Interviews with Community Supported Agriculture (CSA) growers in Iowa, a majority of whom are women, shed light on the relationship between gender and CSA as a system of resource management. Growers, male and female alike, are differentiated by care and caring-practices. Care-practices, historically associated with women, place priority on local context and relationships. The concern of these growers for community, nature, land, water, soil, and other resources is manifest in care-motives and care-practices. Their specific mix (...) of motives differs: providing safe and nutritious food, educating self and others, and building relationships with other growers, shareholder-members, and the land. Care-practices include reducing or eliminating chemical usage, encouraging or accepting beneficial insects and wildlife, building soil, and creating resource management partnerships with shareholder members. CSA, viewed through a lens of care, may offer a means of transcending gender stereotypes. (shrink)

Community Supported Agriculture (CSA) seeks to address injustices in the food system by supporting small-scale farmers applying agroecological practices through a long-term partnership: a community of members covers the cost of production and receives a share of the harvest throughout the season in return. Despite an orientation towards a more just and inclusive food system, the existing literature points towards a rather homogeneous membership in CSA. A majority of CSAs tends to involve (upper) middle-class consumers with (...) above average education and income levels. Low income is still a major obstacle in joining a CSA. Membership diversification through social support actions is one possible way. Our main objective is to systematize and appraise social support actions of the CSA movement. Taking the CSA principles as a starting point, our main research question is: How do social support actions in CSAs operate in terms of social inclusion and what obstacles and challenges are associated with them? The theory of strategic action fields assists in describing how the CSA movement is positioning itself as an actor in and across neighboring strategic action fields. The CSA movement is clearly positioned in the Food Sovereignty field. By shifting the focus from justice to farmers to justice for members, the CSA movement is now also exploring the Food Justice field. Indeed, the CSAs’ contribution to the food justice movement is still largely uncharted. In our results, we identify both social support actions that are already implemented in the CSA movement in different countries, and the challenges that are associated with these actions. We pinpoint a classification of social support actions implemented by CSA organizers to increase access to their initiatives. We make a distinction between the emancipatory actions that empower beneficiaries and contribute to a systemic change, and punctual, charitable interventions that neither affect the structure of a CSA nor the food system. (shrink)

Community-supported agriculture (CSA) initiatives are spaces where diverse work relations are performed. From a postcapitalist perspective, these initiatives attempt to create alternative-capitalist and non-capitalist work relations next to capitalist ones. While analyses of work relations in CSA abound, it remains uncertain how such diversification is made possible and how it is shaped by the micro-politics of and power relations in these initiatives. This paper addresses this gap by analysing how power shapes transformations to postcapitalist work relations in (...) CSA. It provides substantial empirical evidence of multiple manifestations of power enabling or constraining postcapitalist work relations through a comparative case study of three CSA initiatives in Portugal. Results show that while CSA creates postcapitalist work relations that are non-alienated, non-monetised and full of care, they insufficiently unmake unbalanced power relations established in capitalist work relations. This paper argues that, when establishing postcapitalist work relations, the selected CSA initiatives could benefit from actively deconstructing internal hierarchies, de-centralising decision-making power from farm owners and addressing oppressive power relations that are ossified in their local and cultural context. (shrink)

Community-supported agriculture (CSA) is a grassroots response to the threat the global industrial agri-food system poses to smallholders. The degrowth community, calling for a radical transformation away from the environmentally destructive and socially unjust primacy of economic growth in current societies, has started to pay tribute to CSA, commonly considering it an embodiment of degrowth ideas. However, the CSA movement does not reciprocate the interest of the degrowth community. This article therefore undertakes a systematic analysis (...) of the potential for a coalition between CSA and degrowth in Germany. We draw on social movement theories to compare both movements’ ideological and strategic alignment, as well as the conducive and/or hindering factors for coalition building. We find that the ideologies and political strategies of the two movements are not aligned, which manifests in their main frames and action repertoires, among other areas, which are articulated at different levels of abstraction; CSA has a practical focus on the safeguarding of smallholder agriculture, while degrowth more abstractly centres on the growth-dependent economy. Scarce resources, differing forms of internal organisation, and a lack of knowledge about degrowth on the side of CSA represent further obstacles to entering a coalition. At the same time, our analysis shows existing social ties and an initial ideological alignment between the CSA movement and sufficiency-oriented degrowth. We conclude that, despite prevailing differences, the two movements seem complementary, and that entering a coalition would bring with it the benefits of combining practice- and discourse-driven social change. (shrink)

In 2016, the Atlanta Community Food Bank launched the Stabilizing Lives project to develop programs and policies that could better address clients’ needs as well as including clientele as part of the planning process. The ACFB partnered with a research team at the University of Georgia to conduct a participatory research project aimed at developing deeper insights into the factors contributing to both instability and stability in the lives of pantry clientele. This article describes the outcomes this research, offering (...) both a substantive contribution to scholarship on food insecurity and emergency food systems and a methodological innovation through a staged mixed-method participatory research project. Through use of a culture-centered approach, this project created discursive spaces within which to outline emergency food models that support informal networks of care. We used a range of methods, including photo elicitation, concept mapping, individual interviews, and focus groups, to facilitate conversation among agency staff, volunteers, and clientele about the effectiveness of current program models and potential new ideas. Specifically, we suggest that through such practices, food pantries and local agencies may help inform new program models that contribute to household stability, and push back against the sometimes alienating and atomizing paradigm found in current emergency food programs. (shrink)

Background:Through the Norwegian ethics project, ethics activities have been implemented in the health and care sector in more than 200 municipalities.Objectives:To study outcomes of the ethics activities and examine which factors promote and inhibit significance and sustainability of the activities.Research design:Two online questionnaires about the municipal ethics activities.Participants and research context:A total of 137 municipal contact persons for the ethics project answered the first survey, whereas 217 ethics facilitators responded to the second survey.Ethical considerations:Based on informed consent, the study was (...) approved by the Data Protection Official of the Norwegian Social Science Data Services.Findings:Around half of the respondents found the ethics project to have been highly significant for daily professional practice. Outcomes include better handling of ethical challenges, better employee cooperation, better service quality, and better relations to patients and next of kin. Factors associated with sustainability and/or significance of the activities were sufficient support from stakeholders, sufficient available time, and ethics facilitators having sufficient knowledge and skills in ethics and access to supervision.Discussion:This study shows that ethics initiatives can be both sustainable and significant for practice. There is a need to create regional or national structures for follow-up and develop more comprehensive ethics training for ethics facilitators.Conclusion:It is both possible and potentially important to implement clinical ethics support activities in community health and care services systematically on a large scale. Future ethics initiatives in the community sector should be designed in light of documented promoting and inhibiting factors. (shrink)

