Surgery is an important part of health care worldwide. Without access to surgical treatments, morbidity and mortality increase. Access to surgical treatment is a significant problem in global public health because surgical services are not equally distributed in the world. There is a disproportionate scarcity of surgical access in low-income countries. There are many charitable organizations around the world that sponsor surgical missions to under served nations. One such organization is Operation Smile International, a group with which both authors have (...) volunteered. This paper will describe the purpose and processes involved in Operation Smile and identify some of the key ethical issues that arise in short term medical volunteer work highlighting the importance of sustainability. (shrink)

Integral Science's most distinctive effect is to shift the context of human interactions from competition against one another to seeking what is good for both one's self and the larger whole. The partnership environment it suggests creates a foundation of relationship that powerfully increases organizational intelligence. This simple switch creates the potential for both more humanistic and more effective organizations that are better able to meet the needs of the populations they serve.

Suffering is a universal human phenomenon. In a time when religious differences are evident and often fuel conflict, shared narratives may provide common ground in which true understanding may take root. This paper will consider the problem of suffering and address how adherents of the three great monotheistic traditions seek understanding, comfort, and the believer’s appropriate response from the same story found within their respective sacred texts: the story of Job, the servant of Yahweh in the Tanakh/Old Testament of Judaism (...) and Christianity— known as Ayyub, prophet of Allah, in the Qur’an. The story of Job addresses more than the distribution of evil problem. At stake in the story is Job’s very relationship to his God. This paper will consider a few of the many Jewish, Christian, and Islamic insights from the ancient story, hopefully leading to mutual understanding and empathy. Keywords: suffering, Tanakh, Qur’an, Job, Ayyub. (shrink)

The purpose of the current study was to examine the reliability and validity of the RESTQ-Sport-36 for use in the collegiate student-athlete population. A total of 494 collegiate student-athletes competing in National Collegiate Athletic Association Division I, II, or III sanctioned sport completed the RESTQ-Sport-36 and Brief Profile of Mood States. Structural equation modeling procedures were used to compare first order to hierarchical model structures. Results of a confirmatory factor analysis and exploratory structural equation modeling analysis indicated that the first (...) order 12-factor structure demonstrated the best fit of all models tested. Support was not observed for the fit of any hierarchical model. Moderate to strong correlations were observed between stress and recovery subscales and mood states, thus supporting the construct validity of the abbreviated RESTQ measurement model. The current findings provide support for the measure’s use in this population and give pause as it relates to the scoring and interpretation of hierarchical factors such as Total Stress and Total Recovery. Overall, the current results indicate that the RESTQ-Sport-36 may be a useful tool for collegiate student-athlete training load and competition monitoring. (shrink)

During the past two decades, several reports have documented substantial support from clinicians, policy-makers, and the general public for the use of advance directives, yet studies continue to find that only a minority of individuals have completed these legal documents. Advance directives are written instructions, such as living wills or durable powers of attorney for health care, which describe an individual's medical treatment wishes in the event that individual becomes incapacitated in the future. The completion and use of advance directives (...) is one of several components of the broader activity of advance care planning, that is, the overall planning and communication of personal wishes concerning future medical care.In December 1991, the federal Patient Self-Determination Act became effective. Promoted as a federal initiative to enhance an individual's control over medical treatment decision making and, therefore, patient autonomy and self-determination, PSDA placed several new requirements on health care organizations receiving Medicare or Medicaid payments. (shrink)

During the past two decades, several reports have documented substantial support from clinicians, policy-makers, and the general public for the use of advance directives, yet studies continue to find that only a minority of individuals have completed these legal documents. Advance directives are written instructions, such as living wills or durable powers of attorney for health care, which describe an individual's medical treatment wishes in the event that individual becomes incapacitated in the future. The completion and use of advance directives (...) is one of several components of the broader activity of advance care planning, that is, the overall planning and communication of personal wishes concerning future medical care.In December 1991, the federal Patient Self-Determination Act became effective. Promoted as a federal initiative to enhance an individual's control over medical treatment decision making and, therefore, patient autonomy and self-determination, PSDA placed several new requirements on health care organizations receiving Medicare or Medicaid payments. (shrink)

There is limited knowledge about cancer patients' experiences of uncertainty while waiting for genome sequencing results, and whether prolonged uncertainty contributes to psychological factors in this context. To investigate uncertainty in patients with a cancer of likely hereditary origin while waiting for genome sequencing results, we collected questionnaire and interview data at baseline, and at three and 12 months follow up. Participants had negative attitudes towards uncertainty at baseline, and low levels of uncertainty at three and 12 months. Uncertainty about (...) genome sequencing did not change significantly over time [t = 0.660, p = 0.510]. Greater perceived susceptibility for cancer [r = 0.14, p < 0.01], fear of cancer recurrence [r = 0.19, p < 0.01], perceived importance of genome sequencing [r = 0.24, p < 0.01], intention to change behavior if a gene variant indicating risk is found [r = 0.29, p < 0.01], perceived ability to cope with results [r = 0.36, p < 0.01], and satisfaction with decision to have genome sequencing [r = 0.52, p < 0.01] were significantly correlated with negative attitudes towards uncertainty at baseline. Multiple primary cancer diagnoses [B = −2.364 [−4.238, −0.491], p = 0.014], lower perceived ability to cope with results [B = −0.1.881 [−3.403, −0.359], p = 0.016] at baseline, greater anxiety about genome sequencing [B = 0.347 [0.148, 0.546], p = 0.0012] at 3 months, and greater perceived uncertainty about genome sequencing [B = 0.494 [0.267, 0.721] p = 0.000] at 3 months significantly predicted greater perceived uncertainty about genome sequencing at 12 months. Greater perceived uncertainty about genome sequencing at 3 months significantly predicted greater anxiety about genome sequencing at 12 months [B = 0.291 [0.072, 0.509], p = 0.009]. Semi-structured interviews revealed that while participants were motivated to pursue genome sequencing as a strategy to reduce their illness and risk uncertainty, genome sequencing generated additional practical, scientific and personal uncertainties. Some uncertainties were consistently discussed over the 12 months, while others emerged over time. Similarly, some uncertainty coping strategies were consistent over time, while others emerged while patients waited for their genome sequencing results. This study demonstrates the complexity of uncertainty generated by genome sequencing for cancer patients and provides further support for the inter-relationship between uncertainty and anxiety. Helping patients manage their uncertainty may ameliorate psychological morbidity. (shrink)

