The α‐actinins are an ancient family of actin‐binding proteins that play structural and regulatory roles in cytoskeletal organisation and muscle contraction. α‐actinin‐3 is the most‐highly specialised of the four mammalian α‐actinins, with its expression restricted largely to fast glycolytic fibres in skeletal muscle. Intriguingly, a significant proportion (∼18%) of the human population is totally deficient in α‐actinin‐3 due to homozygosity for a premature stop codon polymorphism (R577X) in the ACTN3 gene. Recent work in our laboratory has revealed a strong association (...) between R577X genotype and performance in a variety of athletic endeavours. We are currently exploring the function and evolutionary history of the ACTN3 gene and other α‐actinin family members. The α‐actinin family provides a fascinating case study in molecular evolution, illustrating phenomena such as functional redundancy in duplicate genes, the evolution of protein function, and the action of natural selection during recent human evolution. BioEssays 26:786–795, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

In humans, there are two skeletal muscle α‐actinins, encoded by ACTN2 and ACTN3, and the ACTN3 genotype is associated with human athletic performance. Remarkably, approximately 1 billion people worldwide are deficient in α‐actinin‐3 due to the common ACTN3 R577X polymorphism. The α‐actinins are an ancient family of actin‐binding proteins with structural, signalling and metabolic functions. The skeletal muscle α‐actinins diverged ∼250–300 million years ago, and ACTN3 has since developed restricted expression in fast muscle fibres. Despite ACTN2 and ACTN3 retaining considerable (...) sequence similarity, it is likely that following duplication there was a divergence in function explaining why α‐actinin‐2 cannot completely compensate for the absence of α‐actinin‐3. This paper focuses on the role of skeletal muscle α‐actinins, and how possible changes in functions between these duplicates fit in the context of gene duplication paradigms. (shrink)

Chief Executive Officers and other organizational leaders can affect how corporate social responsibility initiatives are perceived in their organizations. However, in order to be successful with regard to promoting CSR, leaders need to have strong network competencies and to move beyond charismatic leadership. In this paper we offer a critique of charismatic leadership as it relates to CSR, posit that the intellectual stimulation brought about by transformational leadership is more important in this regard, propose that internal and networking is a (...) leadership competence highly relevant to CSR, and emphasize the importance of working through highly credible opinion leaders in promoting CSR. (shrink)

IntroductionThere is a paucity of clinical guidelines for the routine assessment of maladaptive reproductive grief reactions in outpatient primary care and OB-GYN settings in the United States. Because of the disenfranchised nature of perinatal grief reactions, many clinicians may be apt to miss or dismiss a grief reaction that was not identified in the perinatal period. A significant number of those experiencing a reproductive loss exhibit signs of anxiety, depression, or post-traumatic stress disorder. Reproductive losses are typically screened for and (...) recorded numerically as part of a woman’s well-visit intake, yet this process often fails to identify patients emotionally troubled by a prior pregnancy loss.Materials and MethodsA summative content analysis of 164 recent website blogs from female participants who self-reported having experienced a miscarriage or abortion in their lifetime was conducted. The narratives were reviewed for details regarding the time span between the pregnancy loss and the composition of the blog post. The stories were analyzed for subsequent relationship problems and detrimental mental health conditions. Maladaptive reactions were contrasted for those that indicated a greater than 12 months’ time-lapse and those who had not.ResultsMore than a third of the women reported in the narrative that at least one year or more had passed since experiencing the miscarriage or abortion. For those women, the median time span between the loss and composing the blog was 4 years with a range of 47 years. Mental health conditions attributed to the reproductive loss by those who reported longer bereavement times included subsequent relationship problems, substance misuse, depression, suicidal ideation, and PTSD. The percent of reported maladaptive issues was more than double for those who reported that a year or more had passed since the loss of the pregnancy.DiscussionGrief reactions following the loss of a pregnancy may be prolonged or delayed for several months which can contribute to adverse biopsychosocial outcomes. Recognition and treatment of maladaptive grief reactions following a pregnancy loss are critical. Screening methods should be enhanced for clinicians in medical office settings to help identify and expedite the appropriate mental health assistance. (shrink)

