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Like many others, I believe that the information revolution is a constitutive moment in human history, and not only because of the development of technologies that change our habits and improve the quality of our lives. More than anything else, it is because the information revolution profoundly and dramatically changes our self-concept. That revolution is changing our understanding of the place we occupy in the universe (the erosion of anthropocentrism), forcing us to rethink our uniqueness as human beings and our human essence. I believe that the preconditions of our existence are changing dramatically nowadays, and consequently, our notions of belonging and identity require revision.
End-of-life care (EOLC) communication is beneficial but underutilized, particularly in conditions with a variable course such as chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF). Physicians’ emotional distress intolerance has been identified as a barrier to EOLC communication. However, studies of emotional distress intolerance in EOLC have largely relied on anecdotal reports, qualitative data, or observational studies of physician–patient communication. A free-standing measure of multiple dimensions of distress tolerance is warranted to enable the identification of individuals experiencing distress intolerance and to facilitate the effective targeting of interventions to improve distress tolerance.
Objectives
This study provides preliminary data on the reliability and validity of the Physician Distress Intolerance (PDI) scale. We examine potential subdimensions of emotional distress intolerance.
Method
Family medicine and internal medicine physicians completed the PDI, read vignettes describing patients with COPD or CHF, and indicated whether they initiated or delayed EOLC communication with their patients with similar conditions.
Results
Exploratory and confirmatory factor analyses were performed on separate samples. Confirmatory factor analysis confirmed that a three-factor solution was superior to a two- or one-factor solution. Three subscales were created: Anticipating Negative Emotions, Intolerance of Uncertainty, and Iatrogenic Harm. The full scale and subscales had adequate internal consistency and demonstrated evidence of validity. Higher scores on the PDI, indicating greater distress intolerance, were negatively associated with initiation and positively associated with delay of EOLC communication. Subscales provided unique information.
Significance of results
The PDI can contribute to research investigating and addressing emotional barriers to EOLC communication.
Title VI of the Civil Rights Act of 1964 and its implementing regulations prohibit federally-funded educational institutions and healthcare centers from engaging in disparate impact discrimination “on the ground of race, color, or national origin” in all of their operations.
From 2014 to 2020, we compiled radiocarbon ages from the lower 48 states, creating a database of more than 100,000 archaeological, geological, and paleontological ages that will be freely available to researchers through the Canadian Archaeological Radiocarbon Database. Here, we discuss the process used to compile ages, general characteristics of the database, and lessons learned from this exercise in “big data” compilation.
Electrical injury (EI) is a significant, multifaceted trauma often with multi-domain cognitive sequelae, even when the expected current path does not pass through the brain. Chronic pain (CP) research suggests pain may affect cognition directly and indirectly by influencing emotional distress which then impacts cognitive functioning. As chronic pain may be critical to understanding EI-related cognitive difficulties, the aims of the current study were: examine the direct and indirect effects of pain on cognition following EI and compare the relationship between pain and cognition in EI and CP populations.
Method:
This cross-sectional study used data from a clinical sample of 50 patients with EI (84.0% male; Mage = 43.7 years) administered standardized measures of pain (Pain Patient Profile), depression, and neurocognitive functioning. A CP comparison sample of 93 patients was also included.
Results:
Higher pain levels were associated with poorer attention/processing speed and executive functioning performance among patients with EI. Depression was significantly correlated with pain and mediated the relationship between pain and attention/processing speed in patients with EI. When comparing the patients with EI and CP, the relationship between pain and cognition was similar for both clinical groups.
Conclusions:
Findings indicate that pain impacts mood and cognition in patients with EI, and the influence of pain and its effect on cognition should be considered in the assessment and treatment of patients who have experienced an electrical injury.
Reliable spatially resolved compositional analysis through atom probe tomography requires an accurate placement of the detected ions within the three-dimensional reconstruction. Unfortunately, for heterogeneous systems, traditional reconstruction protocols are prone to position some ions incorrectly. This stems from the use of simplified projection laws which treat the emitter apex as a spherical cap, although the actual shape may be far more complex. For instance, sampled materials with compositional heterogeneities are known to develop local variations in curvature across the emitter due to their material phase specific evaporation fields. This work provides three pivotal precursors to improve the spatial accuracy of the reconstructed volume in such cases. First, we show scanning probe microscopy enables the determination of the local curvature of heterogeneous emitters, thus providing the essential information for a more advanced reconstruction considering the actual shape. Second, we demonstrate the cyclability between scanning probe characterization and atom probe analysis. This is a key ingredient of more advanced reconstruction protocols whereby the characterization of the emitter topography is executed at multiple stages of the atom probe analysis. Third, we show advances in the development of an electrostatically driven reconstruction protocol which are expected to enable reconstruction based on experimental tip shapes.
