Objective: There are benefits and risks of giving patients more granular control of their personal health information in electronic health record (EHR) systems. When designing EHR systems and policies, informaticists and system developers must balance these benefits and risks. Ethical considerations should be an explicit part of this balancing. Our objective was to develop a structured ethics framework to accomplish this. -/- Methods: We reviewed existing literature on the ethical and policy issues, developed an ethics framework called a “Points to (...) Consider” (P2C) document, and convened a national expert panel to review and critique the P2C. -/- Results: We developed the P2C to aid informaticists designing an advanced query tool for an electronic health record (EHR) system in Indianapolis. The P2C consists of six questions (“Points”) that frame important ethical issues, apply accepted principles of bioethics and Fair Information Practices, comment on how questions might be answered, and address implications for patient care. -/- Discussion: The P2C is intended to clarify whatis at stake when designers try to accommodate potentially competing ethical commitments and logistical realities. The P2C was developed to guide informaticists who were designing a query tool in an existing EHR that would permit patient granular control. While consideration of ethical issues is coming to the forefront of medical informatics design and development practices, more reflection is needed to facilitate optimal collaboration between designers and ethicists. This report contributes to that discussion. (shrink)

Communicative Understandings of Women's Leadership Development: From Ceilings of Glass to Labyrinth Paths, edited by Elesha L. Ruminski and Annette M. Holba, weaves the disciplines of communication studies, leadership studies, and women's studies to offer theoretical and practical reflection about women's leadership development in academic, organizational, and political contexts. This work claims a space for women's leadership studies and acknowledges the paradigmatic shift from discussing women's leadership using the glass ceiling to what Eagly and Carli identify as the labyrinth of (...) leadership. (shrink)

Volume 20, Issue 7, July 2020, Page 1-5.

Kathryn Paxton George's recent publication, Animal, Vegetable, or Woman?, is the culmination of more than a decade's work and encompasses standard and original arguments against the feminist-vegetarian connection. This paper demonstrates that George's key arguments are deeply flawed, antithetical to basic feminist commitments, and beg the question against fundamental aspects of the debate. Those who do not accept the feminist-vegetarian connection should rethink their position or offer a non-question-begging defense of it.

The growth and sustainability of the nursing profession depends on the ability to recruit and retain the upcoming generation of professionals. Understanding the career choice experiences and professional expectations of Millennial nurses (born 1980 or after) is a critical component of recruitment and retention strategies. This study utilized Polkinghorne's interpretive, narrative approach to understand how Millennial nurses explain, account for and make sense of their choice of nursing as a career. The positioning of nursing as a virtuous choice was both (...) temporally and contextually influenced. The decision to enter the profession was initially emplotted around a traditional understanding of nursing as a virtuous profession: altruistic, noble, caring and compassionate. The centricity of virtues depicts one‐dimensional understanding of the nursing profession that alone could prove dissatisfying to a generation of professionals who have many career choices available to them. The narratives reveal how participants' perceptions and expectations remain influenced by a stereotypical understanding of nursing, an image that remains prevalent in society and which holds implications for the future recruitment, socialization and retention strategies for upcoming and future generations of nurses. (shrink)

ABSTRACT The Swedish case bears out Lewin's contention, in Self-Interest and Public Interest in Western Politics, that public spiritedness is much more important than is suggested by public-choice theories positing the universal dominance of self-interestedness. However, in Sweden we find that public spiritedness on the part of the public—as evidenced, for example, in sociotropic voting—was cultivated by political institutions, policies, and rhetoric that transformed a divided, conflictual society into one in which the “public interest” was both coherent and desirable. In (...) turn, this cultivation was the result of decisions by politicians that were, in the most simplistic sense, self-interested, because they secured the politicians’ election and re-election. But the goal of election and re-election was to create a just society. In short, the politicians, too, were public spirited. (shrink)

