Local food systems can have economic and social benefits by providing income for producers and improving community connections. Ongoing global climate change and the acute COVID-19 pandemic crisis have shown the importance of building equity and resilience in local food systems. We interviewed ten stakeholders from organizations and institutions in a U.S. midwestern city exploring views on past, current, and future conditions to address the following two objectives: 1) Assess how local food system equity and resilience were impacted by the (...) COVID-19 pandemic, and 2) Examine how policy and behavior changes could support greater equity and resilience within urban local food systems. We used the Community Capitals Framework to organize interviewees’ responses for qualitative analyses of equity and resilience. Four types of community capital were emphasized by stakeholders: cultural and social, natural, and political capital. Participants stated that the local food system in this city is small; more weaknesses in food access, land access, and governance were described than were strengths in both pre- and post-pandemic conditions. Stakeholder responses also reflected lack of equity and resilience in the local food system, which was most pronounced for cultural and social, natural and political capitals. However, local producers’ resilience during the pandemic, which we categorized as human capital, was a notable strength. An improved future food system could incorporate changes in infrastructure (e.g., food processing), markets (e.g., values-based markets) and cultural values (e.g., valuing local food through connections between local producers and consumers). These insights could inform policy and enhance community initiatives and behavior changes to build more equitable and resilient local food systems in urban areas throughout the U.S. Midwest. (shrink)

Although medical providers rely on similar tools to “treat” intersex and trans individuals, their enactment of medicalization practices varies. To deconstruct these complexities, we employ a comparative analysis of providers who specialize in intersex and trans medicine. While both sets of providers tend to hold essentialist ideologies about sex, gender, and sexuality, we argue they medicalize intersex and trans embodiments in different ways. Providers for intersex people are inclined to approach intersex as an emergency that necessitates medical attention, whereas providers (...) for trans people attempt to slow down their patients’ urgent requests for transitioning services. Building on conceptualizations of “giving gender,” we contend both sets of providers “give gender” by “giving sex.” In both cases too, providers shift their own responsibility for their medicalization practices onto others: parents in the case of intersex, or adult recipients of care in the case of trans. According to the accounts of most providers, successful medical interventions are achieved when a person adheres to heteronormative gender practices. (shrink)

When a group does harm, sometimes there’s no obvious individual who bears moral responsibility, and yet we still intuit that someone is to blame. This apparent ‘deficit’ of moral responsibility has led some scholars to posit that groups themselves can be responsible, and that this responsibility is distributed in some uniform fashion among group members. This solution to the deficit, however, risks providing a scapegoat for individuals who have acted wrongly and shifting blame onto those who have not. Instead, this (...) article argues that, in most deficit cases, moral responsibility is borne not by the group but by specific individual members. When an individual acts within a group, she gains an increased potential for doing harm – and, accordingly, heightened duties of care toward others. These duties can, depending on the individual’s position, require amending the group’s rules, procedures, and norms. In most deficit cases, it is individuals who have failed to fulfill these duties who are responsible. (shrink)

During the Philippine-American War, the Anti-Imperialist League was the organizational vanguard of an anti-imperialist movement. Research on this period of U.S. imperialism has focused on empire building, ignoring the gendered activity of anti-imperialists in the metropole. The author outlines the constitutive relationship between gendered structures and experience that informed anti-imperialists' “contentious politics,” using archival sources of the Anti-Imperialist League and anti-imperialist debates in newspapers. The author shows how anti-imperialist leaders informally included women's monetary donations, labor, networks, and reputations while formally (...) excluding their full membership. Finally, the author shows how masculinist ambivalence, or the pattern of the gendered inclusions/exclusions of anti-imperialists, explains the incremental transformations and reproductions of gendered structures in anti-imperialists' contentious politics. The author suggests masculinist ambivalence has theoretical utility for explaining gendered inclusions and exclusions in movements that are not explicitly about gender conflict or change. (shrink)

