Near ubiquitous use of electronic fetal monitoring (EFM) during low-risk childbirth constrains both maternal agency and maternal autonomy. An analysis of interdisciplinary literature about EFM reveals that its use cannot be understood apart from broader norms and values that have significant implications for the agency and autonomy of laboring women. Overreliance on EFM use for low-risk women threatens their autonomy in several ways: by privileging the status of the fetal patient, by delegitimizing women’s embodied experience of childbirth, and by constructing (...) EFM data as objective science despite evidence to the contrary. In birth situations defined as high-risk, however, EFM may lead to greater maternal agency by enabling women to choose vaginal over cesarean birth. Viewing doctor-patient interactions as a co-construction in the context of an understanding that sees EFM as a social as well as technological construction may improve autonomy in childbirth. (shrink)

Following decades of maltreatment of women in obstetric care, professional respect for maternal autonomy in obstetric decision making and care have become codified in global and national professional ethical guidelines. Yet, using the example of birth after cesarean, identifiable threats to maternal autonomy in obstetrics continue. This paper focuses on how current scientific knowledge and obstetric practice patterns factor into restricted maternal autonomy as evidenced in three representative maternal accounts obtained prior and subsequent to birth after cesarean. Short- and long-term (...) remedies to improve the current state of restricted maternal autonomy in clinical practice surrounding decision making on birth after cesarean are provided. (shrink)

IntroductionThis study reports the findings on how Child life specialists implemented an innovative approach to providing therapeutic support to pediatric patients.MethodsPart of a larger study that uncovered themes about CLSs’ experiences while working with MEDi®, this study reports the reflections that CLSs have about the process of implementation. Seven CLSs participated in semi-structured interviews. Content analysis was conducted on interview data and three themes were generated.ResultsThe first was in regards to the adoption process whereby CLS challenges, successes, and surprises were (...) revealed. Second, CLSs explained how using MEDi® aligned with the roles and responsibilities of their profession. The third area of understanding was in CLS explanation of the friendly emotional impact MEDi® seems to have on the hospital environment.ConclusionChild life specialists are encouraged to use the MEDi® robot to support children at the bedside. (shrink)

Aims: To describe individuals’ perceptions of the activities that take place within the cancer genetics clinic, the relationships between these activities and how these relationships are sustained. Design: Qualitative interview study. Participants: Forty individuals involved in carrying out cancer genetics research in either a clinical (n = 28) or research-only (n = 12) capacity in the UK. Findings: Interviewees perceive research and clinical practice in the subspecialty of cancer genetics as interdependent. The boundary between research and clinical practice is described (...) as vague or blurred, and this ambiguity is regarded as being sustained by a range of methodological, ethical and economic factors. The implications of these findings for the “therapeutic misconception” are explored. It is argued that while research participation is seen as having therapeutic benefit for individual patients, the interviewees are not labouring under any misconceptions about the relationship between research and clinical care. It is suggested that concepts such as the “therapeutic misconception” may have less relevance in highly technological specialities that are characterised by a developing evidence base. (shrink)

Integrated developmental and elemental information in teeth provide a unique framework for documenting breastfeeding histories, physiological disruptions, and neurotoxicant exposure in humans and our primate relatives, including ancient hominins. Here we detail our method for detecting the consumption of mothers’ milk and exploring health history through the use of laser ablation‐inductively coupled plasma‐mass spectrometry (LA‐ICP‐MS) mapping of sectioned nonhuman primate teeth. Calcium‐normalized barium and lead concentrations in tooth enamel and dentine may reflect milk and formula consumption with minimal modification during (...) subsequent tooth mineralization, particularly in dentine. However, skeletal resorption during severe illness, and bioavailable metals in nonmilk foods, can complicate interpretations of nursing behavior. We show that explorations of the patterning of multiple elements may aid in the distinction of these important etiologies. Targeted studies of skeletal chemistry, gastrointestinal maturation, and the dietary bioavailability of metals are needed to optimize these unique records of human health and behavior. (shrink)

