California is a landmark setting for studying produce recovery efforts and policy implications because of its global relevance in agricultural production, its complex network of food recovery organizations, and its environmental and public health regulations. Through a series of focus groups with organizations involved in produce recovery (gleaning organizations) and emergency food operations (food banks, food pantries), this study aimed to deepen our understanding of the current produce recovery system and determine the major challenges and opportunities related to the produce (...) recovery system. Operational and systematic barriers to produce recovery were highlighted by both gleaning and emergency food operations. Operational barriers, such as the lack of appropriate infrastructure and limited logistical support were found to be a challenge across groups and were directly tied to inadequate funding for these organizations. Systematic barriers, such as regulations related to food safety or reducing food loss and waste, were also found to impact both gleaning and emergency food organizations, but differences were observed in how each type of regulation impacted each stakeholder group. To support the expansion of food recovery efforts, participants expressed need for better coordination within and across food recovery networks and more positive and transparent engagement from regulators to increase understanding of the specifics of their unique operational constraints. The focus group participants also provided critiques on how emergency food assistance and food recovery are inscribed within the current food system and for longer term goals of reducing food insecurity and food loss and waste a systematic change will be required. (shrink)

Objective: Even when critically ill patients are almost certain to die from their illnesses, there is generally an element of prognostic uncertainty. Little is known about how physicians handle this uncertainty in conversations with surrogate decision makers. We sought to evaluate whether and how physicians discuss prognostic uncertainty with surrogate decision makers of patients who are highly likely, but not certain, to die. Design: We audiotaped and transcribed discussions between clinicians and surrogate decision makers at two major California teaching hospitals (...) from 2006 through 2008. Physicians completed a questionnaire addressing their prognostic estimates for patients' survival to hospital discharge. Participants: We included physicians and surrogates of 12 incapacitated, critically ill patients. Measurements: We analyzed transcripts of discussions in which physicians' estimates of patients' chances of hospital survival were 1% to 5%; we coded whether physicians disclosed the prognostic uncertainty and, if so, how they conveyed that death was highly likely but not certain. Results: Physicians' estimates of short-term survival were 1% to 5% for 12 of the 70 patients enrolled in the original study. In 8 of 12 cases, physicians conveyed prognostic uncertainty by using probabilistic language or by an explicit mention of uncertainty. In four cases, physicians made at least one statement that either implied or was ambiguous about whether death was certain. Conclusion: We observed variability in how physicians handle prognostic uncertainty in their discussions with surrogates of patients who are highly likely, but not certain, to die, including some circumstances in which physicians stated or implied that death was certain. (shrink)

We discuss a case where clinical genomic investigation of muscle weakness unexpectedly found a genetic variant that might (or might not) predispose to kidney cancer. We argue that despite its off-target and uncertain nature, this variant should be discussed with the man who had the test, not because it is medical information, but because this discussion would allow the further clinical evaluation that might lead it to becoming so. We argue that while prominent ethical debates around genomics often take ‘results’ (...) as a starting point and ask questions as to whether to look for and how to react to them, the construction of genomic results is fraught with ethical complexity, although often couched as a primarily technical problem. We highlight the need for greater focus on, and appreciation of, the ethical work undertaken daily by scientists and clinicians working in genomic medicine and discuss how public conversations around genomics need to adapt to prepare future patients for potentially uncertain and unexpected outcomes from clinical genomic tests. (shrink)

Accessing BRCA1/2 data facilitates the detection of disease-associated variants, which is critical to informing clinical management of risks. BRCA1/2 data sharing is complex and many practices exist. We describe current BRCA1/2 data-sharing practices, in the United States and globally, and discuss obstacles and incentives to sharing, based on 28 interviews with personnel at U.S. and non-U.S. clinical laboratories and databases. Our examination of the BRCA1/2 data-sharing landscape demonstrates strong support for and robust sharing of BRCA1/2 data around the world, increasing (...) global accesses to diverse data sets. (shrink)

