Scholars and professional organizations in bioethics describe various approaches to “quality assessment” in clinical ethics. Although much of this work represents significant contributions to the literature, it is not clear that there is a robust and shared understanding of what constitutes “quality” in clinical ethics, what activities should be measured when tracking clinical ethics work, and what metrics should be used when measuring those activities. Further, even the most robust quality assessment efforts to date are idiosyncratic, in that they represent (...) evaluation of single activities or domains of clinical ethics activities, or a range of activities at a single hospital or healthcare system. Countering this trend, in this article we propose a framework for moving beyond our current ways of understanding clinical ethics quality, toward comprehensive quality assessment. We first describe a way to conceptualize quality assessment as a process of measuring disparate, isolated work activities; then, we describe quality assessment in terms of tracking interconnected work activities holistically, across different levels of assessment. We conclude by inviting future efforts in quality improvement to adopt a comprehensive approach to quality assessment into their improvement practices, and offer recommendations for how the field might move in this direction. (shrink)

In this Matters Arising article, we outline how the recent article “The impact on patients of objections by institutions to assisted dying: a qualitative study of family caregivers’ perceptions” (White et al., 2023 Mar 13;24(1):22) informed Voluntary Assisted Dying (VAD) implementation in our large Australian public health setting, where objections do not emanate from, but within, the institution. In reporting the harms to patients and caregivers created by institutional objection, White et al. provide an evidenced-based road map for potential potholes (...) or risks associated with VAD implementation. We discuss the complexities emerging from the diverse views of health professionals and the ethical tensions arising from such, especially within certain specialties, and how we developed systemic strategies that support patients, caregivers and staff alike. We highlighted the need to shift from “Do you support VAD?“ to “How can we support you as healthcare professionals to integrate VAD into your practice, in a way that complies with the legislation, meets the needs of patients and caregivers, and feels safe and does not compromise your moral stance?“. (shrink)

© 2015 Elsevier Inc.Postnatal organogenesis occurs in an immune competent environment and is tightly controlled by interplay between positive and negative regulators. Innate immune cells have beneficial roles in postnatal tissue remodeling, but roles for the adaptive immune system are currently unexplored. Here we show that adaptive immune responses participate in the normal postnatal development of a non-lymphoid epithelial tissue. Since the mammary gland is the only organ developing predominantly after birth, we utilized it as a powerful system to study (...) adaptive immune regulation of organogenesis. We found that antigen-mediated interactions between mammary antigen-presenting cells and interferon-γ -producing CD4+ T helper 1 cells participate in MG postnatal organogenesis as negative regulators, locally orchestrating epithelial rearrangement. IFNγ then affects luminal lineage differentiation. This function of adaptive immune responses, regulating normal development, changes the paradigm for studying players of postnatal organogenesis and provides insights into immune surveillance and cancer transformation. Plaks et al. (shrink)

Ecclesiazusae, the first surviving work of Aristophanes from the fourth centuryb.c.e., has often been dismissed as an example of Aristophanes’ declining powers and categorized as being less directly rooted in politics than its fifth-century predecessors owing to the after-effects of Athens’ defeat in the Peloponnesian War. Arguing against this perception, which was largely based on the absence of ad hominem attacks characterizing Aristophanes’ earlier works, this paper explores howEcclesiazusaeengages with contemporary post-war Athenian politics in a manner which, while different to (...) his earlier comedies, remained closely rooted in the political and cultural concerns of the 390s. By examining the figure of Praxagora, I will first consider recent suggestions thatEcclesiazusaehints at the possibility of an anti-democratic coup. I will then examine how contemporary discussions of constitutional and legal reforms (including the invocation of ‘founding fathers’ such as Solon and Lycurgus) are incorporated into both Praxagora's language and the scenes featuring the Selfish Man and Hags that follow the establishment of Praxagora's regime. Examining these final scenes, I conclude thatEcclesiasuzaedoes not suggest that the idea of democratic equality itself is fundamentally flawed, but instead argues that Athens needs a suitable leader, well suited to the rough and tumble of assembly rhetoric, in order to successfully function. In the world ofEcclesiazusae,the men of Athens have failed too often to inspire any hope, putting their own interest above the state, and the new leader must be someone different. Thus Aristophanes sets up Praxagora as a female Solon to remake the state and lead the democracy. The second half of the play demonstrates this need for a strong leader, as problems arise both from the quarter of critical bystanders (the Selfish Man and Epigenes, the Young Man in the ‘hag scene’) and from over-zealous enforcers (the Old Women). (shrink)

