Moral distress, is, at its core, an organizational problem. It is experienced on a personal level, but its causes originate within the system itself. In this commentary, we argue that moral distress is not inherently good, that effective interventions must address the external sources of moral distress, and that while there is a place for resilience in the healthcare professions, it cannot be an effective antidote to moral distress.

In this article, we consider infants’ acquisition of foundational aspects of language and emotion through the lens of statistical learning. By taking a comparative developmental approach, we highlight ways in which the learning problems presented by input from these two rich communicative domains are both similar and different. Our goal is to encourage other scholars to consider multiple domains of human experience when developing theories in developmental cognitive science.

To examine the ethical duty to patients and families in the setting of the resuscitation bay, we address a case with a focus on providing optimal care and communication to family members. We present a case of nonsurvivable traumatic injury in a minor, focusing on how allowing family more time at the bedside impacts the quality of death and what duty exists to maintain an emotionally optimal environment for family grieving and acceptance. Our analysis proposes tenets for patient and family-centric (...) care that, in alignment with trauma-informed care principles, optimize the long-term well-being of the family, namely valuing family desires and sensitivity to location. (shrink)

Developing a care plan in a critical care context can be challenging when the therapeutic alliance between clinicians and families is compromised by anger. When these cases occur, clinicians often turn to clinical ethics consultants to assist them with repairing this alliance before further damage can occur. This paper describes five different reasons family members may feel and express anger and offers concrete strategies for clinical ethics consultants to use when working with angry families acting as surrogate decision makers for (...) critical care patients. We reviewed records of consults using thematic analysis between January 2015 and June 2016. Each case was coded to identify whether the case involved a negative encounter with an angry family. In our review, we selected 11 cases with at least one of the following concerns or reasons for anger: perceived or actual medical error, concerns about the medical team’s competence, miscommunication, perceived conflict of interest or commitment, or loss of control. To successfully implement these strategies, clinical ethics consultants, members of the medical team, and family members should share responsibility for creating a mutually respectful relationship. (shrink)

Racial inequities in medicine are the consequence of intersecting, multidimensional factors. As detailed in the articles by Braddock, Mithani, Cooper, and Boyd, and Yearby, the...

Abnormalities in the ability of cells to properly degrade proteins have been identified in many neurodegenerative diseases. Recent work has implicated synaptojanin 1 (SynJ1) in Alzheimer's disease and Parkinson's disease, although the role of this polyphosphoinositide phosphatase in protein degradation has not been thoroughly described. Here, we dissected in vivo the role of SynJ1 in endolysosomal trafficking in zebrafish cone photoreceptors using a SynJ1‐deficient zebrafish mutant, nrca14. We found that loss of SynJ1 leads to specific accumulation of late endosomes and (...) autophagosomes early in photoreceptor development. An analysis of autophagic flux revealed that autophagosomes accumulate because of a defect in maturation. In addition we found an increase in vesicles that are highly enriched for PI(3)P, but negative for an early endosome marker in nrca14 cones. A mutational analysis of SynJ1 enzymatic domains found that activity of the 5'phosphatase, but not the Sac1 domain, is required to rescue both aberrant late endosomes and autophagosomes. Finally, modulating activity of the PI(4,5)P2 regulator, Arf6, rescued the disrupted trafficking pathways in nrca14 cones. Our study describes a specific role for SynJ1 in autophagosomal and endosomal trafficking and provides evidence that PI(4,5)P2 participates in autophagy in a neuronal cell type. -/- . (shrink)

Attentional control theory suggests that high cognitive demands impair the flexible deployment of attention control in anxious adults, particularly when paired with external threats. Extending this...

