United States public health experts have long expressed concern about the prevalence of the human immunodeficiency virus among injection drug users. The United States has the largest reported IDU population in the world: 1.1 to 1.5 million. Recent estimates from the Centers for Disease Control and Prevention suggest that 50 percent of incident HIV infections occur among IDUs, with additional infections occurring among their sex partners and offspring. More than 33 percent of new AIDS cases occur in IDUs, their sexual (...) partners, and their children. Almost one half of all women diagnosed with AIDS in the United States are IDUS. Many of the remaining infected women were infected as a result of sex with a male IDU.While public health agencies, legislators, community leaders, and religious groups have engaged in vigorous debate over the merits of needle exchange programs as an intervention to reduce HIV transmission, the programs, some legal and some illegal, have been implemented in fifty-five cities across the country. (shrink)

United States public health experts have long expressed concern about the prevalence of the human immunodeficiency virus among injection drug users. The United States has the largest reported IDU population in the world: 1.1 to 1.5 million. Recent estimates from the Centers for Disease Control and Prevention suggest that 50 percent of incident HIV infections occur among IDUs, with additional infections occurring among their sex partners and offspring. More than 33 percent of new AIDS cases occur in IDUs, their sexual (...) partners, and their children. Almost one half of all women diagnosed with AIDS in the United States are IDUS. Many of the remaining infected women were infected as a result of sex with a male IDU.While public health agencies, legislators, community leaders, and religious groups have engaged in vigorous debate over the merits of needle exchange programs as an intervention to reduce HIV transmission, the programs, some legal and some illegal, have been implemented in fifty-five cities across the country. (shrink)

The essays in this volume present versions of feminism that are explicitly liberal, or versions of liberalism that are explicitly feminist. By bringing together some of the most respected and well-known scholars in mainstream political philosophy today, Amy R. Baehr challenges the reader to reconsider the dominant view that liberalism and feminism are 'incompatible.'.

1. Introduction; Elisabeth A. Lloyd and Eric Winsberg.- Section 1: Confirmation and Evidence.- 2. The Scientific Consensus on Climate Change: How Do We Know We’re Not Wrong?; Naomi Oreskes.- 3. Satellite Data and Climate Models Redux.- 3a. Introduction to Chapter 3: Satellite Data and Climate Models; Elisabeth A. Lloyd.- Ch. 3b Fact Sheet to "Consistency of Modelled and Observed Temperature Trends in the Tropical Troposphere"; Benjamin D. Santer et al..- Ch. 3c Reprint of "Consistency of Modelled and Observed (...) Temperature Trends in the Tropical Troposphere"; Benjamin D. Santer et al..- 4. The Role of ’Complex’ Empiricism in the Debates about Satellite Data and Climate Models; Elisabeth A. Lloyd.- 5. Reconciling Climate Model/Data Discrepancies: The Case of the Trees That Didn’t Bark; Michael Mann.- 6. Downscaling of Climate Information; Linda O. Mearns et al..- Section 2: Uncertainties and Robustness.- 7. The Significance of Robust Model Projections; Wendy S. Parker.- 8. Building Trust, Removing Doubt? Robustness Analysis and Climate Modeling; Jay Odenbaugh.- Section 3: Climate Models as Guides to Policy.- 9. Climate Model Confirmation: From Philosophy to Predicting Climate in the Real World; Reto Knutti.- 10. Uncertainty in Climate Science and Climate Policy; Jonathan Rougier and Michel Crucifix.- 11. Communicating Uncertainty to Policy Makers: The Ineliminable Role of Values; Eric Winsberg.- 12. Modeling Climate Policies: A Critical Look at Integrated Assessment Models; Mathias Frisch.- 13. Modelling Mitigation and Adaptation Policies to Predict their Effectiveness: The Limits of Randomized Controlled Trials; Alexandre Marcellesi and Nancy D. Cartwright. (shrink)

In December 1990, an empirical study assessing hospital ethics committee (HEC) success was completed. Success was measured in terms of the number of interventions undertaken by the committees in four functional areas: education, guidelines development, prospective and retrospective case review. Some commonly quoted success determinants, such as multidisciplinarity, physician chairpersons, and a high institutional status of the chairperson were found not to foster success; the latter two, actually decreased committee success.

