FOSTER J, CHIANG F, HILLARD RC, HALL P and HEATH A. Nursing Inquiry 2010; 17: 309–316 Team process in community‐based participatory research on maternity care in the Dominican RepublicA cross‐cultural team consisting of US trained academic midwife researchers, Dominican nurses, and Dominican community leaders have partnered in this international nursing and midwifery community‐based participatory research (CBPR) project in the Dominican Republic to understand the community experience with publicly funded maternity services. The purpose of the study was to understand community (...) perceptions of maternity services. This article highlights the activities that the research team carried out during each phase of the research process, and how they established team identity, team trust, and team efficacy. This research has created a platform for new avenues for health providers and community to partner to improve maternal‐newborn care. Community‐based participatory research is one way forward to address the past and present inequities constitutive of global health disparities. (shrink)

The electoral scene in the period from 133 to 129 b.c.e. was doubtless unpredictable, even in the centuriate assembly, and any prosopographical modelling based on the available data would be adventurous. The report that Appius Claudius Pulcher (cos. 143 and bitter opponent to Scipio Aemilianus) ran in 133 for a second consulship is not implausible, and the possibility of a thwarted candidature, whatever its duration and the reason for its termination, should be registered. The successful candidates were P. Popillius Laenas (...) and P. Rupilius, the latter a close associate of Scipio. The unsuccessful consular candidacy of Rupilius’ brother Lucius should be dated to 132, 131 or 130. The elimination of the first of those options by F.X. Ryan (CQ 45 [1995], 263–5) is challenged. (shrink)

Our objective is to test an optimality model of human fertility that specifies the behavioral requirements for fitness maximization in order (a) to determine whether current behavior does maximize fitness and, if not, (b) to use the specific nature of the behavioral deviations from fitness maximization towards the development of models of evolved proximate mechanisms that may have maximized fitness in the past but lead to deviations under present conditions. To test the model we use data from a representative sample (...) of 7,107 men living in Albuquerque, New Mexico, between 1990 and 1993. The model we test proposes that low fertility in modern settings maximizes number of grandchildren as a result of a trade-off between parental fertility and next generation fertility. Results do not show the optimization, although the data do reveal a trade-off between parental fertility and offspring education and income.We propose that two characteristics of modern economies have led to a period of sustained fertility reduction and to a corresponding lack of association between income and fertility. The first is the direct link between costs of investment and wage rates due to the forces of supply and demand for labor in competitive economies. The second is the increasing emphasis on cumulative knowledge, skills, and technologies in the production of resources. Together they produce historically novel conditions. These two features of modern economies may interact with evolved psychological and physiological mechanisms governing fertility and parental investment to produce behavior that maximizes the economic productivity of lineages at the expense of fitness. If cognitive processes evolved to track diminishing returns to parental investment and if physiological processes evolved to regulate fertility in response to nutritional state and patterns of breast feeding, we might expect non-adaptive responses when returns from parental investment do not diminish until extremely high levels are reached. With high economic payoffs from parental investment, people have begun to exercise cognitive regulation of fertility through contraception and family planning practices. Those cognitive processes maynot have evolved to handle fitness trade-offs between fertility and parental investment. (shrink)

Health care decision making has changed profoundly during the past several decades. Advances in scientific knowledge, technology, and professional skill enable medical providers to extend and enhance life by increasing the ability to cure disease, manage disability, and palliate suffering. Ironically, the same interventions can prolong painful existence and protract the dying process. Recognizing that medical interventions, especially lifesustaining measures, are not always medically appropriate or even desired by a patient or family, health care professionals endeavor to determine who should (...) make health care decisions and according to what standards. The importance that Western culture places on individual rights and self-determination is reflected in the growing advocacy for patient autonomy and the discrediting of physician paternalism. However, the question of autonomy becomes more complex when patients lack the capacity to decide for themselves.Advance directives represent one response to the dilemma of decision making for incapacitated patients. The original advance directive, the living will, is a written list of instructions reflecting the individual's wishes about care, usually at the end of life. (shrink)

