It is "time," writes Reto Winteler in the introduction to this book, to take Nietzsche "seriously, as the sui generis philosopher that he understood himself to be". Since at least the writing of Z, Nietzsche saw the transvaluation of all values as his life's great mission. He had long planned to compose a magnum opus on this topic, but following the completion of A, he suddenly considered it already accomplished. Winteler argues that although this decision has been acknowledged by the (...) scholarly community, no one has convincingly explained it. According to Winteler, it was not that Nietzsche failed to complete his work and his philosophical mission. Instead, he argues, Nietzsche... (shrink)

Critical posthumanism as a philosophical, antifascist nonhierarchical imagination for nursing offers a liberatory passageway forward amidst environmental collapse, an epic pandemic, global authoritarianism, extreme health and wealth disparities, over‐reliance on technology and empirics, and unjust societal systems based in whiteness. Drawing upon philosophical and theoretical works from Black and Indigenous scholars, Haraway's idea of the Chthulucene, Deleuze and Guattari's rhizomatic thought, and Kaba's abolitionist organizing among others, we as activist nurse scholars continue the speculative discussion outlined in prior papers. Here (...) we further imagine how we can engage a radical philosophical mission of care for all beings human and non, walking and working alongside the people and communities nurses accompany, connected as we are on this dystopian celestial orb. Discussion is centred on critical analyses of traditional justice framing in nursing, and on the praxis possibilities found within rhizomatic thought, making kin, and just episteme while knitting filaments of nursing theory and history, humming song lyrics from collective memory, and critically dismantling received wisdoms to stumble toward a more emancipatory present future. (shrink)

We suggest that the emerging field of the conservation humanities can play a valuable role in biodiversity protection in Papua New Guinea (PNG), where most land remains under collective customary clan ownership. As a first step to mobilising this scholarly field in PNG and to support capacity development for PNG humanities academics, we conducted a landscape review of PNG humanities teaching and research relating to biodiversity conservation and customary land rights. We conducted a systematic literature review, a PNG teaching programme (...) review, and a series of online workshops between the authors (10 PNG-based, 7 UK-based). We found a small but notable amount of PNG research and teaching focused on biodiversity conservation or customary land rights. This included explicit discussion of these topics in 8 of 156 PNG-authored humanities texts published 2010-2020 and related teaching content in the curricula of several different humanities-based programmes. We discuss current barriers to PNG academic development. The growth of fully fledged in-country conservation humanities will require a joint collaborative effort by PNG researchers, who are best placed to carry out such work, and researchers from abroad who can access resources to support the process. (shrink)

In “Obligations of the ‘Gift’: Reciprocity and Responsibility in Precision Medicine,” Lee rightly points out that disparities in health care access also lead to disparities in precision medi...

The dual-code proposal of number representation put forward by Cohen Kadosh & Walsh (CK&W) accounts for only a fraction of the many modes of numerical abstraction. Contrary to their proposal, robust data from human infants and nonhuman animals indicate that abstract numerical representations are psychologically primitive. Additionally, much of the behavioral and neural data cited to support CK&W's proposal is, in fact, neutral on the issue of numerical abstraction.

While utopians cannot produce what they can imagine, we can no longer imagine what we produce. It is increasingly the case that undergraduate teacher candidates find themselves enrolled in courses that have been developed “in partnership” with local school districts—districts adjacent to the actual universities where they are enrolled. Recently, one such partnership arrangement had a foundation of education professor and initial certification students oscillating between two school districts located in the same large suburban area. One side of town is (...) inhabited by mostly minority children in underfunded schools—commonly viewed as the “bad” district. The other side of town has the “better” district, as it .. (shrink)

"A frontier is not a wall, but a threshold."The last four decades have witnessed a marked change in the perception of identity in Spain. The country's rapid transformation from dictatorship to democracy with the death of its dictator, General Francisco Franco, in 1975, accelerated the economic modernization begun in the 1960s. Soon after, Spain joined Western countries as a significant entity in world events, and became an appealing destination for immigrants looking for a better chance at economic sustainability. Consequently, the (...) country's population shifted from one of net emigration in the 1960s and '70s, to one with a slight immigrant population of.52 percent in 1981, to harboring an immigrant population of. (shrink)

