The goals of vascular composite allotransplantation for hand are to maximize functional status and psychosocial wellbeing and to improve quality of life. Candidates are carefully vetted by transplant programs through an extensive evaluation process to exclude those patients with contraindications and to select those that are most likely to attain functional or quality of life benefit from transplant. Patient choice for any treatment, however, requires that candidates be able to understand the risks, benefits, and alternatives before choosing to proceed. This (...) study aimed to understand patients’ knowledge and perceptions about treatment options for hand loss, including hand transplant. This study will be used to inform a standardized education approach and develop conversation aids for use by clinicians and patients throughout the treatment decision process. Ten individuals who had experienced hand amputation or had congenital limb loss were interviewed to better understand previous and current decisions about treatment, experiences in adjusting to their treatment, and perceptions about hand VCA. From this qualitative interview data, four findings emerged: knowledge and education around VCA as a treatment option; adaptation of individuals with limb loss; fear of risk associated with transplantation; issues of aging and overuse injuries to existing limbs. Results suggests that there is opportunity for expanding education about all treatment options for patients with new loss, long-term loss, and congenital limb loss. Establishing a baseline of knowledge about all options–prosthetics, rehabilitative strategies, and VCA—can help patients evaluate their values and goals of treatment. Issues associated with aging, including overuse and injury, and adaptability over the life course should be included in considerations about treatment choices. Data indicate the need for routinely assessing patient preferences about treatment choice so patients can plan for their future as they adapt and age and as technology for treatments change. To assure that thorough information is provided for current and future decision-making, education about treatment choices and selection procedures for VCA should be standardized. (shrink)

Reconstructive allografts using Vascularized Composite Allotransplantation are providing individuals living with upper limb loss and facial disfigurement with new opportunities for a sensate, esthetically acceptable, and functional alternative to current treatment strategies. Important research attention is being paid to how best to assess and screen candidates for VCA, measure optimal patient outcomes, and support patient adherence to lifelong behaviors and medical regimens. Far less attention, however, has been dedicated to the team science required for these complex VCA teams to form, (...) prepare, and provide the highest quality clinical and psychosocial care to those receiving VCA. VCA teams are unique in that they require specialized team members whose scope of practice may not otherwise overlap. The team also needs to constantly negotiate balancing patient safety with multiple risks throughout the transplant process. This study aimed to elucidate the team science needed for this highly innovative and complex area of medicine. Using in-depth qualitative interviews with 14 VCA team members and observations at team meetings, we found that careful consideration of team composition, team structure, and organizational commitment influences team performance and patient outcomes, but that to be efficient and truly effective, teams need to commit to developing processes that foster collaboration. These processes are action-oriented, strategic and interpersonal. Dedication and commitment to team science allows teams to manage conflict under stress and exercise ways to leverage strengths to provide optimal performance or patient psychosocial and clinical outcomes. This study can provide insight into quality improvement efforts for VCA teams and guidance for other transplant programs that wish to consider expansion into VCA. (shrink)

This collection of essays by Sheila Jasanoff explores how democratic governments construct public reason, that is, the forms of evidence and argument used in making state decisions accountable to citizens.

The power of technology? -- Risk and responsibility? -- The ethical anatomy of disasters? -- Remaking nature? -- Tinkering with humans? -- Information's wild frontiers? -- Whose knowledge, whose property? -- Reclaiming the future? -- The ethics of invention?

Interrogating the relationship of the sovereign power of the nation state to the scientist's expert knowledge as a legitimating--and sometimes challenging- ...

Cet article examine les défis épistémologiques actuels de l’économie à travers le prisme de l’épistémologie des Lumières écossaises. Smith et Hume s’étaient concentrés sur la manière dont les connaissances (provisoires et incertaines) étaient formulées, en examinant comment des circonstances différentes engendrent et soutiennent différentes théories et approches. Sur cette base, nous explorons le discours actuel sur la manière dont les économistes doivent aborder les défis épistémologiques des situations de crise et leurs causes.

