The nutrition transition concept developed by Popkin has gained wide currency within the nutritional sciences literature as a way of understanding population wide changes to diet and energy balance and their related health outcomes in society. It offers a useful template of different nutritional patterns societies progress through, but it has not provided a comprehensive understanding of the why and how of dietary change. Building on insights from the literature on food regimes in the social sciences, this paper (...) argues the concept of dietary regimes can augment the nutrition transition model and can serve as a bridge between social and health sciences around nutrition and dietary change. The political economy analysis of the dietary regime approach provides insights into the historical degradation of food and the diffusion of nutrient-poor products throughout food environments today. It also engages analysis of the key actors shaping food environments and diets in the industrial era. The dietary regime approach can provide fruitful directions with respect to concrete policy options to address the major issue of population wide weight gain that the nutrition transition model has sought to confront in recent iterations. (shrink)

The nutrition transition—a process of dietary change that describes the shift to calorie-dense, higher fat and protein diets from cereal based ones—is happening in India. This paper argues that relatively little is known about the nature of nutrition transition in India. This is a result of both a lack of adequate and timely data and a consequence of national and state-level statistics, which render an incomplete and potentially misleading picture of how these processes are unfolding in (...) local contexts. This may be especially true in India where very little ethnographic research has documented the dual edges of nutrition transitions. Analyzing data collected from the Kumaon Hills, Uttarakhand in 2013, this paper suggests the ways in which aspects of the nutrition transition have developed unevenly over space and time. In particular, while new types of calorie dense foods have infiltrated these rural, remote areas, the process has been uneven and fraught with contestation due to preexisting social practices. More troubling is the evidence that though incomes are rising, the predicted increases in high value, protein rich foods may actually be declining. This paper concludes by arguing that the widely influential nutrition transition literature needs look to ethnographic and in-depth qualitative methods to form better policies relevant to the contingencies of dietary and epidemiological change. (shrink)

This article works in a recursive manner by using the tools of a food regime approach to reinterpret the nutrition transition that has been underway internationally for 100 years, and then describing the contributions of nutrition science to the 1st and 2nd Food Regimes and the passages between Food Regimes. The resulting history—from the ‘imperial calorie’ through the ‘protective’ vitamin to the ‘empty calorie’—illuminates a neglected dimension to food regime theorising: the role of socio-technical systems in shaping (...) a set of value relations that are central to class relations. Contestation over one such system, nutritionalisation, currently involves an ungovernable array of actors. In describing the protagonists to the system of nutritionalisation, a classic confrontation emerges between technical and lifeworld rationality. Representing the former approach are actor networks responsible for the ‘trade-in-health’ sector which produces foods and nutritional values aimed at both over-nourished and under-nourished populations. Clinging to a lifeworld rationality are ‘culture eaters’ worldwide, for whom nutrition value relations are secondary to communal and ecological relations. This dynamic appears within wealthier Asian states which are emerging as central to the trade-in-nutritional health sector while acting to protect their own customary dietary practices. (shrink)

Highlights: -/- • Breastfeeding and breastfeeding support can contribute to mitigating climate change. • Achieving global nutrition targets will save more emissions than fuel-switching. • Breastfeeding support programmes support a just transition. • This work can support the expansion of mitigation options in energy system models. -/- Abstract: -/- Renewable gas has been proposed as a solution to decarbonise industrial processes, specifically heat demand. As part of this effort, the breast-milk substitutes industry is proposing to use renewable gas (...) as a substitute for fossil natural gas. However, decarbonising the industrial processing of breast-milk substitutes can increase social license for these products, potentially undermining breastfeeding. World Health Organisation nutrition targets aim to increase exclusive breastfeeding to at least 50% globally by 2025 to improve maternal, infant, and young child health and nutrition. This target will have implications for the energy transition. A weakness of existing energy models is that demands for end-use products such as breast-milk substitutes are typically not considered explicitly. This paper develops an analytical framework for explicitly representing infant feeding methods in energy systems models. We compare the emissions saved in Ireland from decarbonising the industrial processing of breast-milk substitutes with renewable gas with the emissions saved by an increase in exclusive breastfeeding to 50% in both Ireland and a key export market, China. We demonstrate that the emissions saved from achieving the minimum global breastfeeding target are greater than when renewable gas is used to displace natural gas in the production of breast-milk substitutes in Ireland. We discuss the decarbonisation of breast-milk substitutes in relation to the principle of justice as non-maleficence, a principle based on the commitment to avoid harm, a novel application of a principle of justice. We conclude that breastfeeding support can be considered a demand-side measure for mitigating climate change by reducing the demand for energy services to produce breast-milk substitutes. A key recommendation is to position breastfeeding support as both a public health and a climate justice issue that is relevant for a just transition. The framework developed for this paper could be applied to support the inclusion of a wider range of mitigation options with social justice outcomes in energy system models. [Open access]. (shrink)

This qualitative study examined hospital nurses’ methods in handling meal and nutrition care during inpatient time, with an underlying focus on undernourished older adult. Observations and interviews were used to document nurses’ methods through the span of a transition (defined by an entry, passage, and exit). The study finds inconsistencies in care methods due to institutional processes restricting both mealtime care and nutritional logging of information throughout hospitalization. It is concluded that the consequences of these inconsistencies must be (...) recognized and that new approaches to meals and nutritional care should be introduced in order to provide greater flexibility. Based on the assumption that mobilizing patient resources is pivotal for meal and nutritional care, it is argued that it may be important to mobilize patient resources during mealtime and in nutritional logging of information in order to increase the visibility of meal and nutritional care in patient transitions within the institution and across settings. Both nurses’ methods and institutions developmental initiatives regarding meal and nutritional care need to accommodate the differences between what in this paper is defined as social‐bodily care and text‐based care. This could be met through care methods that take place with, more than for the patient. (shrink)

Bowel necrosis is a commonly observed condition in elderly patients with longstanding diabetes. In such condition, intestinal resection is usually performed for the removal of the gangrenous part. Post-surgical dietary management after bowel resection poses several challenges for the health care team. The case presented in this study is that of an elderly diabetic male who developed acute renal failure as a result of neglect in post-surgical feeding after intestinal resection. After the intervention by a trained dietitian, a transitional diet (...) was planned and successfully executed, resulting in reversal of acute renal failure, dehydration, and post-surgical stress. Several complications including hepatic dysfunction and mouth ulcers were resolved through well-planned transitional diet. The patient was finally discharged in a stable health condition and was regularly followed up for any nutritional or medical issues. Neglects in nutritional care of patients can have severe implications including development of medical complications, resulting in increased length of hospital stay, augmenting the disease stress of the patient and family, and finally the preventable drainage of several human and monetary resources. Therefore, recognition of nutritional intervention as an important part of in-hospital health care may have social as well as economic impacts. (shrink)