Several scholars have claimed that small-scale agriculture in which farmers sell goods to the local market has the potential to strengthen social ties and a sense of community, a phenomenon referred to as “civic agriculture.” Proponents see promise in the increase in the number of community supported agriculture programs, farmers markets, and other locally orientated distribution systems as well as the growing interest among consumers for buying locally produced goods. Yet others have suggested that (...) these novel or reborn distribution mechanisms are still primarily means of instrumental economic exchange and that optimistic characterizations of a renewed sense of community emerging from these practices are unfounded. This study provides an empirical assessment of the extent to which these community-based agriculture markets are associated with connection to community, volunteerism, and civic and political activities. In order to assess the relationship between civic agriculture and community engagement, we surveyed over 1,300 people in the Mid-Hudson region of New York State. The study design includes “civic agriculture participants” as the unit of analysis, defined as CSA farm members, shoppers at independent health food stores, and farmers market patrons. For comparison, a telephone survey of randomly selected residents of the region’s general population was also conducted. Unlike studies that focus solely on the perceptions of certain civic agriculture participants, by comparing the perceptions and behaviors of those engaged in a range of civic agriculture practices, we are able to identify the effects of different forms of participation. The results demonstrate higher levels of voluntarism and engagement in local politics among civic agriculture participants relative to the general population. In addition, we found variation among those engaged in different forms of civic agriculture, with those immersed in more socially embedded forms of exchange demonstrating greater community and political involvement. These findings lend empirical support to the civic agriculture thesis. (shrink)

In this paper we seek to understand the interplay between increasingly widely held concerns about the hegemony of industrialized agriculture and the emergence of counter-hegemonic activities, such as membership of community supported agriculture (CSA) initiatives. Informed by Blackshaw’s (Leisure, Abingdon, Routledge, 2010) work on “liquid leisure,” we offer a new leisure-based conceptualization of the tactics of counter-hegemony, arguing in the process that food politics offers a rich site for new, transitional identity formation. Using a case study (...) of a well-established community farm in southeast England, we demonstrate how the community members devote themselves to transient and inconsequential activities as a means of attempting to realize a larger self-related identity project. We also demonstrate how the seemingly close inter-personal bonds typical of CSA may not reflect the permanence accorded to them, with members able willingly to leave these communities once they can no longer progress their identity project. We conclude by arguing that our findings are emblematic of society in transition, with people moving well beyond the work/leisure activity into a world in which they embody the idea and the practice of being an active co-producer—in our case, of food. While recognizing that this does not necessarily mean that there is simple causality between practice and identity formation, we do argue that there is evidence of an increasing relationship between activity, time, and the performance of a new form of civil labor practice. (shrink)

Based upon research into small community-based organisations, Information and Communication Technologies (ICTs) can be interpreted as a technology that emerges from complex environments of support, teaching, and community development. While the ICTs investigated are commonplace and relatively simple systems (personal computers, Internet), they are part of complex and extended systems of action, knowledge, information, and support that reach into local communities. This basket of processes and skills, oriented around social justice principles, can be conceived of as ‘technologies of (...) care’, strongly influenced by the values and work activity primarily concerned with supporting people in need. Furthermore, prior research has tended to take a dystopic view about the use of technology by women, who are the major workforce in such environments, but a more nuanced approach is taken her, demonstrating that while workers are competent with ICTs, they is only one element in a process which relies upon communicative and interpretive independence. This understanding of the place of ICTs in human services work has important implications for those implementing or designing ICTs, though clarifying workers’ tacit understandings is a research challenge. Based on more recent research, suggestions are also made about the limitations of the study and the need to take into account other ways of articulating tacit, practical knowledge about ICT relationships through methods such as CO-MAP. (shrink)

Background: Due to the aging society the number of informal caregivers is growing. Most informal caregivers are women working as nurses within a health organization and they have a high risk of developing mental and physical exhaustion. Until now little research attention has been paid to the expectations and needs of double duty caregivers and the role of self-management in managing private-work balance.Objective: The overall aim of this study was to investigate the expectations and needs of double duty caregivers in (...) Netherlands, and to examine the meaning of self-management in managing work-life balance.Method: Different research methods have been applied in this exploratory study. Firstly, a scoping review has been conducted on the topics self-management and sustainable employability of double-duty caregivers using the search engines: CINAHL, MEDLINE, PubMed, and Google Scholar. Furthermore, a qualitative study has been conducted through focus groups with double duty caregivers.Results: Twenty studies that met the inclusion criteria could be identified. We found that double duty caregivers have different motivations for being a double duty caregiver based on internal and external expectations. Double duty caregiving causes a lot of mental and physical pressure for the caregiver. To be able to combine both duty’s, double duty caregivers need flexibility and understanding from the workplace. Through two focus groups we found that social support from the workplace is not enough to be able to manage the situation. Self-management skills are important to be able to communicate effectively with the workplace and community care organizations about the kind of support needed. Also, health care organizations should offer the same support to double duty caregivers as any other informal caregiver.Discussion: Double-duty caregivers are at high risk of developing symptoms of overload and risk of reduced self-management quality and employability levels across time. Health care organizations and the double duty caregiver often wait too long to act instead of taking more preventive measures. Furthermore, community care organizations should dialog with double duty caregivers about their wishes concerning the division of caring tasks. This finding calls for special attention, with long-term solutions at both macro, organizational, and employee level. (shrink)

In recent years Community Supported Agriculture (CSA), an innovative grassroots movement connecting consumers with a local farm, has rapidly spread across Germany and other industrialized countries. An increasing number of consumers who are dissatisfied with conventional food supply chains have signed up to receive fresh produce, support a local community and protect the environment. So far little is known, though, about the underlying value structures of CSA. Nevertheless, identifying factors influencing consumers’ interest in CSA is regarded (...) as a major aim of contemporary CSA research. This research aims to provide insights into CSA members’ value structures, and delineates CSA members by comparing their value structures to those of the German population in general. Schwartz’s Portrait Value Questionnaire was used in a standardized online survey of CSA members to mirror the dataset which is available to the German public via the European Social Survey. A total sample of 205 CSA members was used to examine common value structures by comparing them with the German public. This study’s findings strongly indicate that a CSA membership goes along with a characteristic value pattern: CSA members highly appreciate self-transcendence and openness to change, but tend to reject conservation and self-enhancement values. Addressing members’ preference for openness to change and self-transcendence may help CSAs to reduce fluctuation rates. It might also enhance CSA marketing strategy by addressing potential members’ interests more precisely. Therefore, identifying and communicating common values of a CSA might be a key factor in determining its long-term success and stability. (shrink)

With an estimated 12.1% of children aged 2–5 years already obese, prevention efforts must target our youngest children. One of the best places to reach young children for such efforts is the early care and education setting. More than 11 million U.S. children spend an average of 30 hours per week in ECE facilities. Increased attention at the national, state, and community level on the ECE setting for early obesity prevention efforts has sparked a range of innovative efforts. To (...) assist these efforts, CDC developed a technical assistance and training framework – the Spectrum of Opportunities for Obesity Prevention in the ECE setting – which also served as the organizing framework for the Weight of the Nation ECE track. Participants highlighted their efforts at national, state, and local levels pursuing opportunities on the Spectrum, the standards and best practices that had been the emphasis of their efforts, and common steps for developing, implementing, and evaluating initiatives. Strong leadership and collaboration among a broad group of stakeholders; systematic assessment of needs, opportunities and resources; funding sources; and training and professional development were reported to be integral for successful implementation of standards and best practices, and sustainability. (shrink)