BackgroundSexual minority (SM) older adults experience mental health disparities. Psychiatric disorders and neuropsychiatric symptoms (NPS) are risk factors for cognitive decline. Although older people in same-sex (SSR) compared to mixed-sex relationships (MSR) perform more poorly on cognitive screening tests, prior studies found no differences in rates of dementia diagnosis or neuropsychological profiles. We sought to explore the role of NPS on neurocognitive outcomes for SM populations. We compared cognitive performance and structural brain parameters of older adults in SSR and MSR.MethodsData (...) were originally collected at Alzheimer's Disease Research Centers (ADRCs). Inclusion criteria were: age of 55+ years, a study partner identified as a spouse/partner, and availability of T1-MRI brain volumes/thickness. Participants were labeled as either SSR or MSR based on their/their co-participant's reported sex. We identified 1,073 participants (1,037 MSR−555 cognitively unimpaired [CU]; 36 SSR−23 CU) with structural MRI data, Mini-Mental State Exam (MMSE), and Neuropsychiatric Inventory Questionnaire (NPI-Q) scores. A subset of the overall sample completed comprehensive neuropsychological assessment (n = 939; 908 MSR−494 CU; 31 SSR−22 CU). Covariates included in statistical models were age, sex, education, total intracranial volume, and apolipoprotein E genotype.ResultsMultivariate general linear models showed significant diagnosis-by-relationship interaction effects on the left parahippocampal gyrus volume. After stratification by relationship group, only cognitively impaired (CI) MSR had significantly smaller left parahippocampal volumes than MSR-CU. The SSR group showed better episodic memory performance. Severity of neuropsychiatric symptoms was negatively associated with volume/thickness of bilateral fronto-temporal areas and with MMSE scores, predominantly in the MSR group.ConclusionIn our study, MSR participants presented with a more compromised cognitive profile than SSR participants. MSR-CI participants showed significantly smaller left medio-temporal volumes, a neural signature of AD. Neuropsychiatric symptoms predicted smaller fronto-temporal volumes in the MSR more consistently than in the SSR group. These findings may be due to unexplored protective factors against cognitive decline in SM elders. Indeed, social support has been proposed as a protective factor warranting future investigation. (shrink)

The American Journal of Bioethics, Volume 11, Issue 9, Page 42-43, September 2011.

This paper addresses the potentially interactive effects of descriptive and injunctive norm perceptions on an unethical workplace behavior: counterproductive work behavior perpetration. We draw on the Focus Theory of Normative Conduct and its conceptual distinction between norm types to refine research on this topic. We also test a person-by-environment interaction to determine whether the interactive effects of these norms for CWB are enhanced among employees reporting a stronger need to belong to social groups. In two studies, predictors were assessed in (...) an initial survey and the dependent variable was assessed weeks later. Individuals employed across a range of industries served as participants. In Study 1, descriptive and injunctive norm perceptions of CWB interacted to predict CWB perpetration. This finding was replicated in Study 2. Additionally, Study 2 demonstrated that the interaction between the two norm types was especially strong among individuals high in NTB. Results suggest that to decrease CWB perpetration, organizations may profitably leverage the persuasive effects of “social norms marketing” to alter employee perceptions of the typicality and level of approval for CWBs. This is the first study to demonstrate that both descriptive and injunctive norm perceptions predict CWB perpetration. The demonstrated three-way interaction between the two norm types and NTB advances existing theory regarding the cognitive and motivational mechanisms underlying normative social influence. (shrink)

Boys and men tend to underperform in language education, and they are also underrepresented in language-related fields. Research suggests that stereotypes can affect students’ performance and sense of belonging in academic subjects and test settings via stereotype threat. For example, girls and women sometimes underperform on math tests following reminders that math is for boys. We sought to test whether stereotypes that women have better language skills than men would affect men. In a series of four experiments (N = 542), (...) we tested the effect of explicit stereotype threats on men’s performance in language-related tasks, and their sense of belonging to language-related domains. We found little evidence for stereotype threat effects on men in language. Bayesian analysis suggested that the null hypothesis was consistently more likely than the alternative, and mini-meta analyses showed effect sizes near zero. Future research should explore other explanations for gender gaps in language. (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)

The name of the third author was incomplete in the initial online publication. The original article has been corrected.

This study investigates the role of “moral” emotional traits—guilt proneness, shame proneness, empathic concern, and perspective taking—as predictors of workplace bullying perpetration. We also test and find support for a model derived from moral emotions literature and the sociometer theory of self-esteem in which the tendency to take reparative action following interpersonal transgressions mediates the buffering effect of guilt proneness on bullying. Data were obtained from working MBA students and advanced undergraduates during 2 survey sessions, 4 to 6 weeks apart. (...) Findings indicate that moral emotional traits may be useful to consider in personnel selection as a means to reduce workplace bullying. (shrink)

This hypothesis proposes that increased extracellular glutamate in Amyotrophic Lateral Sclerosis (ALS) and cerebral ischemia, currently viewed as a trigger for excitotoxicity, is actually beneficial as it stimulates the utilization of glutamate as metabolic fuel. Renewed appreciation of glutamate oxidation by ischemic neurons has raised questions regarding the role of extracellular glutamate in ischemia. Is it detrimental, as suggested by excitotoxicity in early in vitro studies, or beneficial, as suggested by its oxidation in later in vivo studies? The answer may (...) depend on the activity of N‐methyl‐D‐aspartate (NMDA) glutamate receptors. Early in vitro procedures co‐activated NMDA receptors (NMDARs) containing 2A (GluN2A) and 2B (GluN2B) subunits, an event now believed to trigger excitotoxicity; however, during in vivo ischemia D‐serine and zinc molecules are released and these ensure only GluN2B receptors are stimulated. This not only prevents excitotoxicity but also initiates signaling cascades that allow ischemic neurons to import and oxidize glutamate. (shrink)