Urban dwellers’ food and nutritional wellbeing are both dependent on infrastructure and can be indicative of wider wellbeing in urban contexts and societal health. This paper focuses on the multiple relationships that exist between food and infrastructure to provide a thorough theoretical and empirical grounding to urgent work on urban food security and nutrition in the context of rapid urban and nutrition transitions in the South. We argue that urban systems and food systems thinking have not been well (...) aligned, but that such alignment is not only timely and overdue but also fruitful for both thematic areas of research and policy. We draw in particular on work within wider urban political economy and political ecology that can be classified as part of the ‘infrastructural turn’ that is influential with urban studies but little acknowledged within food studies. Drawing on these literatures helps us to better understand the interrelationships between people, things and ideas that make up both infrastructure and food systems. Policy, planning and research relating to both food and urban systems cannot afford to ignore such interlinkages, though much policy still operates on the neat assumptions of progressive connectivity to ‘the grid’ and formal food retail. Instead we argue how in many urban governance systems, a variety of hybrid mechanisms—on and off the grid, public and private formal and informal—better represent how urban residents, particularly the most marginalised, meet their everyday food and infrastructural needs along a continuum of gridded and off-grid access. (shrink)

Gypsy people are the most poorly considered minority in Spain. Their current circumstances in relation to growth rate and trend variation in this country are not well known. The main objective of this paper is to show what happens to a person's growth process in a transitional minority group affected by the process of globalisation. As target population and the articulation of social actions to have an implementation of quality of life is an additional objective. The research team, in collaboration (...) with “Apoyo”, an NGO, made contact with each Gypsy family. The sample comprised 189 boys aged 5 to 14 years. The boys and their families have been rehoused in two large buildings, named “Ruedo” and “Herradura”, in an attempt to accommodate the marginal Gypsy population following the disappearance of their shanties in Madrid. Morphological and physiological variables were considered as well as social situation and nutritional habits. Large family size (5–6 children), smoking and coffee- drinking habits and the intake of less than the internationally recommended number of calories after the age of 8 years endangers the healthy growth of these European Union citizens. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Managing the Transition from Patient-Centered Care to ProtocolDavid SlakterI learned that I would need a kidney transplant in the summer of 2015. This was not a complete surprise to me, as I had been subjected to a number of tests and invasive procedures to investigate nephritis since I was a child. I had heard similar stories of clinicians performing repeated tests on my father for similar reasons without (...) any conclusions. Following my recommendation for transplant and consultation with genomics specialists, the cause of my kidney failure was determined to be Alport syndrome. What made Alport syndrome so difficult to diagnose in my case was that the associated mutation is a rare, autosomal-dominant one that has only recently been associated with the condition.After reviewing the data on survival rates for transitioning to dialysis versus a transplant, my family and I then considered the success rates for living versus cadaver donors, and the success rates at various transplant centers. The current data favor the long-term outcomes of transplant over dialysis and living over cadaver donors. Since we had decided to focus on searching for a live donor, my nephrologist recommended contacting Renewal, an organization that specializes in connecting those in need of a kidney transplant with live donors and providing support for donors to make the donation process less burdensome.On Renewal’s recommendation, my family and friends reached out across their social networks to search for potential donors. Many of those tested for compatibility were eliminated on basic matching criteria, others due to previously undiagnosed medical problems. Finally, the wife of a childhood friend came forward as an eligible donor and was also an incredibly close match on the antigens tested for kidney transplants.Having a living donor who was also a friend made the transplant experience somewhat less intimidating than it might have been. It meant the transformation of an existing relationship with someone already close to me, with fewer open questions about what may have motivated them to be so generous than if the donor had been someone I did not know. It also meant our families could be together in the waiting room, and that we shared in each other’s recoveries.Life post-transplant has been a significant improvement from what it was like immediately beforehand. Before my transplant, I regularly weighed food and consulted nutrition charts to gauge how much potassium I was consuming. To prevent too much potassium from building up in my bloodstream, I had to take sodium polystyrene [End Page 111] regularly. As one might guess from the name, it tastes much like burnt Styrofoam, and I could only ingest it with copious amounts of fruit-flavored syrup (strawberry covered up the awful flavor the best). There are other potassium binders on the market now, so fewer people with kidney failure will likely need to engage in such gustatory experimentation.I was also able to engage in more activities than what was possible even years before my transplant. I had long experienced difficulty with aerobic exercises, but assumed the reason was merely being out of shape. Though I have always walked regularly, even the one-mile walk from my office to my apartment had become a chore by the end. Within a few months after my transplant, I was riding a bicycle all over NYC, from Harlem to Brooklyn and back regularly, and hiking trails in nearby state parks. I began sessions with a personal trainer and attained a level of fitness I had not reached since I played soccer as a child.The transition from personalized care to one more driven by protocol has been a surprising and challenging aspect of the transplant process. While my previous experience with medical treatment has been individual meetings with physicians, my post-transplant care is managed by a team of nephrologists and other specialists in transplant care. My initial transplant nephrologist was automatically assigned to me. Because the standard of care for transplant patients is often driven by protocol, my assigned nephrologist recommended a biopsy on my transplanted kidney due to results in my recent lab tests. When pressed on the necessity of a biopsy in my case versus... (shrink)