Efforts towards adaptation, dissemination, and implementation of culturally robust, evidence-informed mental health care rely on community-engaged research. Academic-community partnerships help bring science to service for vulnerable and historically disenfranchised populations. A growing literature supports the development of a framework of ethics for CEnR. This article examines ethical tensions in the context of the American Psychological Association Ethics Code General Principles – Beneficence and Nonmaleficence; Fidelity and Responsibility; Integrity; Justice; and Respect for People’s Rights and Dignity – and presents (...) the 4R action plan to support application of APA guidelines to academic-community partnership with youth-serving organizations. (shrink)

This study reconsiders the purported benefits of community found in Community Supported Agriculture (CSA). Using an online survey of members who belong to CSAs in New York, between November and December 2010, we assess members’ reasons for joining a CSA, and their perceptions of community within their CSA and beyond. A total of 565 CSA members responded to the survey. Results show an overwhelming majority of members joined their CSA for fresh, local, organic produce, while (...) few respondents joined their CSA to build community, meet like-minded individuals or share financial risk with farmers. Members reported that they do not derive a strong sense of community from either their CSA or other forms of community, yet they volunteered at their CSA and appear to be engaged in activities within their communities, though the frequency of the latter is unknown. These data suggest New York CSAs are oriented toward the instrumental and functional models, which emphasize the economic aspects of farming rather than collaborative models, which foster community (Feagan and Henderson 2009). (shrink)

Although beef and dairy production in Alberta, Canada, enjoys strong public support, there are enduring public concerns, including farm animal welfare. Evolving codes of practice and animal care councils prescribe changes and improvements to many areas of farm management, and may be seen by farmers as an appropriate response to public animal welfare concerns. However, codes of practice do not address every animal welfare concern, and new concerns can arise over time. Drawing on social practice theory and (...) in-depth field research with 36 cattle and dairy farmers, this paper explores the materials, competencies, and meanings of four animal husbandry practices: branding, dehorning, weaning, and on-farm handling and moving. Findings show that branding and dehorning are evolving slowly with attention to pain management, but remain firmly rooted in ranching tradition and communities of practice. Weaning and animal handling practices are evolving more quickly with attention to changing materials, attitudes, and values that are more prevalent within producer communities. (shrink)

While questions about the environmental sustainability of contemporary farming practices and the socioeconomic viability of rural communities are attracting increasing attention throughout the US, these two issues are rarely considered together. This paper explores the current and potential connections between these two aspects of sustainability, using data on community members’ and farmers’ views of agricultural issues in California’s Central Valley. These views were collected from a series of individual and group interviews with biologically oriented and conventional farmers as well (...) as community stakeholders. Local marketing, farmland preservation, and perceptions of sustainable agriculture comprised the primary topics of discussion. The mixed results indicate that, while many farmers and community members have a strong interest in these topics, sustainable community development and the use of sustainable farming practices are seldom explicitly linked. On the other hand, many separate efforts around the Valley to increase local marketing and agritourism, improve public education about agriculture, and organize grassroots farmland preservation initiatives were documented. We conclude that linking these efforts more explicitly to sustainable agriculture and promoting more engagement between ecologically oriented farmers and their communities could engender more economic and political support for these farmers, helping them and their communities to achieve greater sustainability in the long run. (shrink)

To determine the role Latino community gardens play in community development, open space, and civic agriculture, we conducted interviews with 32 community gardeners from 20 gardens, and with staff from 11 community gardening support non-profit organizations and government agencies. We also conducted observations in the gardens, and reviewed documents written by the gardeners and staff from 13 support organizations and agencies. In addition to being sites for production of conventional and ethnic vegetables and herbs, the (...) gardens host numerous social, educational, and cultural events, including neighborhood and church gatherings, holiday parties, children’s activities, school tours, concerts, health fairs, and voter registration drives. In some cases, the gardens also serve to promote community activism. The primary concern of gardeners is to secure land tenure in the face of pressures to develop the garden sites for housing. The support organizations and agencies provide help with land tenure, as well as with advocacy, organization, and horticultural practices. Although the role of the Latino gardens in community development appears to be more important than their role in open space or agricultural production, the gardens can also be viewed as unique “participatory landscapes” that combine aspects of all three movements, as well as provide a connection between immigrants and their cultural heritage. (shrink)

This special issue of the Journal of Agricultural and Environmental Ethics presents so-called ethical tools that are developed to support systematic public deliberations about the ethical aspects of agricultural biotechnologies. This paper firstly clarifies the intended connotations of the term “ethical tools” and argues that such tools can support liberal democracies to cope with the issues that are raised by the application of genetic modification and other modern biotechnologies in agriculture and food production. The paper secondly characterizes the societal (...) discussion on agricultural biotechnology and defends the thesis that normative perspectives fuel this discussion, so one cannot come to grips with this discussion if one neglects these perspectives. The paper thirdly agrues that no such thing exists as “one” societal debate in which these issues should be discussed. There are several interwined debates, and different actors participate in different discourses. Some practical instruments are necessary in order to include the right issues in these debates. These instruments will be coined as “ethical tools,” since they are practical instruments that can be used (tools) in order to support debates and deliberative structures for a systematic engagement with ethical issues (hence, ethical tools). Finally, the paper clarifies the ethics of these ethical tools and presents the tools as discussed in the remainder of this special issue: 1) tools to include ethical issues in public consulation and involvement; 2) tools to support systematic reflection upon ethical issues in decision-making; and 3) tools to support explicit communication about values in the food chain. (shrink)

Background: Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. Aim: To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A case study (...) was conducted in a professional development course for home care nurses, including participant observations and focus groups. The theoretical notion of ‘relational agency’ and the moral concept of ‘practices of responsibility’ were used to conduct a narrative analysis on the nurses’ stories about autonomy. Participants: Eight nurses, two coaches and two university lecturers who participated in the learning circle. Ethical considerations: Informed consent was sought at the start of the course and again, at specific moments during the course of the learning circle. Findings: Three main themes were found that expressed the moral demands experienced and negotiated by the nurses: adapting to the person, activating patients’ strengths and collaboration with patients and informal caregivers. Discussion: On a policy and organisational level, the moral discourse on patient autonomy gets intertwined with the instrumental discourse on healthcare budget savings. This is manifested in the ambiguities the nurses face in fostering patient autonomy in their daily home care practice. To support nurses, critical thinking, moral sensitivity and trans-professional working should be part of their professional development. Conclusion: The turn towards autonomy in healthcare raises moral questions about responsibilities for care. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together. (shrink)