This study examines how one student teaching seminar employed collective critical observation and reflection of an experienced high school social studies teacher's pedagogy using a multimedia representation of teaching. Pre-service teachers watched this teacher implement two full class lessons and reflections on teaching about freedom of speech. This study's pre-service social studies teachers exhibited a developing ability, through collective observation, to critically reflect on their individual methodological and philosophical goals, social studies teaching and learning, and professional and curricular visions in (...) relation to their student teaching experiences and future practice. The study's findings offer implications for how pre-service social studies teachers critically reflect on their practice, while also developing knowledge of learners, subject matter, and teaching social studies. (shrink)

ImportancePrevious studies of post-acute COVID-19 syndrome have focused on critical cases with severe disease. However, most cases are mild to moderate in disease severity.ObjectiveWe aimed to examine cognitive outcomes in cases of non-critical, mild-to-moderate COVID-19. Design, Setting, and Participants: In this cross-sectional study, we enrolled 72 adults aged 22 to 65 years in Central Texas who had non-critical, mild-to-moderate COVID-19 infection between 13 January 2021 and 20 April 2021.Main Outcomes and MeasuresWe remotely administered cognitive-behavioral testing to determine the frequency of (...) cognitive impairment and examine demographic, clinical, and psychosocial contributors to impairment.ResultsThe frequency of objective cognitive impairment was 40%. The largest number of participants showed impairment on a measure of executive functioning. Attention and processing speed was more impaired in males. Males endorsed lower adherence to social distancing guidelines, which was in turn associated with cognitive impairment across participants. Younger age was correlated with impairment but was also associated with racial/ethnic minority status and increased psychological symptoms. Moderate COVID-19 severity was associated with attention/processing speed impairment, increased pain, and higher number of COVID-19 symptoms.Conclusion and RelevanceMild or moderate COVID-19 infection may be associated with cognitive impairments, especially in the domain of executive functioning. A subgroup of younger individuals may be more vulnerable to cognitive and psychosocial effects of COVID-19.HighlightsQuestion: How frequent is cognitive impairment among non-critical, mild-to-moderate COVID-19 survivors?FindingsIn this cross-sectional study of 72 adults, 40% demonstrated cognitive impairment, particularly in executive function.MeaningNeurologic sequelae, such as cognitive impairment, may be common following COVID-19 infection. (shrink)

Forty years after Dax Cowart fought to have his voice heard regarding his medical treatment, patient autonomy and rights are at the heart of patient care today. Yet, despite its centrality in patient care, the tension between a severely burned patient’s right to stop treatment and the physician’s role in saving a life has not abated. As this case study explores, barriers remain to hearing and respecting a patient’s treatment decisions. Dismantling these barriers involves dispelling the myths that burn patients (...) must grin and bear intense pain to recover and that a patient’s choice to discontinue treatment equals physician failure. Moreover, in these situations, sustained, direct engagement between physician and patient can reduce the moral distress of all involved and enable physicians to hear and better accept when a patient is calling for the end of the day. (shrink)

In their article “A Broader Understanding of Moral Distress,” Campbell, Ulrich, and Grady (2016) correctly assert that moral distress is well established in the nursing literature and is gaining at...

The devastating impact of the national opioid epidemic has given rise to hundreds of lawsuits. This article details the extremely broad range of legal claims, compares the opioid cases to other public health litigation efforts, including tobacco, and describes the special mechanism — a multidistrict litigation — through which more than 700 opioid-related cases have been consolidated thus far, with settlement almost certain to follow.

Kolbe and de Melo-Martin’s (2023) arguments draw attention to what is most useful about moral distress—identifying its causes is at least as important as measuring its severity. Jameton’s original...

As gene editing technologies such as CRISPR have become increasingly prominent, so have media portrayals of them. With this in mind, the present study builds on theoretical accounts of framing effects, cultivation effects, and genre-specific viewing effects to examine how different forms of media use predict attitudes toward applications of gene editing. Specifically, the study tests how news use, overall television viewing, and science fiction viewing are related to such attitudes. The analyses draw on original data from two surveys of (...) the U.S. public, one conducted in 2020 and the other in 2021. The results from both surveys indicate that news use and overall television viewing predict support for uses of gene editing, whereas science fiction viewing is not significantly related to opinion. The findings suggest that media frames and images may carry implications for the trajectory of public opinion about gene editing technologies and, ultimately, the social context for their development and adoption. (shrink)