This essay critically comments on Contingent Future Persons (1997), an anthology of thirteen papers on the same topic as Obligations to Future Generations (1978), namely, the morality of decisions affecting the existence, number and identity of future persons. In my discussion, I identify the basic point of dispute between R. M. Hare and Michael Lockwood on potentiality; I criticize Nick Fotion's thesis that the Repugnant Conclusion is too far-fetched to be philosophically valuable; I object to Clark Wolf's "Impure Consequentialist Theory (...) of Obligation"; and I discuss the Non-Identity Problem in connection with essays by Robert Elliot and Ingmar Persson. (shrink)

This study examines the public's and physicians' willingness to support deception of insurance companies in order to obtain necessary healthcare services and how this support varies based on perceptions of physicians' time pressures. Based on surveys of 700 prospective jurors and 1617 physicians, the public was more than twice as likely as physicians to sanction deception (26% versus 11%) and half as likely to believe that physicians have adequate time to appeal coverage decisions (22% versus 59%). The odds of public (...) support for deception compared to that of physicians rose from 2.48 to 4.64 after controlling for differences in time perception. These findings highlight the ethical challenge facing physicians and patients in balancing patient advocacy with honesty in the setting of limited societal resources. (shrink)

Liberalism, in any of its forms, places a strong emphasis on the individual---it prioritizes equal rights and liberties, and measures are taken to assure for all citizens the opportunity to make full use of their freedoms and entitlements. Many conceptions of human rights are objected to on the grounds that they are based on liberal premises, and insufficiently sensitive to the fact of reasonable cultural pluralism. ;Using as a foil recent work in this area by John Rawls, I argue in (...) chapter one for a justificatory basis of human rights that advances values---in particular values of minimal democracy including the right to political participation---that may have emerged historically alongside liberalism but that we ought not consider specifically liberal. My account diverges form Rawls' at this point: he does not believe that such values can be defended from premises that are not specifically liberal. ;Since a group is, after all, merely a collection of individuals, liberalism appears to be committed, unsatisfactorily, to a permissive right to secede in the sense that, other things being equal, groups always ought to be permitted to secede voluntarily. I show in my second chapter that liberalism is not committed to this permissive view. Though liberalism implies that no one has a duty to refrain from secession, it does not support the stronger thesis that states must permit groups to secede if they wish. My treatment of secession argues for a more general framework in which those liberties whose protection is of basic importance to liberalism are distinguished from those whose protection is not so guaranteed. ;Derek Parfit has put forth a general difficulty regarding our obligations to future generations to which I respond in chapter three. Parfit claims, plausibly, that we may suppose a major public policy decision to have sufficiently broad ramifications that in about two hundred years there would be nobody alive who would have been alive had some different policy been selected. But then the choice of such a policy would not make those people worse off, since they would not otherwise have been born. This would remain so even in the case of policies that cause the lives of future generations to be of a very low quality. Parfit's "Non-Identity Problem" challenges us to provide plausible moral reasons against such public policies. ;I argue that the only adequate response to this problem comes from a liberal focus on the rights of future generations, and the moral status that this confers on them. Taking such seriously, many public polices can be shown to be objectionable despite the fact that such policies may not harm the interests of those affected by them. (shrink)

A first-person account of some victims of the virus, the author puts faces and circumstances to the tragedy of the Covid-19 pandemic. Told from a chaplain’s point of view, these narratives will take the reader beyond the numbers and ask questions like: What is the cost of keeping families separated at the end of life, and, if patient/family centered care is so central to healthcare these days, why was it immediately discarded? Is potentially saving human lives worth the risk of (...) damaging them beyond repair? (shrink)

_Discourse, Dialogue and Technology Enhanced Learning_ is invaluable to all those wanting to explore how dialogic processes work and how we facilitate them. Dialogue is an important learning tool and it is by understanding how language affects us and how we use language to encourage, empathise, inquire, argue and persuade that we come closer to understanding processes of change in ourselves and our society. Most researchers in Education will find themselves interpreting some form of data in the form of words; (...) whether these words be explanations, conversations, narrations, reflections, debates or interviews and whether they are conducted through digital media or face-to-face. Discourse, textual or spoken, is therefore central to researching education. Each chapter focuses on the ways in which alternative levels of discourse analysis provide tools for the researcher, enabling insights into the way language works in learning, teaching practice and wider society. Drawing on the author’s own ‘DISCOUNT’ discourse analysis coding scheme and including a wide range of dialogue examples, this book covers: Why Dialogue? The Role of Dialogue in Education. Debate: Learning to Argue and Arguing to Learn Towards Meaning-Making: Inquiry, Narrative and Experience The Role of the Significant Other: Facilitation, Scaffolding and Mediation Inclusion, Collaboration and Community Media, Mode and Digital Literacy Researching Voices and Texts Discourse, Dialogue and Technology Enhanced Learning will be an essential resource for all students, educators and educational researchers who have an interest in the role of discourse in educational contexts. (shrink)