This article describes a qualitative content analysis of 37 elementary examples of social studies Inquiry Design Models (C3 Teachers, 2023a), conducted with the purpose of identifying the core student skills necessary to successfully engage in these inquiries. Prior research identifies core inquiry teaching skills for teachers across content areas and grade bands, but there has been little research on the demands placed on elementary students in social studies inquiry. In this study, we identify 33 broad skills, each of which are (...) observable and teachable. Four of these skills occurred in high frequency: generation of new ideas ( n = 152), writing process ( n = 110), linking evidence with claims ( n = 65), and discussion ( n = 63). These most frequently occurring skills all required higher-level and/or critical thinking. Implications for preservice and in-service teacher education are discussed. (shrink)

This collection of writings offers a glimpse into the minds of three N.A.A.C.P. leaders who occupied the center of black thought and action during some of the most troublesome and pivotal times of the civil rights movement. The volume delineates fifty-seven years of the N.A.A.C.P.'s program under the successive direction of James Weldon Johnson, Walter White, and Roy Wilkins. These writings illustrate the vital roles of these three leaders in building a peoples liberation, underscoring not only their progressive influence throughout (...) their time in power, but also a vision of the future as race relations enter the 21st Century. Much of the material, notably "The Secretary's Reports to the Board," is published here for the first time, offering an invaluable resource for those seeking a deeper knowledge of the history of race in America. (shrink)

