Smoker, Barbara 'Why is there something rather than nothing?' This question is often pressed by modern Christian theologians - especially, in my experience, the Catholic Dominicans - although it was a secular mathematician, Leibniz, who first framed it, three centuries ago.

Smoker, Barbara The late Mohammed Emwazi greatly enjoyed his hobby, which was beheading people. Any infidel would do, though the people he really loathed were naturally former Muslims, guilty of apostasy.

IntroductionCognition generally declines gradually over time due to progressive degeneration of the brain, leading to dementia and eventual loss of independent functions. The rate of regression varies among the six cognitive domains. Current modality of cognitive assessment using neuropsychological paper-and-pencil screening tools for cognitive impairment such as the Montreal Cognitive Assessment has limitations and is influenced by age. Virtual reality is considered as a potential alternative tool to assess cognition. A novel, fully immersive automated VR system has been developed to (...) assess the six cognitive domains. As cognition is associated with age, VR performance is postulated to vary with age using this system.AimsThis is a feasibility study to evaluate the VR performance of cognitively healthy adults aged between 35 and 74 years old, based on the performance score and completion time using the CAVIRE system.MethodsConducted in a public primary care clinic in Singapore, 25 multi-ethnic Asian adults were recruited in each of the four age groups in years: 35–44; 45–54; 55–64, and 65–74. The eligibility criteria included a MoCA score of 26 or higher to reflect normal cognition and understanding English instructions. They completed common daily activities ranging from brushing teething to shopping, across 13 VR segments. Their performances scores and completion time were automatically computed by the CAVIRE system. These VR performance indices were compared across the four age groups using one-way ANOVA, F-test of the hypothesis, followed by pair-wise comparisons in the event of a significant F-test.ResultsOne participant dropped out from Group 1. The demographic characteristics of 99 participants were similar across the 4 age groups. Overall, younger participants in Groups 1 and 2 attained higher VR performance scores and shorter completion time, compared to those in Groups 3 and 4, in all six cognitive domains.ConclusionThe CAVIRE VR performance scores and completion time significantly differ between the younger and older Asian participants with normal cognition. Enhancements to the system are needed to establish the age-group specific normal performance indices. (shrink)

This study examines truthfulness through eight dimensions to explicate truth in health communication and explores the relationships between message truthfulness and message attributes and audience characteristics. A content analysis of 974 television antismoking ads from the Centers for Disease Control (CDC) reveals a high degree of truthfulness. Message truthfulness is related to thematic frames, emotion appeals, source, age, social role and smoking status, and positive framing of consequences. Ads targeted at teens/youth and smokers tend to have lower message truthfulness (...) than ads targeting older age groups and non-smokers. Ads with humor and fear appeals are found to be less truthful. (shrink)

The question whether rights to health care should be altered by smoking behaviour involves wideranging implications for all who indulge in hazardous behaviours, and involves complex economic utilitarian arguments. This paper examines current debate in the UK and suggest the major significance of the controversy has been ignored. That this discussion exists at all implies increasing division over the scope and purpose of a nationalised health service, bestowing health rights on all. When individuals bear the cost of their own health (...) care, they appear to take responsibility for health implications of personal behaviour, but when the state bears the cost, moral obligations of the community and its doctors to care for those who do not value health are called into question. The debate has far-reaching implications as ethical problems of smokers' rights to health care are common to situations where health as a value comes into conflict with other values, such as pleasure or wealth. (shrink)

Julian Le Grand's case for saying that it would be equitable if smokers and smokers alone were to pay the costs of smoking-related health care is considered and found to be deficient.

In this paper I propose an approach to decision theory that I call metanormativism, where the key idea is that decision theory should take into account decision-theoretic uncertainty. I don’t attempt to argue in favor of this view, though I briefly offer some motivation for it. Instead, I argue that if the view is correct, it has important implications for the causal versus evidential decision-theory debate. First, it allows us to make rational sense of our seemingly divergent intuitions across the (...) Smoking Lesion and The Psychopath Button cases. Second, it generates strong new arguments for preferring the causal approach to decision-theory over the evidential approach. (shrink)

This article explores gender inequities and sexual double standards in teens’ digital image exchange, drawing on a UK qualitative research project on youth ‘sexting’. We develop a critique of ‘postfeminist’ media cultures, suggesting teen ‘sexting’ presents specific age and gender related contradictions: teen girls are called upon to produce particular forms of ‘sexy’ self display, yet face legal repercussions, moral condemnation and ‘slut shaming’ when they do so. We examine the production/circulation of gendered value and sexual morality via (...) teens’ discussions of activities on Facebook and Blackberry. For instance, some boys accumulated ‘ratings’ by possessing and exchanging images of girls’ breasts, which operated as a form of currency and value. Girls, in contrast, largely discussed the taking, sharing or posting of such images as risky, potentially inciting blame and shame around sexual reputation (e.g. being called ‘slut’, ‘slag’ or ‘sket’). The daily negotiations of these new digitally mediated, heterosexualised, classed and raced norms of performing teen feminine and masculine desirability are considered. (shrink)