Health care decision making has changed profoundly during the past several decades. Advances in scientific knowledge, technology, and professional skill enable medical providers to extend and enhance life by increasing the ability to cure disease, manage disability, and palliate suffering. Ironically, the same interventions can prolong painful existence and protract the dying process. Recognizing that medical interventions, especially lifesustaining measures, are not always medically appropriate or even desired by a patient or family, health care professionals endeavor to determine who should (...) make health care decisions and according to what standards. The importance that Western culture places on individual rights and self-determination is reflected in the growing advocacy for patient autonomy and the discrediting of physician paternalism. However, the question of autonomy becomes more complex when patients lack the capacity to decide for themselves.Advance directives represent one response to the dilemma of decision making for incapacitated patients. The original advance directive, the living will, is a written list of instructions reflecting the individual's wishes about care, usually at the end of life. (shrink)

This paper lays the groundwork for a theory of time allocation across the life course, based on the idea that strength and skill vary as a function of age, and that return rates for different activities vary as a function of the combination of strength and skills involved in performing those tasks. We apply the model to traditional human subsistence patterns. The model predicts that young children engage most heavily in low-strength/low-skill activities, middle-aged adults in high-strength/high-skill activities, and older adults (...) in low-strength/high-skill activities. Tests among Machiguenga and Piro forager-horticulturalists of southeastern Peru show that males and females focus on low-strength/low-skill tasks early in life (domestic tasks and several forms of fishing), switch to higher-strength/higher-skill activities in their twenties and thirties (hunting, fishing, and gardening for males; fishing and gardening for females), and shift focus to high-skill activities late in life (manufacture/repair, food processing). (shrink)

In ”Skepticism,” Peter Klein distinguishes between the “Academic Skeptic” who proposes that we cannot have knowledge of a certain set of propositions and the “Pyrrhonian Skeptic” who refrains from opining about whether we can have knowledge. Klein argues that Academic Skepticism is plausibly supported by a “Closure Principle‐style” argument based on the claim that if x entails y and S has justification for x, then S has justification for y. He turns to contextualism to see if it can contribute to (...) the discussion between one who claims that we can have knowledge about some epistemically interesting class of propositions and the Academic Skeptic. He outlines the background of Pyrrhonian Skepticism, pointing out that the Pyrrhonist withholds assent concerning our knowledge‐bearing status because reason cannot provide an adequate basis for assent. He assesses three possible patterns of reasoning, and concludes that the Pyrrhonist view, that reason cannot resolve matters concerning the nonevident, is vindicated. (shrink)

We routinely observe others’ choices and use them to guide our own. Whose choices influence us more, and why? Prior work has focused on the effect of perceived similarity between two individuals, such as the degree of overlap in past choices or explicitly recognizable group affiliations. In the real world, however, any dyadic relationship is part of a more complex social structure involving multiple social groups that are not directly observable. Here we suggest that human learners go beyond dyadic similarities (...) in choice behaviors or explicit group memberships; they infer the structure of social influence by grouping individuals based on choices, and they use these groups to decide whose choices to follow. We propose a computational model that formalizes this idea, and we test the model predictions in a series of behavioral experiments. In Experiment 1, we reproduce a well-established finding that people's choices are more likely to be influenced by someone whose past choices are more similar to their own past choices, as predicted by our model as well as dyadic similarity models. In Experiments 2–5, we test a set of unique predictions of our model by looking at cases where the degree of choice overlap between individuals is equated, but their choices indicate a latent group structure. We then apply our model to prior empirical results on infants’ understanding of others’ preferences, presenting an alternative account of developmental changes. Finally, we discuss how our model relates to classical findings in the social influence literature and the theoretical implications of our model. Taken together, our findings demonstrate that structure learning is a powerful framework for explaining the influence of social information on decision making in a variety of contexts. (shrink)

