Recent developments of three-dimensional printing of biomaterials in medicine have been portrayed as demonstrating the potential to transform some medical treatments, including providing new responses to organ damage or organ failure. However, beyond the hype and before 3D bioprinted organs are ready to be transplanted into humans, several important ethical concerns and regulatory questions need to be addressed. This article starts by raising general ethical concerns associated with the use of bioprinting in medicine, then it focuses on more particular ethical (...) issues related to experimental testing on humans, and the lack of current international regulatory directives to guide these experiments. Accordingly, this article considers whether there is a limit as to what should be bioprinted in medicine; examines key risks of significant harm associated with testing 3D bioprinting for humans; investigates the clinical trial paradigm used to test 3D bioprinting; analyses ethical questions of irreversibility, loss of treatment opportunity and replicability; explores the current lack of a specific framework for the regulation and testing of 3D bioprinting treatments. (shrink)

There has been a surge in mass media reports extolling the potential for using three-dimensional printing of biomaterials to treat a wide range of clinical conditions. Given that mass media is recognized as one of the most important sources of health and medical information for the general public, especially prospective patients, we report and discuss the ethical consequences of coverage of 3D bioprinting in the media. First, we illustrate how positive mass media narratives of a similar biofabricated technology, namely the (...) Macchiarini scaffold tracheas, which was involved in lethal experimental human trials, influenced potential patient perceptions. Second, we report and analyze the positively biased and enthusiastic portrayal of 3D bioprinting in mass media. Third, we examine the lack of regulation and absence of discussion about risks associated with bioprinting technology. Fourth, we explore how media misunderstanding is dangerously misleading the narrative about the technology. (shrink)

The past years have seen the official completion of the Opera Omnia of Nicholas of Cusa and have witnessed, as well, the production of a plethora of new studies on this fifteenth-century thinker. It is no longer enough, however, to be familiar with scholarship in German, Italian, and English in order to have a comprehensive view of the newer Cusanus research. One must also have a command of Spanish and Portuguese as well. An informal survey of the Philosopher's Index, by (...) no means exhaustive, of the secondary literature on Cusa reveals that over the last decade, the ratio approaches 1:1 when one compares Spanish and Portuguese entries on Cusa with those in other languages. Although Cusa was already a figure of interest in these two countries in the early 1960s, due in no small part to the work of Eusebio Colomer involving Ramon Llull, and that of Mariano Álvarez-Gómez, one can now see the work of these earlier scholars bearing fruit in the work of their students and their students' students. This scholarship, while it may be categorized broadly as history of philosophy or ideas, has tended to. (shrink)

The spatial dynamics of the optical emission from an array of 50 times 50 individual microcavity plasma devices is investigated. The array is operated in argon and argon-neon mixtures close to atmospheric pressure with an ac voltage. The optical emission is analysed with phase and space resolution. It has been found that the emission is not continuous over the entire ac period, but occurs once per half period. Each of the observed emission phases shows a self-pulsing of the discharge, with (...) several bursts of emission of fixed width and repetition rate. The number of emission bursts depends on applied voltage and frequency. Spatially resolved measurements prove that the emission bursts are formed by overlapping emission pulses from single discharge cavities. Intensity differences between positive and negative half-wave can be interpreted through spatially resolved measurements of single discharge cavities. (shrink)

Highlights: -/- • Breastfeeding and breastfeeding support can contribute to mitigating climate change. • Achieving global nutrition targets will save more emissions than fuel-switching. • Breastfeeding support programmes support a just transition. • This work can support the expansion of mitigation options in energy system models. -/- Abstract: -/- Renewable gas has been proposed as a solution to decarbonise industrial processes, specifically heat demand. As part of this effort, the breast-milk substitutes industry is proposing to use renewable gas as a (...) substitute for fossil natural gas. However, decarbonising the industrial processing of breast-milk substitutes can increase social license for these products, potentially undermining breastfeeding. World Health Organisation nutrition targets aim to increase exclusive breastfeeding to at least 50% globally by 2025 to improve maternal, infant, and young child health and nutrition. This target will have implications for the energy transition. A weakness of existing energy models is that demands for end-use products such as breast-milk substitutes are typically not considered explicitly. This paper develops an analytical framework for explicitly representing infant feeding methods in energy systems models. We compare the emissions saved in Ireland from decarbonising the industrial processing of breast-milk substitutes with renewable gas with the emissions saved by an increase in exclusive breastfeeding to 50% in both Ireland and a key export market, China. We demonstrate that the emissions saved from achieving the minimum global breastfeeding target are greater than when renewable gas is used to displace natural gas in the production of breast-milk substitutes in Ireland. We discuss the decarbonisation of breast-milk substitutes in relation to the principle of justice as non-maleficence, a principle based on the commitment to avoid harm, a novel application of a principle of justice. We conclude that breastfeeding support can be considered a demand-side measure for mitigating climate change by reducing the demand for energy services to produce breast-milk substitutes. A key recommendation is to position breastfeeding support as both a public health and a climate justice issue that is relevant for a just transition. The framework developed for this paper could be applied to support the inclusion of a wider range of mitigation options with social justice outcomes in energy system models. [Open access]. (shrink)

