It is widely accepted now that a patient's right to refuse treatment extends to circumstances in which the exercise of that right may lead to the patient's death. However, it is also often effectively assumed, without argument, that this implies a patient's right to request another agent to intervene so as to bring about his or her death, in a way which would render that agent guilty of murder in the absence of such a request. But the right to refuse (...) treatment can, logically, have no such implication, and the mistaken supposition that it does conflates a right to die with a right to be killed. Confusion over this issue is brought out by an examination of conflicting opinion concerning the permissible termination of ventilation for mentally competent patients. A wider lesson may be drawn regarding the need for the ethical assessment of new forms of life-sustaining medical technology. (shrink)

© 2015 NATCO, The Organization for Transplant Professionals.Despite the known benefits of kidney transplant, less than 30% of the 615 000 patients living with end-stage renal disease in the United States have received a transplant. More than 100 000 people are presently on the transplant waiting list. Although the shortage of kidneys for transplant remains a critical factor in explaining lower transplant rates, another important and modifiable factor is patients' lack of comprehensive education about transplant. The purpose of this article (...) is to provide an overview of known best practices from the broader literature that can be used as an evidence base to design improved education for ESRD patients pursuing a kidney transplant. Best practices in chronic disease education generally reveal that education that is individually tailored, understandable for patients with low health literacy, and culturally competent is most beneficial. Effective education helps patients navigate the complex health care process successfully. Recommendations for how to incorporate these best practices into transplant education design are described. Providing more ESRD patients with transplant education that encompasses these best practices may improve their ability to make informed health care decisions and increase the numbers of patients interested in pursuing transplant. (shrink)

The lateralized ERP N2pc component has been shown to be an effective marker of attentional object selection when elicited in a visual search task, specifically reflecting the selection of a target item among distractors. Moreover, when targets are known in advance, the visual search process is guided by representations of target features held in working memory at the time of search, thus guiding attention to objects with target-matching features. Previous studies have shown that manipulating working memory availability via concurrent tasks (...) or within task manipulations influences visual search performance and the N2pc. Other studies have indicated that visual vs. spatial working memory manipulations have differential contributions to visual search. To investigate this the current study assesses participants' visual and spatial working memory ability independent of the visual search task to determine whether such individual differences in working memory affect task performance and the N2pc. Participants completed a visual search task to elicit the N2pc and separate visual working memory and spatial working memory assessments. Greater SPWM, but not VWM, ability is correlated with and predicts higher visual search accuracy and greater N2pc amplitudes. Neither VWM nor SPWM was related to N2pc latency. These results provide additional support to prior behavioral and neural visual search findings that spatial WM availability, whether as an ability of the participant's processing system or based on task demands, plays an important role in efficient visual search. (shrink)

Maternity careproviders often have strong views concerning a woman’s choice of where to give birth. These views may be based on the ethical principle of autonomy, or on the principle of beneficence. The authors propose that an approach utilizing shared decision making allows careproviders and women to move beyond disagreements regarding which evidence on risk should “count,” instead adopting a process of increased knowledge and support for women and their partner while they make choices regarding place of birth.

An interdisciplinary course was designed as an introduction to the applications of, and the socio-economic issues associated with, biotechnology. College students enrolled in the course were surveyed prior to the first formal lecture, and again upon completion of the course. Assessment was made of the impact of the educational materials on the attitudes and perceptions of the students toward the applications of biotechnology to agriculture. Data were collected for the first three semesters in which the course was offered. Answers to (...) survey questions were analyzed on a before and after basis. It was found that students were very accepting of biotechnology prior to taking the course, despite a generally low level of exposure to this type of technology. The course was effective in increasing the knowledge base of the students, but not as effective in allaying their perceptions of risks associated with biotechnology. (shrink)

Moral Case Deliberations are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support, it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases. These limitations warrant (...) research into complementary ways of providing CES to healthcare professionals. Our research objective was therefore to develop a low threshold CES tool based on a series of MCDs on autonomy in long-term care. We used a qualitative research design in which we analyzed the process and content of a series of MCDs, combined with reflections on the theoretical background of MCD. In total 28 MCDs were analyzed by means of a thematic content analysis. In various rounds of development, the results of the analysis were combined with theoretical reflections on CES. Consequently, the tool was evaluated in three focus groups and adjusted. The CES tool, called ‘moral compass’, guides the users through a series of six subsequent questions in order to methodically reflect on their concrete moral dilemma, in the form of a booklet of 23 pages. It combines a methodical element that encourages and structures a reflection process with a substantive element, including norms, values, options, strategies, and insights regarding dealing with client autonomy. By using data from a series of MCDs, combined with theoretical reflections on MCD, ethics support and moral learning, we developed a thematic, low-threshold CES tool that supports healthcare professionals in daily practice in dealing with moral questions regarding client autonomy. It integrates examples and insights from earlier MCDs on the same topic. The moral compass is not a replacement of, but can be used complementary to MCD. The feasibility and impact of the moral compass need to be investigated in an evaluative follow-up study. The methodology presented in this paper may be used to develop moral compasses on different topics in various healthcare organizations. (shrink)