With the aim of studying foundations for self-other relations and understanding, we conducted an experimental investigation of a specific aspect of imitation in children with autism: the propensity to copy self-other orientation. We hypothesised that children with autism would show limitations inidentifying withthe stance of another person. We tested 16 children with autism and 16 non-autistic children with learning difficulties, matched on both chronological and verbal mental age, for their propensity to imitate the self- or other-orientated aspects of another person’s (...) actions. All participants were attentive to the demonstrator and copied her actions, but the children with autism were significantly less likely to imitate those aspects of her actions that involved movement in relation to her own vis-à-vis the child’s body. There were a number of children with autism who copied the identical geometric orientation of objects acted-upon. These results suggest that children with autism have a diminished propensity to identify with other people, and point to the importance of this mechanism for shaping self-other relations and flexible thinking. (shrink)

With the aim of studying foundations for self-other relations and understanding, we conducted an experimental investigation of a specific aspect of imitation in children with autism: the propensity to copy self-other orientation. We hypothesised that children with autism would show limitations inidentifying withthe stance of another person. We tested 16 children with autism and 16 non-autistic children with learning difficulties, matched on both chronological and verbal mental age, for their propensity to imitate the self- or other-orientated aspects of another person’s (...) actions. All participants were attentive to the demonstrator and copied her actions, but the children with autism were significantly less likely to imitate those aspects of her actions that involved movement in relation to her own vis-à-vis the child’s body. There were a number of children with autism who copied the identical geometric orientation of objects acted-upon. These results suggest that children with autism have a diminished propensity to identify with other people, and point to the importance of this mechanism for shaping self-other relations and flexible thinking. (shrink)