Şiâ’nın temel inanç ilkelerinden biri olan ricʿat doktrini potansiyel olarak radikal yorumlara olanak sunmaktadır. Ricʿat inanışının arka planında gaybet anlayışı ve ona yüklenen insan üstü özel mana son derece hayati öneme sahiptir. Şiîlik içerisinde günümüze ulaşan ve Şiîlerin büyük çoğunluğunu oluşturan İmamiyye ya da On iki İmam (İsnâ aşeriyye) Şiîliğine göre, on ikinci imam Muhammed b. el-Hasan, 941 yılında büyük gaybete gitmiştir. Bu doktrinle, gizli imamın bir gün geri döneceğine, zulüm ve haksızlıklarla dolu olan tüm dünyayı adaletle hükmedeceğine ve refaha (...) ulaştıracağına inanılır. Esasında ricʿat inanışıyla ilgili ortaya atılan iddiaları daha erken dönemlere götürmek mümkündür. İslam tarihinin erken dönemlerinde, Ali b. Ebi Talib (ö. 40/661) ve oğlu Hüseyin (ö. 61/680) gibi önemli şahsiyetlerin ölümsüzlüğünü iddia eden bazı radikal mezhepler (gulât) ortaya çıkmıştır. Onuncu yüzyıl da yine Şiîler arasında gaybette olduğuna ve tüm insanlığa rehberlik etmek üzere bir gün yeniden ortaya çıkacağına inanılan gizli imam Muhammed b. el-Hasan'ın dönüşüne dair bu tür iddialara sahne olmuştur. Bu çalışmada Şiâ içerisinde ortaya çıkmış üç alt grup olan Nusayrîler, Dürzîler ile Bâbî ve Bahâîler’in ricʿat doktrinine yükledikleri anlam incelenmektedir. İlk ikisi eş zamanlı olarak onuncu yüzyılda, Bâbî ve Bahâîler ise on dokuzuncu yüzyılda ortaya çıkmıştır. Ricʿat doktrinine yaklaşımda bâb kavramının aracılık görevini üstlendiğini ifade etmek gerekir. Nusayrî fırkasının kurucusu Muhammed b. Nusayr en-Nemîrî (ö. 270/883), kendisini on birinci ve on ikinci imama açılan kapı olarak ilan ederek ricʿat doktrinine ezber bozan bir yaklaşım ortaya koymuştur. Buna ilaveten, tanrının ruhunun Hz. Ali’nin bedeninde zuhur ettiği, sonrasında da bu ruhun on ikinci imama gelinceye kadar imamların bedenlerine intikal ettiği inancı yayılmıştır. Dürzîler bâb kavramından ziyade doğrudan Hakim Biemrillah’ın ulûhiyyetine odaklanmışlardır. Bâbî ve Bahâîler ise bâb kavramı temel olmak üzere mehdilik ve yeni bir din olma iddiasıyla ricʿat doktrinini te’vil etmişlerdir. Özellikle Nusayrî ve Dürzîler ricʿat inanışını yorumlayarak bunu hulûl ve tenasühe dönüştürmüşlerdir. Bâbî ve Bahâîler ise nübüvvet vazifesinin Hz. Muhammed ile son bulduğu inanışını reddederek ricʿat anlayışını nübüvvete dönüştürmüşlerdir. Böylece onlar, önceki dinlerin hükümlerini ortadan kaldıran yeni bir din olma iddiasında bulunmaktadırlar. Bu çalışmanın amacı, Şiîlik içerisinden neş’et ederek ortaya çıkmış yukarda adı geçen mezheplerin ricʿat doktrinine nasıl yaklaştıklarını ve bu olguyu ne olarak yorumladıklarını ortaya koymaktır. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Breaking EarthAlexis Rider (bio) and Paul A. Harris (bio)“He takes all that, the strata and the magma and the people and the power, in his imaginary hands. Everything. He holds it. He is not alone. The earth is with him. Then he breaks it.”― N. K. Jemisin, The Fifth SeasonBreaking Earth, a collection of visual and written essays brought together for this special issue of SubStance, is a disruptive (...) engagement with concepts and terms that have become touchstones for the geologic/planetary turn in the inhumanities. The project took initial inspiration in conversations the co-editors had about N. K. Jemisin’s Broken Earth trilogy, in which geologic and human power interweave in complex webs among bodies born of chiasmic crossings of Anthro-progeny and Geo-orogeny. Conceived as a companion almanac to Jemisin’s trilogy—though references to that work are intentionally oblique—the volume pursues new ways of reading, and being with, the geos of this planet. In doing so, Breaking Earth seeks to reframe and deepen the discussions, both historical and philosophical, around the relationship between geology and humanity.The notion of the Anthropocene has, for several decades, monopolized said discussions. Since its articulation in the early 2000s, the concept has been equal parts galvanizing and problematic in thinking with the Earth (Crutzen). Proposed by an atmospheric chemist, incorporated (with caveats) into the geologic deep time of the planet by geologists, and taken up with vigor by humanists, social scientists, and artists, the Anthropocene has, for better or worse, broken significant new ground in Earth-oriented thought.The term’s core proposals—that humans are a geologic force and we have entered a wholly new period of Earth history—has compelled scholars to engage with a geologic tradition of mapping and classifying the history of said forces along a temporal scale. This tradition—exemplified in the International Chronostratigraphic Chart (ICC) below (Figure 1)—relies on the translation of messiness and difference into abstracted orderly categories of strata and type. Of course, no geologist would claim that the ICC is a direct representation of the materiality of the rocky Earth we live on, so full of faults, fissures, and unconformities. But as writers, [End Page 3] artists, and activists have made clear, the repositioning of humans-as-strata is far riskier than imposing abstract order on a cliff face: it dangerously flattens out the messiness of human history and difference—obfuscating the uneven histories of extraction and oppression to which the mining of geophysical energies and resources is so clearly bound. The Anthropocene has therefore helped reveal the immense pitfalls of conflating a species with the geologic, and made clear the need for humanists—both within the academy and beyond—to develop a language and method for thinking about the changing Earth. Click for larger view View full resolutionFigure 1.International Chronostratigraphic Chart (ICC), International Commission on Stratigraphy, 2023, www.stratigraphy.org.At the same time, the very act of attempting to identify the Anthropocene within stratigraphic nomenclature has usefully challenged old and brittle binaries. Contemporary rhetoric around how to conceive of change—backed often by disciplinary boundary-keeping—exemplifies such divisions. Take, for example, the grammatical distinction between political, social forces and physical, environmental forcings (Hulme). These seemingly inane suffixes recast agency and allow the natural and social worlds to exist in two separate spheres (albeit ones that overlap via extraction) where human action is more wholly filled with intent. Breaking this distinction via a reconceptualization of geologic agency underpins [End Page 4] what scholars, including Pratik Chakrabarti and Kathryn Yusoff, have been articulating so clearly: rocks have politics. To unpack this carefully and fully, however, requires moving beyond the collapse of anthropos into geos: there is too much texture, history, and action lost in such a sweeping and simple formulation.This collection takes these problematics of the Anthropocene as self-evident: it critically engages with the chronostratigraphic logic that implicitly upholds a view of time, history, and knowledge which operationalizes the extractive carbon capital economies fueled by colonialism and slavery. This assertion bears emphasizing, given the announcement from the Anthropocene Working Group (AWG) in the summer of 2023 that the origin of... (shrink)