This case study attempts to frame the ethical considerations between hiring a known smoker over a non-smoker in today’s cultural climate. Referenced data from a parallel project gauging the likelihood of Human Resources representatives to hire smokers and accommodate them in the workforce could help manage the response and critical thinking components of the case scenario. Questions also arise as to whether it is advisable for employers to take particular attitudes toward smoking in the workplace. This is not only (...) in the interest of the health of employees, customers and clients, but is also on the basis of a concern that employers may otherwise expose themselves to lawsuits where employees may, on the basis of illness contracted due to a smoking environment supported by an employer, sue for the costs of care and income. (shrink)

In the United States, low-income or minority populations tend toward earlier births than the more advantaged. In disadvantaged populations, one factor that may exert pressure toward early births is “weathering,” or pervasive health uncertainty. Are subjective perceptions of health related to fertility timing? Drawing on a small sample of intensive interviews with teenage mothers-to-be, I suggest that low-income African American teenagers may expect uncertain health and short lifespans. Where family economies and caretaking systems are based on kin networks, such perceptions (...) may influence the decision to become a young mother. Heuristic typologies of ways socially situated knowledge may contribute to the reproduction of fertility timing practices contrast the experiences of poor African American interviewees, working class white interviewees, and middle-class teens who typically postpone childbearing. (shrink)

Over the last ten years the sharing of nude images or videos (sometimes known as “sexting”) by young people has emerged as a concern. Despite this, no research had been conducted on the prevalence of the sharing of nudes among young New Zealanders. This study addresses this and raises important questions for all those with a role in supporting young people’s healthy development. We believe this report makes an important contribution to the overall understanding of young people’s experience of these (...) behaviours. However, it only provides a snapshot, and more work is required to understand how best to support young people as they navigate the challenges and potential risks. This report is being released as part of a larger project exploring young people’s experiences of digital risk and harm, carried out by a partnership between Netsafe and the Ministry for Women. (shrink)

In the United Kingdom, a number of National Health Service Clinical Commissioning Groups have proposed controversial measures to restrict elective surgery for patients who either smoke or are obese. Whilst the nature of these measures varies between NHS authorities, typically, patients above a certain Body Mass Index and smokers are required to lose weight and quit smoking prior to being considered eligible for elective surgery. Patients will be supported and monitored throughout this mandatory period to ensure their clinical needs (...) are appropriately met. Controversy regarding such measures has primarily centred on the perceived unfairness of targeting certain health states and lifestyle choices to save public money. Concerns have also been raised in response to rhetoric from certain NHS authorities, which may be taken to imply that such measures punitively hold people responsible for behaviours affecting their health states, or simply for being in a particular health state. In this paper, we examine the various elective surgery rationing measures presented by NHS authorities. We argue that, where obesity and smoking have significant implications for elective surgical outcomes, bearing on effectiveness, the rationing of this surgery can be justified on prognostic grounds. It is permissible to aim to maximise the benefit provided by limited resources, especially for interventions that are not urgently required. However, we identify gaps in the empirical evidence needed to conclusively demonstrate these prognostic grounds, particularly for obese patients. Furthermore, we argue that appeals to personal responsibility, both in the prospective and retrospective sense, are insufficient in justifying this particular policy. Given the strength of an alternative justification grounded in clinical effectiveness, rhetoric from NHS authorities should avoid explicit statements, which suggest that personal responsibility is the key justificatory basis of proposed rationing measures. (shrink)

Andy Egan's Smoking Lesion and Psycho Button cases are supposed to be counterexamples to Causal Decision Theory. This paper argues that they are not: more precisely, it argues that if CDT makes the right call in Newcomb's problem then it makes the right call in Egan cases too.

Do people who cause themselves to be ill (e.g. by smoking) forfeit some of their rights to healthcare? This paper examines one argument for the view that they do, the restoration argument. It goes as follows. Smokers need more health‐resources than non‐smokers. Given limited budgets, we must choose between treating everyone equally (according to need) or reducing smokers' entitlements. If we choose the former, non‐smokers will be harmed by others' smoking, because there will be less resources (...) available for them than if no‐one smoked. This is unfair: why should non‐smokers suffer because of others' unhealthy lifestyle choices? We should therefore choose the latter and reduce smokers' entitlements. This paper criticises the restoration argument on the following grounds. In order to avoid generating unpalatable conclusions elsewhere, it must be combined with a principle according to which activities which are sufficiently ‘socially valuable’ (e.g. parenting) are immune from restoration claims. This however means that what was supposed to be one of the argument's most attractive features, its compatibility with ‘liberal neutrality’ with respect to the value of different lifestyles, doesn't really exist. Hence, the restoration argument is nowhere near as attractive as it at first appears to be. (shrink)

