Objective Standards of care regarding obstetric management of life-threatening anomalies are not defined. It is hypothesised that physicians' management of these pregnancies is variable and influenced by demographic factors. Design A questionnaire was mailed to members of the Society of Maternal–Fetal Medicine with valid US addresses assessing obstetric management of both ‘uniformly lethal’ (eg, anencephaly, renal agenesis) and ‘uniformly severe, commonly lethal’ (eg, trisomy 13 and 18) anomalies. Respondents were asked to answer as if not limited by state/institutional restrictions. Fisher's (...) exact or χ2 tests were used as appropriate and correction made for multiple comparisons in analyses that were not prespecified. Results The response rate was 36% (732/2038). Nearly 100% of respondents discuss termination for both uniformly and commonly lethal anomalies. In continuing pregnancies, with patient request for obstetric non-intervention 99% of providers would comply for either uniformly or commonly lethal anomalies. The majority ‘encourage’ such management, but some were non-directive or discouraged this management. In continuing pregnancies, with patient request for full obstetric intervention the majority of respondents was willing to comply for both uniformly (71%) and commonly (82%) lethal anomalies. While most practitioners ‘discouraged’ full intervention, some were non-directive or encouraged this management. Demographics and severity of anomaly influenced counselling. Conclusion Discrepancies exist regarding the management of life-threatening fetal anomalies. Patients may be offered different options based on practitioner demographics. The majority of physicians comply with patient wishes. Differences were noted when comparing the management of lethal with that of severe commonly lethal anomalies, suggesting that practitioners make a distinction when counselling patients. (shrink)

What considerations place genuine constraints on an adequate semantics for normative and evaluative expressions? Linguists recognize facts about ordinary uses of such expressions and competent speakers’ judgments about which uses are appropriate. The contemporary literature reflects the widespread assumption that linguists don’t rely upon an additional source of data—competent speakers’ judgments about possible disagreement with hypothetical speech communities. We have several good reasons to think that such judgments are not probative for semantic theorizing. Therefore, we should accord these judgments no (...) probative value for the development of a semantics for our moral terms. Such judgments can no longer be presumed to put pressure on theories according to which our moral expressions share a semantics with ordinary, descriptive terms. Many rivals to pure, Descriptivist theories count among their advantages the ability to accommodate these judgments. If these judgments have no probative value, such theories lose an important source of support. (shrink)

This provocative book paved the way for nursing research informed by f eminist scholarship, critical theory, and post-modern thought. Controv ersial then, relevant today.

This chapter discusses three puzzles about practical conditionals and inferences and shows how the flexible, contextualist semantic framework for “ought”. The chapter develops elsewhere resolves all three puzzles more satisfactorily than any of its three most prominent rivals, the relativist account of Niko Kolodny and John MacFarlane, the wide-scoping account of John Broome, and the “trying on” account of James Dreier. The chapter first introduces the puzzle cases and six desiderata for their solutions, and then shows how only flexible contextualism (...) about “ought” is able to resolve each while satisfying all six desiderata. (shrink)

Perhaps more controversial than whether physicalism is true is what exactly would have to be true for physicalism to be true. Everyone agrees that, intuitively at least, physicalism is the thesis that there is nothing over and above the physical. The disagreements arise in how to get beyond this intuitive formulation. Until about ten years ago, participants in this debate were concerned primarily with answering two questions. First, what is it for a property, kind, relation, or individual to be a (...) physical one? (shrink)

This volume contains essays on an array of topics originally presented orally by a master teacher and scholar. With characteristic rhetorical elegance, Msgr. Synan, late professor at the Pontifical Institute in Toronto, delivered these papers in a variety of settings on issues relating to his specialty of mediaeval Christian philosophy and to his interest in Jewish-Christian dialogue, on the theology of sanctity and of death, and on morally significant historical events. Medieval figures represented here include Aquinas, Augustine, Abelard, and Godfrey (...) of St. Victor; some topics treated are war and peace, philosophical innovations, ecclesiology, evil, goliardic verse, law and abortion, Church councils and Jews in the Middle Ages, and convictions uniting Jews and Christians. This book also contains representative sermons–including a Month’s Mind for Etienne Gilson, an introduction detailing Synan’s background and professional contributions, an updated bibliography of his published works, and an extensive index. Especially appealing to those who knew Synan are three posthumous tributes and thirteen photographs from throughout his life. The selections in this volume are scholarly but non-technical, intended for anyone moved to seek elucidation of the topics discussed. (shrink)

