Obtaining consent for medical treatment in older adults raises a number of complex challenges. Despite being required by ethics and the law, consent for medical treatment is not always validly sought in this population. The dynamic nature of capacity, particularly in individuals who have dementia or other cognitive impairments, adds complexity to obtaining consent. Further challenges arise in ensuring that older people comprehend the medical treatment information provided and that consent is not vitiated by coercion or undue influence. Existing mechanisms (...) to address issues surrounding consent for older adults only address incapacity and raise further challenges. As the ageing population increases, these issues are likely to become more profound, thus action is required to address these challenges. Raising awareness, more education, engaging with people with dementia, and conducting further research would assist in beginning to overcome these challenges. (shrink)

L’excellent ouvrage de Pascale Barthélémy constitue un nouveau titre, très bienvenu, dans la floraison d’études dévolues à ce que Gregory Mann a appelé « la relation contrainte particulière » entre la France et l’Afrique. Pascale Barthélémy s’est penchée sur la petite minorité d’Africaines – à peine un millier au total – issues de la fédération d’Afrique Occidentale Française (AOF) et formées par les Français pour devenir sages-femmes, infirmières-visiteuses (jusqu’en 1938) ou encore institut...

En racontant de très belle manière la vie de Madame Luce, enseignante française et arabophone dans l’Algérie de la fin du xixe siècle, Rebecca Rogers enrichit les travaux, de plus en plus nombreux, sur les Européennes installées dans la colonie dans les premières décennies de la colonisation. Centré sur une femme ordinaire, qui a laissé peu de traces dans les archives publiques, ce travail est en réalité une étude plus large, consacrée à l’histoire sociale des changements de pratiques éducati...

In a recent study, female dispersal in nineteenth-century Sweden has been found to correlate negatively with access to resources: women with limited access to local resources tended to migrate more frequently. In this paper I review the literature to explore whether this observed correlation was derived from a relationship in which a woman’s limited access to resources worsened her position in the marriage market and led to migration, as a strategy to improve resources and this position. Many studies within a (...) variety of disciplines indicate that a woman’s propensity to disperse from her parish of birth variedinversely with her propensity to inherit resources. My review of the literature suggests that the less likely a woman was to inherit resources, the lower her probability of marriage, the later her expected age at marriage, and the earlier she left home, presumably to improve her resource base for marriage. (shrink)

Emerging adult newlywed couples often experience many demands on their time, and three common problems may surface as couples try to balance these demands—problems related to finances, sleep, and sex. We used two waves of dyadic data from 1,001 emerging adult newlywed couples to identify four dyadic latent profiles from husbands’ and wives’ financial management behaviors, sexual satisfaction, and sleep quality: Flounderers, Financially Challenged Lovers, Drowsy Budgeters, and Flourishers. We then examined how husbands’ and wives’ marital satisfaction, in relation to (...) profile membership, varied at a later wave. We found that Financially Challenged Lovers and Flourishers had significantly higher marital satisfaction than Drowsy Budgeters and Flounderers. Whereas, Financially Challenged Lovers and Flourishers did not differ in terms of marital satisfaction, Drowsy Budgeters seemed to have slightly higher marital satisfaction than Flounderers for wives only. However, we did not find evidence that these connections meaningfully differed by sex. Implications for the efforts of clinicians and educators are discussed. (shrink)

This article explores the issue of girls’ concerns about sexual activity in a liberal Nordic context. Drawing on ethnographic fieldwork among young people in Denmark, the article identifies three types of concerns girls can have about sexual activity: social expectations, relational expectations and dignity. Whilst contemporary research has tended to focus on the influence different sexual morality discourses have in shaping different expectations and concerns about these, little attention seems to be paid to girls’ normative concerns about sex related to (...) well-being. This article sheds light on how these normative concerns are related to girls’ sense of dignity based on Andrew Sayer’s work on dignity and moral sentiments. Finally, the article argues that tension between sexual morality discourses and moral sentiments may be the source of resistance that girls practise with a new ‘fuckboy’ discourse. (shrink)

ABSTRACTPast research reveals important connections between meditative practices and compassion. Most studies, however, focus on the effects of one type of meditation (vs. a no-intervention control...

Hospitals long ago shed their role as alms houses for the poor. What vestiges remain of the early American hospital are the tax-exempt, nonprofit hospital form and a general perception that hospitals, as charitable institutions, owe a duty to their communities. The appropriateness of the nonprofit hospital tax exemption has long been debated, and many theories have been advanced to justify the tax exemption of nonprofit hospitals. In a growing number of jurisdictions, however, state and local authorities have gone beyond (...) the theoretical debate and are challenging the tax exemption of their nonprofit hospitals. For various reasons, efforts are afoot to capture greater community benefit from nonprofit hospitals.At the heart of such challenges is the debate over the nature and extent of the duty charitable institutions owe to their communities. A demand is growing for nonprofit hospitals to earn their tax exemptions by benefiting their communities in concrete ways. Some have been stripped of their tax-exempt status by local authorities or pressured to make payments in lieu of taxes. A number of states have recently implemented initiatives in an attempt to make hospitals more accountable for their community benefits. Many hospitals are responding to this heightened scrutiny in a proactive way, by voluntarily documenting community benefits. A number of nonprofit hospitals and hospital associations are cooperating with—or even sponsoring—state legislation in this area. (shrink)

