Biblical Christianity should be a powerful, life-forming, paradigm-shifting experience leading to increasing levels of Christlikeness. Unfortunately, the experience of many Christians today is far short of the transformation described in Scripture. This article reports on a portion of mixed-methods research examining the transformative learning reported by alumni of a 22-lesson discipleship process called the Immersion Experience by Aphesis Group Ministries. Holistic spiritual health involves listening to our emotions, confronting toxic shame, addressing childhood defenses, and untangling our distorted spirituality.

Ethical approval must be obtained before medical research can start. We describe the differences in EA for an pseudonymous, non-interventional, observational European study. Sixteen European national coordinators of the international study on very old intensive care patients answered an online questionnaire concerning their experience getting EA. N = 8/16 of the NCs could apply at one single national ethical committee, while the others had to apply to various regional ECs and/or individual hospital institutional research boards. The time between applying for (...) EA and the first decision varied between 7 days and 300 days. In 9/16 informed consent from the patient was not deemed necessary; in 7/16 informed consent was required from the patient or relatives. The upload of coded data to a central database required additional information in 14/16. In 4/16 the NCs had to ask separate approval to keep a subject identification code list to de-pseudonymize the patients if questions would occur. Only 2/16 of the NCs agreed that informed consent was necessary for this observational study. Overall, 6/16 of the NCs were satisfied with the entire process and 8/16 were unsatisfied. 11/16 would welcome a European central EC that would judge observational studies for all European countries. Variations in the process and prolonged time needed to get EA for observational studies hampers inclusion of patients in some European countries. This might have a negative influence on the external validity. Further harmonization of ethical approval process across Europe is welcomed for low-risk observational studies. Getting ethical approval for low-risk, non-interventional, observational studies varies enormously across European countries. (shrink)

Worldwide there are substantial differences within and between countries in aggression and violence. Although there are various exceptions, a general rule is that aggression and violence increase as one moves closer to the equator, which suggests the important role of climate differences. While this pattern is robust, theoretical explanations for these large differences in aggression and violence within countries and around the world are lacking. Most extant explanations focus on the influence of average temperature as a factor that triggers aggression, (...) or the notion that warm temperature allows for more social interaction situations in which aggression is likely to unfold. We propose a new model, CLimate, Aggression, and Self-control in Humans, that helps us to understand differences within and between countries in aggression and violence in terms of differences in climate. Lower temperatures, and especially larger degrees of seasonal variation in climate, call for individuals and groups to adopt a slower life history strategy, a greater focus on the future, and a stronger focus on self-control. The CLASH model further outlines that slow life strategy, future orientation, and strong self-control are important determinants of inhibiting aggression and violence. We also discuss how CLASH differs from other recently developed models that emphasize climate differences for understanding conflict. We conclude by discussing the theoretical and societal importance of climate in shaping individual and societal differences in aggression and violence. (shrink)

Background: The American Medical Association, the British Medical Association and the Canadian Medical Association have guidelines that specifically discourage physicians from self-prescribing or prescribing to family members, but only the BMA addresses informal prescription requests between colleagues. Objective: To examine the practices of paediatric providers regarding self-prescribing, curbsiding colleagues, and prescribing and refusing to prescribe to friends and family. Methods: 1086 paediatricians listed from the American Academy of Paediatrics 2007 web-based directory were surveyed. Results: 44% of eligible survey respondents returned (...) usable surveys. Almost half of respondents had prescribed for themselves. An equal number had informally requested a prescription from a colleague. Three-quarters stated they had been asked to prescribe a prescription drug for a first-degree or second-degree relative, and 51% had been asked by their spouse. Eighty-six per cent stated that they had refused to write a prescription on at least one occasion for a friend or family member. The following reasons “strongly influenced” their decision to refuse a prescription request: outside of provider’s expertise ; patient’s need for his or her own physician ; not medically indicated ; need for a physical examination. Conclusion: These data confirm that most physicians have engaged in self-prescribing or curbside requests for prescriptions. It can be argued that curbsiding is more morally problematic than self-prescribing because it implicates a third party, and should be discouraged regardless of whether the requester is a colleague, family member or friend. (shrink)

A total of 80 authors working in a variety of scientific disciplines commented on the theoretical model of CLimate, Aggression, and Self-control in Humans. The commentaries cover a wide range of issues, including the logic and assumptions of CLASH, the evidence in support of CLASH, and other possible causes of aggression and violence. Some commentaries also provide data relevant to CLASH. Here we clarify the logic and assumptions of CLASH and discusses its extensions and boundary conditions. We also offer suggestions (...) for future research. Regardless of whether none, some, or all of CLASH is found to be true, we hope it will stimulate future research on the link between climate and human behavior. Climate is one of the most presing issues of our time. (shrink)

