United States of America demographic profiles illustrate a nation rich in cultural and racial diversity. Approximately 29% of the population are minorities and demographic projections indicate an increase to 50% by the year 2050. This creates a highly mobile and constantly changing environment, revealing the need for new levels of cultural awareness and sensitivity. These issues are particularly critical in the medical community where medical professionals must understand the impact cultural differences and barriers can have on evaluation, treatment, and rehabilitation. (...) During times of stress, such as when injury strikes, problems associated with lack of cultural sensitivity are intensified. Cultural diversity is of particular concern when standard measures for diagnosis and prognosis are derived from established norms for responding, because culture defines norms. This paper details a ten point checklist designed to facilitate cultural awareness and sensitivity in medical settings to ensure maximum successful recovery and outcomes for all patients. (shrink)

The fertilizing ability of spermatozoa is inhibited by certain substances present in the seminal fluid. Most of these antifertility factors are proteinaceous in nature and differ in their physical characteristics. They inhibit fertilization by inhibiting either motility, capacitation, acrosome reaction or penetration of the ovum investments by the spermatozoa. This review describes and discusses the properties of these factors and their possible role, individually and collectively, in the regulation of fertility.

This paper explores the gray area of questionable research practices (QRPs) between responsible conduct of research and severe research misconduct in the form of fabrication, falsification, and plagiarism (Steneck in SEE 12(1): 53–57, 2006). Up until now, we have had very little knowledge of disciplinary similarities and differences in QRPs. The paper is the first systematic account of variances and similarities. It reports on the findings of a comprehensive study comprising 22 focus groups on practices and perceptions of QRPs across (...) main areas of research. The paper supports the relevance of the idea of epistemic cultures (Knorr Cetina in: Epistemic cultures: how the sciences make knowledge, Harvard University Press, Cambridge, 1999), also when it comes to QRPs. It shows which QRPs researchers from different areas of research (humanities, social sciences, medical sciences, natural sciences, and technical sciences) report as the most severe and prevalent within their fields. Furthermore, it shows where in the research process these self-reported QRPs can be found. This is done by using a five-phase analytical model of the research process (idea generation, research design, data collection, data analysis, scientific publication and reporting). The paper shows that QRPs are closely connected to the distinct research practices within the different areas of research. Many QRPs can therefore only be found within one area of research, and QRPs that cut across main areas often cover relatively different practices. In a few cases, QRPs in one area are considered good research practice in another. (shrink)

Social evolution theory conventionally takes an externalist explanatory stance, treating observed cooperation as explanandum and the positive assortment of cooperative behaviour as explanans. We ask how the circumstances bringing about this positive assortment arose in the first place. Rather than merely push the explanatory problem back a step, we move from an externalist to an interactionist explanatory stance, in the spirit of Lewontin and the Niche Construction theorists. We develop a theory of ‘social niche construction’ in which we consider biological (...) entities to be both the subject and object of their own social evolution. Some important cases of the evolution of cooperation have the side-effect of causing changes in the hierarchical level at which the evolutionary process acts. This is because the traits that act to align the fitness interests of particles in a collective can also act to diminish the extent to which those particles are bearers of heritable fitness variance, while augmenting the extent to which collectives of such particles are bearers of heritable fitness variance. In this way, we can explain upward transitions in the hierarchical level at which the Darwinian machine operates in terms of particle-level selection, even though the outcome of the process is a collective-level selection regime. Our theory avoids the logical and metaphysical paradoxes faced by other attempts to explain evolutionary transitions. (shrink)

Objective: The objectives of this study are to understand the current functions, structure and operation of hospital ethics committees (HECs) in Shanghai and to facilitate their improvement. Methods: (1) A questionnaire survey, (2) interviews with secretaries and (3) on-site document reviews of HECs in Shanghai were used in the study, which surveyed 33 hospitals. Results: In Shanghai, 57.56% of the surveyed hospitals established HECs from 1998 to 2005. Most HECs used bioethical review of research involving human subjects as well as (...) bioethical review or consultation regarding medical care services and administrative decision- making. Of the surveyed HECs, 14.3% did not provide any formal bioethical training to the HECs’ members and many HECs had no standard operating procedures. Some HECs had no clear definition of what was “conflict of interest” that should be considered by the HECs, while 44.4% of the HECs did not perform continuing review. Discussion: After the issues of related national regulations, more and more hospitals established HECs in Shanghai, but the functions of HECs need to be further developed and formal training on bioethics should be provided to HEC members. To assure the independence and good performance of HECs, the conflict of interest procedure, the standard operating procedures and bioethical review should be improved. Conclusion: HECs in Shanghai had developed in the preceding 10 years and they played great roles in protecting the rights and welfare of human subjects and patients; some areas need improvement. (shrink)

Physician-written “do not resuscitate” DNR orders elicit negative reactions from stakeholders that may decrease appropriate end-of-life care. The semantic significance of the phrase has led to a proposed replacement of DNR with “allow natural death” . Prior to this investigation, no scientific papers address the impact of such a change. Our results support this proposition due to increased likelihood of endorsement with the term AND.