The idea of a profound urban–rural divide has shaped analysis of the 2016 U.S. presidential election results. Here, through examples from agri-food systems, we consider the limitations of the urban–rural divide framework in light of the assumptions and intentions that underpin it. We explore the ideas and imaginaries that shape urban and rural categories, consider how material realities are and are not translated into U.S. rural development, farm, and nutrition policies, and examine the blending of rural and urban identities through (...) processes of rural deagrarianization and urban reagrarianization. We do not argue that an urban–rural divide does not exist, as studies and public opinion polls illustrate both measured and perceived differences in many aspects of the lived experiences that shape our individual and collective actions. Ultimately, we suggest that the urban–rural divide concept obscures the diversity and dynamism of experiences each category encompasses. Additionally, it ignores the connections and commonalities that demand integrative solutions to challenges in agri-food systems, and draw attention to the power relations that shape resource access and use within and across urban and rural spaces. (shrink)

CRISPR, a recently developed gene-editing tool, has become synonymous with rapid biological advancement. While gene editing had been performed in life sciences research for decades, genetic engineering with CRISPR is much more straightforward, faster, and less expensive—and thus, the technology has been rapidly democratized. CRISPR was built on a natural mechanism, the method by which bacteria resist infections from viruses called bacteriophage. Once infected, bacteria may recognize specific genetic sequences of the invading bacteriophage virus and chop its genetic material into (...) pieces. This bacterial immune response, discovered through basic research, has been exploited by scientists to develop a gene-editing tool... (shrink)

This thought-provoking book examines the science behind human attractiveness—the ratios, proportions, and other factors that to a large extent dictate what we find "beautiful." It's said that "beauty is in the eye of the beholder," but recent scientific research suggests that human attractiveness is much more objective than we once thought, deeply rooted in our biology and evolutionary history. For instance, facial symmetry is considered extremely attractive because it indicates good health and nutrition during the formative developmental years. This book (...) explores these insights. Part I of The Biology of Beauty: The Science behind Human Attractiveness takes a closer look at what traits we find the most alluring and why. It discusses why attractiveness is important from an evolutionary standpoint and the advantages (and disadvantages) of being attractive. In addition to exploring these beauty "universals," it examines how beauty ideals can be shaped by factors such as culture, religion, and the media. Part II provides an in-depth analysis of individual features that contribute to attractiveness, offering scientific explanations for our preferences. The book also includes a collection of insightful sidebars that highlight beauty ideals in different parts of the world and at other times in history. (shrink)

Perceived control in contingency learning is linked to psychological wellbeing with low levels of perceived control thought to be a cause or consequence of depression and high levels of control considered to be the hallmark of mental healthiness. However, it is not clear whether this is a universal phenomenon or whether the value that people ascribe to control influences these relationships. Here we hypothesize that values affect learning about control contingencies and influence the relationship between perceived control and symptoms of (...) mood disorders. We tested these hypotheses with European university samples who were categorized as endorsing (or not) values relevant to control - individualist and collectivist values. Three online experimental contingency learning studies (N1 = 127, N2 = 324, N3 = 272) were carried out. Evidence suggested that individualist values influenced basic learning processes via an effect on learning about the context in which events took place. Participants who endorsed individualist values made control judgments that were more in line with an elemental associative learning model, whilst those who were ambivalent about individualist values made judgments that were more consistent with a configural process. High levels of perceived control and individualist values were directly associated with increased euphoric symptoms of bipolar disorder, and such values completely mediated the relation between perceived control and symptoms. The effect of low perceived control on depression was moderated by collectivist values. Anxiety created by dissonance between values and task may be a catalyst for developing mood symptoms. Conclusions are that values play a significant intermediary role in the relation between perceived control and symptoms of mood disturbance. (shrink)