In the United States, the field of bioethics has expanded over the last two decades. Several institutions offer graduate-level training at both the masters and doctoral level. However, a lack of published literature on the outcomes of doctoral training in bioethics from the perspective of graduates exists. Researchers conducted an online survey of doctoral students who had finished all doctoral requirements but their dissertation, as well as doctoral graduates, of four US-based institutions to ascertain their perspectives on a number of (...) items regarding their doctoral training and their perception of how that training prepared them for their current role in the workforce. Responses from 34 participants were assessed. Respondents had positive overall views on the utility of a bioethics doctorate and the educational training they received in their respective programs. A number of areas for improvement were identified, including better structured clinical ethics training, greater opportunities for research and publishing, and having the ability to teach during their doctoral program, as well as formal pedagogy training. Greater exposure to clinical ethics consultation during the doctoral program was associated with feeling fully prepared as a clinical ethics consultant. This is the first study to assess the perspectives of bioethics doctoral graduates and ABD students regarding the utility of a bioethics doctorate. Per the perspectives of graduates and ABD students, bioethics doctorates are important and effective to train professional bioethicists. We recommend that a few key changes to these programs’ curricula can further bolster their effectiveness. (shrink)

Johanna Knapstein,1 Daniel Grimm,1 Marcus A Wörns,1 Peter R Galle,1 Hauke Lang,2 Tim Zimmermann111st Department of Internal Medicine, Johannes Gutenberg-University, Mainz, Germany; 2Department of General, Visceral and Transplantation Surgery, Johannes Gutenberg-University, Mainz, GermanyIntroduction: Hepatitis C virus reinfection occurs universally after liver transplantation, with accelerated cirrhosis rates of up to 30% within 5 years after liver transplantation. Dual antiviral therapy with pegylated interferon-2a and ribavirin only reaches sustained virological response rates of ~30% after liver transplantation. With the approval of viral (...) NS3/4A protease inhibitors telaprevir, boceprevir, and simeprevir and the NS5B polymerase inhibitor sofosbuvir, combination therapy offers new therapeutic options for HCV-infected patients, resulting in considerably higher sustained virological response rates in the nontransplant setting. Case presentation: We report three cases of TVR-based triple antiviral therapy in HCV genotype 1 reinfected patients after liver transplantation, of whom a 57-year-old Caucasian female and a 43-year-old Caucasian male were therapy naïve, and a 49-year-old Caucasian male patient was pretreated ineffectively. After 4 weeks of therapy, viral load decreased one to three log10 and became negative in weeks 6 to 8 in the therapy naïve patients. The pretreated patient showed a negative viral load in week 4. TVR was administered over 12 weeks, 750 mg thrice daily. Doses of immunosuppression with cyclosporine were reduced four to six fold. Initial peg-IFN and RBV doses ranged from 135–180 µg/week and 800–1,200 mg/day, according to the patient's body weight. Doses of peg-IFN and RBV were adapted to 90–135 µg/week and 400–800 mg/day after 2 to 12 weeks of protease inhibitor therapy. Dual therapy was continued for 36 weeks with total treatment duration of 48 weeks in the therapy naïve patients leading to a sustained virological response 12 weeks after the end of therapy. In the pretreated patient a breakthrough was detected in week 24 and therapy was discontinued. Overall, antiviral therapy was well tolerated. Side effects included dysgeusia and anemia leading to erythropoietin application and blood transfusions. Conclusion: This case series emphasizes that triple therapy with TVR is an efficient treatment for therapy naïve HCV genotype 1 reinfected patients after liver transplantation. But therapeutic options for pretreated patients require improvement. Keyword: cyclosporine, interferon, ribavirin, hepatitis C, protease inhibitor. (shrink)

Music is a natural human expression present in all cultures, but the functions it serves are still debated. Previous research indicates that rhythm, an essential feature of music, can enhance coordination of movement and increase social bonding. However, the prolonged effects of rhythm have not yet been investigated. In this study, pairs of participants were exposed to one of three kinds of auditory stimuli (rhythmic, arrhythmic, or white‐noise) and subsequently engaged in five trials of a joint‐action task demanding interpersonal coordination. (...) We show that when compared with the other two stimuli, exposure to the rhythmic beat reduced the practice effect in task performance. Analysis of the behavioral data suggests that this reduction results from more temporally coupled motor movements over successive trials and that shared exposure to rhythm facilitates interpersonal motor coupling, which in this context serves to impede the attainment of necessary dynamic coordination. We propose that rhythm has the potential to enhance interpersonal motor coupling, which might serve as a mechanism behind its facilitation of positive social attitudes. (shrink)