In the U.S. there has been considerable interest in connecting low-income households to alternative food networks like Community Supported Agriculture. To learn more about this possibility we conducted a statewide survey of CSA members in California. A total of 1149 members from 41 CSAs responded. Here we answer the research question: How do CSA members’ socioeconomic and demographic backgrounds, household conditions potentially interfering with membership, and CSA membership experiences vary between lower-income households and higher-income households? We divided (...) members into LIHHs and HIHHs. We present comparisons of LIHHs’ and HIHHs’ employment, race/ethnicity, household composition and education, use of food support, and enjoyment of food-related activities; conditions interfering with membership and major life events; and sources of information influencing decision to join, reasons for joining, ratings of importance of and satisfaction with various CSA attributes, gaps between importance of and satisfaction with various CSA attributes, valuing of the share and willingness to pay more, and impacts of membership. We find that LIHHs are committed CSA members, often more so than HIHHs, and that CSA members in California are disproportionately white, but that racial disproportionality decreases as incomes increase. We conclude by considering: the economic risks that LIHHs face in CSA membership, the intersection of economic risks with race/ethnicity and cultural coding in CSA; and the possibilities of increasing participation of LIHH in CSA. (shrink)

Rural queer studies, viewed through the lens of relational agriculture, offer critiques of heteropatriarchal norms in farming and highlight strategies used by queer farmers to manoeuvre discrimination and thrive in rural areas. This paper responds to recent calls for further scrutiny of the experiences of gender and sexually underrepresented groups in community-supported agriculture (CSA). It investigates the empowerment of rural queer people in CSA Guadiana, South Portugal, through the experiences of 12 queer members. I collected data (...) through participant observation, semi-structured interviews and a focus group and analysed them through open coding, followed by focused coding. Results indicate that CSA Guadiana, despite not originally designed for this purpose, facilitates various forms of empowerment and active engagement among queer members, particularly influenced by the leadership of queer producers and recurrent gatherings in queer-owned farmland. Three key lessons of queer empowerment in CSA Guadiana emerge from the analysis and contribute to debates on the politics of recognition, queer community action and visibility in the rural context: (i) self-confidence to perform queerness may be restricted to a selective rural community; (ii) partnerships between producers and co-producers may enable reciprocal queer empowerment; and (iii) queer leadership in agri-food community action may quietly represent gender and sexual diversity in the countryside. These findings offer the rural queer literature novel insights into the complexities, contradictions and limitations of empowerment experienced by queer farmers, artisanal food producers and consumers in a rural CSA. (shrink)

Background Non-invasive prenatal testing (NIPT), which can screen for aneuploidies such as trisomy 21, is being implemented in several public healthcare systems across Europe. Comprehensive communication and information have been highlighted in the literature as important elements in supporting women’s reproductive decision-making and addressing relevant ethical concerns such as routinisation. Countries such as England and France are adopting broadly similar implementation models, offering NIPT for pregnancies with high aneuploidy probability. However, we do not have a deeper understanding of how professionals’ (...) counselling values and practices may differ between these contexts. Methods In this paper, we explore how professionals in England and France support patient decision-making in the provision of NIPT and critically compare professional practices and values. We draw on data from semi-structured interviews with healthcare professionals. Results Both English and French professionals emphasised values relating to patient choice and consent. However, understandings and application of these values into the practice of NIPT provision differed. English interviewees placed a stronger emphasis on interpreting and describing the process of counselling patients and clinical care through a “principle” lens. Their focus was on non-directiveness, standardisation, and the healthcare professional as “decision-facilitator” for patients. French interviewees described their approach through a “procedural” lens. Their focus was on formal consent, information, and the healthcare professional as “information-giver”. Both English and French professionals indicated that insufficient resources were a key barrier in effectively translating their values into practice. Conclusion Our findings illustrate that supporting patient choice in the provision of NIPT may be held as an important value in common on a surface level, but can be understood and translated into practice in different ways. Our findings can guide further research and beneficially inform practice and policy around NIPT provision. (shrink)

The focus of this article is community supported agriculture (CSA) as an alternative food movement and a bottom-up response to the problems of the dominant food systems. By utilizing social innovation approach that explores the relationship between causes for human needs and emergence of socially innovative food initiatives, the article examines how the CSA projects emerge and why, what is their innovative role as part of the social economy and what is their transformative potential. Based on qualitative (...) data from four different models of CSA case studies in different regions of Wales, UK, and by using concepts from an alternative model for social innovation (ALMOLIN) as analytical tool, the article demonstrates that the Welsh CSA cases play distinctive roles as part of the social economy. They satisfy the needs for ecologically sound and ethically produced food, grown within communities of like-minded people and they empower individuals and communities at micro level, while at the same time experiment with how to be economically sustainable and resilient on a small scale. The paper argues that in order to become ‘workable utopias’, the CSA initiatives need to overcome the barriers that prevent them from replicating, participating in policies and decision-making at macro level, and scaling up. (shrink)

The idea of “food miles,” the distance that food has to be shipped, has entered into debates in both popular and academic circles about local eating. An oft-cited figure claims that the “average item” of food travels 1,500 miles before it reaches your plate. The source of this figure is almost never given, however, and indeed, it is a figure with surprisingly little grounding in objective research. In this study, I track the evolution of this figure, and the ways that (...) scholars and popular writers have rhetorically employed it. I then explore the ongoing debates over food miles and local food, debates that often oversimplify the idea of local eating to a caricature. I then examine a series of in-depth interviews with community-supported agriculture members and farmers in order to bring complexity back to discussions of local food consumers. I argue that the overwhelming focus on “food miles” among scholars threatens to eclipse the multitude of other values and meanings contained in the word “local” that underlie people’s decisions to “eat locally,” foremost among them, a desire to reintegrate food production and consumption within the context of place. (shrink)

The Patients Changing Things Together (PATCHATT) programme supports individuals with a life-limiting illness to lead a change that matters to them. Individuals join a facilitated online peer support group to identify an issue they feel strongly about, plan for change and take action to bring that change about. The programme is developed and guided by a Programme Advisory Group with clinical and lay membership. This article charts the trialling of the patients changing thing together ethics pack, designed to support all (...) members of the Programme Advisory Group in taking an equal role in ethical decision-making as they guide the programme's ongoing development. As a trial of its efficacy, the pack was used by the author to consider an ethical dilemma at the heart of the development of the Patients Changing Things Together programme, that is, is it ethical to offer a community palliative care programme which has the potential to bring participants harm as well as good? The author reports a strong ethical argument for offering this programme, while concluding the need for the Programme Advisory Group to make the final decision, using the Patients Changing Things Together ethics pack to consider the results of the evaluation of the programme's pilot. The article concludes that this pack provides an effective tool to guide ethical novices through the ethical complexities of developing a community-based palliative care intervention programme. It raises the issue that such inclusivity is achieved through a normative decision-making process which denies the fluidity and creativity which may inform the best ethical decision-making practice. (shrink)

