Whole genome sequencing is quickly becoming more affordable and accessible, with the prospect of personal genome sequencing for under $1,000 now widely said to be in sight. The ethical issues raised by the use of this technology in the research context have received some significant attention, but little has been written on its use in the clinical context, and most of this analysis has been futuristic forecasting. This is problematic, given the speed with which whole genome sequencing technology is likely (...) to be incorporated into clinical care. This paper explores one particular subset of these issues: the implications of adopting this technology in the prenatal context without a good understanding of when and how it is useful. Prenatal whole genome sequencing differs from current prenatal genetic testing practice in a number of ethically relevant ways. Most notably, whole genome sequencing would radically increase the volume and scope of available prenatal genetic data. The wealth of new data could enhance reproductive decision‐making, promoting parents' freedom to make well‐informed reproductive decisions. We argue, however, that there is potential for prenatal whole genome sequencing to alter clinical practice in undesirable ways, especially in the short term. We are concerned that the technology could (1) change the norms and expectations of pregnancy in ways that complicate parental autonomy and informed decision‐making, (2) exacerbate the deleterious role that genetic determinism plays in child rearing, and (3) undermine children's future autonomy by removing the option of not knowing their genetic information without appropriate justification. (shrink)

Costs at the end of life disproportionately contribute to health care costs in the United States. Addressing these costs will therefore be an important component in making the U.S. health care system more financially sustainable. In this paper, we explore the moral justifications for having discussions of end-of-life costs in the doctor-patient encounter as part of an effort to control costs. As health care costs are partly shared through pooled resources, such as insurance and taxation, and partly borne by individuals (...) through out-of-pocket expenses, we separate our defense for, and approach to, discussing both pooled and individual aspects of cost. We argue that there needs to be a shift away from formulating the options as a dichotomous choice of paying attention to end-of-life costs versus ignoring such costs. The question should be how personal costs will be managed and how societal expenditures should be allocated. These are issues that we believe patients care about and need to have addressed in a manner with which they are comfortable. Conversations about how money will be spent at the end of life should begin before the end is near. We propose discussing costs from the onset of chronic illness and incorporating financial issues in advance care planning. Through these approaches one can avoid abruptly and insensitively introducing financial issues at the very conclusion of a person's life when one would prefer to address the painful and important issues of spiritual and existential loss that are appropriately the focus when a person is dying. (shrink)

The cost of health care at the end of life accounts for a high proportion of total health care costs in the United States. The percentage of Medicare payments attributable to patients in their last year of life was 28.3% in 1978 and has remained substantially the same at 25.1% in 2006. This indicates how little progress has been made in containing these costs, though doing so will be important to promote a financially sustainable health care system. These expenditures also (...) highlight the prospect that efforts to reduce health care costs overall are likely to disproportionately affect the care patients receive at the end of life. (shrink)

Recently, there have been a number of lawsuits in the United States in which families objected to performance of apnoea testing for determination of brain death. The courts reached conflicting determinations in these cases. We discuss the medicolegal complications associated with apnoea testing that are highlighted by these cases and our position that the decision to perform apnoea testing should be made by clinicians, not families, judges, or juries.

1. Modes of art -- 2. Ways of art -- 3. Illustrations.

Annotation Redefines globalization as merely the framework of the current political debate on the future of world power.

This article unravels the complex set of financial dealings that are at the heart of the Enron story and follows the story through the highs and lows of Enron share prices. The key players are identified and their roles described. Apart from the financial and accounting issues, the Enron story also raises a wide range of ethical issues including corporate governance, organisational culture and ethical leadership and scrutiny. These are discussed in the article. It might be argued that Enron could (...) never have got away with some of its practices if it had been operating in Europe. The article concludes that this view may be naïve, particularly in the light of recent media disclosures of the UK Labour government's continuing flirtation with business donations. The Enron story raises serious considerations in a whole host of financial, economic, political and ethical areas. As the Enron story continues to unfold, an article of this type can only begin to scratch the surface of some of these issues and to lay them out for further investigation. (shrink)

This article unravels the complex set of financial dealings that are at the heart of the Enron story and follows the story through the highs and lows of Enron share prices. The key players are identified and their roles described. Apart from the financial and accounting issues, the Enron story also raises a wide range of ethical issues including corporate governance, organisational culture and ethical leadership and scrutiny. These are discussed in the article. It might be argued that Enron could (...) never have got away with some of its practices if it had been operating in Europe. The article concludes that this view may be naïve, particularly in the light of recent media disclosures of the UK Labour government's continuing flirtation with business donations. The Enron story raises serious considerations in a whole host of financial, economic, political and ethical areas. As the Enron story continues to unfold, an article of this type can only begin to scratch the surface of some of these issues and to lay them out for further investigation. (shrink)

