This mixed-methods case study describes the experiences of a rural health organization in Canada that was a pioneer in undergoing institutionally driven radical change. This change was advocated by senior managers and physicians with the strong backing of the government. The senior managers and physicians made a strong case for the radical change and argued that a focus on efficiency and wellness would lead to improved service and quality of patient-care. However, this radical change initiative was resisted by nurses and (...) support staff who perceived that these changes were being driven by market-based institutional logics and questioned their ethical appropriateness in a public system. They also expressed a lack of trust given the large-scale layoffs in a prior restructuring. These findings run counter to extant theory by highlighting the role of agency despite institutional pressures. Specifically, change implementers not only face the burden of justifying ethical appropriateness of institutional logics, but also are required to engage in persuasive discourse that these institutional logics protect the interests of the members. (shrink)

Listening and responding to patients’ stories for over 20 years as an emergency physician has strengthened my appreciation for the many ways that the skills and principles drawn from writing fiction double as necessary clinical skills. The best medicine doesn’t work on the wrong story, and the stories patients tell sometimes feel like first drafts—vital and fragile works-in-progress. Increasingly complex health challenges compounded by social, financial, and psychological burdens make for stories that are difficult to articulate and comprehend. In this (...) essay, I argue that healthcare providers need to think like creative writers and the skills and sensitivities necessary to story construction deserve a vital space in medical education. A thorough understanding of story anatomy and the imaginative flexibility to work stories into open spaces serve as antidotes to the reductive nature of clinical decision making and have implications as patient safety and risk management strategies. The examples that I have selected demonstrate how thinking like a creative writer functions at the bedside, providing tools for clinical excellence and empathy. This approach asks that we re-imagine the importance of story in clinical care: from a vehicle to a diagnosis to its place as a critical destination. (shrink)

“I'm not afraid of dying,” he says, despite his plea on arrival. “Listen up, douchebag. Are you calling my cousin or what?” The emergency department might be the only sphere of human exchange where one party—patients (and sometimes family)—are permitted to insult, threaten, and even spit at the very people on whom they depend for help, while the offended parties—physicians, nurses, and other health care providers—must not only tolerate the abuse, but treat their tormentors. Does the ED's collective duty to (...) greater numbers of patients demand a revised ethos of tough love for extreme cases of misbehavior? Can we ask these patients to leave without legal recourse after extending genuine, compassionate efforts to participate in their care—barring evidence of a medical explanation for their toxic comportment or a mental illness that puts them at risk of harming themselves or others? (shrink)

Intracellular pH (pHi) regulation is a homeostatic function of all cells. Additionally, the plasma membrane‐based transporters controlling pHi are involved in growth factor activation, cell proliferation and salt transport – all processes active in early embryos. pHi regulation in the early embryos of many species exhibits unique features: in mouse preimplantation embryos, mechanisms for correcting excess acid apparently are inactive, while excess base is removed by the mechanism common in differentiated cells. Additionally, unlike differentiated cells, mouse preimplantation embryos are highly (...) permeable to H+ until the blastocyst stage, where the epithelial cells surrounding the embryo are impermeable. In several non‐mammalian species, of which the best‐studied is sea urchin, cytoplasmic alkalinization at fertilization is necessary for development of the embryo, and elevated pHi must be maintained during early development. Thus, pHi regulatory mechanisms appear to be important for early embryo development in many species. (shrink)

The use of complementary and alternative medicine (CAM) by US consumers has grown in recent years. CAM therapies often utilize medicinal herbs as part of the treatment process; however, research on US practitioner preferences for medicinal herbs is limited, despite growing concern surrounding the sustainability of wild-harvested medicinal herbs. In order better to understand consumer preferences for this emerging market, a mail survey of US practitioners (licensed acupuncturists) was conducted to examine the importance of five herb attributes in practitioners’ herb (...) selection decisions: (1) country of origin, (2) freshness, (3) production method (organic versus conventional), (4) price, and (5) traceability. The significance of these five traits is investigated using discrete choice analysis, and the implications for US medicinal herb growers are discussed. (shrink)

