For decades, aged care facility residents at risk of pressure ulcers (PUs) have been repositioned at two-hour intervals, twenty-four-hours-a-day, seven-days-a-week (24/7). Yet, PUs still develop. We used a cross-sectional survey of eighty randomly selected medical records of residents aged ≥ 65 years from eight Australian Residential Aged Care Facilities (RACFs) to determine the number of residents at risk of PUs, the use of two-hourly repositioning, and the presence of PUs in the last week of life. Despite 91 per cent (73/80) (...) of residents identified as being at risk of PUs and repositioned two-hourly 24/7, 34 per cent (25/73) died with one or more PUs. Behaviours of concern were noted in 72 per cent (58/80) of residents of whom 38 per cent (22/58) were restrained. Dementia was diagnosed in 70 per cent (56/80) of residents. The prevalence of behaviours of concern displayed by residents with dementia was significantly greater than by residents without dementia (82 per cent v 50 per cent, p = 0.028). The rate of restraining residents with dementia was similar to the rate in residents without dementia. Two-hourly repositioning failed to prevent PUs in a third of at-risk residents and may breach the rights of all residents who were repositioned two-hourly. Repositioning and restraining may be unlawful. Rather than only repositioning residents two-hourly, we recommend every resident be provided with an alternating pressure air mattress. (shrink)

ABSTRACT There is limited guidance about whether and how to provide psychological assessment results to research participants. This paper considers several ethical challenges associated with offering individual research results in psychological assessment research. Additionally, the process used to return individual results within a study examining neurodevelopmental effects of anesthesia exposure in children and adolescents is described. Almost all participants requested to know if results were concerning; however, only around a third of those with concerning findings sought additional feedback. Ongoing research (...) and guidance are necessary to establish evidence-based practices and manage challenges that may emerge when disclosing such results. (shrink)

For decades, aged care facility residents at risk of pressure ulcers have been repositioned at two-hour intervals, twenty-four-hours-a-day, seven-days-a-week. Yet, PUs still develop. We used a cross-sectional survey of eighty randomly selected medical records of residents aged ≥ 65 years from eight Australian Residential Aged Care Facilities to determine the number of residents at risk of PUs, the use of two-hourly repositioning, and the presence of PUs in the last week of life. Despite 91 per cent of residents identified as (...) being at risk of PUs and repositioned two-hourly 24/7, 34 per cent died with one or more PUs. Behaviours of concern were noted in 72 per cent of residents of whom 38 per cent were restrained. Dementia was diagnosed in 70 per cent of residents. The prevalence of behaviours of concern displayed by residents with dementia was significantly greater than by residents without dementia. The rate of restraining residents with dementia was similar to the rate in residents without dementia. Two-hourly repositioning failed to prevent PUs in a third of at-risk residents and may breach the rights of all residents who were repositioned two-hourly. Repositioning and restraining may be unlawful. Rather than only repositioning residents two-hourly, we recommend every resident be provided with an alternating pressure air mattress. (shrink)

Concerns about the possibility of a sharp rise in the prevalence of Alzheimer’s disease in Western nations have led to both the significant deployment of resources and the development of national research and healthcare plans. Although often focused on treatment, substantial efforts have also been dedicated toward preventing or delaying AD onset. As a result, recent technological and biomedical advances have greatly improved the understanding of AD pathophysiology. While some new tests can assess only risk ), some tests for (...) certain biomarkers (e.g., amyloid beta accumulation in the brain detected via positron... (shrink)

Introduction to Education provides pre-service teachers with an overview of the context, craft and practice of teaching in Australian schools as they commence the journey from learner to classroom teacher. Each chapter poses questions about the nature of teaching students, and guides readers though the Australian Professional Standards for Teachers. Incorporating recent research and theoretical literature, Introduction to Education presents a critical consideration of the professional, policy and curriculum contexts of teaching in Australia. The book covers theoretical topics in chapters (...) addressing assessment, planning, safe learning environments, and working with colleagues, families, carers and communities. More practical chapters discuss professional experience and building a career after graduation. Rigorous in conception and practical in scope, Introduction to Education welcomes new educators to the theory and practical elements of teaching, learning, and professional practice. (shrink)

