We argue that, under certain plausible assumptions, de Sitter space settles into a quiescent vacuum in which there are no dynamical quantum fluctuations. Such fluctuations require either an evolving microstate, or time-dependent histories of out-of-equilibrium recording devices, which we argue are absent in stationary states. For a massive scalar field in a fixed de Sitter background, the cosmic no-hair theorem implies that the state of the patch approaches the vacuum, where there are no fluctuations. We argue that an analogous conclusion (...) holds whenever a patch of de Sitter is embedded in a larger theory with an infinite-dimensional Hilbert space, including semiclassical quantum gravity with false vacua or complementarity in theories with at least one Minkowski vacuum. This reasoning provides an escape from the Boltzmann brain problem in such theories. It also implies that vacuum states do not uptunnel to higher-energy vacua and that perturbations do not decohere while slow-roll inflation occurs, suggesting that eternal inflation is much less common than often supposed. On the other hand, if a de Sitter patch is a closed system with a finite-dimensional Hilbert space, there will be Poincaré recurrences and dynamical Boltzmann fluctuations into lower-entropy states. Our analysis does not alter the conventional understanding of the origin of density fluctuations from primordial inflation, since reheating naturally generates a high-entropy environment and leads to decoherence, nor does it affect the existence of non-dynamical vacuum fluctuations such as those that give rise to the Casimir effect. (shrink)

Bicycle helmets protect against head injury. Mandatory helmet laws likely increase their use. Although 21 states and Washington, DC have mandatory helmet laws for youth bicyclists, no U.S. state has a mandatory helmet law that applies to all ages; however, some localities have all-age helmet laws for bicyclists. This study abstracted local helmet laws applicable to all-ages to examine their elements.

It would seem, on the surface, logical that entrepreneurs would treat stakeholders with honesty and respect. However, this is not always the case—at times, entrepreneurs lie to stakeholders in order to take a step closer to achieving legitimacy. It is these legitimacy lies that are the focus of the current work. Overall, while we know that legitimacy lies are told, we know very little about the psychological processes at work that may make it more likely for someone to tell a (...) legitimacy lie. Thus, we theorize about the pressure to pursue legitimacy, the situational and individual factors that affect this pursuit, as well as how this context can lead to moral disengagement and the telling of legitimacy lies. Our theorizing advances the existing literature and provides a dynamic framework by which future research can delve more deeply into the nuanced context that breeds the escalation of legitimacy lies. (shrink)

The perceived support of supernatural agents has been historically, ethnographically, and theoretically linked with confidence in engaging in violent intergroup conflict. However, scant experimental investigations of such links have been reported to date, and the extant evidence derives largely from indirect laboratory methods of limited ecological validity. Here, we experimentally tested the hypothesis that perceived supernatural aid would heighten inclinations toward coalitional aggression using a realistic simulated coalitional combat paradigm: competitive team paintball. In a between-subjects design, US paintball players recruited (...) for the study were experimentally primed with thoughts of supernatural support using a guided visualization exercise analogous to prayer, or with a control visualization of a nature scene. The participants then competed in a team paintball battle game modeled after “Capture the Flag.” Immediately before and after the battle, participants completed surveys assessing confidence in their coalitional and personal battle performance. Participants assessed their coalition’s prospects of victory and performance more positively after visualizing supernatural aid. Participants primed with supernatural support also reported inflated assessments of their own performance. Importantly, however, covarying increases in assessments of their overall coalition’s performance accounted for the latter effect. This study provided support for the hypothesis that perceived supernatural support can heighten both prospective confidence in coalitional victory and retrospective confidence in the combat performance of one’s team, while highlighting the role of competitive play in evoking the coalitional psychology of intergroup conflict. These results accord with and extend convergent prior findings derived from laboratory paradigms far removed from the experience of combat. Accordingly, the field study approach utilized here shows promise as a method for investigating coalitional battle dynamics in a realistic, experientially immersive manner. (shrink)

State health departments are at the core of the United States public health infrastructure. Surveillance to monitor trends in disease and injury; the development, coordination, and delivery of services; and public education are some of the core functions health department employees oversee every day. As such, agencies and their employees are well positioned to inform policy decisions that affect the public’s health. However, little is known about the role of health department staff — a sizeable proportion of the public health (...) workforce — as advocates for public health policies, independent of their agency roles. Anecdotally, some health department employees with whom we have spoken expressed reluctance to engage in policy advocacy for fear of violating little known or understood agency or state rules. (shrink)

A Select Bibliography Michael McMahon Sheehan Jacqueline Murray. 16 Ritual and Iconography 134 12-14c Studies in Medieval Domestic Architecture ed M.J. Swanton (London 1975). [English aristocratic housing] 135 11-12c WEDZKI,...

It is commonly supposed that metaphysical modal claims are to be evaluated with respect to a single domain of possible worlds: a claim is metaphysically necessary just in case it is true in every possible world, and metaphysically possible just in case it is true in some possible world. We argue that the standard understanding is incorrect; rather, whether a given claim is metaphysically necessary or possible is relative to which world is indicatively actual. We motivate our view by attention (...) to discussions in Salmon 1989 and Fine 2005, in which various data are taken to support rejecting the transitivity of accessibility and modal monism ; we argue that relativized metaphysical modality can accommodate these data compatible with both standard modal logic and modal monism. Noting an analogy with two-dimensional semantics, we argue that metaphysical modality has a complex structure, reflecting what is counterfactually possible, relative to each indicatively actual world. In arguing for the need for relativization, we are broadly on the same side as Crossley and Humberstone and Davies and Humberstone ; our contribution here is, first, to offer distinctively metaphysical reasons for relativization, and second, to show that relativization can be incorporated in ways minimally departing from standard modal logic. (shrink)