Design: Qualitative interview study. Participants: Fifty-nine patients with a family history of cancer who attend a regional cancer genetics clinic in the UK were interviewed about their current and previous research experiences. Findings: Interviewees gave a range of explanations for research participation. These were categorised as social—research participation benefits the wider society by progressing science and improving treatment for everyone; familial—research participation may improve healthcare and benefit current or future generations of the participant’s family; and personal—research participation provides therapeutic or (...) non-therapeutic benefits for oneself. Conclusions: We discuss the distinction drawn between motives for research participation focused upon self and others, and observe that personal, social and familial motives can be seen as interdependent. For example, research participation that is undertaken to benefit others, particularly relatives, may also offer a number of personal benefits for self, such as enabling participants to feel that they have discharged their social or familial obligations. We argue for the need to move away from simple, static, individualised notions of research participation to a more complex, dynamic and inherently social account. (shrink)

Angiogenesis, the generation of new blood vessels from pre‐existing vessels, is an integral component of wound healing, responses to inflammation and other physiologic processes. It is also an essential part of tumor growth; in the absence of new vessel formation, tumors cannot expand beyond a small volume. Although much is known about angiogenesis and its regulation, there is no overall theory that describes or explains this process. It is here suggested that the intracrine hypothesis, which ascribes to certain extracellular signaling (...) peptides (whether hormones, growth factors, DNA‐binding proteins or enzymes) a role in both intracellular biology and extracellular signaling, can contribute to a more general understanding of angiogenesis. Intracrine factors participate in angiogenesis in the following ways: (1) they can act within the cells that synthesized them (type I intracrine action), (2) they can be secreted and then taken up by their cell of synthesis to act intracellularly (type II intracrine action ), or (3) they can be secreted and internalized by a distant target cell (type III intracrine action). The parallels between the intracrine growth factor mechanisms cancer cells employ in stimulating their own growth and the mechanisms operative in endothelial cell proliferation during angiogenesis (“intracrine reciprocity”) are discussed. Collectively, these explorations lead to testable hypotheses regarding the regulation of normal and pathological angiogenesis, and point to similarities between tumor‐induced angiogenesis and tissue differentiation. BioEssays 28: 943–953, 2006. © 2006 Wiley periodicals, Inc. (shrink)

How do we refer to people in everyday conversation? No matter the language or culture, we must choose from a range of options: full name ('Robert Smith'), reduced name ('Bob'), description ('tall guy'), kin term ('my son') etc. Our choices reflect how we know that person in context, and allow us to take a particular perspective on them. This book brings together a team of leading linguists, sociologists and anthropologists to show that there is more to person reference than meets (...) the eye. Drawing on video-recorded, everyday interactions in nine languages, it examines the fascinating ways in which we exploit person reference for social and cultural purposes, and reveals the underlying principles of person reference across cultures from the Americas to Asia to the South Pacific. Combining rich ethnographic detail with cross-linguistic generalizations, it will be welcomed by researchers and graduate students interested in the relationship between language and culture. (shrink)

How do educators better reach their students, better capture their attention and imagination without sacrificing scholarship? Teachable Moments: Essays on Experiential Education examines the pedagogy of Prescott College, a school that has embraced experiential education and been finding success with it for over thirty years. These essays—from scholars in fields as wide ranging as religious studies, environmental science, psychology, dance, literature, adventure education, and peace studies—examine the challenges and, ultimately, the rewards of student-centered education.

