Collaboration between the arts and health sectors is gaining momentum. Artists are contributing significantly to public health efforts such as vaccine confidence campaigns. Artists and the arts are well positioned to contribute to the social conditions needed to build trust in the health sector. Health professionals, organizations, and institutions should recognize not only the power that can be derived from the insights, artefacts, and expertise of artists and the arts to create the conditions that make trust possible. The health sector (...) must also recognize that, while it can gain much from partnership with artists, artists risk much—namely, the public's trust—when they are in such partnerships. This essay unpacks these claims and considers the care and ethical considerations that must be brought to these partnerships to yield constructive pathways for ethical collaboration as well as for both establishing public trust and continuing to hold the health care profession accountable for becoming more trustworthy. (shrink)

Objective: To provide an ethical analysis of whether the Ethiopian and Tanzanian national HIV/AIDS treatment guidelines can be considered legitimate and fair rationing tools.Method: Qualitative study and ethical analysis involving guideline documents and interviews with nine key members involved in the development of the guidelines. The analysis followed an editing organising style. The theoretical framework was a guideline-specific framework based on theories of just resource allocation in healthcare and conditions that ensure fair processes in guideline development. According to this framework, (...) legitimate rationing requires reasons for patient selection to be explicit, public and relevant, and decisions must be open to question and revision.Results: The only explicit rationing criteria that both guidelines recommended were clinical antiretroviral treatment indications. Explicit non-clinical rationing criteria were expressed in a separate Ethiopian implementation guideline. Neither of the guideline development processes fully satisfies minimal requirements of procedural fairness. There is a lack of transparency. The reasons for decisions are rarely given and are not publicly available. This reduces the opportunity for public questioning, debate and revisions. The guidelines were based on expert opinion and consensus. Recommendations from the WHO were copied without much discussion, disagreement or adjustment.Conclusions: The two national HIV treatment guidelines discussed are de facto mechanisms for rationing but were developed using methods that do not fully satisfy the requirements of fair processes. (shrink)

If a utopia is a near perfect, or even a demonstrably superior, society, is there anything that endangers that society as soon as it is achieved? Yes. Prosperity! I have shown in “More's Utopia and the New World Utopias: Is the Good Life an Easy Life?”, that the actually existing, “real” New World Utopian communities were severely challenged by success. For example, the vigor of the Jansonite community in Bishop Hill, Illinois (1846-1860) sharply declined when that community met their survival (...) needs and had to deal with surpluses and comfort. As soon as communal efforts and group sacrifices produced prosperity, the attractiveness of communism faded. (shrink)

In their article, Nielsen Busch and Mjaaland defend the moral permissibility of cDCD, suggesting that much of the controversy around this donation practice has been the result of a misinterpretatio...

Mathematics word problems provide students with an opportunity to apply what they are learning in their mathematics classes to the world around them. However, students often neglect their knowledge of the world and provide nonsensical responses (e.g., they may answer that a school needs 12.5 buses for a field trip). This study examined if the question design of word problems affects students' mindset in ways that affect subsequent sense‐making. The hypothesis was that rewriting standard word problems to introduce inherent uncertainty (...) about the result would be beneficial to student performance and sense‐making because it requires students to reason explicitly about the context described in the problem. Middle school students (N = 229) were randomly assigned to one of three conditions. In the standard textbook condition, students solved a set of six word problems taken from current textbooks. In the modified yes/no condition, students solved the same six problems rewritten so the solution helped answer a “yes” or “no” question. In the disfluency control condition, students solved the standard problems each rewritten in a variety of fonts to make them look unusual. After solving the six problems in their assigned condition, all students solved the same three “problematic” problems designed to assess sense‐making. Contrary to predictions, results showed that students in the modified yes/no condition solved the fewest problems correctly in their assigned condition problem set. However, consistent with predictions, they subsequently demonstrated more sense‐making on the three problematic problems. Results suggest that standard textbook word problems may be able to be rewritten in ways that mitigate a “senseless” mindset. (shrink)

