Multiple gestations, or multifetal pregnancies,raise a number of significant policy questionsconcerning the well being of women and the wellbeing of the children fetuses might become.Important questions for feminists pertain notonly to multifetal pregnancy itself, but alsoto the medical interventions associated withthese pregnancies. In this paper, we addressthe questions of how many embryos should betransferred in assisted reproduction, how manyfetuses should remain in a multiple gestation,who should make these decisions, and the needto protect women from overexposure to exogenoushormones. Although we focus (...) on assistedreproduction in the United States, we believethat our suggestions are applicable to othercountries where the technology is comparable. (shrink)

Fraud and misconduct in scientific research appears to be increasing since 1980 when several cases were disclosed. Earlier instances were handled awkwardly, but the scientific community has since mobilized and issued guidelines about responding to allegations of misconduct and about the responsible conduct of research. Scientists, editors and the institutions of science are slowly learning how to cope with this problem.

The story of Jonathan and David stands out as the Bible's lengthiest and most complex narrative reflection on friendship. Far from idealizing the mutuality of their devotion, however, this story invites readers to ponder the human freedom to accept, reject, exploit, or reciprocate the gift of a friend's loyalty.

El objetivo de este artículo es comprender las prácticas y percepciones de las navegadoras de pacientes con sospecha o diagnóstico de cáncer de mama en cuatro hospitales públicos argentinos respecto del uso de las tecnologías de información y comunicación en su tarea cotidiana. En el sistema de navegación de CM, la navegadora acompaña a las pacientes para evitar o superar barreras de acceso a la línea de cuidado del CM, buscando lograr diagnóstico, atención y tratamiento en tiempos óptimos. El abordaje (...) metodológico de la investigación aquí presentada es cualitativo con un diseño descriptivo y exploratorio. Se realizaron entrevistas y observaciones participantes. Entre otros hallazgos, observamos que los déficits estructurales de las TIC en los servicios de salud estudiados obstaculizan el desarrollo de la navegación y refuerzan rechazos y desconfianza a su utilización en las navegadoras estudiadas. A pesar de ello, las TIC se instalan progresivamente en la navegación de pacientes con CM. (shrink)

Background: Despite procedural innovations and increasing numbers of uterus transplant attempts worldwide, the perspectives of uterus transplant (UTx) trial participants are lacking. Methods: We conducted a mixed-methods study with women with absolute uterine factor infertility (AUFI). Participants included women who had previously contacted the Cleveland Clinic regarding the Uterine Transplant Trial and met the initial eligibility criteria for participation. In-depth interviews were conducted in conjunction with FertiQoL, a validated and widely used tool to measure the impact of infertility on the (...) quality of life of infertility patients. Results: All (n = 19) rated their overall health as good; some experienced grief and social isolation. AUFI is a life-framing experience that influences acceptance by family, partners, peers, and one’s self. UTx is a means to gain control of reproductive autonomy. UTx allows family-building and the ability to play an active role in prenatal health and well-being. Establishing and maintaining a supportive relationship is a key issue of AUFI and when considering UTx. Risks of UTx are perceived relative to risks to self/child/family posed by adoption/surrogacy. Participants had no overall preference regarding living or deceased donor. Conclusions: The ways in which women with AUFI conceptualize this condition in their lives and choices around UTx and participating in a study of the procedure are multifaceted and textured. These perspectives are critical to understanding its ethical, legal, and social implications. (shrink)

An epistemic logic is built up on the basis of an analysis of two skeptical arguments. the method used is to first construct an inference relation appropriate to epistemic contexts and introduce "a knows that..." as an operator giving rise to sentences closed with respect to this new concept of inference. soundness and completeness proofs are provided using auxiliary three-valued valuations.

Over the last decade, empirical research on compassion has burgeoned in the biomedical, clinical, translational, and foundational sciences. Increasingly sophisticated understandings and measures of compassion continue to emerge from the abundance of multi- and cross-disciplinary studies. Naturally, the diversity of research methods and theoretical frameworks employed presents a significant challenge to consensus and synthesis of this knowledge. To bring the empirical findings of separate and sometimes siloed disciplines into conversation with one another requires an examination of their disparate assumptions about (...) what compassion is and how it can be known. Here, we present an integrated theoretical review of methodologies used in the empirical study of compassion. Our goal is to highlight the distinguishing features of each of these ways of knowing compassion, as well as the strengths and limitations of applying them to specific research questions. We hope this will provide useful tools for selecting methods that are tailored to explicit objectives (methods matching), taking advantage of methodological complementarity across disciplines (methods-mixing), and incorporating the empirical study of compassion into fields in which it may be missing. (shrink)