IntroductionThis case study describes the process faculty at a large research university undertook to build a stand-alone online academic integrity course for first-year and transfer students. Because academic integrity is decentralized at the institution, building a more systematic program had to come from the bottom-up (faculty developed) rather than from the top down (institutionally mandated).Case descriptionUsing the learning management system, faculty and e-learning designers collaborated to build the course. Incorporating nuanced scenarios for six different types of misconduct (consistent with the (...) University’s Code of Student Rights, Responsibilities & Conduct), a pre- and post-test, and assessments for each scenario, the course provides experience in recognizing and avoiding academic misconduct.Discussion and evaluationAs a stand-alone course, the faculty who created it maintain control over content and are able to analyze student performance across the institution. In the ten months since its launch, the course has been eagerly adopted by faculty (n = 1853 students have completed the course) and post-test scores indicate students are learning from the course.ConclusionsAfter the successful launch of the student course, the next step, already underway, is the launch of learning modules for faculty and teaching assistants. (shrink)

Here, an epidemiological model considering pro and anti-vaccination groups is proposed and analyzed. In this model, susceptible individuals can migrate between these two groups due to the influence of false and true news about safety and efficacy of vaccines. From this model, written as a set of three ordinary differential equations, analytical expressions for the disease-free steady state, the endemic steady state, and the basic reproduction number are derived. It is analytically shown that low vaccination rate and no influx to (...) the pro-vaccination group have similar impacts on the long-term amount of infected individuals. Numerical simulations are performed with parameter values of the COVID-19 pandemic to illustrate the analytical results. The possible relevance of this work is discussed from a public health perspective. (shrink)

Background: Little is known about U.S. healthcare provider views and practices regarding evidence, counseling, and shared decision-making about in-hospital versus out-of-hospital birth settings. Methods: We conducted 19 in-depth, semistructured, qualitative interviews of eight obstetricians, eight midwives, and three pediatricians from across the United States. Interviews explored healthcare providers’ interpretation of the current evidence and their personal and professional experiences with childbirth within the existing medical, ethical, and legal context in the United States. Results: Themes emerged concerning risks and benefits, decision-making, (...) and patient-provider power dynamics. Collectively, the narratives illuminated fundamental ideological tensions between in- and out-of-hospital providers arising from divergent assignment of value to described risks and benefits. The majority of physicians focused on U.S.-specific data demonstrating increased neonatal morbidity and mortality associated with delayed access to hospital-based interventions, thereby justifying hospital birth as the standard of care. By contrast, midwives emphasized data demonstrating fewer interventions and superior maternal and neonatal outcomes in high-income European countries, where out-of-hospital birth is more common for low-risk birthing people. A key gap in counseling was revealed, as no interviewees offered anticipatory counseling regarding birth setting options. Providers directly and indirectly illustrated the propensity for asymmetric power relations between birth providers and pregnant people, especially in hospital settings. Conclusions: The narratives highlight the common goal of optimizing maternal and neonatal outcomes despite tensions arising from divergent prioritization of specific maternal and neonatal risks. Our findings suggest opportunities to foster collaboration and optimize outcomes via mutual respect and improved integration of care. (shrink)

The typical approach to decoding speech from the brain (using brain-machine interfaces) is to decode low-level linguistic units (e.g. phonemes, syllables) from motor articulation areas (e.g. Premotor cortex) with the aim of assembling these low-level units into higher-level discourse. We propose that brain-to-speech decoding may benefit from adopting a functional view of language, which conceives of language as an instrumental tool for interacting with others' intentions in order to fulfil one's own intentions. This functional view of language motivates adopting usability (...) (i.e. the decoder's usefulness as a tool for achieving goals), in addition to decoding accuracy, as a criterion for assessing decoder performance. Decoders may achieve gains in usability by incorporating data about communicative situations and speaker intentions in order to generate and fill in speech act templates. We suggest that this intention-oriented, template-based, and functionally inspired view of brain-to-speech decoding may facilitate efforts to achieve naturalistic speech decoding. (shrink)

Current UK legislation is impacting upon the feasibility and cost-effectiveness of medical record-based research aimed at benefiting the NHS and the public heath. Whereas previous commentators have focused on the Data Protection Act 1998, the Health and Social Care Act 2001 is the key legislation for public health researchers wishing to access medical records without written consent. The Act requires researchers to apply to the Patient Information Advisory Group for permission to access medical records without written permission. We present a (...) case study of the work required to obtain the necessary permissions from PIAG in order to conduct a large scale public health research project. In our experience it took eight months to receive permission to access basic identifying information on individuals registered at general practices, and a decision on whether we could access clinical information in medical records without consent took 18 months. Such delays pose near insurmountable difficulties to grant funded research, and in our case £560 000 of public and charitable money was spent on research staff while a large part of their work was prohibited until the third year of a three year grant. We conclude by arguing that many of the current problems could be avoided by returning PIAG’s responsibilities to research ethics committees, and by allowing “opt-out” consent for many public health research projects. (shrink)

