Organ transplantation has increased worldwide while the number of organ donors have not increased similarly. Consequently, the waiting period for transplant candidates is prolonged. Patient narratives have uncovered physical and psychosocial suffering in the transplantation process. However, relatively few studies have explored patients’ experiences in the actual waiting period. This qualitative study was conducted in Norway and aimed to describe patients’ experiences of being accepted as recipients of a new liver and their waiting following this decision. A sample of 21 (...) patients with end‐stage liver disease, placed on the ordinary waiting list for a liver transplant, were interviewed in the hospital before they went home to wait for a compatible liver. Uncertainty related to life and death was a major issue, both in the waiting period and as a response to being put on the waiting list. Another central issue was their overwhelming lack of energy. Patients inferred a linear relationship between lack of energy, physical limitations and mental distress. Despite major advances in medical treatment, little follow‐up was given during the waiting period and most of the patients seemed resigned to the inevitability of their suffering. This raises issues of health personnel responsibility and a need to heighten awareness about patient suffering during the waiting period. (shrink)

The role of membrane receptors is regarded as being to transduce the signal represented by ligand binding from the external cell surface across the membrane into the cell. Signals are subsequently conveyed from the cytoplasm to the nucleus through a combination of second-messenger molecules, kinase/phosphorylation cascades, and transcription factor (TF) translocation to effect changes in gene expression. Mounting evidence suggests that through direct targeting to the nucleus, polypeptide ligands and their receptors may have an important additional signaling role. Ligands such (...) as those of the platelet-derived and fibroblast growth factor classes, as well as cytokines such as interferon-γ and interleukins-1 and -5, have been found to localize in the nucleus through the action of nuclear localization sequences (NLSs). Where tested, these NLSs appear to be essential for full signaling activity and may be responsible for cotranslocating receptors to the nucleus in complexes with their ligands. The implication is that, subsequent to endocytosis at the membrane, particular polypeptide ligands or their receptors, or both, may translocate to the nucleus to participate directly in gene regulation. BioEssays 20:400–411, 1998.© 1998 John Wiley & Sons Inc. (shrink)

Literature has a central place in Hannah Arendt’s writings. In particular, scholars continually discuss the implications of storytelling to her theory of action. This paper takes a different approach by drawing attention to an early literary essay, ”Rilke’s Duino Elegies”, which Arendt co-authored with Günther Stern in 1930. The paper locates the essay in the early twentieth century intellectual response to the ”break in tradition”, arguing that the construction of a poetics dramatized in the Duino Elegies is crucial for judging (...) the originality of Arendt’s philosophical methodology, and the ontological significance of her poetic conception of praise. In this conception, meaning is to be found in things as they appear to human beings capable of using the language designating them poetically. I present my interpretation of the Arendt-Stern essay by contrasting it with Heidegger’s comment on the eighth Elegy from 1942-43 and Blanchot’s reading of Rilke from 1955. (shrink)

BackgroundSwedish healthcare providers are supposed to be value-neutral when making clinical decisions. Recent conducted studies among Swedish physicians have indicated that the proportion of those whose personal values influence decision-making vary depending on the framing and the nature of the issue.ObjectiveTo examine whether the proportions of value-influenced and value-neutral participants vary depending on the extent to which the intervention is considered controversial.MethodsTo discriminate between value-neutral and value-influenced healthcare providers, we have used the same methods in six vignette based studies including (...) 10 more or less controversial interventions. To be controversial was understood as being an intervention where conscientious objections in healthcare have been proposed or an intervention that is against law and regulations.ResultsEnd of life decisions and female reproduction issues are associated with conscientious objection and more or less against regu... (shrink)

Mind attribution may be divided into the subcategories of attribution of agency, associated with moral agency, and attribution of experience and emotion, associated with moral concern and moral patiency (Gray et al. Science 315(5812):619, 2007; Gray et al. Proceedings of the National Academy of Sciences of the United States of America 108(2):477–479, 2011b; Robbins and Jack Philosophical Studies 127(1):59–85, 2006). In this paper I attend to social context and the different psychological needs influencing the different types of mind attribution. A (...) need for social connection drives the attribution of experiences and emotions. The individual’s capacity to regulate emotional reactions is crucial for empathic concern. I further relate differences of mind attribution, attention, and emotional processing, to two different modes of functioning: In an interactive state of mind (comparable to the “second-person perspective” described by Schilbach et al. Behavioral and Brain Sciences, in press), social and emotional cues are attended to; In a detached task-oriented state of mind it may be beneficial to predict the behaviors of others but emotional information may not be attended to. The complexity and plasticity of mind attribution, including the possibility to train attentional mechanisms and regulation of emotions, is promising for the field of moral enhancement. (shrink)

