Exception from Informed Consent (EFIC) regulations detail specific circumstances in which Institutional Review Boards (IRB) can approve studies where obtaining informed consent is not possible prior to subject enrollment.To better understand how IRB members evaluate community consultation (CC) and public disclosure (PD) processes and results, semi-structured interviews of EFIC-experienced IRB members were conducted and analyzed using thematic analysis.Interviews with 11 IRB members revealed similar approaches to reviewing EFIC studies. Most use summaries of CC activities to determine community members’ attitudes; none (...) reported using specific criteria nor recalled any CC reviews that resulted in modifications to or denials of EFIC studies. Most interviewees thought metrics based on Community VOICES’s domains (feasibility, participant selection, quality of communication, community perceptions, investigator/IRB perceptions) would be helpful.IRB members had similar experiences and concerns about reviewing EFIC studies. Development of metrics to assess CC processes may be useful to IRBs reviewing EFIC studies. (shrink)

Self-criticism is a trait associated with increased psychopathology, but self-criticism is also a personality state reflecting an action that people do in moments of time. In the current study, we explored factors associated with heightened self-criticism in daily life. Participants (N = 197) received five random prompts per day for one week on their mobile phones, where they reported their current affect (negative and positive affect), willpower self-efficacy, distress intolerance, degree of support and criticism from others, current context (location, activity, (...) hunger, tiredness) and momentary self-criticism. We first demonstrated that self-criticism varies over time and across contexts, and is associated with heightened trait self-criticism. Then, using multilevel modelling, we explored the contextual factors associated with greater self-criticism. We found that self-criticism was higher when people were at home, and more tired. We also found higher self-criticism to be associated with greater negative and lower positive affect, greater distress intolerance, lower willpower and greater perceived criticism from others. In addition, self-criticism predicted subsequent distress intolerance, willpower and positive affect in lagged analyses. This study provides evidence that both environmental and psychological factors are associated with the dynamics of self-critical thoughts. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

Objective:Prior research examining sexual and intimacy concerns among metastatic breast cancer patients and their intimate partners is limited. In this qualitative study, we explored MBC patients’ and partners’ experiences of sexual and intimacy-related changes and concerns, coping efforts, and information needs and intervention preferences, with a focus on identifying how the context of MBC shapes these experiences.Methods:We conducted 3 focus groups with partnered patients with MBC [N = 12; M age = 50.2; 92% White; 8% Black] and 6 interviews with (...) intimate partners [M age = 47.3; 83% White; 17% Black]. Participants were recruited through the Fox Chase Cancer Center Tumor Registry and the Cancer Support Community. Qualitative data were analyzed using the Framework Method and Dedoose software.Results:Qualitative analyses revealed several key themes reflecting ways in which MBC shapes experiences of sex/intimacy: the heavy disease/treatment burden leads to significant, long-term sexual concerns and consequent heightened emotional distress for both patients and partners ; viewing the relationship as having “an expiration date” influences patients’ and partners’ concerns related to sex/intimacy and complicates coping efforts; and information needs extend beyond managing sexual side effects to include emotional aspects of intimacy and the added strain of the life-limiting nature of the disease on the relationship. The heightened severity of sexual concerns faced by patients with MBC, compounded by the terminal nature of the disease, may place patients and partners at risk for significant adverse emotional and interpersonal consequences.Conclusion:Findings suggest unique ways in which sex and intimate relationships change after a diagnosis of metastatic breast cancer from both patients’ and partners’ perspectives. Consideration of the substantial physical and emotional burden of MBC and the broader context of the relationship and intimacy overall is important when developing a sexuality-focused intervention in this population. Addressing sexual concerns is a critical part of cancer care with important implications for patients’ health and quality of life. (shrink)

When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (n (...) = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p. (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)

Given emerging evidence that learning to play a musical instrument may lead to a number of cognitive benefits for older adults, it is important to clarify how these training programs can be delivered optimally and meaningfully. The effective acquisition of musical and domain-general skills by later-life learners may be influenced by social, cultural and individual factors within the learning environment. The current study examines the effects of a 10-week piano training program on healthy older adult novices’ cognitive and motor skills, (...) in comparison to an inactive waitlisted control group. Fifteen participants completed piano training led by a music facilitator in small groups (max n = 4 per lesson class; two experimental, two waitlisted control groups). Data was collected using an explanatory sequential design: quantitative data from a battery of cognitive and motor tests was collected pre/post-test on all participants, with further post-test data from the waitlisted control group (n = 7). Qualitative data included weekly facilitator observations, participant practice diaries, and an individual, semi-structured, post-experiment interview. Bayesian modelling demonstrated moderate evidence of a strong positive impact of training on part A of the Trail Making test (TMT), indicating improved visuo-motor skills. Moderate evidence for negative impacts of training on part B of the Trail Making Test (and difference score delta) was also found, suggesting no benefit of cognitive... (shrink)