This case study explores the use of collaborative book clubs and word sorts to influence teacher positionality in an undergraduate social studies methods course for pre-service teachers. Drawing upon existing literature that suggests the effectiveness of dialogue as a means of navigating prior beliefs and the benefits of collaborative spaces for teachers to engage in collegial discussions, the study utilized books surrounding socio-political themes and educational inequalities to prompt conversation among participants. Results of the study suggest that dialogic and collaborative (...) activities like word sorts and book clubs provide productive opportunities for pre-service teachers to (re)negotiate their positionalities and grapple with their existing assumptions as they learn and co-construct meaning from and with one another. At the same time, the pre-service teachers’ perceptions of privilege and identity seem to remain somewhat unexamined and the teachers remain hesitant about the practical reality of working to dismantle inequalities in their own classrooms. (shrink)

Stigma against mental disability within the medical field continues to impose significant barriers on physicians and trainees. Here, we examine several implications of this stigma and propose steps toward greater inclusion of persons with mental disabilities in the physician workforce.

This volume is fourth in the series of annuals created under the auspices of The Association for Feminist Ethics and Social Theory . The topics covered herein_from peacekeeping and terrorism, to sex trafficking and women's paid labor, to poverty and religious fundamentalism_are vital to women and to feminist movements throughout the world.

This study examines how different forms of media use predict attitudes toward the development of facial recognition technology (FRT) and applications of it by law enforcement to identify criminal suspects, identify potential terrorists, and monitor public protests. The theoretical framework builds on theories of cultivation and genre-specific viewing to develop hypotheses and research questions. The analyses draw on original data from two nationally representative surveys of the U.S. public conducted in 2020, amid a series of controversies and protests about policing (...) and racial justice. The results demonstrate that overall television viewing and crime media viewing predicted support for multiple uses of FRT, while Fox News viewing predicted support for using FRT to monitor protests. The findings advance our understanding of public opinion toward the technology and its implications for policing, protests, and social justice. (shrink)

This study has two purposes. First, the study evaluates the reliability of self-reports of argumentativeness by comparing self-reported argumentativeness with two other reports of the same target: evaluations by friends and evaluations by intimates. Second, the study examines whether particular characteristics presage a larger or smaller disparity in different reporters’ reports. We found the reliability of both the approach and avoidance subscales to be acceptable for the intimate partner’s responses, but only marginally acceptable when the scale was answered by a (...) friend; on a basic level, we did not find individuals over or under-estimating their level of argumentativeness, self-over and under estimating has limited impact on the self-reporting of argumentativeness, though males are more likely to over-report argumentativeness; and while relational history had little effect on other-reports, there were effects for same-sex couples that should be further explored. (shrink)

Drug recalls and lawsuits against pharmaceutical manufacturers are accompanied by announcements emphasizing harmful drug side-effects. Those with elevated health anxiety may be more reactive to such announcements. We evaluated whether health anxiety and financial incentives affect subjective symptom endorsement, and objective outcomes of cognitive and physiological functioning during a mock drug recall. Hundred and sixty-one participants reported use of over-the-counter pain medications and presented with a fictitious medication recall via a mock Food and Drug Administration website. The opportunity to join (...) a class-action lawsuit was manipulated. We assessed health anxiety, recalled drug usage, blood pressure, heart rate, and performance on a computerized Trail Making Test. Symptom endorsement was strongly predicted by health anxiety. When combined, three health anxiety measures explained 28.5% variance. These effects remain strong after controlling for depression and anxiety. Litigation condition did not predict symptom endorsement. Blood pressure and heart rate were modestly predicted by health anxiety, but not by litigation condition. TMT performance was consistently predicted by health anxiety, with higher scores associated with poorer performance. Although there were no main effects for litigation, interactions consistently emerged for the TMT, with generally poorer performance for those with higher health anxiety in the non-litigation condition; whereas health anxiety was unrelated to performance for the litigation condition. All but one participant joined the litigation when given the opportunity, despite a healthy sample and minimal use of pain medication. Subsequent data from 67 individuals with no mention of the FDA scenario or litigation showed that health anxiety still significantly predicts symptom endorsement, but the explained variance is less than half that obtained in the FDA scenario. The findings suggest that health anxiety plays a significant role in adverse symptom reporting, beyond anxiety or depression, and this effect is independent of the presence of the FDA recall. The lack of differences for health anxiety and symptom endorsement between litigation and non-litigation conditions rules out malingering. Although it is general practice in drug recalls to list potential adverse side effects caused by medications, this may elicit unintended symptom experiences and health anxious individuals may be more susceptible. (shrink)

