Interest is growing in the relocalization of staple crops, including wheat, in western Washington (WWA), a nontraditional wheat-growing area. Commercial bakers are potentially important food chain intermediaries in the case of relocalized wheat production. We conducted a mail survey of commercial bakers in WWA to assess their interest in sourcing wheat/flour from WWA, identify the characteristics of bakeries most likely to purchase wheat/flour from WWA, understand the factors important to bakers in purchasing regionally produced wheat/flour, and identify perceived barriers to (...) making such purchases. Sixty-one percent of survey respondents were interested in purchasing WWA wheat/flour. Bakers who used retail strategies to market their products were more likely to be interested in WWA wheat/flour compared to those not using retail methods. Bakers’ current purchases of Washington wheat/flour were not related to their interest in purchasing WWA flour. The most important factors bakers would consider in purchasing regionally produced wheat/flour were consistency of flour quality, quality of flour, and reliability of supply. Cost was the most frequently mentioned barrier to the purchase of regionally produced wheat/flour. Our results are relevant for other areas attempting to reconnect grain producers, commercial bakers, and consumers in mutually beneficial ways. (shrink)

The lung allocation score system in the United States and several European countries gives more weight to risk of death without transplantation than to survival following transplantation. As a result, centers transplant sicker patients, leading to increased length of initial hospitalization. The care of patients who have accumulated functional deficits or additional organ dysfunction during their prolonged stay can be ethically complex. Disagreement occurs between the transplant team, patients and families, and non-transplant health care professionals over the burdens of ongoing (...) intensive intervention. These cases highlight important ethical issues in organ transplantation, including the nature and requirements of transplant informed consent, the limits of physician prognostication, patient autonomy and decision-making capacity following transplant, obligations to organ donors and to other potential recipients, and the impact of program metrics on individualized recipient care. We outline general ethical principles for the care of lung transplant recipients with prolonged hospitalization and give regulatory, research, and patient-centered recommendations for these cases. (shrink)

Jewish Agrarian Movements (JAM hereafter) in North America express the many different shapes and iterations of Jewish farming on the continent, grounded in historical perspectives that influence current practices and activities. From within this diversity, common threads emerge with much to contribute to agrarian social movements and scholarship. Jewish values of returning (_t_’_shuvah_), releasing (_shmitah_), and repairing (_tikkun_), along with theories of _doikayt_ (an anti-zionist movement around “hereness”) and radical diasporism, animate JAM’s critical engagement with agri-food systems. As researchers who (...) have both studied and participated in Jewish agrarianism in a variety of U.S. and Canadian contexts, we solidify a series of themes and tensions that emerge from JAM: diaspora and indigeneity, modernity and tradition, Jewish agroecological knowledge production, and lived religion. We argue that, while JAM has not yet been examined thoroughly within critical food scholarship, it has the potential to contribute to broader debates and frameworks within sub-fields such as radical food geographies, critical agrarianism, and decoloniality. Without consideration of JAM as a part the study of food and agriculture, there are risks of marginalization of farmers, activists and researchers of Jewish identity. (shrink)

One of six commentaries on “Obesity: Chasing an Elusive Epidemic,” by Daniel Callahan, from the January‐February 2013 issue.

Volume 19, Issue 11, November 2019, Page 37-39.

The publication in 1959 of Russell and Burch's ThePrinciplesofHumaneExperimentalTechnique initiated a new era in the history of the debate between science and animal protection, the era of alternatives. Although Russell and Burch never used the word, and although the animal protection movement was somewhat moribund at the time in both England and the United States, within a decade of the book's publication a number of signs indicating a resurgence of public interest in the issue began to appear. At the same (...) time, increased knowledge and understanding of neurophysiology and ethology heightened scientific awareness of the significance of humane treatment in the laboratory and professionalized laboratory animal science. (shrink)

This book examines how the Romans came to have a literature, how that literature reflected native and foreign impulses, and how it formed a legacy for subsequent generations have become central questions in the cultural history of the Republic. It examines the problem of Rome's literary development by shifting attention from Rome's writers to its readers. The literature we traditionally call 'early' is seen to be a product less of the mid-Republic, when poetic texts began to circulate, than of the (...) late Republic, when they were systematically collected, canonized, and put to new social and artistic uses. Imposing on texts the name and function of literature was often a retrospective activity. This book explores the development of this literary sensibility from the Romans' early interest in epic and drama, through the invention of satire and the eventual enshrining of books in the public collections important to Horace and Ovid. (shrink)