Although tissue plasminogen activator (tPA) is the only medication approved by the United States Food and Drug Administration (FDA) for acute ischemic stroke, there is no consensus about the need for informed consent for its use. As a result, hospitals throughout the U.S. have varying requirements regarding obtaining informed consent from patients for the use of tPA, ranging from no requirement for informed consent to a requirement for verbal or written informed consent. We conducted a study to (1) determine current (...) beliefs about obtaining patients’ informed consent for tPA among a large group of stroke clinicians and (2) identify the ethical, clinical, and organizational factors that influence tPA consent practices. Semi-structured interviews were conducted by trained and experienced investigators and research staff to identify key barriers to implementing acute stroke services. Part of the interview explored current beliefs and practices around informed consent for tPA.This was a multicenter study that included 38 Veterans Health Administration (VHA) hospital locations. Participants were 68 stroke team clinicians, serving primarily on the neurology (35 percent) or emergency medicine (41 percent) service. We conducted thematic analysis based on principles of grounded theory to identify codes about consent for tPA. We used interpretive convergence to ensure consistency among the individual investigators’ codes and to ensure that all of the investigators agreed on coding and themes.We found that 38 percent of the stroke clinicians did not believe any form of consent was necessary for tPA, 47 percent thought that some form of consent was necessary, and 15 percent were unsure. Clinicians who believed tPA required informed consent were divided on whether consent should be written (40 percent) or verbal (60 percent). We identified three factors describing clinicians’ attitudes about consent: (1) legal and policy factors, (2) ethical factors, and (3) medical factors.The lack of consensus regarding consent for tPA creates the potential for delays in treatment, uneasiness among clinicians, and legal liability. The identified factors provide a potential framework to guide discussions about developing a standard of care for acquiring the informed consent of patients for the administration of tPA. (shrink)

The dramatic increases in the survival rate of prematurely born, very low birth weight infants (<1500 g) have created concern about the possible sequelae experienced by these children, in terms of both severe problems and less severe learning and behavior problems. The methodological difficulties involved in answering questions about the outcomes of these children, including the choice of appropriate outcome measures, the analysis of individual variation, the problems associated with dropouts, the relevant comparison groups, the importance of survival rate, and (...) the question of correcting for the degree of prematurity, are considered. In spite of the difficulties in interpreting the studies, the research indicates that many premature children have learning disabilities, particularly in the perceptual and visual motor functioning and some aspects of language and reading. In addition, ethical issues related to prematurity are discussed, including parents’ rights, decision-making, and cost and treatment. Finally, some solutions are proposed involving the use of risk indices for the early detection of developmental problems. (shrink)

As hospital ethics committees become more common in American hospitals, their degree of success should be measured. Just as new technological procedures are evaluated, institutional innovations should also be evaluated. Currently, little is known about the success of HECs, and some authors have wondered whether these committees serve any useful purpose at all. This article reviews the descriptive results of a 1990 study on HEC success as they pertain to the question of how to measure committee success.

In 1983, we were declared a nation at risk. Now, over a decade later the declaration seems to ring even more true, but for different reasons. Our communities have become killing fields, and the assassins that stalk our streets are our children. We sit frozen in horror as the daily news bombards us with the images of children murdering other children and adults for the thrill of it, as a rite of initiation, as an act of racial hatred, for profit, (...) and in anger and retaliation. (shrink)

In 1965, Vice-President Hubert Humphrey addressing the White House Conference on Education stated that our country would go down in history for havin used its educational system to overcome problems of illiteracy, unemployment, crime and violence, urban decay, and even war among nations. Yet, within a few years cries from concerned citizens questioned the ability of the schools to even teach children how to read and write.

An onslaught of ethically questionable actions by top government, business, and religious leaders during the 1980s has brought the issue of ethics in decision making to the forefront of public consciousness. This study examines the ethical orientation of university students in four decision-making situations. The dependent variable — ethical orientation toward work-related decisions — is measured through student responses to questions following four work-related vignettes. Possible responses to each vignette are structured to permit categorization of respondents into two broad orientations: (...) egoistic and ethical. Independent variables are academic major, ethics in business orientation, gender, and religiosity. Generally, students tended to choose an ethical orientation over an egoistic orientation in each vignette. Business majors were generally no less likely to choose an ethical orientation toward work-related decisions than nonbusiness majors. Respondents characterized by moral unity (belief in the consistency between general ethical principles and work-related ethical standards) were more likely to have an ethical orientation toward work-related decisions than those subscribing to the amoral theory of business. Females showed a consistent tendency to be more ethically oriented toward work-related decisions than males. Finally, respondents high on religiosity tended to be more ethically oriented. (shrink)

(1987). French and American women in the age of democratic revolution, 1770–1815: A comparative perspective. History of European Ideas: Vol. 8, No. 4-5, pp. 597-609.