With the aim of studying foundations for self-other relations and understanding, we conducted an experimental investigation of a specific aspect of imitation in children with autism: the propensity to copy self-other orientation. We hypothesised that children with autism would show limitations in identifying with the stance of another person. We tested 16 children with autism and 16 non-autistic children with learning difficulties, matched on both chronological and verbal mental age, for their propensity to imitate the self- or other-orientated aspects of (...) another person’s actions. All participants were attentive to the demonstrator and copied her actions, but the children with autism were significantly less likely to imitate those aspects of her actions that involved movement in relation to her own vis-à-vis the child’s body. There were a number of children with autism who copied the identical geometric orientation of objects acted-upon. These results suggest that children with autism have a diminished propensity to identify with other people, and point to the importance of this mechanism for shaping self-other relations and flexible thinking. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Editors’ NoteJames M. DuBois, Ana S. Iltis, and Heidi A. WalshFrom childhood, David Slakter had undergone tests and invasive procedures to monitor his nephritis. It was not a surprise when in 2015, doctors told him he needed a kidney transplant. The wife of a childhood friend was a close match and gave him one of her kidneys. Before his transplant, aerobic exercise was difficult; a few months after transplant, (...) Slakter could ride his bike, hike, and work out with a personal trainer. He no longer had to weigh food or gauge his potassium consumption, a concern for people with kidney failure. For Slakter, “life post-transplant has been a significant improvement.”Individuals or family members of those who have received an organ transplant from a living or deceased donor share their stories in this issue of Narrative Inquiry in Bioethics. The symposium is titled “Receiving the Gift of Life: Stories from Organ Transplant Recipients.” Organ transplantation can extend an individual’s life by decades. It can also greatly improve an individual’s quality of life, as was Slakter’s experience. At the same time, organ transplantation is expensive and stressful. Recipients can experience complications, including organ rejection, and there are few appealing alternatives.After her heart transplant, author Leilani R. Graham required four open-heart surgeries, ECMO, and an intra-aortic balloon pump. She experienced delirium, necrotizing pneumonia, and severe muscular atrophy that required her to re-learn how to walk. She struggled with weight gain, explosive mood swings, hair loss, and was terrified that her body would reject the new heart. For Graham, “[Transplant] was not the miracle [she] was hoping for.” Graham says she felt unprepared for and inadequately informed about what to expect after her transplant, which left her “battered, beaten, and bruised” with a 12-inch line from neck to navel and “bullet holes” up and down her torso from the chest tubes. When reflecting on her experience post-transplant, Graham says, “It wasn’t the physical trauma that hurt the most. It was that no one seemed surprised [by the aftereffects of transplant].” Seemingly no one, that is except Graham, who calls on transplant providers to “prioritize empathy.”The symposium editors are Jason T. Eberl and Tristan McIntosh. Three commentary articles, written by Macey Leigh Levan, Heather Lannon, and Vidya A. Fleetwood, Roslyn B. Mannon & Krista L. Lentine, offer important insights into the authors’ stories. The editors thank Mid-America Transplant, the UCSF Lung Transplant Program, Donor Connect, William L. Freeman, MD, MPH, MJIL, CIP, Janet Monk, and the individuals who gave anonymous donations to support the publication of this issue, an open-access VOICES edition of the symposium, and accompanying teaching guides.The research article in this issue, “‘A Shell of My Former Self’: Using Figurative Language to Promote Communication about Patient Suffering,” was written by Tyler Tate, Elizabeth Stein, and Robert A. Pearlman. The relief of suffering is a primary goal of medicine. However, the authors note that clinicians often miss or ignore suffering because they focus on the causes rather than the experience of suffering, or the subjective nature of suffering makes it difficult to discuss. The authors believe that “the key to communicating about suffering lies in finding [End Page vii] the right kind of words to describe the experience” and say that figurative language offers a promising approach. In their research, the authors performed qualitative analysis on 52 works of literature and identified 254 excerpts of figurative language with themes of non-physical or psychological suffering. The authors found 13 salient themes: brokenness, diminishment, disorientation, drowning, emptiness, imprisonment, battle, darkness, isolation, invisibility, lifelessness, punishment, and torture. The authors reiterate that developing a shared language of suffering could foster a therapeutic patient-clinician relationship and improve clinicians’ ability to recognize and address a patient’s experience of suffering.María Susana Ciruzzi wrote the first of two case studies included in this issue. “The Sword of King Solomon” addresses a tragic and difficult subject—how to navigate the situation posed by conjoined twins when “any decision will produce damage and suffering.” The case involves two infant male patients born at 37 weeks gestation as omphalo-ischiopagus conjoined twins... (shrink)

Matrices that cannot be handled using conventional clustering, regression or classification methods are often found in every big data research area. In particular, datasets with thousands or millions of rows and less than a hundred columns regularly appear in biological so-called omic problems. The effectiveness of conventional data analysis approaches is hampered by this matrix structure, which necessitates some means of reduction. An evolutionary method called PreCLAS is presented in this article. Its main objective is to find a submatrix with (...) fewer rows that exhibits some group structure. Three stages of experiments were performed. First, a benchmark dataset was used to assess the correct functionality of the method for clustering purposes. Then, a microarray gene expression data matrix was used to analyze the method’s performance in a simple classification scenario, where differential expression was carried out. Finally, several classification methods were compared in terms of classification accuracy using an RNA-seq gene expression dataset. Experiments showed that the new evolutionary technique significantly reduces the number of rows in the matrix and intelligently performs unsupervised row selection, improving classification and clustering methods. (shrink)

The United States has a population of three hundred million, according to latest Census Bureau estimates. Forty-seven million, including many non-citizens, are uninsured. That is, 16% of the total United States population has no health insurance. Millions more have inadequate coverage and are in danger of losing that. Private, corporatized medical coverage, structured by the insurance industry, is the basis for the current system. This article is an attempt to lay out the principal health care issues, to look at the (...) alternatives and the cost of those alternatives, and to try to determine whether there is a particular regime that, despite its imperfections, is the best available to us now. (shrink)

Is helping those whose subsistence needs are not meet a matter of charity or an obligation? What role should ordinary citizens of developed nations play? In a globalized world, the causes, connections, and responsibilities become complicated. Agriculture subsidies that keep food prices low for many in relatively rich countries may, for example, negatively impact poor farmers in developing countries. Students in Ethics/Philosophy 352 report on their project examining whether, and to what extent, a true obligation to aid exists.