Nearly a century ago, Friedrich Leo argued with his characteristic acumen that the neo-Ciceronian style of Tacitus'Dialogus de oratoribuswas as much a function of its genre as its subject. ‘The genre’, he observed, ‘demands its style. One who deals with different genres must write in different styles.’ Alfred Gudeman, the target of Leo's review, had therefore missed a key step in the argument for Tacitean authorship when he invoked ‘the influence of subject-matter’ without considering the demands of genre. In hindsight, (...) the point seems almost obvious, and the sophistication of recent work on the date and style of theDialogushas left Gudeman's discussion far behind. The advance in method—if not necessarily in results—has been profound. Leo's success in linking genre and style, however, has also had a second, less happy result: it has encouraged belief in a corresponding link between genre and content, as if Tacitus necessarily embraced Ciceronian values along with his Ciceronian forms. TheDialogusis often thought to accept Cicero's aesthetic agenda and to examine why the orators of succeeding generations failed to maintain its ideals and standards. Perhaps inevitably, its analysis is then read as a rather depressing tale of oratory's literary, social, and moral decline. This view demands reconsideration. To explore, as theDialoguscertainly does, the collapse of Ciceronian values is not necessarily to regret that collapse. We have, I think, too often read our own prejudices into theDialogusby presuming a post-Augustan decline in oratorical standards and, in the process, reducing our sensitivity to important variations in and departures from the generic conventions that Tacitus so deliberately recalls. The result is a significant distortion of theDialogus' view of oratory under the empire. (shrink)

The medical biography of Ludwig van Beethoven remains enigmatic. Some of his health problems, such as his early and eventually profound deafness, are well documented and extensively discussed, although not necessarily well explained . Other medical problems, and his ultimate cause of death, remain unclear. Perhaps unsurprisingly for such an important musical figure, there has been no dearth of speculation about the illnesses that may have befallen Beethoven. Medical historians and physicians have suggested a myriad of illnesses, including but hardly (...) limited to .. (shrink)

Public health agencies regularly survey randomly selected anonymous students to track drug use, sexual activities, and other risk behaviors. Students are unidentifiable, but a recent project that i...

W. V. Quine famously argues that though all knowledge is empirical, mathematics is entrenched relative to physics and the special sciences. Further, entrenchment accounts for the necessity of mathematics relative to these other disciplines. Michael Friedman challenges Quine’s view by appealing to historicism, the thesis that the nature of science is illuminated by taking into account its historical development. Friedman argues on historicist grounds that mathematical claims serve as principles constitutive of languages within which empirical claims in physics and the (...) special sciences can be formulated and tested, where these mathematical claims are themselves not empirical but conventional. For Friedman, their conventional, constitutive status accounts for the necessity of mathematics relative to these other disciplines. Here I evaluate Friedman’s challenge to Quine and Quine’s likely response. I then show that though we have reason to find Friedman’s challenge successful, his positive project requires further development before we can endorse it. (shrink)

The article is devoted to identifying the specifics of Russian philosophy through the analysis of F. M. Dostoevsky and L.N. Shestov’s texts. The stylistic features of the two philosophers have been considered, their ways of philosophizing and denying of the cult of reason have been examined. The analysis is carried out using additional literature of French existentialism. To date, there are many researches in which study features of Russian philosophy. It is noted, that one of them are imagery, inseparable connection (...) between philosophy and faith and criticism of rationalism. The excessive cult of reason leads to such problems in the history as the creation of the hydrogen bomb, the environmental crisis and so on. The revolt against reason and the state of groundlessness are a response to the processes of modern rationalization and technocratization, an attempt to go beyond the limits of the usual paradigm, to get out of the closed subjectivity. Thus, it’s necessary to define the limits of the reason and develop a new way of philosophizing, for this reason it is proposed to consider the concept of groundlessness in the philosophy of L.N. Shestov, which makes the attempt to construct a philosophy, avoiding strict logic and excessive rationality. (shrink)

