"This is the book that I have been waiting for for twenty years. With exceptional clarity, Draine introduces the underlying physics and brings the basic pieces together to describe the multiphase structure of the interstellar and intergalactic medium. Combined with many useful tables and figures, this book will rapidly become a hit with students and researchers alike. It continues the fine tradition of Princeton professors writing seminal books on this topic."--Ewine van Dishoeck, Leiden University "A true tour de force, providing (...) a definitive account of the physics of interstellar matter. Written with authority and insight by a master of the subject, Bruce Draine's book will be a treasured guide for new graduate students as well as a comprehensive and rigorous reference for galactic and extragalactic researchers."--Eve Ostriker, University of Maryland "Draine has written an interstellar-medium textbook worthy of Lyman Spitzer, updated thirty years later. His coverage of atomic, molecular, radiative, thermal, and dynamical processes is excellent. Most valuable to students and professionals are the combinations of physical processes with multiwavelength observations appropriate for the modern astronomer."--J. Michael Shull, University of Colorado at Boulder "This book is a comprehensive account of the physical processes that take place in the interstellar medium and that determine its behavior. It is likely to become the bible on the subject."--Alexander Dalgarno, Harvard University "This is an outstanding text on an important topic in astrophysics. Draine carefully goes into the physical processes, providing a unifying discussion that is often missing in other treatments."--Christopher F. McKee, University of California, Berkeley. (shrink)

Over the past two decades, we have seen an increase in the use of medical-legal partnerships in health-care and/or legal settings to address health disparities affecting vulnerable populations. MLPs increase medical teams' capacity to address social and environmental threats to patients' health, such as unsafe housing conditions, through partnership with legal professionals. Following the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, we systematically reviewed observational studies published from January 1993-January 2016 to investigate the capacity of MLPs to (...) address legal and health disparities. We identified 13 articles for qualitative analysis from an initial pool of 355 records. The resulting pool of 13 articles revealed more information regarding the capacity of MLPs to address legal outcomes than their capacity to address health outcomes; only 4 studies directly addressed the impact of MLP intervention on patient wellbeing and/or patient utilization of healthcare services. We call for further evaluation/longitudinal studies that specifically address MLPs' short and long term effects upon patient health disparities. Finally, given the demonstrated capacity of MLPs to address unmet legal needs, and their evident potential in regards to improving health outcomes, we present the MLP model as a framework to address HIV-related legal and health disparities. (shrink)

Care drain brings the traditional problem of carers' choice between paid work and family at a new level. Taking care drain from Romania as a case study, I analyse the consequences of parents' migration within a normative framework committed to meeting the needs of vulnerable individuals. The temporary migration of parents who cannot take their children with them involves moral harm, particularly the frustration of children's developmental and emotional needs. I use recent feminist work on justice (...) and care in the economy to address the question whose responsibility it is to fill the void of care created by temporary migration. I argue that the moral issues raised by care drain are also issues of social justice and therefore call for rectification by the states involved. (shrink)

The gendered division of labour in combination with the feminisation of international migration contribute to shortages of care, a phenomenon often called ‘care drain’. I argue that this phenomenon is an issue of global gender justice. I look at two methodological challenges and favourably analyse the suggestions that care drain studies should include the effects of fathers’ and other male caregivers’ migration and, in some cases, the effects of migration within national borders. I also explain (...) why care drain is a problem of distributive justice, by looking at the background conditions that result in much of the care-givers’ migration. (shrink)

Migrant women are often stereotyped. Some scholars associate the feminization of migration with domestic work and criticize the “care drain” as a new form of imperialism that the First World imposes on the Third World. However, migrant women employed as domestic workers in Northern America and Europe represent only 2% of migrant women worldwide and cannot be seen as characterizing the “feminization of migration”. Why are migrant domestic workers overestimated? This paper explores two possible sources of bias. The (...) first is sampling: conclusions about “care drain” are often generalized from small samples of domestic workers. The second stems from the affect heuristic: imagining children left behind by migrant mothers provokes strong feelings of injustice which trump other considerations. The paper argues that neither source of bias is unavoidable and finds evidence of gender stereotypes in the “care drain” construal. (shrink)