For centuries, the British royal family has been the subject of books, articles, broadcast media, and digital communication. The addition of social media platforms has further increased the attention of the royals. Each of the family’s official social media sites have large numbers of followers around the world. The present study uses Goffman’s Presentation of Self to qualitatively examine how the current British royal family portrays itself visually via its official Instagram account. An analysis of two years of posts on (...) the social platform provides a glimpse of how the family works to maintain its image through a highly popular social media platform. Results indicated the presence of three main themes: Queen as the Head of the Monarchy, Honoring the Past, and The Working Royalty. This study offers a means of understanding the importance of visuals in conveying the royal family. (shrink)

While heredity is predominantly controlled by what deoxyribonucleic acid (DNA) sequences are passed from parents to their offspring, a small but growing number of traits have been shown to be regulated in part by the non‐genetic inheritance of information. Transgenerational epigenetic inheritance is defined as heritable information passed from parents to their offspring without changing the DNA sequence. Work of the past seven decades has transitioned what was previously viewed as rare phenomenology, into well‐established paradigms by which numerous traits can (...) be modulated. For the most part, studies in model organisms have correlated transgenerational epigenetic inheritance phenotypes with changes in epigenetic modifications. The next steps for this field will entail transitioning from correlative studies to causal ones. Here, we delineate the major molecules that have been implicated in transgenerational epigenetic inheritance in both mammalian and non‐mammalian models, speculate on additional molecules that could be involved, and highlight some of the tools which might help transition this field from correlation to causation. (shrink)

A book which is intended as an introduction to Bertrand Russell and his views in a variety of fields. In addition to being one of the most important logicians and philosophers of this century, Russell was also, for a very long time, one of it most prominent public figures, and his influence on his time was not confined to academic subjects. Nearly all of his 70 books, including some whose positions are now rather clearly dated, are still, or were until (...) very recently, in print, a continuing tribute both to the attraction of his views and to the grace and polish of his literary style for which he was awarded the Nobel Prize in Literature in 1950. (shrink)

The research program Spit For Science was launched at Virginia Commonwealth University (VCU) in 2011. Since then, more than 10,000 freshmen have been enrolled in the program, filling out extensive questionnaires about their drinking, general substance use, and related behaviors, and also contributing saliva for genotyping. The goals of the program, as initially stated by the investigators, were to find the genes underlying the heritability of alcohol use and related behaviors, and in addition to put genetic knowledge to work in (...) ways that might aid university administrators and mental health professionals in the prevention and treatment of substance abuse. We review every empirical paper involving genetic data that has emerged from the program, and reach a surprising conclusion: the study has never identified a single genetic effect of more than trivial magnitude. Although the quantitative results of the studies were reported transparently, the theoretical ramifications of the negligible results have never been acknowledged. To the contrary, most of the papers ignore the tiny effects, reaching optimistic conclusions about the prospects for future genetic explanations of alcohol use. We explore the implications of these results for the broader prospects of applied psychiatric genetics. (shrink)

This paper presents an extensional account of manyand few that explains data that have previously motivated intensional analyses of these quantifiers :599–620, 2000). The key insight is that their semantic arguments are themselves set intersections: the restrictor is the intersection of the predicates denoted by the N’ or the V’ and the restricted universe, U, and the scope is the intersection of the N’ and V’. Following Cohen, I assume that the universe consists of the union of alternatives to the (...) nominal and verbal predicates, where an alternative to a property ψ is one that shares a pragmatic presupposition with ψ, and a pragmatic presupposition is one that is selected by context from a set of potential presuppositions associated with the sentence. A many/few-quantified sentence is then true iff the proportion of the scope to the restrictor is greater/less than some threshold, n. In addition to explaining various problematic cases from the literature, the analysis shows how the readings of a many/few-quantified sentence can be derived from the same syntactico-semantic structure, it being unnecessary to claim lexical or structural ambiguity. The analysis also provides strong support for the idea that natural language quantification is always purely extensional. (shrink)