In matters of rights, constitutions tend to avoid settling controversies. With few exceptions, rights are formulated in open-ended language, seeking consensus on an abstraction without purporting to resolve the many moral-political questions implicated by rights. The resulting view has been that rights extend everywhere but are everywhere infringed by legislation seeking to resolve the very moral-political questions the constitution seeks to avoid. The Negotiable Constitution challenges this view. Arguing that underspecified rights call for greater specification, Grégoire C. N. Webber draws (...) on limitation clauses common to most bills of rights to develop a new understanding of the relationship between rights and legislation. The legislature is situated as a key constitutional actor tasked with completing the specification of constitutional rights. In turn, because the constitutional project is incomplete with regards to rights, it is open to being re-negotiated by legislation struggling with the very moral-political questions left underdetermined at the constitutional level. (shrink)

An important function of the self is to identify external objects that are potentially personally relevant. We suggest that such objects may be identified through mere ownership. Extant research suggests that encoding information in a self-relevant context enhances memory , thus an experiment was designed to test the impact of ownership on memory performance. Participants either moved or observed the movement of picture cards into two baskets; one of which belonged to self and one which belonged to another participant. A (...) subsequent recognition test revealed that there was a significant memory advantage for objects that were owned by self. Acting on items had no impact on memory. Results are discussed with reference to the importance of self-object associations in cognition. (shrink)

In the past twenty years, the field of science and technology studies (S&TS) has made considerable progress toward illuminating the relationship between scientific knowledge and political power. These insights have not yet been synthesized or presented in a form that systematically highlights the connections between S&TS and other social sciences. This timely collection of essays by some of the leading scholars in the field attempts to fill that gap. The book develops the theme of "co-production", showing how scientific knowledge both (...) embeds and is embedded in social identities, institutions, representations and discourses. Accordingly, the authors argue, ways of knowing the world are inseparably linked to the ways in which people seek to organize and control it. Through studies of emerging knowledges, research practices and political institutions, the authors demonstrate that the idiom of co-production importantly extends the vocabulary of the traditional social sciences, offering fresh analytic perspectiveson the nexus of science, power and culture. (shrink)

Dreamscapes of Modernity offers the first book-length treatment of sociotechnical imaginaries, a concept originated by Sheila Jasanoff and developed in close collaboration with Sang-Hyun Kim to describe how visions of scientific and technological progress carry with them implicit ideas about public purposes, collective futures, and the common good. The book presents a mix of case studies—including nuclear power in Austria, Chinese rice biotechnology, Korean stem cell research, the Indonesian Internet, US bioethics, global health, and more—to illustrate how the concept (...) of sociotechnical imaginaries can lead to more sophisticated understandings of the national and transnational politics of science and technology. A theoretical introduction sets the stage for the contributors’ wide-ranging analyses, and a conclusion gathers and synthesizes their collective findings. The book marks a major theoretical advance for a concept that has been rapidly taken up across the social sciences and promises to become central to scholarship in science and technology studies. (shrink)

This chapter contains sections titled: An Introduction to Motherhood – Philosophy for Everyone Notes.

No thinker in the modern world has laid the way for the development of philosophy so influentially as Immanuel Kant, and it is hard to think of the philosophy of education without some sense of Kant in the background. Yet simplified exegeses and synoptic accounts abound, making for a' picture that readily succumbs to caricature. Interpreting Kant for Education exposes the errors in this picture. Through a spiralling series of arguments, Sheila Webb dismantles the sclerotic dualisms of fact and (...) value, subject and object, and body and mind that have done so much to hamper appreciation of Kant and to harm education. This ground-breaking work in the philosophy of education allows a reappraisal of Kant; it plays its part in the reengagement with Kant in the wider analytic tradition and provides a secure footing for better research and practice in education. (shrink)