Literacy is an essential skill. Learning to read is a requirement for becoming a self-providing human being. However, while spoken language is acquired naturally with exposure to language without explicit instruction, reading and writing need to be taught explicitly. Decades of research have shown that well-structured teaching of phonological awareness, letter knowledge, and letter-to-sound mapping is crucial in building solid foundations for the acquisition of reading. During the COVID-19 pandemic, children worldwide did not have access to consistent and structured teaching (...) and are, as a consequence, predicted to be behind in the development of their reading skills. Subsequent evidence confirms this prediction. With the best evidence-based practice in mind, we developed an online version of a well-structured early literacy training program for 5-year-old children. This 2-week online Reading Camp program is designed for pre-K children. It incorporates critical components of the fundamental skills essential to learning to read and is taught online in an interactive, multi-sensory, and peer-learning environment. We measure the participants’ literacy skills and other related skills before and after participating in the online Reading Camp and compare the results to no-treatment controls. Results show that children who participated in the online Reading Camp improved significantly on all parameters in relation to controls. Our results demonstrate that a well-structured evidence-based reading instruction program, even if online and short-term, benefits 5-year-old children in learning to read. With the potential to scale up this online program, the evidence presented here, alongside previous evidence for the efficacy of the in-person program, indicates that the online Reading Camp program is effective and can be used to tackle a variety of questions regarding structural and functional plasticity in the early stages of reading acquisition. (shrink)

Next SectionObjectives To evaluate the adequacy of paediatric informed consent and its augmentation by a supplemental computer-based module in paediatric endoscopy. Methods The Consent-20 instrument was developed and piloted on 47 subjects. Subsequently, parents of 101 children undergoing first-time, diagnostic upper endoscopy performed under moderate IV sedation were prospectively and consecutively, blinded, randomised and enrolled into two groups that received either standard form-based informed consent or standard form-based informed consent plus a commercial (Emmi Solutions, Inc, Chicago, Il), sixth grade level, (...) interactive learning module (electronic assisted consent). Anonymously and electronically, the subjects' anxiety (State Trait Anxiety Inventory), satisfaction (Modified Group Health Association of America), number of questions asked, and attainment of informed consent were assessed (Consent-20). Statistics were calculated using t test, paired t test, and Mann Whitney tests. Results The ability to achieve informed consent, as measured by the new instrument, was 10% in the control form-based consent group and 33% in the electronic assisted consent group (p<0.0001). Electronically assisting form-based informed consent did not alter secondary outcome measures of subject satisfaction, anxiety or number of questions asked in a paediatric endoscopy unit. Conclusions This study demonstrates the limitations of form-based informed consent methods for paediatric endoscopy. It also shows that even when necessary information was repeated electronically in a comprehensive and standardised video, informed consent as measured by our instrument was incompletely achieved. The supplemental information did, however, significantly improve understanding in a manner that did not negatively impact workflow, subject anxiety or subject satisfaction. Additional study of informed consent is required. Clinical trial registration number ClinicalTrials.gov Identifier NCT00899392. (shrink)

Over the last decade, numerous interventions and techniques that aim to engender, strengthen, and expand compassion have been created, proliferating an evidence base for the benefits of compassion meditation training. However, to date, little research has been conducted to examine individual variation in the learning, beliefs, practices, and subjective experiences of compassion meditation. This mixed-method study examines changes in novice meditators’ knowledge and contemplative experiences before, during, and after taking an intensive course in CBCT®, a contemplative intervention that is increasingly (...) used for both inter- and intrapersonal flourishing. The participants in this study were Christian healthcare chaplains completing a 1-year residency in Clinical Pastoral Education who learned CBCT as part of their professional chaplaincy training curriculum. Prior to and upon completion of training, we surveyed participants to assess their beliefs about the malleability of compassion, types of engagement in compassion meditation, and perceptions of the impact of taking CBCT. We also conducted in-depth interviews with a subset of participants to gain a qualitative understanding of their subjective experiences of learning and practicing compassion meditation, a key component of CBCT. We found that participants reported increases in the extent to which they believed compassion to be malleable after studying CBCT. We also found high levels of variability of individual ways of practicing and considered the implications of this for the study of contemplative learning processes. This multi-methodological approach yielded novel insights into how compassion practice and compassion-related outcomes interrelate, insights that can inform the basic scientific understanding of the experience of learning and enacting compassion meditation as a means of strengthening compassion itself. (shrink)