Opaque value chains as well as environmental, ethical and health issues and food scandals are decreasing consumer trust in conventional agriculture and the dominant food system. As a result, critical consumers are increasingly turning to community-supported agriculture (CSA) to reconnect with producers and food. CSA is often perceived as a more sustainable, localized mode of food production, providing transparent production or social interaction between consumers and producers. This enables consumers to observe where their food is coming (...) from, which means CSA is considered suitable for building trust in food (production). However, it remains unclear how exactly members’ trust in ‘their’ farmers is built. To determine the factors that predict members’ trust in CSA and its farmers, and the importance of these factors when compared to each other, we conducted a quantitative study among CSA members in Germany and applied a multiple regression model (n = 790). The analysis revealed that trust in CSA and its farmers is influenced by “reputation”, “supply of information”, “direct social interaction” and the “duration of CSA membership”. Other factors such as the “certification status of the CSA farm” and “attitudes toward organic certification” did not significantly predict trust. We conclude that producers’ willingness to be transparent already signals trustworthiness to CSA members and is more important to members than formal signals. Other actors within the food system could learn from CSA principles and foster a transition toward a more regionalized value-based food system to help restore agriculture’s integrity. (shrink)

Third World farmers are faced with development projects that foster one-way information flows from the government or organization to the farmers, despite the scholarly and practical interest in participatory development models. This article discusses why development projects do not better support power-sharing and proposes introducing sensemaking methodology into the planning and evaluation stages of agricultural development projects.Participation has been difficult to operationalize for many reasons including that communication models used in development are based on the transmission model of communication in (...) which information is envisioned as a thing external to people and communication is the movement of that information from the source to the audience. Sense-making methodology, however, is based on a constructing model of communication in which information is conceptualized not as external to people but a result of their observing and communicating activity. Communication is a constructing process. And the “audience” is not the target for messages but active participants in creating information. (shrink)

Strategies to support the psychosocial well-being of older adults living in aged-care are needed; and evidence points toward music listening as an effective, non-pharmacological tool with many benefits to quality of life and well-being. Yet, the everyday listening practices of older adults living in residential aged-care remain under-researched. The current study explored older adults’ experiences of music listening in their daily lives while living in residential aged-care and considered how music listening might support their well-being. Specifically, what might go into (...) autonomous listening activities? 32 Australian residents living in two Australian care facilities participated in semi-structured interviews. The results of a qualitative thematic analysis revealed three themes pertaining to “previous music experiences and interest,” “current music listening,” and “barriers to listening.” While an interest in and access to music did not necessarily result in everyday listening practices, of those participants who did listen to music, perceived benefits included outcomes such as entertainment, enjoyment, relaxation, and mood regulation. Drawing on Ruud’s notion of music as a “cultural immunogen” supporting well-being and Self-Determination Theory, theoretical implications of the findings are addressed, relating to how to create and support music activities in aged-care facilities so that they are engaging, meaningful, and promote emotional regulation, community, and well-being. (shrink)

Practitioners and advocates of community food security (CFS) envision food systems that are decentralized, environmentally-sound over a long time-frame, supportive of collective rather than only individual needs, effective in assuring equitable food access, and created by democratic decision-making. These themes are loosely connected in literature about CFS, with no logical linkages among them. Clear articulation in a theoretical framework is needed for CFS to be effective as a guide for policy and action. CFS theory should delimit the level of (...) analysis (i.e., what are the boundaries of “community”); show how CFS relates to individual, household, and national food security and explain emergent properties, which are important at the community level of analysis; point to the best indicators of CFS or its lack; clarify the determinants of CFS; and clarify the stages of movement toward CFS. This theoretical base would allow researchers to develop valid and reliable measures, and allow practitioners to weigh alternative options to create strategic plans. A theoretical base also would help establish common ground with potential partners by making the connections to anti-hunger work, sustainable agriculture, and community development clear. (shrink)

Citizens are called upon to become active participants in creating a more sustainable food system. As food citizens, people participate in defining and constructing their food systems according to their needs and values. In food policies, the concept of food citizenship is often left undefined or with reference only to individual activities. In the food citizenship literature, the role of nonhuman agency in constituting food citizenship needs more examination. Here we investigate food citizenship activities in a citizen-led community-supported (...) agriculture group and explore the role of materiality in constituting food citizenship. We ask (1) what is the role of material-discursive arrangements in community-supported agriculture activities, and (2) how does materiality constitute food citizenship? We analyze semi-structured interviews, as well as observation and visual material, using qualitative content analysis. Our findings indicate that materialities, such as the field, time, and body, play a central role in community-supported agriculture activities. With materialities, food citizenship is understood as collective and active doing, aiming to change the food system. Instead of endorsing food citizenship as a human trait or status, we claim that it is more productive to regard it as a phenomenon, produced in intra-action with(in) material-discursive arrangements. Acknowledging nonhuman agency emphasizes the political, collective, and responsible nature of citizenship as well as the power relations behind the constitution of citizenship. We conclude that in food policies more attention should be paid to collective ways of civic participation and to the materiality of becoming a food citizen. (shrink)

Taking steps to build a more dementia‐friendly society is essential for addressing the needs of people experiencing dementia. Initiatives that improve the quality of life for those living with dementia are needed to lessen controllable factors that can negatively influence how people envision a future trajectory of dementia for themselves. Programs that provide better funding and better coordination for care support would lessen caregiver burden and make it more possible to imagine more people being able to live what they might (...) consider a “good life” with dementia. Specific proposals, such as payment for dementia care managers and new systems to support high‐quality, symptom‐based palliative care beyond the hospice benefit of only six months, would improve and reframe how many people in the United States experience a dementia illness. Such changes should be incorporated into discussions about improving and respecting preferences in the later stages of dementia. (shrink)

Today’s food production and consumption go hand in hand with immense damages to humans and nature. Change is needed, but where to start and which direction to go? This article tries to give an interdisciplinary answer by taking recourse to a vision, that is, an ideal image of the future which is drawn upon ethical reflection and beyond the limits of actual political and economic constraints. The main purpose of this paper is to show that generating and discussing visions can (...) be a powerful process in order to regain ability to act in the face of the complex challenges of our time and that Education for Sustainable Development plays an important role to enable current and future generations to become actors of change. First, a students vision on agriculture and society in 2050 is presented, followed by a theoretical examination of visions, their potentials, limits and practical implications. Subsequently, the results of a field analysis of current innovative solutions to local agriculture are given. These include intercultural gardens and community supported agriculture. Claiming that a sustainable development can only be reached if people are not only able to envision a desirable future, but to develop small scale, locally adapted solutions as answers to challenges such as climate change, this paper then focuses on the competence oriented educational concept of ESD. Here, an approach of integrating ethics in the course of studies of agricultural sciences implemented by a student’s initiative serves as practice example. (shrink)