Secreted Frizzled‐related proteins (SFRPs) are modulators of the intermeshing pathways in which signals are transduced by Wnt ligands through Frizzled (Fz) membrane receptors. The Wnt networks influence biological processes ranging from developmental cell fate, cell polarity and adhesion to tumorigenesis and apoptosis. In the five or six years since their discovery, the SFRPs have emerged as dynamically expressed proteins able to bind both Wnts and Fz, with distinctive structural properties in which cysteine‐rich domains from Fz‐ and from netrin‐like proteins are (...) juxtaposed. The abundant expression of SFRP genes in the early embryo, altered expression patterns in disease states, and potential significance in the evolution of the vertebrate body plan, make these intriguing molecules relevant to investigations in diverse fields of biology and biomedical sciences. BioEssays 24:811–820, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Things Are NOT OkayLynne HillardThree doctors, each with good intentions, led us to believe that everything would be all right for our son Ben. In the fall of 2008, Ben presented with two documented seizures. We first saw a doctor from our pediatrician’s office. He told us not to worry since the basic neurological physical exam showed nothing, but recommended that we see a pediatric neurologist. He gave us (...) a list of recommended doctors, and upon leaving the examining room the doctor then said, “Don’t worry. It’s not a brain tumor.”We arranged a meeting with one of the pediatric neurologists who had been practicing for a long time and had worked in one of the well–respected children’s hospitals before going into private practice. She was attentive and kind and spent a couple hours with us as we went over Ben’s medical history. She examined Ben and found nothing unusual, in fact per her notes, “his neurological examination is better than normal.” She said that she would order an EEG and a brain MRI because he had two witnessed seizures. She asked us to look into family history to see if there was anyone with a history of seizures in either one of our families. Upon leaving she said not to worry that it was probably something that he would out grow.After looking into family history, I found out that my older brother had had a couple of seizures when he was about twelve. He was put on phenobarbital. He eventually outgrew the seizures. Armed with this information I felt certain that Ben’s issues were hereditary. It was right before Christmas 2008, so I delayed on getting the EEG and brain MRI until January of that new year. The results of the EEG were unremarkable. The following week was the MRI. The day after the MRI, the receptionist at the neurologist’s office called. She requested that we come in the next day and asked that Ben not come to the appointment.“I am sorry to tell you, but Ben has a brain tumor.” What? I couldn’t even concentrate on what the doctor was saying. Ben’s tumor was located in the right temporal lobe and extensively involved the right amygdala and right hippocampus.I remember feeling completely overwhelmed with the process of choosing the individual who would ultimately perform brain surgery on our son. My husband and I interviewed three surgeons within a few weeks. On March 20 of 2009 Ben underwent surgery. The neurosurgeon was able to remove about 75 percent of the tumor. Two days after surgery Ben was released from the hospital. I remember that surreal feeling. My son had just had brain surgery and now we were going home with a list of medications and a schedule for administering the medications. I felt inept, unprepared, and yet relieved that my son had made it through; he could talk, he could move all his limbs and everything appeared to be normal. The only distinguishing feature that anything had happened was the six–inch scare on the side of his head.The pathology report said it was a DNET tumor (Dysembryoplastic Neuroepithelial Tumor), one that should not re–grow or cause any further problems. I remember the audible sigh of relief that came out of my mouth. I remember the neurosurgeon’s words: “Ben will grow up to be a fi ne young man, and you will dance with him at his wedding.” I wanted to be happy, like I had won the lottery, but I had this feeling that there must be something more to this, it couldn’t be this easy.In his second year at preschool Ben’s behavior problems became more obvious. When Ben became overwhelmed he would just sit down and not budge. Even when the director of the preschool asked us if there were any problems that were the result of his anti–seizure medication or his surgery, we said “no” because we were told “all should be good.” But all along there was that nagging feeling that not all was good in Ben’s world. [End Page 11]In... (shrink)

It will be noticed that, in the stemma above, no line of descent is marked from the first generation registered therein to the following generations. The genealogy of the Emperor Nerva is customarily traced back to the consul of 36 b.c., M. Cocceius Nerva. This short note will underline the ancient testimony found amongst the Pseudacroniana tracing his descent from the latter's brother, the consummate diplomat. There are ramifications. Amongst the items of interest will be the light shone upon what (...) Dio and Eutropius understood to be Nerva's standing at the time of his accession. Before passing on to Pseudacron's datum, it might be worthwhile pausing on that point, as well as briefly contemplating the factors that actually bore upon the emperor's ancestral training. (shrink)

ExcerptWith the increasing attention devoted to Ernst Jünger, this superb translation of his 1934 essay “On Pain” is sure to enrich discussions on its subjects of pain, sensitivity, the body, and visual media. It comes with an informative introduction by translator David C. Durst as well as a substantial and wide-ranging preface by Russell A. Berman, which situates Jünger's text in the contexts of the Weimar Republic and contemporary culture. In Jünger's essay, pain is the measure of all things. Like (...) our shadow, it is always at our side. But Jünger knows that we wish to be rid of this…. (shrink)

Bioethics needs an expanded moral vision. It is now time for bioethics to take full account of the problems of health disparities and structural injustice that are made newly urgent by the COVID-19 pandemic and the effects of climate change. Nancy M. P. King, Gail E. Henderson, and Larry R. Churchill make the case for a more social understanding and application of justice, a deeper humility in assessing expertise in bioethics consulting, a broader and more relevant research agenda, and greater (...) appreciation of the profound health implications of global warming. (shrink)