The Cistercian order, which had its origins in the late eleventh century, transformed the spiritual landscape of western Europe. The order's insistence on a return to the austerity and simplicity that had originally informed Benedictine life reenergized monasticism, spawning hundreds of new abbeys within decades. By the beginning of the thirteenth century, the Cistercians dominated monastic life, surpassing their black-robed predecessors in terms of popularity and replacing them among patrons as favored recipients of donations. Yet, while a sizable body of (...) historiography exists concerning the ability of men's houses to translate this appeal into spiritual and material success, questions remain regarding the order's female members. In particular, some scholars have constructed a narrative of financial difficulties and eventual decline for Cistercian nunneries, one that began in the thirteenth century and accelerated throughout the late Middle Ages. According to this narrative, such difficulties, by-products of the secondary status of religious women, manifested themselves in small monastic complexes and limited patrimonies. In her work on English Cistercians, Sally Thompson argues that religious women were dependent upon men because of their inferior position in medieval society and generally lacked a true religious vocation, characteristics that led to smaller, impoverished houses. Cistercian nunneries are portrayed in monastic histories as constantly struggling and are often “lumped together as being poor, scandalous, passive institutions which were eschewed by medieval patrons.” The majority of their houses are characterized by modern historians as enjoying a perilous existence at best, permanently poised on the brink of extinction and beset by a host of financial and spiritual difficulties. (shrink)

Although written consent forms are standard in clinical research, there is little regulatory or empirical guidance regarding how to most effectively review consent forms with potential participants. We developed an algorithm for embedding five questions with corrective feedback while reading consent forms with potential participants, and then applied it in the context of seven clinical research studies. A substantial proportion of participants within each protocol displayed initially inadequate responses to at least one question, but after the protocol elements were explained (...) again, most people demonstrated adequate understanding of them. These data illustrate the need for more attention not just to the content of consent forms, but also to the manner in which the forms are incorporated into the consent process. Embedding explicit inquiries about key protocol elements during consent form review and giving corrective feedback appears to be a simple yet effective way to foster better understanding of disclosed information. (shrink)

Although online education is becoming increasingly commonplace in health professional education, methods to evaluate student progress and knowledge base adequately remain uncertain. This paper describes a project that attempted to assess whether or not an online course was an effective way to teach applied ethics to students preparing for the health professions by qualitatively analyzing responses to a pre-test and post-test administered to students in the course. While previous studies have reported various findings regarding the success of online ethics courses, (...) our study failed to demonstrate that students gained a greater understanding of key concepts in ethics—respect for autonomy, decisional capacity, informed consent, and role of the provider. Our findings demonstrate the need for better subjective methods of evaluation and raise questions regarding the efficacy of current models of online ethics courses for health professional students. (shrink)

Background: This study attempts to understand if medical providers beliefs about the moral permissibility of honoring patient-directed refusals of life-sustaining treatment (LST) are tied to their beliefs about the patient’s decision-making capacity. The study aims to answer: 1) does concern about a patient’s treatment decision-making capacity relate to beliefs about whether it is morally acceptable to honor a refusal of LST, 2) are there differences between provider types in assessments of decision-making capacity and the moral permissibility to refuse LST, and (...) 3) do provider demographics impact beliefs about decision-making capacity and the moral permissibility to refuse LST. Methods: A mixed-methods survey using Likert assessment and vignette-based questions was administered to medical providers within a single health system in the upper Midwest (N = 714) to assess their perspectives on the moral acceptance and decision-making capacity in cases of withholding and withdrawing treatment and suicide. Results: Behavioral health providers report accepting of the moral permissibility of suicide (91.2%) more than either medical providers (77.2%) or surgeons (74.4%) (n = 283). Decision-making capacity was questioned more in the vignettes of the patients refusing life-saving surgery (36%) and voluntarily starvation (40.8%) than in the vignette of the patient requesting to deactivate a pacemaker (13%) (n = 283). Behavioral health providers were more concerned about the capacity to refuse life-saving surgery (55.9%) than medical providers (33.8%) or surgeons (23.1%) (n = 283). Conclusions: Respondents endorse the moral permissibility of persons to withhold or withdraw from treatment regardless of motive. Clinical concerns about a patient’s treatment decision-making capacity do not strongly correlate to views about the moral permissibility of honoring refusals of LST. Different provider types appear to have different thresholds for when to question treatment decision-making capacity. Behavioral health providers tend to question treatment decision-making capacity to refuse LST more than non-behavioral health providers. (shrink)