EBONY PATTERSON, RUBEN MARTINEZ, LAURENT CRENSHAW, KARLA R. WILLIAMS, LARRY BROWN, TIFFANY HALL, KRISTEN M.J. HARRIS, MICHAEL SMITH, KHYLA CRAINE, NYAH CARMICHAEL, SHANNA DUBOSE, EBONY DAVIS, NICOLE BREWER, KARLA HARLIN, BRIAN HARRIS, KATRINA GIPSON, CANDICE B.N. REYNOLDS.

In this study, we analyzed the academic integrity policies of colleges in Ontario, Canada, casting a specific lens on contract cheating. We extracted data from 28 individual documents from 22-publicly-funded colleges including policies and procedures (n = 27) and code of conduct (n = 1). We analyzed the characteristics of the documents from three perspectives: (a) document type and titles; (b) policy language; and (c) policy principles. Then we examined five core elements of the documentation including (a) access; (b) approach; (...) (c) responsibility; (d) detail; and (e) support. Key findings revealed that specific and direct language pertaining to contract cheating was largely absent from the policy documents, that underlying policy principles lacked clear definition, and that exemplary policy has yet to be developed in this context. We conclude with recommendations for increased policy research in the area of academic integrity and a call for policy revision in Canadian higher education institutions to more explicitly address the issue of contract cheating, as well as provide more support to students and other campus stakeholders to better understand how contract cheating impacts and impedes teaching and learning. (shrink)

The goal of this study was to evaluate and compare the hygienic-sanitary conditions of two Units of Food and Nutrition (UANs) (A and B) located in two municipalities of the Vale do Taquari, Rio Grande do Sul, by means of Ordinance No. 78/2009, which established the Checklist of Good Practices for Food Services. This legislation composes a checklist with 153 criteria distributed in 12 categories. Each criterion is endowed with the options "Yes", "No" and "NA" (not applicable), which were marked (...) with an "x", being: "NA" when the criterion did not correspond to the UAN reality, "No" when the criteria were not in compliance with the legislation, and "Yes" when UAN met the evaluation criteria legislation. The classification of each UAN followed the scoring criteria established by RDC 275/2002. The a UAN presented a total of 90.85% (n = 129) of compliance and the "B" UAN totaled 88.27% (n = 128) of compliance. Both were classified in Group 1 of DRC 275/2002. The "A" UAN presented 05 nonconforming categories, totaling 13 criteria (9.15%), and Unit B 08 nonconforming categories, totaling 17 criteria (11.72%). Both UANs had good hygienic-sanitary conditions because they met most of the criteria in accordance with the legislation. (shrink)

ABSTRACT Historically, maternal HIV research has focused on prevention of mother‐to‐child transmission and child outcomes, with little focus on the health outcomes of mothers. Over the course of the HIV epidemic, the approach to including pregnant women in research has shifted. The current landscape lends itself to reviewing the public health ethics of this research. This systematic review aims to identify ethical barriers and considerations for including pregnant and postpartum women living with HIV in treatment adherence and retention research. We (...) completed a systematic literature review following PRISMA guidelines with analysis using a relational ethics perspective. The included studies (n = 7) identified ethical barriers related to (a) women research participants as individuals, (b) partner and family dynamics, (c) community perspectives on research design and conduct, and (d) policy and regulatory implications. These broader contextual factors will yield research responsive to, and respectful of, the needs of pregnant and postpartum women living with HIV. While current regulatory and policy environments may be slow to change, actions can be taken now to foster enabling environments for research. We suggest that a relational approach to public health ethics can best support the needs of pregnant and postpartum women living with HIV; acknowledging this population as systematically disadvantaged and inseparable from their communities will best support the health of this population. (shrink)

Categorical perception (CP) refers to how similar things look different depending on whether they are classified as the same category. Many studies demonstrate that adult humans show CP for human emotional faces. It is widely debated whether the effect can be accounted for solely by perceptual differences (structural differences among emotional faces) or whether additional perceiver-based conceptual knowledge is required. In this review, I discuss the phenomenon of CP and key studies showing CP for emotional faces. I then discuss a (...) new model of emotion which highlights how perceptual and conceptual knowledge interact to explain how people see discrete emotions in others’ faces. In doing so, I discuss how language (emotion words included in the paradigm) contribute to CP. (shrink)