Are children the passive recipients of influence from their parents and from society? Is their development determined by their genes and their neurons, or do they have the capacity to think about and influence their own lives and the world around them? How does their interaction with their social and material worlds support or hinder agency? Arechildren agents, and what do we mean by agency? Children as Agents in Their Worlds aims to answer these questions through a critical psychological and (...) relational approach, while referencing and critiquing a wide range of perspectives from otherdisciplinesincludingsociology, anthropology and education. Greene and Nixon review the pioneering work of scholars of childhood studies and current post-human theories of agency and offer a developmental perspective on the emergence of the sense ofagency and the exercise of agencyin children. They discuss key themes includingagency in families, agency within the school context and with peers, and children as agents in the wider public sphere. They explore agency and diversity, examining sex, age, genetic inheritance and contextual sources of difference, such as social class and geographical location. Offering a stronger theoretical base for research and policy, through a synthesis of both psychological and relational theories,Children as Agents in Their Worlds will be essential reading for students and professionals in developmental psychology, sociology and anthropology, as well as education, childhood studies, children⁰́₉s rights and related fields. (shrink)

This book introduces therapy as a socially constructed process, helping you develop as a more socially and culturally aware practitioner.

Though feminists are correct to note that conventional standards of sexiness are oppressive, we argue that feminism should reclaim sexiness rather than reject it. We argue for an aesthetic and ethical practice of working to shift from conventional attributions of sexiness to respectful attributions, in which embodied sexual subjects are appreciated in their full individual magnificence. We argue that undertaking this practice is an ethical obligation, since it contributes to the full recognition of others’ humanity. We discuss the relationship of (...) ethical to aesthetic considerations and argue that the respectful notion of sexiness is a genuinely aesthetic one, even though it does not involve assessment in relation to standards. (shrink)

Individual, family, economic, and other forms of people suffering impact organizations. Suffering in the workplace is probably a more common occurrence than expected in everyday life, and opposite to health and employee wellbeing. According to the World Health Organization, 300 million people worldwide struggle with depression and close to 800.000 people die due to suicide every year. The European Survey on Working Conditions in the European Union gathers the most varied aspects of working conditions, such as the duration of the (...) working day, relationships between collaborators in organizations, or healthy work habits. Among the results of that survey it is noteworthy that almost half of the close to twenty-two thousand workers surveyed in the 27 member countries stated that they felt uneasiness due to the conditions of their work. (shrink)

Marcel Mauss published his essay The Gift in the context of debates about the European sovereign debt crises and the economic growth experienced by the colonies. This article traces the discursive associations between Mauss’ anthropological concepts and the reformist program of French socialists who pushed for an “altruistic” colonial policy in the interwar period. This article demonstrates that the three obligations which Mauss identified as the basis of a customary law of international economic relations served as key references in the (...) French debate about the relationships between metropolises and colonies in the interwar period. Mauss made this relation between colonial policy and the ethnology of the gift explicit in his book, The Nation. Moving beyond Mauss’ interwar writings, the article traces the genealogy of his later reflections to his involvement in prewar debate... (shrink)

How do people learn to talk about the causal and temporal relations between events, and the motivation behind why people do what they do? The narrative practice hypothesis of Hutto and Gallagher holds that children are exposed to narratives that provide training for understanding and expressing reasons for why people behave as they do. In this context, we have recently developed a model of narrative processing where a structured model of the developing situation is built up from experienced events, and (...) enriched by sentences in a narrative that describe event meanings. The main interest is to develop a proof of concept for how narrative can be used to structure, organize and describe experience. Narrative sentences describe events, and they also define temporal and causal relations between events. These relations are specified by a class of narrative function words, including “because, before, after, first, finally.” The current research develops a proof of concept that by observing how people describe social events, a developmental robotic system can begin to acquire early knowledge of how to explain the reasons for events. We collect data from naïve subjects who use narrative function words to describe simple scenes of human-robot interaction, and then employ algorithms for extracting the statistical structure of how narrative function words link events in the situation model. By using these statistical regularities, the robot can thus learn from human experience about how to properly employ in question-answering dialogues with the human, and in generating canonical narratives for new experiences. The behavior of the system is demonstrated over several behavioral interactions, and associated narrative interaction sessions, while a more formal extended evaluation and user study will be the subject of future research. Clearly this is far removed from the power of the full blown narrative practice capability, but it provides a first step in the development of an experimental infrastructure for the study of socially situated narrative practice in human-robot interaction. (shrink)

A team of eminent practitioners and writers contribute to an assessment of the philosophy of landscape, and collectively form a new approach to creative design.