This article integrates research on gendered organizations and the work-family interface to investigate an innovative workplace initiative, the Results-Only Work Environment, implemented in the corporate headquarters of Best Buy, Inc. While flexible work policies common in other organizations “accommodate” individuals, this initiative attempts a broader and deeper critique of the organizational culture. We address two research questions: How does this initiative attempt to change the masculinized ideal worker norm? And what do women’s and men’s responses reveal about the persistent ways (...) that gender structures work and family life? Data demonstrate the ideal worker norm is pervasive and powerful, even as employees begin critically examining expectations regarding work time that have historically privileged men. Employees’ responses to ROWE are also gendered. Women are more enthusiastic, while men are more cautious. Ambivalence about and resistance to change is expressed in different ways depending on gender and occupational status. (shrink)

A limiting factor in ethics education in medical training has been difficulty in assessing competence in ethics. This study was conducted to test the concept that content analysis of pediatric residents’ personal reflections about ethics experiences can identify changes in ethical sensitivity and reasoning over time. Analysis of written narratives focused on two of our ethics curriculum’s goals: 1) To raise sensitivity to ethical issues in everyday clinical practice and 2) to enhance critical reflection on personal and professional values as (...) they affect patient care. Content analysis of written reflections was guided by a tool developed to identify and assess the level of ethical reasoning in eight domains determined to be important aspects of ethical competence. Based on the assessment of narratives written at two times (12 to 16 months/apart) during their training, residents showed significant progress in two specific domains: use of professional values, and use of personal values. Residents did not show decline in ethical reasoning in any domain. This study demonstrates that content analysis of personal narratives may provide a useful method for assessment of developing ethical sensitivity and reasoning. (shrink)

It is estimated that 300,000 children 0–14 years of age are diagnosed with cancer worldwide each year. While the absolute risk of cancer in children is low, it is the leading cause of death due to disease in children in high‐income countries. In spite of this, the etiologies of pediatric cancer are largely unknown. Environmental exposures have long been thought to play an etiologic role. However, to date, there are few well‐established environmental risk factors for pediatric malignancies, likely due to (...) technical barriers in collecting biological samples prospectively in pediatric populations for direct measurements. In this review, we propose the use of novel or underutilized biospecimens (dried blood spots and teeth) and molecular approaches for exposure assessment (epigenetics, metabolomics, and somatic mutational profiles). Future epidemiologic studies of pediatric cancer should incorporate novel exposure assessment methodologies, data on molecular features of tumors, and a more complete assessment of gene‐environment interactions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Narrative Symposium:Conflicting Interests in MedicineLaura Jean Bierut, Sal Cruz-Flores, Laura E. Hodges, Anthony A. Mikulec, Govind K. Nagaldinne, Erine L. Bakanas, John F. Peppin, Joel S. Perlmutter, William H. Seitz Jr., Edward Diao, Andre N. Sofair, and David M. Zientek• To Recruit or Not to Recruit for a Clinical Trial• An Unexpected Lesson• Am I on call for the entire Midwest?• Why is Medicare Wasting Away?• The Downside of (...) the Informed Consent Juggernaut• Expert Testimony at the Food and Drug Administration: Who Wants the Truth?• Crossroads: The Intersection of Personal, Professional Society, and Industry Relationships• A Change of Heart• The Evolution of Conflicts of Interest in a New Subspecialty: A Case Study of the Development of Interventional CardiologyCopyright © 2011 The Johns Hopkins University Press... (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)