The metaphor of “care drain” has been created as a womanly parallel to the “brain drain” idea. Just as “brain drain” suggests that the skilled migrants are an economic loss for the sending country, “care drain” describes the migrant women hired as care workers as a loss of care for their children left behind. This paper criticizes the construction of migrant women as “care drain” for three reasons: 1) it is (...) built on sexist stereotypes, 2) it misrepresents and devalues care work, and 3) it misses the opportunity for a theoretical change about how skills in migration contexts can be understood. (shrink)

Worldwide, many impoverished parents migrate, leaving their children behind. As a result children are deprived of continuity in care and, sometimes, suffer from other forms of emotional and developmental harms. I explain why coercive responses to care drain are illegitimate and likely to be inefficient. Poor parents have a moral right to migrate without their children and restricting their migration would violate the human right to freedom of movement and create a new form of gender injustice. I (...) propose and defend an institutional solution. Taxes levied on the remittances sent by temporary migrants ought to be used to provide migrants' children with psychological counselling in order to mitigate the harm resulted from discontinuity in care. (shrink)

There is a consensus that the effects of medical brain drain, especially in the Sub-Saharan African countries, ought to be perceived as more than a simple misfortune. Temporary restrictions on the emigration of health workers from the region is one of the already existing policy measures to tackle the issue—while such a restrictive measure brings about the need for quite a justificatory work. A recent normative contribution to the debate by Gillian Brock provides a fruitful starting point. In the (...) first step of her defence of emigration restrictions, Brock provides three reasons why skilled workers themselves would hold responsibilities to assist with respect to vital needs of their compatriots. These are fair reciprocity, duty to support vital institutions, and attending to the unintended harmful consequences of one’s actions. While the first two are explained and also largely discussed in the literature, the third requires an explication on how and on which basis skilled workers would have a responsibility as such. In this article, I offer a vulnerability approach with its dependency aspect that may account for why the health workers in underserved contexts would have a responsibility to attend to the unintended side effects of their actions that may lead to a vital risk of harm for the population. I discuss HIV/AIDS care in Zimbabwe as a case in point in order to show that local health workers may have responsibilities to assist the population who are vulnerable to their mobility. (shrink)

The global migration of physicians and nurses produces serious shortages in the developing world, exemplifying one of the ways that global capitalism sets up dynamics of surplus extraction from periphery to global wealth centers. This paper focuses specifically on the Ghanaian situation, and argues that an ethics of care framework offers a way of approaching the problem productively. Recognizing the various commitments and relationships that tie us together allows for a response that protects individual freedom while responding to the (...) need to maintain adequate numbers of trained health-care workers. (shrink)

Clinical Ethics, Ahead of Print. The migration of health-care professionals has often produced morally charged discussions among ethicists, politicians, and policy makers in the migrant-sending and migrant-receiving countries because of its devastating effects on the health of those left behind in the countries of origin.This movement of skilled professionals – their decision to leaving their countries of origin in search of better work environments – has created a phenomenon that has been described as brain drain. Although the migration (...) of health workers continue to bring prosperity to millions of people around the world, they have also evoked hopelessness in many more people. Thus, questions of global justice manifest themselves when it comes to the matters of brain drain and the just distribution of health and healthcare professionals. (shrink)

In this essay, we focus on the moral justification of a highly controversial measure to redress medical brain drain: the duty to stay. We argue that the moral justification for this duty lies primarily in the fact that medical students impose high risks on their fellow citizens while receiving their medical training, which in turn gives them a reciprocity-based reason to temporarily prioritize the medical needs of their fellow citizens.

Many western industrialized countries are currently suffering from a crisis in health human resources, one that involves a debate over the recruitment and licensing of foreign-trained doctors and nurses. The intense public policy interest in foreign-trained medical personnel, however, is not new. During the 1960s, western countries revised their immigration policies to focus on highly-trained professionals. During the following decade, hundreds of thousands of health care practitioners migrated from poorer jurisdictions to western industrialized countries to solve what were then (...) deemed to be national doctor and nursing 'shortages' in the developed world. Migration plummeted in the 1980s and 1990s only to re-emerge in the last decade as an important debate in global health care policy and ethics. This paper will examine the historical antecedents to this ethical debate. It will trace the early articulation of the idea of a 'brain drain', one that emerged from the loss of NHS doctors to other western jurisdictions in the 1950s and 1960s. Only over time did the discussion turn to the 'manpower' losses of 'third world countries', but the inability to track physician migration, amongst other variables, muted any concerted ethical debate. By contrast, the last decade's literature has witnessed a dramatically different ethical framework, informed by globalization, the rise of South Africa as a source donor country, and the ongoing catastrophe of the AIDS epidemic. Unlike the literature of the early 1970s, recent scholarship has focussed on a new framework of global ethics. (shrink)