This historical study aims to explain how the transition from student nurse service to fully qualified “graduate nurse” service in the United States in the 20th century affected assumptions about fundamental patient care in hospital wards and provide historical context for current apprenticeship programs. Through analysis of documents from 1920 when student nurse service, a nurse apprentice model, was the norm to 1960 when the nurse apprentice model was waning in favor of registered nurse service, this study found that the (...) replacement of student nurses with registered nurses led to weakened standardization of fundamental bedside care and the introduction of large numbers of unlicensed nursing assistants. While student nurses could perform all the functions of fully qualified graduate nurses, nursing assistants could not, resulting in a separation of fundamental nursing care from the professional nurse role and changes in assumptions and attitudes toward fundamental care. These changes had a negative effect on fundamental nursing care. New apprenticeship programs provide opportunities for improvement. (shrink)

: Kathryn Paxton George's recent publication, Animal, Vegetable, or Woman? (2000), is the culmination of more than a decade's work and encompasses standard and original arguments against the feminist-vegetarian connection. This paper demonstrates that George's key arguments are deeply flawed, antithetical to basic feminist commitments, and beg the question against fundamental aspects of the debate. Those who do not accept the feminist-vegetarian connection should rethink their position or offer a non-question-begging defense of it.

One-ing is as close a description of "What It May Be All About" that you may ever read.The awesome task that is your destiny is connecting Heaven and Earth and ...

The Swedish case bears out Lewin's contention, in Self-Interest and Public Interest in Western Politics, that public spiritedness is much more important than is suggested by public-choice theories positing the universal dominance of self-interestedness. However, in Sweden we find that public spiritedness on the part of the public—as evidenced, for example, in sociotropic voting—was cultivated by political institutions, policies, and rhetoric that transformed a divided, conflictual society into one in which the “public interest” was both coherent and desirable. In turn, (...) this cultivation was the result of decisions by politicians that were, in the most simplistic sense, self-interested, because they secured the politicians’ election and re-election. But the goal of election and re-election was to create a just society. In short, the politicians, too, were public spirited. (shrink)

This historical study aims to refine understanding of the nature of nursing work. The study focuses on the 1880 crisis at Guy's Hospital in London to examine the nature and meaning of nursing work, particularly the concept of nursing work as many ‘little things.’ In this paper, an examination of Margaret Lonsdale's writing offers an original contribution to our understanding of the ways in which nursing work differs from medical practice. In this way, we use the late-nineteenth-century controversy at Guy's (...) Hospital as a prism through which to examine the contested nature of nursing work. Lonsdale's ideas are corroborated by examination of writings by nurse leaders Florence Nightingale and Eva Luckes. Luckes, in particular, elaborated what was meant by nursing as the performance of a thousand little things, which are specific to nursing work. While physicians had been performing much of what was considered to be nursing work, nurses developed some of these and other interventions into a unique body of work characterized by meticulous attention to significant details. Some implications regarding current nursing practice are discussed. (shrink)

WISDOM OF THE WILD offers a deeper appreciation of life, relationships, and experiences through the exploration of nature's spiritual offerings. This collection of life lessons focuses on aspects of the natural world and their philosophical connection to our own lives, providing insights to daily living and a deeper connection to our spiritual selves. Each entry features a phenomenon found in nature, demonstrating how readers may connect the world to their human experiences. With activities, rituals, and affirmations, this book of natural (...) wonders aligns readers' inner and outer worlds to cultivate peace, balance, and harmony. (shrink)

For centuries, the British royal family has been the subject of books, articles, broadcast media, and digital communication. The addition of social media platforms has further increased the attention of the royals. Each of the family’s official social media sites have large numbers of followers around the world. The present study uses Goffman’s Presentation of Self to qualitatively examine how the current British royal family portrays itself visually via its official Instagram account. An analysis of two years of posts on (...) the social platform provides a glimpse of how the family works to maintain its image through a highly popular social media platform. Results indicated the presence of three main themes: Queen as the Head of the Monarchy, Honoring the Past, and The Working Royalty. This study offers a means of understanding the importance of visuals in conveying the royal family. (shrink)

