Overdiagnosis refers to diagnosis that does not benefit patients because the diagnosed condition is not a harmful disease in those individuals. Overdiagnosis has been identified as a problem in cancer screening, diseases such as chronic kidney disease and diabetes, and a range of mental illnesses including depression and attention deficit hyperactivity disorder. In this paper, we describe overdiagnosis, investigate reasons why it occurs, and propose two different types. Misclassification overdiagnosis arises because the diagnostic threshold for the disease in question has (...) been set at a level where many people without harmful disease are nonetheless diagnosed. We illustrate misclassification overdiagnosis using the example of chronic kidney disease. Misclassification occurs in diseases diagnosed using biomarkers or based on patient reported phenomena. Maldetection overdiagnosis arises because, at the time the diagnosis is made and despite the presence of a 'gold standard' diagnostic test, it is not possible to discriminate between harmful and non-harmful cases of the index disease. We illustrate maldetection overdiagnosis using the example of thyroid cancer. While there is some overlap between misclassification and maldetection overdiagnosis, this conceptual analysis helps to clarify the phenomenon of overdiagnosis and is a necessary first step in developing strategies to address the problem. (shrink)

Ethical sourcing and socially responsible purchasing is increasingly on the business agenda, but developing and implementing policy and practice across a global network of suppliers is challenging. The purpose of this paper is to expand theory on the nature of linkages between firms in a social network, specifically postulating how ties between organizations can be configured to facilitate development, diffusion, and adoption of sustainability initiatives. The theory development provides a lens with which to view the influence of a firm’s structural (...) embeddedness in its organizational social network on developing, diffusing and adopting sustainability initiatives. The focus is on brokers who in various structural alignments help bridge the focal firm’s sustainability initiatives with distant or disconnected stakeholders the focal firm is trying to reach. The brokers help the focal firm engage these stakeholders by sharing knowledge and information regarding sustainability initiatives and by incorporating localized needs into the development of the initiatives to facilitate better diffusion and adoption. The theoretical contribution of this manuscript is a novel perspective on sustainability in organizational networks. This perspective allows for greater explanatory power regarding how organizations can achieve sustainable outcomes that meet a broad base of stakeholder needs and better facilitate sustainability initiatives across a diverse and expansive network. (shrink)

Presenting a field-defining overview of one of the most appliable linguistic theories available today, this Handbook surveys the key issues in the study of systemic functional linguistics, covering an impressive range of theoretical perspectives. Written by some of the world's foremost SFL scholars, including M. A. K. Halliday, the founder of SFL theory, the handbook covers topics ranging from the theory behind the model, discourse analysis within SFL, applied SFL, to SFL in relation to other subfields of linguistics such as (...) intonation, typology, clinical linguistics and education. Chapters include discussion on the possible future directions in which research might be conducted and issues that can be further investigated and resolved. Readers will be inspired to pursue the challenges raised within the volume, both theoretically and practically. (shrink)

Ocean biology helps regulate global climate by fixing atmospheric CO2 and exporting it to deep waters as sinking detrital particles. New observations demonstrate that particle fragmentation is the principal factor controlling the depth to which these particles penetrate the ocean's interior, and hence how long the constituent carbon is sequestered from the atmosphere. The underlying cause is, however, poorly understood. We speculate that small, particle‐associated copepods, which intercept and inadvertently break up sinking particles as they search for attached protistan prey, (...) are the principle agents of fragmentation in the ocean. We explore this idea using a new marine ecosystem model. Results indicate that explicitly representing particle fragmentation by copepods in biogeochemical models offers a step change in our ability to understand the future evolution of biologically‐mediated ocean carbon storage. Our findings highlight the need for improved understanding of the distribution, abundance, ecology and physiology of particle‐associated copepods. (shrink)

Drawing on biosemiotic theory and the Peircean idea of ‘abduction’, I shall propose the idea of a layered structure of bio / semiotic evolution, in which humanknowledge is systemic and recursive — and thus emergent both from what is forgotten and from earlier evolutionary strata. I will argue that abductions are those processes by which we move creatively between often unacknowledged types of knowledge which are rooted in our natural and cultural evolutionary past (e.g., unconscious, preconscious, or tacit knowledge; knowledge (...) that is experienced affectively) and the more familiar types of knowledge associated with self-conscious deductive and inductive reasoning. I shall suggest that these processes of ‘hooking back’ into the past in order to make new sense in the light of subsequent experience, are characteristic of all human inventiveness in both the arts and the sciences, and are facilitated by what Peirce called ‘The Play of Musement’.My reasons for attempting this task are that I hope to offer a semiotic and biosemiotic corrective to the widespread and culturally dominant idea that the progress ofhuman knowledge and cultural evolution depends on self rational efficiency, conceived of in terms of self-conscious deduction and induction alone — a conception which runs the risk of excluding from the account what is actually the most creative part of human knowing. Second, I will suggest that a properly semiotically informed understanding of human creativity — i.e., one which understands the Peircean semiotic as triadic and which draws on the post-Peircean theory that the semiotic drive in nature and in culture derives from the need to model the world as accurately as possible — should provide a very stern warning against the dangers of confusing the map with the territory. For creative artists and scientists (and life-livers, in general) progress, I shall suggest, inasmuch as they ignore the utilitarian dogma in practice. A biosemiotic understanding of human reasoning as an evolutionary semiotic process should thus contribute to a removal of the impediments of modernity which lie in the failure to properly grasp both what language (and semiosis in general) is, as well as the historical and prehistorical evolution that makes such semiosis possible. (shrink)