Aspects of human life history and cognition, such as our long childhoods and extensive use of teaching, theoretically evolved to facilitate the acquisition of complex tasks. The present paper empirically examines the relationship between subsistence task difficulty and age of acquisition, rates of teaching, and rates of oblique transmission among Hadza and BaYaka foragers from Tanzania and the Republic of Congo. We further examine cross-cultural variation in how and from whom learning occurred. Learning patterns and community perceptions of task difficulty (...) were assessed through interviews. We found no relationship between task difficulty, age of acquisition, and oblique transmission, and a weak but positive relationship between task difficulty and rates of teaching. While same-sex transmission was normative in both societies, tasks ranked as more difficult were more likely to be transmitted by men among the BaYaka, but not among the Hadza, potentially reflecting cross-cultural differences in the sexual division of subsistence and teaching labor. Further, the BaYaka were more likely to report learning via teaching, and less likely to report learning via observation, than the Hadza, possibly owing to differences in socialization practices. (shrink)

PURPOSE: To evaluate the effects of social support on comprehension and recall of consent form information in a study of Parkinson disease patients and their caregivers.DESIGN and METHODS: Comparison of comprehension and recall outcomes among participants who read and signed the consent form accompanied by a family member/friend versus those of participants who read and signed the consent form unaccompanied. Comprehension and recall of consent form information were measured at one week and one month respectively, using Part A of the (...) Quality of Informed Consent Questionnaire .RESULTS: The mean age of the sample of 143 participants was 71 years . Analysis of covariance was used to compare QuIC scores between the intervention group and control group . In the 1-week model, no statistically significant intervention effect was found . However, the intervention status by patient status interaction was statistically significant . In the 1-month model, no statistically significant intervention effect was found . Again, however, the intervention status by patient status interaction was statistically significant . At both time periods, intervention group patients scored higher on the QuIC than did intervention group caregivers, and control group patients scored lower on the QuIC than did control group caregivers.IMPLICATIONS: Social support played a significant role in enhancing comprehension and recall of consent form information among patients. (shrink)

We prove the following results: (i) PV proves NP ⊆ P/poly iff PV proves coNP ⊆ NP/O(1). (ii) If PV proves NP ⊆ P/poly then PV proves that the Polynomial Hierarchy collapses to the Boolean Hierarchy. (iii) $S_{2}^{1}$ proves NP ⊆ P/poly iff $S_{2}^{1}$ proves coNP ⊆ NP/O(log n). (iv) If $S_{2}^{1}$ proves NP ⊆ P/poly then $S_{2}^{1}$ proves that the Polynomial Hierarchy collapses to PNP[log n]. (v) If $S_{2}^{2}$ proves NP ⊆ P/poly then $S_{2}^{2}$ proves that the Polynomial Hierarchy (...) collapses to PNP. Motivated by these results we introduce a new concept in proof complexity: proof systems with advice, and we make some initial observations about them. (shrink)

Metaphors for the encounter between God and humanity and a roaming theologian’s reflective journey. This article maps the theology of Christo van der Merwe as a mobilising theology which aided the Netherdutch Reformed Church in Africa in discerning its character, role and purpose. The core of Van der Merwe’s theology consists of a journey with God as encountered in the narratives about Jesus and the Spirit told in the Christian Bible. The article shows that the mobilising core of his theology (...) is due to an ‘interoperational relationship’ between ‘knowing and believing’. In the article, the metaphor ‘roaming’ is used to illustrate this biographical journey as contextual theology which equips pastors with ministerial skills to take care of people who are haunted by trauma. (shrink)

Exception from Informed Consent (EFIC) regulations detail specific circumstances in which Institutional Review Boards (IRB) can approve studies where obtaining informed consent is not possible prior to subject enrollment.To better understand how IRB members evaluate community consultation (CC) and public disclosure (PD) processes and results, semi-structured interviews of EFIC-experienced IRB members were conducted and analyzed using thematic analysis.Interviews with 11 IRB members revealed similar approaches to reviewing EFIC studies. Most use summaries of CC activities to determine community members’ attitudes; none (...) reported using specific criteria nor recalled any CC reviews that resulted in modifications to or denials of EFIC studies. Most interviewees thought metrics based on Community VOICES’s domains (feasibility, participant selection, quality of communication, community perceptions, investigator/IRB perceptions) would be helpful.IRB members had similar experiences and concerns about reviewing EFIC studies. Development of metrics to assess CC processes may be useful to IRBs reviewing EFIC studies. (shrink)

The radical nub of Byrne & Russon's argument is that passive priming effects can produce much of the evidence of higher-order cognition in nonhuman primates. In support of their position we review evidence of similar behavioral priming effects n humans. However, that evidence further suggests that even program-level imitative behavior can be produced through priming.