Next SectionAccess to medicines, vaccination and care in resource-poor settings is threatened by the emigration of physicians and other health workers. In entire regions of the developing world, low physician density exacerbates child and maternal mortality and hinders treatment of HIV/AIDS. This article invites philosophers to help identify ethical and effective responses to medical brain drain. It reviews existing proposals and their limitations. It makes a case that, in resource-poor countries, ’locally relevant medical training’—teaching primarily locally endemic diseases (...) and practice in scarcity conditions, training in rural communities and admitting rural students preferentially—could help improve retention. Locally relevant training would arguably diminish medical brain drain in five ways. It would (i) make graduates less attractive for Western employers, (ii) align graduates’ expectations with actual practice, diminishing ‘burn-out’, (iii) enhance the professional prestige of local practice, (iv) hold rotations in, and recruit applicants from, rural areas, which is known to improve retention there, and (v) create local career development options that attract practitioners to stay. Such educational reform may raise worries about poor-quality care, breach of the freedom of education and occupation, breach of the freedom of movement, unequal distribution of opportunities among students, hypocrisy and resistance from influential actors. We address these worries. (shrink)

The authors examine the nursing practice of disposing unaltered controlled substances into public water systems as an issue for nurses concerned with the environmental harm it can cause. A summary of the history of controlled substance management reveals inconsistencies in the interpretation of current regulations that have led to disposal policies that vary by institution, according to a benchmarking survey of regional hospitals. Much attention has been given to the phenomenon of conscientious objection in the context of patient care (...) that conflicts with a nurse’s moral integrity. Nurses who are compelled to dispose narcotics down drains may also face this struggle. The authors submit that this disposal method is based on a type of double effect logic where preventing diversion is viewed as a good effect of flushing unused controlled substances that outweighs any harm it may cause, though there is little evidence to support this conclusion. Consequently, the topic deserves further study so that nurse managers and administrators can support and offer alternatives to nurses who object to flushing drugs down the drain. (shrink)

In recent years, a proportion of older Germans has been sent to relatively high‐end care homes within lower‐income countries where the care tends to be cheaper and more extensive than that in German care homes. Destination countries are found predominantly within Eastern Europe (e.g. Poland, Hungary, Czech Republic), but to a lesser extent also within South‐East Asia (e.g. Thailand). At the same time, these expatriations have caused much controversy, with some German commentators calling them ‘inhumane’ and ‘shameful’. (...) In this article, I argue that such criticisms are overdrawn. Although sending an older individual to a care home within a lower‐income country can be morally impermissible, I find that there are at least three sets of conditions under which it is not. (shrink)

The care of terminally ill patients can be physically, emotionally as well as psychologically exhausting. In the era where everyone is busy with his or her hectic daily schedule, caring for someone diagnosed with HIV on her or his deathbed can be a daunting challenge. Caring for someone dying of AIDS does not only challenge the physical being but rather leaves the carer emotionally drained. What was of concern to the author was to see the struggle that the caregiver (...) goes through whilst caring for the sufferer. More often than not, pastoral care and counselling concentrate mainly on the pain and the suffering of the sick person. In the process, pastoral care loses sight of the agony, the emotional strain and, above all, the trauma of the caregivers in their search for answers as they care for the infected. This scenario has prompted the author to look into the theology of caring with an emphasis on pastoral care of the carers with a view of alleviating their emotional burden in caring for the HIV patients. (shrink)