The National Blood Policy in India relies heavily on voluntary blood donors, as they are usually assumed to be associated with low levels of transfusion-transmitted infections . In India, it is mandatory to test every unit of blood collected for hepatitis B, hepatitis C, HIV/AIDS, syphilis and malaria. Donors come to the blood bank with altruistic intentions. If donors test positive to any of the five infections, their blood is discarded. Although the blood policy advocates disclosure of TTI status, donors (...) are not, in practice, informed about their results. The onus is on the donor to contact the blood bank. Out of approximately 16 000 donations in the past 2 years, 438 tested positive for TTI, including 107 for HIV. Only 20% of the donors contacted the blood bank; none of them were HIV positive. Disclosure by blood banks of TTI status by telephone or mail has resulted in serious consequences for some donors. Health providers face an ethical dilemma, in the absence of proper mechanisms in place for disclosure of test results, regarding notification to donors who may test positive but remain ignorant of their TTI status. Given the high cost of neglecting to notify infected donors, the authors strongly recommend the use of rapid tests before collecting blood, instead of the current practice, which takes 3 h to obtain results, and disclosure of results directly to the donor by a counsellor, to avoid dropouts and to ensure confidentiality. (shrink)

The development and use of nanotechnology in the food industry have grown steadily. While visions for nanofood suggest that the applications will improve quality and safety, they are also controversial for several reasons including potential health risks coupled with difficulty in assessing low-dosage nanoparticle risks as well as values-based objections. In recent years, debate over nanofoods has sparked inquiry into factors that predict public attitudes and purchase intentions. Such studies have investigated the roles of demographics and sociographics, value predispositions toward (...) science and technology, preferences for natural products, trust in regulatory agencies, scientific knowledge, and media attention. This study assesses the role of each of these factors in shaping public attitudes toward nanofood and improves the predictive models by evaluating concepts from protection motivation theory. We find that incorporating threat and coping appraisals provides the best predictive models of public attitudes and intention to purchase nanofood products. (shrink)

Family planning is the usual modern route to producing a small family. Can human behavioral ecology provide a framework for understanding family planning behavior? Hillard S. Kaplan (Yearb. Phys. Anthropol. 39:91–135) has proposed a general theory of human parental investment based on the importance of skills development in children. As modern, skills-based, competitive market economies are established, parental investment strategies would be predicted to become oriented toward producing increasingly competitive offspring in a pattern of coordinated investment in their embodied capital—in (...) other words, skills training along with good health to ensure their long-term productivity. Parental embodied capital and resources are also expected to be associated with motivation to produce competitive offspring. The basic parental investment trade-off between quality and quantity should predict greater investment in fewer children and the adoption of family planning behavior. Data on family planning in two ethnic groups in Northeast India (Khasi and Bengali) currently experiencing early-phase transition into modern market economies from very different social and ecological baselines are examined within this analytical framework. The results show a mixture of strategies in conjunction with family planning that involve decreased as well as increased investment in the embodied capital of children among Bengali and a divergence of investments in education and health among Khasi. These mixtures of strategies provide some insight into the motivations to use family planning in the face of economic transition, given differing local cultural and ecological conditions and the opportunity structures they provide. (shrink)

From an architectural perspective, the purpose of this paper is to explore the dynamic relations between individuals and the environments using the concept of affordance. In three different cases of architectural research, the concept of affordance is used as an analytical tool – yet demonstrating different scopes and outcomes. A post-occupancy evaluation of an office space in transformation; a lighting assessment and intervention in low vision rehabilitation situated in private home environments; and an urban event at an architecture festival involving (...) the intervention of a sound- and scentscape. The three cases show that the concept of affordance can embrace and operationalize the human perception of the environment, pointing at descriptive, prescriptive, and exploratory possibilities in relation to architectural design and research. The concept of affordance enables rich descriptions and explorations of qualities of architecture, related to multisensorial, emotional, and social interactional aspects of humans and their environments. (shrink)

What follows is an attempt to do some conceptual housekeeping around the notion of secret law as provided by Christopher Kutz (2013). First I consider low-salience (or merely obscure) law, suggesting that it fails to capture the legal and moral facts that are at stake in the case which Kutz used to motivate it. Then I outline a theoretical contrast between mere obscurity and secrecy, in contrast to the 'neutral' account of secrecy provided by Sissela Bok (1989). The upshot of (...) the two sections is that low-salience law is neither secret law nor necessarily problematic, though it closely resembles a kind of law that is both secret and problematic: namely, those legal obscurities that subvert manifest interests related to the informational needs of citizens. The ensuing argument undermines the fiction of constructive presence found in Austin and Blackstone. (shrink)