This paper explores the role of strategic conversations in corporate social responsibility (CSR) strategy formation. The authors suggest that explicitly engaging stakeholders in the CSR strategy-making process, through the mechanism of strategic conversations, will minimize future stakeholder concerns and enhance CSR strategy making. In addition, suggestions for future research are offered to enable a better understanding of effective strategic conversation processes in CSR strategy making and the resulting performance outcomes.

This paper is a response to Ray's recent proposal that the intellectual property rights attached to potentially life saving/life sustaining innovations should become public goods in cases where markets are either unable or unwilling to pay for the creation of the intellectual property. Using a free market approach to innovation based on Western moral philosophy, we suggest that treating intellectually protected life saving/life sustaining innovations as public goods will likely reduce social welfare over the long term.

This paper examines the discursive transformation of the historic American public market from that of a municipally regulated institution intended to ensure fair trade and equitable food distribution to “a public place” that emphasizes community identity and sociability. Using a semiotic analysis of interviews with 31 market managers of 30 historic and contemporary American public markets, data from historic documents, and multiple site visits, we compare the social construction of the contemporary public market to farmers markets, supermarkets, and the early (...) twentieth century public market. We analyze the meanings managers create in the contemporary public market to understand the administrative rationalities within which the public market operates. Our analysis reveals evidence of competing imaginaries active in the public market, organized around broad notions of “public benefit,” “community culture” and “institutional viability.” We propose that these tensions are embedded in the public market as an institution historically implicated in regimes of food distribution. In the contemporary context, we conclude, public markets largely substitute the spectacle of community and the image of an historic public life for a legally instated commitment to the just governance of food systems. (shrink)

Water is the major contributor to the eating and keeping qualities and structure of baked products. Its management and control during preparation, processing, baking, cooling and storage is essential for the optimisation of product quality. This successful and highly practical volume describes in detail the role and control of water in the formation of cake batters, bread, pastry and biscuit doughs, their subsequent processing and the baked product. Now in a fully revised and updated second edition, the book has been (...) expanded and developed through the inclusion of new information and references related to the formation and processing of batters and dough into baked products. The new edition includes a selection of case studies based on practical experience in the manufacture and optimisation of baked products. Each case study, illustrated as appropriate, considers the various roles that water may play in different manufacturing contexts. The book is aimed at food scientists and technologists in bakery companies; ingredient suppliers; flour millers; researchers and students in academic food science departments. (shrink)

This article relates the emergence of a group of faculty researchers utilizing complexity science approaches. The narrative emerges from three projects combining research into complexity, communities, and technologies. Details of how the research was initiated, and the nature and quality of the conversational method, are provided. In addition, theoretical concepts that were consciously applied and others that arose through insights from the data as it was collected are discussed. Although this is like most real narratives, a never-ending story, it concludes (...) with a presentation of some of the ideas that separate complexity-informed research from other paradigms. (shrink)

Compared to other health care professions such as medicine, nursing and pharmacy, few studies have been conducted to examine the nature of practice errors in occupational and physical therapy. In an ongoing study to determine root causes, typographies and impact of occupational and physical therapy error on patients, focus group interviews have been conducted across the United States. A substantial number of harmful practice errors and/or other patient safety events (deviations or accidents) have been identified. Often these events have had (...) moral dimensions that troubled the therapist involved. In this article, six of these transcribed cases are analyzed, using predominant bioethical theories, ethical principles and professional codes of ethics. The cases and their analyses are intended to be exemplary, improving the readers’ ability to discern and critically address similar such events. Several patient safety strategies are suggested that might have prevented the events described in these cases. (shrink)

Social Responsibility (SA) 8000 registration/certification is a response by the business community to address consumer and investor perceptions of the importance of emerging global social issues such as child labor, worker rights, discrimination, compensation, etc. As more U.S. and European firms outsource production to less developed nations, social, environmental, and reputational issues have become more important. SA8000 is a series of behavioral standards that represents a comprehensive, and potentially global, corporate social responsibility registration system that provides a standard of socially (...) responsible treatment of workers. This paper explores how SA8000 adoption may impact a firm's marketing activities. (shrink)