First published in 1982, this reissue contains a critical exposition of the views of Frege, Dedekind and Peano on the foundations of arithmetic. The last quarter of the 19th century witnessed a remarkable growth of interest in the foundations of arithmetic. This work analyses both the reasons for this growth of interest within both mathematics and philosophy and the ways in which this study of the foundations of arithmetic led to new insights in philosophy and striking advances in logic. This (...) historical-critical study provides an excellent introduction to the problems of the philosophy of mathematics - problems which have wide implications for philosophy as a whole. This reissue will appeal to students of both mathematics and philosophy who wish to improve their knowledge of logic. (shrink)

This book views Green's philosophical opus through his public life and political commitments. It demonstrates how his main ethical and political conceptions -- his idea of 'self realisation' and his theory of individuality within community -- were informed by evangelical theology, popular Protestantism and an idea of the English national consciousness as formed by religious conflict. While the significance of Kant and Hegel is acknowledged, it is argued that 'indigenous' qualities of Green's teachings resonated with Victorian Liberal values.

First published in 1987. Routledge is an imprint of Taylor & Francis, an informa company.

As a preliminary step to beginning to assess the usefulness of clinical vignettes to measure ethical sensitivity in undergraduate medical students, five clinical vignettes with seven to nine ethical issues each were created. The ethical issues in the vignettes were discussed and outlined by an expert panel. One randomly selected vignette was presented to first, second and third year students at the University of Toronto as part of another examination. The students were asked to list the issues presented by the (...) patient problem. Responses from 281 students were obtained. These students identified an average of 2.72 ethical issues per vignette. Each response was classified under the domains of autonomy, beneficence and justice. Comparisons were made between classes and between vignettes. There was considerable variation between classes and the responses to different vignettes seem to indicate that different vignettes measure the various domains in different ways. It does appear that the use of vignettes is one way to measure aspects of ethical sensitivity in medical students but more study is required to clarify exactly what is being measured. (shrink)

An instrument to assess 'ethical sensitivity' has been developed. The instrument presents four clinical vignettes and the respondent is asked to list the ethical issues related to each vignette. The responses are classified, post hoc, into the domains of autonomy, beneficence and justice. This instrument was used in 1990 to assess the ethical sensitivity of students in all four medical classes at the University of Toronto. Ethical sensitivity, as measured by this instrument, is not related to age or grade-point average. (...) Sensitivity increases between the 1st and 2nd year and then decreases throughout the rest of undergraduate medical training, such that the 4th-year students identify fewer issues than those entering medical school. Students expressing a career choice of family medicine identify more issues than their peers. Several problems with the use of the instrument and the interpretation of the data were found. Nonetheless, these findings, if reproducible, are important and their meaning needs further discussion. (shrink)

Engineering is 'the people-serving profession'. The work of engineers involves interaction with clients, other engineers, and the public at large. More than any other profession, their work also directly involves and affects the environment. This book makes the case that engineers have special professional obligations to protect and enhance the environment, and the authors - one, an engineer and the other, a philosopher - seek to provide an ethical basis for these obligations. In exploring these ethical issues, the authors aim (...) to show that engineers make a difference. The text opens with a series of case studies in which engineers face complex and challenging decisions about the environment. Succeeding chapters examine different ideas about environmental ethics for engineers, including professional codes and both modern and historical discussions of environmental responsibility. The book concludes with a collection of readings that complement the text. Students, as well as practising engineers, will find much of interest in this well-argued and thought-provoking book. (shrink)

This is the first book to take a comprehensive look at white collar criminal offenses from the perspective of moral and legal theory. Focussing on the way in which key white collar crimes such as fraud, perjury, false statements, obstruction of justice, bribery, extortion, blackmail, insider trading, tax evasion, and regulatory and intellectual property offenses are shaped and informed by a range of familiar, but nevertheless powerful, moral norms.

First published in 1987. Routledge is an imprint of Taylor & Francis, an informa company.