The Hadza foragers of Tanzania are currently experiencing a nutritional shift that includes the intensification of domesticated cultigens in the diet. Despite these changes, no study, to date, has examined the possible effects of this transition on the food collection behavior of young foragers. Here we present a cross-sectional study on foraging behavior taken from two time points, 2005 and 2017. We compare the number of days foraged and the type and amount of food collected for young foragers, aged (...) 5–14 years, in age- and season-matched samples. Compared with 2005, in 2017 fewer subadults left camp to forage, and overall, they targeted a smaller variety of wild foods, with the noticeable absence of wild honey, figs, and tubers. In addition, participants in 2017 were significantly more likely to have attended school. Despite the increased presence of domesticated plant foods in the diet and increased attendance at school, some young foragers continue to be highly productive in collecting wild, undomesticated foods. Despite the preliminary nature of our results, our findings suggest that the range of wild foods targeted by subadults is decreasing as the amount of domesticated cultigens in the diet increases. These data underscore the importance of studying diet composition and foraging decisions across temporal, nutritional, and ecological landscapes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 41, no. 3. © 2015 by Feminist Studies, Inc. 623 Jaye Cee Whitehead, Kath Bassett, Leia Franchini, and Michael Iacolucci “The Proof Is in the Pudding”: How Mental Health Practitioners View the Power of “Sex Hormones” in the Process of Transition In the United States today, popular discourse touts the power of “sex hormones” and hormone receptors in the brain to chemically produce gender expressions (manifested (...) in physical sex traits, behaviors, and attitudes) and identities (a sense of self as feminine or masculine). These accounts range from common assumptions that Western ideals of femininity (such as empathy understanding, cooperative orientation, nurturing behavior) and masculinity (rational/spatial understanding, competitive orientation, violent behavior) are produced by corresponding sex hormones, to studies that reduce complex gender identities and macrosocial economic phenomena to presocial, binary, hormonal processes.1 For sociologists, accounts that reduce complex identities to internal hormonal reactions are problematic for two primary reasons: first, they are inaccurate because they fail to examine how hormonal reactions are embedded in a complex cultural process of meaning and interpretation; second, they operate as bioreductive ideologies that obscure the social power inherent to the process of gender identity construction. In what follows, we extend both of these insights by examining mental health 1. For an example of a hybrid popular-scientific account of the power of sex hormones to destabilize economic structures, see Jon Coates and Joe Herbert, “Endogenous Steroids and Financial Risk Taking on a London Trading Floor,” Proceedings of the National Academy of Sciences 105, no. 16 (April 2008): 6167–72. 624 Whitehead, Bassett, Franchini, and Iacolucci practitioners’ divergent interpretations of the power of sex hormones in the process of gender transition.2 In doing so, we examine the cultural power of sex hormones in crafting gender identities without reproducing reductionist interpretations of trans embodiment. Perhaps what is most perplexing about the way we speak of sex hormones is that we know it is inaccurate to describe these hormones as sexed; scientists have acknowledged since the 1930s that they are neither sex specific in their function, nor in terms of their location in male or female bodies.3 In her extensive historicization of sex hormones, Anne Fausto-Sterling concludes that it is more accurate to call androgen- and estrogen-based hormones, “steroid hormones” as they have functions that are not confined to corresponding sexed bodies. In fact she urges scientists to “break out of the sex hormone straightjacket” and to look at steroids as just one of a number of components that are important to the creation of sex and gender, including environment and experience.4 Scholars also point to an inextricable link between the chemical operation of hormones and the social process of constructing meaning, both at the level of social interaction and macrocultural constructions of sex categories and gender ideologies.5 While brain organization/activation theory attributes sex and gender differences to hormonal interactions within the developing brain, Fausto-Sterling questions the distinction between activation and organization by pointing out how “the brain can respond to hormonal stimuli with anatomical changes…hormonal systems, after all, respond exquisitely to experience, be it in the form of nutrition, stress, or sexual activity (to name but a few possibilities ).”6 Drawing from Elizabeth Grosz, Fausto-Sterling argues that the power of hormones is best understood according to the model of the 2. “Gender transition” is a controversial phrase, as it implies that transgendered individuals who receive hormone therapy are changing identities. We are only using it for lack of clear alternative phrasing, not because we believe body modifications change gender identities. 3. See Anne Fausto-Sterling, Sexing the Body: Gender Politics and the Construction of Sexuality (New York: Basic Books, 2000); Rebecca Jordan-Young, Brainstorm: The Flaws in the Science of Sex Differences (Cambridge, MA: Harvard University Press, 2010); and Nelly Oudshoorn, Beyond the Natural Body: An Archeology of Sex Hormones (New York: Routledge, 1994). 4. Fausto-Sterling, Sexing the Body, 193–94. 5. Fausto-Sterling, Sexing the Body. 6. Ibid., 232. Whitehead, Bassett, Franchini, and Iacolucci 625 Möbius strip, wherein internal components of the self are always connected to and continuous with outer components such as culture and environment.7 In other... (shrink)

Health research has shown that overweight and obesity in children and adults are becoming significant public health problems in the developing world. Evidence suggests that this phenomenon is more marked in urban than rural areas and may be associated with modernization. However, the underlying reasons for this nutrition transition remain unclear. Dietary shifts, often in conjunction with income and time constraints in urban environments, may entail a greater reliance on more convenient sugar and fat-dense food. Also, the necessity (...) of labor-intensive agricultural work to meet rural subsistence needs is supplanted in urban environments by sedentary work. This paper extends the application of human behavioral ecology theory into the realm of international development and policy by applying Kaplan’s embodied capital theory to explore differences in food habits and nutritional status of Indo-Fijian children within the context of urbanization. Urban high-embodied-capital women demonstrate higher rates of wage-earning employment than urban low-embodied-capital or rural women. Findings indicate that urban high-embodied-capital households spend significantly more on food purchases, purchase a greater proportion of processed foods, and have children with higher body mass indexes (BMI) than do urban low-embodied-capital or rural households. This suggests that urban high-embodied-capital mothers, who tend to be employed, may be making trade-offs between income and food choices. (shrink)

Research on the nutrition transition often treats dietary changes as an outcome of increased trade and urban living. The Northern Food Crisis presents a puzzle since it involves hunger and changing diets, but coincides with a European ban on trade in seal products. I look to insights from economic sociology and decolonizing scholarship to make sense of the ban on seal products and its impacts. I examine how trade arrangements enact power imbalances in ways that are not always (...) obvious. I explain how the ban’s exemption for Inuit-produced seal goods explicitly aims to protect Inuit from the harshness of capitalism and preserve their traditions. In this respect, the Northern Food Crisis is an embodiment of European visions of who Inuit are expected to be and how they are supposed to act in the global economy. (shrink)

This article works in a recursive manner by using the tools of a food regime approach to reinterpret the nutrition transition that has been underway internationally for 100 years, and then describing the contributions of nutrition science to the 1st and 2nd Food Regimes and the passages between Food Regimes. The resulting history—from the ‘imperial calorie’ through the ‘protective’ vitamin to the ‘empty calorie’—illuminates a neglected dimension to food regime theorising: the role of socio-technical systems in shaping (...) a set of value relations that are central to class relations. Contestation over one such system, nutritionalisation, currently involves an ungovernable array of actors. In describing the protagonists to the system of nutritionalisation, a classic confrontation emerges between technical and lifeworld rationality. Representing the former approach are actor networks responsible for the ‘trade-in-health’ sector which produces foods and nutritional values aimed at both over-nourished and under-nourished populations. Clinging to a lifeworld rationality are ‘culture eaters’ worldwide, for whom nutrition value relations are secondary to communal and ecological relations. This dynamic appears within wealthier Asian states which are emerging as central to the trade-in-nutritional health sector while acting to protect their own customary dietary practices. (shrink)

This article works in a recursive manner by using the tools of a food regime approach to reinterpret the nutrition transition that has been underway internationally for 100 years, and then describing the contributions of nutrition science to the 1st and 2nd Food Regimes and the passages between Food Regimes. The resulting history—from the ‘imperial calorie’ through the ‘protective’ vitamin to the ‘empty calorie’—illuminates a neglected dimension to food regime theorising: the role of socio-technical systems in shaping (...) a set of value relations that are central to class relations. Contestation over one such system, nutritionalisation, currently involves an ungovernable array of actors. In describing the protagonists to the system of nutritionalisation, a classic confrontation emerges between technical and lifeworld rationality. Representing the former approach are actor networks responsible for the ‘trade-in-health’ sector which produces foods and nutritional values aimed at both over-nourished and under-nourished populations. Clinging to a lifeworld rationality are ‘culture eaters’ worldwide, for whom nutrition value relations are secondary to communal and ecological relations. This dynamic appears within wealthier Asian states which are emerging as central to the trade-in-nutritional health sector while acting to protect their own customary dietary practices. (shrink)

This chapter contains sections titled: A Riff on Infant Feeding Ethical Questions about Infant Feeding Closing Thoughts on Classification and Responsibility Notes.