Two related themes have dominated discussions about the Left in advanced industrial democracies in recent years. The first is that an increasingly integrated world economy is creating a fundamentally new situation for leaders and publics, imposing burdens and constraining choices. You can either opt out of the system and languish, or put on what New York Times columnist Thomas Friedman has called neoliberalism's “Golden Straightjacket”—at which point “two things tend to happen: your economy grows and your politics shrinks.” The second (...) is that traditional social democracy has played itself out as a political ideology, creating a vacuum that can and should be filled by some new progressive movement with greater contemporary relevance. For example, Ralf Dahrendorf has argued that “socialism is dead, and … none of its variants can be revived,” while Anthony Giddens has written that reformist socialism has become “defensive” and perhaps even “moribund.”. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Community and the “Absolutely Feminine”Sheri I. Hoem (bio)I’ve emphasized the importance of the moment of dissent in the process of constructing knowledge, lying at the heart of the community of thought.—Jean-François Lyotard, The Postmodern ExplainedMaurice Blanchot’s The Unavowable Community places side by side a “community” of writers who confront the very possibility of community as it comes to be inscribed in politico-philosophical and literary modes. His “little book” (...) [56], as he calls it, takes up these modes of discourse separately, in two parts. The first section of his text, “The Negative Community,” constitutes an analytical defense of Bataille’s theoretical concepts of community as they have been interpreted by Jean-Luc Nancy in The Inoperative Community. Blanchot engages the question of community, communion, and communism not simply to contest or continue Nancy’s text, but to restore Bataille to a brotherhood, or “fraternity” [26] of friends and scholars who have come to think in terms of an “unworking” [23] or “negative” community. The second section of Blanchot’s text, “The Community of Lovers,” performs a critical reading of Marguerite Duras’s fictional work The Malady of Death.In The Inoperative Community—the pretext, at least in part, for part one of Blanchot’s little book—Nancy credits Bataille as having “gone farthest into the crucial experience of the modern destiny of community” [16] in that Bataille’s thinking reveals the experience of discerning communism’s failure, followed by a fascination with fascism, and finally a “withdrawal from communitarian enterprises” [16–17] altogether. According to Nancy, at the juncture of the historical and theoretical failings of community, Bataille abandons all forms of community other than “an accursed isolation of lovers and of the artist” [24]. Admitting that he is dealing only with ‘“themes’” rather than with Bataille’s “writing” itself, Nancy nevertheless asserts that Bataille’s thinking on community has always been limited by “the theme of the sovereignty of the subject” [23], even in his community of lovers:Bataille’s lovers are also, at the limit, a subject and an object—where the subject, moreover, is always the man, and the object always the woman, due no doubt to a very classical manipulation of sexual difference in an appropriation of self by self. (However, on another register and in another reading of Bataille’s text, it is not certain that love and jouissance do not pertain essentially to the woman—and to the woman in man. To discuss this it would be necessary to consider Bataille’s writing... something I cannot do here, inasmuch as I am for the moment considering only its “themes.”).[24]Nancy’s reading of Bataille thus clears a space for Nancy’s own investigation into the possibility of community after or beyond the subject, so to speak. Instead of a subject described as an (undivided) individual, Nancy speaks of a “singular being” who is always already othered. Singular beings as such are “constituted by... sharing that makes them [End Page 49] others: other for one another... ‘“communicating’ by not ‘communing’” [25]. For Nancy, it is the very experience of the limits of communication that allows each being to discover a certain singularity in common.Blanchot too reflects on the “theme” of community in Bataille’s works without examining Bataille’s “writing” as such, but he reads Bataille differently. Blanchot demonstrates how Bataille’s thinking gives the effect of “mutation” [4], that Bataille comes to an understanding of self-difference beyond the subject, beyond the limits imposed by Nancy’s reading, beyond the classical construct of subject/object discourse. Blanchot’s “Negative Community” establishes Bataille as one who experienced stages of thought: his thought exhibited its own infidelity.Blanchot turns to certain of Bataille’s terms, particularly “sacrifice,” “ecstasy,” and “inner experience,” to present an alternative to Nancy’s reading. According to Blanchot, the “inner experience” (l’expérience intérieure) is a concept in Bataille that does the opposite of what one might expect. The “inner experience,” Blanchot explains, is amovement of contestation that, coming from the subject, devastates it, but has as a deeper origin the relationship with the other which is community itself... (shrink)