In anticipation of extraterritorial application of antiabortion laws, many states have enacted laws that attempt to shield abortion providers, helpers, and patients from civil, professional, or criminal liability associated with legal abortion care. This essay analyzes and compares the statutory schemes of the seven early adopting shield states: California, Connecticut, Delaware, Illinois, Massachusetts, New Jersey, and New York. After describing what the laws do and how they operate, we offer reflections on coming disputes, areas of legal uncertainty, and ways to (...) improve future shield laws. (shrink)

In the current career landscape and labor market, career transitions have become a critical aspect of career development and are significant for Human Resource Development research and practice. Our research examines the type of support used during different career transitions and who can provide that support to women in career transition. We investigated four types of social support—emotional, appraisal, informational, and instrumental—and their roles in five types of career transitions: school-to-work transition, upward mobility transition, transition to a new profession, transition (...) to entrepreneurship, career re-entry transition, and transition to retirement. We analyzed 80 journal articles using directed content analysis, cross-tabulation, and nonparametric statistical tests. Instrumental support appears to be the most commonly documented type of social support in this career transition literature. Appraisal support was consistently documented least for each type of career transition. Our results may highlight the importance of personal connections and internal resources in successful career transitions for women. Based on our findings, we offer a model of women's social support network for career transitions and advocate for expanded networks of social support for women anticipating and during career transitions. The results of our study contain insights for how women can be supported in transitioning to the next career experience. We conclude with suggestions for future research. (shrink)

The linked stanza form of Pearl is widely known and admired. Yet there exists no complete account of how this aspect of Pearl compares with other Middle English poems written in twelve-line units. The omission is surprising, not least because this information may offer a background for dating Pearl. Four editors—of Pearl or of other verse—have compiled lists of verse specimens with a cognate stanza, but none of these tentative lists is complete or entirely accurate. The best resource for tracking (...) such information, Carleton Brown and Rossell Hope Robbins's Index of Middle English Verse, has become increasingly outdated and therefore unreliable: new poems have been discovered; verses listed as unpublished have now been printed; some single listings have turned out to comprise two or more different pieces; and separate listings have been recognized as variants of the same poem. Consequently, when scholars attempt to compare Pearl with other poems in this or related stanza forms, confusions arise because we still lack the context that a comparative history would supply. In this article I hope to provide such a context by examining the lyrics that survive in the three main types of twelve-line stanzas and, with this evidence, to reconsider the question of the date of Pearl. (shrink)