Ouija board sessions are illustrious examples of how subjective feelings of control – the Sense of Agency - can be manipulated in real life settings. We present findings from a field experiment at a paranormal conference, where Ouija enthusiasts were equipped with eye trackers while using the Ouija board. Our results show that participants have a significantly lower probability at visually predicting letters in a Ouija board session compared to a condition in which they are instructed to deliberately spell out (...) words with the Ouija board planchette. Our results also show that Ouija board believers report lower SoA compared to sceptic participants. These results support previous research which claim that low sense of agency is caused by a combination of retrospective inference and an inhibition of predictive processes. Our results show that users in Ouija board sessions become increasingly better at predicting letters as responses unfold over time, and that meaningful responses from the Ouija board can only be accounted for when considering interactions that goes on at the participant pair level. These results suggest that meaningful responses from the Ouija board may be an emergent property of interacting and predicting minds that increasingly impose structure on initially random events in Ouija sessions. (shrink)

Eating behaviors evolve during the first years of life as biological and behavioral processes directed towards meeting requirements for health and growth. For the vast majority of human history, food scarcity has constituted a major threat to survival, and human eating behavior and child feeding practices have evolved in response to this threat. Because infants are born into a wide variety of cultures and cuisines, they come equipped as young omnivores with a set of behavioral predispositions that allow them to (...) learn to accept the foods made available to them. During historical conditions of scarcity, family life and resources were devoted to the procurement and preparation of foods, which are often low in energy, nutrients, and palatability. In sharp contrast, today in non-Third World countries children's eating habits develop under unprecedented conditions of dietary abundance, where palatable, inexpensive, ready-to-eat foods are readily available. (shrink)

This study examines the extent to which scientific and biomedical journals have adopted conflict of interest (COI) policies for authors, and whether the adoption and content of such policies leads to the publishing of authors’ financial interest disclosure statements by such journals. In particular, it reports the results of a survey of journal editors about their practices regarding COI disclosures. About 16 percent of 1396 highly ranked scientific and biomedical journals had COI policies in effect during 1997. Less than 1 (...) percent of the articles published during that year in the journals with COI policies contained any disclosures of author personal financial interests while nearly 66 percent of the journals had zero disclosures of author personal financial interests. Nearly three fourths of journal editors surveyed usually publish author disclosure statements suggesting that low rates of personal financial disclosures are either a result of low rates of author financial interest in the subject matter of their publications or poor compliance by authors to the journals’ COI policies. (shrink)

The study examined the influence of the Pond Report on the teaching of medical ethics in the London medical schools. A questionnaire was given to both medical students and college officers. All medical colleges reported that ethics was included in the curriculum. However, from students' replies, it seems that attendance of optional courses is low and that not all current final year medical students have had any formal teaching in medical ethics. Stronger guidelines are necessary to ensure appropriate ethical training (...) in London medical schools. (shrink)

Current UK legislation is impacting upon the feasibility and cost-effectiveness of medical record-based research aimed at benefiting the NHS and the public heath. Whereas previous commentators have focused on the Data Protection Act 1998, the Health and Social Care Act 2001 is the key legislation for public health researchers wishing to access medical records without written consent. The Act requires researchers to apply to the Patient Information Advisory Group for permission to access medical records without written permission. We present a (...) case study of the work required to obtain the necessary permissions from PIAG in order to conduct a large scale public health research project. In our experience it took eight months to receive permission to access basic identifying information on individuals registered at general practices, and a decision on whether we could access clinical information in medical records without consent took 18 months. Such delays pose near insurmountable difficulties to grant funded research, and in our case £560 000 of public and charitable money was spent on research staff while a large part of their work was prohibited until the third year of a three year grant. We conclude by arguing that many of the current problems could be avoided by returning PIAG’s responsibilities to research ethics committees, and by allowing “opt-out” consent for many public health research projects. (shrink)

A pattern of research findings indicates that excessive devotion to a favorite celebrity is linked to attitudes and behaviors that are psychologically unhealthy and may predict low life satisfaction. This study examines whether four common measures of life satisfaction predict admiration for celebrities in two university samples and one community sample of young adults. Our results showed significant correlations between celebrity admiration and two measures of life satisfaction. We also found that the predictors of life satisfaction correlate with each other (...) in ways that are consistent with previous research in positive psychology. Our research suggests an inverse relationship between celebrity admiration and life satisfaction. In addition, the results contribute to establishing the validity of four contemporary life satisfaction measures. (shrink)