Part I: The Life of Cognitive Science:. William Bechtel, Adele Abrahamsen, and George Graham. Part II: Areas of Study in Cognitive Science:. 1. Analogy: Dedre Gentner. 2. Animal Cognition: Herbert L. Roitblat. 3. Attention: A.H.C. Van Der Heijden. 4. Brain Mapping: Jennifer Mundale. 5. Cognitive Anthropology: Charles W. Nuckolls. 6. Cognitive and Linguistic Development: Adele Abrahamsen. 7. Conceptual Change: Nancy J. Nersessian. 8. Conceptual Organization: Douglas Medin and Sandra R. Waxman. 9. Consciousness: Owen Flanagan. 10. Decision Making: J. Frank Yates (...) and Paul A. Estin. 11. Emotions: Paul E. Griffiths. 12. Imagery and Spatial Representation: Rita E. Anderson. 13. Language Evolution and Neuromechanisms: Terrence W. Deacon. 14. Language Processing: Kathryn Bock and Susan M. Garnsey. 15. Linguistics Theory: D. Terence Langendoen. 16. Machine Learning: Paul Thagard. 17. Memory: Henry L. Roediger III and Lyn M. Goff. 18. Perception: Cees Van Leeuwen. 19. Perception: Color: Austen Clark. 20. Problem Solving: Kevin Dunbar. 21. Reasoning: Lance J. Rips. 22. Social Cognition: Alan J. Lambert and Alison L. Chasteen. 23. Unconscious Intelligence: Rhianon Allen and Arthur S. Reber. 24. Understanding Texts: Art Graesser and Pam Tipping. 25. Word Meaning: Barbara C. Malt. Part III: Methodologies of Cognitive Science:. 26. Artificial Intelligence: Ron Sun. 27. Behavioral Experimentation: Alexander Pollatsek and Keith Rayner. 28. Cognitive Ethology: Marc Bekoff. 29. Deficits and Pathologies: Christopher D. Frith. 30. Ethnomethodology: Barry Saferstein. 31. Functional Analysis: Brian Macwhinney. 32. Neuroimaging: Randy L. Buckner and Steven E. Petersen. 33. Protocal Analysis: K. Anders Ericsson. 34. Single Neuron Electrophysiology: B. E. Stein, M.T. Wallace, and T.R. Stanford. 35. Structural Analysis: Robert Frank. Part IV: Stances in Cognitive Science:. 36. Case-based Reasoning: David B. Leake. 37. Cognitive Linguistics: Michael Tomasello. 38. Connectionism, Artificial Life, and Dynamical Systems: Jeffrey L. Elman. 39. Embodied, Situated, and Distributed Cognition: Andy Clark. 40. Mediated Action: James V. Wertsch. 41. Neurobiological Modeling: P. Read Montague and Peter Dayan. 42. Production Systems: Christian D. Schunn and David Klahr. Part V: Controversies in Cognitive Science:. 43. The Binding Problem: Valerie Gray Hardcastle. 44. Heuristics and Satisficing: Robert C. Richardson. 45. Innate Knowledge: Barbara Landau. 46. Innateness and Emergentism: Elizabeth Bates, Jeffrey L. Elman, Mark H. Johnson, Annette Karmiloff-Smith, Domenico Parisi, and Kim Plunkett. 47. Intentionality: Gilbert Harman. 48. Levels of Explanation and Cognition Architectures: Robert N. McCauley. 49. Modularity: Irene Appelbaum. 50. Representation and Computation: Robert S. Stufflebeam. 51. Representations: Dorrit Billman. 52. Rules: Terence Horgan and John Tienson. 53. Stage Theories Refuted: Donald G. Mackay. Part VI: Cognitive Science in the Real World:. 54. Education: John T. Bruer. 55. Ethics: Mark L. Johnson. 56. Everyday Life Environments: Alex Kirlik. 57. Institutions and Economics: Douglass C. North. 58. Legal Reasoning: Edwina L. Rissland. 59. Mental Retardation: Norman W. Bray, Kevin D. Reilly, Lisa F. Huffman, Lisa A. Grupe, Mark F. Villa, Kathryn L. Fletcher, and Vivek Anumolu. 60. Science: William F. Brewer and Punyashloke Mishra. Selective Biographies of Major Contributors to Cognitive Science: William Bechtel and Tadeusz Zawidzki. (shrink)

En el contexto del cambio de una concepcion sustancialista a una concepcion desustancialista, en la cual se pierde de vista el fundamento mismo de la persona, el autor de este estudio cree que el problema de la identidad humana exige un replanteamiento y una reconstruccion. Es preciso entonces emprender un camino que conduzca a reconstruir al hombre, sacandolo del anonimato nihilista en el que lo habia sumido la modernidad al exagerar indebidamente el intelectualismo de la filosofia tradicional precedente. La antropologia (...) actual podra reivindicar la autenticidad de la propia persona y el verdadero alcance de la libertad humana en su configuracion. Jaime Calderon Calderon nacio en 1966 en Churintzio, Michoacan (Mexico). Ordenando sacerdote en 1991. Obtuvo el doctorado en filosofia en la Pontificia Universidad Gregoriana de Roma con la presente disertacion. (shrink)