Background: The magnitude of bullying and harassment among psychiatrists is reportedly high, yet no peer-review published studies addressing this issue could be found. Therefore, it was decided to conduct a pilot study to assess the degree of the problem, the types of bullying/harassment and to provide some insights into the situation.Methods and Principal Findings: Following multiple focus group meetings, a yes/no response type questionnaire was developed to assess the degree and type of bullying and harassment experienced by psychiatrists. Over a (...) 3-month period the questionnaire was administered to a random sample of 60 psychiatrists. 57 out of the 60 psychiatrists reported harassment and bullying. Frequencies of the following response variables are presented in descending order: rumours 40% ; defamation 20% ; passing remarks 20% ; false accusations 15% ; threats 13.3% ; verbal abuse 13.3% ; unjustified complaints 13.3% ; promotion blocked 13.3% ; humiliation 13% ; bad reference given 10% ; credentials questioned 8.3% ; physical attacks 5% ; termination 5% ; derogatory remarks 1.7% and 1.7% were subjected to personal work. As a result of being subjected to harassment, 66.7% of the psychiatrists did not take any action, whereas 33.3% confronted the person they believed responsible. Asked whether the bullying and harassment caused distress, 18.3% of the psychiatrists did not report any effect, 30% reported mild distress, 40% moderate distress and severe distress was reported by 11.7%.Conclusions: It was concluded that the magnitude of bullying and harassment among psychiatrists may be quite high, as evidenced by this pilot study. There is a need for extensive systematic studies on this subject and to establish strategies to prevent and address this issue at a national and regulatory level. (shrink)

L'ouvrage ici presente appartient peut-etre a la derniere periode de la production d'Avicenne. Le Livre des directives et remarques supplee les parties perdues de La philosophie orientale, dernier grand projet avicennien, en ce sens qu'il tend a rearticuler science divine et science universelle, par raport a l'entreprise philosophique du Shifa'. Neanmoins les Directives ne sont aucunement un traite, mais plutot un recueil de notes sur des points controverses. Les liens entre les chapitres sont souvent tenus, parfois meme arbitraires, mais il (...) ressort pourtant de la des modifications importantes par rapport aux philosophes grecs. Les theories d'Avicenne sont ainsi toutes en faveur d'une pensee rationaliste et scientifique. L'avance scientifique des orientaux a, pour lui, ouvert a l'intelligence des voies nouvelles; les methodes grecques de pensee demeurent fondamentales, mais des exigences inconnues de leur temps demandent qu'elles soient depassees. (shrink)

The nature of quantum computation is discussed. It is argued that, in terms of the amount of information manipulated in a given time, quantum and classical computation are equally efficient. Quantum superposition does not permit quantum computers to ''perform many computations simultaneously'' except in a highly qualified and to some extent misleading sense. Quantum computation is therefore not well described by interpretations of quantum mechanics which invoke the concept of vast numbers of parallel universes. Rather, entanglement makes available types of (...) computation processes which, while not exponentially larger than classical ones, are unavailable to classical systems. The essence of quantum computation is that it uses entanglement to generate and manipulate a physical representation of the correlations between logical entities, without the need to completely represent the logical entities themselves. (shrink)

Objectives: Evidence based patient choice seems based on a strong liberal individualist interpretation of patient autonomy; however, not all patients are in favour of such an interpretation. The authors wished to assess whether ideals of autonomy in clinical practice are more in accordance with alternative concepts of autonomy from the ethics literature. This paper describes the development of a questionnaire to assess such concepts of autonomy.Methods: A questionnaire, based on six moral concepts from the ethics literature, was sent to aneurysm (...) patients and their surgeons. The structure of the questionnaire was assessed by factor analysis, and item reduction was based on reliability.Results: Ninety six patients and 58 surgeons participated. The questionnaire consisted of four scales. Two of the scales reflected the paternalistic and consumerist poles of the liberal individualist model, one scale reflected concepts of Socratic autonomy and of procedural independence, and the fourth scale reflected ideals of risk disclosure.Discussion: The Ideal Patient Autonomy Scale is a 14 item normative instrument. It is clearly distinct from the generally used psychological preference questionnaires that assess preferences for physician-patient roles. (shrink)

Adrian Viens, Guest Editor of this Olivieri symposium, and Julian Savulescu, the Editor of JME, set the scene for the symposium."In failing...[her] when she needed them most, it is now clear that some members of the University’s Faculty of Medicine heard her muffled cries of academic freedom from the back room, yet their response was to serve another round of drinks and turn the music up louder. With the bombshell revelations in the...affair, the plug may have been pulled on this (...) business sponsored party, and hopefully a sober re-examination of the university’s neglected role and responsibility toward independent inquiry and academic freedom can begin.1" "These guys don’t get one thing—we’re not going away. This isn’t a personal vendetta. This is something I want patients to be protected from when I’m dead, fifty years from now.2" "[The Olivieri affair is] not a mystery novel, but instead the latest skulduggery at Toronto’s Hospital for Sick Children.1" "The legal assaults which you have endured in your battle against the drug company, and in your battle against the medical establishment appear to have been fought with the type of uncommon bravery that is rarely seen. It is for this reason that our trustees have unanimously chosen to recognise you for this most prestigious award.3" "[The Olivieri affair resulted from] a fundamental misreading of the issue as a mere contractual and scientific dispute...[it is] Canada’s worst academic and research scandal in decades...[Since 1998, Olivieri has been] demoted, then restored, then harassed. She has been smeared with allegations attacking her competence, integrity, sanity and personality....4"The Olivieri affair is one of the most important events to occur in research ethics. From its dominance in the Canadian and international news media, to changes in the governance of public health, academic medicine, …. (shrink)