In this article, the authors highlight connections between research on Two Spirit Native Americans and standard social studies curriculum. Two Spirit is a Pan-Indian term describing Native Americans who believe they embody both masculine and feminine characteristics/traits in one physical body. Findingsfrom this research expand the field's conception of multiple perspectives and diversity, while creating opportunities for nuanced understandings of genderexpression and gender that go beyond the male/female dichotomy currently accepted as the norm. The authors utilize historical research and a (...) semi-structured,in-depth interview with a current Ojibwe leader to better understand and theorize Native Americans' acceptance of diverse ways of being. The authors conclude that modern-day social studies teachers and students have much to learn from this traditional Native worldview. Specifically, the authors believe that encouraging students to adopt more inclusive perspectives on gender expression and to recognize the plausibility of multiple genders may lead to more advanced, social learning. Combined with reinforcement from responsible adults at school, this recognition would lessen a variety of present-day social ills, including the incidence of teen suicide caused by homophobia. (shrink)

Interviewed by Christian Sheppard about Richard Kearney’s book The God Who May Be (2001), and speaking also of Kearney’s On Stories (2002) and Strangers, Gods and Monsters (2002), David Tracy remarks on Kearney’s development of the possible as a major philosophical and theological category. Showing the importance of the idea of the infinite, he speaks of the need for a hermeneutical moment to follow the initial encounter, and of a call for general criteria of judgment of the Other. He (...) discusses, too, the dangers and the rewards of doing both theology and philosophy at the same time. To him the category of the Impossible enters into the possible and is not only positive but desired. In a conversation that ranges widely - Derrida and Levinas, Jean-Luc Marion, Angelus Silesius, Kierkegaard, Nicholas of Cusa, Heidegger and Ricoeur, and, in the call for plurality, William James - the two speakers discuss both poetic sensibility and the call for justice. Reflecting on fragmentation, Tracy speaks of the need to focus on suffering and the importance of attaining a sense of ‘the entire story, all of the metaphors’. (shrink)

De Interpretatione is among Aristotle's most influential and widely read writings; C. W. A. Whitaker presents the first systematic study of this work, and offers a radical new view of its aims, its structure, and its place in Aristotle's system. He shows that De Interpretatione is not a disjointed essay on ill-connected subjects, as traditionally thought, but a highly organized and systematic treatise on logic, argument, and dialectic.

This anthology of philosophical texts by Greek and Roman authors brings together works from the late fifth century BC to the sixth century AD that comment on major aesthetic issues such as the perception of beauty and harmony in music and the visual arts, structure and style in literature, and aesthetic judgement. It includes important texts by Plato and Aristotle on the status and the role of the arts in society and in education, and Longinus' reflections on the sublime in (...) literature, in addition to less well-known writings by Philodemus, Cicero, Seneca, Plotinus, Augustine and Proclus. Most of the texts have been newly translated for this volume, and some are available in English for the first time. A detailed introduction traces the development of classical aesthetics from its roots in Platonism and Aristotelianism to its ultimate form in late Antiquity. (shrink)

D.J. Sheppard reflects on Carey's controversial What Good are the Arts?

As doctoral students from New Zealand and Australia, advised by supervision teams with a diversity of critical realist experience from limited to none, we came independently to the 2018 Critical Re...

As doctoral students from New Zealand and Australia, advised by supervision teams with a diversity of critical realist experience from limited to none, we came independently to the 2018 Critical Re...

To understand why autistic people are misperceived in the way Jaswal & Akhtar suggest, we should embrace concepts like the “double empathy problem” and camouflaging and recognize the negative consequences these have for mental health in autism. Moreover, we need to value expertise from experience so that autistic people have a voice and indeed a stake in research into autism.