Serious ethical violations in medicine, such as sexual abuse, criminal prescribing of opioids, and unnecessary surgeries, directly harm patients and undermine trust in the profession of medicine. We review the literature on violations in medicine and present an analysis of 280 cases. Nearly all cases involved repeated instances of intentional wrongdoing, by males in nonacademic medical settings, with oversight problems and a selfish motive such as financial gain or sex. More than half of cases involved a wrongdoer with a suspected (...) personality disorder or substance use disorder. Despite clear patterns, no factors provide readily observable red flags, making prevention difficult. Early identification and intervention in cases requires significant policy shifts that prioritize the safety of patients over physician interests in privacy, fair processes, and proportionate disciplinary actions. We explore a series of 10 questions regarding policy, oversight, discipline, and education options. Satisfactory answers to these questions will require input from diverse stakeholders to help society negotiate effective and ethically balanced solutions. (shrink)

Ample research demonstrates that parents’ experience-based mental representations of attachment—cognitive models of close relationships—relate to their children’s social-emotional development. However, no research to date has examined how parents’ attachment representations relate to another crucial domain of children’s development: brain development. The present study is the first to integrate the separate literatures on attachment and developmental social cognitive neuroscience to examine the link between mothers’ attachment representations and 3- to 8-year-old children’s brain structure. We hypothesized that mothers’ attachment representations would relate (...) to individual differences in children’s brain structures involved in stress regulation—specifically, amygdala and hippocampal volumes—in part via mothers’ responses to children’s distress. We assessed 52 mothers’ attachment representations and children’s brain structure. Mothers’ secure base script knowledge was significantly related to children’s smaller left amygdala volume but was unrelated to hippocampal volume; we found no indirect links via maternal responses to children’s distress. Exploratory analyses showed associations between mothers’ attachment representations and white matter and thalamus volumes. Together, these preliminary results suggest that mothers’ attachment representations may be linked to the development of children’s neural circuitry related to stress regulation. (shrink)

In some views, philosophy’s glory days in bioethics are over. While philosophers were especially important in the early days of the field, so the argument goes, the majority of the work in bioethics today involves the “simple” application of existing philosophical principles or concepts, as well as empirical work in bioethics. Here, we address this view head on and ask: What is the role of philosophy in bioethics today? This paper has three specific aims: (1) to respond to skeptics and (...) make the case that philosophy and philosophers still have a very important and meaningful role to play in contemporary bioethics, (2) to discuss some of the current challenges to the meaningful integration of philosophy and bioethics, and (3) to make suggestions for what needs to happen in order for the two fields to stay richly connected. We outline how bioethics center directors, funders, and philosopher bioethicists can help. (shrink)

Stimulated by our conversations at the 2018 International Philosophy of Nursing Society Conference and our shared interests, the coauthors present an argument for augmenting the broader discussion of “missed care” with our synthesized concept called structural missingness. We take the problem of missed care to be largely grounded on a particular economic construction of the healthcare system within an era of what some are calling the Capitalocene, capturing the pervasive influence of capitalism on nature, humanity and the world order. Our (...) perspective is that of the United States, however, extrapolations can be made to the social and healthcare systems in other countries. We are concerned with the underlying conditions that structurally reify inequality and ultimately undermine nursing practice. To situate the discussion, we briefly review existing literature on the contextualization of missed care. We understand contemporary circumstances of missed care as a function of the neoliberalization of healthcare, including the idea of nursing as a commodity. From this, we discuss the implications of missed care, which forms the basis of our critique. Synthesizing the term “structural missingness, we locate a moral imperative in the professional and disciplinary commitments of nursing to consider who and what have been left out. This moral imperative for the nursing profession, along with other social and health related professions, underscores our obligation to be involved in uncovering inequities and conceptualizing upstream solutions for structural missingness. (shrink)