In the aftermath of the dramatic collapse of the Icelandic bubble economy in 2008, the Centre for Ethics of the University of Iceland felt all the more compelled to find ways to promote ethical ref...

How does evolution grow bigger brains? It has been widely assumed that growth of individual structures and functional systems in response to niche-specific cognitive challenges is the most plausible mechanism for brain expansion in mammals. Comparison of multiple regressions on allometric data for 131 mammalian species, however, suggests that for 9 of 11 brain structures taxonomic and body size factors are less important than covariance of these major structures with each other. Which structure grows biggest is largely predicted by a (...) conserved order of neurogenesis that can be derived from the basic axial structure of the developing brain. This conserved order of neurogenesis predicts the relative scaling not only of gross brain regions like the isocortex or mesencephalon, but also the level of detail of individual thalamic nuclei. Special selection of particular areas for specific functions does occur, but it is a minor factor compared to the large-scale covariance of the whole brain. The idea that enlarged isocortex could be a a by-product of structural constraints later adapted for various behaviors, contrasts with approaches to selection of particular brain regions for cognitively advanced uses, as is commonly assumed in the case of hominid brain evolution. (shrink)

Until recently, it was assumed that co-representation of others’ actions, an essential part in joint action, is biologically tuned. However, research demonstrated that we also simulate actions of non-biological interaction partners under certain conditions. In the present study, we investigated whether perceived intentionality or perspective taking is the underlying mechanisms of this phenomenon. Participants saw a short video fragment of a non-biological agent as main character. The movements of this agent were either described as intentional or as unintentional. Furthermore, participants (...) were instructed to either take the perspective of this non-biological agent or not. Results show that perspective taking and perceived intentionality both lead to action co-representation of non-biological actions. Possible explanations for these findings are discussed. (shrink)

Until recently, it was assumed that co-representation of others’ actions, an essential part in joint action, is biologically tuned. However, research demonstrated that we also simulate actions of non-biological interaction partners under certain conditions. In the present study, we investigated whether perceived intentionality or perspective taking is the underlying mechanisms of this phenomenon. Participants saw a short video fragment of a non-biological agent as main character. The movements of this agent were either described as intentional or as unintentional. Furthermore, participants (...) were instructed to either take the perspective of this non-biological agent or not. Results show that perspective taking and perceived intentionality both lead to action co-representation of non-biological actions. Possible explanations for these findings are discussed. (shrink)

Until recently, it was assumed that co-representation of others’ actions, an essential part in joint action, is biologically tuned. However, research demonstrated that we also simulate actions of non-biological interaction partners under certain conditions. In the present study, we investigated whether perceived intentionality or perspective taking is the underlying mechanisms of this phenomenon. Participants saw a short video fragment of a non-biological agent as main character. The movements of this agent were either described as intentional or as unintentional. Furthermore, participants (...) were instructed to either take the perspective of this non-biological agent or not. Results show that perspective taking and perceived intentionality both lead to action co-representation of non-biological actions. Possible explanations for these findings are discussed. (shrink)

To understand public discourse in the United States on genetic causation of behavioral disorders, we analyzed media representations of genetic research on addiction published between 1990 and 2010. We conclude first that the media simplistically represent biological bases of addiction and willpower as being mutually exclusive: behaviors are either genetically determined, or they are a choice. Second, most articles provide only cursory or no treatment of the environmental contribution. A media focus on genetics directs attention away from environmental factors. Rhetorically, (...) media neglect the complexity underlying the etiology the addiction and direct focus back toward individual causation and responsibility. (shrink)

The aim of the paper is to show that topoi are useful in the categorial analysis of the constructive logic with strong negation. In any topos ϵ we can distinguish an object Λ and its truth-arrows such that sets ϵ have a Nelson algebra structure. The object Λ is defined by the categorial counterpart of the algebraic FIDEL-VAKARELOV construction. Then it is possible to define the universal quantifier morphism which permits us to make the first order predicate calculus. The completeness (...) theorem is proved using the Kripke-type semantic defined by THOMASON. (shrink)

First, we clarify the central nature of our argument: our attempt is to apportion variation in brain size between developmental constraint, system-specific change, and change, underlining the unexpectedly large role of developmental constraint, but making no case for exclusivity. We consider the special cases of unusual hypertrophy of single structures in single species, regressive nervous systems, and the unusually variable cerebellum raised by the commentators. We defend the description of the cortex (or any developmentally-constrained structure) as a potential spandrel, and (...) weigh the implications of the spandrel concept for the course of human evolution. The empirical and statistical objections raised in the commentary of Barton are discussed at length. Finally, we catalogue and comment on the suggestions of new ways to study brain evolution, and new aspects of brain evolution to study. (shrink)