBTQ+. In this article, ethical considerations regarding waivers of parental consent in the context of the American Psychological Association’s (APA) general ethical principles are reviewed and recommendations for psychological researchers seeking waivers of parental consent are offered. A vignette is used to demonstrate a question-and-answer guide to help determine if a waiver of parental consent is ethically justified. (shrink)

The practical difficulties that trouble any effort to discuss “pluralism” in American literary studies can be glimpsed in the following exchange. In a 1980 interview in the Literary Review of Edinburgh, Ken Newton put this question to Derrida:It might be argued that deconstruction inevitably leads to pluralist interpretation and ultimately to the view that any interpretation is as good as any other. Do you believe this and how do you select some interpretations as being better than others?Derrida replied:I am not (...) a pluralist and I would never say that every interpretation is equal but I do not select. The interpretations select themselves. I am a Nietzschean in that sense. You know that Nietzsche insisted on the fact that the principle of differentiation was in itself selective. The eternal return of the same was not repetition, it was a selection of the more powerful forces. So I would say that some are more powerful than others. The hierarchy is between forces and not between true and false.1­­The irony of Newton’s identification of pluralism with the very interpretive irresponsibility that it accuses others—Derrida foremost among them—of embracing is certainly not lost on those critics who call themselves pluralists; it comes as no surprise to them that Derrida declines to join their company. Nevertheless, the breezy gloss of pluralism as “the view that any interpretation is as good as any other” is bound to seem plausible to the large numbers of readers for whom the word denotes a generalized tolerance the refusal of dogmatism. That Derrida should be called upon to dissociate himself from pluralism is in fact symptomatic of the profound confusion surrounding the term. At present, the pervasiveness of such loose talk compels pluralists to defend themselves regularly against this kind of misinterpretation. Thus, the colloquial reading of pluralism that construes it as mere relativism, the absence of principled constraints, is frequently acknowledged, if only to be rejected. Even Bruch Erlich must emphasize that pluralism does not want “a totally free critical market, for that involves the proliferation of a hundred flowers, what Booth dismissively terms ‘chaotic warfare.’ ”2 1. James Kearn and Ken Newton, “An Interview with Jacques Derrida,” Literary Review 14 , p.21.2. Bruce Erlich, “Amphibolies: On the Critical Self-Contradictions of ‘Pluralism,’ ” this volume, p. 527; all further references to this essay will be included in the text. Ellen Rooney teaches English and women’s studies at Brown University. She is currently at work on a study entitled Seductive Reasoning: Pluralism and the Problematic of General Persuasion. (shrink)

Purpose: The purpose of this study was to verify the long-term effect of adverse childhood experiences, school disengagement, and the reasons for leaving school on adolescent delinquency while adjusting for sex.Methods: Data were collected from 663 teenagers [male 368, female 295; mean age = 16.81 ; age range = 13–19 years] through a Longitudinal Survey and Support Plan for Dropouts.Results: Multivariate latent growth modeling demonstrated that ACEs and school disengagement are positively associated with delinquency and the mediating effect of school (...) disengagement on association between ACEs and delinquency was verified. Teenagers who quit school for personal reasons reported fewer instances of delinquent behavior than adolescents who left because of school reasons.Conclusion: This study suggests that researchers and teachers need to consider ACEs and school disengagement as a warning index for delinquency with school dropout. In addition, the reason for leaving school should be considered to clarify the effect of school dropout on delinquency in adolescents who dropout. (shrink)

This study explores some possibilities of social network analysis for studying adolescents’ communication patterns. A full network analysis was conducted on third-grade high school students (15 year olds, 137 students) in Belgium. The results pointed out that face-to-face communication was still the most prominent way for information to flow through the network. Interactions through communication media (e-mail, instant messaging, text messaging, mobile phone, and landline phone), however, supplemented this flow of information in a substantive way. Communication media use patterns (...) were characterized by multiplexity and could be placed on a unidimensional scale indicating a media hierarchy. Close friends (strong ties) used all communication media at their disposal to connect with each other; students who were just friends (weak ties) preferred face-to-face communication and social network sites. In the discussion, some other possibilities of social network analysis for studying adolescents’ communication media are discussed. (shrink)

Objective Adolescents have had very limited access to research on biomedical prevention interventions despite high rates of HIV acquisition. One concern is that adolescents are a vulnerable population, and trials carry a possibility of harm, requiring investigators to take additional precautions. Of particular concern is preventive misconception, or the overestimation of personal protection that is afforded by enrolment in a prevention intervention trial. Methods As part of a larger study of preventive misconception in adolescent HIV vaccine trials, we (...) interviewed 33 male and female 16–19-year-olds who have sex with men. Participants underwent a simulated HIV vaccine trial consent process, and then completed a semistructured interview about their understanding and opinions related to enrolment in a HIV vaccine trial. A grounded theory analysis looked for shared concepts, and focused on the content and process of adolescent participants’ understanding of HIV vaccination and the components of preventive misconception, including experiment, placebo and randomisation. Results Across interviews, adolescents demonstrated active processing of information, in which they questioned the interviewer, verbally worked out their answers based upon information provided, and corrected themselves. We observed a wide variety of understanding of research concepts. While most understood experiment and placebo, fewer understood randomisation. All understood the need for safer sex even if they did not understand the more basic concepts. Conclusions Education about basic concepts related to clinical trials, time to absorb materials and assessment of understanding may be necessary in future biomedical prevention trials. (shrink)

The recent process of deinstitutionalization of the psychiatric treatment system, in both Denmark and other European countries, has relied heavily on the involvement in treatment and recovery of cohabitant relatives of diagnosed people. However, political objectives regarding depression and involvement rely on a limited body of knowledge about people’s ways of managing illness-related problems in everyday life. Drawing on a discursive notion of gender laid out by Raewyn Connell, the aim of the article is to elucidate how the involvement of (...) relatives is guided by an extra- individual rationale about gender and caregiving, and how this gendered discourse might frame different challenges and burdens, depending on the gender of the diagnosed person and the cohabitant relative. Drawn from a larger, multisited field study on involvement processes in Danish psychiatry, t he article is based on field notes and 21 interviews with seven heterosexual couples. The analysis shows that gender works as a decisive premise for the division of caregiving labour among the couples, and clarifies how the couples’ gendered institution is disrupted after the onset of depression. The article argues that gender-blind involvement strategies could produce divergent treatment outcomes and varying social effects in relation to couples’ everyday family lives. (shrink)