Hospitals long ago shed their role as alms houses for the poor. What vestiges remain of the early American hospital are the tax-exempt, nonprofit hospital form and a general perception that hospitals, as charitable institutions, owe a duty to their communities. The appropriateness of the nonprofit hospital tax exemption has long been debated, and many theories have been advanced to justify the tax exemption of nonprofit hospitals. In a growing number of jurisdictions, however, state and local authorities have gone beyond (...) the theoretical debate and are challenging the tax exemption of their nonprofit hospitals. For various reasons, efforts are afoot to capture greater community benefit from nonprofit hospitals.At the heart of such challenges is the debate over the nature and extent of the duty charitable institutions owe to their communities. A demand is growing for nonprofit hospitals to earn their tax exemptions by benefiting their communities in concrete ways. Some have been stripped of their tax-exempt status by local authorities or pressured to make payments in lieu of taxes. A number of states have recently implemented initiatives in an attempt to make hospitals more accountable for their community benefits. Many hospitals are responding to this heightened scrutiny in a proactive way, by voluntarily documenting community benefits. A number of nonprofit hospitals and hospital associations are cooperating with—or even sponsoring—state legislation in this area. (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)

Background: The factors influencing parents’ willingness to enroll their children in biobanks are poorly understood. This study sought to assess parents’ willingness to enroll their children, and their perceived benefits, concerns, and information needs under different consent and data-sharing scenarios, and to identify factors associated with willingness. Methods: This large, experimental survey of patients at the 11 eMERGE Network sites used a disproportionate stratified sampling scheme to enrich the sample with historically underrepresented groups. Participants were randomized to receive one of (...) three consent and data-sharing scenarios. Results: In total, 90,000 surveys were mailed and 13,000 individuals responded (15.8% response rate). 5737 respondents were parents of minor children. Overall, 55% (95% confidence interval 50–59%) of parents were willing to enroll their youngest minor child in a hypothetical biobank; willingness did not differ between consent and data-sharing scenarios. Lower educational attainment, higher religiosity, lower trust, worries about privacy, and attitudes about benefits, concerns, and information needs were independently associated with less willingness to allow their child to participate. Of parents who were willing to participate themselves, 25% were not willing to allow their child to participate. Being willing to participate but not willing to allow one’s child to participate was independently associated with multiple factors, including race, lower educational attainment, lower annual household income, public health care insurance, and higher religiosity. Conclusions: Fifty-five percent of parents were willing to allow their youngest minor child to participate in a hypothetical biobank. Building trust, protecting privacy, and addressing attitudes may increase enrollment and diversity in pediatric biobanks. (shrink)

Quality improvement (QI) is fundamental to maintaining high standards of health care. Significant debate exists concerning the necessity for an ethical approval system for those QI projects that push the boundaries, appearing more similar to research than QI. The authors discuss this issue identifying the core ethical issues in family medicine (FM), drawing upon the fundamental principles of medical ethics, including principles of autonomy, utility, justice and non-maleficence. Recent debate concerning the application of QI ethics boards is discussed with relevance (...) to primary care and issues such as general practitioner (GP) intentions, the impact of QI on patients and the use of confidential patient data and the impact of dissemination. The authors conclude that a system of QI ethical approval leaves many issues unresolved and potentially creates several barriers to implementing QI. To ensure ethical QI work is generated within FM it is essential for GPs to learn about and engage in more ethical reflection so that they can better judge and resolve these issues. (shrink)

The threat to the survival of humankind posed by nuclear weapons has been a frightening and essential focus of public debate for the last four decades and must continue to be so if we are to avoid destroying ourselves and the natural world around us. One unfortunate result of preoccupation with the nuclear threat, however, has been a new kind of "respectability" accorded to conventional war. In this radical and cogent argument for pacifism, Robert Holmes asserts that all war--not (...) just nuclear war--has become morally impermissible in the modern world. Addressing a wide audience of informed and concerned readers, he raises dramatic questions about the concepts of "political realism" and nuclear deterrence, makes a number of persuasive suggestions for nonviolent alternatives to war, and presents a rich panorama of thinking about war from St. Augustine to Reinhold Niebuhr and Herman Kahn. Holmes's positions are compellingly presented and will provoke discussion both among convinced pacifists and among those whom he calls "militarists." "Militarists," we realize after reading this book, include the majority of us who live a friendly and peaceful personal life while supporting a system which, if Holmes is correct, guarantees war and risks eventual human extinction. Originally published in 1989. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)