The origins of agriculture lie in the distant past, approximately 12 000 years ago, when hunter-gatherers of the Palaeolithic embraced sedentism at the dawn of the Neolithic. The variety of life history transitions emanating from this unique phenomenon have had an enormous impact on the biodiversity of the planet, while subjecting humanity to a variety of life-changing physical and social challenges right up to the present. The ever-present consequences of the Agricultural Revolution continue to demand our attention, yet frustrate our (...) efforts, on a seemingly perpetual basis, to effectively manage the outcomes. Here we review the origins and lasting after-effects of the Agricultural Revolution and its impact on the human condition, with reference to sedentism, nutrition, health issues, disease, gender discrimination as well as mythmaking and religion. Contribution: Our aim is to engage a wider audience with respect to the causes and consequences of the Agricultural Revolution. We discuss a broad spectrum of relevant phenomena implicated in this epochal event and consequently underline that the Agricultural Revolution precipitated not only major changes to the ecology of the planet, but also and most importantly to the social and cultural well-being of humanity. (shrink)

The organism is one of the fundamental concepts of biology and has been at the center of many discussions about biological individuality, yet what exactly it is can be confusing. The definition that we find generally useful is that an organism is a unit in which all the subunits have evolved to be highly cooperative, with very little conflict. We focus on how often organisms evolve from two or more formerly independent organisms. Two canonical transitions of this type—replicators clustered in (...) cells and endosymbiotic organelles within host cells—demonstrate the reality of this kind of evolutionary transition and suggest conditions that can favor it. These conditions include co-transmission of the partners across generations and rules that strongly regulate and limit conflict, such as a fair meiosis. Recently, much attention has been given to associations of animals with microbes involved in their nutrition. These range from tight endosymbiotic associations like those between aphids and Buchnera bacteria, to the complex communities in animal intestines. Here, starting with a reflection about identity through time, we consider the distinctions between these kinds of animal–bacteria interactions and describe the criteria by which a few can be considered jointly organismal but most cannot. (shrink)

Addiction: A Philosophical Approach CHAPTER ABSTRACTS “Introduction: Dismantling the Catchphrase” by Candice Shelby Shelby dismantles the catchphrase “disease of addiction.” The characterization of addiction as a disease permeates both research and treatment, but that understanding fails to get at the complexity involved in human addiction. Shelby introduces another way of thinking about addiction, one that implies that is properly understood neither as a disease nor merely as a choice, or set of choices. Addiction is a phenomenon emergent from a complex (...) dynamic system that is at once physical, psychological, social, and more. “A Philosophical Analysis of Addiction” by Candice Shelby Shelby brings much-needed clarity to the discourse surrounding the topic of addiction. Arguing that addiction can neither properly be understood as a disease nor as merely a set of choices, Shelby exposes the weaknesses of both approaches. She shows that addicted persons do not exhibit the elements characteristic of compulsion, nor does an account of addiction in terms of weakness of will, or irrational choosing, provide a satisfying explanation. Instead, by replacing traditional substance ontology with process ontology, and accepting the reality of emergent entities, a coherent account of persons, minds, and addiction can be provided. A fundamental philosophical shift is necessary to see that bodies, minds, values, and addictions are all part of the natural world. “Addiction at the Individual Level” by Candice Shelby Shelby discusses the most influential accounts of addiction as it is understood at the purely individual level. From hedonic theories to incentive sensitization, to habit theories of addiction, to behavioral theories and the ego depletion theory, Shelby considers a variety of approaches to understanding addiction in individuals, as framed in both psychological and in neuroscientific terms. She notes some important caveats that should be considered before accepting the research regarding addiction at the individual level, namely that the scanning studies that are so popularly used to characterize addiction in neurobiological terms are ambiguous, and rely on numerous assumptions that may be false, and that certainly mislead. Shelby provides much-needed critique of both disease and choices models as they characterize addiction at the individual level. “Addiction and the Local Environment” by Candice Shelby Shelby argues that human addiction cannot be understood without serious consideration of the individual’s local environment, her home and family. From the gestational environment to interactions with caregivers during post-natal development to the adult environment in which people become addicted, Shelby shows that no one becomes an addict in a vacuum. Stress is a major influence in the environment throughout life, and has serious consequences for addictive vulnerability. Genetic influences as well are important to addictive vulnerability, but genes always express in interaction with their environment. Social acceptance or rejection is another particularly important factor in the local environment with respect to both coming to be addicted and transitioning out of it. “The Relation Between Addiction and Culture” by Candice Shelby Shelby provides a groundbreaking analysis of the relation between addicts and the cultures that breed them. In this cultural critique, Shelby shows that addictions to certain substances have historically been both the solution to the problem of how to grow economies and control people, and a problem for economic productivity and controlling citizens. Not all cultures have even the concept of addiction, while others, such as the contemporary Western world, and the U.S. in particular, seem to foster it. Shelby shows that addiction is both a cultural construct and, from another way of thinking about it, the result of conditions created by particular cultures. Social inequities, alienation, driving capitalism, and in particular the power of pharmaceutical companies, all contribute to the spiraling endemic of addiction. “Addiction and Meaning” by Candice Shelby Shelby provides a unique argument that understanding how meanings work is essential to a complete analysis of addiction. Individuals experiencing addiction and those who care about and for them often utterly fail to communicate. This is because their respective systems of meanings come to be significantly different. Meanings are not, Shelby argues, best understood in the symbolic terms that characterized the theory of language in the 20th century, but are better apprehended as emotion-rich prototypes carved from repeated interaction with the world. Becoming addicted essentially changes one’s entire system of meanings. Requisite to transitioning out of addiction is a Gestalt-type shift in one’s system of meanings. This holistic way of understanding meanings also provides one level of explanation of what happens when an addict relapses. “The Phenomenology of Addiction and its Implications” by Candice Shelby One way of judging theories of addiction is by how well they capture the phenomenal descriptions that addicts give of their own experiences. Shelby considers variations on 5 basic patterns of addictive experience through the eyes of particular individuals who lived through addictive periods, and shows how even the most influential theories of addiction fail to capture all of them. She argues that an important implication of taking the details of individuals’ addictive stories seriously is that addiction must be understood as a personal phenomenon emergent from a particular complex dynamic system. As her theory of addiction would lead one to expect, no two addicts are the same, and no single-focus theory can explain why not. “Possibilities for Transitioning Out of Addiction” by Candice Shelby Shelby provides numerous strategies for transitioning out of addiction. Given that the vast majority of addiction treatment programs currently available are 12-step based and only successful about 5-8% of the time, it is essential that other approaches be undertaken. Shelby canvasses a variety of options for helping addicted individuals to make the transition out of their troubled pattern of thinking and behaving. From direct brain interventions to drugs to trauma therapy to exercise and nutrition to habit reformation to use of narrative and changing one’s social context as ways of redefining the self, Shelby shows that the possibilities for transitioning out of addiction are legion. Perhaps the best approach is to understand addiction treatment in terms of providing physical, psychological, and social tool kits. “Addiction Emerges from a Complex Dynamic System” by Candice Shelby Shelby considers whether there truly exists such a thing as “an addict” or “addictive thinking” in the universal sense. She concludes that within the context of disruptive substance use or repetitive engagement in certain activities, ordinary human cognitive biases and behavior patterns are categorized as addictive. Addiction, she argues, is best understood as an irreducible human reality, emergent from a sufficiently complex dynamic system (an organism with self-awareness, within a particular cultural milieu) that is both shaped by and contributes to the shaping of its environment. Attempts to simplify addiction into one or a few dimensions may create a solvable problem, but by doing so they fail to solve the real one. (shrink)