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

Transcription factor (TF) signaling regulates gene transcription and requires a complex network of proteins. This network includes co‐activators, co‐repressors, multiple TFs, histone‐modifying complexes, and the basal transcription machinery. It has been widely appreciated that pioneer factors, such as FoxA1 and GATA1, play an important role in opening closed chromatin regions, thereby allowing binding of a secondary factor. In this review we will focus on a newly proposed model wherein multiple TFs, such as steroid receptors (SRs), can function in a pioneering (...) role. This model, termed dynamic assisted loading, integrates data from widely divergent methodologies, including genome wide ChIP‐Seq, digital genomic footprinting, DHS‐Seq, live cell protein dynamics, and biochemical studies of ATP‐dependent remodeling complexes, to present a real time view of TF chromatin interactions. Under this view, many TFs can act as initiating factors for chromatin landscape programming. Furthermore, enhancer and promoter states are more accurately described as energy‐dependent, non‐equilibrium steady states. (shrink)

Science and emotions are typically juxtaposed: science is considered rational and unattached to outcomes, whereas emotions are considered irrational and harmful to science. Ethnographic studies of the daily lives of scientists have problematized this opposition, focusing on the emotional experiences of scientists as they go about their work, but they reveal little about disciplinary differences. We build on these studies by analyzing Citation Classics: accounts about the making of influential science. We document how highly cited scientists retrospectively describe emotional aspects (...) of their research and assess variation in these narratives across six diverse disciplines: Chemistry; Clinical Medicine; Neurobiology; Physics; Plant and Animal Science; and Psychology and Psychiatry. Using correspondence analysis, we develop a multidimensional model to explain disciplinary variation in scientists’ accounts of emotions and link this variation to internal, external, and material aspects of the disciplines. We find differences in norms of appropriate emotional expression, or “feeling rules,” between the “hard” and “soft” sciences, the basic and applied sciences, and the sciences that study living organisms versus those that study organs, cells, or atoms. By comparing accounts across disciplines and elaborating the structuring principles underlying these patterns, we integrate knowledge from varied case studies into an integrative and multifaceted model. (shrink)

Essential skills and attitudes necessary for active citizenship need to be cultivated as early as prekindergarten. This exploratory study investigated if three and four-year olds could be actively engaged in social studies practices through inquiry learning in a school garden. Eleven children openly interacted and conducted personally-driven investigations on a daily basis in the school garden located on their playground over nine-months. Three interviews with children, teacher observation notes, and lesson plans were analyzed to discover whether NCSS preK-12 learning themes (...) (2010) for the social studies curriculum could be correlated with garden inquiries. Three prevalent NCSS themes surfaced from data analysis with Civic Ideals and Practices, People, Places, and Environments, and Time, Continuity, and Change being most prevalent. Results imply that working in a school garden through inquiry learning can foster the development of democratic competencies and thus, could be used to design C3 lessons for preschoolers in the garden. (shrink)

The majority of food in the US is distributed through global/national supply chains that exclude locally-produced goods. This situation offers opportunities to increase local food production and consumption and is influenced by constraints that limit the scale of these activities. We conducted a study to assess perspectives of producers and consumers engaged in food systems of a major Midwestern city. We examined producers’ willingness to include/increase cultivation of local foods and consumers’ interest in purchasing/increasing local foods. We used focus groups (...) of producers (two groups of conventional farmers, four local food producers) and consumers (three conventional market participants, two locavores) to pose questions about production/consumption of local foods. We transcribed discussions verbatim and examined text to identify themes, using separate affinity diagrams for producers and consumers. We found producers and consumers are influenced by the _status quo_ and real and perceived barriers to local foods. We also learned participants believed increasing production and consumption of local foods would benefit their community and creating better infrastructure could enhance efforts to scale up local food systems. Focus group participants also indicated support from external champions/programs could support expansion of local foods. We learned that diversifying local food production was viewed as a way to support local community, increase access to healthy foods and reduce environmental impacts of conventional production. Our research indicates that encouraging producers and consumers in local food systems will be more successful when support for the local community is emphasized. (shrink)