Photo ID 72893750 © Rawpixelimages|Dreamstime.com ABSTRACT Solidarity is a concept increasingly employed in bioethics whose application merits further clarity and explanation. Given how vital cooperation and community-level care are to mitigating communicable disease transmission, we use lessons from the COVID-19 pandemic to reveal how solidarity is a useful descriptive and analytical tool for public health scholars, practitioners, and policymakers. Drawing upon an influential framework of solidarity that highlights how solidarity arises from the ground up, we reveal how structural forces can (...) impact the cultivation of solidarity from the top down, particularly through ensuring robust access to important social determinants of health. Public health institutions can support solidarity movements among individuals and communities by adopting a lens of social justice when considering public health priorities and, in turn, promote health equity. INTRODUCTION Over the past two decades, scholars have invoked the concept of solidarity when assessing a wide range of topics in bioethics, from CRISPR-Cas9 technology to organ donation to structural racism.[1] However, the growing literature on solidarity has not fully examined the roles and responsibilities of institutions and governments in fostering solidarity, especially regarding public health measures that implicate entire populations. We argue that it remains unclear how public health institutions should engage with solidarity and how their engagement will affect public health and its ethics. We first take Prainsack and Buyx’ three-tiered framework as an analytical starting point.[2] We then explore how public health institutions can foster solidarity by carefully considering factors that may bolster it on an interpersonal, community, and national scale. We conclude that public health institutions should adopt a lens of social justice to promote solidarity at the interpersonal and community levels, thereby promoting equity in future public health efforts. BACKGROUND Calls for solidarity in bioethics raise longstanding normative questions about the nature and limits of our duties to one another and how to weigh autonomy over considerations of justice.[3] Though the term is diversely applied, Prainsack and Buyx propose a potentially unifying definition in the 2011 Nuffield Council report, “Solidarity: Reflections On An Emerging Concept in Bioethics.” The report defines solidarity as an activity involving “shared practices reflecting a collective commitment to carry financial, social, emotional, and or other ‘costs’ to assist others.” Their conceptualization also includes important features that distinguish solidarity from other values like empathy or altruism: solidarity emphasizes action rather than mere internal feeling and recognition of connection as motivation.[4] Bioethicists have since applied this conceptualization when analyzing issues in public and global health, given that population-level efforts need cooperation from individuals and communities. Prainsack and Buyx further note that solidarity is relevant in bioethics discourses about justice and equity, in support of providing aid to low- and middle-income countries, and as a value exemplified by European welfare states.[5] Other bioethicists have argued that promoting solidarity can contribute to community engagement, partnership with Tribal communities, and global health equity.[6] Most recently, scholars have applied solidarity as a lens to assess the COVID-19 pandemic, highlighting the pitfalls of national mitigation efforts and global disparities in disease outcomes.[7] I. Solidarity at Three Levels It seems impossible to foster solidarity in public health if we cannot identify it in general contexts. Prainsack and Buyx articulate three levels of solidarity: interpersonal solidarity, group solidarity, and legal or contractual codifications of solidarity.[8] They argue that each level inherently informs the one ‘above’ it in a unilateral direction. In other words, solidarity is fundamentally a bottom-up phenomenon. Solidarity among individuals influences group norms, which then have the potential to shape policy and institutional practice.[9] Within the Prainsack and Buyx framework, it would seem nonsensical to posit how solidarity might be expressed vertically or from the “top down.” It appears intuitively odd to imagine how a government entity might ‘be’ in solidarity with a person or group if solidarity requires some cognition about their condition per Prainsack and Buyx’ definition. Some have argued that solidarity does not seem like something that one can impose, as instances of it arise from agents recognizing and acting upon some bond rather than in response to a command. Indeed, people may be rightfully hesitant to engage in solidarity if the official messaging is overly paternalistic or coercive.[10] However, some authors have countered that governments can express solidarity through enacting structural and policy changes, though it is ambiguous how these actions are distinct from a justice-driven approach.[11] If a bottom-up approach is thus the most practical means of achieving policy that reflects solidarity, then it does not add much to public health. Institutions would be ineffective without the population’s initiation of the corresponding social norms. However, we find this conclusion overly pessimistic. Fostering a culture of solidarity to improve public health has potential merit. Prainsack and Buyx’ framework overlooks how public health actors can influence solidarity between individuals and across communities. To clarify, we agree with the view that solidarity is a bottom-up phenomenon. Solidarity may not be able to originate in a top-down fashion, but we suggest that public health institutions can take a more active role in providing the public with accurate information, promoting social justice, and intervening in the social determinants of health. II. The COVID-19 Pandemic as a Case Study Lessons learned from the ongoing COVID-19 pandemic support our argument. The pandemic deepened socioeconomic disparities in the US and hindered access to vital resources such as food, housing, and healthcare.