IntroductionHead and neck cancer diagnosis and treatment can be a significant life trauma. Some HNC survivors experience post-traumatic growth, which has been linked with better health-related quality-of-life. Empirical research on PTG, and theoretical models, point to the importance of being able to purposely make sense of the traumatic experience. Intrusive rumination, by contrast, is linked to poorer outcomes. This study explored HNC survivors’ experiences of rumination.MethodsTwenty HNC survivors between 9 months and 5 years post-diagnosis were recruited. They had a range (...) of HNC sub-types and cancer treatments. Participants underwent a semi-structured interview about their cancer diagnosis and treatment. Reflexive thematic analysis identified themes and sub-themes around rumination.ResultsFour themes with linked subthemes on the content and process of rumination were identified. Theme 1 was rumination and worry related to diagnosis. Here, survivors discussed how the HNC diagnosis and plans for treatment had dominated their initial thoughts. Theme 2 was processing the trauma of HNC. This theme reflected rumination on the traumatic experience of diagnosis and treatment and how the participant was reacting to it. Theme 3 was considering the impact. This theme encompassed retrospective thinking and comparisons between the participant now versus the early days after diagnosis. Theme 4 was continued rumination. This theme included ongoing intrusive and distressing rumination about the trauma and impact of cancer. Those who expressed ongoing rumination revisited fears or returned to negative experiences.ConclusionThis study uniquely describes the nature and content of rumination following HNC. Early intrusive rumination is common and may reflect perceptions of cancer as an existential threat. Over time, rumination can become more reflective and move towards deliberate meaning-making. Some HNC survivors may benefit from interventions to reduce barriers to this transition. The content of distressing and difficult to control rumination helps to identify those who may benefit from more directed psychological support. (shrink)

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

Factive mental states, such as knowing or being aware, can only link an agent to the truth; by contrast, nonfactive states, such as believing or thinking, can link an agent to either truths or falsehoods. Researchers of mental state attribution often draw a sharp line between the capacity to attribute accurate states of mind and the capacity to attribute inaccurate or “reality-incongruent” states of mind, such as false belief. This article argues that the contrast that really matters for mental (...) state attribution does not divide accurate from inaccurate states, but factive from nonfactive ones. (shrink)

It has become almost commonplace to claim that utilitarianism was, from its inception, an imperialist theory. Many writers, from Bentham’s own followers to recent scholars, have suggested that from Bentham onward, utilitarians reveled in the opportunity that they believed despotic power provided for the establishment of perfectly rational laws and institutions. A closer look at Bentham’s own views on empire, however, reveals a sharp break between his position on European colonies and that of followers such as James and John (...) Stuart Mill. For Bentham, the utilitarian doctrine led to criticisms of the empires of his day. Bentham is better understood as a participant in the late-eighteenth-century skepticism about imperial conquests and aspirations than he is as a proto-colonialist or a “Solon” of India. Once he is understood in this light, our picture of his successors, especially J. S. Mill, is revised as well. (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)

"You have to come to my wedding," Kavita told me, turning to face me where I sat next to her on the couch. "You can come with the other people from the street. You will get everything you need for your *research* there." "I will come, I will come!" I replied enthusiastically. I had only met Kavita and her two younger sisters, Arthi and Deepti (see Figure 2.1), mere minutes before this invitation was extended. I had initially come to Pulan (...) that day in October 2012 to meet another woman, Heena, whose family rents a room on the third story of Kavita's family's home. Heena and I had been sitting in the furniture refurbishing store she operates with her husband on the main street of Pulan when Deepti, Kavita's youngest sister, passed by. Heena introduced us and told me to go with Deepti to meet her family. When we reached the family's three-story house-the largest in the gali-Deepti led me past the empty rooms on the ground floor, which I would eventually begin renting, to the second-story living room. There, we found Kavita and Arthi organizing clothing and jewelry they had purchased earlier in the day for the upcoming wedding festivities. Kavita made room for me to sit next to her on the couch and began asking me about myself. I immediately warmed to her because of her open, friendly smile and sharp, staccato Hindi, which I delighted in being able to understand. I explained that I had come to India to study how women's lives are different in rural and urban areas, and Kavita assured me that she and her family could help. She noted that her parents had come to Udaipur from Ram Nagar, a large village thirty-five kilometers north of the city, and that the family would be returning for her and her older brother Krishna's weddings the following month. Their weddings would be held five days apart to help reduce the difficulties of family members traveling from outside Udaipur. Prompted by the description of my research, Kavita commented on differences that she recognized between the village and the city. The biggest difference, she suggested, was the experience of caste, namely that in the village, people from different jatis live separately, whereas in the city, people are "mixed." As I would come to learn when visiting Ram Nagar for various functions, there is a fair amount of caste and religious diversity in the village. Although spatial and ritual segregation was rather strictly maintained during religious observances, it is likely more flexible in everyday life. The segregation during ritual functions-the occasions for which Kavita also traveled to the village-likely informed her sense of a lack of "mixing" in the village as. The majority of residents in the area of Ram Nagar where the family maintains a home were also from the Mali (lit: gardener) jati, although Mali was not a majority jati in Pulan. (shrink)