This paper begins by isolating the reductive component of Brandom's inferentialism. In order to assess to what extent that reductive component is supported by the considerations Brandom marshals in its defense, I assess the comparative degree of support those considerations provide a non-reductive counterpart of Brandom's original, reductive theory. One of the central claims here is that once the reductive and non-reductive theories are placed side-by-side, it is clear that, save one, all of the considerations Brandom marshals in defense of (...) inferentialism equally well support its non-reductive counterpart. This shows that those considerations offer no support for the reductions at inferentialism's heart. -/- What the considerations raised here ultimately show is that Brandom's defense of the reductive core of his theory ultimately rests on the simple fact that it has a certain feature, namely, that it is reductive in the sense reserved here. I close with a brief discussion of some advantages that some reductive theories have over non-reductive ones, but show how none of these advantages are had by Brandom's theory in particular. (shrink)

The Tibetan Plateau’s Permafrost is melting at an alarming rate. Six of the world’s major rivers are sourced in the Tibetan Himalayas that are warming at a faster rate than the rest of the earth. If the temperature of the region continues to increase, the rivers will dry up and the earth will warm at an even faster rate. Buddha Yeshe Tsogyal, long considered the Mother of Tibetan Tantric Buddhism, was the consort of Padmasambhava. She reached “complete liberation” or Nirvana (...) in a single lifetime. Her stories are preserved in rman thar. Her life was an exemplary practice of compassion, responsible care, and non-violence toward all sentient beings and the world. Can we follow her proto-eco-feminist example? Can we build responsible care for our planet and humanity across disciplines and faith traditions? What does compassionate, non-violent Buddhist thought and Roman Catholic pastoral care bring to eco-feminism? Can an eco-feminist epistemology informed by Buddhist EcoDharma construct programs of sustainability into humanity’s excessive habits integrating science’s ability to quantify, with Buddha nature? Can Catholicism’s pastoral ability to show dependence on God, the peaceful, compassionate Creator of all allow us to see our dependence on God and our earth? Many women have already begun this work around the globe. In 2002, Rosemary Radford Ruether brought 16 women together from around the globe in Women Healing Earth: Third World Women on Ecology, Feminism, and Religion to tell us how they are doing it and succeeding. Each is highlighted here for their visions on how to heal the planet at the grassroots level. From their insights, this article explores their contributions as being still relevant today and adding new concerns about the dangers arising on the Tibetan Plateau. The article emphasizes their ideas, provides a warning and other ideas that collective activation might inspire to address climate change. (shrink)

This paper shows how, according to st. thomas aquinas, basic descriptive moral principles can be both substantive and necessarily true. aquinas's position on reference (the function of the subject term) is similar to that of the contemporary logician, saul kripke, who argues for necessary informative propositions. such propositions in aquinas (which are analyzed in detail in the paper) include definitions-e.g., "human beings, or men, are rational animals"-and property statements. the latter encompass those concerned with natural inclinations. from this foundation the (...) necessity of fundamental moral principles is explained. still, moral principles can be refined as we discover more about human nature; "if" true, such statements will be necessarily true. the paper ends with an explanation of how basic moral principles can be considered to be not simply "per se", but also "per se nota". (shrink)