This rich and varied collection of essays addresses some of the most fundamental human questions through the lenses of philosophy, literature, religion, politics, and theology. Peter Augustine Lawler and Dale McConkey have fashioned an interdisciplinary consideration of such perennial and enduring issues as the relationship between nature and history, nature and grace, reason and revelation, classical philosophy and Christianity, modernity and postmodernity, repentance and self-limitation, and philosophy and politics.

Hospital administrators may lack familiarity with what clinical ethicists do (and do not do), and many clinical ethicists report receiving inadequate financial support for their clinical ethics consultation services (CECSs). Ethics consultation is distinct in that it is not reimbursable by third parties, and its financial benefit to the hospital may not be quantifiable. These peculiarities make it difficult for clinical ethicists to resort to tried-and-true outcome-centered evaluative strategies, like cost reduction or shortened length of stay for patients, to show (...) a “need” for ethics consultation. Likewise, it can be difficult for clinical ethicists to “speak the same language” as healthcare administrators and managers, which, in turn, means that CECSs run the risk of being unable to demonstrate value to those who pay for the service. The purpose of this descriptive article is to provide practical guidance to clinical ethicists and program directors on how to cultivate administrative support for a CECS. Specifically, we discuss two elements that clinical ethics leaders must critically appraise and successfully argue to meet the expectations of administrators— the value of a CECS and its fit in clinical workflow. (shrink)

