Background: Moral distress, which is especially high in critical care nurses, has significant negative implications for nurses, patients, organizations, and healthcare as a whole. Aim: A moral distress workshop and follow-up activities were implemented in an intensive care unit in order to decrease levels of moral distress and increase nurses’ perceived comfort and confidence in ethical decision-making. Design: A quality improvement (QI) initiative was conducted using a pre- and post-intervention design. The program consisted of a four-hour interactive workshop, followed by (...) two individual self-reflection activities at 2–3 weeks and 5–6 weeks after the workshop. Participants: Critical care nurses working in a heart and vascular intensive care unit at a large academic medical center. Ethical Considerations: This study was deemed to be a QI project by the institution’s Institutional Review Board. Participation was voluntary. Findings: Nurses experienced a significant decrease in moral distress. The participants’ average ethical confidence increased in four areas (ability to identify the conflicting values at stake, knowing role expectations, feeling prepared to resolved ethical conflict, and being able to do the right thing), with knowledge of role expectations and feeling prepared to resolve ethical conflict yielding statistically significant increases. Qualitative findings resulted in consistent themes related to causes of moral distress and ways nurses approached addressing moral distress. Discussion: This study reinforces previous evidence on moral distress and its causes in critical care nurses, and provides a mechanism for improving moral distress and ethical confidence. Conclusions: This QI study demonstrates the effectiveness of an evidence-based program for decreasing critical care nurses’ moral distress and increasing their ethical confidence. The strategies described in this paper can replicated by nursing leaders who wish to effect change at their local level, or adapted and expanded to other professions and clinical care units. (shrink)

In recent years, several prominent biologists have pointed to the relatively new field of evolutionary developmental biology (EvoDevo) as evidence of an Extended Synthesis in evolutionary biology. More particularly, these biologists claim that theoretical and empirical EvoDevo research is extending the Modern Synthesis framework of evolutionary theory through investigation of evolutionarily important concepts that are not part of the framework developed during the 20th century. To describe the current changes in evolutionary biology as an Extended Synthesis, however, is incorrect. Through (...) review of Extended Synthesis arguments and analysis of the same biological concepts used to support these arguments, I argue that the foundation of the Modern Synthesis framework, theoretical population genetics, faces significant, perhaps insurmountable challenges from the concepts highlighted by EvoDevo research. As the foundation of the Modern Synthesis framework will require considerable remodeling—if possible—in light of the concepts emphasized by EvoDevo, it is incorrect to describe the ongoing changes in evolutionary biology as an Extended Synthesis. (shrink)

The study of evolutionary developmental biology (“evo‐devo”) has recently experienced a dramatic surge in popularity among researchers and theorists concerned with evolution. However, some biologists and philosophers remain skeptical of the claims of evo‐devo. This paper discusses and responds to the recent high profile criticisms of evo‐devo presented by biologists Hopi E. Hoekstra and Jerry A. Coyne. I argue that their objections are unconvincing. Indeed, empirical research supports the main tenets of evo‐devo, including the claim that morphological evolution is the (...) result of cis ‐regulatory change and the distinction that evo‐devo draws between morphological and physiological traits. *Received January 2008; revised March 2009. †To contact the author, please write to: Department of Philosophy, University of Cincinnati, Cincinnati, OH 45221; e‐mail: [email protected]. (shrink)

In recent years, several prominent biologists have pointed to the relatively new field of evolutionary developmental biology as evidence of an Extended Synthesis in evolutionary biology. More particularly, these biologists claim that theoretical and empirical EvoDevo research is extending the Modern Synthesis framework of evolutionary theory through investigation of evolutionarily important concepts that are not part of the framework developed during the 20th century. To describe the current changes in evolutionary biology as an Extended Synthesis, however, is incorrect. Through review (...) of Extended Synthesis arguments and analysis of the same biological concepts used to support these arguments, I argue that the foundation of the Modern Synthesis framework, theoretical population genetics, faces significant, perhaps insurmountable challenges from the concepts highlighted by EvoDevo research. As the foundation of the Modern Synthesis framework will require considerable remodeling—if possible—in light of the concepts emphasized by EvoDevo, it is incorrect to describe the ongoing changes in evolutionary biology as an Extended Synthesis. (shrink)

The relatively new field of evolutionary developmental biology continues to attract considerable attention from biologists, philosophers, and historians, in part, because work in this field demonstrates that important changes are underway within biology. Though studies of development and evolution were closely connected during the 19th century, continued work in genetics fostered a general split between the two during the first decades of the twentieth century (e.g., Allen 1978; Gilbert 1978; Mayr and Provine 1980; Gilbert, Opitz and..

The concept of energy, the premier concept of physics and indeed of all science, is here investigated from the standpoint of its early historical origin and the philosophical implications thereof. The fundamental assumption is made that the root of the concept is the notion of invariance or constancy in the midst of change. Salient points in the development of this idea are presented from ancient times up to the publication of Lagrange'sMécanique Analytique (1788).