Experience has recently reemerged as an important analytical category for historians of the Old Regime and the French Revolution. Reacting against the perceived excesses of discourse analysis, which made political language independent of any social determinants, certain post-revisionists are now seeking to contextualize political language by relating it to the experience of those who use it. Political agency, in these analyses, is understood to be the effect of particular formative experiences. This article suggests that the search for an experiential antidote (...) to discourse is misconceived because it perpetuates an untenable dichotomy between thought and reality. Access to the phenomenon of historical agency should be pursued not through experience or discourse but through the category of consciousness, since the make-up of the subject's consciousness determines how he/she engages the world and decides to attempt changing it. After a brief discussion of an important study that exemplifies both the allure and the functionality of the notion of experience, Timothy Tackett's Becoming a Revolutionary, the article focuses on the evolving political consciousness of a man who became a revolutionary agitator in 1789, J.-M.-A. Servan. Analysis of his writings between 1769 and 1789 shows that the way in which his perspective was constructed, rather than the lessons of experience per se, determined the shape of his revolutionary intentions in 1789. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:BonaventureJay M. HammondChristopher M. Cullen, Bonaventure, Great Medieval Thinkers Series. Oxford: Oxford University Press, 2006. ISBN: 0-19-514925-4 (paperback); 0-19-514926-2 (hardback). Pages: xviii + 251.This volume makes a valuable contribution to the "great medieval thinkers" series from OUP by providing an accessible introduction to the philosophy and theology of the great Franciscan St. Bonaventure († 1274). The Preface presents the book's organizing principle: "to analyze Bonaventure's thought by following (...) his own division of the branches of philosophy and theology" (xi) as found in the Bonaventure's classic text On the Reduction of the Arts to Theology (text explained on 29-32; oddly the book never addresses the discrepancy in the dating of the text, c. 1254 or c. 1270). This text considers how the new core subjects of the arts, heavily influenced by Aristotle and expanding beyond the trivium and quadrivium, are illuminations that should lead back to theology, that is to Scripture, which "lies hidden in all knowledge and in all nature."Part I, contains two chapters: the Introduction and another on the definition of Christian Wisdom, the ultimate goal of the Reduction of the Arts. Part II, "The Light of Philosophical Knowledge," contains three chapters on Bonaventure's physics, metaphysics, and moral philosophy. Part III, "The Light of Theological Knowledge," includes seven chapters organized according to Bonaventure's Breviloquium: the Trinity, Creation, Sin, the Incarnation, Grace, the Sacraments, and the Last Things.The preface sets out three claims that color the rest of the book. First, as mentioned, the book attempts an "introduction to the philosophy and theology" of Bonaventure, which the book calls "Christian Philosophy" (a term introduced by Étienne Gilson, Leon Veuthey and later adopted by John Quinn). Yet, I agree with the preface that "it is not easy to say precisely what this means in practice" (xi). Although Bonaventure did employ the phrase "Christian Wisdom" throughout his writings, he never used the phrase "Christian [End Page 541] Philosophy." More explanation of this key term would have been helpful because it seems to relate more to the neo-scholastic disputes of the early to mid twentieth century than to Bonaventure's thirteenth century thought. Second, the book claims that "his Commentary on the Sentences should have a priority of place in any accurate reading" of his thought. On this point the book delivers by citing more from the Sentence Commentary than any other of Bonaventure's works (139 times overall, 63 from Book II alone), but with the much shorter Breviloquium coming in a close second (128 times). Four works come in a distant third (Hexaemeron 38, Itinerarium 32, De mysterio Trinitatis 21, and De scientia Christi 21). Unfortunately little attention is given to Bonaventure's sermons, scripture commentaries, hagiographies and spiritual tracts. Third, whatever shortcomings the book has regarding the coverage of Bonaventure's many works, the book still fulfills its claim to provide "an overview of [Bonaventure's] synthesis," which is "an elaborate and sophisticated synthesis, created in a specific historical context" (xiv).The book begins with an introductory sketch of Bonaventure's life framed by three key historic movements of the thirteenth century: the rediscovery of Aristotle, the emergence of the "universities," and the rise of the mendicant orders. These overlapping contexts are indispensable to understanding Bonaventure's writings, which the introduction surveys in general chronological order and according to genre. After reviewing his life and works, the Introduction concludes with a consideration of Bonaventure's influence. The Introduction is helpful in orienting the modern reader to Bonaventure's thought, particularly his unique synthesis of Augustine and Aristotle. However, some of the dating is imprecise. For example, in October 1255 (not 1256) Bonaventure responded to William of Saint-Amour's attacks against the mendicants with Q.1 De humilitate of his De perfectione evangelica. Thus, Bonaventure entered the secular-mendicant controversy before Thomas Aquinas and Thomas of York (12, 17). Likewise, Bonaventure most likely incepted into the Parisian consortium of masters in April 1254 not October 1257 (11).While all of Part II provides good information on the intricacies of Bonaventure's philosophy, the sections explaining [End Page 542] his hylomorphic metaphysics (42... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:I would like to begin by thanking Gregory LaNave for his analysis of Bonaventure's Itinerarium. His interpretation has helped me clarify my own understanding of that rich text. I would also like to thank the editors of Franciscan Studies who invited this response. It focuses on LaNave's misreading of "symbolic theology," his own "scientific" interpretation of the Itinerarium, and the relationship between scientific and symbolic theology as explained by (...) Bonaventure. Accordingly, I divide my response into three parts: Clarifying the Meaning of Symbolic Theology, Critique of Dr. LaNave's Analysis, and Scientific and Symbolic Theology.Clarifying the Meaning of Symbolic TheologyIn Divine and Created Order in Bonaventure's Theology, I employ the term "symbolic theology" to help the modern reader approach and appreciate Bonaventure's profuse use of symbols in the Itinerarium. Dr. LaNave acknowledges that such an accommodation is valuable: "The symbolic reading of Bonaventure has undoubted merits, not least of which is its attempts to do justice to his deft use of an array of symbols in his theology."In my "attempts to do justice" to the ubiquitous symbols throughout the Itinerarium, I describe "symbolic theology" in two ways. First, I claim that Bonaventure:does not employ symbols to prove anything, rather, he resorts to the effusive nature of symbols to demonstrate ineffable mysteries that elude easy description … symbolic thinking, in its most authentic form, is not a second-best mode of grasping reality but a penetration of its most profound metaphysical structure and dynamics.LaNave seems to have two concerns. On the one hand, since symbols do not "prove anything" he deems them as rather inadequate in describing metaphysical realities. For LaNave, symbols can not be "merely symbolic" if "they are in fact ways to penetrate the real metaphysical structure of the realities in question." The "merely" points to the need for something more, which LaNave identifies as the "objectivity of sensation" according to the "canons of a scientific theology ," In effect, he emphasizes by a threefold repetition that the "objectivity of sensation" can better examine "what is really there." It seems that symbols are less equipped for such a task.On the other hand, LaNave's contrast of "symbolic" with "scientific" seems to confuse what I identified as a general characteristic for the actual methodology I employed to analyze the Itinerarium: an analysis of the analogical triads produced by the threefold method of doubling. Like LaNave, I base my interpretation upon the dialectic of seeing God through and in a mirror . Hence, I disagree that I employ a "symbolic approach to theology." Rather, my approach primarily examines the text's analogical triads.Second, I also comment, "Bonaventure uses symbols to provide the imagination with powerful images with which one may ponder the deepest and highest levels of knowing." As an example, I provide the two symbols of the Seraph and Temple from Isaiah 6:1-2. However, LaNave does not comment on this second description of Bonaventure's "symbolic theology." Instead he states:the mystery revealed in any such symbol points to the whole of the mystery, never to any one part in isolation. For example, one may speak about creation and its relationship to the single creative activity of the Creator; but one must at the same time know that Creator to be the Trinity, and see the analogous presence of the Trinity in the creature. Analytical thinking might try to separate these elements; symbolic thinking always strives to see them implied in each other.To justify his claim, he cites pages 228-29 of Divine and Created Order.These pages do not treat or even mention "symbolic theology." Rather, they explain the terms principium, primum, and primitas, and their relation to the notion of ordo. These three terms concern foundational concepts that shape the ontology, metaphysics, and epistemology of Bonaventure's theology. In effect, LaNave correctly.. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:In light of the careful work of Joshua Benson who argues that the De reductione is the second part to Bonaventure's inception sermon, this article will date the De reductione by determining when he incepted. This is not an easy task because the date of his inception has been a point of confusion within Bonaventurian scholarship. Scholars date it as early as 1248 and as late as 1257. Within (...) those nine years they assign various scenarios regarding his status as regent master. For example, the most common scenario has Bonaventure incepting in 1253 or 1254 and assuming the Franciscan Chair in theology, but only teaching in the Franciscan convent, unrecognized by the university until either 1256 or 1257.My thesis is that Bonaventure incepted in April 1254 to replace William of Middleton who relinquished the Franciscan chair in the wake of the Lenten riot of 1253. To argue this thesis, the paper divides into three parts. The first will briefly present the various dating for Bonaventure's inception. The second will examine all the thirteenth and fourteenth century sources that are used for determining Bonaventure's chronology so as to establish the evidence for calculating his inception. And third, building upon the evidence gleaned from those witnesses, I will present a narrative chronology that details events surrounding Bonaventure's inception in April 1254.I. Various Dating of Bonaventure's inception as MasterScholars assign various dates to his inception, which has caused much confusion. The Quaracchi editors of the Opera omnia, Robinson, Gilson, Moorman, and Crowley claim Bonaventure incepted in 1248; Robson alone gives a 1252 date; Callebaut, Longpré, the Spanish editors of the Obras de San Buenaventura, Abate, Bonafede, the earlier Brady, the later Hayes, and Hammond give a date of 1253; Pelster, Glorieux, the Quaracchi editors of the Opera theologica selecta, Veuthey, the earlier Bougerol, Cousins, Schlosser and Delio opt for 1253 or 1254; the later Bougerol, Quinn, the earlier Hayes, Noone, Hauser, and Cullen hold for a 1254 date; the later Brady posits a 1255 date; Bettoni and Dufeil push the inception back to 1257.Table 1 highlights the disparity between the last two studies that focus specifically on Bonaventure's chronology during his time at Paris. Click for larger viewTable 1. Disputed dates in Bonaventure's ChronologyAt least the two studies have one date in common, and with that one fixed date of 1257, we turn to examine the thirteenth and fourteenth century witnesses so as to dispel the disparity.II. Examining the SourcesEven though the dating for Bonaventure's inception spans nine years, there are only seven sources that scholars can use to calculate those dates. More specifically, the majority of scholars support a 1253 or 1254 dating, with the year discrepancy likely deriving from how they calculate the dates in the sources according to medieval/modern calendars. Thus, to sort through the tangle of dating, all the evidence will first be presented in full. Then, in light of all the evidence, a scenario for dating Bonaventure's inception can be advanced.The thirteenth and fourteenth century sources fall into four groups: the Chronica fratris Salimbene de Adam ; the two independent, short lists of General Ministers: Series Magistrorum Generalium Ordinis Fratrum Minorum , and Chronicon Abbreviatum de Successione Generalium Ministrorum ; the three interdependent texts of the Catalogus Generalium Ministrorum,Catalogus XV Generalium , and the Chronica XXIV Generalium , which contain significant variances from one another; and the Chronica Franciscis Fabrianensis . As will become clear, scholars who advance a 1248 date read Salimbene in light of Fabriano, while those who favor 1253 or 1254 read Salimbene in light of the Catalogus Generalium Ministrorum and related texts. Those who favor a 1257 dating, seem to.. (shrink)