The chapter addresses the complex relationships between law and identity as a jurisprudential problem and as a constitutional concern. It examines several conceptual aspects of identity right claims without taking a stance in the identarian–dignitarian moral and political debate. It sheds light on a neglected facet of identity right claims: the feasibility of the notion of identity as a foundation for constitutional rights. The conceptual feasibility of identity right claims is independent of and unconcerned with the validity and accuracy of moral ideologies. The chapter discusses whether identity right claims are conceptually defensible on the basis of constitutional reasoning. It argues that the notion of identity not only is definitionally vague, but also is a metamorphic concept that suffers from unsteadiness.
Contemporary philosophers remind us that the conceptual bases of human rights law, human rights movements and human rights discourse are not sufficiently grounded, tend to overlook the distinction between values and rights and engage inadequately with the practice of human rights. Other commentators criticise human rights on practical bases, casting doubts on whether human rights treaties have indeed improved the well-being of people, or even resulted in respect for the rights in those treaties. Such criticisms emphasise the relative weakness of humanitarian impulse that underlay human rights law and the unsystematic strategic and instrumental bases for human rights.
This collection of essays is written by some of the world's leading experts in international human rights law, and corresponds to the main junctures in the professional life of Professor David Kretzmer, a leading human right academic and practitioner. The different essays focus on contemporary human rights protection challenges. They address conceptual problems such as differences between limits and restrictions, and application of human rights standards to businesses and international organisations; legal doctrinal responses to changing realities in the field of surveillance and identity politics; the weakness of monitoring institutions engaged in standard setting; and the practical difficulties in applying international human rights law to the Israeli-Palestinian conflict in a manner sensitive to gender dimensions and the particular political dynamics of the situation. Collectively, the essays offer a rich picture of the current potential shortcomings of international human rights law in addressing complex problems of law, politics and ethics.
Implementation of clinically useful research discoveries in the academic environment is challenged by limited funding for early phase proof-of-concept studies and inadequate expertise in product development and commercialization. To address these limitations, the National Institutes of Health (NIH) established the National Centers for Accelerated Innovations (NCAI) program in 2013. Three centers competed successfully for awards through this mechanism. Here, we present the experience of one such center, the Boston Biomedical Innovation Center (B-BIC), and demonstrate its remarkable success at the translation of innovations to clinical application and commercialization, as well as skills development and education.
Adolescent females are at elevated risk for the development of depression. In this study, we addressed two questions: Are pubertal hormones associated with adolescent mental health? Might this association depend on pubertal development? We tested the hypothesis that estradiol, which has been associated with adolescent social sensitivity, might interact with pubertal stage to predict depression risk at three time points in ninth and tenth grade. Hormones and pubertal development were measured ninth-grade females. Linear regression analyses were used to predict fall ninth-grade (N = 79), spring ninth-grade (N = 76), and spring tenth-grade (N = 67) Children's Depression Inventory (CDI) scores. The hypothesized model was not statistically significant, but exploratory analyses revealed that two- and three-way interactions incorporating estradiol, puberty (stage and perceived onset), and cortisol predicted current and future CDI scores. Our exploratory model did not predict changes in CDI but did account for future (spring of ninth grade) CDI scores. Specifically, estradiol was positively correlated with fall and spring ninth-grade depressive symptoms in participants with high cortisol who also reported earlier stages and later perceived onset of pubertal development. These findings suggest that hormones associated with sensitivity to the social environment deserve consideration in models of adolescent depression risk.
The lift and drag forces acting on a small spherical particle in a single wall-bounded linear shear flow are examined via numerical computation. The effects of shear rate are isolated from those of slip by setting the particle velocity equal to the local fluid velocity (zero slip), and examining the resulting hydrodynamic forces as a function of separation distance. In contrast to much of the previous numerical literature, low shear Reynolds numbers are considered ($10^{-3} \lesssim Re_{\gamma } \lesssim 10^{-1}$). This shear rate range is relevant when dealing with particulate flows within small channels, for example particle migration in microfluidic devices being used or developed for the biotech industry. We demonstrate a strong dependence of both the lift and drag forces on shear rate. Building on previous theoretical $Re_{\gamma } \ll 1$ studies, a wall-shear-based zero-slip lift correlation is proposed that is applicable when the wall lies both within the inner and outer regions of the disturbed flow. Similarly, we validate an improved wall-shear-based zero-slip drag correlation that more accurately captures the drag force when the particle is close to, but not touching, the wall. Application of the new correlations to predict the movement of a force-free particle shows that the examined shear-based lift force is as important as the previously examined slip-based lift force, highlighting the need to accurately account for shear when predicting the near-wall movement of force-free particles.