This paper examines economic arguments employers sometimes use to justify restricting or excluding from employment those workers who are Iikely to incur high costs in health care insurance. We argue that, although profit-making is a legitimate goal for businesses, hiring practices based on non-job-related criteria violate principles of self determination, autonomy, discrimination, justice, and privacy. We conclude that hiring practices based on Iiability-driven ethics are not morally justified, but that as long as health care insurance and employment are Iinked, businesses (...) will continue to have an incentive to use liability-driven arguments. (shrink)

Locked-in syndrome (LIS) is a severe neurological condition that typically leaves a patient unable to move, talk and, in many cases, initiate communication. Brain Computer Interfaces (or BCIs) promise to enable individuals with conditions like LIS to re-engage with their physical and social worlds. In this paper we will use extended mind theory to offer a way of seeing the potential of BCIs when attached to, or implanted in, individuals with LIS. In particular, we will contend that functionally integrated BCIs (...) extend the minds of individuals with LIS beyond their bodies, allowing them greater autonomy than they can typically hope for in living with their condition. This raises important philosophical questions about the implications of BCI technology, particularly the potential to change selves, and ethical questions about whether society has a responsibility to aid these individuals in re-engaging with their physical and social worlds. It also raises some important questions about when these interventions should be offered to individuals with LIS and respecting the rights of these individuals to refuse intervention. By aiding willing individuals in re-engaging with their physical and social worlds, BCIs open up avenues of opportunity taken for granted by able individuals and introduce new ways in which these individuals can be harmed. These latter considerations serve to highlight our emergent social responsibilities to those individuals who will be suitable for, and receive, BCIs. (shrink)

The present study aimed to examine the relations between physical self-concept, intrinsic and extrinsic motivation as well as physical performance of 1,082 children aged 7–8 years. The central objective of this study was to contrast a mediation model assuming physical self-concept as a mediator of the relations between both types of motivation and physical performance to a mediation model assuming both types of motivation as mediators of the relations between physical self-concept and physical performance. Physical self-concept and both types of (...) motivation were measured by using self-reported questionnaires, while physical performance was measured with 10 motor skill tests. All tests were carried out during regular school hours (8–12 A.M.) by qualified test personnel. Beyond correlation analyses, structural equation modeling (SEM) was performed to find evidence for the predictive relations between the variables under study. Results showed that physical self-concept was significantly positively related to both types of motivation and physical performance (allp< 0.001). In contrast, results of SEM revealed that only physical self-concept (p< 0.001) and intrinsic motivation (p< 0.05) were significantly positively linked to physical performance. Furthermore, physical self-concept proved to significantly mediate the relations of both types of motivation to physical performance (p< 0.001), while only intrinsic motivation, but not extrinsic motivation, proved to significantly mediate the relation between physical self-concept and physical performance (p< 0.05). These results suggest that school-based or extracurricular interventions targeted at improving younger children's physical performance only by means of an increased level of physical activity or by external factors without supporting children's physical self-concept and intrinsic motivation may have less or no effects on their physical performance. (shrink)