Emoji faces, which are ubiquitous in our everyday communication, are thought to resemble human faces and aid emotional communication. Yet, few studies examine whether emojis are perceived as a particular emotion and whether that perception changes based on rendering differences across electronic platforms. The current paper draws upon emotion theory to evaluate whether emoji faces depict anatomical differences that are proposed to differentiate human depictions of emotion. We modified the existing Facial Action Coding System to apply to emoji faces. An (...) equivalent “emoji FACS” rubric allowed us to evaluate two important questions: First, Anatomically, does the same emoji face “look” the same across platforms and versions? Second, Do emoji faces perceived as a particular emotion category resemble the proposed human facial expression for that emotion? To answer these questions, we compared the anatomically based codes for 31 emoji faces across three platforms and two version updates. We then compared those codes to the proposed human facial expression prototype for the emotion perceived within the emoji face. Overall, emoji faces across platforms and versions were not anatomically equivalent. Moreover, the majority of emoji faces did not conform to human facial expressions for an emotion, although the basic anatomical codes were shared among human and emoji faces. Some emotion categories were better predicted by the assortment of anatomical codes than others, with some individual differences among platforms. We discuss theories of emotion that help explain how emoji faces are perceived as an emotion, even when anatomical differences are not always consistent or specific to an emotion. (shrink)

The patient wished to receive an experimental drug that she was instrumental in developing. After her diagnosis, she had investigated treatments that might help her condition and discovered that a specific compound could be beneficial. To further the development of this potential drug, she obtained preclinical data, founded a company, and sought investment from venture capitalists. The company was about to begin phase I testing, but the clinical trial had not yet opened. In addition, she would not have been a (...) candidate for the study, as it excluded patients with advanced disease. To be able to administer this drug to her, the patient's team of oncologists was in the process of drafting an individual patient investigational new drug application, including the protocol for the drug's delivery, to the Food and Drug Administration. The company developing the drug had preliminarily agreed to provide it. This protocol was also under review by the institutional review board of the university, and the ethics committee was consulted to determine whether she should receive the drug. (shrink)

The essence оf the Christian dogma by Erich Fromm. In the article is widely considered the dynamics of religious beliefs Erich Fromm. For the first time a comparative analysis of all Fromm’s work relating to the theme of religion. Fromm devoted to the search itself and society in faith quite a lot of time because such research is very important and requires a recess in the nature of some of the world’s religions, including Christianity. Questions and countermeasures manifestations of humanism (...) and authoritarian Christianity, its historical evolution and ideals throw a kind of challenge to the outstanding philosopher, and forced him to work on this complex issue almost all his life. Dogma Erich Fromm developed so that initially there was an idea of the man who became God, and turned on the idea of God became man. The concept of the Old Testament prophets world extend beyond relationships between people, harmony should prevail between man and nature. Peace between man and nature is harmony between them. Erich Fromm permanently broke with Judaism in ‘26 and has since considered himself a Christian. But Christianity Fromm, his understanding of God, the role of Christ in history, the interpretation of the evolution of ideas and Savior is surprising for its boldness. (shrink)

These three Ciceronian references, each used only once, have given rise to a most confusing variety of interpretations. In this article I hope to show, as far as the evidence will allow, who these poets were and what sort of poetry Cicero probably had in mind.οί νєώτєροι.

These three Ciceronian references, each used only once, have given rise to a most confusing variety of interpretations. In this article I hope to show, as far as the evidence will allow, who these poets were and what sort of poetry Cicero probably had in mind.οί νєώτєροι.