The reovirus cell attachment protein σ1 is a lollipopshaped structure with the fibrous tail anchored to the virion. Since it interacts with the cell receptor, σ1 is a major determinant of reovirus infectivity and tissue tropism. Studies on its structure‐function relationships have been facilitated by the fact that protein σ1 produced in any expression system is capable of binding to cell receptors. The use of site‐specific and deletion mutants has led to the identification and characterization of its virion anchorage and (...) receptor binding domains. Studies on the oligomeric status of σ1 have revealed that σ1 is a homotrimer and that two independent trimerization events at different loci (the N‐ and C‐terminal halves, respectively) of the protein, are involved in its generation. This also accounts for a clearly demonstrable dominant negative effect by a mutant subunit in a wild‐type/mutant σ1 heterotrimer. Current efforts are focused on the involvement of chaperones in the generation of σ1 and on events that take place upon σ1 binding to the cell receptor. Protein σ1 has therefore become an excellent model system for the study of both virus attachment and protein oligomerization and folding mechanisms. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Response to Krista Riggs, “Foundations for Flow: A Philosophical Model For Studio Instruction”Patrick K. FreerKrista Riggs has written a provocative paper examining the relationship between psychology and pedagogy within the applied music studio. The sources Riggs employs as the basis for her arguments reflect some of the most enduring voices in educational psychology and philosophy (including music), and performance practice/preparation in music. Riggs draws important connections between these (...) occasionally disparate fields. I appreciate this opportunity to add to the discussion.As the foundation of this model, Riggs employs the study of optimal experience, known as 'flow theory,' as researched by Mihalyi Csikszentmihalyi1 over the past three decades. The flow experience is only possible when an individual's personal capacities are congruent with the opportunities and goals afforded by the environment.2 When coupled with the necessary congruency between challenges and skills inherent in the flow model, Riggs' analysis raises questions concerning the definition of success within applied studio instruction, the position of studio instruction within the totality of a student's experience, and the ways in which teachers and students negotiate learning within applied music instruction.Three QuestionsIs the definition of success different for students than it is for teachers?At first blush, this paper concerns the "how" of music education—how we teach and how we encourage student motivation. Oftentimes, "how" we teach is dependent upon "why" we teach and "what" we teach. This becomes clear in the paper's introduction when success is defined as an outcome of education. Is the purpose of music education to build toward success using a very narrow, career-specific definition or is the purpose of music education to build toward broader success in many facets of musical knowledge and skill?Of course, this paper is contextualized to teaching within the applied studio and it may be that success in studio teaching is somewhat narrowly defined. But, at core is a potential conflict in the definition of success as defined by the teacher and the definition of success as appropriate for the student. In the model presented here, the definition of success is clearly student-centered and the success of the instructor is measured by the degree to which the student is supported on that pathway toward success. This is not to say that the instructional content of [End Page 225] the studio experience becomes less rigorous in any way, but rather that the instruction itself is modified to better ensure the success of students in learning and applying that content. Riggs implies, and Csikszentmihalyi would agree, that teachers cannot create flow experiences in students, but can create the conditions within which flow experiences can occur. The question is: What are those conditions and are they in conflict with the definition of success used by many studio teachers?The conditions necessary for flow experience have been identified through research and are embedded throughout Riggs' paper. The conditions are stated here in a purely student-centered manner. But, there are two players in this scene and it is the relationship between the student and teacher that most determines the experience of each. I am an unabashed proponent of attempts to optimize the quality of experience for students. However, the needs of the instructor seem to be missing from this discussion. It might be argued that this model is purely about studio instruction itself and an exploration of the instructor's needs is better suited for a different paper. Even so, the instructor's experiences, both in the past and in the present, do have bearing upon the student experience of the present. For example, it is probably a fair assumption that each instructor has, at some point, been a student in a studio. Might there be substantial value in a process of reflective analysis of that experience? Riggs does invoke the roles of reflection-in-action and reflection-on-action from the student viewpoint, but it might be illuminating to discern the instructor's reflections as well—and for these to be selectively shared with the student. In this way, studio teachers would be closer to fulfilling another necessary exemplar role: that of "master" teacher (or "mentor" teacher). If... (shrink)

The study examines the ontological similarity between the concept of competitor orientation and questionable intelligence-gathering efforts. Respondents from the hotel industry were surveyed with self-administered questionnaires. Exploratory factor analysis was carried out to identify the structure underlying variables of market orientation and ethical judgment on questionable intelligence-gathering efforts. The results suggest that the surveyed hotel managers are unable to distinguish the legitimate tactics of competitor orientation from the questionable practice of industrial espionage.