The diet of expectant mothers was a significant issue of social, political and scientific concern between 1930 and 1960. However, while histories of maternity services and nutritional science are independently available, no existing study addresses the nutrition of expectant mothers in this period. Between 1900 and 1930, maternal mortality rates were rising despite improving clinical antenatal provisions. Breakthroughs in nutritional science resulted in the identification of key dietary components, while changing social attitudes meant hunger was increasingly being seen as (...) a humanitarian issue requiring a modern solution. As a result, the diet of expectant mothers first began to be addressed as a social concern in the 1930s. It subsequently made a transition into official policy as part of wartime rationing. The government entirely changed its attitude to maternal nutrition in a beneficial and successful way during the war; conferring to modern historians another example of war being a generator of change. Diet in pregnancy finally became the concern of the scientific community post-war, as illustrated by the work of the Royal College of Obstetrics and Gynaecology Nutrition Committee for Pregnancy, whose papers are considered for the first time here. This paper charts the rise of diet in pregnancy as a concern and considers the contributions of different communities involved between 1930 and 1960. It also notes that the actual recommended diet stayed the same. Thus while diet is the subject here, discussion focuses on why there were such distinct rearrangements of social, political and scientific forces around an issue that itself remained unchanged. (shrink)

Clear guidelines addressing the ethically appropriate use of anti-infectives in the setting of hospice care do not exist. There is lack of understanding about key treatment decisions related to infection treatment for patients who are eligible for hospice care. Ethical concerns about anti-infective use at the end of life include: (1) delaying transition to hospice, (2) prolonging a dying process, (3) prescribing regimens incongruent with a short life expectancy and goals of care, (4) increasing the reservoir of potential resistant (...) pathogens, (5) placing unreasonable costs on a capitated hospice system. Although anti-infectives are thought to be relatively safe, they can place a burden on patients and be inconsistent to particular care plans. The current complex, and at times fragmented, medical care often fails to address these issues in decision-making. In many ways, the ethics governing the end of life decisions related to dialysis, hydration/nutrition, and hypercalcemia parallel those of anti-infectives. In this article we articulate important elements in ethical decision-making in the application of anti-infectives for patients who are eligible for hospice care, and we point to the need for prospective studies to help refine particular guidelines in these cases. (shrink)

ABSTRACT Clear guidelines addressing the ethically appropriate use of anti‐infectives in the setting of hospice care do not exist. There is lack of understanding about key treatment decisions related to infection treatment for patients who are eligible for hospice care. Ethical concerns about anti‐infective use at the end of life include: (1) delaying transition to hospice, (2) prolonging a dying process, (3) prescribing regimens incongruent with a short life expectancy and goals of care, (4) increasing the reservoir of potential (...) resistant pathogens, (5) placing unreasonable costs on a capitated hospice system. Although anti‐infectives are thought to be relatively safe, they can place a burden on patients and be inconsistent to particular care plans. The current complex, and at times fragmented, medical care often fails to address these issues in decision‐making. In many ways, the ethics governing the end of life decisions related to dialysis, hydration/nutrition, and hypercalcemia parallel those of anti‐infectives. In this article we articulate important elements in ethical decision‐making in the application of anti‐infectives for patients who are eligible for hospice care, and we point to the need for prospective studies to help refine particular guidelines in these cases. (shrink)