After acquiring knowledge of the neuroscience of learning, memory, stress and emotions, teachers incorporate more cognitive engagement and student-centered practices into their lessons. However, the role understanding neuroscience plays in teachers own affective and motivational competencies has not yet been investigated. The goal of this study was to investigate how learning neuroscience effected teachers’ self-efficacy, beliefs in their ability to teach effectively, self-responsibility and other components of teacher motivation. A pilot training-of-trainers program was designed and delivered in Liberia combining basic (...) neuroscience with information on social, emotional, behavioral and mental health issues faced by students. Tier I of the professional development was a 2 weeks workshop led by a visiting neuroscientist. A subset of the 24 Tier I secondary science teachers formed a Leadership Team who adapted the content to the Liberian context and subsequently led additional workshops and follow-up sessions for the Tier II secondary science teachers. Science teachers in both tiers completed the affective-motivational scales from the internationally vetted, multiscale Innovative Teaching for Effective Learning Teacher Knowledge Survey from the OECD. Tier II teachers completed the survey in a pre-post-delayed post design. Tier I teachers completed the survey after the workshop with their attitudes at that time and separately with retrospective projections of their pre-workshop attitudes. Ten of the 92 Tier II teachers participated in structured interviews at follow-up. Statistical analysis of survey data demonstrated improved teacher self-efficacy, self-responsibility for student outcomes, and motivation to teach. Qualitatively, teachers expressed more confidence in their ability to motivate students, engage them through active learning, and manage the class through positive rather than negative reinforcement. Teachers’ own self-regulation improved as they made efforts to build supporting relationships with students. Together, these results demonstrated that (i) teacher affective-motivational attitudes can be altered with professional development, (ii) basic neuroscience, as knowledge of how students learn, can improve teacher competency, and (iii) a training-of-trainers model can be effective in a low and middle income country for disseminating neuroscience knowledge, increasing teachers’ knowledge of students’ social and emotional needs, and promoting educational improvement. (shrink)

This article defends as correct and as faithful to Aquinas’s thought the tenets of “descriptivism” (sometimes called “naturalism”) in the context of criticisms that Patrick Lee has made in “Is Thomas’s Natural Law Theory Naturalist?” (American Catholic Philosophical Quarterly 71:4 [1997]: 567–87). “Revisiting Aquinas” argues that evaluative utterances are descriptive; so even if human goods were immediately known by practical reason (a position nonetheless rejected), their understanding would be a descriptive one, which moral objectivity requires. The arising of the prescriptivity (...) of precepts in relation to practical reason is then treated. The descriptivism articulated in this paper supports Lee’s emphasis on the primacy of love and choice; it further stresses that submission to an understood order of objective goods is essential to willing well. (shrink)

Institutional review board delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are exposed to untested or undertested interventions, implemented by well-intentioned leaders who bypass the research process altogether. To illustrate, we offer two case examples. We posit that IRB delays often appear in (...) the service of managing institutional risk, rather than protecting research participants. Regulators may see more risk associated with moving quickly than risk related to delay, choosing to err on the side of bureaucracy. The authors of this article, all of whom are military-funded researchers, government stakeholders, and/or human subject protection experts, offer feasible recommendations to improv... (shrink)

Qualitative longitudinal research (QLR) provides temporal understanding of the human response to health, illness, and the life course. However, little guidance is available for conducting QLR in the nursing literature. The purpose of this review is to describe the methodological status of QLR in nursing. With the assistance of a medical librarian, we conducted a thorough search circumscribed to qualitative, longitudinal nursing studies of patients’ and care‐givers’ experiences published between 2006 and 2016. The methodological quality of the 74 reviewed studies (...) varied tremendously; many reports lacked sufficient detail in reporting on sampling and attrition, retention strategies, and data collection and analysis, making it difficult for readers to evaluate the credibility and transferability of study findings. Based on the strengths and limitations of the studies reviewed and findings in the literature, we provide recommendations for enhancing the reporting of the research process as a supplement to the standards for qualitative research more broadly. These recommendations are offered in the spirit of encouraging dialogue among colleagues and assisting journal reviewers and editors in their evaluation of QLR. (shrink)