The grammar of faith language in the Canons of Dordt as a result of the nation-state ideology. This article aims to decipher the spirit of the notion ‘predestination’ codified in the Canons of Dordt. It reconsiders the relevance of these dogmatic propositions about predestination as a grammar of the faith language which originated in a very specific context, namely the political concerns and the religious convictions held in the uniting Dutch provinces as a nation-state. In this context Calvin’s views about (...) predestination became instrumental to the establishment of an upcoming nationalistic ideology, based on different interpretations and perceptions of Calvin’s theology. Within the context of the Protestant Dutch resistance against the RomanCatholic Spanish-Habsburg hegemony, the Canons were formulated during the Synod of Dordrecht in 1618–1619 as a Calvinistic movement against the Remonstrants who were stigmatised as collaborators of the Spanish-Habsburg reign over the Netherlands. This article demonstrates that different receptions of Dordt heighten the dogmatic gap between the socalled liberal modernism of the Remonstrants and a strict confessionalism of neo-Calvinism which has influenced the present-day understanding of the Canons of Dordt. It is argued that the grammar of the Canons of Dordt needs to be understood against this background and the meaning of the faith language it reflects, interpreted accordingly. (shrink)

In hierdie hoofstuk word Jürgen Moltmann se bydrae tot Reformatoriese teologie ondersoek. Sy teologie kan beskryf word as 'n teologie wat Bybels gegrond is, 'n eskatologiese gerigtheid en 'n politieke verantwoordelikheid het. Dit is juis om hierdie rede dat sy teologie ook 'reformatories' is. Dit is 'n beskrywing waarvoor hy ook doelbewus kies, omdat die begrip 'reformatories' die dinamiese, voortgaande en profetiese karakter van Reformatoriese teologie aandui. Hierdie teologiese karakter kom veral na vore in Moltmann se verstaan van die Triniteitsleer (...) en sy trinitariese teologie, wat beskryf kan word as 'n 'Trinitariese teologie van solidariteit en sosiale geregtigheid.' Die lewensruimte van die Triniteit word deur Moltmann as 'wye ruimte' beskryf, en as 'n 'uitnodigende ruimte' waarin daar nie beknoptheid is nie. Binne die hoofstuk word dit geargumenteer dat Moltmann se Triniteitsteologie die hartklop is van sy bydrae tot Reformatoriese teologie. Dit is baie nou verbind aan sy politieke teologie en word geïllustreer op die wyse waarop sy Triniteitsteologie en sy politieke teologie van inklusiwiteit en geregtigheid met mekaar verweef is. (shrink)

The objective of this study is to describe researchers', health-care providers' and other stakeholders' views of ethical review and research governance procedures. The study design involved qualitative semi-structured interviews. Participants included 60 individuals who either undertook research in the subspecialty of cancer genetics (n = 40) or were involved in biomedical research in other capacities (n = 20), e.g. research governance and oversight, patient support groups or research funding. While all interviewees observed that oversight is necessary to protect research participants, (...) ethical review and research governance (ERG) arrangements were described negatively throughout these interviews. Interviewees identified a number of problems with ERG, including: over-bureaucratization, over-standardization of information requirements for different types of research, a lack of standardization in the types of information required by different committees for the same research and a lack of consistency in different committees' responses. A number of solutions were proposed including streamlining application procedures and harmonizing committees' responses and information requirements. Recent reports suggest that ethical review procedures and research governance arrangements threaten the possibility of undertaking clinical research in the UK, hence the introduction of the Integrated Research Application System (IRAS) is long overdue. However, while IRAS may solve some of the problems identified by interviewees, it remains to be seen to what extent it will impact upon the very negative perceptions of ethics and research governance procedures reported here. (shrink)

Fragments from Dinnaga. H. N. Randle. Motilal Banarsidass, Delhi 1981. xii + 93 pp. Rs. 40.