In this paper, T. M. Murray defends a vision of liberal tolerance as grounding the common good. She critiques the discourse that Western liberalism amounts to ‘Islamophobia’ or ‘cultural imperialism’. She argues that liberal academics, in maintaining these narratives, contradict their own vaunted values and tacitly collude with religious hypocrisy and intolerance. She argues for a universal vision of the common good broadly grounded in human flourishing and human nature and linked to the philosophies of Aristotle and J. S. (...) Mill. (shrink)

Background:New graduate transition into the workforce is challenging and can involve managing ethical tensions. Ethical tensions cause new graduates to doubt their capabilities due to their lack of experience. To support new graduates, we need to know what these ethical tensions are.Objectives:To explore the ethical tensions perceived to occur in practice for new graduate health professionals.Research design:This qualitative systematic review involved a search of five databases (Medline, EMBASE, AMED, CINAHL and Scopus) which resulted in the retrieval of 3554 papers. After (...) the two-phased screening process, eight studies were identified that met the inclusion criteria and had rich data on the review question. Articles were read several times, critically appraised and analysed through thematic analysis.Ethical considerations:No ethical approval was required for the systematic review. The review was conducted following well-established reporting guidelines enabling transparency and rigour.Findings:Studies originated from Australia, United States, Iran and China. One study included speech pathologists and seven were with nurses. Four themes included the following: (1) enduring an unknown workplace culture that generates uncertainty without support for new graduates; (2) being vulnerable because of distress from bullying, exclusion and being a scapegoat; (3) constraining systems and institutional restrictions that cause dilemmas; and (4) experiencing disillusionment from lost ideals about ethical practice.Discussion:This review has brought to light the vulnerability of new graduates to negative workplace culture and collegial incivility. In addition, new graduates are subjected to ethical tensions created by institutional constraints which can create dilemmas and uncertainties through practice that does not align with what they anticipated.Conclusion:Understanding ethical tensions experienced by new graduates enables provision of informed support. There needs to be considerable cultural change for orientation and socialisation of new graduates to enable them to learn and manage ethical tensions. (shrink)

This volume illustrates the central importance of diversity of human values throughout healthcare. The readings are organized around the main stages of the clinical encounter from the patient's perspective. They run from staying well and 'first contact' through to either recovery or to long-term illness, death and dying.

Background Inadequate knowledge among health care providers (HCPs) and parents of affected children limits the understanding and utility of secondary genetic findings (SFs) in under-represented populations in genomics research. SFs arise from deep DNA sequencing done for research or diagnostic purposes and may burden patients and their families despite their potential health importance. This study aims to evaluate the perspective of both groups regarding SFs and their choices in the return of results from genetic testing in the context of orofacial (...) clefts.Methods Using an online survey, we evaluated the experiences of 252 HCPs and 197 parents across participating cleft clinics in Ghana and Nigeria toward the return of SFs across several domains.Results Only 1.6% of the HCPs felt they had an expert understanding of when and how to incorporate genomic medicine into practice, while 50.0% agreed that all SFs should be returned to patients. About 95.4% of parents were willing to receive all the information from genetic testing (including SFs), while the majority cited physicians as their primary information source (64%).Conclusions Overall, parents and providers were aware that genetic testing could help in the clinical management of diseases. However, they cited a lack of knowledge about genomic medicine, uncertain clinical utility, and lack of available learning resources as barriers. The knowledge gained from this study will assist with developing guidelines and policies to guide providers on the return of SFs in sub-Saharan Africa and across the continent. (shrink)

A general framework by which dynamic interactions within a protein will promote the necessary series of structural changes, or “conformational cycle,” required for function is proposed. It is suggested that the free‐energy landscape of a protein is biased toward this conformational cycle. Fluctuations into higher energy, although thermally accessible, conformations drive the conformational cycle forward. The amino acid interaction network is defined as those intraprotein interactions that contribute most to the free‐energy landscape. Some network connections are consistent in every structural (...) state, while others periodically change their interaction strength according to the conformational cycle. It is reviewed here that structural transitions change these periodic network connections, which then predisposes the protein toward the next set of network changes, and hence the next structural change. These concepts are illustrated by recent work on tryptophan synthase. Disruption of these dynamic connections may lead to aberrant protein function and disease states. (shrink)

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

Academic dishonesty, including cheating and plagiarism, is on the rise in colleges, particularly among engineering students. While students decide to engage in these behaviors for many different reasons, academic integrity training can help improve their understanding of ethical decision making. The two studies outlined in this paper assess the effectiveness of an online module in increasing academic integrity among first semester engineering students. Study 1 tested the effectiveness of an academic honesty tutorial by using a between groups design with a (...) Time 1- and Time 2-test. An academic honesty quiz assessed participants’ knowledge at both time points. Study 2, which incorporated an improved version of the module and quiz, utilized a between groups design with three assessment time points. The additional Time 3-test allowed researchers to test for retention of information. Results were analyzed using ANCOVA and t tests. In Study 1, the experimental group exhibited significant improvement on the plagiarism items, but not the total score. However, at Time 2 there was no significant difference between groups after controlling for Time 1 scores. In Study 2, between- and within-group analyses suggest there was a significant improvement in total scores, but not plagiarism scores, after exposure to the tutorial. Overall, the academic integrity module impacted participants as evidenced by changes in total score and on specific plagiarism items. Although future implementation of the tutorial and quiz would benefit from modifications to reduce ceiling effects and improve assessment of knowledge, the results suggest such tutorial may be one valuable element in a systems approach to improving the academic integrity of engineering students. (shrink)