Research Objective: This study focuses on ADs in the Netherlands and introduces a cross-cultural perspective by comparing it with other countries. Methods: A questionnaire was sent to a panel comprising 1621 people representative of the Dutch population. The response was 86%. Results: 95% of the respondents didn't have an AD, and 24% of these were not familiar with the idea of drawing up an AD. Most of those familiar with ADs knew about the Advanced Euthanasia Directive (AED, 64%). Both low (...) education and the presence of a religious conviction that plays an important role in one's life increase the chance of not wanting to draw up an AD. Also not having experienced a request for euthanasia from someone else, and the inconceivability of asking for euthanasia yourself, increase the chance of not wanting to draw up an AD. Discussion: This study shows that the subjects of palliative care and end-of-life-decision-making were very much dominated by the issue of euthanasia in the Netherlands. The AED was the best known AD; and factors that can be linked to euthanasia play an important role in whether or not people choose to draw up an AD. This differentiates the Netherlands from other countries and, when it comes to ADs, the global differences between countries and cultures are still so large that the highest possible goals, at this moment in time, are observing and possibly learning from other cultural settings. (shrink)

Seeking consent for genetic and genomic research can be challenging, particularly in populations with low literacy levels, and in emergency situations. All of these factors were relevant to the MalariaGEN study of genetic factors influencing immune responses to malaria in northern rural Ghana. This study sought to identify issues arising in practice during the enrolment of paediatric cases with severe malaria and matched healthy controls into the MalariaGEN study.

BackgroundStreet-connected children and youth in low- and middle-income countries have multiple vulnerabilities in relation to participation in research. These require additional considerations that are responsive to their needs and the social, cultural, and economic context, while upholding core ethical principles of respect for persons, beneficence, and justice. The objective of this paper is to describe processes and outcomes of adapting ethical guidelines for SCCY’s specific vulnerabilities in LMIC.MethodsAs part of three interrelated research projects in western Kenya, we created procedures to (...) address SCCY’s vulnerabilities related to research participation within the local context. These consisted of identifying ethical considerations and solutions in relation to community engagement, equitable recruitment, informed consent, vulnerability to coercion, and responsibility to report.ResultsSubstantial community engagement provided input on SCCY’s participation in research, recruitment, and consent processes. We designed an assent process to support SCCY to make an informed decision regarding their participation in the research that respected their autonomy and their right to dissent, while safeguarding them in situations where their capacity to make an informed decision was diminished. To address issues related to coercion and access to care, we worked to reduce the unequal power dynamic through street outreach, and provided access to care regardless of research participation.ConclusionsAlthough a vulnerable population, the specific vulnerabilities of SCCY can to some extent be managed using innovative procedures. Engaging SCCY in ethical research is a matter of justice and will assist in reducing inequities and advancing their health and human dignity. (shrink)

Psychopathy refers to a range of complex behaviors and personality traits, including callousness and antisocial behavior, typically studied in criminal populations. Recent studies have used self-reports to examine psychopathic traits among noncriminal samples. The goal of the current study was to examine the underlying factor structure of the Self-Report of Psychopathy Scale–Short Form (SRP-SF) across complementary samples and examine the impact of gender on factor structure. We examined the structure of the SRP-SF among 2,554 young adults from three undergraduate samples (...) and a high-risk young adult sample. Using confirmatory factor analysis, a four-correlated factor model and a four-bifactor model showed good fit to the data. Evidence of weak invariance was found for both models across gender. These findings highlight that the SRP-SF is a useful measure of low-level psychopathic traits in noncriminal samples, although the underlying factor structure may not fully translate across men and women. (shrink)

The article by Mr. David L. Miller, called ‘Purpose, Design and Physical Relativity', in the July 1936 issue of Philosophy of Science, consists mainly of a commentary on the development of Whitehead's thought from the Enquiry Concerning the Principles of Natural Knowledge to Process and Reality. Now most criticisms of Whitehead so far published have been from realists of the anti-metaphysical Cambridge school, complaining that his later works retract the teaching of his earlier works on the philosophy of natural science; (...) and this complaint is raised quite unjustly, because a careful reading of the earlier works will show that there is nothing in them that precludes the logical possibility of a metaphysics of nature such as Whitehead expounded later. We should be grateful for any comment on Whitehead which does not repeat this hoary error. But unfortunately two opposed misinterpretations do not together make a correct interpretation. The opposite distortion of Whitehead is effected by those readers who, having found that the earlier books showed genius but were, alas, too much under the influence of ill-advised realist dogma, proceed to construe the succession of later books as the gradual self-correction of the great man towards a mature judgment which is in full accord with the reader's own. Of this distortion, I am afraid, Mr. Miller has given us an example. (shrink)

If “Big Gods” evolved in part because of their ability to morally regulate groups of people who cannot count on kin or reciprocal altruism to get along, then powerful gods would tend to be good gods. If the mechanism for this cooperation is some kind of fear of supernatural punishment, then we may expect that mighty gods tend to be punishing gods. The present study is a statistical analysis of superhuman being concepts from 20 countries on five continents to explore (...) whether the goodness of a god is related to its mightiness. Gods that looked more like the God of classical theism and gods that were low in anthropomorphism were more likely to be regarded as morally good and to be the target of religious practices. Mighty gods were not, however, especially likely to punish or to be a “high god.”. (shrink)