The need to create more sustainable food systems calls for careful attention to justice in making the transition. However, to achieve a just transition and create policies to support the goal of developing sustainable food systems, we need more knowledge of the ways current policies tackle justice. This knowledge can reveal blind spots and development needs and increase the transparency of potentially conflicting goals, which is essential for designing just transition policies. From the normative perspective of food (...) justice, a food system should produce three principal outcomes: food security and nutrition, livelihoods and fair income, and environmental sustainability. In this article, we take these outcomes as the starting point to study how they relate to the distributive, procedural, and recognitive aspects of food justice in the context of Finnish food policies. Our data consist of Finnish policy strategies relating to the national food system and data from interviews with experts involved in the policy processes. Our results suggest that food security and farmer livelihoods have dominated justice related considerations at the cost of environmental sustainability. Although these are important for distributive justice and for recognizing vulnerabilities, the current setting reveals risks regarding the possibilities of transitioning to a low-carbon food system. The invisibility of the often-invisible groups is also notable in the policy documents. To promote justice more broadly, there should be greater emphasis on environmental sustainability as well as procedural and recognitive justice and opportunities for diverse people to participate in food policymaking. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bibliography of Resources by and about André E. Hellegers*Compiled by Doris Mueller Goldstein (bio)This bibliography is derived from the holdings of the National Reference Center for Bioethics Literature and the BIOETHICSLINE© database (both of which are at the Kennedy Institute of Ethics and supported by the National Library of Medicine); the archives of Lauinger Library, Georgetown University; the Medline databases of the National Library of Medicine; the WorldCat database (...) of OCLC, Dublin, Ohio, and selected Internet sites.Primarily comprised of writings by Dr. Hellegers, the list also includes interviews and media programs in which he participated, as well as writings about him that were written following his death. The arrangement within each section is by date. The 231 authored pieces reflect the transition from Dr. Hellegers’s early career as a researcher in fetal physiology at Johns Hopkins Medical School, where he published his first research report at the age of 29, to the early years of the Kennedy Institute, where he produced so many provocative columns on bioethical issues that influenced the growth of the field.Due to the diversity of sources and the 40-year time span covered, there are some variations in bibliographic style. Time and availability constraints precluded verifying all of the citations with the original documents. Any additions or corrections should be submitted to the compiler.Works Authored by André E. HellegersNo Date Ethical Issues in Sterilization of the Retarded. Unpublished paper.1956Vitamin B12 Serum Level and Pregnancy. American Journal of Clinical Nutrition 4: 440+, 1956. [With Bacon F. Chow and Kunio Okuda] [End Page 89]1957Vitamin B12 Absorption in Pregnancy and in the Newborn. American Journal of Clinical Nutrition 5: 327+, 1957. [With Bacon F. Chow, Robert E. L. Nesbitt, Kunio Okuda, and David W. Smith]1958The Effects of Acute Hypoxia on the Osmotic Pressure of the Plasma. Quarterly Journal of Experimental Physiology 43: 197+, 1958. [With Donald H. Barron, Frederick C. Battaglia, and Giacomo Meschia]Studies on the Absorption of Vitamin B12 in Human Pregnancy with Especial Reference to the Effect of D-Sorbitol. American Journal of Obstetrics and Gynecology 76: 91+, 1958. [With Bacon F. Chow, Harry Prystowsky, and Vernon Wong]1959The Alveolar PCO2 and PO2 in Pregnant and Nonpregnant Women at Altitude. Proceedings of the Society for Clinical Investigation 38: 1010+, 1959. [With Donald Barron, William Huckabee, Giacomo Meschia, James Metcalfe, and Harry Prystowsky]A Comparison of the Oxygen Dissociation Curves of the Bloods of Maternal and Fetal Goats at Various pHs. Quarterly Journal of Experimental Physiology 44: 215–21, July 1959. [With Donald Barron, Giacomo Meschia, Harry Prystowsky, and A. Stark Wolkoff]Fetal Blood Studies. XII. On the Relationship Between the Position of the Oxygen Dissociation Curve of Human Fetal Blood and Adult Fetal Hemoglobin. American Journal of Obstetrics and Gynecology 77: 585+, 1959. [With Paul D. Bruns, Julian Cotter, and Harry Prystowsky]Fetal Blood Studies. XIV. A Comparative Study of the Oxygen Dissociation Curve of Nonpregnant, Pregnant and Fetal Human Blood. American Journal of Obstetrics and Gynecology 78: 489–93, September 1959. [With Paul D. Bruns and Harry Prystowsky]Fetal Blood Studies. XVI. On the Changes in Total Osmotic Pressure and Sodium and Potassium Concentration of Amniotic Fluid During the Course of Human Gestation. Surgery, Gynecology and Obstetrics 109: 509–12, October 1959. [With Frederick Battaglia, Paul D. Bruns, Harry Prystowsky, and Clayton Smisson]Further Observations on the Metabolism of Vitamin B12 in Human Pregnancy. American Journal of Obstetrics and Gynecology 77: 1+, 1959. [With Bacon F. Chow, Harry Prystowsky, Bruno Ranke, and Elma Ranke]The Oxygen Dissociation Curves of the Bloods of Adult and Fetal Llamas. Federation Proceedings 18, 1959. [With Donald Barron, William Huckabee, Giacomo Meschia, James Metcalfe, and Harry Prystowsky] [End Page 90]Transfer of Oxygen Across the Sheep Placenta at High Altitude. Federation Proceedings 18, 1959. [With Donald Barron, William Huckabee, Giacomo Meschia, and Harry Prystowsky]Uterine Blood Flow and Metabolism in Pregnant Sheep at High Altitude. Federation Proceedings 18, 1959. [With Donald Barron, William Huckabee, Giacomo Meschia, James Metcalfe, and Harry Prystowsky]Uterine Blood Flow and Metabolism in Unanesthetized Pregnant Sheep. Federation Proceedings 18, 1959. [With Donald Barron, William Huckabee, Giacomo... (shrink)

Regional institutional marketing supports sustainable farming by bringing wholesome, nutritious food to members of the community. Schools, in particular, can benefit greatly from this arrangement in comprehensive efforts to address childhood obesity. Nineteen previous publications examined issues around supply of and/or demand for regional food procurement by institutions across the United States, including levels of interest, perceived benefits, and barriers to this arrangement. Food service directors, farmers, and/or distributors participated in surveys, interviews, workshops/forums, case studies, and one evaluation about regional (...) food procurement. Accounts of seven farmer cooperatives or networks indicate that institutional customers are more often restaurants (n = 5), health care facilities (n = 2), colleges/universities (n = 2), and other facilities (n = 2), than public schools (n = 1) or food retailers (n = 1). The studies agree that the main benefits offered by regional food procurement are support of the local economy and increased access to fresh and nutritious food. Barriers consistently faced by food services and farmers have to do with lack of infrastructure and financial support for processing and central distribution. Though obstacles vary by district and/or geographic characteristics, results indicate that across groups there is a clear need for better support mechanisms by which farms can connect with regional markets. The practice of farm-to-institution marketing holds the potential to improve nutritional status of community members and financial stability of farmers, though institutional support is needed for systemic transition to this purchasing method. (shrink)

The aim of this article is to show that, just as in recent years Cobreros, Egré, Ripley and van Rooij have provided a non-transitive counterpart of classical logic (i.e. one in which all classically acceptable inferences are valid but Cut and other metainferences are not), the same can be done for every Tarskian logic, with full generality. To establish this fact, a semantic approach is taken by showing that appropriate structures can be devised to characterize a non-transitive counterpart of every (...) Tarskian logic, starting from the logical matrices that are usually taken to render them. (shrink)

Research on transition to higher education and young people with disabilities has increased in recent years. However, there is still limited understanding of transition issues and how digital technologies, such as social media and mobile devices, are used by this group of students to manage these issues. This article presents the findings of an empirical study that addressed this matter based on young people’s views and experiences. The qualitative study was conducted in the context of a group of (...) students with vision impairments transitioning to a New Zealand university. The findings draw from observations, a researcher diary, focus groups, individual interviews, and data from social media. The study shows that, like their non-disabled peers, the students actively engaged with interactive and collaborative digital technologies to make sense, individually and collectively, of different transition issues before, during and after the first academic trimester of their university journey. (shrink)

This article introduces Transition 2.0, a paradigm shift designed to study and support students with disabilities' transition to higher education. Transition 2.0 is the result of a qualitative study about how a group of young people with vision impairments used digital technologies for their transition to university. The findings draw from observations, a researcher diary, focus groups, individual interviews, and data from social media. The article discusses a conventional view of transition, referred to here as (...) Transition 1.0, which has dominated disability-related research and service provision in higher education. It counters this view by further developing the conceptual framework for Transition 2.0. The findings expand current conceptual approaches to transition by incorporating in the analysis the role played by digital tools such as social media and mobile devices. They also provide a new lens through which to study and understand student engagement in higher education. (shrink)

It is argued that if we take grounding to be univocal, then there is a serious tension between truth-grounding and one commonly assumed structural principle for grounding, namely transitivity. The primary claim of the article is that truth-grounding cannot be transitive. Accordingly, it is either the case that grounding is not transitive or that truth-grounding is not grounding, or both.