[12] Prainsack recently noted: “[n]ext to the immediate health effects of the virus, poverty and grave inequalities have been the root causes of human suffering during the pandemic.”[13] Prior to the pandemic, many rural and low-income populations lacked reliable access to the internet and devices like laptops or smartphones. This continued lack of access restricts the flow of information and prevents people from accessing telemedicine services.[14] Preexisting social, political, and health inequities worsened health outcomes among many marginalized racial and ethnic groups. It is well-documented that communities of color, including Black, American Indian or Alaska Native, and Latinx populations, had greater COVID-related mortality and morbidity due to the effects of structural racism.[15] Although federal US agencies such as the Centers for Disease Control and Prevention enacted laws that provided safety nets (e.g., the Federal Eviction Moratorium), the majority of such programs have ended, leaving many with little assistance and the threat of further hardship.[16] These disparities are relevant because Prainsack, Buyx, and others note that solidarity arises from agents recognizing and acting on some perceived attainable collective goal(s). Income inequality and disparate access to food, education, and health care may lead people to consider public health goals unattainable. This could limit the desire to work toward those goals collectively.[17] The existing literature on collective action theory supports this intuition. It emphasizes that structural conditions, such as an absence of perceived hope for social change among a group, can lead to low ‘group efficacy’ and little willingness to cooperate, both within and across socioeconomic strata.[18] The pandemic spurred countless messages from public health agencies. The messaging did not recognize or attend to the different material realities and circumstances of the US population. How can people feel comfortable getting vaccinated if they deeply distrust the government, including public health institutions? How can people remain motivated to wear masks and distance themselves if they cannot afford basic necessities and work jobs without adequate pay and leave policies? We ask these questions to illustrate how socioeconomic disparities can marginalize people if they feel ignored, apathetic, or resentful of those better off or those in power whom they perceive to “not be doing enough.” This marginalization precludes the formation of solidarity. There are instances when a population has disparate access to resources and social capital, but solidarity may still emerge from a shared goal or vision for the future. For example, a heterogeneous population living in the same town may come together to protest an environmental injustice that impacts their water supply with the common goal of securing access to safe drinking water. However, many populations in the US failed to recognize shared goals of this kind during the COVID-19 pandemic. A significant minority of the US population was reluctant to acknowledge the severity of COVID-19 infection and thus refused to participate in efforts to mitigate its spread. Even between groups who shared the goal of slowing COVID-19 transmission, the methods were widely debated. Approximately 20 percent of the adult population eligible for vaccination remains unvaccinated.[19] Governmental bodies responsible for disseminating information, coordinating the allocation of resources, and establishing guidelines have a large role in mediating these disagreements and intervening in socioeconomic conditions that impact people's ability and willingness to engage in solidarity. III. Solidarity, Social Justice, and the Role of Public Health Institutions Adopting a lens of social justice provides further insights into how public health actors impact solidarity. Powers and Faden argue that the “foundational moral justification for the social institution of public health is social justice.”[20] Their theory of social justice has two aims. First, it ensures that everyone has a sufficient amount of the six core elements of well-being and that public health institutions are responsible for “adopting policies and creating environments” where all can flourish.[21] Second, public health institutions should distribute resources meant to promote well-being and focus on the “needs of those who are the most disadvantaged.”[22] Public health institutions should enact policies that address injustice. In doing so, public health institutions can seed the opportunity to build solidarity from the bottom up. Equipping individuals and communities with resources will foster cooperation and adherence to policies that require solidarity, such as masking and vaccination. This is consistent with arguments illustrating how institutions such as Tribal governments promote the conditions needed for their group, and especially its most vulnerable members, to flourish.[23] Addressing social determinants of health with a social justice lens will create the circumstances under which more individuals and groups can find common causes and foster solidarity. In the long run, such efforts may result in the establishment of values and practices from the bottom up. There are societal and public health preconditions required before institutions can expect their audience to act in solidarity with one another. Through their great influence over information and resources, public institutions do have the power to impact what values are most widespread. Furthermore, public health may foster trust and hope, which are important psychosocial factors that influence collective action,[24] if policies increase access to resources that promote well-being. Messaging efficacy also depends on the context of public trust, education, and whether the institutions meet one’s basic needs. Disparate messaging across different public institutions