Background: More and more quantitative information is becoming available about the risks of complications arising from medical treatment. In everyday practice, this raises the question whether each and every risk, however low, should be disclosed to patients. What could be good reasons for doing or not doing so? This will increasingly become a dilemma for practitioners.Objective: To report doctors’ views on whether to disclose or withhold information on low risks of complications.Methods: In a qualitative study design, 37 respondents were included. (...) Focus group interviews were held with 22 respondents and individual in-depth interviews with 15.Results: Doctors have doubts about disclosing or withholding information on complication risk, especially in a risk range of 1 in 200 to 1 in 10 000. Their considerations on whether to disclose or to withhold information depend on a complicated mix of patient and doctor-associated reasons; on medical and personal considerations; and on the kind and purpose of intervention.Discussion: Even though the degree of a risk is important in a doctor’s considerations, the severity of the possible complications and patients’ wishes and competencies have an important role as well. Respondents said that low risks should always be communicated when there are alternatives for the intervention or when the patient may prevent or mitigate the risk. When the appropriateness of disclosing risks is doubtful, doctors should always tell their patients that no intervention is without risk, give them the opportunity to gather all the information they need or want, and enable them to detect a complication at an early stage. (shrink)

Freely falling point-like objects converge toward the center of the Earth. Hence the gravitational field of the Earth is inhomogeneous, and possesses a tidal component. The free fall of an extended quantum mechanical object such as a hydrogen atom prepared in a high principal-quantum-number state, i.e. a circular Rydberg atom, is predicted to fall more slowly than a classical point-like object, when both objects are dropped from the same height above the Earth’s surface. This indicates that, apart from transitions between (...) quantum states, the atom exhibits a kind of quantum mechanical incompressibility during free fall in inhomogeneous, tidal gravitational fields like those of the Earth.A superconducting ring-like system with a persistent current circulating around it behaves like the circular Rydberg atom during free fall. Like the electronic wavefunction of the freely falling atom, the Cooper-pair wavefunction is quantum mechanically incompressible. The ions in the lattice of the superconductor, however, are not incompressible, since they do not possess a globally coherent quantum phase. The resulting difference during free fall in the response of the nonlocalizable Cooper pairs of electrons and the localizable ions to inhomogeneous gravitational fields is predicted to lead to a charge separation effect, which in turn leads to a large Coulomb force that opposes the convergence caused by the tidal gravitational force on the superconducting system.A “Cavendish-like” experiment is proposed for observing the charge separation effect induced by inhomogeneous gravitational fields in a superconducting circuit. The charge separation effect is determined to be limited by a pair-breaking process that occurs when low frequency gravitational perturbations are present. (shrink)

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

ObjectivePhysical isolation measures, known as lockdown or shelter-in-place, experienced during coronavirus disease 2019 have the potential to cause psychological distress. This study was conducted to examine parents’ perceived stress and whether reports of rewards and challenges during lockdown impact stress.MethodsData were collected using a cross-sectional online survey in New South Wales, Australia, across the 4-week lockdown. The survey was completed by 158 parents of children aged under 6 years. Stress was measured using the short form of the Perceived Stress Scale. (...) Rewards and challenges were reported in response to two open-ended questions.ResultsThere was a weak negative correlation between PSS-4 scores and days in isolation, with parents who had spent longer in isolation reporting fewer stress symptoms. The relationship between time in isolation and stress was moderated by the degree to which parents described more rewards than challenges: parents who perceived high rewards and low challenges reported lower PSS-4 scores with more days in lockdown, whereas parents who perceived low rewards and high challenges reported higher PSS-4 scores with more days in lockdown. The moderation model examining associations between time in isolation and rewards ratio explained 13% of the variance in PSS-4 scores.ConclusionLockdowns are not uniformly or consistently negative experiences for parents. Identifying positive aspects of the experience may serve to buffer negative mental health risks across time. Understanding resilience strategies is critical for supporting current psychological wellbeing and to adequately prepare for future pandemic experiences. (shrink)

Handwashing is important in preventing infectious diseases like COVID-19. The current public health emergency has required rapid implementation of increased handwashing in the general public; however, rapidly changing health behavior, especially on this scale, is difficult. This study considers attitudes and affective responses to handwashing as possible factors predicting COVID-19 related changes to handwashing behavior, future intentions, and readiness to change during the early stages of the pandemic in the United States. Income was explored as a potential moderator to these (...) relationships. To explore these issues, data from 344 community participants were analyzed. Results indicate that stronger affective responses toward handwashing relate to increases in handwashing since the outbreak of COVID-19, and both attitudes and affect uniquely predict handwashing intentions. Income significantly moderated the relationship between affect and readiness to change. Those with low income were more influenced by both affective responses and attitudes. These results suggest messages targeting both cognitions and affective responses are needed to increase the handwashing behavior during a global pandemic and these variables are critical in increasing readiness to change in low-income individuals. (shrink)