Gordon Baker and I had been colleagues at St John’s for almost ten years when we resolved, in 1976, to undertake the task of writing a commentary on Wittgenstein’s Philosophical Investigations. We had been talking about Wittgenstein since 1969, and when we cooperated in writing a long critical notice on the Philosophical Grammar in 1975, we found that working together was mutually instructive, intellectually stimulating and great fun. We thought that we still had much to say about Wittgenstein’s philosophy, and (...) it seemed to us that misinterpretations of passages in the Investigations were so extensive that it would be worth trying to write a detailed analytical commentary. It is difficult to recapture the excitement of those early days in being among the first to work on the microfilms and, subsequently, on the photocopies of Wittgenstein’s Nachlass. We spent many hundreds of hours poring over the typescripts and the often only semi-legible manuscripts, fascinated and privileged to be able to try to follow the development of the thoughts of a great philosophical genius. We talked endlessly about what we had found in Wittgenstein’s manuscripts and typescripts, and debated how it should be understood. The first fruit of our labours was Wittgenstein – Understanding and Meaning. Its guiding idea was to draw attention to the manner in which Wittgenstein linked the concepts of meaning, understanding and explanation, and so to bypass the connections between meaning, truth and truth-conditions that so fascinated philosophers of the 1970s, and to abandon the red-herring of assertion-conditions and anti-realism. After a hiatus of four years, during which time we wrote a controversial book entitled Frege – Logical Excavations and a polemical book on contemporary philosophy of language – Language, Sense. (shrink)

This paper concerns the translation and interpretation of a succinct quip of Sextus Clodius, a rhetorician in Antony's entourage, on the subject of Fulvia's swollen cheek. The jest is often interpreted as having suggested that she tempted Clodius’ pen, and various double meanings have been proposed. Contextualization may supply a key. The remark could mean that Fulvia seemed to be testing the point of her stylus, and the dark allusion might then be to reports of the manner in which Fulvia (...) had allegedly mistreated the severed head of Cicero. (shrink)

Even though female food acquisition is an area of considerable interest in hunter-gatherer research, the ecological determinants of women’s economic decisions in these populations are still poorly understood. The literature on female foraging behavior indicates that there is considerable variation within and across foraging societies in the amount of time that women spend foraging and in the amount and types of food that they acquire. It is possible that this heterogeneity reflects variation in the trade-offs between time spent in food (...) acquisition and child care activities that women face in different groups of hunter-gatherers. In this paper we discuss the fitness trade-offs between food acquisition and child care that Hiwi and Ache women foragers might face. Multiple regression analyses show that in both populations the daily food acquisition of a woman’s spouse is negatively related to female foraging effort. In addition, nursing mothers spend less time foraging and acquire less food than do nonnursing women. As the number of dependents that a woman has increases, however, women also increase foraging time and the amount of food they acquire. Some interesting exceptions to these general trends are as follows: (a) differences in foraging effort between nursing and nonnursing women are less pronounced when fruits and roots are in season than in other seasons of the year; (b) foraging return rates decrease for Ache women as their numbers of dependents increase; and (c) among Ache women, the positive effect of number of dependents on foraging behavior is less pronounced when fruits are in season than at other times of the year. Lastly, in the Hiwi sample we found that postreproductive women work considerably harder than women of reproductive age in the root season but not in other seasons of the year. We discuss how ecological variation in constraints, the number of health insults to children that Hiwi and Ache mothers can avoid, and the fitness benefits they can gain from spending time in food acquisition and child care might account for differences and similarities in the foraging behaviors of subgroups of Hiwi and Ache mothers across different seasons of the year. Valid tests of the explanations we propose will require considerable effort to measure the relationship between maternal food acquisition, child care, and adverse health outcomes in offspring. (shrink)

Differential scanning calorimetry (DSC) has been employed to investigate the glass transition activation energy E g, thermal stability and glass-forming ability (GFA) of Se90In10− x Sb x (x = 0, 2, 4, 6, 8, 10) chalcogenide glasses. DSC runs were performed at six different heating rates. Well-defined endothermic and exothermic peaks were obtained at glass transition and crystallization temperature. The dependence of glass transition temperature T g on heating rate (α), as well as composition of Sb, has been studied. From (...) the dependence of glass transition temperature on heating rate, the E g has been calculated on the basis of the Kissinger [Anal. Chem. 29 (1957) p.1702] and Moynihan [J. Phys. Chem. 78 (1974) p.267] models. Thermal stability has been monitored through the calculation of temperature differences T c–T g, the stability parameter S, and the enthalpy released during crystallization H c. The GFA has been investigated on the basis of the Hruby parameter H r, which is strong indicator of GFA. Results for GFA are in good agreement with fragility index F i calculations, indicating that Se90In6Sb4 is an excellent glass-former. (shrink)