Risk analysis and regulatory systems are usually evaluated according to utilitarian frameworks, as they are viewed to operate “objectively” by considering the health, environmental, and economic impacts of technological applications. Yet, the estimation of impacts during risk analysis and the decisions in regulatory review are affected by value choices of actors and stakeholders; attention to principles such as autonomy, justice, and integrity; and power relationships. In this article, case studies of biotechnology are used to illustrate how non-utilitarian principles are prominent (...) in risk analysis and regulatory review and to argue that these relationships should be carefully considered as we consider nanotechnology oversight systems for its products. We argue that there are not distinct separations between “science-based” review systems, in which evaluations of the consequences of technological products are primarily considered, and principles of integrity, justice, non-maleficence, and autonomy. It should further be expected that, given research into fair treatment during decision-making processes, attention to ethics will affect how citizens assess emerging technologies. Finally, a more holistic approach for evaluating oversight systems for the products of nanotechnology is suggested, one which does not draw a sharp distinction between risk analysis, regulation, and respect for non-utilitarian values. (shrink)

Just as it is impossible to understand the American religious landscape without some familiarity with evangelicalism, one cannot grasp the shape of contemporary Christian ethics without knowing the contributions of evangelical Protestants. This newest addition to the Library of Theological Ethics series begins by examining the core dynamic with which all evangelical ethics grapples: belief in an authoritative, inspired, and unchanging biblical text on the one hand, and engagement with a rapidly evolving and increasingly post-Christian culture on the other. It (...) explores the different roles that scholars and popular figures have played in forming evangelicals' understandings of Christian ethics. And it draws together the contributions of both senior and emerging figures in painting a portrait of this diverse, vibrant, and challenging theological and ethical tradition. This book represents the breadth of evangelical ethical voices, demonstrating that evangelical ethics involves nuance and theological insight that far transcend any political agenda. Contributors include David P. Gushee, Carl F. H. Henry, Jennifer McBride, Stephen Charles Mott, William E. Pannell, John Perkins, Soong-Chan Rah, Gabriel Salguero, Francis Schaeffer, Ron Sider, Helene Slessarev-Jamir, Glen H. Stassen, Eldin Villafañe, Allen Verhey, Jim Wallis, Nicholas Wolterstorff, and John Howard Yoder. The Library of Theological Ethics series focuses on what it means to think theologically and ethically. It presents a selection of important, and otherwise unavailable, texts—English-language texts and translations that have fallen out of print, new translations, and collections of significant statements about problems and themes of special importance—in an easily accessible form. This series enables sustained dialogue on new and classic works in the field. (shrink)

We consider whether given a simple, finite description of a group in the form of an algorithm, it is possible to algorithmically determine if the corresponding group has some specified property or not. When there is such an algorithm, we say the property is recursively recognizable within some class of descriptions. When there is not, we ask how difficult it is to detect the property in an algorithmic sense. We consider descriptions of two sorts: first, recursive presentations in terms of (...) generators and relators, and second, algorithms for computing the group operation. For both classes of descriptions, we show that a large class of natural algebraic properties, Markov properties, are not recursively recognizable, indeed they are \-hard to detect in recursively presented groups and \-hard to detect in computable groups. These theorems suffice to give a sharp complexity measure for the detection problem of a number of typical group properties, for example, being abelian, torsion-free, orderable. Some properties, like being cyclic, nilpotent, or solvable, are much harder to detect, and we give sharp characterizations of the corresponding detection problems from a number of them. We give special attention to orderability properties, as this was a main motivation at the beginning of this project. (shrink)