Marine ecosystems are under increasing pressure from human activity, yet successful management relies on knowledge. The evidence-based policy (EBP) approach has been promoted on the grounds that it provides greater transparency and consistency by relying on ‘high quality’ information. However, EBP also creates epistemic responsibilities. Decision-making where limited or no empirical evidence exists, such as is often the case in marine systems, creates epistemic obligations for new information acquisition. We argue that philosophical approaches can inform the science-policy interface. Using marine (...) biosecurity examples, we specifically examine the epistemic challenges in the acquisition and acceptance of evidence to inform policy, discussing epistemic due care and biases in consideration of evidence. (shrink)

Multi-stakeholder initiatives for biodiversity conservation on working landscapes often necessitate strategies to facilitate learning in order to foster successful collaboration. To investigate the learning processes that both undergird and result from collaborative efforts, this case study employs the concept of boundary work as a lens to examine learning between rice growers and conservation professionals in California’s Central Valley, who were engaged in a collaborative research project focused on migratory bird conservation. Through analysis of workshop observations, project documents, and interviews with (...) rice growers and conservation professionals, we identified five distinct factors of the collaborative research process that influenced learning amongst these two groups: having mutually beneficial goals, sharing ownership of the collaborative research process, building trust, integrating knowledge, and institutional alignment. We also examined and identified learning outcomes for both rice growers and conservation professionals, which included new knowledge of the social-ecological system, new practices around farming and collaboration, and shifting identities. Our findings suggest that applying these factors and outcomes for learning when structuring collaborative research, and other multi-stakeholder initiatives, can foster learning amongst diverse stakeholder groups to support new approaches for balancing resource use and adaptive management. (shrink)

The authors conducted a baseline survey of baccalaureate and graduate degree health humanities programs in the United States and Canada. The object of the survey was to formally assess the current state of the field, to gauge what kind of resources individual programs are receiving, and to assess their self-identified needs to become or remain programmatically sustainable, including their views on the potential benefits of program accreditation. A 56-question baseline survey was sent to 111 institutions with baccalaureate programs and 20 (...) institutions with graduate programs. Respondents were asked about three areas: (1) program administration (managing unit, paid director, faculty lines, paid staff, funding sources); (2) educational program (curricular structure, CIP code usage, completion rates); and (3) views on accreditation for the field. A clear majority of respondents agreed that some form of accreditation or consultation service could address resource and sustainability issues. Overall, the survey responses to staffing, curricular structure, and support suggest the need for developing a sustainable infrastructure for health humanities. (shrink)

Can epistemologies anchor processes of social inequality? In this paper, we consider how epistemological dominance in science, engineering, and health fields perpetuates disadvantages for students who enter higher education with alternative epistemologies. Drawing on in-depth interviews with Native American students enrolled at two US research universities who adhere to or revere indigenous epistemologies, we find that epistemological dominance in SE&H degree programs disadvantages students through three processes. First, it delegitimizes Native epistemologies and marginalizes and silences students who value them. Second, (...) in the process of imparting these dominant scientific epistemologies, SE&H courses sometimes require students to participate in pedagogical practices that challenge indigenous ways of knowing. Third, students encounter epistemological imperialism: most students in the sample are working to earn SE&H degrees in order to return to tribal communities to “give back,” yet, because the US laws regulating the practice of SE&H extend onto tribal lands, students must earn credentials in epistemologies that devalue, delegitimate, and threaten indigenous knowledge ways to practice on tribal lands. We examine how students navigate these experiences, discuss the implications of these findings for SE&H education, and describe how epistemological dominance may serve as a mechanism of inequality reproduction more broadly. (shrink)

These essays engage Jin Y. Park’s recent translation of the work of Kim Iryŏp, a Buddhist nun and public intellectual in early twentieth-century Korea. Park’s translation of Iryŏp’s Reflections of a Zen Buddhist Nun was the subject of two book panels at recent conferences: the first a plenary session at the annual meeting of the Society for Asian and Comparative Philosophy and the second at the Eastern Division of the American Philosophical Association on a group program session sponsored by the (...) International Society for Buddhist Philosophy. This exchange also includes a response from Park. (shrink)