We argue that, under certain plausible assumptions, de Sitter space settles into a quiescent vacuum in which there are no dynamical quantum fluctuations. Such fluctuations require either an evolving microstate, or time-dependent histories of out-of-equilibrium recording devices, which we argue are absent in stationary states. For a massive scalar field in a fixed de Sitter background, the cosmic no-hair theorem implies that the state of the patch approaches the vacuum, where there are no fluctuations. We argue that an analogous conclusion (...) holds whenever a patch of de Sitter is embedded in a larger theory with an infinite-dimensional Hilbert space, including semiclassical quantum gravity with false vacua or complementarity in theories with at least one Minkowski vacuum. This reasoning provides an escape from the Boltzmann brain problem in such theories. It also implies that vacuum states do not uptunnel to higher-energy vacua and that perturbations do not decohere while slow-roll inflation occurs, suggesting that eternal inflation is much less common than often supposed. On the other hand, if a de Sitter patch is a closed system with a finite-dimensional Hilbert space, there will be Poincaré recurrences and dynamical Boltzmann fluctuations into lower-entropy states. Our analysis does not alter the conventional understanding of the origin of density fluctuations from primordial inflation, since reheating naturally generates a high-entropy environment and leads to decoherence, nor does it affect the existence of non-dynamical vacuum fluctuations such as those that give rise to the Casimir effect. (shrink)

Governing Animals explores the role of the liberal state in protecting animal welfare. Examining liberal concepts such as the social contract, property rights, and representation, Kimberly K. Smith argues that liberalism properly understood can recognize the moral status and social meaning of animals and provides guidance in fashioning animal policy.

This book is designed as a basic text for courses that are part of an interdisciplinary program in environmental studies. The intended reader is anyone who expects environmental stewardship to be an important part of his or her life, as a citizen, a policy maker, or an environmental management professional. In addition to discussing major issues in environmental ethics, it invites readers to think about how an ethicist's perspective differs from the perspectives encountered in other environmental studies courses. Additional topics (...) covered include corporate social responsibility, ecological citizenship, property theory, and the concept of stewardship as a vocation. (shrink)

The concept of wilderness found in the black American intellectual tradition poses a provocative alternative to the preservationist concept. For black writers, the wilderness is not radically separate from human society but has an important historical and social dimension. Nor is it merely a feature of the external landscape; there is also a wilderness within, a vital energy that derives from and connects one to the external wilderness. Wilderness is the origin and foundation of culture; preserving it means preserving not (...) merely the physical landscape but our collective memory of it. But black writers also highlight the racial essentialism that infuses both their own and traditional American concepts of the wild, giving us greater insight into why the wilderness celebrated by preservationists can be a problematic value for racial minorities. (shrink)

Environmental political theory poses new challenges to our received political concepts and values. Increasingly, we are reconceptualising nature as a subject rather than solely an object of politics. On one front, we are being challenged to think of natural entities as subjects of justice – as bearers of rights or interests that the political system should accommodate. On a second front, we are being challenged to see nature as a subject of power, constructed and ordered through scientific and political practice. (...) These reconceptualisations have significant implications for our political practices and institutions. (shrink)

Elizabeth Anderson’s “pluralist–expressivist” value theory, an alternative to the understanding of value and rationality underlying the “rational actor” model of human behavior, provides rich resources for addressing questions of environmental and animal ethics. It is particularly well-suited to help us think about the ethics of commodification, as I demonstrate in this critique of the pet trade. I argue that Anderson’s approach identifies the proper grounds for criticizing the commodification of animals, and directs our attention to the importance of maintaining social (...) practices and institutions that respect the social meanings of animals. Her theory alone, however, does not adequately address the role of the state in this project. Drawing on social contract theory to fill this gap, I conclude that the state’s role in regulating the pet trade should be limited to ensuring the welfare of animals in the stream of commerce, not prohibiting their mass marketing altogether. (shrink)

