This study examined the relationship between moral distress intensity, moral distress frequency and the ethical work environment, and explored the relationship of demographic characteristics to moral distress intensity and frequency. A group of 106 nurses from two large medical centers reported moderate levels of moral distress intensity, low levels of moral distress frequency, and a moderately positive ethical work environment. Moral distress intensity and ethical work environment were correlated with moral distress frequency. Age was negatively correlated with moral distress intensity, (...) whereas being African American was related to higher levels of moral distress intensity. The ethical work environment predicted moral distress intensity. These results reveal a difference between moral distress intensity and frequency and the importance of the environment to moral distress intensity. (shrink)

The role that trust plays in blockchain-based systems is understood and portrayed in various manners. The blockchain technology is said to enable and establish trust as well as to redirect it, to substitute for it, and to make it obsolete. Furthermore, there is disagreement on whom or what users have to trust when using the blockchain technology: code, math, algorithms, and machines, or still human actors. This paper hypothesizes that the divergences of the depictions largely rest on implicitly adhering to (...) different accounts of trust. Thus, the goal of this paper is to outline how the current lack of a shared understanding of the term “trust” leads to diverging interpretations of the blockchain technology’s core features. Furthermore, it shows how this lack of common understanding obstructs scholars from referring to one another meaningfully in the discourse on blockchain technology. To do so, this paper outlines the most prominent depictions of the setup of relevant trust relationships within blockchain-based systems and traces their roots to different underlying assumptions on the nature of trust. (shrink)

The 'Discussion' section of this issue contains the following responses to Wilfred Beckerman's article 'Sustainable Development: Is it a Useful Concept?' Environmental Values 3,3 (1994): 191-209. Herman Daly, 'On Wilfred Beckerman's Critique of Sustainable Development'; Michael Jacobs, 'Sustainable Development, Capital Substitution and Humility: A Response to Beckerman'; and Henryk Skolimowski, 'In Defence of Sustainable Development'. These criticisms are answered by Beckerman in Environmental Values 4,2.

The 'Discussion' section of this issue contains the following responses to Wilfred Beckerman's article 'Sustainable Development: Is it a Useful Concept?' Environmental Values 3,3 (1994): 191-209. Herman Daly, 'On Wilfred Beckerman's Critique of Sustainable Development'; Michael Jacobs, 'Sustainable Development, Capital Substitution and Humility: A Response to Beckerman'; and Henryk Skolimowski, 'In Defence of Sustainable Development'. These criticisms are answered by Beckerman in Environmental Values 4,2.

We review the evidence for the concept of the “initial” or prototype brain. We outline four possible modes of brain evolution suggested by our new findings on the evolutionary status of the dolphin brain. The four modes involve various forms of deviation from and conformity to the hypothesized initial brain type. These include examples of conservative evolution, progressive evolution, and combinations of the two in which features of one or the other become dominant. The four types of neocortical organization in (...) extant mammals may be the result of selective pressures on sensory/motor systems resulting in divergent patterns of brain phylogenesis. A modular “modification/multiplication” hypothesis is proposed as a mechanism of neocortical evolution in eutherians. Representative models of the initial ancestral group of mammals include not only extant basal Insectivora but also Chiroptera; we have found that dolphins and large whales have also retained many features of the archetypal or initial brain. This group evolved from the initial mammalian stock and returned to the aquatic environment some 50 million years ago. This unique experiment of nature shows the effects of radical changes in environment on brain-body adaptations and specializations. Although the dolphin brain has certain quantitative characteristics of the evolutionary changes seen in the higher terrestrial mammals, it has also retained many of the conservative structural features of the initial brain. Its neocortical organization is accordingly different, largely in a quantitative sense, from that of terrestrial models of the initial brain such as the hedgehog. (shrink)

This book offers a broad survey of psychotherapy discourses, including: The psychoanalytic The interpersonal The experiential The cognitive-behavioural The transpersonal This book offers a comprehensive overview of the ways in which these ...