Philosophy for the 21st Century, an introductory anthology, is an extraordinarily comprehensive collection of historical and contemporary readings. It covers all major fields, including not only metaphysics, epistemology, ethics, and philosophy of religion, but also philosophy of science, philosophy of mind, philosophy of language, political philosophy, and philosophy of art. This volume is unique in drawing on the judgments of a new generation of scholars, each of whom has chosen the articles and provided the introduction for one section of the (...) book. These associate editors--Delia Graff, Robin Jeshion, L. A. Paul, Jesse J. Prinz, Stuart Rachels, Gabriela Sakamoto, David Sosa, and Cynthia A. Stark--are at the forefront of 21st-century philosophy. Their selections include the work of such leading contemporary thinkers as Nancy Cartwright, Saul A. Kripke, David Lewis, Thomas Nagel, Robert Nozick, Derek Parfit, and Sydney Shoemaker, along with classic works from 2500 years of philosophy. The book has been structured to maximize continuity, and an introductory essay by Simon Blackburn explains the tools of symbolic logic. This groundbreaking volume sets a new standard for introducing students to the importance and fascination of philosophical inquiry. (shrink)

While a number of valid molecular targets have been discovered for tumours over the past decade, finding an effective way of delivering therapeutic genes specifically to tumours has proved more problematic. A variety of viral and non‐viral delivery vehicles have been developed and applied in anti‐cancer gene therapies. However, these suffer from either inefficient and/or short‐lived gene transfer to target cells, instability in the bloodstream and inadequate tumour targeting. Recently, various types of non‐pathogenic obligate anaerobic and facultative anaerobic bacteria have (...) been shown to infiltrate and selectively replicate within solid tumours when delivered systemically. This has prompted the development of cancer gene therapy protocols that use such bacteria as gene delivery vehicles. Here, we review the evidence for the success of these in pre‐clinical models and clinical trials, as single modality treatments and in combination with conventional cancer therapies. BioEssays 28:84–94, 2006. © 2005 Wiley Periodicals, Inc. (shrink)

This study examines the relation between firms’ corporate philanthropic giving and their performance in three other social domains – employee relations, environmental issues, and product safety. Based on a sample of 384 U.S. companies and using data pooled from 1998 through 2000, we find that worse performers in the other social areas are both more likely to make charitable contributions and that the extent of their giving is larger than for better performers. Analyses of each separate area of social performance, (...) however, indicate that the relation between giving and negative social performance (cited concerns) only holds for the environmental issues and product safety areas. We find no significant association between corporate philanthropy and employee relations concerns. In general, these findings suggest that corporate philanthropy may be more a tool of legitimization than a measure of corporate social responsibility. (shrink)

Philosophy for the 21st Century, an introductory anthology, is an extraordinarily comprehensive collection of historical and contemporary readings. It covers all major fields, including not only metaphysics, epistemology, ethics, and philosophy of religion, but also philosophy of science, philosophy of mind, philosophy of language, political philosophy, and philosophy of art. This volume is unique in drawing on the judgments of a new generation of scholars, each of whom has chosen the articles and provided the introduction for one section of the (...) book. These associate editors--Delia Graff, Robin Jeshion, L. A. Paul, Jesse Prinz, Stuart Rachels, Gabriela Sakamoto, David Sosa, and Cynthia A. Stark--are at the forefront of 21st-century philosophy. Their selections include the work of such leading contemporary thinkers as Nancy Cartwright, Saul Kripke, David Lewis, Thomas Nagel, Robert Nozick, Derek Parfit, and Sydney Shoemaker, along with classic works from 2500 years of philosophy. The book has been structured to maximize continuity, and an introductory essay by Simon Blackburn explains the tools of symbolic logic. This groundbreaking volume sets a new standard for introducing students to the importance and fascination of philosophical inquiry. (shrink)

Expectations of receiving personal health information as a fringe benefit of biospecimen donation—termed diagnostic misconception—are increasingly documented. We developed an instrument measuring conflation of observational biospecimen-based research and clinical care for use with Latino communities, who may be particularly affected by diagnostic misconception due to limited health care access.