The United States has a population of three hundred million, according to latest Census Bureau estimates. Forty-seven million, including many non-citizens, are uninsured. That is, 16% of the total United States population has no health insurance. Millions more have inadequate coverage and are in danger of losing that. Private, corporatized medical coverage, structured by the insurance industry, is the basis for the current system. This article is an attempt to lay out the principal health care issues, to look at the (...) alternatives and the cost of those alternatives, and to try to determine whether there is a particular regime that, despite its imperfections, is the best available to us now. (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)

Scholars have assumed that trust is fragile: difficult to build and easily broken. We demonstrate, however, that in some cases trust is surprisingly robust—even when harmful deception is revealed, some individuals maintain high levels of trust in the deceiver. In this paper, we describe how implicit theories moderate the harmful effects of revealed deception on a key component of trust: perceptions of integrity. In a negotiation context, we show that people who hold incremental theories reduce perceptions of their counterpart’s integrity (...) after they learn that they were deceived, whereas people who hold entity theories maintain their first impressions after learning that they were deceived. Implicit theories influenced how targets interpreted evidence of deception. Individuals with incremental theories encoded revealed deception as an ethical violation; individuals with entity theories did not. These findings highlight the importance of implicit beliefs in understanding how trust changes over time. (shrink)

Sustainability problems often seem intractable. One reason for this is due to difficulties coordinating actors’ efforts to address socially responsible outcomes. Drawing on theories of bounded ethicality and incorporating work on communicating shared values in coordinating action this paper outlines the lack coordination as a matching issue, one complicated by underlying heterogeneity in actors’ moral values and thus motivation to address socially responsible outcomes. Three factors contribute to this matching problem. First, we argue it is not actors’ simple cognitive awareness, (...) but their moral awareness of social issues that explains why certain actors move to address problems while others do not. In other words, actors may recognize sustainability problems, but are not motivated to solve them as they are not understood as moral problems. Second, we posit that progress requires alignment in issues that some actors find worth addressing whereas others do not, thus explaining how heterogeneity in moral perceptions interrupt coordination towards socially important goals. Finally, we propose that progress is undermined if actors myopically focus on level-specific outcomes in ways that elucidates why institutional responses often fail to address individual outcomes and vice versa. We use the existing literature on the socially important issue of food waste to examine our theoretical contribution and develop a typology that explains conditions that inhibit coordination. Thus, our work proposes a psycho-structural view on matching and coordination toward sustainable outcomes, highlighting how psychological and structural constraints prevent effective coordination in addressing sustainability goals. (shrink)

ABSTRACT Recent efforts to engage with Heidegger’s Origin of the Work of Art have focused on its development in the context of Heidegger’s corpus at a key interval in his political ascendancy to, and subsequent decline from, the Rectorship. This article explores the ambiguous role Nietzsche plays in delimiting Heidegger’s engagement with art by tracking the relation between art and truth in two of the four lecture courses Heidegger offered on Nietzsche between 1936 and 1940. Having tracked the shift in (...) this relation, I turn to the 1956 Addendum to Heidegger’s Origin to bring his retrospective reflections on the human to bear on the congruence between his diagnosis of Nietzsche and his own efforts to pose the question of art in terms of the evental happening of truth. (shrink)