In The Frontiers of Justice, Martha Nussbaum argues that social contract theory cannot accommodate political duties to animals because it requires the parties to the contract to enjoy rough physical and mental equality. Her interpretation of the social contract tradi­tion is unpersuasive; social contract theory requires only that the parties be equally free and deserving of moral consideration. Moreover, social contract theory is superior to her capabilities approach in that it allows us to limit the scope of the community of (...) justice to animals we are capable of recognizing as subjects of justice and with whom we have a political relationship. (shrink)

The coronavirus (COVID-19) pandemic has challenged the dental health profession in an unprecedented manner. Suspension of elective dental care across the United States during the initial phase of the pandemic was necessary to prevent viral transmission. The emergency dental care that was provided had to be tailored to minimize the generation of aerosols. With the suspension of elective care, over time, the proportion of dental emergencies was anticipated to rise. Dentists who care for children have continued to provide emergency dental (...) treatment to this vulnerable population. Treatment decisions for pediatric dental emergencies had to be tailored to principles of public health that best mitigated risk of viral transmission. Decisions needed to balance the benefits of chosen treatment modality for the individual child with the risk of viral transmission to dental professionals and their staff, patients, and community. The paucity of reliable research for dentists to aid in clinical decision making may have left careproviders feeling ethically and morally insecure in shifting from a patient-centered to a community-centered paradigm. We present analysis of four pediatric emergency case scenarios that are representative of those likely to present to a private practice, academic setting, or emergency department during the pandemic. This analysis aims to empower dentists who care for children to implement the American Dental Association’s Principles of Ethics & Code of Professional Conduct within the context of a global health crisis. (shrink)

The affordable housing crisis is a quintessential wicked social problem. Lower wage workers in particular are increasingly priced out of desired locations and essential workers such as teachers, police and healthcare providers often struggle to live within the very communities they serve. We investigate the role of remote work in this multi-faceted problem, leveraging multi-year data derived for the United States to examine a path in which remote work opportunities skew to higher wage workers who commonly use their geographic flexibility (...) to relocate to more affordable locales. We probe how this form of residential sorting among higher wage workers creates both positive and negative externalities in relation to home prices, focusing most closely on the social cost borne by lower wage workers and the role of organizations through the lens of corporate social responsibility (CSR). Our research broadens the social role for organizations in the domain of affordable housing and, critically, specifies theoretical logic that extends CSR to the contemporary landscape of remote work and its resulting spatial interdependencies that render responsibility well beyond traditional geographic boundaries. (shrink)

This conceptual paper revisits the concept of equality as a base of distributive justice and contends that it is underspecified, both theoretically and in terms of its ethical and pragmatic application to human resource management (HRM) within organizations. Prior organizational literature focuses primarily upon distributive equality of remunerative outcomes within small groups and implicitly employs an equity-based conception of inputs to define equality. In contrast, through exposition of the philosophical roots of equality principles, we reconceptualize inputs as de facto equal (...) and consider the systemic application of distributive equality in the form of status leveling practices. Ethical ramifications of distributive equality so viewed are explored. We conclude by arguing that, to implicitly insert a stronger ethics focus into the study and practice of HRM, perhaps there should be "equality theory" competing with equity theory for recognition in managerial and scholarly discourse. (shrink)

A survey of 525 undergraduates found that 40 percent of the women and 28.7 percent of the men had been sexually harassed by a college professor or instructor. Most incidents were gender harassment. While women reported significantly more gender harassment than did men, there were no gender differences in the frequency of unwanted sexual attention or sexual coercion. At least one incident of sexual harassment by a professor was experienced by 30 percent of the Blacks, 30 percent of the Hispanics, (...) 33 percent of the Asians, 30 percent of the students of other minority groups, and 39 percent of the whites. Again, most of the experiences were gender harassment. Among those respondents who had experienced at least one incident of sexual harassment, almost all answered “never” to the question “Have you ever been sexually harassed by a college professor or instructor?” We conclude with some suggestions, particularly the need to improve measurement of the harassment experiences of men and of nonwhite women. (shrink)