In recent years, a proportion of older Germans has been sent to relatively high‐end care homes within lower‐income countries where the care tends to be cheaper and more extensive than that in German care homes. Destination countries are found predominantly within Eastern Europe (e.g. Poland, Hungary, Czech Republic), but to a lesser extent also within South‐East Asia (e.g. Thailand). At the same time, these expatriations have caused much controversy, with some German commentators calling them ‘inhumane’ and ‘shameful’. (...) In this article, I argue that such criticisms are overdrawn. Although sending an older individual to a care home within a lower‐income country can be morally impermissible, I find that there are at least three sets of conditions under which it is not. (shrink)

My paper focuses on the theme of visibility by teasing out some paradoxes of invisibility. In the ordinary social world, what is said to be invisible is generally what is here, right before our eyes, but to which we pay no attention. Care is invisible because it goes on without us seeing it. By suddenly making visible what is ordinarily invisible, the COVID pandemic has been a strange pedagogical moment, making visible the people who take care of “us”, (...) and revealing our entire society’s ignorance of what allows it to live—whether in the context of everyday life or in the urgency of the risk of death. The grammar of care has thus imposed itself on everyone, because care is never so visible as in those situations where a form of life is shaken. Care work has been revealed as invisible work that keeps everyone going. “Invisible” does not refer to a difficulty in perceiving but rather a refusal to see. A refusal to see something that is not hidden, but which we do not see precisely because it is right before our eyes. Invisibility is thus denial, in both the social and the theoretical realms, especially when care work is envisioned in the terms of the further invisibilization of care work when it is done for the benefit of women as in the “care drain” from poor to rich countries. The asymmetry in the relations between North and South is part of the invisibility of what sustains societies. The invisible chains of care reveal the extent to which the question of service is the fundamental question of social invisibility. (shrink)

Siyaves Azeri (2020) quite well shows that arithmetical thinking emerges on the basis of specific social practices and material engagement (clay tokens for economic exchange practices beget number concepts, e.g.). But his discussion here is relegated mostly to Neolithic and Bronze Age practices. While surely such practices produced revolutions in the cognitive abilities of many humans, much of the cognitive architecture that allows normative conceptual thought was already in place long before this time. This response, then, is an attempt to (...) sketch the deep prehistory of human cognition in order to show the inter-social bases of normative thought in general. To do this, I will look first to the work of Vygotsky and Leontiev, two often neglected psychologists whose combined efforts culminate in a developmental account of human cognitive origins. Then, I will review some key insights from the contemporary comparative psychologist Michael Tomasello—whose project is admittedly a Vygotskian one—in order to further shed light on the social-practical basis of abstract thought, of which mathematical cognition is surely a part. (shrink)

L.S. Vygotsky’s “regulative” account of the development of human thinking hinges on the centralization of “directive” speech acts (commands or imperatives). With directives, one directs the activity of another, and in turn begins to “self-direct” (or self-regulate). It’s my claim that Vygotsky’s reliance on directives de facto keeps his account stuck at Tomasello's level of individual intentionality. Directive speech acts feature prominently in Tomasello’s developmental story as well. But Tomasello has the benefit of accounting for a functional differentiation in directive (...) communication—i.e., in collaborative activity, the command gives way to both the request and informational assertion. Lacking such differentiation, Vygotsky’s account runs the risk of playing to a rather strident conception of the socius, one more Machiavellian than Marxist. (shrink)

The situated potentials for action between material things in the world and the interactional processes thereby afforded need to be seen as not only constituting the possibility of agency, but thereby also comprising it. Eo ipso, agency must be de-fused from any local, "contained" subject and be understood as a situational property in which subjects and objects can both participate. Any technological artifact should thus be understood as a complex of agential capacities that function relative to any number of social (...) and material factors. Keeping in mind that we are co-constituted by webs of relations involving increasingly complex collections of artefacts, networks, niches, and communities of practice, our investigation will be guided by interrogating the functional potential of a thing that in the last fifteen years has seamlessly worked its way into the everyday life of millions of human agents. This "thing," the smartphone, is merely a nodal point in a highly complex network. Recognizing this massive "collective," we nevertheless want to show some of the ways in which something as seemingly mundane as a smartphone can reflexively alter the range of actions available to a cognitive agent (Latour 1994). Specifically, we hope to shed light on some of the social-cognitive consequences of technological mediation by looking at the complementary, if not mutually implied, domains of memory and knowledge. (shrink)