The influential threat simulation theory asserts that dreaming yields adaptive advantage by providing a virtual environment in which threat-avoidance may be safely rehearsed. We have previously found the incidence of biologically threatening dreams to be around 20%, with successful threat avoidance occurring in approximately one-fifth of such dreams. TST asserts that threat avoidance is over-represented relative to other possible dream contents. To begin assessing this issue, we contrasted the incidence of ‘avoidance’ dreams with that of their opposite: ‘approach’ dreams. Because (...) TST states that the threat-avoidance function is only fully activated in ecologically valid contexts, we also performed this contrast for populations living in both high- and low-threat environments. We find that ‘approach’ dreams are significantly more prevalent across both contexts. We suggest these results are more consistent with the view that dreaming is generated by reward-seeking systems than by fear-conditioning systems, although reward-seeking is clearly not the only factor determining the content of dreams. (shrink)

In recent years, two distinct trajectories of bioethical inquiry have emerged: neuroethics and nanoethics. The former deals with issues in neuroscience, whereas the latter deals with issues in nanoscience and nanotechnology. In both cases, the ethical inquiries have coalesced in response to rapidly increasing scientific and engineering developments in each field. Both also present major issues for contemplation in bioethics. However, the questions are (1) how different are the ethical issues raised, and (2) is it beneficial for neuroethics and nanoethics (...) inquiries to proceed on often-divergent trajectories by ethicists who otherwise might never interact? If, for example, ethical inquiry occurs only within the disciplinary confines of their predominant area(s) of science (which now seems to be the case) or by overlooking prior discussions in other scientific realms (like genetics), then the opportunity for a richer, more comprehensive discourse may be lost. I argue that this (1) is a disservice to bioethics, (2) is antithetical to some of the aims of bioethical inquiry, and (3) encourages the reductionism bioethicists’ claim that is counterproductive. (shrink)

We have all heard a refrain much like this one over the last decade, increasingly so, as the cost of genetic sequencing has been drastically reduced with improvements in associated techniques and technologies. Already, discoveries are being made in laboratories that can help doctors determine from which drug a particular patient will receive the most efficacious treatment. The working presumption is that, eventually, individuals’ genetic sequence information will be included in each of their personal medical records.

Theories of leadership have traditionally focused on leadership traits, styles, and situational factors that influence leader behaviors. We propose that The Four Umpires Model described herein, which examines how four leadership types view reality and perception, provides a useful example of an effective steward leader. We use the Five Beliefs Model identified by Edgar Schein and Peter Senge to frame the implicit assumptions underlying the core beliefs and mental models of each of the four umpires. We suggest that the stewardship (...) model of Umpire Number Four, the Facilitating Idealist, is the best model for leadership of the four umpires described. In our review of the Four Umpires Model we also explain why it is importance for every leader to thoughtfully assess the assumptions that form the ethical basis for leadership decisions and actions. (shrink)

In Ralph Waldo Emerson’s groundbreaking essay Nature, he wrote, “The moral law lies at the centre of nature and radiates to the circumference. It is the pith and marrow of every substance, every relation, and every process.”1 This moral quality of nature is embedded in its very core—the stems of plants and the interior of bones—the very places where the transactions that give life take place. And it goes out, like the light of the sun and the stars, to the (...) farthest reaches of the universe. But how did Emerson interpret this book of Nature to which he turned in his religious imagination? While Emerson is often read as a secularizing force in American society, the American liberal religious traditions that .. (shrink)

Courting Death: The Supreme Court and Capital Punishment by Carol and Jordan Steiker is, as the introduction states, “the story of how the American death penalty has come full circle over the past...

A core symptom of depression, anhedonia, involves deficits in the ability to experience positive emotion (American Psychiatric Association, 2000). Positive emotional disturbances play a central rol...