Historically, the hypothesis driving emotion research has been that emotion’s data-base—in language, physiology, and behavior— is organized around specific mental states, as reflected in evaluative language. It is suggested that this approach has not greatly advanced a natural science of emotion and that the developing motivational model of emotion defines a better path: emotion is an evolved trait founded on motivational neural circuitry shared by mammalian species, primitively prompting heightened perceptual processing and reflex mobilization for action to appetitive or threatening (...) survival cues. As the field moves forward with increasingly sophisticated measurement technology and assessing more complex affective functioning, scientific understanding of human emotion will proceed best within the framework of this mammalian brain model. (shrink)

The article considers patterns of reactivity in organ systems mediated by the autonomic nervous system as they relate to central neural circuits activated by affectively arousing cues. The relationship of these data to the concept of discrete emotion and their relevance for the autonomic feedback hypothesis are discussed. Research both with animal and human participants is considered and implications drawn for new directions in emotion science. It is suggested that the proposed brain-based view has a greater potential for scientific advance (...) than the traditional model that emphasizes specific states of mind as mediators or reflectors of visceral action. (shrink)

Our view is that fundamental appetitive and defensive motivation systems evolved to mediate a complex array of adaptive behaviors that support the organism’s drive to survive—defending against threat and securing resources. Activation of these motive systems engages processes that facilitate attention allocation, information intake, sympathetic arousal, and, depending on context, will prompt tactical actions that can be directed either toward or away from the strategic goal, whether defensively or appetitively determined. Research from our laboratory that measures autonomic, central, and somatic (...) reactions when processing emotional scenes is described which indicates that motivationally relevant cues, whether appetitive or defensive, capture attention preferentially, prompt enhanced perceptual processing and information gathering, and occasion metabolic arousal that mobilizes the organism for coping actions. (shrink)

The volume documents, and makes an original contribution to, an astonishing period in twentieth-century philosophy—the progress of Arne Naess's ecophilosophy from its inception to the present. It includes Naess's most crucial polemics with leading thinkers, drawn from sources as diverse as scholarly articles, correspondence, TV interviews and unpublished exchanges. The book testifies to the skeptical and self-correcting aspects of Naess's vision, which has deepened and broadened to include third world and feminist perspectives. Philosophical Dialogues is an essential addition to the (...) literature on environmental philosophy. (shrink)

Als im Jahr 1516 die neue Ausgabe des Neuen Testaments, das Novum Instrumentum des Erasmus von Rotterdam erschien, war dies ein herausragendes Ereignis mit weitreichenden Konsequenzen und Wirkungen. Sowohl die Reformation des 16. Jahrhunderts mit ihrer zentralen Stellung der biblischen Schriften und ihrer Exgeses als auch die Entwicklung der in die Moderne weisenden biblischen Textkritik lassen sich ohne die Arbeiten des Erasmus kaum denken. Dennoch ist auch Erasmus in einem breiteren Zusammenhang der mannigfachen Bibel- und Text-orientierten Reformbewegung des Spätmittelalters, der (...) Renaissance und des Humanismus zu sehen. Des verdeutlichen die einzelnen Beiträge des vorliegenden Bandes. (shrink)

ABSTRACT:Bioethicists today are taking a greater role in the design and implementation of emerging technologies by "embedding" within the development teams and providing their direct guidance and recommendations. Ideally, these collaborations allow ethical considerations to be addressed in an active, iterative, and ongoing process through regular exchanges between ethicists and members of the technological development team. This article discusses a challenge to this embedded ethics approach—namely, that bioethical guidance, even if embraced by the development team in theory, is not easily (...) actionable in situ. Many of the ethical problems at issue in emerging technologies are associated with preexisting structural, socioeconomic, and political factors, making compliance with ethical recommendations sometimes less a matter of choice and more a matter of feasibility. Moreover, incentive structures within these systemic factors maintain them against reform efforts. The authors recommend that embedded bioethicists utilize principles from behavioral science (such as behavioral economics) to better understand and account for these incentive structures so as to encourage the ethically responsible uptake of technological innovations. (shrink)