Unrealistic optimism is a bias that leads people to believe, with respect to a specific event or hazard, that they are more likely to experience positive outcomes and/or less likely to experience negative outcomes than similar others. The phenomenon has been seen in a range of health-related contexts—including when prospective participants are presented with the risks and benefits of participating in a clinical trial. In order to test for the prevalence of unrealistic optimism among participants of early-phase oncology trials, we (...) conducted a survey with patients over 18 years of age who were enrolled in a phase I, phase I/II, or phase II clinical cancer trial in the New York City area between August 2008 and October 2009. Participants in our study were asked to compare their own chances of experiencing a range of risks and benefits related to the trial they were enrolled in with the chances of the other trial participants. We found a significant optimistic bias in their responses. Respondents tended to overestimate the benefits of the trial they were enrolled in and underestimate its risks. In addition, we found no significant relationship between respondents’ understanding of the trial’s purpose and how susceptible they were to unrealistic optimism. Our findings suggest that improving the consent process for oncology studies requires more than addressing deficits in understanding. (shrink)

The quality of early childhood education and care (ECEC) is important for children’s development. One instrument that was developed to assess an aspect of ECEC quality is the Classroom Assessment Scoring System for pre-kindergarten children (CLASS Pre-K). We examined the factorial validity of the instrument using data from 177 German preschool classrooms. The three-factor teaching through interaction model (Hamre et al., 2013) was contrasted to a one-factor, a two-factor, and a bifactor model as proposed by Hamre et al. (2014). Our (...) results indicated that the three-factor structure with the domains of emotional support, classroom organization, and instructional support fit the data best. The fit of the teaching through interaction model was satisfying after adding a cross-loading of the dimension language modeling on emotional support, and two correlated residuals. Evidence of convergent and discriminant validity are provided. In terms of factor structure and pattern score comparisons, the results were similar to previous U.S. and German studies. The discussion concerns the justifiability of the factor model revisions and draws directions for further research. We concluded that our study offers further evidence of the applicability of the CLASS Pre-K for the assessment of teacher-child interaction quality in the German context. (shrink)

ObjectiveMost young adults diagnosed with breast or gynecologic cancers experience adverse reproductive or sexual health outcomes due to cancer and its treatment. However, evidence-based interventions that specifically address the RSH concerns of young adult and/or LGBTQ+ survivor couples are lacking. Our goal is to develop a feasible and acceptable couple-based intervention to reduce reproductive and sexual distress experience by young adult breast and gynecologic cancer survivor couples with diverse backgrounds.MethodsWe systematically adapted an empirically supported, theoretically grounded couple-based intervention to address (...) the RSH concerns of young couples coping with breast or gynecologic cancer through integration of stakeholder perspectives. We interviewed 11 couples with a history of breast or gynecologic cancer to review and pretest intervention materials. Three of these couples were invited to review and comment on intervention modifications. Content experts in RSH and dyadic coping, clinicians, and community advisors participated throughout the adaptation process.ResultsFindings confirmed the need for an online, couple-based intervention to support young couples experiencing RSH concerns after breast or gynecologic cancer. Qualitative themes suggested intervention preferences for: A highly flexible intervention that can be tailored to couples’ specific RSH concerns; Active steps to help members of a dyad “get on the same page” in their relationship and family building plans; A specific focus on raising partners’ awareness about how cancer can affect body image and physical intimacy; and Accessible, evidence-based information about RSH for both partners. These results, along with feedback from stakeholders, informed adaptation and finalization of the intervention content and format. The resulting virtual intervention, Opening the Conversation, includes five weekly sessions offering training to couples in communication and dyadic coping skills for addressing RSH concerns.ConclusionThe systematic adaptation process yielded a theory-informed intervention for young adult couples facing breast and gynecological cancers, which will be evaluated in a randomized controlled trial. The long-term goal is to implement and disseminate Opening the Conversation broadly to reach young adult couples with diverse backgrounds who are experiencing RSH concerns in cancer survivorship. (shrink)

We concur with Cohen Kadosh & Walsh (CK&W) that representation of numbers in the parietal cortex is format dependent. In addition, we suggest that all formats do not automatically, and equally, access analog magnitude representation in the intraparietal sulcus (IPS). Understanding how development, learning, and context lead to differential access of analog magnitude representation is a key question for future research.