Carceral spaces such as prisons are designed to restrict freedoms and keep inhabitants confined and under surveillance through various mechanisms. As a result, prisons are spaces where movement is restricted through confinement, while prisoners’ ability to move is conflated with freedom. We aim to move beyond this dichotomy and consider a complex rethinking of the body in criminological theory and practice through dance in carceral space. In doing so, we explore under what conditions movement represents agentic practices. Understanding these nuances (...) requires an interrogation of prisoner agency, including prisoners’ subtle maneuverability of power dynamics within the prison. We explore these dynamics using feminist and arts-based methods, specifically dance workshops delivered to twenty participants incarcerated in a Canadian provincial women’s prison. We find that movement and expression in prison may create moments of agentic freedom for incarcerated women under certain conditions. We argue that more nuanced understandings of incarcerated women’s agency can be found in their daily negotiations of time and space, and movement can provide numerous meanings. Our findings suggest arts-based approaches within prison environments create opportunities for women to express their identity and sexuality through movement in ways otherwise not permitted in prison. For many incarcerated women in this study, this sense of freedom may be associated with the ability to focus and take care of themselves while confined. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics & the Environment 8.2 (2003) 132-139 [Access article in PDF] Environmentalism: A Global History, by Ramachandra Guha. New York: Longman, 161 pp, includes Bibliographic Essay and Index. Softcover, ISBN 0-321-01169-4. This short but wide-ranging book is a global survey of the history of environmental thought by one of the people most responsible for broadening environmental discussions to include recognition of post-colonial societies. The overall goal of this introductory (...) textbook is to explain multiple environmental discourses from Brazil, the United States, China, India, the Soviet Union, and Africa, and then to situate them as complimentary components of a global socially oriented environmental discursive framework.With that said, it is always difficult to evaluate an introductory textbook. In this case, much of what is covered represents well-worn ground for the environmental scholar. The thesis that emerges is less about a new set of environmental proposals and more about how we ought to understand the history of ideas that informs the development of policy and what ideas ought to be taught in the classroom. Since this book is designed as a textbook, much of my commentary stems from a consideration of how it might work in the classroom. [End Page 132]As an educator regularly teaching courses in environmental thought, ethics, planning, and policy, I have often wondered why so few texts exist on the global history of environmental thought. Guha's work represents an attempt to bridge this gap in the literature. Despite Guha's admirable intentions, I am hesitant to endorse this work as an introductory textbook on the global history of environmental thought for one important reason: Guha's methodology leads to the omission of important components of the global history of environmental thought. From the outset, it is important to acknowledge the difficulty of this type of project. The very title of this work signals perhaps an impossible project, given the 145 pages of text set aside for the task. Guha does cover a number of subjects well, and some are welcome additions to the discussion of the history of environmental thought. Overall though, the topics not covered work to neutralize what is accomplished by the topics that are covered. Consider first what Guha does include.The book is divided into two parts, each focusing on a wave of environmental thought. In the first part, there are four chapters and an afterword. In the initial chapter, Guha argues that a more social and international environmentalism can be a spur to "human reflection and human action," and not just a "scientific study of the state of nature or a balance sheet of the impact of human beings on the earth" (p. 3). While it is common to divide the environmental movement into waves (usually three or four), Guha chooses to delineate only one major shift and thus only two waves of environmentalism. The first wave is comprised of what Guha calls a "period of pioneering and prophecy" and an initial reaction to industrialization; the second wave is comprised of the more socially oriented responses that have emerged in recent decades (p. 3). There are good reasons for delineating more waves, but Guha's project is generally well-served by the two-wave distinction.Guha divides the first wave into three varieties distinguished by their different guiding ideologies—back-to-the-land, scientific conservation, wilderness idea—which are treated respectively in chapters two, three, and four. What I found most compelling about Guha's varieties are some of the figures he chose to include. For example, in chapter two Guha offers a treatment of the back-to-the-land ideology that concurrently condemned excessive industrialization and espoused a commitment to agrarian and pastoral values. From William Wordsworth, William Blake, John Clare, Edward Carpenter, Henry David Thoreau, John Ruskin, Edward Carpenter, [End Page 133] Henry David Thoreau, William Morris, and Octavia Hill, to Gandhi and the Nazis, Guha's range here is impressive. While I do have reservations about how convincing it is to link Wordsworth, Ruskin, and Gandhi according to a largely generic and nondescript agrarian ideal that he claims... (shrink)