This piece, included in the drift special issue of continent. , was created as one step in a thread of inquiry. While each of the contributions to drift stand on their own, the project was an attempt to follow a line of theoretical inquiry as it passed through time and the postal service(s) from October 2012 until May 2013. This issue hosts two threads: between space & place and between intention & attention . The editors recommend that to experience the (...) drifiting thought that attention be paid to the contributions as they entered into conversation one after another. This particular piece is from the BETWEEN SPACE & PLACE thread: April Vannini, Those Between the Common * Laura Dean & Jesse McClelland, Ballard: A Portrait of Placemaking * Amara Hark Weber, Crossroad * Isaac Linder & Berit Soli-Holt, The Call of the Wild: Terro(i)r Modulations * Ashley D. Hairston, Momma taught us to keep a clean house * Sean Smith, The Garage (Take One) * * * * Momma taught us to keep a clean house. Dust the wood furniture every two weeks. Clean the bathrooms once a week. Wipe down the baseboards once a season (Those damn baseboards. I still got bruises on my knees from scrubbing those things). Sweep away the cobwebs—and pray that those spiders are either dead or delirious (Livin in the country don’t mean you like bugs, especially the ones with too many legs ). Didn’t matter that the house was full of stuff: Great-Grandma’s heirloom dresser, that weird Mammy salt shaker and matching Uncle Tom pepper grinder (Where the hell did Momma get those P.O.S.’s?), the outdated drapes from Belks, Dad’s favorite wooden TV tray, and that uuuuugly love seat that some crazy uncle thought was a glorious find from the Salvation Army (Momma tried to make it pretty with some pillows, but no amount of love could help that seat). Spring Cleaning meant pullin all that furniture away from the walls and holdin your breath to see what time collected in the crevices. Then you gotta be careful not to breathe out too heavy cause the dust would go flying fore you got a chance to catch it. If you didn’t, you’d quickly find out if you’re allergic to dust. Quarter cup of lemon Lysol in a bucket of steaming water and an old wash rag. Maybe two. A dust towel and citrus-scent Pledge. Me and my brothers would fight over who cleaned what. Somehow the twins always got the easy stuff: vacuuming or moving dirt around with the feather-duster. Finishing in enough time to fly down the street on their bikes with the neighborhood kids. Older sister never got off that easy. Each of my stubby fingers morphed into plump, lemon-fresh golden raisins by the time that whole damn house was done. I would finish just in time to sit with Nadine on the porch, counting the seconds til the sun turned off and the fireflies fluttered on. The craziest thing: despite all that cleaning, the house still smelled like Momma’s cookin. That Old House. Might have been some of Grandma’s and Great-Grandma’s cookin mixed in there too. Pork chops. Ham hock soaked in collards. Pinto beans and mustard greens. Corn bread and my Auntie’s famous macaroni and cheese. Didn’t matter if the oven was cold and the valve of the gas stove had been shut for days. A stranger woulda thought someone’d been slavin away in that kitchen for a week straight. No Sweet Citrus & Zest Fabreze back then. Lysol would mask the odors for a little while. Not long enough to overpower the 50 years of goodness marinated in buttermilk, kneaded with lard, and fried in Crisco that’d been embedded in the wallpaper and window treatments. All that grime—dead skin, hair follicles, Carolina clay, carpet lint, yippee-little-dog fur—was evidence of life. We were a socially-awkward newly-minted teenager, two rowdy twin boys, a multi-tasking mother, and a road-warrior father. Eventually a strangely-feline Yorkie was added to the mix. And don’t forget about the stray distant relative stopping by unannounced. No corner of that damn house was unmarked. Hand-sewn pillows in the living room that we were forbidden to breathe on somehow had tiny burnt orange paw prints on them (sneaky little dog). It drove Momma crazy. And tore up my fingernails. They still won’t grow back right. Wipe all that shit off just for it to build up again. But that house was inherited and fully paid for. No reason to move. I did move. I was ready to move on. Move up. Move out. Over that small town. Into the big city. Here the streets take on the smells of Momma’s house. Plus piss, shit, and unbathed skin. A hot day means everything cooks and stews in its own juices, making the stench 10x more intense. The apartment is another story. 11 floors up. Big, east-facing windows. Great view of the skyline dotted with some green foliage. And the great lake. Immaculate. Odorless. Not even a trace of tobacco from the previous tenant’s bad habits. No lingering scent of lemon Lysol. No street stench seeping through the window panes. No stray cat hairs. Or dog fur. Not a speck of dust. Futon. Throw pillows. Photos. Knickknacks. Bowls of fresh citrus. Cursedly-assembled desk set from IKEA. Yet the void is too big to fill. Too clean. (shrink)

ABSTRACTConcerned with how individuals assess scientific experts on the Internet, our research investigates the virtual r/science subreddit and their popular Ask-Me-Anything series, where sci...

We explore physiological linkage among 34 same-sex male couples. Interbeat interval, an indicator of cardiovascular arousal, was collected across four conversational contexts in the lab: a baseline period that did not involve conversation, a conversation about body image, a conversation about health goals, and a recovery period that allowed for unstructured conversation. We used a newly developed R statistical package that simplifies the use of dynamic models for investigating interpersonal emotional processes. We identified two different PL patterns: a simple one (...) that was characterized by stable synchronization and low frequency of oscillation; and a complex one that was characterized by drifting synchronization, high frequency of oscillation, and eventual damping. Guided by social baseline theory and the reactive flexibility perspective, we explored the interactions between couple relationship functioning and conversational context as predictors of the PL patterns. The results suggest that partners in well-functioning relationships and emotionally challenging situations may be especially likely to show complex PL patterns that may reflect coregulatory processes. (shrink)