Background Advance Care Planning via Group Visits (ACP-GV) is a patient-centered intervention facilitated by a clinician using a group modality to promote healthcare decision-making among veterans. Participants in the group document a “Next Step” to use in planning for their future care needs. The next step may include documentation of preferences in an advance directive, discussing plans with family, or anything else to fulfill their ACP needs. This evaluation seeks to determine whether there are identifiable subgroups of group participants with (...) differing needs prior to delivery of the ACP-GV program and, if so, to use information about the subgroups to enhance the program offered to veterans in United States Department of Veterans Affairs (VA) healthcare settings. Methods We conducted a secondary analysis of national data from a quality improvement evaluation. Patient- and provider-level data from administrative healthcare records for VA users in all 50 states, territories, and the District of Columbia provides data on veterans attending ACP-GV during federal fiscal years 2018–2022 (N = 26,857). Latent class analysis seeks to identify the various subgroups of veterans based on their level of ACP self-efficacy before attending ACP-GV and any demographic differences across the resulting subgroups of veterans attending ACP-GV. ACP self-efficacy is derived from seven items obtained from a participant worksheet used during the group. Results Analysis revealed two distinct groups of veterans, distinguishable by their pre-ACP-GV levels of one aspect of ACP self-efficacy: prior knowledge of ACP. Veterans with higher prior knowledge of ACP are associated with an identified next step focused on checking their current AD status and updating it, and veterans with lower ACP prior knowledge are associated with identifying a next step to discuss ACP more fully with family. Differences in age, sex, race, ethnicity, and marital status exist across subgroups of veterans. Conclusion Greater attention must be paid to ACP and veterans’ prior knowledge of ACP to consistently encourage annual review and status updates. (shrink)

Preparing the Next Generation of Oral Historians is an invaluable resource to educators seeking to bring history alive for students at all levels. Filled with insightful reflections on teaching oral history, it offers practical suggestions for educators seeking to create curricula, engage students, gather community support, and meet educational standards. By the close of the book, readers will be able to successfully incorporate oral history projects in their own classrooms.

This study investigated whether employee perceptions of corporate social responsibility (CSR) were associated with the presence of Corporate Psychopaths in corporations. The article states that, as psychopaths are 1% of the population, it is logical to assume that every large corporation has psychopaths working within it. To differentiate these people from the common perception of psychopaths as being criminals, they have been called “Corporate Psychopaths” in this research. The article presents quantitative empirical research into the influence of Corporate Psychopaths on (...) four perceptual measures of CSR and three further measures of organizational commitment to employees. The article explains who Corporate Psychopaths are and delineates the measures of CSR and organizational commitment to employees that were used. It then outlines the research conducted among 346 corporate employees in Australia in 2008. The reliability of the instrument used is commented on favorably in terms of its statistical reliability and its face and external validity. Results of the research are described showing the highly significant and negative influence of Corporate Psychopaths on all of the measures of CSR and of organizational commitment to employees used in the research. When Corporate Psychopaths are present in leadership positions within organizations, employees are less likely to agree with views that: the organization does business in a socially desirable manner; does business in an environmentally friendly manner and that the organization does business in a way that benefits the local community. Also, when Corporate Psychopaths are present in leadership positions within organizations, employees are significantly less likely to agree that the corporation does business in a way that shows commitment to employees, significantly less likely to feel that they receive due recognition for doing a good job, to feel that their work was appreciated and to feel that their efforts were properly rewarded. The article argues that academics and researchers in the area of CSR cannot ignore the influence of individual managers. This is particularly the case when those managers have dysfunctional personalities, or are actually psychopaths. The article further argues that the existence of Corporate Psychopaths should be of interest to those involved in corporate management and corporate governance because their presence influences the way corporations are run and how corporations affect society and the environment. (shrink)

We examine ethical considerations in access to facial transplantation (FT), with implications for promoting health equity. As a form of vascularised composite allotransplantation, FT is still considered innovative with a relatively low volume of procedures performed to date by a small number of active FT programmes worldwide. However, as numbers continue to increase and institutions look to establish new FT programmes, we anticipate that attention will shift from feasibility towards ensuring the benefits of FT are equitably available to those in (...) need. This manuscript assesses barriers to care and their ethical implications across a number of considerations, with the intent of mapping various factors relating to health equity and fair access to FT. Evidence is drawn from an evolving clinical experience as well as published scholarship addressing several dimensions of access to FT. We also explore novel concerns that have yet to be mentioned in the literature. (shrink)