RÉSUMÉ : Dans son récent recueil d’articles Language, Truth and History, Donald Davidson semble pencher en faveur d’une philosophie du langage mettant l’accent sur la notion de l’intention communicative du sujet parlant; en quoi il se rapproche du point de vue de Paul Grice. Si cela est juste, la pensée de Davidson se serait dégagée de l’approche sémantique formelle qu’il soutenait dans ses Inquiries into Truth and Interpretation. Dans cet article, je soutiens que, bien qu’il y ait beaucoup de similitudes (...) entre ces deux penseurs, Davidson n’a pas abandonné ses précédentes vues sur le langage. (shrink)

SummaryI contend on both theoretical and historical grounds that quantitative risk assessment is relevant for policy determination only as a cost estimate. In particular, it provides a method for estimating the costs of a hypothetical insurance policy against the potential liabilities associated with a given course of action. It is not relevant to the question of rational choice under risk.RésuméJe montre, en partant d'arguments aussi bien théoriques qu'historiques, que le calcul quanti‐tatif des risques n'aide à la détermination d'une politique à (...) suivre qu'en tant qu'estimation des coûts. En particulier, il fournit une méthode pour estimer les primes d'une police hypothétique d'assurance contre les responsabilites potentielles associées à une suite donnée d'actions. 11 ne permet pas un choix rationnel dans des situations comportant des risques.ZusammenfassungIch argumentiere, sowohl aus theoretischen als auch aus historischen Gründen, dass eine quantitative Risikoberechnung für die Wahl einer Handlungsweise nur als Kostenschätzung relevant ist. Namentlich bietet sie eine Methode, um die Prämie einer Versicherungspolice gegen pot‐entielle Haftbarkeit, welche mit den Vorgängen eines Aktionsverlaufs verbunden ist, zu bestim‐men. Bei der Frage einer rationalen Wahl in einer Risikosituation ist sie nicht relevant. (shrink)

In What is Philosophy?, Deleuze and Guattari think the concept of concept otherwise. In keeping with Deleuze’s professed empiricism, he and Guattari study various concepts and ‘extract’ a new concept of the concept. This constructive method does not illuminate how and why their proposed concept differs from the traditional. This paper considers how Deleuze and Guattari’s concept does differ, as a first step towards arriving at some evaluation of their analysis.Dans Qu’est-ce que la philosophie?, Deleuze et Guattari pensent le concept (...) autrement. Tout en s’en tenant à I’empirismé avoué de Deleuze, ce dernier et Guattari analysent différents concepts et en ‘extraient’ un nouveau concept de concept. Cette méthode constructive n’éclaire cependant pas comment et pourquoi le concept qu’ils proposent diffère du concept traditionnel. Après avoir considéré la façon dont le concept de Deleuze et Guattari diffère en effet de I’acception traditionnelle, cet article pourra se pencher sur la question de I’évaluation de leur analyse. (shrink)

In What is Philosophy?, Deleuze and Guattari think the concept of concept otherwise. In keeping with Deleuze’s professed empiricism, he and Guattari study various concepts and ‘extract’ a new concept of the concept. This constructive method does not illuminate how and why their proposed concept differs from the traditional. This paper considers how Deleuze and Guattari’s concept does differ, as a first step towards arriving at some evaluation of their analysis.Dans Qu’est-ce que la philosophie?, Deleuze et Guattari pensent le concept (...) autrement. Tout en s’en tenant à I’empirismé avoué de Deleuze, ce dernier et Guattari analysent différents concepts et en ‘extraient’ un nouveau concept de concept. Cette méthode constructive n’éclaire cependant pas comment et pourquoi le concept qu’ils proposent diffère du concept traditionnel. Après avoir considéré la façon dont le concept de Deleuze et Guattari diffère en effet de I’acception traditionnelle, cet article pourra se pencher sur la question de I’évaluation de leur analyse. (shrink)