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

This special issue, entitled “Post-AIDS’ and Global Health Discourses: Interdisciplinary Perspectives,’ emerged from a one day Medical Humanities symposium at the Leeds Centre for Medical Humanities, at the University of Leeds, England, on February 27th 2015. This special issue focusses on the perceived deprioritising of HIV and AIDS in the Sustainable Development Goals, or SDGs, that were launched in 2015. The SDGs function as policy benchmarks for all entities within the United Nations system and they supersede the Millennium Development Goals, (...) or MDGs, which expired in 2015. As the word millennium indicates, the MDGs were launched in 2000 and 2015 was designated as the benchmark year when the successes and shortcomings of the MDGs would be critically assessed. One key difference between the MDGs and the SDGs, which D’Ambruoso foregrounds, is that the writing process underpinning the SDGs involved lengthy consultations, and feedback, with communities and health care practitioners around the world. By contrast, because the MDGs were mainly written by government officials, policy makers and health care practitioners without consulting wider communities, the processes underpinning the SDGs consultations are more inclusive than the MDGs. What is most critical about the SDGs for this special issue, however, is that they reflect a clear shift away from ‘HIV exceptionalism’ and towards what critics have described as ‘post-AIDS’ rhetoric, specifically when one compares the MDG health goal 6 and the SDG health goal 3. (shrink)

This book rounds off the study of St. Augustine's view of the human condition which Fr. O'Connell began in St. Augustine's Early Theory of Man, A.D. 386-391, and continued in St. Augustine's Confessions: The Odyssey of Soul. The central thesis of that first book, and the guiding hypothesis of the second, proposed that Augustine thought of us in "Plotinian" terms, as "fallen souls," and that he interpreted, in all sincerity, the teachings of Scripture as reflecting that same view. O'Connell sees (...) the weightiest objection to his proposal as stemming from what scholars generally agree is Augustine's firm rejection of that view in his later works. The central contention here is that Augustine did indeed reject his earlier theory, but only for a short while. He came to see the text from Romans 9, 11 as apparently compelling that rejection. But then his firm belief that all humans are guilty of original sin would have left him traducianism as his only acceptable way of understanding the origin of sinful human souls. The materialistic cast of traducianism, however, always repelled Augustine. Hence, he struggles to elaborate a fresh interpretation of Romans 9,11, and eventually he finds one that permits him to return to a slightly revised version of his earlier view. That theory, O'Connell argues, is encased in both the De Civitate Dei and the final version of the De Trinitate. This terse summary barely hints at the richness of detail contained here: O'Connell beginswith a minute analysis of the third book of the De Libero Arbitrio, then of the letters and works ostensibly supporting rival chronological patterns which he must overturn in order to make his case. Finally, in the light of his findings, he offers fresh interpretations of Augustine's three mature masterpieces, On Genesis, The Trinity, and City of god. These, along with Fr. O'Connell's contention that Augustine's anti-Pelagian De Peccatorum Meritis et Remissione must have seen publication no earlier than A.D. 416/17, will doubtless fuel scholarly debate for some time to come. Indeed, Pelagianism made the question of the soul's origin so pivotal for Augustine, that few of our current interpretations of Augustine are likely to remain unaffected by the results of O'Connell's searching and provocative study. (shrink)

Selon M. E. Alflatt, ibid., 20, 1974, p. 113-134, Augustin d'Hippone dit que l'acte involontaire peut être un péché au sens propre du terme. L'A. montre que cette conclusion repose sur une interprétation erronée d'une traduction anglaise de « De lib. arb. » III, 19, 54, traduction faite par J. H. S. Burleigh et parue dans la « Library of Christian Classics », London, SCM Press, 1953.