The account of the death of Patroklos occupies a strategic position in the narrative economy of the Iliad: before this event, Achilles has withdrawn from combat out of indignation against Agamemnon; afterwards, his anger turns against Hector, whom he holds responsible for his friend's death. Achilles returns to battle and kills Hector in an act of vengeance that, as we have known from the beginning of the poem, will lead to his own demise, which is not actually recounted in the (...) Iliad. This episode stands out because it is atypical both in the contents of the narration and in the means of expression used (what are generally termed “formulas”). I will give some examples of these oddities and then propose an interpretation. Here is the text, in the translation by Richmond Lattimore:So long as the sun was climbing still to the middle heaven, so long the thrown weapons of both took hold, and men dropped under them; but when the sun had gone to the time for unyoking of cattle, then beyond their very destiny the Achaians were stronger and dragged the hero Kebriones from under the weapons and the clamour of the Trojans, and stripped the armour from his shoulders. And Patroklos charged with evil intention in on the Trojans. Three times he charged in with the force of the running war god, screaming a terrible cry, and three times he cut down nine men; but as for the fourth time he swept in, like something greater than human, there, Patroklos, the end of your life was shown forth, since Phoibos came against you there in the strong encounter dangerously, nor did Patroklos see him as he moved through the battle, and shrouded in a deep mist came in against him and stood behind him, and struck his back and his broad shoulders with a flat stroke of the hand so that his eyes spun. Phoibos Apollo now struck away from his head the helmet four-horned and hollow-eyed, and under the feet of the horses it rolled clattering, and the plumes above it were defiled by blood and dust. Before this time it had not been permitted to defile in the dust this great helmet crested in horse-hair; rather it guarded the hear and the gracious brow a godlike man, Achilleus; but now Zeus gave it over to Hektor to wear on his head, Hektor whose own death was close to him. And in his hands was splintered all the huge, great, heavy, iron-shod, far-shadowing spear, and away from his shoulders dropped to the ground the shield with its shield sling and its tassels. The lord Apollo, son of Zeus, broke the corselet upon him. Disaster caught his wits, and his shining body went nerveless. He stood stupidly, and from close behind his back a Dardanian man hit him between the shoulders with a sharp javelin: Euphorbos, son of Pantho(s, who surpassed all men of his own age with the throwing spear, and in horsemanship and the speed of his feet. He had already brought down twenty men from their horses since first coming, with his chariot and his learning in warfare. He first hit you with a thrown spear, o rider Patroklos, nor broke you, but ran away again, snatching out the ash spear from your body, and lost himself in the crowd, not enduring to face Patroklos, naked as he was, in close combat. (shrink)

Neoliberal cultural frames of individual choice inform mothers’ accounts of why they refuse state-mandated vaccines for their children. Using interviews with 25 mothers who reject recommended vaccines, this article examines the gendered discourse of vaccine refusal. First, I show how mothers, seeing themselves as experts on their children, weigh perceived risks of infection against those of vaccines and dismiss claims that vaccines are necessary. Second, I explicate how mothers see their own intensive mothering practices—particularly around feeding, nutrition, and natural living—as (...) an alternate and superior means of supporting their children’s immunity. Third, I show how they attempt to control risk through management of social exposure, as they envision disease risk to lie in “foreign” bodies outside their networks, and, therefore, individually manageable. Finally, I examine how these mothers focus solely on their own children by evaluating—and often rejecting—assertions that their choices undermine community health, while ignoring how their children benefit from the immunity of others. By analyzing the gendered discourse of vaccines, this article identifies how women’s insistence on individual maternal choice as evidence of commitment to their children draws on and replicates structural inequality in ways that remain invisible, but affect others. (shrink)

This essay will focus on the moral issues relating to surrogacy in the global context, and will critique the liberal arguments that have been offered in support of it. Liberal arguments hold sway concerning reproductive arrangements made between commissioning couples from wealthy nations and the surrogates from socioeconomically weak backgrounds that they hire to do their reproductive labor. My argument in this paper is motivated by a concern for controlling harms by putting the practice of globalized commercial surrogacy into the (...) context of care ethics. As I will argue, the unstable situations into which children of global surrogacy arrangements are born is symbolic of the crisis of care that the practice raises. Using the Baby Manji case as my touch point, I will suggest that liberalism cannot address the harms experienced by Manji and children like her who are created through the global practice of assisted reproductive technology. I will argue that, if commissioning couples consider their proposed surrogacy contracts from a care ethics point of view, they will begin to think relationally about their actions, considering the practice from an ethical lens, not just an economic or contractual one. (shrink)