"Con su narración generosa, cargada de ideas y reflexiones fundamentales, este libro de Jesús Martín-Barbero nos permite conocer la genealogía de sus interpretaciones sobre la realidad latinoamericana. El texto que aquí presentamos es fruto de su tesis doctoral de 1972. Fue publicado en 2018 por la Universidad Javeriana de Colombia. Ahora se edita por primera vez en nuestro país. "La palabra y la acción" nos permite conocer el lazo articulador de su pensamiento, tributario de las contribuciones de Paulo Freire, Antonio (...) Gramsci y Paul Ricoeur, para alojar la atmósfera en que se gesta su célebre concepto de mediaciones y colocar a los estudios culturales en el centro de debate sobre el tema del poder. Este maestro de la comunicación que ha poblado las aulas de nuestro continente con ideas originales y profundas, siempre imprescindibles, nos propone un material que desnuda con precisión quirúrgica y destreza conceptual su compromiso desde el primer momento con el devenir de las luchas sudamericanas. La tesis desmiente, de una vez y para siempre, a aquellos críticos de su obra que enunciaban que las ideas de Martín-Barbero circulaban a contramano de las tramas de la radicalización política en América Latina en las décadas de 1960 y 1970. Lo que explica este trabajo es que el autor no solo se implicó sino que este fue el elemento clave que lo llevó a producirla. Jesús Martín-Barbero nos propone un viaje hacia el pasado, que en términos benjaminianos no deja de ser presente. Y nos permite descubrir las primeras notas de una sinfonía que recorre los encuentros académicos de nuestro continente. Alfredo Alfonso." --Descripción del editor. (shrink)

Macphail’s comparative approach to intelligence focused on associative processes, an orientation inconsistent with more multifaceted lay and scientific understandings of the term. His ultimate emphasis on associative processes indicated few differences in intelligence among vertebrates. We explore options more attuned to common definitions by considering intelligence in terms of richness of representations of the world, the interconnectivity of those representations, the ability to flexibly change those connections, knowledge, and individual differences. We focus on marine mammals, represented by the amphibious pinnipeds (...) and the aquatic cetaceans and sirenians, as animals that transitioned from a terrestrial existence to an aquatic one, experiencing major changes in ecological pressures. They adapted with morphological transformations related to streamlining the body, physiological changes in respiration and thermoregulation, and sensory/perceptual changes, including echolocation capabilities and diminished olfaction in many cetaceans, both in-air and underwater visual focus, and enhanced senses of touch in pinnipeds and sirenians. Having a terrestrial foundation on which aquatic capacities were overlaid likely affected their cognitive abilities. Vocal and behavioral observational learning capabilities in the wild and in laboratory experiments suggest versatility in group coordination. Empirical reports on aspects of intelligent behavior like problem-solving, spatial learning, and concept learning by various species of cetaceans and pinnipeds, suggest rich cognitive abilities. The high energy demands of the brain suggest brain-intelligence relationships might be fruitful areas for the study when specific hypotheses are considered, e.g., brain mapping indicates hypertrophy of specific sensory areas in marine mammals. Modern neuroimaging techniques provide ways to study neural connectivity, and the patterns of connections between sensory, motor, and other cortical regions provide a biological framework for exploring how animals represent and flexibly use information in navigating and learning about their environment. At this stage of marine mammal research, it would still be prudent to follow Macphail’s caution that it is premature to make strong comparative statements without more empirical evidence, but an approach that includes learning more about how animals flexibly link information across multiple representations could be a productive way of comparing species by allowing them to use their specific strengths within comparative tasks. (shrink)

All past interpretations of this passage involve an obscure train of thought. There appear to be two ideas running right through; light-twilight-night, and quick-slow-. But how are we to combine these ideas so as to make sense of them? Most, if not all, past commentators have agreed in taking to mean ‘punishes’’ and most interpretations conform to one or other of the following patterns.

Background: Discussing treatment risks has become increasingly important in medical communication. Still, despite regulations, physicians must decide how much and what kind of information to present. Objective: To investigate patients’ preference for information about a small risk of a complication of colonoscopy, and whether medical and personal factors contribute to such preference. To propose a disclosure policy related to our results. Design: Vignettes study. Setting: Department of Gastroenterology, Academic Medical Centre, the Netherlands. Patients: 810 consecutive colonoscopy patients. Intervention: A home-sent (...) questionnaire containing three vignettes. Vignettes varied in the indication for colonoscopy, complication severity and level of risk. Patients were invited to indicate their wish to be informed and the importance of such information. In addition, sociodemograhic, illness-related and psychological characteristics were assessed. Main outcome measurements: Wish to be informed and importance of information. Results: Of 810 questionnaires, 68% were returned. Patients generally wished to be informed about low-risk complications, regardless of the indication for colonoscopy or the severity of the complication. The level of risk did matter, though (OR = 2.48, SE = 0.28, p = 0.001). The information was considered less important if done for population screening purposes or diagnosis of colon cancer, if the complication was less severe (bleeding) and if the risk was smaller (0.01% and 0.1%). Patients’ information preference was also related to age, mood and coping style. Limitations: Difficulty of vignettes. Conclusions: Patients generally wish to be informed about all possible risks. However, this might become uninformative. A stepwise approach is suggested. (shrink)