If the field of agricultural ethics is to realize its potential and if the agricultural and philosophical communities are to address the impending changes in world food production, there is a need for education in public, governmental, and academic arenas. The development of a symposium on agriculural ethics is an effective method for “raising awareness” of the imminent need for a consolidation of philosophical and agricultural expertise. Based on experience, a series of organizational guidelines and their associated philosophical issues are (...) presented. The initial step is a determination of the purposes of the symposium, which leads to the consideration of the choice of speakers and topics. The best series of speakers will ultimately prove to be ineffectual if the logistics of the symposium are not carefully planned. The scheduling, format, timing and location of the talks are critical. Related to these practical aspects is the organization of promotional efforts. Since one of the goals is, presumably, to enlighten a target audience, effective promotion should be a central concern. Underlying all of these considerations is the budget. How the agricultural ethics symposium at the University of Wyoming addressed these issues is presented, with a critical review of our efforts based on external evaluations. (shrink)

Allied health professionals play an integral role in providing safe, affordable care to communities in need. Laws that define the permissible scope of practice for these professionals may take full advantage of these providers and may unnecessarily restrict safe and effective care. Nurse practitioners in many states may provide care independent of a physician; research reveals that this care is safe, affordable and accessible. Yet hurdles exist that prevent communities from securing the full benefit of NPs in independent (...) class='Hi'>practice. The scope of independent practice for allied dental providers varies greatly across the country, often including stringent supervision requirements. Emerging approaches to allowing allied dental providers to practice independently in certain settings or with dentist supervision via telemedicine and creating the intermediate provider, the dental therapist, may increase access to safe, affordable dental care. Research on the impact of laws that allow broader independent practice by NPs to ferret out the hurdles to full implementation of the spirit of such laws is needed. That research could support expanded independent scope for allied dental providers and other allied health care providers. (shrink)

This article deals with the biotechnology revolution in agriculture and analyzes it in terms of Bernard Stiegler’s theory of techno-evolution and his thesis that technologies have an intrinsically pharmacological nature, meaning that they can be both supportive and destructive for sociotechnical practices based on them. Technological innovations always first disrupt existing sociotechnical practices, but are subsequently always appropriated by the social system to be turned into a new technical system upon which new sociotechnical practices are based. As constituted and (...) conditioned by a technical system, human cultures are necessarily systems of care. Humans take care of themselves and the world through technologies. Agriculture is a very old system of care, stable for more than 10,000 years, but at the moment it is experiencing a profound rupture thanks to the invention of genetic engineering technologies, that promise to revolutionize it. However, their current deployment under capitalist conditions everywhere leads to processes of proletarianization, due to the fact that they enable the expropriation of farmers of the means of production, depriving them of the possibility of appropriating these new technologies and frustrating the invention of a new agricultural system of care. This has lead to a widespread rejection of the new technologies, which is a grave error though, as these technologies can become the basis of a new system of care. But only under the condition that they are wrought from corporate control and redeployed instead to initiate a process of deproletarianization. It is argued that current initiatives in open source and commons-based biotech are probably the most promising harbingers of such a process of deproletarianization. (shrink)

State patronage and the role of central government in modernization are often cited as the key factors that underpin the development of science in Russia. This paper argues that the development of Russian agricultural science had predominantly local and non-governmental sources of support. Historically Russian agricultural research was funded and promoted through private patronage, but from the middle of the 19th century agricultural societies and community administrations began to sponsor research and promotion of new ideas in the agricultural sector. (...) At the end of the 19th century the majority of initiatives to set up agricultural experiment stations were undertaken on behalf of provincial agricultural societies, supported by local community administrations independent of the state bureaucratic apparatus (zemstvos). During the last two decades of the Russian Empire, agricultural societies and zemstvos became leaders in the modernization of Russian agriculture. Establishing regional experiment stations, and thus promoting development of local knowledge, they provided models for the subsequent governmental activity in this field. In the case of supporting agricultural research and institutionalizing the new discipline of scientific plant breeding, the Russian public led the state, rather than the reverse. (shrink)

In post-Fordist economies, the nature of laboring activities can no longer be subsumed under a Taylorized model of labor, and the service sector now constitutes a larger share of the market. For Maurizio Lazzarato, Michael Hardt, Antonio Negri, and other theorists in the post-Marxist tradition, labor has changed from a commodity-producing activity to one that does not produce a material object. For these authors, this new type of labor is immaterial labor and entails communicative acts as well as added worker (...) agency. This paper reflects on this new paradigm of labor by examining the paid practices of care defined as the activities performed by individuals who have a mandate to help another adult accomplish the tasks of self-care. Because care workers take care of other bodies, care labor exemplifies an embodied practice. I make use of the corporeality of care to put forward the notion of thin and thick embodiment in order to examine critically the meaning of immaterial labor and to support my claim that immaterial labor, as conceptualized by Hardt and Negri, erases both the materiality and relationality of care labor. Furthermore, typifying care labor as immaterial only serves to maintain its marginalized status.Care Assistant. Required to work within a private residential center to assist nursing staff. Experience desirable, qualifications an advantage, but caring and understanding more important than either. Must have good English to understand instructions and be co-operative to work in a friendly team environment (Toynbee 2007, 220). (shrink)

Ethics support in primary health care has been sparser than in hospitals, the need for ethics support is probably no less. We have, however, limited knowledge about how to develop ethics support that responds to primary health-care workers’ needs. In this article, we present a survey with a mixture of closed- and open-ended questions concerning: How frequent and how distressed various types of ethical challenges make the primary health-care workers feel, how important they think it is to deal with these (...) challenges better and what kind of ethics support they want. Five primary health-care institutions participated. Ethical challenges seem to be prominent and common. Most frequently, the participants experienced ethical challenges related to scarce resources and lack of knowledge and skills. Furthermore, ethical challenges related to communication and decision making were common. The participants welcomed ethics support responding to their challenges and being integrated in their daily practices. (shrink)

ABSTRACT Objectives There is little research on moral uncertainties and distress of palliative and hospice care providers (PHCPs) working in jurisdictions anticipating legalising voluntary assisted dying (VAD). This study examines the perception and anticipated concerns of PHCPs in providing VAD in the State of Queensland, Australia prior to legalisation of the practice in 2021. The findings help inform strategies to facilitate training and support the health and well-being of healthcare workers involved in VAD. Design The study used a qualitative (...) approach to examine and analyse the perception and anticipated concerns of PHCPs regarding challenges of providing assisted dying in Queensland. Fourteen PHCPs were recruited using a purposive sampling strategy to obtain a broad representation of perspectives including work roles, geographical locations and workplace characteristics. Data were collected via one in-depth interview per participant. The transcripts were coded for patterns and themes using an inductive analysis approach following the tradition of Grounded Theory. Setting The study was conducted in hospital, hospice, community and residential aged care settings in Queensland, Australia. These included public and private facilities, secular and faith-based facilities, and regional/rural and urban facilities. Participants Interviews were conducted with fourteen PHCPs: 10 nurses and 4 physicians; 11 female and 3 male. The median number of years of palliative care practice was 17, ranging from 2 to 36 years. For inclusion, participants had to be practising palliative and hospice care providers. Results PHCPs are divided on whether VAD should be considered part of palliative care. Expectations of moral distress and uncertainty about practising VAD were identified in five areas: handling requests, assessing patient capacity, arranging patient transfers and logistical issues, managing unsuccessful attempts, and dealing with team conflicts and stigma. Conclusions The possibility of having to practise VAD causes moral distress and uncertainty for some PHCPs. Procedural clarity can address some uncertainties; moral and psychological distress, however, remains a source of tension that needs support to ensure ongoing care of both patients and PHCPs. The introduction of VAD post-legalisation may present an occasion for further moral education and development of PHCPs. (shrink)