The ethical naturalist asks us to take seriously the idea that practical norms are a species of natural norms, such that moral goodness is a kind of natural goodness. The ethical naturalist has not demonstrated, however, how it is possible for a power of reason to be governed by natural norms, because her own attempts to do this have led her into a dilemma. If she takes the first horn and stresses that ethical naturalism provides objective, natural norms of the (...) species, then she fails to show how such norms are practical, or operative from a deliberative point of view. If she takes the second horn and stresses that ethical naturalism yields a picture of knowledge of human life that is practical because it comes through virtuous dispositions of intellect and will, then she fails to have an account of how it is knowledge of facts about a life form, potentially accessible to a non-human knower. In this paper, I argue that one potential resolution to this dilemma can be found in the writings of Thomas Aquinas. On a broadly Thomist account of practical reason, the first principles of practical reason are our common human ends or goods, which are constitutive of a good human life. The work of practical reason on this naturalistic account is twofold: to conceive and order these ends into some general conception of how to live, and to apply this general conception to the particular situations of one’s life in order to realize one’s vision of the good life, here and now. (shrink)

Behavioural evidence suggests that cephalopod molluscs may have a form of primary consciousness. First, the linkage of brain to behaviour seen in lateralization, sleep and through a developmental context is similar to that of mammals and birds. Second, cephalopods, especially octopuses, are heavily dependent on learning in response to both visual and tactile cues, and may have domain generality and form simple concepts. Third, these animals are aware of their position, both within themselves and in larger space, including having a (...) working memory of foraging areas in the recent past. Thus if using a ‘global workspace’ which evaluates memory input and focuses attention is the criterion, cephalopods appear to have primary consciousness. (shrink)

This article examines the case of institutional inertia in Japanese financial regulation, focusing on the reasons why institutions centered on informal modes of organization and interaction proved particularly The Japanese case serves as a particularly tough test for theories of institutional adaptation and change because even crisis failed to produce timely institutional change. The paper argues that informal, exclusionary and opaque relational ties served as a functional substitute for formal regulation and promoted cooperative government-bank relationships in an earlier period. Yet, (...) when the informal attributes of the system began to impede the sound functioning of the financial system, the very opacity of these ties and the informational dynamics underlying them meant that the Diet and the general public were less than fully aware of the extent of dysfunction present as time went on. (shrink)

This paper treats the political and ethical issues associated with the new caretaking technologies. Given the number of feminists who have raised serious concerns about the future of care work in the United States, and who have been critical of the degree to which society “free rides” on women's caretaking labor, I consider whether technology may provide a solution to this problem. Certainly, if we can create machines and robots to take on particular tasks, we may lighten the care burden (...) that women currently face, much of which is heavy and repetitious, and which results in injury and care “burnout” for many female caretakers. Yet, in some contexts, I argue that high-tech robotic care may undermine social relationships, cutting individuals off from the possibility of social connectedness with others. (shrink)

Very little research into women farmers in developed countries has been produced by economists, but much of what has been studied by scholars in other disciplines has economic implications. This article reviews such research produced by scholars in all disciplines to explore to what extent women farmers are becoming more equal to men farmers and to suggest further contributions to the literature. As examples, topics that has been widely researched in developing countries but have received almost no attention in developed (...) countries include comparisons of men and women farmers’ productivity and their access to and use of resources. Discoveries in these and other areas will be important not only for their insights into the agricultural industry in developed countries, but also because they will inform, and be informed by, research on women farmers in developing countries. (shrink)

This essay revisits Elizabeth Anscombe's ‘Modern Moral Philosophy' with two goals in mind. The first is to recover and reclaim its radical vision, by setting forth a unified account of its three guiding theses. On the interpretation advanced here, Anscombe's three theses are not independently intelligible; their underlying unity is the perceived necessity of absolute prohibitions for any sound account of practical reason. The second goal is to show that Anscombe allows for a thoroughly unmodern sense of ‘moral' that applies (...) to human actions; the paper concludes with some reasons to think that this unmodern sense of ‘moral' is worthy of further philosophical attention and defense. (shrink)

Introduction -- From paideia to humanism -- Pietism and the problem of human craft (Menschen-Kunst) -- The harmonious harp-playing of humanity: J. G. Herder -- Ethical formation and the invention of the religion of art -- The rise of the Bildungsroman and the commodification of literature -- Authorship and its resignation in Goethe's Wilhelm Meister -- "The Bildung of self-consciousness itself towards science": Hegel.