POHLMAN S, CIBULKA NJ, PALMER JL, LORENZ RA and SMITHBATTLE L. Nursing Inquiry 2013; 20: 71–81 The placebo puzzle: examining the discordant space between biomedical science and illness/healingThe placebo response presents an enigma to biomedical science: how can ‘inert’ or ‘sham’ procedures reduce symptoms and produce physiological changes that are comparable to prescribed treatments? In this study, we examine this puzzle by explicating the discordant space between the prevailing biomedical paradigm, which focuses on a technical understanding of diagnosis and treatment, (...) and a broader understanding of illness and healing as relational and embodied. Although biomedical achievements are impressive, the knowledge resulting from this paradigm is limited by its ontological and epistemological assumptions. When the body and world are objectified, illness meanings, therapeutic relationships, and healing practices are dismissed or distorted. In spite of a robust critique of the tenets of biomedicine for guiding practice, the biomedical paradigm retains a tenacious hold on evidence-based medicine and nursing, downplaying our clinical understanding of the sentient body, patients’ life-worlds, and illness and healing. In reality, skilled nurses rely on multiple forms of knowledge in providing high-quality care to particular patients. Clinically wise nurses integrate their experience and knowledge of patients’ priorities, fears, and illness trajectories along with biomedical findings to make astute judgments and promote health and healing. (shrink)

Hybridisations between related species with divergent ontogenies can provide insights into the bases for evolutionary change in development. One example of such hybridisations involves sea urchin species that exhibit either standard larval (pluteal) stages or those that develop directly from embryo to adult without an intervening feeding larval stage. In such crosses, pluteal features were found to be restored in fertilisations of the eggs of some direct developing sea urchins (Heliocidaris erythrogramma) with the sperm of closely (Heliocidaris tuberculata) and distantly (...) (Pseudoboletia maculata) related species with feeding larvae. Such results can be argued to support the punctuated equilibrium model—conservation in pluteal regulatory systems and a comparatively rapid switch to direct development in evolution.1,2 Generation of hybrids between distantly related direct developers may, however, indicate evolutionary convergence. The ‘rescue’ of pluteal features by paternal genomes may require maternal factors from H. erythrogramma because the larva of this species has pluteal features. In contrast, pluteal features were not restored in hybridisations with the eggs of Holopneustes purpurescens, which lacks pluteal features. How much of pluteal development can be lost before it cannot be rescued in such crosses? The answer awaits hybridisations among indirect and direct developing sea urchins differing in developmental phenotype, in parallel with investigations of the genetic programs involved. BioEssays 26:343–347, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Obesity continues to be a global issue. In recent years, researchers have started to question the role of our novel yet ubiquitous use of digital media in the development of obesity. With the recent COVID-19 outbreak affecting almost all aspects of society, many people have moved their social eating activities into the digital space, making the question as relevant as ever. The bombardment of appetizing food images and photography – colloquially referred to as “food porn” – has become a significant (...) aspect of the digital food experience. This review presents an overview of whether and how the viewing, creating, and online sharing of digital food photography can influence consumer eating behavior. Moreover, this review provides an outlook of future research opportunities, both to close the gaps in our scientific understanding of the physiological and psychological interaction between digital food photography and actual eating behavior, and, from a practical viewpoint, to optimize our digital food media habits to support an obesity-preventive lifestyle. We do not want to rest on the idea that food imagery’s current prevalence is a core negative influence per se. Instead, we offer the view that active participation in food photography, in conjunction with a selective use of food-related digital media, might contribute to healthy body weight management and enhanced meal pleasure. (shrink)

The Scottish Mental Health Arts and Film Festival has seen hundreds of arts, public and community groups coproduce over 300 events to over 25,000 audience members. Integral to this arts-based approach, in contrast to social marketing or public education models, is the notion that mental health is an essentially contested concept whereby meanings are negotiated and debate encouraged. With emerging evidence that the festival is an ef ective way of engaging people intellectually and emotionally, we explore ethical issues, challenges and (...) paradoxes that have emerged as the festival has developed. Consideration is given to issues of power, purpose, opportunity costs, reach, impact, programming risks, and participation from those with experience of mental ill-health. Throughout, we explore practical implications for funding, managing, programming, marketing and evaluation of this and similar endeavours. (shrink)