Almost one-third of all U.S. Americans believe that Jesus Christ will return to Earth in the next 40 years, thereby signaling the end of the world. The prevalence of this end-times theology has meant that sustainability initiatives are often met with indifference, resistance, or even hostility from a significant portion of the American population. One of the ways that the scientific community can respond to this is by making scientific discourse, particularly as related to sustainability, more palatable to end-times (...) believers. In this paper, I apply a historical–ecological framework, which emphasizes the interdisciplinary study of landscapes to understand long-term human–environment interactions, to three millennial religious groups that formed communes in nineteenth century America. The Shakers, Inspirationalists, and Mormons all blended deep beliefs in end-times theology with agricultural practices that were arguably more sustainable than those in use in the mainstream, and their ability to reconcile eschatology with sustainability provides us with potential lessons. By examining the history, doctrines, and agroecology of these nineteenth century communes, I propose communication strategies based in autonomy, institutional support, multigenerational narratives, and anthropocentricism as potential pathways for a more productive dialogue between advocates of sustainability initiatives and end-times believers in the modern United States. (shrink)

BackgroundThere have been notable investments in large multi-partner research programmes across the agriculture-nutrition-health (ANH) nexus. These studies often involve human participants and commonly require research ethics review. These ANH studies are complex and can raise ethical issues that need pre-field work, ethical oversight and also need an embedded process that can identify, characterise and manage ethical issues as the research work develops, as such more embedded and dynamic ethics processes are needed. This work builds on notions of ‘ethics in (...) practice’ by developing an approach to facilitate ethical reflection within large research programmes. This study explores the application of a novel ‘real-time research ethics approach’ (RTREA) and how this can support ethical mindfulness. This involves embedding ethical analysis and decision-making within research implementation, with a continuous dialogue between participants and researchers. The aim is to improve ethical responsiveness and participant experience, which in turn may ethically support adherence and retention. In this case study, a bioethics team (BT) was embedded in a community-based randomised, controlled trial conducted in rural Malawi, titled the ‘Addressing Hidden Hunger with Agronomy’. To identify ethical issues, the researchers conducted ten focus group discussions, fourteen in-depth interviews with key informants, two workshops, observed two sensitisation and three activity meetings conducted by the trial team, and analysed fifteen reports from pre-trial to trial implementation.ResultsThe RTREA facilitated the identification of social and ethical concerns and made researchers aware of participants’ ‘lived research experience’. To address concerns and experiences, the BT worked with researchers to facilitate conversation spaces where social and ethical issues were discussed. Conversation spaces were designed to create partnerships and promote participatory methods to capture trial participants’ (TPs) perspectives and experiences.ConclusionsThe use of RTREA showed the value of real-time and continuous engagement between TPs and researchers. These real-time processes could be embedded to complement traditional ethical guidance and expert opinions. A deeper engagement appeared to support greater operationalising of principles of inclusion, empowerment, and participant autonomy and supported researchers ‘ethical mindfulness’ which in turn may support instrumental outcomes of high recruitment, retention, and adherence levels. (shrink)

This article suggests a shift in focus from stories as verbal accounts to narrative interpretation of the every day as a resource for achieving person‐centred health and social care. The aim is to explore Ricoeur's notion of narrative and action, as expressed in his arguments on a threefold mimesis process, using this as a grounding for the use of narration to achieve person‐centredness in health and social care practice. This focus emerged from discussions on this matter at the IPONS (...) conference in Gothenburg, 2021. Based on philosophical resources from Ricoeur's notions of narrative and action developed in his arguments on a threefold mimesis process, we propose a wider use of stories in health and social care practices. We suggest expanding from only focusing on verbal accounts to focusing on narrative as a human way to interpret and make sense of everyday life and circumstances and to communicate possible meanings. We discuss how such complementary focus can be a resource in getting patients involved and collaborating in their health and social care and thereby help develop person‐centred practices. (shrink)

BackgroundExisting clinical ethics support (CES) instruments are considered useful. However, users report obstacles in using them in daily practice. Including end users and other stakeholders in developing CES instruments might help to overcome these limitations. This study describes the development process of a new ethics support instrument called CURA, a low-threshold four-step instrument focused on nurses and nurse assistants working in palliative care. MethodWe used a participatory development design. We worked together with stakeholders in a Community of (...) class='Hi'>Practice throughout the study. Potential end users (nurses and nurse assistants in palliative care) used CURA in several pilots and provided us with feedback which we used to improve CURA.ResultsWe distinguished three phases in the development process. Phase one, Identifying Needs, focused on identifying stakeholder and end user needs and preferences, learning from existing CES instruments, their development and evaluation, and identify gaps. Phase two, Development, focused on designing, developing, refining and tailoring the instrument on the basis of iterative co-creation. Phase three, Dissemination, focused on implementation and dissemination. The instrument, CURA, is a four-step low-threshold instrument that fosters ethical reflection.ConclusionsParticipatory development is a valuable approach for developing clinical ethics support instruments. Collaborating with end users and other stakeholders in our development study has helped to meet the needs and preferences of end users, to come up with strategies to refine the instrument in order to enhance its feasibility, and to overcome reported limitations of existing clinical ethics instruments. (shrink)

This book identifies and explores ethical themes in the structure and delivery of hospice care in the United States. As the fastest growing sector in the US healthcare system, in which over forty percent of patients who die each year receive care in their final weeks of life, hospice care presents complex ethical opportunities and challenges for patients, families, clinicians, and administrators. Thirteen original chapters, written by seventeen hospice experts, offer guidance and analysis that promotes best ethical practice for (...) hospice organizations and professionals. The book addresses common questions and issues faced by those who work in hospice care, a dynamic movement that, in only 30 years, has shifted from an all-volunteer care alternative at the end of life to a highly regulated industry in which over half of providers are for-profit enterprises in a very competitive health care marketplace. The chapters show how the history and philosophy of hospice care can inform the values and composition of care teams, the operations of inpatient units, and access to care for pediatric and long-term care populations. Various chapters propose frameworks for deliberating organizational approaches to ethical questions in changing regulatory and legal environments, including a model for hospice ethics committees. The final chapter outlines an expanded model of hospice as a community based, interdisciplinary, and holistic form of palliative care emphasizing advance planning, case management, and a flexible spectrum of services. This model can serve as a centrepiece for a new quality of life and social support approach, not only to terminal care, but also long-term care during the later stages of chronic illness and fraility. (shrink)