Augustine famously claimed that the virtues of pagan Rome were nothing more than splendid vices. This critique reinvented itself as a suspicion of acquired virtue as such, and true Christian virtue has, ever since, been set against a false, hypocritical virtue alleged merely to conceal pride. _Putting On Virtue_ reveals how a distrust of learned and habituated virtue shaped both early modern Christian moral reflection and secular forms of ethical thought. Jennifer Herdt develops her claims through an argument of (...) broad historical sweep, which brings together the Aristotelian tradition as taken up by Thomas Aquinas with the early modern thinkers who shaped modern liberalism. In chapters on Luther, Bunyan, the Jansenists, Mandeville, Hume, Rousseau, and Kant, she argues that efforts to make a radical distinction between true Christian virtue and its tainted imitations actually created an autonomous natural ethics separate from Christianity. This secular value system valorized pride and authenticity, while rendering graced human agency less meaningful. Ultimately, _Putting On Virtue_ traces a path from suspicion of virtue to its secular inversion, from confession of dependence to assertion of independence. (shrink)

The perennial appeal of Kantian ethics surely lies in its conception of autonomy. Kantianism tells us that the good life is fundamentally about acting in accordance with an internal rather than an external authority: a good will is simply a will in agreement with its own rational, self-constituting law. In this paper, I argue against Kantian autonomy, on the grounds that it excessively narrows our concept of the good, it confuses the difference between practical and theoretical modes of knowing the (...) good, and it cannot respect the essential efficacy of the principles of practical reason. (shrink)

In this paper, I will argue that there is a deep connection between home-based care, technology, and the self. Providing the means for persons to receive care at home is not merely a kindness that respects their preference to be at home: it is an important means of extending their selfhood and respecting the unique selves that they are. Home-based technologies like telemedicine and robotic care may certainly be useful tools in providing care for persons at home, but they also (...) have important implications for sustaining selfhood in ways that are of value to individuals and those who care for them. I will argue, by appealing to Hilde Lindemann’s notion of “holding” persons’ identities in place, that technological interventions are not only useful tools for improving and sustaining health and good care at home, but that they may also help to extend our personal identities and relational capacities in ways that are practically and ethically good. Because of these important goods, I will claim that there is a prima facie moral duty to do this “holding” work and that it is best done by family members and loved ones who are well suited to the job because of their history and relationship with the individual that needs to be “held” in place. (shrink)

This paper applies a relational and familial ethic to address concerns relating to nursing home deaths and advance care planning during Covid‐19 and beyond. The deaths of our elderly in nursing homes during this pandemic have been made more complicated by the restriction of visitors even at the end of life, a time when families would normally be present. While we must be vigilant about preventing unnecessary deaths caused by coronavirus outbreaks in nursing homes, some deaths of our elders are (...) inevitable. Thus, it is essential that advanced care planning occurs in a way that upholds the familial and relational aspects of elders’ lives that often matter to them the most. We invoke concepts from feminist ethicists like Hilde Lindemann and Eva Kittay and introduce Avery Weisman and Thomas Hackett’s concept of “appropriate death” to suggest better ways of planning for those deaths of our elderly that cannot be avoided. Our hope is to allow for deaths that are as meaningful as possible for both the elderly and the family members who survive them. (shrink)

Mammals have an XX:XY system of chromosomal sex determination in which a small heterochromatic Y controls male development. The Y contains the testis determining factor SRY, as well as several genes important in spermatogenesis. Comparative studies show that the Y was once homologous with the X, but has been progressively degraded, and now consists largely of repeated sequences as well as degraded copies of X linked genes. The small original X and Y have been enlarged by cycles of autosomal addition (...) to one partner, recombination onto the other and continuing attrition of the compound Y. This addition–attrition hypothesis predicts that the pseudoautosomal region of the human X is merely the last relic of the latest addition. Genes (including SRY) on the conserved or added region of the Y evolved functions in male sex determination and differentiation distinct from the general functions of their X‐linked partners. Although the gonadogenesis pathway is highly conserved in vertebrates, its control has probably changed radically and rapidly in vertebrate – even mammalian – evolution. (shrink)