In this article, we consider similarities and differences in emotion research on older adults and individuals with bipolar disorder (BD). Recent research and theory within both areas has focused on the importance of positive emotion, but the case of older adults is generally considered a case of “adaptive” positivity whereas BD is usually considered maladaptive positivity. We explore the paradox of the same phenomenon being labeled as adaptive in one group and yet maladaptive in another, with attention to commonalities and (...) distinctions between these two groups. We identify only limited areas of overlap, and suggest a refinement of models of positive emotionality in the two populations. (shrink)

This paper examines economic arguments employers sometimes use to justify restricting or excluding from employment those workers who are Iikely to incur high costs in health care insurance. We argue that, although profit-making is a legitimate goal for businesses, hiring practices based on non-job-related criteria violate principles of self determination, autonomy, discrimination, justice, and privacy. We conclude that hiring practices based on Iiability-driven ethics are not morally justified, but that as long as health care insurance and employment are Iinked, businesses (...) will continue to have an incentive to use liability-driven arguments. (shrink)

Parents and guardians in child protection systems are in unequal power relationships with child protection practitioners. This relationship is experienced as exclusionary or even oppressive by many parents and guardians. For families and communities in the child protection system who experience intersectional discrimination and disadvantage, such as people with intellectual disabilities and First Nations people, this unequal relationship and subsequent potential exclusion and oppression can be even more profound. A growing body of literature indicates that advocacy can assist in addressing (...) unequal relationships in other contexts, such as involuntary mental health. This paper explores the role of representational advocacy in supporting parents in child protection settings through a case study of an advocacy service in Victoria, Australia. Using a human rights framework to guide the analysis, the paper highlights how advocacy can help support rights, but that broader structural change will be required to consistently uphold the rights of parents. (shrink)

Healthcare systems and health professionals are facing a litany of stressors that have been compounded by the pandemic, and consequently, this has further perpetuated suboptimal mental health and burnout in nursing. The purpose of this paper is to report select findings from a larger, national study exploring gendered experiences of mental health, leave of absence (LOA), and return to work from the perspectives of nurses and key stakeholders. Given the breadth of the data, this paper will focus exclusively on the (...) qualitative results from 53 frontline Canadian nurses who were purposively recruited for their workplace insight. This paper focuses on the substantive theme of “Breaking Point,” in which nurses articulated a multiplicity of stress points at the individual, organizational, and societal levels that amplified burnout and accelerated mental health LOA from the workplace. These findings exemplify the complexities that underlie nurses' mental health and burnout and highlight the urgent need for multipronged individual, organizational, and structural interventions. Robust and timely interventions are needed to restore the health of the nursing profession and sustain its future. (shrink)

There are a limited number of neuroimaging investigations into motor control of the lumbopelvic musculature. Most investigation examining motor control of the lumbopelvic musculature utilize transcranial magnetic stimulation and focus primarily on the motor cortex. This has resulted in a dearth of knowledge as it relates to how other regions of the brain activate during lumbopelvic movement. Additionally, task-based functional connectivity during lumbopelvic movements has not been well elucidated. Therefore, we used functional magnetic resonance imaging to examine brain activation and (...) ROI-to-ROI task-based functional connectivity in 19 healthy individuals during the performance of three lumbopelvic movements: modified bilateral bridge, left unilateral bridge, and right unilateral bridge. The whole brain analysis found robust, bilateral activation within the motor regions of the brain during the bilateral bridge task, and contralateral activation of the motor regions during unilateral bridging tasks. Furthermore, the ROI-to-ROI analysis demonstrated significant connectivity of a motor network that included the supplemental motor area, bilateral precentral gyrus, and bilateral cerebellum regardless of the motor task performed. These data suggest that while whole brain activation reveals unique patterns of activation across the three tasks, functional connectivity is very similar. As motor control of the lumbopelvic area is of high interest to those studying low back pain, this study can provide a comparison for future research into potential connectivity changes that occur in individuals with LBP. (shrink)

Current law does not adequately protect patients' privacy or their medical records. Proposals to computerize these records could further erode confidentiality unless new federal laws are enacted.