The men and women who serve in the armed forces, in the words of Major General Joseph Caravalho, “sign a blank check, co-signed by their families, payable to the Army, Navy, Air Force, or Marines, up to and including their lives.” It is human nature to consider such a pact in polarized terms; the pact concludes in either a celebratory homecoming or funereal mourning. But in reality, surviving catastrophic injury may incur the greatest debt. The small but real possibility of (...) losing the ability to bear biological children due to genitourinary combat injury has been a topic of discussion in hushed tones, behind closed doors. But as policy changes move the conversation into the open, we must be fully aware of the far-reaching and long-term impacts of decisions on those who have sustained genitourinary injury. In January 2016, Secretary of Defense Ashton Carter outlined a set of reforms that would improve the quality of life for military families by recognizing the importance of maintaining fertility, even in the face of severe injury. This first promising step could build a solid foundation of insuring fertility preservation for wounded service members with genitourinary injury, and it could set a precedent beyond the military for insuring treatment for people who have lost their reproductive capacity. Thus, the ethical challenges raised by the new policy require careful analysis. (shrink)

The ethical development of business graduates is a critical issue. Yet, little empirical evidence exists on the factors affecting business graduate ethical development and behaviour using an Islamic perspective. This study examines the effects of mentoring support, the perceived standard of ethical conduct of peers, and individual ethical attributes of National female (Emirati) business graduates from the United Arab Emirates. Research has shown that formal and informal mentoring relationships benefit new employees by enabling them to further learn and grow within (...) an organisation. On the other hand, some employees have also shown that these relationships can have a negative impact on a new employee’s ethical orientation. The aim of this study is to investigatethe ethical orientations of Emirati female business graduates as they move from the relative sanctity of home and university into a new multicultural, westernised business environment. The results suggest that the ethical evaluations and behavioural intentions of Emirati graduates are affected by a multiplicity of sources including professional bodies and both mentors and peers in the workplace. It may be prudent at such a significant time in the UAE’s development that educators consider introducing ethical education into tertiary curriculum. (shrink)

In this review I argue that while Berger makes out a good argument that the language of civic engagement covers too much (and hence too little) and that education plays a vital role in developing civic-minded sensibilities, I am less sanguine that the strategies for the reform of our “attention deficit democracy” will achieve the desired effect in a political society dominated by the corrupting influence of corporations who actively seek to undermine just such sensibilities as anathema to their objectives. (...) As corporate objectives become more and more wedded to the state, so too reform becomes less and less likely to be successful. An excellent example of this is the power wielded by the current incarnation of the fossil fuel empire and it’s influence over law-making concerning hydraulic fracturing in Pennsylvania. While I applaud Berger’s objectives, I am no longer convinced that pragmatism and not a more revolutionary approach can fulfill Berger’s—and my own—democratic ideals. (shrink)

On the morning of May 26, 2004, New York Times readers found a note from the paper’s editors on Page A10. The headline read “From the Editors—The Times and Iraq,” and the 1,000-word article that followed served as a disclosure that the Times had failed in its duty of both aggressive information gathering and careful reporting with a critical eye. Response to the note was fast and widespread as newspeople across the country commented on the paper’s public admission of its (...) flawed coverage. The editors’ note, together with the responses it generated, provides a glimpse into the state of American journalism and the way those enmeshed in it understand and expect the practice to operate. Beyond serving a descriptive purpose, however, the texts can be used to start a discourse in the normative realm, to offer suggestions for how our understanding of journalism perhaps ought to change to better reflect the reality of what is truly a human institution. This paper provides both a descriptive and normative analysis of themes that emerge from the case, and it prompts both journalists and citizens to reflect on the practice and then continue moving forward through a landscape in constant flux. (shrink)

In April 2002, New York Times columnist Thomas Friedman was awarded a Pulitzer Prize for a series of columns he wrote in the months following September 11. On the surface, the columns seemed to fit Cummins Gauthier’s criteria for public grieving: they engaged readers emotionally; they empathized with victims and survivors; and they helped readers develop moral attitudes, opinions and responses. However, in analyzing the columns from a feminist ethic of care perspective—one that expands the boundaries of the moral community (...) beyond the borders of a nation-state—one finds that Friedman’s columns can distort the process of public grieving, leading citizens toward anger and an “us” verus “them” mentality rather than healing and a genuine concern that embraces the value of all human beings. (shrink)

Environmental pragmatism is rightly described as “cynical” if good reasons exist to worry its advocates would endorse oppressive measures to achieve its goals. Given the history of human chauvinism, moreover, this worry is not far-fetched. It is, however, misguided: conflation not-withstanding, human chauvinism and human-centeredness (anthropocentrism) are not the same thing. “Chauvinism” describes an objectionable but alterable course of human history; anthropocentrism is an indigenous feature of the experiential conditions of Homo sapiens from which no particular course of human history (...) necessarily follows. Properly understood, I argue, human-centeredness is an ally in the quest for environmental responsibility—not its foe. (shrink)

This book contains the 1992 Tanner Lectures on Human Values delivered by Christine M. Korsgaard at Cambridge University, along with commentaries by G. A. Cohen, Raymond Geuss, Thomas Nagel, and Bernard Williams, as well as a reply by Korsgaard. The theme taken up in these lectures is the source and authority of norms, what Korsgaard calls “the normative question,” which asks “what justifies the claims that morality makes on us”. With clarity and elegance, she examines four proposed answers to this (...) question: voluntarism, realism, reflective endorsement, and the appeal to autonomy. (shrink)