Atherosclerosis is the major cause of death in the industrialised world. Though much work on the pathogenesis of atherosclerosis points to 'oxidised' low density lipoprotein (LDL) as a key aetiological feature in the generation of the atherosclerotic plaque, the nature of this 'oxidised' LDL in vivo remains an enigma. We argue here that glycated LDL shows many of the characteristics attributed to 'oxidised LDL' and may be the source of the latter in vivo. These include the increased uptake and impaired (...) degradation of glycated LDL by macrophages and the stimulation of transendothelial chemotaxis of monocytes, cytokine secretion and platelet aggregation. We hypothesise that the covalent binding of glycated LDL to the endothelial cell wall may result in the formation of the early atherosclerotic lesion of the fatty streak and that apolipoprotein E may mediate the physiological clearance of glycated moieties. The proposed role of glycation in the pathogenesis of atherosclerosis would explain its high incidence among diabetics and the contentious epidemiological and experimental correlations between dietary sugar and atherosclerosis. (shrink)

Commonsense metaphysics populates the world with an enormous variety of macroscopic objects, conceived as being capable of persisting through time and undergoing various changes in their properties and relations to one another. Many of these objects fall under J. L. Austin’s memorable description, “moderate-sized specimens of dry goods.” More broadly, they include, for instance, all of those old favourites of philosophers too idle to think of more interesting examples—tables, books, rocks, apples, cats, and statues. Some of them are natural objects, (...) such as rocks, apples, and cats. Some are artefacts, such as tables, books, and statues. Some are living things, such as apples and cats. Some are inanimate things, such as tables, books, rocks, and statues. To such a list we could add much larger natural objects, such as planets and stars, as well as much smaller ones barely visible to the naked eye, such as mites and pollen grains. Telescopes and microscopes enable us to extend the scale further in both directions, to include such things as galaxies and microbes. To call into question the existence of all or any of these things would appear to be an extravagance of the sort that only a philosopher could indulge. Until fairly recently in the history of philosophy, however, the only way in which their existence would have been called into question was in the context of the debate between realism and idealism. Idealism calls their existence into question by questioning the existence of an “external world” as such, proposing instead that only minds and their experiences exist. What is much more recent is the suggestion that, although there is an external world of entities existing in space and time, it is not in fact populated by most, or perhaps even by any, of the objects recognized by common sense. Instead, it is suggested, the world is populated by submicroscopic entities of a highly esoteric kind best understood by theoretical physicists—entities which may not even qualify as “objects” in anything like the familiar sense because, quite possibly, they should not be thought of as having precise spatiotemporal locations or as persisting over time and through processes of qualitative change. Let us call these putative entities ‘atoms’, without prejudice as to whether they conform to the descriptions currently favoured by physicists in speaking of what they call ‘atoms’. In other words, let us use ‘atom’ as a place-holder for whatever kind or kinds of entities an ideal or completed physics would postulate as the “ultimate” constituents, as opposed to infinitely descending levels of ever more fine-grained physical structure, but let us set aside dispute over these alternatives for the time being, if only because we have little idea as to how to settle it. (shrink)

Objective:To characterize the prevalence of hyperpalatable foods (HPF) among baby foods in the U.S. and examine the prevalence of HPF exposure and consumption from both baby food and adult food sources among infants aged 9–15 months.Methods:A U.S. baby food database as well as baby foods from three 24-h dietary recalls of 147 infants were used to identify baby foods as HPF per previous publication. HPF exposure was defined as intake of any HPF during the 3-day measurement period. To determine the (...) extent of HFP consumption, % kilocalorie (kcal) intake from HPF was characterized.Results:Only 12% of baby foods were HPF; however, nearly all participants (>90%) consumed HPF, primarily through exposure to adult foods. Younger infants (<12 months) consumed 38% [standard deviation (SD) = 23.6%] of their daily food kcal from HPF and older infants (≥12 months) consumed 52% (SD = 16.4%) of daily food kilocalorie from HPF. Most younger infants (68%) and older infants (88%) had repeated exposure to the same HPF across the measurement period.Conclusions:The prevalence of HPF among baby foods in the U.S. is low. However, almost all infants were exposed to HPF, and HPF comprised a substantial percentage of daily food kilocalorie in infants' diets. Findings highlight the transition to solid food consumption during complimentary feeding period is a critical time for early HPF exposure. (shrink)

En faisant usage des intuitions de la philosophie de la science, l'étude compare les voies d'approches en recherche néotestamentaire et en philologie classique. La recherche néotestamentaire a mis en oeuvre une certaine méthode qui était en vogue en philologie classique durant le 19ème siècle, mais qui fut finalement rejetée par la plupart des philologues classiques. Il s'agit d'une méthode sceptique plutôt que critique, car elle rend toute prétention à la connaissance problématique ou même impossible. Son origine dernière se trouve dans (...) la méthode du doute systématique proposée par Descartes. Telle qu'elle est pratiquée aujourd'hui, cependant, la méthode sceptique est semblable à la philosophie de la science suggérée par le cercle de Vienne en les années 1920, mais que les héritiers de cette école regardent aujourd'hui comme trop simpliste. Des exemples concrets, tirés de la pratique courante de la recherche, montrent comment une méthode sobrement critique peut trouver place dans les études du Nouveau Testament, à condition seulement que les dangers de la méthode sceptique soient clairement aperçus. (shrink)