Advocates for the professionalization of clinical bioethics argue that bioethics professionals play an important role in contemporary medicine and patient care, especially when addressing complex ethical questions that arise in the delivery of reproductive medicine. For bioethics consultants to serve effectively, they need adequate training in the medical and ethical issues that patients and clinicians will face, and they need skills to facilitate effective dialog among all parties. Because clinical ethics consultation is a “high‐stakes endeavor” that can acutely affect patient (...) care, efforts are under way to ensure that bioethics consultants have the competence to provide such guidance. Yet to date, no studies have examined whether the training of bioethics consultants meets the needs of health care professionals who are on the front lines of such issues. In fact, limited information is available on the reproductive health issues that bioethics training programs address or the degree to which these programs meet the needs of patients confronting reproductive health decisions and their clinicians. It is therefore important to answer this key question: What are the primary ethical issues encountered in reproductive medicine that currently affect patient care? Equally important, are bioethics training programs prepared to address those issues?To begin to answer these questions, we conducted parallel surveys of directors of graduate bioethics training programs and obstetrician‐gynecologists. The goal of this project is to lay the groundwork to establish a working partnership between bioethics educators and reproductive medicine practitioners to address the often troubling and frequently complex ethical issues in reproductive medicine. (shrink)

The sensitive period for phonetic learning, evidenced by improved native speech processing and declined non-native speech processing, represents an early milestone in language acquisition. We examined the extent that sensory encoding of speech is altered by experience during this period by testing two hypotheses: early sensory encoding of non-native speech declines as infants gain native-language experience, and music intervention reverses this decline. We longitudinally measured the frequency-following response, a robust indicator of early sensory encoding along the auditory pathway, to a (...) Mandarin lexical tone in 7- and 11-months-old monolingual English-learning infants. Infants received either no intervention or music intervention randomly between FFR recordings. The language-experience group exhibited the expected decline in FFR pitch-tracking accuracy to the Mandarin tone, while the music-intervention group did not. Our results support both hypotheses and demonstrate that both language and music experiences alter infants’ speech encoding. (shrink)

It is argued that the preservation of truth by an inference relation is of little interest when premiss sets are contradictory. The notion of a level of coherence is introduced and the utility of modal logics in the semantic representation of sets of higher coherence levels is noted. It is shown that this representative role cannot be transferred to first order logic via frame theory since the modal formulae expressing coherence level restrictions are not first order definable. Finally, an inference (...) relation, calledyielding, is introduced which is intermediate between the coherence preservingforcing relation introduced elsewhere by the authors and the coherence destroying, inference relation of classical logic. (shrink)

This essay introduces a special report from The Hastings Center entitled Democracy in Crisis: Civic Learning and the Reconstruction of Common Purpose, which grew out of a project supported by the John S. and James L. Knight Foundation. This multiauthored report offers wide‐ranging assessments of increasing polarization and partisanship in American government and politics, and it proposes constructive responses to this in the provision of objective information, institutional reforms in government and the electoral system, and a reexamination of cultural and (...) political values needed if democracy is to function well in a pluralistic and diverse society. The essays in the special report explore the norms of civic learning and institutions, social movements, and communal innovations that can revitalize civic learning in practice. This introductory essay defines and explains the notion of civic learning, which is a lynchpin connecting many of the essays in the report. Civic learning pertains to the ways in which citizens learn about collective social problems and make decisions about them that reflect the duties and responsibilities of citizenship. Such learning can occur in many social settings in everyday life, and it can also be facilitated through participation in the processes of democratic governance on many levels. Civic learning is not doctrinaire and is compatible with a range of public goals and policies. It is an activity that increases what might be called the democratic capability of a people. (shrink)

The Deese/Roediger–McDermott paradigm has been used extensively to examine false memory. During the study session, participants learn lists of semantically related items, referred to as targets. Critical lures are items which are also associated with the lists but are intentionally omitted from study. At test, when asked to remember targets, participants often report false memories for critical lures. Findings from experiments using the DRM show the ease with which false memories develop in the absence of suggestion or misinformation. Given this, (...) it is important to examine factors which influence the generalizability of the findings. One important factor is the persistence of false memory, or how long false memories last. Therefore, we conducted a systemic review to answer this research question: What is the persistence of false memory for specific items in the DRM paradigm? To help answer this question our review had two research objectives: to examine the trajectory of target memory and false memory for critical lures and to examine whether memory for targets exceeded false memory for critical lures. We included empirical articles which tested memory for the same DRM lists with at least two testing sessions. We discuss the results with respect to single-session delays, long-term memory recall and recognition, remember and know judgments for memory, and the effect of development, valence, warning, and connectivity on the trajectory of memory. Overall, the trajectory of targets showed a relatively consistent pattern of decrease across delay. The trajectory of critical lures was inconsistent. The proportion of targets versus critical lures across delay was also inconsistent. Despite the inconsistencies, we conclude that targets and critical lures have a dissimilar trajectory across delay and that critical lures are more persistent than targets. The findings with respect to long-term recall and recognition are consistent with both Fuzzy Trace Theory and Associative-Activation Theory of the DRM effect. The generation of false memory with brief delays is better explained by Associative-Activation Theory. Examining the connectivity between target items, and critical lures, and the effect that has during study and retrieval, can provide insight into the persistence of false memory for critical lures. (shrink)