On Kratzer’s canonical account, modal expressions (like “might” and “must”) are represented semantically as quantifiers over possibilities. Such expressions are themselves neutral; they make a single contribution to determining the propositions expressed across a wide range of uses. What modulates the modality of the proposition expressed—as bouletic, epistemic, deontic, etc.—is context.2 This ain’t the canon for nothing. Its power lies in its ability to figure in a simple and highly unified explanation of a fairly wide range of language use. Recently, (...) though, the canon’s neat story has come under attack. The challenge cases involve the epistemic use of a modal sentence for which no single resolution of the contextual parameter appears capable of accommodating all our intuitions.3 According to these revisionaries, such cases show that the canonical story needs to be amended in some way that makes multiple bodies of information relevant to the assessment of such statements. Here I show that how the right canonical, flexibly contextualist account of modals can accommodate the full range of challenge cases. The key will be to extend Kratzer’s formal semantic account with an account of how context selects values for a modal’s.. (shrink)

What considerations place genuine constraints on an adequate semantics for normative and evaluative expressions? Linguists recognize facts about ordinary uses of such expressions and competent speakers’ judgments about which uses are appropriate. The contemporary literature reflects the widespread assumption that linguists don’t rely upon an additional source of data—competent speakers’ judgments about possible disagreement with hypothetical speech communities. We have several good reasons to think that such judgments are not probative for semantic theorizing. Therefore, we should accord these judgments no (...) probative value for the development of a semantics for our moral terms. Such judgments can no longer be presumed to put pressure on theories according to which our moral expressions share a semantics with ordinary, descriptive terms. Many rivals to pure, Descriptivist theories count among their advantages the ability to accommodate these judgments. If these judgments have no probative value, such theories lose an important source of support. (shrink)

2. The Contingency and A posteriority Constraint: A formulation of the thesis must make physicalism come out contingent and a posteriori. First, physicalism is a contingent truth, if it is a truth. This means that physicalism could have been false, i.e. there are counterfactual worlds in which physicalism is false, for example, counterfactual worlds in which there are miracle -performing angels.[9] Moreover, if physicalism is true, our knowledge of its truth is a posteriori. This is to say that there are (...) ways the world could turn out to be such that physicalism is false. For example, if there are miracle -performing angels, then physicalism is false. So there are worlds considered as actual in which physicalism is false.[10] For short, call this ‘the a posteriority constraint’.[11]. (shrink)

The importance of public confidence in scientific findings and trust in scientists cannot be overstated. Thus, it becomes critical for the scientific community to focus on enhancing the strategies used to educate future scientists on ethical research behaviors. What we are lacking is knowledge on how faculty members shape and develop ethical research standards with their students. We are presenting the results of a survey with 3,500 research faculty members. We believe this is the first report on how faculty work (...) with and educate their PhD students on basic research standards. Specifically, we wanted to determine whether individual faculty members, who are advisors or mentors, differ in how they implemented components of responsible conduct of research (RCR) with their PhD students. Mentors were more likely than advisors or supervisors to report working with all of their PhDs, who graduated in the last 5 years, on the 17 recognized critical components of RCR training and research skill development. We also found about half of the faculty members believe RCR is an institutional responsibility versus a faculty responsibility. Less than a quarter have had opportunities to participate in faculty training to be a better mentor, advisor, or research teacher, and about one third of faculty did not or could not remember whether they had guidelines related to their responsibilities to PhD students. We discuss the implications of our findings and focus on ways that PhD research mentoring can be enhanced. (shrink)