This paper explores possible connections between gender and the willingness to engage in unethical business behavior. Two approaches to gender and ethics are presented: the structural approach and the socialization approach. Data from a sample of 213 business school students reveal that men are more than two times as likely as women to engage in actions regarded as unethical but it is also important to note that relatively few would engage in any of these actions with the exception of buying (...) stock with inside information. Fifty percent of the males were willing to buy stock with insider information. Overall, the results support the gender socialization approach. (shrink)

When Dr. van Fleteren writes of the articles I criticized as dating from some twenty years ago, the unwary reader might infer that my criticism of those articles was, for its part, relatively recent. The fact is, however, that when the two connected articles I eventually criticized appeared in the volumes of Augustinian Studies, I wrote this reply while Fr. Robert Russell, of happy memory, was still at the helm, and was promised publication in the near future. Meanwhile, however, Fr. (...) Russell had the discourtesy to move on to a more intimate acquaintance with Augustine than any of us on this confused planet can boast of, and someone sowed cockle into field he had tended: in unaccountable fashion my article seems to have disappeared. Only a recent letter of inquiry on my part, and Fr. Allan Fitzgerald’s understanding reply, resulted in this renewal of dialogue between Dr. van Fleteren and me. Let me assure both Dr. van Fleteren and Fr. Fitzgerald that I am grateful for giving it exactly that form, a courteous dialogue. (shrink)

Peirce’s doctrine of God has scarcely been studied at all. This is surprising because his own naturally religious temperament, his desire for philosophical completeness and the influence of Kant, all led him to give an important place to theistic speculation in his philosophy. It is true that few parts of his philosophy reveal more than the fragmentary and unfinished nature of his thinking. This however does not take away from its importance both for the interpretation of his philosophy and for (...) the evaluation of its contribution. In this paper I want to examine his doctrine of God mainly in order to discover and outline what views he held in the matter. Such examination is an essential preliminary to any consideration of the value of his theistic thinking. Moreover, an objective exposition is already the best beginning of evaluation. However it is impossible to undertake this kind of examination without a careful search into various corners of his writings and a meticulous and slightly laboured presentation of one’s findings. But I think that the patience involved in such research has a rich reward. (shrink)

John Paul II’s encyclical Veritatis Splendor lists several objections to the theological concept of fundamental option. This article summarizes that concept, primarily as presented by Josef Fuchs. It then locates the concept, as Fuchs did, in the overarching theological anthropology of Karl Rahner, which is discussed at length. The objections of the encyclical are then engaged. In some cases, it is shown, the encyclical misunderstands fundamental option. In other cases, its rejection of the idea seems to entail rejection also of (...) traditional Catholic doctrines. All this leads to concluding reflections in which fundamental option is evaluated in terms of its cogency, adequacy, usefulness, and necessity for a contemporary Christian anthropology. (shrink)

Unlike other primate males, men invest substantial effort in producing food that is consumed by others. The Hunting Hypothesis proposes this pattern evolved in early Homo when ancestral mothers began relying on their mates’ hunting to provision dependent offspring. Evidence for this idea comes from hunter-gatherer ethnography, but data we collected in the 1980s among East African Hadza do not support it. There, men targeted big game to the near exclusion of other prey even though they were rarely successful and (...) most of the meat went to others, at significant opportunity cost to their own families. Based on Hadza data collected more recently, Wood and Marlowe contest our position, affirming the standard view of men’s foraging as family provisioning. Here we compare the two studies, identify similarities, and show that emphasis on big game results in collective benefits that would not be supplied if men foraged mainly to provision their own households. Male status competition remains a likely explanation for Hadza focus on big game, with implications for hypotheses about the deeper past. (shrink)