Despite triggering one of the largest civilian death tolls in modern history, the policy and human consequences of economic sanctions on Iraq between 1990-2003 remain largely unexamined. This lack of scrutiny mirrors the euphemism and mis-information surrounding the embargo itself and the Oil-for-Food program ostensibly adopted to protect Iraq's civilian population. But it also reflects incomprehension among Western publics - long removed from the realities of hunger and economic destitution - of the intimate link between economic conditions and mortality. Iraq (...) suffered an estimated 1.5 million excess deaths because of a catastrophic undermining of civilian livelihood triggered by the embargo; an outcome termed slow famine in the demographic literature. With much of the population fully dependent on daily food rations of less than 21 cents per person for much of the sanctions period, OfF `relief' was inherently incapable of substituting for a functioning civil economy. Recent positive accounts of the impact of OfF, in the form of the Independent Inquiry Committee into the Oil-for-Food Program, are refuted by close analysis of malnutrition and mortality rates across the sanctions period. The example of Iraq reveals the danger in treating economic sanctions as a cheap, `non-violent' tool for conflict resolution. In reality their deadly power is terrorizing for societies not protected from their application by permanent member status on the UN Security Council, a threat which continues to generate global insecurity. The Iraq experience reveals how current, narrowly framed, international law prohibitions on starvation as a weapon of war need to be extended to cover interference with civilian livelihood and hence access to food. (shrink)

This article illustrates instrumental variable (IV) estimation by examining an unexpected finding of the research on career adaptability and job satisfaction. Theoretical and empirical arguments suggest that in the general population, people’s abilities to adapt their careers are beneficial to their job satisfaction. However, a recent meta-analysis unexpectedly found no effect when personality traits are controlled for. We argue that a reverse effect of job satisfaction on career adaptability, originating from affective tendencies tied to personality, might explain this null effect. (...) Our argument implies that the estimates obtained with traditional ordinary least squares (OLS) regressions are biased by endogeneity, a correlation between an explanatory variable and the error term in a regression model. When experimental manipulations are impossible, IV estimations, such as two-stage least squares (2SLS) regressions, are one possible solution to the endogeneity problem. Analyzing three waves of data from a sample of 836 adults, the concurrent and time-lagged effect of job satisfaction on career adaptability was revealed to be more consistent than the reverse. Our results provide an explanation, rooted in affective dispositions, as to why recent meta-analytical estimates unexpectedly found that career adaptability does not predict job satisfaction at the interindividual level. We also discuss IV estimation in terms of its limits, weight the interpretation of its estimates against the temporality criterion for causal inference, and consider its possible extension to analyses of change. (shrink)

In this article, I consider the standard interpretation of the superiority theory of humor attributed to Plato, Aristotle, and Hobbes, according to which the theory allegedly places feelings of superiority at the center of humor and comic amusement. The view that feelings of superiority are at the heart of all comic amusement is wildly implausible. Therefore textual evidence for the interpretation of Plato, Aristotle, or Hobbes as offering the superiority theory as an essentialist theory of humor is worth careful consideration. (...) Through textual analysis I argue that not one of these three philosophers defends an essentialist theory of comic amusement. I also discuss the way various theories of humor relate to one another and the proper place of a superiority theory in humor theory in light of my analysis. (shrink)