may confuse or disillusion individuals. To apply our theory of solidarity to the decision to vaccinate, a policy would be to foster conditions that facilitate access to vaccines and information about vaccine efficacy instead of imposing a top-down mandate without first eliciting public trust. IV. Counterargument Some argue that discordant public health messaging, ineffective government, and inadequate social programs can also bring people together under pressure and foster solidarity. One may argue that the most powerful motivators towards solidarity are strife and disparity, as evidenced throughout history. During the pandemic alone, political struggle and personal hardship inspired solidarity in the US, from individual neighbors helping each other to mutual aid groups forming across communities. We thus do not claim that solidarity is possible only when our government programs and public health institutions are most effective. We instead point out that solidarity can be further hindered when people feel alienated, hopeless, and pitted against each other. CONCLUSION Many competing conceptualizations of solidarity persist in the bioethics literature, and Prainsack and Buyx offer one compelling framework that public health ethicists continue to draw upon.[25] However, their framework fails to acknowledge how public health institutions impact interpersonal and group solidarity. Public health institutions can foster solidarity through actions other than mere messaging, invoking catchphrases like “we are all in this together.” Efforts to address socioeconomic preconditions and alleviate health disparities can cultivate group solidarity. As we saw during the pandemic, cooperation and solidarity go hand-in-hand with disease mitigation efforts; solidarity has clear intrinsic value.[26] As this relationship becomes more apparent, we will continue to see attempts from public health institutions to foster or invoke solidarity. Therefore, public health institutions would be remiss to ignore their role in addressing the social determinants of health. Adopting a social justice lens when planning public health interventions will clarify and strengthen their role in facilitating solidarity. Ultimately, if health disparities continue to persist or widen, it is very hard to imagine how group solidarity can ever be achieved. The widescale adoption of many public health measures needed to promote health and well-being would be conducive to solidarity. - Disclaimer: The opinions expressed are the authors’ and do not represent the views of the NIH, DHHS, or the U.S. government. Funding Disclosure: This work was supported in part by the Intramural Program of the National Institutes of Health Clinical Center. - [1] John J Mulvihill et al., “Ethical Issues of CRISPR Technology and Gene Editing through the Lens of Solidarity,” British Medical Bulletin 122 (2017): 17–29, https://doi.org/10.1093/bmb/ldx002; Ben Saunders, “Altruism or Solidarity? The Motives for Organ Donation and Two Proposals,” Bioethics 26, no. 7 (September 2012): 376–81, https://doi.org/10.1111/j.1467-8519.2012.01989.x; -Vanessa Y Hiratsuka, “SPECIAL REPORT: A Critical Moment in Bioethics: Reckoning with Anti-Black Racism through Intergenerational Dialogue A Call for Solidarity in Bioethics: Confronting Anti-Black Racism Together,” 2022, https://doi.org/10.1002/hast.1380. [2] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics London: Nuffield Council on Bioethics, 2011; Prainsack and Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach.” Bioethics 26, no. 7 (September 2012): 343–50. https://doi.org/10.1111/J.1467-8519.2012.01987.X. [3] Bob Simpson, “A ‘We’ Problem for Bioethics and the Social Sciences: A Response to Barbara Prainsack,” Science, Technology, & Human Values 43, no. 1 (January 12, 2018): 45–55, https://doi.org/10.1177/0162243917735899. [4] Barbara Prainsack and Alena Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics (London: Nuffield Council on Bioethics, 2011). [5] Barbara Prainsack and Alena Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach,” Bioethics 26, no. 7 (September 2012): 343–50, https://doi.org/10.1111/J.1467-8519.2012.01987.X. [6] Bridget Pratt, Phaik Yeong Cheah, and Vicki Marsh, “Solidarity and Community Engagement in Global Health Research,” The American Journal of Bioethics : AJOB 20, no. 5 (May 3, 2020): 43–56, https://doi.org/10.1080/15265161.2020.1745930; Sara Chandros Hull, F. Leah Nez (Diné), and Juliana M. Blome, “Solidarity as an Aspirational Basis for Partnership with Tribal Communities,” The American Journal of Bioethics 21, no. 10 (October 3, 2021): 14–17, https://doi.org/10.1080/15265161.2021.1965258; Mbih J. Tosam et al., “Global Health Inequalities and the Need for Solidarity: A View from the Global South,” Developing World Bioethics 18, no. 3 (September 1, 2018): 241–49, https://doi.org/10.1111/DEWB.12182. [7] Peter West-Oram, “Solidarity Is for Other People: Identifying Derelictions of Solidarity in Responses to COVID-19,” Journal of Medical Ethics 47, no. 2 (February 1, 2021): 65–68, https://doi.org/10.1136/MEDETHICS-2020-106522; Barbara Prainsack, “Solidarity in Times of Pandemics,” Democratic Theory 7, no. 2 (December 1, 2020): 124–33, https://doi.org/10.3167/DT.2020.070215; F. Marijn Stok et al., “Social Inequality and Solidarity in Times of COVID-19,” International Journal of Environmental Research and Public Health 18, no. 12 (June 2, 2021), https://doi.org/10.3390/IJERPH18126339; Ming Jui Yeh, “Solidarity in Pandemics, Mandatory Vaccination, and Public Health Ethics,” American Journal of Public Health 112, no. 2 (February 1, 2022): 255–61, https://doi.org/10.2105/AJPH.2021.306578; Barbara Prainsack, “Beyond Vaccination Mandates: Solidarity and Freedom During COVID-19.,” Am J Public Health 112, no. 2 (February 1, 2022): 232–33, https://doi.org/10.2105/AJPH.2021.306619. 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[26] Ruth Chadwick, “COVID‐19 and the Possibility of Solidarity,” Bioethics 34, no. 7 (September 8, 2020): 637–637, https://doi.org/10.1111/bioe.12813. (shrink)