Moral distress is a pervasive phenomenon in healthcare for which there is no straightforward “solution.” Rhetoric surrounding moral distress has shifted over time, with some scholars arguing that moral distress needs to be remedied, resolved, and eradicated, while others recognize that moral distress can have some positive value. The authors of this paper recognize that moral distress has value in its function as a warning sign, signaling the presence of an ethical issue related to patient care that requires deeper exploration, (...) rather than evidencing identification of the “right” course of action. Once the experience of moral distress is identified, steps ought to be taken to clarify the moral issue, and, if possible and reasonable, the patient’s values ought to be prioritized. This paper offers concrete actions steps, drawn from theory, which can be used in clinical practice to provide peer support or to facilitate self-reflection for morally distressed individuals. This approach empowers morally distressed individuals to explore ethical issues, identify concrete steps that can be taken, and mitigate feelings of powerlessness that are often associated with moral-constraint distress. The questions guide individuals and peers to reflect first on the micro-space and then more broadly on the institutional culture, facilitating meso- and macro-reflection and action. (shrink)

In 1973, Jim Hightower and his associates at the Agribusiness Accountability Project dropped a bombshell – Hard Tomatoes, Hard Times – on the land-grant college and agricultural science establishments. From the early 1970s until roughly 1990, Hightower-style criticism of and activism toward the public agricultural research system focused on a set of closely interrelated themes: the tendencies for the publicly supported research enterprise to be an unwarranted taxpayer subsidy of agribusiness, for agricultural research and extension to favor large farmers (...) and be disadvantageous for family farmers, for public research to stress mechanization while ignoring the concerns and interests of farm workers, and for the research and extension establishment to ignore rural poverty and other rural social problems. By 1990, however, there had been a quite fundamental restructuring of the agricultural technology opposition movement – one that is not often well recognized. Two overarching changes had occurred. First, agricultural-technology activism had shifted from contesting land-grant/public research priorities and practices to contesting private agribusiness technological priorities and practices. Second, the relatively integrated, overarching Hightower-type opposition had undergone bifurcation into two quite distinct social movements: the agricultural sustainability/local food systems movement on one hand, and the anti-GM food/crop and anti-food-system-globalization movement on the other. In this paper I explore the causes and consequences of these restructurings of the agricultural research and technology opposition movement. Chief among the major factors involved was the fact that “Hightowerism'' involved an ineffectual representational politics. Hightowerist claims – especially the claim that land-grant research was detrimental to family farmers – generated little support among the groups it claimed to represent (particularly “small'' or “family'' farmers). The two successor movements, by contrast, have relatively clear and dependable constituents. Further, the progressive molecularization of agricultural research, which proved to be both an antecedent and consequence of corporate involvement in agricultural research in the US, has decisively changed the issues that are contested by technology activists. Since the age of Hightower, the agricultural technology activist movement has shifted its 1970s and early 1980s emphasis from contesting public sector/land-grant research priorities to contesting private sector activities, particularly genetic engineering, GM crops, and globalization of agricultural technologies and regulatory practices. Even the sustainability/localism wing of the new agricultural technology movement configuration has progressively backed away from contesting public research priorities. The efforts of the sustainable agricultural and localism movement have increasingly focused on quasi-private efforts such as community supported agriculture, green/“value-added'' labeling and marketing strategies, and community food security. Some implications of this increasingly bifurcated, agricultural technology, activist movement configuration in which there is decreased interest in land-grant/public research priorities are discussed. (shrink)

Introduction: Agricultural workers perform intense labor outside in direct sunlight and in humid environmental conditions exposing them to a high risk of heat-related illness (HRI). To implement effective cooling interventions in occupational settings, it is important to consider workers’ perceptions. To date, an analysis of agricultural workers’ experience and perception of cooling devices used in the field while working has not been published. -/- Methods: Qualitatively data from 61 agricultural workers provided details of their perceptions and experiences with cooling interventions. (...) -/- Results: The participants in the bandana group reported the bandana was practical to use at work and did not interfere with their work routine. Cooling vest group participants agreed that the vest was effective at cooling them, but the practicality of using the vest at work was met with mixed reviews. -/- Conclusion: The findings of this qualitative study support and extend existing research regarding personal cooling and heat prevention research interventions with vulnerable occupational groups. Personal cooling gear was well received and utilized by the agricultural workers. Sustainable heat prevention studies and governmental protection strategies for occupational heat stress are urgently needed to reduce the risk of heat-related morbidity, mortality, and projected climate change health impacts on outdoor workers. (shrink)

BackgroundDefensive practice occurs when physicians provide services, such as tests, treatments and referrals, mainly to reduce their perceived legal or reputational risks, rather than to advance patient care. This behaviour is counter to physicians’ ethical responsibilities, yet is widely reported in surveys of doctors in various countries. There is a lack of qualitative research on the drivers of defensive practice, which is needed to inform strategies to prevent this ethically problematic behaviour.MethodsA qualitative interview study investigated the views and (...) experiences of physicians in Australia on defensive practice and its contribution to low value care. Interviewees were recruited based on interest in medico-legal issues or experience in a health service involved in ‘Choosing Wisely’ initiatives. Semi-structured interviews averaged 60 min in length. Data were coded using the Theoretical Domains Framework, which encapsulates theories of behaviour and behaviour change.ResultsAll participants (n = 17) perceived defensive practice as a problem and a contributor to low value care. Behavioural drivers of defensive practice spanned seven domains in the TDF: knowledge, focused on inadequate knowledge of the law and the risks of low value care; skills, emphasising patient communication and clinical decision-making skills; professional role and identity, particularly clinicians’ perception of patient expectations and concern for their professional reputation; beliefs about consequences, especially perceptions of the beneficial and harmful consequences of defensive practice; environmental context and resources, including processes for handling patient complaints; social influences, focused on group norms that encourage or discourage defensive behaviour; and emotions, especially fear of missing a diagnosis. Overall, defensive practice is motivated by physicians’ desire to avoid criticism or scrutiny from a range of sources, and censure from their professional peers can be a more potent driver than perceived legal consequences.ConclusionsThe findings call for strengthening knowledge and skills, for example, to improve clinicians’ understanding of the law and their awareness of the risks of low value care and using effective communication strategies with patients. Importantly, supportive cultures of practice and organisational environments are needed to create conditions in which clinicians feel confident in avoiding defensive practice and other forms of low value care. (shrink)

Professional ethics has currently raised its public profile in the UK as part of social anxiety around governance of health and social care, fuelled by catastrophically bad practice identified in particular healthcare facilities. Professional ethics is regulated by compliance with abstracted, normative codes but experienced as contextualised exercise of personal qualities, understanding and engagement. This study examined how practitioners from one speciality of occupational therapy, an Allied Health Profession, develop ethical practice through dialogical engagement in local OT communities (...) of practice, supporting and modifying understanding of and approaches to specific situations experienced as ethically difficult and individual reflection on the personal bildungsroman underpinning their own professional practice. Engagement in community of practice and personal reflection contributed to ethical development for participating OTs. Opportunities to engage in peer OT groups and professional reflection should be considered by employers as integral to productive practice and not a distraction from it. (shrink)