Background: Editorial peer review is universally used but little studied. We examined the relationship between external reviewers' recommendations and the editorial outcome of manuscripts undergoing external peer-review at the Journal of General Internal Medicine. Methodology/Principal Findings: We examined reviewer recommendations and editors' decisions at JGIM between 2004 and 2008. For manuscripts undergoing peer review, we calculated chance-corrected agreement among reviewers on recommendations to reject versus accept or revise. Using mixed effects logistic regression models, we estimated intra-class correlation coefficients at the (...) reviewer and manuscript level. Finally, we examined the probability of rejection in relation to reviewer agreement and disagreement. The 2264 manuscripts sent for external review during the study period received 5881 reviews provided by 2916 reviewers; 28% of reviews recommended rejection. Chance corrected agreement on rejection among reviewers was 0.11. In mixed effects models adjusting for study year and manuscript type, the reviewer-level ICC was 0.23 and the manuscript-level ICC was 0.17. The editors' overall rejection rate was 48%: 88% when all reviewers for a manuscript agreed on rejection and 20% when all reviewers agreed that the manuscript should not be rejected. Conclusions/Significance: Reviewers at JGIM agreed on recommendations to reject vs. accept/revise at levels barely beyond chance, yet editors placed considerable weight on reviewers' recommendations. Efforts are needed to improve the reliability of the peer-review process while helping editors understand the limitations of reviewers' recommendations. © 2010 Kravitz et al. (shrink)

We argue that Parfit's "Triviality Objection" against some naturalistic views of normativity is not compelling. We think that once one accepts, as one should, that identity statements can be informative in virtue of their pragmatics and not only in virtue of their semantics, Parfit's case against naturalism can be overcome.

Our goal here is to help identify the contextualist’s most worthy competitor to relativism. Recently, some philosophers of language and linguists have argued that, while there are contextualist-friendly semantic theories of deontic modals that fit with the relativist’s challenge data, the best such theories are not Lewis-Kratzer-style semantic theories. If correct, this would be important: It would show that the theory that has for many years enjoyed the status of the default view of modals in English and other languages is (...) in need of revision. Here we defend the default view by showing how a Kratzer-style semantics is able to make available readings of the relevant utterances that fit with the pretheoretical judgments opponents purport it cannot fully capture. Having established this, we turn to considering the more theoretical grounds proponents have offered for preferring their rival contextualist views. Here the question is to what extent such grounds favor semantic over what Korta and Perry call “near-side pragmatic” explanations of our judgments. In particular, we argue that our favored readings figure in near-side pragmatic explanations of those judgments that possess the methodological and theoretical advantages of systematicity and unity at least as well as, if not to a greater extent than, those of opponents who argue for their revised semantic theories on the basis of these advantages. (shrink)

For decades, presidents of the Association of American Geographers have written insightful columns in the AAG Newsletter. One of the most popular sections of the newsletter, these columns illustrate the changes and consistencies of geography over the past thirty-four years. They offer an insight into the past of the geography discipline and a broader perspective on the future. Previously inaccessible even to most professional geographers, the Presidential Columns will now be available in Presidential Musings from the Meridian: Reflections of the (...) Nature of Geography. (shrink)

Elephants show a rich social organization and display a number of unusual traits. In this paper, we analyse reports collected over a thirty-five year period, describing behaviour that has the potential to reveal signs of empathic understanding. These include coalition formation, the offering of protection and comfort to others, retrieving and 'babysitting' calves, aiding individuals that would otherwise have difficulty in moving, and removing foreign objects attached to others. These records demonstrate that an elephant is capable of diagnosing animacy and (...) goal directedness, and is able to understand the physical competence, emotional state and intentions of others, when they differ from its own. We argue that an empathic understanding of others is the simplest explanation of these abilities, and discuss reasons why elephants appear to show empathy more than other non-primate species. (shrink)

Through narrative reflections of Jack?s story of inclusive recreational sport, the meaning of dignity in professional practice is explored. Jack?s story is one of respect, strong humiliation and embarrassment, and vulnerability. Through the lens of relational ethics, the aggression of a stranger illustrates how the lack of mutual respect, compassion and knowledge creates experiences of indignity. Jack?s story highlights how relationships can shape, constrain and enable lives. Understanding that which constitutes a dignified recreational sport context for instructors and participants opens (...) opportunities for authentic social relationships based upon respect of oneself, as well as others to emerge. Jack?s narrative further reinforces the need to create pedagogical spaces for discussions of various forms of dignity and ethical professional practice in inclusive recreational sport contexts. (shrink)