What is the value of having medical students engage in creative production as part of their learning? Creating something new requires medical students to take risks and even to fail--something they tend to be neither accustomed to nor comfortable with doing. “Making stuff” can help students prepare for such failures in a controlled environment that doesn’t threaten their professional identities. Furthermore, doing so can facilitate students becoming resilient and creative problem-solvers who strive to find new ways to address vexing questions. (...) Though creating something new can be fun, this is not the main outcome of interest. Rather, the principle reason we recommend devoting precious curricular time to creative endeavors is because it helps medical students become better doctors. (shrink)

Over 100 million Americans suffer from chronic pain, which causes more disability than any other medical condition in the United States at a cost of $560–$635 billion per year. Opioid analgesics are frequently used to treat CP. However, long term use of opioids can cause brain changes such as opioid-induced hyperalgesia that, over time, increase pain sensation. Also, opioids fail to treat complex psychological factors that worsen pain-related disability, including beliefs about and emotional responses to pain. Cognitive behavioral therapy can (...) be efficacious for CP. However, CBT generally does not focus on important factors needed for long-term functional improvement, including attainment of personal goals and the psychological flexibility to choose responses to pain. Acceptance and Commitment Therapy has been recognized as an effective, non-pharmacologic treatment for a variety of CP conditions. However, little is known about the neurologic mechanisms underlying ACT. We conducted an ACT intervention in women with chronic musculoskeletal pain. Functional magnetic resonance imaging data were collected pre- and post-ACT, and changes in functional connectivity were measured using Network-Based Statistics. Behavioral outcomes were measured using validated assessments such as the Acceptance and Action Questionnaire, the Chronic Pain Acceptance Questionnaire, the Center for Epidemiologic Studies Depression Scale, and the NIH Toolbox Neuro-QoLTM scales. Results suggest that, following the 4-week ACT intervention, participants exhibited reductions in brain activation within and between key networks including self-reflection, emotion, and cognitive control. These changes in connectivity strength were correlated with changes in behavioral outcomes including decreased depression and pain interference, and increased participation in social roles. This study is one of the first to demonstrate that improved function across the DMN, SN, and FPN may drive the positive outcomes associated with ACT. This study contributes to the emerging evidence supporting the use of neurophysiological indices to characterize treatment effects of alternative and complementary mind-body therapies. (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)

Background With increased emphasis on healthcare transparency, parents are increasingly asking to be present for procedures performed on their children, especially in high-acuity contexts like care of children with congenital heart disease (CHD), where procedures may inform critical care decisions. In addition, observations of complex care may better communicate clinical knowledge and benefit grieving after adverse events. We examined clinicians’ views on current family presence (FP) efforts and on the expansion of FP to include the observation of operative procedures.Methods This (...) is a qualitative study using semi-structured interviews and content analysis within a pediatric heart center. Participants included perioperative and ICU nurses, physicians, advanced practice providers, and child life specialists. Interviews were recorded, transcribed, and analyzed using inductive content analysis.Results Twenty provider interviews were conducted; 70% had less than 10 years of experience, with 30% having between 10 and 20 years; 50% were physicians who work in procedural environments; 25% were nurses; 15% were advanced practice providers; 10% were child-life specialists. Four categories emerged: (1) positive impact of FP, (2) negative impact of FP, (3) limitations to achieving FP, and (4) policies and procedures for FP.Conclusion Participants reported that current FP uses reduce patient anxiety and improve patient safety, family understanding of clinical decisions, and coping. Drawbacks include parental interference in care, lack of protocols to guide FP, increased family/staff anxiety, lack of staff resources to support FP, and potential access limitations for diverse populations. Participants anticipated that these problems would occur with the expansion to intraoperative FP. (shrink)