According to Leontiev’s “activity approach,” the external world is not something available to be “worked over” according to a subject’s inner or “ideal” representations; at stake instead is the emergence of an “idealized” objective world that relates to a subject’s activity both internally and externally construed. In keeping with a Marxian account of anthropogenesis, Leontiev links the emergence of “ideality” with social activity itself, incorporating it within the general movement between the poles of ‘inner’ cognition and ‘external’ action. In this (...) manner, Leontiev both parallels and goes beyond Hutto and Myin’s recent “enactivist” account of “content-involving” cognition, where representational thought depends on socio-cultural scaffolding and, as such, is uniquely human. What traditionally comes to be called representational content is for Leontiev the result of the transition from a primitive cognitive apparatus of “image-consciousness” to a one which is mediated by social activity. For the being endowed with “activity-consciousness,” mental content is something apprehended by assimilating “the objective world in its ideal form” [Leontiev, 1977, p. 189]. And the precondition for such assimilation is the apprehension of meanings from their origin in the social-material system of activity. The genesis of content-involving cognition is thus coeval with the development of socializing activity systems, replete with the external representations of values and norms as described in enactivist literature as publicly scaffolded symbol systems. Leontiev thus offers an anti-internalist account of cognition commensurate with Hutto and Myin but with the added dimension of a developmental scale of analysis with which to explain the origin of human-specific cognition. (shrink)

This paper reconstructs L.S. Vygotsky’s account of anthropogenesis with respect to the work of anthropologist André Leroi-Gourhan and late philosopher Bernard Stiegler, situating Vygotsky as a forerunner to recent theories that posit cultural scaffolding and niche construction as the main drivers of human cognitive evolution. One might think there is an immediate affinity between Vygotsky and the techno-centric accounts of Leroi-Gourhan and Stiegler. Following Leroi-Gourhan, Stiegler argues that “technics” is the main driver in the anthropogenic development of “reflective consciousness.” Vygotsky (...) likewise claims that “psychological tools” are responsible for the development of uniquely human forms of consciousness. However, closer inspection reveals deep disparities between Vygotsky and the French thinkers. In Stiegler’s philosophical redeployment of Leroi-Gourhan’s anthropology, “reflective” cognition is the product of a prehistorical rupture in which some threshold of technical-cortical complexification is breached. For Vygotsky, on the other hand, the inverse scenario obtains. Technical development initially proceeds in tandem with the complexification of biologically based signaling behavior until the introduction of signs, which then radically restructure the cognitive apparatus. Due to inconsistencies regarding the equivalency of the technical and semiotic in Stiegler and Leroi-Gourhan, I advance a Vygotskian account where anthropogenesis is the result of semiotic rather than technical intervention. This aims to establish Vygotsky’s “Cultural Historical” approach, and the Marxian-dialectical tradition from which he draws, as not only presaging recent naturalistic accounts of development, but offering a relevant theoretical program that may continue to inspire contemporary enculturated accounts of anthropogenesis. (shrink)

In the preceding article, Buchner and Wippich used a guessing-corrected, multinomial process-dissociation analysis to test whether a gender bias in fame judgments reported by Banaji and Greenwald was unconscious. In their two experiments, Buchner and Wippich found no evidence for unconscious mediation of this gender bias. Their conclusion can be questioned by noting that the gender difference in familiarity of previously seen names that Buchner and Wippich modeled was different from the gender difference in criterion for fame judgments reported by (...) Banaji and Greenwald, the assumptions of Buchner and Wippich's multinomial model excluded processes that are plausibly involved in the fame judgment task, and the constructs of Buchner and Wippich's model that corresponded most closely to Banaji and Greenwald's gender-bias interpretation were formulated so as to preclude the possibility of modeling that interpretation. Perhaps a more complex multinomial model can model the Banaji and Greenwald interpretation. (shrink)