Research has shown that both physical exercise and cognitive training help to maintain cognition in older adults. The question is whether combined training might produce additive effects when the group comparisons are equated in terms of exercise intensity and modality. We conducted a systematic electronic search in MEDLINE, PsycInfo, and Cochrane Central Register of Controlled Trials databases to identify relevant studies published up to February 2021. Seven hundred and eighty-three effect sizes were obtained from 50 published intervention studies, involving 6,164 (...) healthy older adults, and submitted to a three-level meta-analysis. Results showed that combined training produced a small advantage in comparison to single cognitive training on executive functions, whereas both types of training achieved similar effects on attention, memory, language, processing speed, and global cognition. Combined training achieved higher training gains in balance than single physical training, indicating a transfer from cognitive training to balance. Performing cognitive and physical exercise simultaneously, and interactive training produced the largest gains in executive functions, speed, and global cognition, as well as the largest improvements in physical functions. Aerobic training was associated with higher effects in attention and fitness, whereas non-aerobic training produced larger effects in global cognition and balance. For all cognitive and physical outcomes, training resulted more advantageous when performed in a social context, even though individual training obtained similar results in balance as group training.Systematic Review Registration:www.crd.york.ac.uk/prospero/, identifier: CRD42020175632. (shrink)

Are women's requests for aid in dying honored more often than men's, or less? Feminist arguments can support conclusions either that gendered perceptions of women as self‐sacrificing predispose physicians to accede to women's requests to die — or that cultural understandings of women as not fully rational agents lead physicians to reject their requests as irrational.

Augustine famously claimed that the virtues of pagan Rome were nothing more than splendid vices. This critique reinvented itself as a suspicion of acquired virtue as such, and true Christian virtue has, ever since, been set against a false, hypocritical virtue alleged merely to conceal pride. _Putting On Virtue_ reveals how a distrust of learned and habituated virtue shaped both early modern Christian moral reflection and secular forms of ethical thought. Jennifer Herdt develops her claims through an argument of (...) broad historical sweep, which brings together the Aristotelian tradition as taken up by Thomas Aquinas with the early modern thinkers who shaped modern liberalism. In chapters on Luther, Bunyan, the Jansenists, Mandeville, Hume, Rousseau, and Kant, she argues that efforts to make a radical distinction between true Christian virtue and its tainted imitations actually created an autonomous natural ethics separate from Christianity. This secular value system valorized pride and authenticity, while rendering graced human agency less meaningful. Ultimately, _Putting On Virtue_ traces a path from suspicion of virtue to its secular inversion, from confession of dependence to assertion of independence. (shrink)

Neurosurgery for psychiatric disorders, also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to (...) set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law, what types of regulations are required, and how to approach international harmonization given the potential migration of researchers and patients. (shrink)

As the size of the published scientific literature has increased exponentially over the past 30 years, review articles play an increasingly important role in helping researchers to make sense of original research results. Literature reviews can be broadly classified as either “systematic” or “narrative”. Narrative reviews may be broader in scope than systematic reviews, but have been criticised for lacking synthesis and rigour. The submission of more scientific manuscripts requires more researchers acting as peer reviewers, which requires adding greater numbers (...) of new reviewers to the reviewing population over time. However, whereas there are many easily accessible guides for reviewers of primary research manuscripts, there are few similar resources to assist reviewers of narrative reviews. Here, I summarise why literature reviews are valued by their diverse readership and how peer reviewers with different levels of content expertise can improve the reliability and accessibility of narrative review articles. I then provide a number of recommendations for peer reviewers of narrative literature reviews, to improve the integrity of the scientific literature, while also ensuring that narrative review articles meet the needs of both expert and non-expert readers. (shrink)

In this book, McMahon argues that a reading of Kant’s body of work in the light of a pragmatist theory of meaning and language leads one to put community reception ahead of individual reception in the order of aesthetic relations. A core premise of the book is that neo-pragmatism draws attention to an otherwise overlooked aspect of Kant’s "Critique of Aesthetic Judgment," and this is the conception of community which it sets forth. While offering an interpretation of Kant’s aesthetic theory, (...) the book focuses on the implications of Kant’s third critique for contemporary art. McMahon draws upon Kant and his legacy in pragmatist theories of meaning and language to argue that aesthetic judgment is a version of moral judgment: a way to cultivate attitudes conducive to community, which plays a pivotal role in the evolution of language, meaning, and knowledge. (shrink)