In 1982, without waiting for the findings of the National Hospice Study, Congress passed legislation enabling certified hospices to receive Medicare reimbursement. What emerged is a reimbursement program that differs substantially from the movement that spawned it. Hospices now face many dilemmas, among them shifting the burden of care to the family, determining who controls the course of patient care, and breaking even financially.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Figures of Entanglement: Diffractive Readings of Barad, New Materialism, and Rhetorical Theory and Criticism ed. by Christopher N. Gamble and Joshua S. HananSavannah Greer DowningFigures of Entanglement: Diffractive Readings of Barad, New Materialism, and Rhetorical Theory and Criticism. Edited by Christopher N. Gamble and Joshua S. Hanan. Routledge, 2021. xvi + 122 pp. $168 (hardcover), $47.16 (electronic book). ISBN: 9780367903794.Rhetorical scholars have turned to various new materialist (...) frameworks to shift the discipline's historically anthropocentric focus and fully engage matter's rhetoricity. While all such frameworks attempt to challenge "the anthropocentric assumption that nonhuman matter is intrinsically passive or non-agential and thus external to or separable from (human) meaning," Figures of Entanglement enters this burgeoning conversation by centering the unique contributions of Karen Barad (xi, x). Readers may recognize this collection from a 2016 special issue of Review of Communication. Yet, with a new foreword by editors Christopher N. Gamble and Joshua S. Hanan and an afterword by Laurie Gries, this collection makes Barad's distinct approach to matter's rhetoricity even more apparent, underscoring its fruitful potential for new materialist rhetorics invested in ethical, political transformation.In the book's foreword Gamble and Hanan differentiate Barad's per-formative new materialism from "vital" as well as what they refer to as "negative" new materialisms to show the generative potential of Barad's framework and the notion of entanglement (x). Other new materialisms tend to be "inclusionary"—add matter and stir—and fail to complicate "the human" itself and its differences (xiv, xi). First, vital and negative new materialisms maintain a distinction between being and knowing, allowing humans to emerge with a unique capacity to "objectively observe and know the existence of something essential, determinate, and unchanging about [End Page 395] reality that precedes and remains unaffected by both its own activities and our observations of it" (xi). On the contrary, Barad's performative approach suggests that "no aspect of reality—including human thought, meaning, and observation—is in any sense external to matter or ever remains entirely unchanged by matter's ongoing performances" (x). Here, humans are not "outside" of observation, but all observation "human or otherwise" co-constitutes what is observed (xi). Second, failing to interrogate "the human" in an attempt to observe matter's vitality is an ethical flaw that makes other approaches less capable of grappling with difference: they have been charged with "erasing associations between race, gender, and matter" and (re)producing a homogenizing, "Western-colonialist notion of humanness" (xiv). In contrast, Barad's is a "thoroughly relational," performative new materialism (1).Barad's concept of "entanglement" draws attention to the indeterminacy of matter and meaning, but it is accompanied by an ethical imperative to examine how difference, human or otherwise, is produced and the implications of power imbalances that arise through these enactments. For Barad, the notion of entanglement does not dissolve difference; difference is what matters. Indeed, they give us a way of thinking about how performative intra-actions produce difference through material-discursive practices, or apparatuses—differences that may be expected but are not inevitable. Rhetorical scholars are therefore invited to interrogate the production of boundaries that cause harm and reconfigure them, rather than assume the discreteness of boundaries from the start. Gamble and Hanan thus make a convincing case for how Barad's work may contribute to important scholarship in decolonial and critical rhetorics for which vital and negative new materialisms are less equipped.Gamble and Hanan utilize the introduction to show how Barad's per-formative new materialism both "supports and affirms" rhetorical materialism, or rhetoric's materiality, and enriches it (5). Ushered in by Michael Calvin McGee, "standard" rhetorical materialism worked to challenge the centuries-old debate about rhetoric's secondary, supplementary status vis-à-vis philosophy by recognizing rhetoric as part of a "shifting and dynamic material history" (6). Building upon this view, Ronald Walter Greene utilizes Foucault's notion of the apparatus to demonstrate how even the "material history" McGee called our attention to is itself "produced by apparatuses"—history is not "outside" of meaning (6). Instead, rhetoric's materiality is a "publicity effect" produced through technologies of rhetoric and intersecting power... (shrink)

Transnational politics and labor markets are undermining national industrial relations systems in Europe. This article examines the construction industry, where the internationalization of the labor market has gone especially far. To test hypotheses about di ferences between “national systems,” the authors examine the United Kingdom, Finland, and Germany, alongside European-level policy making. Regardless of overall national institutional framework, employers seek to avoid industrial relations rules, while unions attempt to relocalize labor relations. Both use shop-floor, national, and European power resources. The (...) authors argue that comparative industrial relations should take seriously the connection between action at the national and transnational levels. (shrink)

This is a thorough treatment of first-order modal logic. The book covers such issues as quantification, equality (including a treatment of Frege's morning star/evening star puzzle), the notion of existence, non-rigid constants and function symbols, predicate abstraction, the distinction between nonexistence and nondesignation, and definite descriptions, borrowing from both Fregean and Russellian paradigms.

Background Achieving meaningful consent can be challenging, particularly in contexts of diminished literacy, yet is a vital part of participant protection in global health research. Method We explored the challenges and potential solutions of achieving meaningful consent through a qualitative study in a predominantly hill tribe ethnic minority population in northern Thailand, a culturally distinctive population with low literacy. Semi-structured interviews were conducted with 37 respondents who had participated in scrub typhus clinical research, their family members, researchers and other key (...) informants. A thematic analysis was conducted. Results Our analysis identified four interrelated themes surrounding participants’ ability to give consent: varying degrees of research understanding, limitations of using informal translators, issues impacting decisions to join research, and voluntariness of consent. Suggestions for achieving more meaningful consent included the use of formal translators and community engagement with research populations. Conclusions Participant’s agency in decision making to join research should be supported, but research information needs to be communicated to potential participants in a way that they can understand. We found that improved understanding about the study and its potential benefits and harms goes beyond literacy or translation and requires attention to social and cultural factors. (shrink)

Augustine’s first conversion is to the Christian Platonism of his day, which brought along with it a free-will defence to the problem of evil. Formative as this philosophical influence was, however, Augustine’s own experience of sin combines with his sense of God’s sovereignty to lead him to modify the views he inherited in significant ways. This transformation is demonstrated by setting Augustine’s evolving position against that of Gregory of Nyssa.