Surgeons have an ethical obligation to ensure all patients, regardless of their personal characteristics, receive the same quality of care. Established surgeons also have an obligation to ensure equal treatment for their peers and for those who would like to join the field. The commitment to ethical hiring and working standards entails making certain all individuals have the same opportunities free from discriminatory practices. The world of business has long realized the positive implications of having a diverse and inclusive workforce. (...) Studies have shown a positive correlation between increased racial and gender diversity and company performance. Diversity can lead to an increase in knowledge by sharing ideas with individuals who come from different life experiences and breakdown cultural barriers. We have already begun to see the impact of ignoring the importance of diversity within healthcare, including surgery. Healthcare disparities are defined by the NIH as “differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups.” Healthcare disparities persist despite decades acknowledging their existence, and they are pernicious and prevalent in surgery. One proposed method to help reduce or eliminate healthcare disparities is to increase the diversity of the workforce treating the patients, which would in turn reduce potential bias the patients face in the healthcare setting. Implicit bias can play a key role in interactions with patients and colleagues and needs to be explored on an individual basis. Cultural competence training can also provide surgeons the ability to effectively communicate with not only a diverse population of patients but also a diverse surgical workforce. All surgeons regardless of their role can have a positive impact on diversity as it relates to patient care and the surgical workforce. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Neuroscientists are searching for the engram within the conceptual framework established by John Locke's theory of mind. This framework was elaborated before the development of information theory, before the development of information processing machines and the science of computation, before the discovery that molecules carry hereditary information, before the discovery of the codon code and the molecular machinery for editing the messages written in this code and translating it into transcription factors that mark abstract features of organic structure such as (...) anterior and distal. The search for the engram needs to abandon Locke's conceptual framework and work within a framework informed by these developments. The engram is the medium by which information extracted from past experience is transmitted to the computations that inform future behavior. The information-conveying symbols in the engram are rapidly generated in the course of computations, which implies that they are molecules. (shrink)

In this rich and resonant work, Soren Kierkegaard reflects poetically and philosophically on the biblical story of God's command to Abraham, that he sacrifice his son Isaac as a test of faith. Was Abraham's proposed action morally and religiously justified or murder? Is there an absolute duty to God? Was Abraham justified in remaining silent? In pondering these questions, Kierkegaard presents faith as a paradox that cannot be understood by reason and conventional morality, and he challenges the universalist ethics and (...) immanental philosophy of modern German idealism, especially as represented by Kant and Hegel. This volume, first published in 2006, presents the first new English translation for twenty years, by Sylvia Walsh, together with an introduction by C. Stephen Evans which examines the ethical and religious issues raised by the text. (shrink)

The title may be understood in three ways. Firstly, the truth under study is the truth about freedom. We speak of the truth of something, in as much as we presume that there are many misconceptions about that something, and it stands in need of clarification. Thus, the many misconceptions about freedom will have to be divested, if freedom is to be rightly grasped. Secondly, in the sense that there is a truth in the core of freedom, indeed, truth is (...) the essence of freedom. If truth is to be rightly grasped, its core has to be penetrated. Thirdly, there is a deeper relation between truth and freedom. Freedom cannot be understood, much less rightly practised, if we do not comprehend the necessary relation that freedom bears to truth. This essay purports to study all three senses, not quite generally, but with special reference to Ratzinger, the German theologian-cum-phenomenologist of religion, who also happens to be the current pope Benedict XVI of the Catholic Christianity. The study proceeds in three stages. First of all, I will give the statement of the problem. Secondly, I will briefly dwell on the modern Western history of freedom. Thirdly, I will study the interface between freedom and truth, highlighting the nature of human freedom, the relation between freedom and responsibility, and the relation between freedom and the truth of human existence itself. The essay is more interpretive than evaluative, with an eye to be as close to the insightful thoughts of Ratzinger as possible. (shrink)

Pain is an important focus for consciousness research because it is an avenue for exploring somatic awareness, emotion, and the genesis of subjectivity. In principle, pain is awareness of tissue trauma, but pain can occur in the absence of identifiable injury, and sometimes substantive tissue injury produces no pain. The purpose of this paper is to help bridge pain research and consciousness studies. It reviews the basic sensory neurophysiology associated with tissue injury, including transduction, transmission, modulation, and central representation. In (...) addition, it highlights the central mechanisms for the emotional aspects of pain, demonstrating the physiological link between tissue trauma and mechanisms of emotional arousal. Finally, we discuss several current issues in the field of pain research that bear on central issues in consciousness studies, such as sickness and sense of self. (shrink)

Recent reports published by the United Nations and the World Health Organization suggest that the brain drain of healthcare professionals from the developing to the developed world is decimating the provision of healthcare in poor countries. The migration of these key workers is driven by a combination of economic inequalities and the recruitment policies of governments in the rich world. This article assesses the impact of the healthcare brain drain and argues that wealthy countries have a moral obligation to reduce (...) the flow of healthcare workers from the developing to the developed world. (shrink)

R. S. Peters, C. A. Mace; VII—Emotions and the Category of Passivity, Proceedings of the Aristotelian Society, Volume 62, Issue 1, 1 June 1962, Pages 117–142, h.