Professional workplaces that embody an “ideal worker” image that is implicitly white and male set-up persistent biases against the competence and suitability for authority of those who are not white men, forcing them to work harder to prove their competence and fit in. The added labor of coping with these burdens is largely invisible to dominant actors in the workplace who do not experience them. To facilitate change by making such burdens visible for all, we present data from a survey (...) of 1,349 architects, including white, Asian, Black, Latinx, and mixed race/other underrepresented men and women, about their specific behavioral experiences of prove-it-again bias, tightrope bias, problems of fit, exclusion, emotion work, and interruptions. Across all measures, white men architects report significantly lower levels of these burdens than do women of any race and almost all non-white men. Consistent with status expectations and stereotype prototypicality theories, we find intersectional patterns in the relative burdens experienced by women and men of different racial groups. Gender differences in bias experiences are greatest among white, less among Asian, and least among Black architects. Women of color report the highest levels of bias overall. (shrink)

In _Hidden Questions, Clinical Musings_, M. Robert Gardner chronicles an odyssey of self-discovery that has taken him beneath and beyond the categoies and conventions of traditional psychoanalysis. His essays offer a vision of psychoanalytic inquiry that blends art and science, a vision in which the subtly intertwining not-quite-conscious questions of analysand and analyst, gradually discerned, open to ever-widening vistas of shared meaning. Gardner is wonderfully illuminating in exploring the associations, images, and dreams that have fueled his own analytic inquiries, but (...) he is no less compelling in writing about the different perceptual modalities and endlessly variegated strategies that can be summoned to bring hidden questions to light. This masterfully assembled collection exemplifies the lived experience of psychoanalysis of one of its most gifted and reflective practitioners. In his vivid depictions of analysis oscillating between the poles of art and science, word and image, inquiry and self-inquiry, Gardner offers precious insights into tensions that are basic to the analytic endeavor. Evincing rare virtuosity of form and content, these essays are evocative clinical gems, radiating the humility, gentle skepticism, and abiding wonder of this lifelong self-inquirer. Gardner's most uncommon musings are a gift to the reader. (shrink)

In _Hidden Questions, Clinical Musings_, M. Robert Gardner chronicles an odyssey of self-discovery that has taken him beneath and beyond the categoies and conventions of traditional psychoanalysis. His essays offer a vision of psychoanalytic inquiry that blends art and science, a vision in which the subtly intertwining not-quite-conscious questions of analysand and analyst, gradually discerned, open to ever-widening vistas of shared meaning. Gardner is wonderfully illuminating in exploring the associations, images, and dreams that have fueled his own analytic inquiries, but (...) he is no less compelling in writing about the different perceptual modalities and endlessly variegated strategies that can be summoned to bring hidden questions to light. This masterfully assembled collection exemplifies the lived experience of psychoanalysis of one of its most gifted and reflective practitioners. In his vivid depictions of analysis oscillating between the poles of art and science, word and image, inquiry and self-inquiry, Gardner offers precious insights into tensions that are basic to the analytic endeavor. Evincing rare virtuosity of form and content, these essays are evocative clinical gems, radiating the humility, gentle skepticism, and abiding wonder of this lifelong self-inquirer. Gardner's most uncommon musings are a gift to the reader. (shrink)

Many publicly-funded health systems apply cost-benefit frameworks in response to the moral dilemma of how best to allocate scarce healthcare resources. However, implementation of recommendations based on costs and benefit calculations and subsequent challenges have led to ‘special cases’ with certain types of health benefits considered more valuable than others. Recent debate and research has focused on the relative value of life extensions for people with terminal illnesses. This research investigates societal perspectives in relation to this issue, in the UK.

Defense of reproductive choice is an important motivation in women's self-protection psychology for which the “staying alive theory” cannot fully account. Evidence indicates that some elements of women's self-protection psychology function to protect reproductive choice rather than survival, or may be equally well explained by either motivation. Integrating perspectives will result in greater explanatory breadth and precision in theory testing.