Luck egalitarianism, a theory of distributive justice, holds that inequalities which arise due to individuals’ imprudent choices must not, as a matter of justice, be neutralized. This article deals with the possible application of luck egalitarianism to the area of health care. It seeks to investigate whether the ethos of luck egalitarianism can be operationalized to the point of informing health care policy without straying from its own ideals. In the transition from theory to practise, luck egalitarianism encounters several difficulties. (...) We argue that the charge of moral arbitrariness can, at least in part, be countered by our provided definition of “imprudent actions” in the health area. We discuss the choice for luck egalitarianism in health care between ex ante and ex post policy approaches, and show how both approaches are flawed by luck egalitarianism’s own standards. We also examine the problem of threshold setting when luck egalitarianism is set to practise in health care. We argue that wherever policy thresholds are set, luck egalitarianism in health care risks pampering the imprudent, abandoning the prudent or, at worst, both. Furthermore, we claim that moves to mitigate these risks in turn diminish the normative importance of the ethos of luck egalitarianism to policy. All in all, our conclusion is that luck egalitarianism cannot be consistently applied as a convincing and relevant normative principle in health care policy. (shrink)

To investigate whether Swedish physicians, contrary to Swedish health care policy, employ considerations of patient responsibility for illness when rationing expensive treatments.

Background The aim of this study was to investigate whether physicians who felt strongly for or against a treatment, in this case a moderately life prolonging non-curative cancer treatment, differed in their estimation of medical indication for this treatment as compared to physicians who had no such sentiment. A further aim was to investigate how the notion of medical indication was conceptualised. Methods A random sample of GPs, oncologists and pulmonologists comprised the study group. Respondents were randomised to receive either (...) version of a case presentation; in one version, the patient had smoked and in the other version she had never smoked. The physicians were labelled value-neutral and value-influenced on the basis of their attitude towards the treatment. Results In the ‘value-influenced’ group, there was a significant difference in the estimation of medical indication for treatment depending upon whether the patient had smoked or never smoked ). There was no such difference in the ‘value-neutral’ group. Conclusion This study shows that compared to value-neutral physicians, value-influenced physicians are more likely to base decisions of medical indication on medically irrelevant factors. Moreover, medical indication is used in an ambiguous manner. Hence, we recommend that the usage of ‘medical indication’ be disciplined. (shrink)

"A compelling, insightful, and intimate portrait of William James as artist, philosopher, and psychologist, The Compromised Scientist explains James's emergence as a founding father of American experimental psychology. Unlike most books about James, this one emphasizes the fact that he had found a career as a painter and was not really a "buried" philosopher or psychologist. He was, in fact, an artist who was forced to compromise his urge to paint by developing a unique psychological language--the language of the "stream (...) of consciousness." Daniel W. Bjork offers an entirely new perspective on James by analyzing his famous diary as a record of his brilliant flight from art to psychology. In addition, Bjork explores the ways in which James's artistic orientation inevitably brought him into conflict with such other major psychological pioneers as Hugo Münsterberg, Edward Bradford Titchener, and James McKeen Cattell, all of whom dissented from James's psychological and professional outlook and, in particular, his enthusiastic crusade for the unconscious and psychic research. For them too, James was a "compromised scientist"--A man who had abandoned scientific standards. This indispensable study, complete with ample diary notations and illustrations, brings into new perspective the leading figure in American experimental psychology."--Provided by publisher. (shrink)

In the present paper, we first argue that it is critical for humans to forget; that is, to have some means of preventing out-of-date information from interfering with the recall of current information. We then argue that the primary means of accomplishing such adaptive updating of human memory is retrieval inhibition: Information that is rendered out of date by new learning becomes less retrievable, but remains at essentially full strength in memory as indexed by other measures, such as recognition and (...) word-fragment completion. We conclude with a speculation that certain unconscious influences of prior events may, in fact, be stronger if those events were to be forgotten rather than to be remembered. (shrink)