Background:Nursing practice is complex, as nurses are challenged by increasingly intricate moral and ethical judgments. Inadequately studied in underrepresented groups in nursing, moral distress is a serious problem internationally for healthcare professionals with deleterious effects to patients, nurses, and organizations. Moral distress among nurses has been shown to contribute to decreased job satisfaction and increased turnover, withdrawal from patients, physical and psychological symptoms, and intent to leave current position or to leave the profession altogether.Research question:Do significant gender differences exist in (...) the moral distress scores of critical care nurses?Research design:This study utilized a quantitative, descriptive methodology to explore moral distress levels in a sample of critical care nurses to determine whether gender differences exist in their mean moral distress scores.Participants and research context:Participants ( n = 31) were critical care nurses from an American Internet nursing community who completed the Moral Distress Scale–Revised online over a 5-day period in July 2013.Ethical considerations:Institutional review board review approved the study, and accessing and completing the survey implied informed consent.Findings:The results revealed a statistically significant gender difference in the mean moral distress scores of participants. Females reported statistically significantly higher moral distress scores than did males. Overall, the moral distress scores for both groups were relatively low.Discussion:The findings of a gender difference have not previously been reported in the literature. However, other findings are consistent with previous studies on moral distress.Conclusion:Although the results of this study are not generalizable, they do suggest the need for continuing research on moral distress in underrepresented groups in nursing, including cultural and ethnic groups. (shrink)

The phase space formulation of quantum mechanics is based on the use of quasidistribution functions. This technique was pioneered by Wigner, whose distribution function is perhaps the most commonly used of the large variety that we find discussed in the literature. Here we address the question of how one can obtain distribution functions and hence do quantum mechanics without the use of wave functions.

This paper considers two contenders for the title of highest good in Kant's theory of practical reason: happiness proportioned to virtue and the maximization of happiness and virtue. I defend the against criticisms made by Andrews Reath and others, and show how it resolves a dualism between prudential and moral practical reasoning. By distinguishing between the highest good as a principle of evaluation and an object of agency, I conclude that the maximization of happiness and virtue is a corollary of (...) the instantiation of the proportionality thesis. (shrink)

This study investigates the impact of Securities and Exchange Commission enforcement actions on individuals holding Certified Public Accountant accreditation. While prior research has investigated both the characteristics of companies that have been investigated by the SEC and litigation against audit firms, it has not addressed the ways in which SEC investigations impact CPAs. Using a sample of 262 CPAs, we find that the most common CPA breach was associated with overstating revenues/income or earnings. The study finds serious consequences for CPAs (...) in terms of employment restrictions and SEC actions, incorporating suspension, which is often permanent. We find that the primary factors relating to the severity of actions by the SEC is whether the CPA intentionally breached the professional code of conduct, the age of the CPA, whether the CPA is still a member of the AICPA with CPA status and whether the CPA was operating as an external auditor or in a corporate accounting role. Our findings have implications for accounting practitioners, the AICPA and boards of directors. (shrink)

Elizabeth Anscombe introduced the notion of “practical knowledge” into contemporary philosophy. Philosophers of action have criticized Anscombe’s negative characterization of such knowledge as “non-observational,” but have recently come to pay more attention to her positive characterization of practical knowledge as “the cause of what it understands.” I argue that two recent Anscombean accounts of practical knowledge, “Formalism” and “Normativism,” each fail to explain the productive character of practical knowledge in a way that secures its status as non-observational. I argue that (...) to do this, we must appreciate the role of know-how or skill in practical knowledge. (shrink)

Abstract:This paper contends that rationality is more properly evaluated as a property of an organization’s relationships with its stakeholders than of the organization itself. We predicate our approach on the observation that stakeholders can hold goals quite distinct from those of owners and top managers, and these too can be rationally pursued. We build upon stakeholder theory and Weber’s classic distinction betweenwertrationalitatandzweckrationalitat, adding to them the “new institutionalist” concept of the organization field (1983, 1991). Stakeholders employ a variety of direct (...) and indirect mechanisms to rationalize relations with the firm. We discuss four: internal subunits, legislated stakeholder participation, legislated access to information, and direct stakeholder activism. These developments are blurring the distinction between the environment and the organization by importing the values and goals of external stakeholders into the internal organization. They are also precipitating a more structured set of relationships among the actors who comprise the field. To the extent that thezweckrationalitatvalues of managers and owners as well as thewertrationalitatconcerns of stakeholders are met, the firm is more rational. (shrink)

In this editorial, we argue that midwives should focus on climate change, a link which has been underexplored.

This article addresses the question of whether God's existence would be obvious to everyone if God performed more miracles. I conclude that it would not be so. I look at cases where people have been confronted with what they believe to be miracles and have either not come to believe in God, or have come to intellectual belief in God but declined to follow him. God's existence could be made undeniable not by spectacular signs, but only by God impressing his (...) existence upon us in a direct, non-propositional way. (shrink)