BackgroundRandomized controlled trials (RCTs) are often complex and expensive to perform. Less than one third achieve planned recruitment targets, follow-up can be labor-intensive, and many have limited real-world generalizability. Designs for RCTs conducted using cohorts and routinely collected health data, including registries, electronic health records, and administrative databases, have been proposed to address these challenges and are being rapidly adopted. These designs, however, are relatively recent innovations, and published RCT reports often do not describe important aspects of their methodology in (...) a standardized way. Our objective is to extend the Consolidated Standards of Reporting Trials (CONSORT) statement with a consensus-driven reporting guideline for RCTs using cohorts and routinely collected health data.MethodsThe development of this CONSORT extension will consist of five phases. Phase 1 (completed) consisted of the project launch, including fundraising, the establishment of a research team, and development of a conceptual framework. In phase 2, a systematic review will be performed to identify publications (1) that describe methods or reporting considerations for RCTs conducted using cohorts and routinely collected health data or (2) that are protocols or report results from such RCTs. An initial “long list” of possible modifications to CONSORT checklist items and possible new items for the reporting guideline will be generated based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statements. Additional possible modifications and new items will be identified based on the results of the systematic review. Phase 3 will consist of a three-round Delphi exercise with methods and content experts to evaluate the “long list” and generate a “short list” of key items. In phase 4, these items will serve as the basis for an in-person consensus meeting to finalize a core set of items to be included in the reporting guideline and checklist. Phase 5 will involve drafting the checklist and elaboration-explanation documents, and dissemination and implementation of the guideline.DiscussionDevelopment of this CONSORT extension will contribute to more transparent reporting of RCTs conducted using cohorts and routinely collected health data. (shrink)

Comparative Political Theory and Cross-Cultural Philosophy explores new forms of philosophizing in the age of globalization by challenging the conventional border between the East and the West, as well as the traditional boundaries among different academic disciplines. This rich investigation demonstrates the importance of cross-cultural thinking in our reading of philosophical texts and explores how cross-cultural thinking transforms our understanding of the traditional philosophical paradigm.

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

Essays that put noted political thinkers of the past—including Plato, Machiavelli, Hobbes, Wollstonecraft, Marx, and Confucius—in dialogue with current environmental political theory. Contemporary environmental political theory considers the implications of the environmental crisis for such political concepts as rights, citizenship, justice, democracy, the state, race, class, and gender. As the field has matured, scholars have begun to explore connections between Green Theory and such canonical political thinkers as Plato, Machiavelli, Locke, and Marx. The essays in this volume put important figures (...) from the political theory canon in dialogue with current environmental political theory. It is the first comprehensive volume to bring the insights of Green Theory to bear in reinterpreting these canonical theorists. Individual essays cover such classical figures in Western thought as Aristotle, Hume, Rousseau, Mill, and Burke, but they also depart from the traditional canon to consider Mary Wollstonecraft, W. E. B. Du Bois, Hannah Arendt, and Confucius. Engaging and accessible, the essays also offer original and innovative interpretations that often challenge standard readings of these thinkers. In examining and explicating how these great thinkers of the past viewed the natural world and our relationship with nature, the essays also illuminate our current environmental predicament. Essays on Plato • Aristotle • Niccolò Machiavelli • Thomas Hobbes • John Locke • David Hume • Jean-Jacques Rousseau • Edmund Burke • Mary Wollstonecraft • John Stuart Mill • Karl Marx • W. E. B. Du Bois • Martin Heidegger • Hannah Arendt • Confucius Contributors Sheryl D. Breen, W. Scott Cameron, Peter F. Cannavò, Joel Jay Kassiola, Joseph H. Lane Jr. Timothy W. Luke, John M. Meyer, Özgüç Orhan, Barbara K. Seeber, Francisco Seijo, Kimberly K. Smith, Piers H. G. Stephens, Zev Trachtenberg, Andrew Valls, Harlan Wilson. (shrink)

Sefer Ḳol min ḥayim -- Sefer Ḳol rinah ṿi-yeshuʻah -- Sefer Orḥot ḥayim ʻim perush Netiv ḥayim -- Sefer Zikhron ʻolam -- Maʼamar Zikhron Yerushalayim.