Edited by Hans-Christoph Schmidt am Busch & Christopher Zurn. This volume collects original, cutting-edge essays on the philosophy of recognition by international scholars eminent in the field. By considering the topic of recognition as addressed by both classical and contemporary authors, the volume explores the connections between historical and contemporary recognition research and makes substantive contributions to the further development of contemporary theories of recognition.

Competition over reproductive opportunities among members of one sex often harms the opposite sex, creating a conflict of interest between individual males and females. Recently, this battle of the sexes has become a paradigm in the study of intersexual coevolution. Here, we review recent theoretical and empirical advances suggesting that – as in any scenario of intraspecific competition – selfishness (competitiveness) can be influenced by the genetic relatedness of competitors. When competitors are positively related (e.g. siblings), an individual may refrain (...) from harming its competitor(s) and their mate(s) because this can improve the focal individual's inclusive fitness. These findings reveal that population genetic structure might be of paramount importance when studying the battle of the sexes. We conclude by identifying some new lines of research at the interface of sexual selection and social evolution. (shrink)

Since their discovery over two decades ago, the molecular and cellular functions of the NIPSNAP family of proteins (NIPSNAPs) have remained elusive until recently. NIPSNAPs interact with a variety of mitochondrial and cytoplasmic proteins. They have been implicated in multiple cellular processes and associated with different physiologic and pathologic conditions, including pain transmission, Parkinson's disease, and cancer. Recent evidence demonstrated a direct role for NIPSNAP1 and NIPSNAP2 proteins in regulation of mitophagy, a process that is critical for cellular health and (...) maintenance. Importantly, NIPSNAPs contain a 110 amino acid domain that is evolutionary conserved from mammals to bacteria. However, the molecular function of the conserved NIPSNAP domain and its potential role in mitophagy have not been explored. It stands to reason that the highly conserved NIPSNAP domain interacts with a substrate that is ubiquitously present across all species and can perhaps act as a sensor for mitochondrial health. (shrink)

This article examines the contention, frequently defended by contemporary African philosophers, that philosophy is universal. Examples of the thesis are cited; various interpretations of its meaning are analyzed; and arguments against it by other African philosophers are presented. The article argues that the universalist thesis, however interpreted, contributes nothing to African philosophy and should be abandoned.