In this paper, I draw on Heidegger’s phenomenology of “moods” (_Stimmungen_) to interpret loneliness as a diffused and atmospheric feeling-state that often undergirds the lives of older adults, shaping the ways in which they are attuned to and make sense of the world. I focus specifically on residents in long-term care facilities to show how the social isolation and lockdown measures of the COVID-19 pandemic dramatically intensified the mood. The aim is to shed light on how profound and totalizing (...) the experience has been for residents. Making use of Heidegger’s account of the affective “collapse” or “breakdown” (_Zusammenbruch_) of meaning, I argue that when older adults are functionally locked in their rooms for months at a time and cut off from the orienting routines and rhythms of the relational world, the result is a crumbling of the fundamental meaning-structures that constitute subjectivity. The global sense of abandonment and disconnection strips away the possibility for self-understanding, and residents are often left confused and abandoned to an existence that has been drained of meaning and significance. (shrink)

Health care ethics is a sensitive domain, which if ignored, can lead to patient dissatisfaction, weakened doctor–patient interaction and episodes of violence. Little importance has been paid to medical ethics within undergraduate medical education in developing countries such as Pakistan. Three doctors in Pakistan are currently facing an official police complaint and arrest charges, following the death of a sanitary worker, who fell unconscious while cleaning a drain and was allegedly refused treatment as he was covered in sewage (...) filth. The medical license of the doctors in question should be cancelled, if found guilty following a thorough investigation into the case. The ‘right to life’ has been universally assured by all moral, cultural and legal codes and no society can ever argue against the sacredness of a human life. It is quite clear that the aforesaid doctors’ actions are not only against the core principles of the physicians’ code, but also go against the doctrine of human rights. If serious efforts on an urgent basis are not made by the regulatory and governing bodies, one can definitely expect similar incidents for at least a few more decades before any noticeable change is seen. (shrink)

The cross-disciplinary framework of Material Engagement Theory (MET) has emerged as a novel research program that flexibly spans archeology, anthropology, philosophy, and cognitive science. True to its slogan to ‘take material culture seriously’, “MET wants to change our understanding of what minds are and what they are made of by changing what we know about what things are and what they do for the mind” (Malafouris 2013, 141). By tracing out more clearly the conceptual contours of ‘material engagement,’ and firming (...) up its ontological commitments, the main goal of this article is to help refine Malafouris’ fertile approach. In particular, we argue for a rapprochement between MET and the tradition of Cultural-Historical Activity Theory, based on the ‘Vygotskian’ hypothesis of scaffolded and/or distributed cognition. (shrink)

A review of 'The Hand, an Organ of the Mind: What the Manual Tells the Mental', ed. Zdravko Radman.

The world is suffering from a dearth of health care workers, and sub-Saharan Africa, an area of great need, is experiencing the worst shortage. Developed countries are making the problem worse by luring health care workers away from the countries that need them most, while developing countries do not have the resources to stem the flow or even replace those lost. Postmodern philosopher Emmanuel Levinas offers a unique ethical framework that is helpful in assessing both the irresponsibility inherent (...) in the current global health care situation and the responsibility and obligation held by the stakeholders involved in this global crisis. Drawing on Levinas’ exploration of individual freedom and self-pursuit, infinite responsibility for the Other, and the potential emergence of a just community, we demonstrate its effectiveness in explaining the health care worker crisis, and we argue in favor of a variety of policy and development assistance measures that are grounded in an orientation of non-indifference toward Others. (shrink)

Partant du constat d’une certaine confusion régnant dans les études sur le néolibéralisme, cette étude entend apporter des éléments de clarification quant au sens et à l’histoire de la doctrine. Pour ce faire, elle s’efforce tout d’abord de dresser une typologie originale des diverses tendances (ordolibérale, néoclassique, autrichienne et française), puis essaie d’éclairer, à la lueur de cette cartographie, les différentes mutations du mouvement jusqu’à aujourd’hui.

In Decent People, Norman Care explores how we may understand and be reconciled to the fragility of our moral nature. In his highly original vision of what it means to be a decent person, Care claims that our moral-emotional nature pressures us to seek relief from moralized pain - pain that comes from our awareness of our own wrongdoing, the suffering of current or future people, and our experience of indifference to moral imperatives. Care argues that decent (...) people are neither 'pure' nor self-righteous and that they are vulnerable to the need for forgiveness. Decent people may take morality seriously, but they are not guaranteed success at its challenges. (shrink)