The metabolic requirements of differentiated neurons are significantly different from that of neuronal precursor and neural stem cells. While a re‐programming of metabolism is tightly coupled to the neuronal differentiation process, whether shifts in mitochondrial mass, glycolysis, and oxidative phosphorylation are required (or merely consequential) in differentiation is not yet certain. In addition to providing more energy, enhanced metabolism facilitates differentiation by supporting increased neurotransmitter signaling and underpinning epigenetic regulation of gene expression. Both epidemiological and animal studies demonstrate that micronutrients (...) (MNs) significantly influence many aspects of neonatal brain development, particularly neural migration and survival, neurite outgrowth, and process maturation. Here we review recent insights into the importance of metabolic reprogramming in neuronal differentiation, before considering evidence that micronutrient signaling may be key to regulating these processes. (shrink)

Both Carnap and Quine made significant contributions to the philosophy of mathematics despite their diversedviews. Carnap endorsed the dichotomy between analytic and synthetic knowledge and classified certainmathematical questions as internal questions appealing to logic and convention. On the contrary, Quine wasopposed to the analytic-synthetic distinction and promoted a holistic view of scientific inquiry. The purpose of thispaper is to argue that in light of the recent advancement of experimental mathematics such as Monte Carlosimulations, limiting mathematical inquiry to the domain of (...) logic is unjustified. Robustness studies implemented inMonte Carlo Studies demonstrate that mathematics is on par with other experimental-based sciences. (shrink)

This volume contains the selected discourses of four seventeenth-century philosophers, carefully chosen to illustrate the tenets characteristic of the influential movement known as Cambridge Platonism. Fundamental to their beliefs is the statement most clearly voiced by Benjamin Whichcote, their leader by common consent, that the spiritual is not opposed to the rational, nor Grace to nature. Religion is based on reason, even in the presence of 'mystery'. Free will and Grace are not mutually exclusive. The editor's comprehensive introduction delineates the (...) main principles of the Cambridge Platonists, in the light of their heritage. It compares their attitude to contemporary thought, stressing their mistrust both of institutionalised religion and of the rising tide of materialism. The sermons are reprinted from the original texts and fully annotated with comparisons and references to a wide range of works. The editor also includes a useful list for further reading, biographical notes and a comprehensive index. (shrink)

Humanity needs a way to pool scientific community opinion quickly and efficiently on a given statement of interest. This should be on a very large scale, such that one can have confidence that the result reflects international scientific opinion. For this pilot project (2022-23), we developed tailored architecture in the form of a novel polling platform, to survey a network of scientists at 30 academic institutions around the world. Personal, one-to-one emails were sent to all relevant scientists at those institutions, (...) asking them for their position on our pilot statement, "Science has put it beyond reasonable doubt that COVID-19 is caused by a virus." Scientists answered by clicking a URL embedded in the email, and confirming their response on a 5-point Likert scale. Voting was anonymous, with the token linking the scientist to their vote being destroyed upon voting, and their response logged against the demographics of scientific field of expertise (broadly construed) and institution for subsequent data analysis. (shrink)

Drawing on feminist and sociocultural theories of emotion that focus on the social, political, and dynamic nature of emotions in history teachers’ pedagogical decision-making, this article presents findings from the analysis of interviews with two white teachers on the role of emotions in their teaching of history in comprehensive, urban high schools. While the teachers perceived that students’ emotional connection to historical content was a necessary step in learning history, each teacher negotiated different emotional rules in their classrooms, creating unique (...) learning experiences for their students. This study demonstrates the significance of emotions in history teaching, providing examples of the complexity of how teachers navigate dominant discourses about students and education and their own personal goals when it comes to teaching about the past. (shrink)