This volume is a detailed study of the concept of the nutritive capacity of the soul and its actual manifestation in living bodies in Aristotle and Aristotelianism. Aristotle’s innovative analysis of the nutritive faculty has laid the intellectual foundation for the increasing appreciation of nutrition as a prerequisite for the maintenance of life and health that can be observed in the history of Greek thought. According to Aristotle, apart from nutrition, the nutritive part of the soul is also (...) responsible for or interacts with many other bodily functions or mechanisms, such as digestion, growth, reproduction, sleep, and the innate heat. After Aristotle, these concepts were used and further developed by a great number of Peripatetic philosophers, commentators on Aristotle and Arabic thinkers until early modern times. This volume is the first of its kind to provide an in-depth survey of the development of this rather philosophical concept from Aristotle to early modern thinkers. It is of key interest to scholars working on classical, medieval and early modern psycho-physiological accounts of living things, historians and philosophers of science, biologists with interests in the history of science, and, generally, students of the history of philosophy and science. (shrink)

D. W. Winnicott is increasingly recognized as one of the most important psychoanalysts since Freud, but the relevance of his Independent version of object relations theory to psychoanalytic literary criticism has not been sufficiently appreciated. As Peter L. Rudnytsky notes, "There must be ten literary critics conversant with Lacan's ecrits for every one who has read Winnicott's Playing and Reality." Transitional Objects and Potential Spaces begins to redress this imbalance. The title and subtitle of this collection highlight three of Winnicott's (...) key concepts: transitional objects, potential space, and the use of an object. Because Winnicott is unique in respecting the integrity of art as an autonomous human activity while continuing to insist on its infantile origins, he may be said to offer the first adequate psychoanalytic account of aesthetics. This volume is organized into three sections: The Analytic Frame, Literary Objects, and Cultural Fields. Beginning with Winnicott's "The Location of Cultural Experience," it features essays by a distinguished group of contributors, including Marion Milner and two current leading members of the British Psycho-Analytical Society, Christopher Bollas and Patrick J. Casement, as well as such eminent critics as Richard Poirier, Murray M. Schwartz, Ellen Handler Spitz, and Madelon Sprengnether. Transitional Objects and Potential Spaces makes a timely and persuasive case for the power of Winnicott's ideas. In defining for the first time an independent tradition of psychoanalytic criticism, it will reorient future work in literary and cultural studies. (shrink)

The idea of personalized nutrition is to give tailored dietary advice based on personal health-related data, i.e. phenotoype, genotype, or lifestyle. PN may be seen as part of a general trend towards personalised health care and currently various types of business models are already offering such services in the market. This paper explores ethical issues of PN by examining how PN services within the contextual environment of four future scenarios about health and nutrition in Europe might affect aspects (...) of social justice according to Martha Nussbaum’s capability approach. The scenarios have been created by a mixed group of stakeholders and experts in three consecutive workshops. This resulted in the definition of four future scenarios within a scenario space consisting of two variables: the ‘logic of health care systems’ and ‘conception of health’. Within each scenario, PN is likely to play a more or less important role in improving health by influencing food consumption patterns in society. Nussbaum’s capability approach implies a concept of social justice as a function of a minimum standard of human dignity. This denotes an account for equality in terms of a minimum of entitlements. However, also the ability of achieving individual objectives is essential for social justice. Personalisation advice in health and food consumption patterns, as aimed for by PN, is therefore acceptable provided a minimum of entitlements is guaranteed to all members of a society, and at the same time freedom concerning personal preferences is respected. Potential variation of how different people might benefit from PN should therefore be consistent with the minimum required as defined by the list of capabilities. (shrink)

This cross sectional study was carried out among the workers of British American Tobacco Company, Dhaka with a view to explore their nutritional status, personal hygiene and health seeking behavior as because they are working on a tobacco processing company. The sample size was 179 which were selected purposively. The study showed that out of 179 respondents 89 (49.7%) were in the age groups of 30-39 years and the mean age of the respondents were 31.99 ± 6.01 years. A large (...) number of respondents (55.9%) had monthly family income of Taka 10001-20000 and the mean family income was Taka 12776.54 ± 5230.13. Maximum respondents (73.7%) were Muslim, more than half (54.2%) were shift in charge, 39.1% of the respondents consisted of 4 family members, 43.6% respondents were accustomed to other type of eating habit and 38.5% respondents knew that malnutrition was the effect of lack of proper nutrition, 59.8% of the respondents knew that night blindness was the disease due to malnutrition, most of the respondents (91.6%) performed duties to maintain health, majority (62.0%) respondents used to do nothing to maintain healthcare for their children and 35.9% visited doctor’s single time in a month, 40.2% of the respondents told regular tooth brushing as type of healthy habits. Majority (64.8%) respondents used to brush twice a day, majority (50.8%) respondents used to wash hand after toileting, majority (62.08%) respondents used to bath daily, 43.0% and 31.8% of the respondents told that dysentery and diarrhea was due to eating without proper hand washing respectively. Majority (53.6%) respondents informed that they learned about personal hygiene from television, 45.8% respondents understood that use of safe water in every work as sanitation. Majority (50.84%) came from nuclear family; most (84.92%) had exercise habit and 40.22% had education level of class VIII. Most (75.42%) of the respondents had semi pucca houses and majority (69.83%) of the respondents used only water as materials for hand washing. This study provided some important information which might help the concerned authority to take appropriate measures to improve the health status of the workers. (shrink)

Linguists, biological anthropologists, and cognitive scientists come together in this book to explore the origins and early evolution of phonology, syntax, and semantics. They consider the nature of pre- and proto-linguistic communication, the internal and external triggers that led to its transformation into language, and whether and how language may be considered to have evolved after its inception. Evidence is drawn from many domains, including computer simulations of language emergence, the songs of finches, problem-solving abilities in monkeys, sign language, and (...) the structure of languages today. (shrink)

Medical and non-medical experts increasingly argue that individuals, whether they are diagnosed with a specific chronic disease or condition or not (and whether they are judged at minimal risk of these consequences or not), have an obligation to make ‘healthy’ food choices. We argue that this obligation is neither scientifically nor ethically justified at the level of the individual. Our intent in the article is not simply to argue against moralization of the value of prudential uses of food for nutritional (...) health, but to situate nutritional advocacy in the context of Western liberal democracy that values free choice. We have two objectives: (i) to untangle and examine the substance of discourses on ‘healthy’ food choice that simplify nutrition science and place a moral obligation on individuals and (ii) to establish a more comprehensive view of the relationship among food, ethics and health. Although critical of certain features of the liberal political and moral tradition, we argue that John Stuart Mill’s notion of experiments in living provides fertile ground for an improved ethical understanding of individual obligation and of the interconnections among food, health and well-being. (shrink)

Nutrition and hydration—including artificially delivered, or assisted, nutrition and hydration (ANH)—are typically considered ordinary or proportionate care in the Roman Catholic moral tradition. They are thus morally obligatory, except when the benefit to the patient does not justify the burden their administration places on the patient or when they no longer prolong life (e.g., in end-stage disease when death is imminent). A review of Church documents and the medical literature provides convincing evidence that there are cases in which (...) ANH provides little hope of benefit and may impose an excessive burden on the patient. This paper closely examines advanced dementia of the Alzheimer’s (DAT) type and shows how ANH can be properly considered extraordinary care and hence is not obligatory in patients with advanced DAT. National Catholic Bioethics Quarterly 8.2 (Summer 2008): 291–305. (shrink)