It is the aim of this paper to examine certain aspects of a point of view which has attracted much attention in physical methodology. This is the standpoint known as operationalism. We wish to discuss its significance in the construction and interpretation of physical theories.The essential meaning of operationalism in physics is that physical concepts should be defined in terms of actual physical operations. On this view there is no meaning to a concept unless it represents an operation which can (...) be performed in the laboratory. Thus the term “pressure of a gas” signifies nothing until an operation is described which constitutes the measurement of pressure. When one thinks of pressure one must think. of some actual apparatus, such as, for example, some glass and rubber tubing and some mercury and certain operations performed using these until finally one gets a pointer reading which one calls the pressure of the gas. The same stand is taken with respect to length, time, velocity, acceleration, temperature, etc. (shrink)

In the fourteenth century William of Occam in the course of his attack on the medieval scholastic philosophy enunciated his famous “razor”: Entia non sunt multiplicanda praeter necessitatem. This is the classic claim for the description of nature in terms of the minimum possible number of fundamental concepts. It was presumably so recognized by Newton in the third book of his “Principia” in 1687 when he wrote: “We are to admit no more causes of natural things than such as are (...) both true and sufficient to explain their appearances. To this purpose the philosophers say that Nature does nothing in vain, and more is in vain when less will serve; for Nature is pleased with simplicity and affects not the pomp of superfluous causes.”. (shrink)

Baron assumes that ethical decision-making can be evaluated without specifying more general features of the cognitive system within which it occurs. It is suggested that ethical principles are heuristics employed during goal-oriented action planning. Heuristics are bound to generate suboptimal decisions in some cases. It is rational to replace a particular heuristic only when the cost of associated error exceeds the cost of constructing and installing a more successful alternative.

Two types of variables impact face recognition: estimator variables that cannot be controlled and system variables that are under direct control by the criminal justice system. This article addresses some of the reasons that eyewitnesses are prone to making errors, particularly false identifications. It provides a discussion of the differences between typical facial memory and eyewitness studies and shows that the two areas generally find similar results. It reviews estimator variable effects and focuses on system variables. Traditional facial recognition researchers (...) rarely study system variables but reveal important factors that police and policy makers should consider with regard to eyewitness identification and the courts. It concludes that there is still room for considerable improvement in identification procedures and wants to encourage more system variable research as a means of reducing wrongful convictions. (shrink)

The modern theoretical physicist is a strange creature. Perhaps in every age the theoretical physicist has seemed so to his contemporaries who took the trouble to observe and think about him. There seems, for example, something almost too magical in the uncanny way in which he pulls a brand new atomic particle out of a theory, a way that reminds us of a rabbit being produced out of a hat. This is usually done in an off-hand manner with a considerable (...) amount of patter of a highly abstract symbolic character but with a few words inserted in the right places for the benefit of the experimental physicist and a final prediction that if the experimenter does thus and so in the laboratory he will find a certain result. No wonder the observer marvels when the answer comes out right. But as he thinks further he is inclined to wonder whether it is necessary or desirable for the details of the process which led to the result to be so unintelligible. For unintelligible they seem to be to a great many people who are directly concerned with their understanding, to the people who for years have been laboring under the belief that they are engaged in the task of finding out how Nature works. What is this curious process whose whole task, according to one distinguished exponent of it, is merely to predict experimental results, and what is its future likely to be? These are the questions we are setting for ourselves in the present discussion. It is unlikely that the answers given here will satisfy everybody, but it is reasonably certain that nobody who aspires to an interest in science can fail to attach some meaning to them whether or not he agrees. (shrink)

An organization's management control system can play an important role in influencing ethical behavior among employees. In this paper a theoretical framework of control is developed by linking various ethics related control mechanisms reported in the literature to the primary components of a management control system. In addition, the findings of a survey of the Financial Post's Top 1 000 Canadian industrial and service companies are reported. The survey investigated organizations' use of ethical codes of conduct, whistleblowing systems, ethics committees, (...) judiciary boards, employee training in ethics, and ethics focused corporate governance and reward systems. The findings indicate that ethics related control mechanisms, particularly codes of conduct, are being used by a good number of organizations. However, closer analysis of the data suggests that many companies may only be paying lip service to the importance of promoting ethical behavior. (shrink)