Findings suggest a positive impact of bilingualism on cognition, including the later onset of dementia. However, it is not clear to what extent these effects are influenced by variations in attentional control demands in response to specific task requirements. In this study, 20 bilingual and 20 monolingual older adults performed a task-switching task under explicit task-cuing vs. memory-based switching conditions. In the cued condition, task switches occurred in random order and a visual cue signaled the next task to be performed. (...) In the memory-based condition, the task alternated after every second trial in a predictable sequence without presenting a cue. The performance of bilinguals did not vary across experimental conditions, whereas monolinguals experienced a pronounced increase in response latencies and error rates in the cued condition. Both groups produced similar switch costs and mixing costs, but bilinguals produced them with lower response latencies. The cognitive benefits of bilingualism seem not to apply to executive functions per se but to affect specific cognitive processes that involve task-relevant context processing. The present results suggest that lifelong bilingualism could promote in older adults a flexible adjustment to environmental cues, but only with increased task demands. However, due to the small sample size, the results should be interpreted with caution. (shrink)

Vaccine refusal has increasingly been the focus of public health concern. Rates of children who are up to date on vaccines have declined in recent years, and vaccine refusal has been implicated in disease outbreaks. Most research on children who are not fully immunized identifies white affluent mothers as most likely to opt out by choice and Black mothers as more likely to face structural barriers that limit access to vaccines for their children. In this paper, we analyze social media (...) posts and online discussions among Black mothers to better understand their concerns about vaccines. Unlike white women who reject vaccines as a personal choice, Black mothers express unique concerns about the role of the state in their lives. Specifically, some Black mothers using social media view vaccines as a white technology and claim that white women have greater freedom in opting out of vaccines without the same risks to their families. They describe efforts to strategize interactions with pediatricians and other healthcare providers who can report them to social service agencies or block access to welfare and nutritional benefits for their families if they refuse vaccines. Black women’s experiences with structural gendered racism in interactions with healthcare and education systems shape vaccine decisions and should be taken seriously. (shrink)

Tool use research has suffered from a lack of consistent theoretical frameworks. There is a plethora of tool use definitions and the most widespread ones are so inclusive that the behaviors that fall under them arguably do not have much in common. The situation is aggravated by the prevalence of anecdotes, which have played an undue role in the literature. In order to provide a more rigorous foundation for research and to advance our understanding of the interrelation between tool use (...) and cognition, we suggest the adoption of Fragaszy and Mangalam's (2018) tooling framework, which is characterized by the creation of a body-plus-object system that manages a mechanical interface between tool and surface. Tooling is limited to a narrower suite of behaviors than tool use, which might facilitate its neurocognitive investigation. Indeed, evidence in the literature indicates that tooling has distinct neurocognitive underpinnings not shared by other activities typically classified as tool use, at least in primates. In order to understand the extent of tooling incidences in previous research, we systematically surveyed the comprehensive tool use catalog by Shumaker et al. (2011). We identified 201 tool use submodes, of which only 81 could be classified as tooling, and the majority of the tool use examples across species were poorly supported by evidence. Furthermore, tooling appears to be phylogenetically less widespread than tool use, with the greatest variability found in the primate order. However, in order to confirm these findings and to understand the evolution and neurocognitive mechanisms of tooling, more systematic research will be required in the future, particularly with currently underrepresented taxa. (shrink)

As scholars integrate empirical approaches to ethical questions in healthcare, relational autonomy theory must inform research design and change practice. Qualitative approaches are well suited to issues where patient values play a central role, and they can be combined with relational autonomy theory to investigate the factors influencing autonomy-rich experiences. This paper draws upon my experience conducting bioethics research related to clinical trial decision-making to develop a systematic method for applying relational autonomy as a theoretical lens to qualitative health research. (...) The resultant practical guide utilizes Susan Sherwin’s theory of relational autonomy and presents an empirical method responsive to autonomy-relevant questions. (shrink)

Since 1997 there has been a significant increase in the number and percentage of Kansas farmers who are women. Using Reskin and Roos’ model of “job queues and gender queues” I analyze changes in the agricultural industry in Kansas that resulted in more women becoming “principal farm operators” in the state. I find there are three changes largely responsible for women increasing their representation in the occupation: an increase in the demand for niche products, a decrease in the average farm (...) size, and greater societal acceptance of women as farmers. This study adds to the growing literature on women principal farm operators in developed countries, and is among the first to explore why women are becoming a larger percentage of the occupation in the United States. (shrink)