We review the evidence for the concept of the “initial” or prototype brain. We outline four possible modes of brain evolution suggested by our new findings on the evolutionary status of the dolphin brain. The four modes involve various forms of deviation from and conformity to the hypothesized initial brain type. These include examples of conservative evolution, progressive evolution, and combinations of the two in which features of one or the other become dominant. The four types of neocortical organization in (...) extant mammals may be the result of selective pressures on sensory/motor systems resulting in divergent patterns of brain phylogenesis. A modular “modification/multiplication” hypothesis is proposed as a mechanism of neocortical evolution in eutherians. Representative models of the initial ancestral group of mammals include not only extant basal Insectivora but also Chiroptera; we have found that dolphins and large whales have also retained many features of the archetypal or initial brain. This group evolved from the initial mammalian stock and returned to the aquatic environment some 50 million years ago. This unique experiment of nature shows the effects of radical changes in environment on brain-body adaptations and specializations. Although the dolphin brain has certain quantitative characteristics of the evolutionary changes seen in the higher terrestrial mammals, it has also retained many of the conservative structural features of the initial brain. Its neocortical organization is accordingly different, largely in a quantitative sense, from that of terrestrial models of the initial brain such as the hedgehog. (shrink)

This book is a resource for providers and students, integrating germane basic science information with clinical-medicine insights. The goal is to improve primary-care outpatient interactions for physicians, APRNs, and PAs. It is unique, integrating germane basic-science information with clinical-medicine. Unlike other resources that introduce these concepts more distinctly, this book bridges the gap and provides insights for providers and students. Also, there are succinct, yet comprehensive, presentations on managing the more common out-patient problems. The book is designed for primary care (...) providers and students, e.g., physicians, APRNs, and PAs, who desire to improve their patient-education, diagnostic, and treatment skills. The PEARLS are instruments to embellish and emphasize important concepts. The focus of the book is to improve outpatient medicine delivery, and better informed and confident providers are keys to the process. (shrink)

Although the details of the Clinton health care plan have yet to emerge from the continuing policy debate over the shape and size of the administration’s reform measures, one thing has become increasingly clear. Several recent developments in antitrust law will have important implications for what the plan will permit and how it will work.By all accounts, the broad outline of the administration’s plan revolves around the development of large and powerful consumer groups who, with the help of sophisticated, government-established (...) intermediaries, will presumably purchase health care wisely and well. This alliance of massed consumer purchasing and government information-gathering will, it is hoped, produce a health care market more in competitive balance than the current version, which is widely regarded as dominated by powerful providers who dictate terms to small, uninformed buying groups. (shrink)

Although the details of the Clinton health care plan have yet to emerge from the continuing policy debate over the shape and size of the administration’s reform measures, one thing has become increasingly clear. Several recent developments in antitrust law will have important implications for what the plan will permit and how it will work.By all accounts, the broad outline of the administration’s plan revolves around the development of large and powerful consumer groups who, with the help of sophisticated, government-established (...) intermediaries, will presumably purchase health care wisely and well. This alliance of massed consumer purchasing and government information-gathering will, it is hoped, produce a health care market more in competitive balance than the current version, which is widely regarded as dominated by powerful providers who dictate terms to small, uninformed buying groups. (shrink)

It can be really hard—or really easy—to explain what I do for a living. Chaplains share academic training with clergy, but we complete clinical residencies and work in health care organizations. Our affinities are with the patient and family, but we may also chair the ethics committee or serve on the institutional review board, and we spend a lot of time with staff. We must demonstrate a relationship with an established religious tradition, but we serve patients of all faiths, and (...) of no faith, and seek to protect patients against proselytizing. We provide something that may be called “pastoral” care, “spiritual” care, or just “chaplaincy”—but even among ourselves, we do not always agree about what that thing is. (shrink)

Der Philosoph und Schriftsteller Fritz Mauthner, geb. am 22.11.1849 in Horschitz, Bohmen, befasste sich hauptsachlich mit der Sprachkritik und sah dies als seine Lebensarbeit an. In der Wissenschaft galt er immer als Freigeist. Mauthners Werk Die drei Bilder der Welt" ist ein unfertiges Buch, das posthum erschien.".