This paper examines the use of case studies in ethics education. While not dismissing their value for specific purposes, the paper shows the limits of their use. While agreeing that case studies are narratives, although rather thin stories, the paper argues that the claim that case studies could represent reality is difficult to sustain. Instead, the paper suggests a way of using stories in ethics teaching that could be more real for students, while also giving them a way of thinking (...) about their own professional practices. The paper shows how the method can be used to develop a more critical and reflective practice for students in the health care professions. Some immediate problems with the method are discussed. (shrink)

Informed consent enjoys an unassailable position in both clinical and research situations as a safeguard of patients’ rights. Keeping the patient involved in the decision making process is easier when there is direct communication with the individual. The Pakistani milieu offers challenges to this process because crucial decision making is often done by family members or is left entirely up to the attending physician. There seems to be a general acceptance of this shifting of focus from the individual to other (...) players. This also raises certain ethical dilemmas for physicians who may feel uncomfortable with communication which excludes the patient or in accepting a paternalistic primary decision making role. The objective of this informal qualitative study was to ascertain physicians’ perceptions regarding the process of information delivery to the patient in the Pakistani context and the various influences acting upon it. (shrink)

Parents’ freedom to choose infant male circumcision is the correct policyIndividuals and groups lobbying to have infant male circumcision prohibited or restricted often argue that the practice of routinely circumcising infants is unjustified. For instance, in this issue of the journal, John Hutson argues that it is virtually impossible to justify a policy in which the medical establishment should be able to embark on a “mass circumcision” campaign of 100% of the infant male population [see page 238].1Indeed, I would be (...) hard pressed to find anyone who could rationally disagree with this contention. However, this is because no one is currently arguing for the enactment of a policy that stipulates that all healthy male infants should be routinely circumcised . Arguments seeking to support a prohibition of “routine infant circumcision”, such as the one by Hutson, are arguing against a straw man—and a pitiful one at that.2 Such arguments only serve to misconstrue the debate and avoid engaging in the real and pressing issues concerning the legitimacy of the provision of this procedure.The questions that should be considered, and the ones which I shall be interested in discussing here, are what reasons are justifiable for allowing parents to choose to have their son circumcised? After well informed and careful deliberation should parents have the freedom to choose to have their son circumcised? These are the most relevant questions to be considered because there is a growing collection of citizens, medical practitioners, and lawyers who are currently lobbying for the practice of infant male circumcision to be outlawed—for example, there is a bioethicist who argues that the criminal law should be used …. (shrink)

In classical Greek poetry there is a familiar distinction between verse which repeats line upon line, and that which forms patterns liable to closure at intervals, in stanzas or lyric sections. This is often equated with the distinction between spoken and sung verse, but the equation is only approximate. At an earlier stage all verse had some musical accompaniment—so much can be deduced from a number of passages in Homer, and is in any case implicit in the nature of quantitative (...) verse. By Hellenistic times it seems that, in new composition, the more complex lyric structures had died out, while of the simpler ones more and more were being taken over as spoken verse. In the fifth century—and this can probably be extended to at least the late sixth and most of the fourth—only two kinds of verse are known to have dispensed with music altogether in performance: the heroic hexameter and the iambic trimeter. (shrink)

In classical Greek poetry there is a familiar distinction between verse which repeats line upon line, and that which forms patterns liable to closure at intervals, in stanzas or lyric sections. This is often equated with the distinction between spoken and sung verse, but the equation is only approximate. At an earlier stage all verse had some musical accompaniment—so much can be deduced from a number of passages in Homer, and is in any case implicit in the nature of quantitative (...) verse. By Hellenistic times it seems that, in new composition, the more complex lyric structures had died out, while of the simpler ones more and more were being taken over as spoken verse. In the fifth century—and this can probably be extended to at least the late sixth and most of the fourth—only two kinds of verse are known to have dispensed with music altogether in performance: the heroic hexameter and the iambic trimeter. (shrink)