Introduction Hundreds of thousands of premature neonates born in low-income countries are implicitly denied treatment each year. Studies from India show that treatment is rationed even for neonates born at 32 gestational age weeks (GAW), and multiple external factors influence treatment decisions. Is withholding of life-saving treatment for children born between 28 and 32 GAW acceptable from an ethical perspective? Method A seven-step impartial ethical analysis, including outcome analysis of four accepted priority criteria: severity of disease, treatment effect, cost effectiveness (...) and evidence for neonates born at 28 and 32 GAW. Results The ethical analysis sketches out two possibilities: (a) It is not ethically permissible to limit treatment to neonates below 32 GAW when assigning high weight to health maximisation and overall health equality. Neonates below 32 GAW score high on severity of disease and efficiency and cost-effectiveness of treatment if one gives full weight to early years of a newborn life. It is in the child's best interest to be treated. (b) It can be considered ethically permissible if high weight is assigned to reducing inequality of welfare and maximising overall welfare and/or not granting full weight to early years of newborns is considered acceptable. From an equity-motivated health and welfare perspective, we would not accept (b), as it relies on accepting the lack of proper welfare policies for the poor and disabled in India. Conclusion Explicit priority processes in India for financing neonatal care are needed. If premature neonates are perceived as worth less than other patient groups, the reasons should be explored among a broad range of stakeholders. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:In Search of a Reality-Based Community:Illusion and Tolerance in Music, Education, and SocietyPatrick K. SchmidtThe two questions that arise in this symposium are: What kind of world engagement is required of music education? and Should music educators participate in political understanding? While my immediate response was and is: How we can afford not to? that is, not to engage fully with the world and not to do so politically, (...) at the same time I also recognize the ways in which that has been problematic in the music education profession. Particularly, in how we continue to experience what I would call events without future: ersatz events made of illusions. Such a proposition is implicated in the following questions: How seriously are we committed to rethinking our practice and re-engaging with our ideals, traditions, visions, and discourses? Has our conception and practice of democracy disappeared (or remained unformed) in the insubstantiality of shadows? How do [End Page 160] we react to political understandings that dismiss the communities in which we live, as well as the singularities and differences that mark us? Who are those of us supposedly living in the/a "reality-based community?"1An aide of the current administration explains the White House stance by saying, "We are an empire now, and when we act, we create our own reality."2 The idea, of course, is that we not only can, but perhaps, must dissociate from such communities (particularly those that do not conform to such envisioned reality). An Empire, one might say, seeks power as well as expansion, confluence as well as stability, tradition as well as ideological certainty. It probably comes as no surprise then, that dictatorial regimes are often more stable, including economically, than new or recalcitrant democracies. (I myself grew up in such a regime in Brazil in the 1970s and early 80s.) The word "Empire" conjures up images that are localized, monocentric, confluent, and institutional. The reality today, however, seems much closer to what Antonio Negri and Richard Hardt portray:3 a reality modeled upon the production of subjects with increasingly similar desires and prone to a certain subservience to commodity and technology. But if this "we" is no longer "us" but an illusion, if this reality-based community no longer distinguishes, questions, problematizes, or engages with its own reality or realities, perhaps more than ever it is time that we began to think politically, that our assumptions and that of others be challenged, and that we seek understandings that, as Randall Allsup has proposed, "are rendered in a world that is contingent, political, and always in motion."Following the model adopted here I will address some of the concepts Estelle Jorgensen proposes, particularly those associated with the notion of supremacy and its propagation through "reductionistic and nationalistic forces." Such a vista will serve as a departing point for my own reflections on the shades, contradictions, complexities, and possibilities we might find when considering majority led silence and voicing, as well as the role of political and empathetic dialogue in our practices, be they professional and/or connected to citizenship.4A Search for the Ethical: Majority Rule?Today, music education as a society negotiates a reality that is more complex and multiple—one of a multitude of one5 —of separation through categories that, while preserving the impression of distinctiveness, allows for a larger invisible and uncontested majority to instill what Alexis de Toqueville called over a century ago the "tyranny of the majority."6 We need to consider here that, as Negri and Hardt propose, there is no one center to this Empire, "no tangible, nuclear element to be identified and/or resisted." This tyrannical majority is paradoxical, for while it dictates it is also silent.7 What is there, then, are spaces in and through which our disengagement allows for the strengthening of what is [End Page 161] perceived and experienced as inevitable, as a faceless majority that controls and decrees, that denies and structures.This tyranny of the majority, the underside of our democratic visions, can lead in politics, as in our professional practices, to a sense of the famous Foucaultian panopticon where total surveillance is... (shrink)