Reproductive autonomy is central to women’s welfare both because childbearing takes place in women’s bodies and because they are generally expected to take primary responsibility for child rearing. In 2005, the factors that influence their autonomy most strongly are poverty and belief systems that devalue such autonomy. Unfortunately, such autonomy is a low priority for most societies, or is anathema to their belief systems altogether. This situation is doubly sad because women’s reproductive autonomy is intrinsically valuable for women and also (...) instrumentally valuable for the welfare of humankind. This paper takes for granted the moral and practical necessity of such autonomy and digs deeper into the question of what such a commitment might entail, focusing on the mid-level policy making that, at least in the US and Canada, plays a significant role in shaping women’s options. This paper examines a large teaching hospital’s policy on reduction of multifetal pregnancies. The policy permits reduction of triplets to twins, but not twins to a singleton. As there is no morally relevant difference between these two types of reduction, it is evident that inappropriate medicalisation can still limit women’s autonomy in undesirable ways. (shrink)

The comorbidity of chronic pain and opioid addiction is a serious problem that has been growing with the practice of prescribing opioids for chronic pain. Neuroimaging research has shown that chronic pain and opioid dependence both affect brain structure and function, but this is the first study to evaluate the neurophysiological alterations in patients with comorbid chronic pain and addiction. Eighteen participants with chronic low back pain and opioid addiction were compared with eighteen age- and sex-matched healthy individuals in a (...) pain-induction fMRI task. Unified structural equation modeling (SEM) with Lagrange multiplier (LM) testing yielded a network model of pain processing for patient and control groups based on 19 a priori defined regions. Tests of differences between groups on specific regression parameters were determined on a path-by-path basis using z-tests corrected for the number of comparisons. Patients with the chronic pain and addiction comorbidity had increased connection strengths; many of these connections were interhemispheric and spanned regions involved in sensory, affective, and cognitive processes. The affected regions included those that are commonly altered in chronic pain or addiction alone, indicating that this comorbidity manifests with neurological symptoms of both disorders. Understanding the neural mechanisms involved in the comorbidity is crucial to finding a comprehensive treatment, rather than treating the symptoms individually. (shrink)

In this paper, we report on the development and validity of the Professional Decision-Making in Research measure, a vignette-based test that examines decision-making strategies used by investigators when confronted with challenging situations in the context of empirical research. The PDR was administered online with a battery of validity measures to a group of NIH-funded researchers and research trainees who were diverse in terms of age, years of experience, types of research, and race. The PDR demonstrated adequate reliability and parallel form (...) correlation. As hypothesized, the PDR was significantly negatively correlated with narcissism, cynicism, moral disengagement, and compliance disengagement; it was not correlated with socially desirable responding. In regression analysis, the strongest predictors of higher PDR scores were low compliance disengagement, speaking English as a native language, conducting clinical research with human subjects, and low levels of narcissism. Given that the PDR was written at an eighth grade reading level to be suitable for use with English as a second language participants and that only one-fourth of items focused on clinical research, further research into the possible roles of culture and research ethics training across specialties is warranted. This initial validity study demonstrates the potential usefulness of the PDR as an educational outcome assessment measure and a research instrument for studies on professionalism and integrity in research. (shrink)

Background: Evidence indicates that the processing of facial stimuli may be influenced by incidental factors, and these influences are particularly powerful when facial expressions are ambiguous, such as neutral faces. However, limited research investigated whether emotional contextual information presented in a preceding and unrelated experiment could be pervasively carried over to another experiment to modulate neutral face processing.Objective: The present study aims to investigate whether an emotional text presented in a first experiment could generate negative emotion toward neutral faces in (...) a second experiment unrelated to the previous experiment.Methods: Ninety-nine students were randomly assigned to read and evaluate a negative text or a neutral text in the first experiment. In the subsequent second experiment, the participants performed the following two tasks: an attentional task in which neutral faces were presented as distractors and a task involving the emotional judgment of neutral faces.Results: The results show that compared to the neutral context, in the negative context, the participants rated more faces as negative. No significant result was found in the attentional task.Conclusion: Our study demonstrates that incidental emotional information available in a previous experiment can increase participants’ propensity to interpret neutral faces as more negative when emotional information is directly evaluated. Therefore, the present study adds important evidence to the literature suggesting that our behavior and actions are modulated by previous information in an incidental or low perceived way similar to what occurs in everyday life, thereby modulating our judgments and emotions. (shrink)