The development of clinical ethic support in the UK arguably brings with it a series of legal questions, which need to be addressed. Most particularly, these concern questions of due process and formal justice, which I argue are central to the provision of appropriate ethical advice. In this article, I will compare the UK position with the more developed system in the USA, which often provides a template for development in the UK. While it is not argued that the provision (...) of clinical ethics support in the UK will necessarily follow the path mapped in the USA, there are lessons that can be learned from the US experience – particularly in terms of attention to process – from which UK clinical ethics support service might well benefit. (shrink)

In calling for the transformation of military medical education and training, the 2005 Base Realignment and Closure Commission recommended relocating basic and specialty enlisted medical training to a single site to take advantage of economies of scale and the opportunity for joint training. As a result, a joint medical education and training campus (METC) has been established at Fort Sam Houston, Texas. Two of METC's primary long-term goals are to become a high-performing learning organization and to seek accreditation as a (...) community college. Such goals require a clear model of organizational improvement with well-defined metrics for measuring its performance and using research and evaluation to assess and improve that performance. Lessons learned from a review of practices at institutions with similar missions -- such as community colleges, corporate universities, the UK's Defence Medical Education and Training Agency, and other federal agencies, such as the Veterans Health Administration -- establish a clear need for an office of institutional research to help METC attain its organizational goals. They also provide useful recommendations regarding the METC office's structure, scope, and governance. (shrink)

STS research has devoted relatively little attention to the promotion and reception of science and technology by non-scientific actors and institutions. One consequence is that the relationship of science and technology to political power has tended to remain undertheorized. This article aims to fill that gap by introducing the concept of sociotechnical imaginaries. Through a comparative examination of the development and regulation of nuclear power in the US and South Korea, the article demonstrates the analytic potential of the imaginaries concept. (...) Although nuclear power and nationhood have long been imagined together in both countries, the nature of those imaginations has remained strikingly different. In the US, the state’s central move was to present itself as a responsible regulator of a potentially runaway technology that demands effective containment. In South Korea, the dominant imaginary was of atoms for development which the state not only imported but incorporated into its scientific, technological and political practices. In turn, these disparate imaginaries have underwritten very different responses to a variety of nuclear shocks and challenges, such as Three Mile Island (TMI), Chernobyl, and the spread of the anti-nuclear movement. (shrink)

From Hippocrates to paternalism to autonomy : the new hegemony -- From autonomy to consent -- Consent, autonomy, and the law -- Autonomy at the end of life -- Autonomy and pregnancy -- Autonomy and genetic information -- Autonomy and organ transplantation -- Autonomy, consent, and the law.

Francisco de Vitoria offers a stimulating vision of moral cosmopolitanism that foreshadows the cosmopolitanism implicit in contemporary Catholic social teaching. After drawing a distinction between moral cosmopolitanism and political cosmopolitanism, this essay retrieves Vitoria’s cosmopolitan vision in his efforts to defend “the rights of the Indians” through concepts such as subjective rights, ius gentium, the right to travel, and the inherent human dignity of all people. Nonetheless, he opposes all claims of universal sovereignty. Vitoria thus appears as advocating moral but (...) not political cosmopolitanism, perhaps because his political imagination is shaped by monarchies, with their totalitarian tendencies, rather than by modern democracies. The final part of the essay explores how the distinction between different kinds of cosmopolitanism illuminates the variety of positions on the subject to be found in contemporary Catholic social teaching. (shrink)

The International Olympic Committee (IOC) has always been plagued by what queer theorist Judith Butler calls gender trouble. In 2000, the IOC discontinued their practice of sex-testing because medical experts could not agree on what defined a genetic female and so an adequate medical testing measure could not be found. In response to outside pressure, the IOC adopted a policy enabling transsexual athletes to compete in the 2004 Olympic Games. This article argues that the IOC policy on sex reassignment does (...) not operate to guard against discrimination and harassment against transsexual athletes but that it operates to maintain the popular illusion that there are two, binary gender designations. While both transsexual and Olympic bodies have unique histories and vastly different experiences in the social and political realms, using psychoanalysis we contend that the need to test gendered bodies is incited by an anxiety about bodily deterioration, aging, and, ultimately, mortality. (shrink)