SummaryThe nutritional status of under-five children is a sensitive sign of a country's health status as well as economic condition. This study investigated the differential impact of some demographic, socioeconomic, environmental and health-related factors on the nutritional status among under-five children in Bangladesh using Bangladesh Demographic and Health Survey 2007 data. Two-level random intercept binary logistic regression models were used to identify the determinants of under-five malnutrition. The analyses revealed that 16% of the children were severely stunted and 25% were (...) moderately stunted. Among the children under five years of age 3% were severely wasted and 14% were moderately wasted. Furthermore, 11% of the children were severely underweight and 28% were moderately underweight. The main contributing factors for under-five malnutrition were found to be child's age, mother's education, father's education, father's occupation, family wealth index, currently breast-feeding, place of delivery and division. Significant community-level variations were found in the analyses. (shrink)

Within the framework of 'Temporalities and the Urban Fabric: Co-Producing Liminal Spaces in Transitional Epochs,' this rigorous examination unravels the multilayered nuances of temporality and its intimate relationship with urban spaces in times of transition. The research delineates the intricate interplay between public exhibitions, urban realms, and socio-political paradigms, particularly within the dynamic settings of the metropolitan entities of Houston and Amsterdam. These cities, as epitomes of temporal urban flux, become fertile grounds for exploring the ephemeral essence of liminal (...) spaces and their transformative manifestations. By weaving together diverse academic domains – from Design Computation and Fabrication to Urban Communities and Spatial Justice – this study underscores the symbiotic fusion of Augmented Reality (AR) and Gamification within the broader canvas of urban temporalities. Crucially, the research accentuates the transformative potential of Extended Reality (XR) in augmenting the theoretical and methodological contours of urban studies within these transitional epochs. (shrink)

Nutrition and hydration—including artificially delivered, or assisted, nutrition and hydration (ANH)—are typically considered ordinary or proportionate care in the Roman Catholic moral tradition. They are thus morally obligatory, except when the benefit to the patient does not justify the burden their administration places on the patient or when they no longer prolong life (e.g., in end-stage disease when death is imminent). A review of Church documents and the medical literature provides convincing evidence that there are cases in which (...) ANH provides little hope of benefit and may impose an excessive burden on the patient. This paper closely examines advanced dementia of the Alzheimer’s (DAT) type and shows how ANH can be properly considered extraordinary care and hence is not obligatory in patients with advanced DAT. National Catholic Bioethics Quarterly 8.2 (Summer 2008): 291–305. (shrink)

New Natural Law Theory and the Catholic medico-moral tradition often lead to similar conclusions in hard cases regarding end-of-life care. Considering the provision of artificial nutrition and hydration to patients suffering from post-coma unresponsive wakefulness, however, brings to light subtle ways in which NNL differs from the centuries-old natural law tradition. In this essay, I formalize the methodology embedded within the casuistry of the medico-moral tradition and show how it differs from NNL with respect to the role played by (...) double-effect reasoning and the perspective for analyzing cases regarding care for those who cannot speak for themselves. Importantly, the ordinary/extraordinary means distinction has never historically been understood as an application of double effect and logically cannot be so understood. Given the outsized role that double effect plays in NNL, the theory leads to conclusions that deviate from the Catholic medico-moral tradition and creates additional burdens and duties for the sick. (shrink)

ABSTRACTThis paper provides a naturalistic account of inference. We posit that the core of inference is constituted by bare inferential transitions, transitions between discursive mental representations guided by rules built into the architecture of cognitive systems. In further developing the concept of BITs, we provide an account of what Boghossian [2014] calls ‘taking’—that is, the appreciation of the rule that guides an inferential transition. We argue that BITs are sufficient for implicit taking, and then, to analyse explicit taking, we (...) posit rich inferential transitions, which are transitions that the subject is disposed to endorse. (shrink)

D. W. Winnicott is increasingly recognized as one of the most important psychoanalysts since Freud, but the relevance of his Independent version of object relations theory to psychoanalytic literary criticism has not been sufficiently appreciated. As Peter L. Rudnytsky notes, "There must be ten literary critics conversant with Lacan's ecrits for every one who has read Winnicott's Playing and Reality." Transitional Objects and Potential Spaces begins to redress this imbalance. The title and subtitle of this collection highlight three of Winnicott's (...) key concepts: transitional objects, potential space, and the use of an object. Because Winnicott is unique in respecting the integrity of art as an autonomous human activity while continuing to insist on its infantile origins, he may be said to offer the first adequate psychoanalytic account of aesthetics. This volume is organized into three sections: The Analytic Frame, Literary Objects, and Cultural Fields. Beginning with Winnicott's "The Location of Cultural Experience," it features essays by a distinguished group of contributors, including Marion Milner and two current leading members of the British Psycho-Analytical Society, Christopher Bollas and Patrick J. Casement, as well as such eminent critics as Richard Poirier, Murray M. Schwartz, Ellen Handler Spitz, and Madelon Sprengnether. Transitional Objects and Potential Spaces makes a timely and persuasive case for the power of Winnicott's ideas. In defining for the first time an independent tradition of psychoanalytic criticism, it will reorient future work in literary and cultural studies. (shrink)

On what I take to be the standard account of supererogation, an act is supererogatory if and only if it is morally optional and there is more moral reason to perform it than to perform some permissible alternative. And, on this account, an agent has more moral reason to perform one act than to perform another if and only if she morally ought to prefer how things would be if she were to perform the one to how things would be (...) if she were to perform the other. I argue that this account has two serious problems. The first, which I call the latitude problem, is that it has counterintuitive implications in cases where the duty to be exceeded is one that allows for significant latitude in how to comply with it. The second, which I call the transitivity problem, is that it runs afoul of the plausible idea that the one-reason-morally-justifies-acting-against-another relation is transitive. What’s more, I argue that both problems can be overcome by an alternative account, which I call the maximalist account. (shrink)

The purpose of this paper is to assess Profet’s (1992) and others’ hypothesis that nausea and vomiting in pregnancy (NVP) is adaptive. A number of studies have found an association between NVP and a decreased risk for early fetal loss (<20 weeks). It is assumed that the adaptive benefits of improved survivorship associated with NVP outweigh the minimal nutritional consequences. However, in populations that experience marginal levels of nutrition, NVP may have important nutritional consequences. To test these potential consequences, (...) a study on NVP, nutritional status, and pregnancy outcome was conducted among Turkana pastoralists, who experience seasonal and chronic nutritional stress. Interviews and anthropometric assessments were conducted on 68 pregnant Turkana women of Kenya during a 1993–1994 field season. The results from the case study suggest that women who experience NVP do encounter nutritional consequences in the later stages of pregnancy and are more likely to experience poor pregnancy outcomes. These results suggest that NVP may not be adaptive in all environmental settings, particularly among marginally nourished populations. (shrink)