BackgroundVast sums are distributed based on grant peer review, but studies show that interrater reliability is often low. In this study, we tested the effect of receiving two short individual feedback reports compared to one short general feedback report on the agreement between reviewers.MethodsA total of 42 reviewers at the Norwegian Foundation Dam were randomly assigned to receive either a general feedback report or an individual feedback report. The general feedback group received one report before the start of the reviews (...) that contained general information about the previous call in which the reviewers participated. In the individual feedback group, the reviewers received two reports, one before the review period and one during the period. In the individual feedback group, the reviewers were presented with detailed information on their scoring compared with the review committee as a whole, both before and during the review period. The main outcomes were the proportion of agreement in the eligibility assessment and the average difference in scores between pairs of reviewers assessing the same proposal. The outcomes were measured in 2017 and after the feedback was provided in 2018.ResultsA total of 2398 paired reviews were included in the analysis. There was a significant difference between the two groups in the proportion of absolute agreement on whether the proposal was eligible for the funding programme, with the general feedback group demonstrating a higher rate of agreement. There was no difference between the two groups in terms of the average score difference. However, the agreement regarding the proposal score remained critically low for both groups.ConclusionsWe did not observe changes in proposal score agreement between 2017 and 2018 in reviewers receiving different feedback. The low levels of agreement remain a major concern in grant peer review, and research to identify contributing factors as well as the development and testing of interventions to increase agreement rates are still needed.Trial registrationThe study was preregistered at OSF.io/n4fq3. (shrink)

Advancing women’s empowerment and gender equality in agriculture is a recognised development goal, also within crop breeding. Increasingly, breeding teams are expected to use ‘market-based’ approaches to design more ‘demand-led’ and ‘gender-responsive’ crop varieties. Based on an institutional ethnography that includes high-profile development-oriented breeding initiatives, we unpack these terms using perspectives from political agronomy and feminist science and technology studies. By conceptualising the market as an ongoing, relational performance made up of discourses, practices and human and nonhuman actors, we trace (...) how the market is understood as an effective socioeconomic institution for soliciting demand, but also becomes a normative agenda. Construed as a demand variable, the relational and structural dimensions of gender are rendered less visible, which might strengthen rather than transform power relations’ status quo. On the other hand, a feminist science and technology perspective broadens the field of vision not only to the gendered dimensions of crop breeding, but also to the nonhuman actors, such as the crops and traits falling outside the market sphere of interest. By putting political agronomy and feminist science and technology studies into conversation, the article contributes to the development of a feminist political agronomy. (shrink)

SummaryThis article addresses how and why the Dutch translation of Forbonnais's Elémens de commerce came about and the reasons for its lack of success. It explores the context in which the Utrecht printers and booksellers Spruit and Haanebrink in 1771 published a Dutch version of the first edition of the Elémens. In the preceding decades the deteriorating wealth and power of the Dutch Republic had become a major theme in the transnational debates on political economy. Recent research has established that (...) Dutch authors contributed to this debate as well, initially by propagating neutrality of trade in combination with an attempt reform the staple market system, but increasingly by arguing the necessity of another type of economy. Inspired by foreign examples, a movement of reformative patriotism emerged, advocating a more balanced economy in which international commerce stimulated mature agricultural and industrial sectors. This type of political economy could be found in Forbonnais's Elémens and may have triggered its rendering into Dutch. It was the first in a series of translations instigated by Hendrik van den Heuvel, the organiser of economic patriotism in the Dutch Republic. Spruit and Haanebrink dedicated the Dutch version of the Elémens to him and mentioned Van den Heuvel's recommendation of the French original. The fact that the intended buyers, economic patriots, were able to read the Elémens in French, may have precluded a big sale of the title, but the poor quality of the translation did not help either. However, one should not conclude that the Dutch reading public was not interested in the Elémens. In 1780 Van den Heuvel still recommended another edition in a better translation. Other sources, such as Dirk Hoola van Nooten's Dutch version of Condillac's Le commerce et le gouvernement considérés relativement l'un à l'autre, suggest that Forbonnais's ideas were acknowledged. (shrink)