Introduction: Neuropsychiatry has generally been regarded as a hybrid discipline that lies in the borderland between the disciplines of psychiatry and neurology. There is much debate on its current and future identity and status as a discipline. Materials and Methods: Taking a historical perspective, the future of neuropsychiatry is placed within the context of recent developments in clinical neuroscience. Results: The authors argue that with the maturation of the discipline, it must define its own identity that is not dependent entirely (...) upon the parent disciplines. The requirements for this are the claiming of neuropsychiatric territory, a strong training agenda, an emphasis on treatments that are uniquely neuropsychiatric, and a bold embrace of new developments in clinical neuroscience. Conclusion: The exponential growth in neuroscientific knowledge places neuropsychiatry in an excellent position to carve out a strong identity. It is imperative that the leaders of the discipline seize the moment. (shrink)

India is a major producer and exporter of hand-knotted carpets to the world since the beginning of the British rule over India. Majority of the hand-knotted carpets exported from India are produced in the Bhadohi-Mirzapur region, popularly called as the carpet belt of India. Given deplorable working conditions and very high prevalence of child labour in the cluster, in the mid-1990, four social labels were implemented to improve the labour standards, in addition to slew of labour laws implemented by the (...) state of India. The objective of this study is to explore the prevailing labour standards and effectiveness of social labels in improving labour standards in the hand-knotted carpet manufacturing cluster. This study found that even after the implementation of social labels and slew of labour laws, there had been barely any improvement in the working conditions of carpet workers. The workers continued to be adversely incorporated in the carpet commodity chain. However, realising that there is very little scope of social upgrading in this occupation, many carpet workers have shifted to other occupations. But this study found very few child workers in carpet manufactories in the cluster. (shrink)

Antiphon's speech on the murder of Herodes has been variously dated by several scholars, but all seem to agree that it was delivered a good many years after the revolt and recapture of Mytilene. According to this opinion the speaker in § 74 declares himself too young to know much of what happened in those days. Before going into this more carefully, it seems necessary to visualize the situation of the accused man. In order to achieve this the best we (...) can do is to follow his own words in the Sirjyrjcris, §§ 20–24: ‘I travelled from Mytilene on the same ship as the lost man; we were on our journey to Ainos, I to see my father—he happened to be there at that time—he in order to sell some slaves to Thracian natives. These natives, who were to pay the ransom, and the slaves were on board too.—All this I will prove by witnesses.—As we, however, met with stormy weather, we were compelled to put in to a harbour in the territory of Methymna; there we found that* ship into which Herodes changed; in that ship, according to the accusers, he died. Now all this was mere chance: obviously I had not persuaded him to travel with me, no, he was travelling on his own business. Then I, personally, had a very good reason for travelling to Ainos; our putting in to that harbour was not premeditatd, we were compelled to. And again, when we were lying at anchor, the change of ship took place without any trickery or fraud: again, it was done because of necessity. The ship, viz., on which we had been travelling was not covered, the other one on the contrary had a covering; that was because of the rain.—All this I will prove by witnesses.—After boarding the other ship we drank some wine. After that it is only known that he left the ship, but did not return. I myself never left the ship that night at all. When the next day but did not return. I myself never left the ship that night at all. When the next day he had disappeared, we looked for him, I as well as the others. Probably it seemed strange to them, it certainly did to me. And it was I who caused a messenger to be sent to Mytilene, not one of the crew or the passengers belonging to Herodes, but my own servant. If I had been guilty, I would not, of course, have sent a man who might have informed against me. But when the man could not be found in Mytilene, nor anywhere else, and when the weather had improved and all the other ships were putting out, I also sailed.—All this I will prove by witnesses. (shrink)

Chapter Promising in Law and Morals Promissory and contractual obligations raise many issues of common interest to philosophers and lawyers. ...