Vaccine research, as well as the development, testing, clinical trials, and commercial uses of vaccines involve complex processes with various biological data that include gene and protein expression, analysis of molecular and cellular interactions, study of tissue and whole body responses, and extensive epidemiological modeling. Although many data resources are available to meet different aspects of vaccine needs, it remains a challenge how we are to standardize vaccine annotation, integrate data about varied vaccine types and resources, and support advanced vaccine (...) data analysis and inference. To address these problems, the community-based Vaccine Ontology (VO) has been developed through collaboration with vaccine researchers and many national and international centers and programs, including the National Center for Biomedical Ontology (NCBO), the Infectious Disease Ontology (IDO) Initiative, and the Ontology for Biomedical Investigations (OBI). VO utilizes the Basic Formal Ontology (BFO) as the top ontology and the Relation Ontology (RO) for definition of term relationships. VO is represented in the Web Ontology Language (OWL) and edited using the Protégé-OWL. Currently VO contains more than 2000 terms and relationships. VO emphasizes on classification of vaccines and vaccine components, vaccine quality and phenotypes, and host immune response to vaccines. These reflect different aspects of vaccine composition and biology and can thus be used to model individual vaccines. More than 200 licensed vaccines and many vaccine candidates in research or clinical trials have been modeled in VO. VO is being used for vaccine literature mining through collaboration with the National Center for Integrative Biomedical Informatics (NCIBI). Multiple VO applications will be presented. (shrink)

The fourth volume in the Criminalization series, this volume explores some of the most general principles and theories of criminalization. It includes not only philosophical work, but also historical, legal, and sociological investigations into criminalization, clarifying the state of the discipline today.

The third book in the Criminalization series examines the constitutionalization of criminal law. It considers how the criminal law is constituted through the political processes of the state; how the agents of the criminal law can be answerable to it themselves; and finally how the criminal law can be constituted as part of the international order.

Health justice is both a community-led movement for power building and transformational change and a community-oriented framework for health law scholarship. Health justice is distinguished by a distinctively social ethic of care that reframes the relationship between health care, public health, and the social determinants of health, and names subordination as the root cause of health inequities.

The nineteenth-century strategist Carl von Clausewitz describes “fog” and “friction” as fundamental features of war. Military leverage of sophisticated information technology in the twenty-first century has improved some tactical operations but has not lifted the fog of war, in part, because the means for reducing uncertainty create new forms of it. Drawing on active duty experience with an American special operations task force in Western Iraq from 2007 to 2008, this article traces the targeting processes used to “find, fix, and (...) finish” alleged insurgents. In this case they did not clarify the political reality of Anbar province but rather reinforced a parochial worldview informed by the Naval Special Warfare community. The unit focused on the performance of “direct action” raids during a period in which “indirect action” engagement with the local population was arguably more appropriate for the strategic circumstances. The concept of “data friction”, therefore, can be understood not simply as a form of resistance within a sociotechnical system but also as a form of traction that enables practitioners to construct representations of the world that amplify their own biases. (shrink)

Despite ample evidence of the efficacy and effectiveness of evidence-based parenting programmes (EBPPs) within research-led environments, there is very little evidence of maintenance of effectiveness when programmes are delivered as part of regular service provision. The present study examined the effectiveness of EBPPs provided during a period of sustained service-led implementation in comparison to research-led effectiveness evaluation. Data from 3706 parents who received EBPPs during sustained implementation by services were compared to data from 1390 parents who had participated in an (...) earlier researcher-led effectiveness trial of a national roll-out of EBPPs in England. In both phases, parents completed measures of child behaviour problems, parenting style and parental mental well-being prior to starting parenting programmes (pre-test), at the end of the programmes (post) and at 12-months follow up. Results from Generalised Estimating Equations controlling for potential covariates indicated significant improvements in child behaviour problems during sustained implementation, similar to the effectiveness phase; significant improvements in parenting style which were larger than the effectiveness phase at 12-month follow up; and significant improvements in parental mental well- being. Our findings demonstrate effective maintenance of gains when EBPPs are provided as part of regular provision across a large sample of English parents. Successful long-term implementation should consider effectiveness of EBPPs across the population, given the large contextual changes that take place between researcher-led evaluations and service take-up. Our findings support the integration of EBPPs in public health approaches to addressing child behaviour problems and parent well-being. (shrink)

Although task-unrelated thinking has been increasingly investigated in recent years, the content and correlates of everyday off-task thought in clinical d...

This book examines influential conceptions of sport and then analyses the interplay of challenging borderline cases with the standard definitions of sport. It is meant to inspire more thought and debate on just what sport is, how it relates to other activities and human endeavors, and what we can learn about ourselves by studying sport.

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

The abbreviation-symbols of the Romans, found in ancient uncial MSS., may be roughly divided into three classes: Those peculiar to juristic writing, e.g. R.P. ‘res priuata’ , Q.D.R.A. ‘qua de re agitur.’ They are properly called ‘notae iuris.’ They abound in the famous Verona MS. of Gaius. A few used in histories, etc., e.g. R.P. 'respublica' , Q. ‘Quintus’ . Valerius Probus, who compiled a manual of ancient Notae, calls this class ‘notae publicae’. They appear in such MSS. as the (...) codex Puteanus of Livy ; and since they have been transferred into modern editions of the Latin historians, etc., no one is at a loss to interpret them nowadays, although they puzzled mediaeval scribes. Symbols of ordinary words of frequent occurrence in any type of literature, e.g. Q. ‘que.’ It is this class which is the subject of this article. (shrink)