Paternalist policies in public health often aim to improve people’s well-being by reducing their options, regulating smoking offering a prime example. The well-being challenge is to show that people really are better off for having their options reduced. The distribution challenge is to show how the policies are justified since they produce losers as well as winners. If we start from these challenges, we can understand the importance of the empirical evidence that a very high proportion of smokers regret (...) smoking. In short, it is important that they regret it and important that the proportion is so high. This paper explains how, philosophically, regret can relate to well-being and it considers some of the strengths and weakness in the empirical research that the explanation brings out. The regret case for regulating smoking is indeed strong, although not as strong as the empirical researchers think. It is much weaker for paternalistic intervention in other public health problems, such as obesity and binge drinking. (shrink)

To investigate whether Swedish physicians, contrary to Swedish health care policy, employ considerations of patient responsibility for illness when rationing expensive treatments.

Drawing on in-depth interviews, I analyze how teen fathers talk about the responsibility for having a baby at a young age. In addition to negotiating the stigma often associated with teen pregnancy, teen fathers also confront stereotypes that label them as selfish and uncaring. In telling their stories of “what happened,” they utilize three gendered discourses to deny responsibility for the pregnancy: the feminization of birth control, a discourse of uncontrollable male sexual desire, and love. Their narratives (...) also reveal the ways in which gendered norms can solve some problems while creating others. Aligning themselves with certain notions of masculinity can serve as a resource for denying responsibility for the pregnancy while also signifying their manhood, but these same discourses are also constraining in that they reinforce stereotypes of teen fathers as selfish, even predatory. While these approaches may allow teen fathers to claim masculine identities, they also stigmatize them as the wrong kind of men. In short, teen fathers are not only negotiating the potential stigma of teen pregnancy, they are also negotiating their identities as men. (shrink)

This article focuses on the representation of youth as a key moment of transition in contemporary western societies, set between the dependent state of childhood and the supposed maturity and independence of adult status. Young people are viewed as gendered, racialized and sexualized beings who also occupy specific class locations, and are assumed to move through crucial points of transition as they leave full-time education and enter the job market, as well as the (hetero)sexual and marriage marketplaces. The article examines (...) some of the main discursive configurations and treatment regimes through which ‘troubled teens’ are constructed and managed, especially in relation to notions about disordered patterns of consumption and transition. The paper considers the moment of the ‘discovery’ of adolescence in the late nineteenth century, going on to examine young women's particular relationships to discourses around consumption in the contemporary British youth research literature, and to debates about ‘disrupted transitions’ and citizenship in the 1990s. The article ends with a brief examination of one approach to the ‘problem of troubled teens’ in the USA: Specialty Schools that offer a combination of educational, therapeutic and correctional regimes aimed at young people who have been identified in relation to various disorders of transition and consumption. (shrink)

Why be good -- Laws and legalisms -- Moral actor, moral acts -- Paths of glory : virtues -- Moral heroes.

Should tobacco be banned? The answer depends largely on two further questions. How much are smokers benefitted by being made to stop, or to not start? And what is the moral cost of their being made to stop by their government, as opposed to stopping due to the influence of policies that fall short of coercion? Grill and Voigt provide one answer to the first question. They argue that the benefits of cessation are high enough to justify a ban (...) on tobacco products.1 I partly agree: I share their view that the harms of tobacco consumption are great enough to justify at least some policies that force (rather than merely encourage) people to not smoke.i But the differences between policies of this sort are large enough that any general conclusion in favour of ‘a ban’ is incomplete.ii By not elaborating on what a ban might come to, Grill and Voigt leave the second question rather unaddressed. Of course, the authors hardly mean to say that anything goes when it comes to forming policies that force people to not smoke. Nevertheless, it is appropriate to build on their defence of the benefits of forced cessation by comparing different sorts of bans, and by comparing bans with other sorts of coercive policies. I will pick up, therefore, where they leave off: granting that a ban's effects on well-being would be overall positive, a principal moral cost of a ban can be measured in terms of its infringement of smokers’ autonomy. Comparisons, then, can be sought in terms of how different policies infringe autonomy in different ways. What exactly might it mean, however, to speak of smokers’ autonomy? According to Grill and Voigt, autonomy should be thought of as a sort of ‘self-direction’ which obtains given ‘the absence of external …. (shrink)

The aim of the study was to examine the role of self-esteem in resisting the influence of materialistic goals of four social role models in adolescents. Previous studies showed a negative correlation between the psychological health of teens and striving for materialistic goals, one of the main sources is the social modeling of materialism. Two studies were carried out. The first, correlational study, was conducted on target teens and their mothers, fathers, and peers of their choice. It examined if self-esteem (...) is a moderator of the relationship between the materialism of social role models and the materialism of teens. The second, experimental study, was conducted on target teens only. It examined how boosting the self-esteem of teens and activating materialism of social role models may affect the materialism of teens. Study 1 showed a significant interaction effect of self-esteem and the materialism of peers on the materialism of teens. The interaction effects of self-esteem and other role models were not significant. Study 2 showed that elevated self-esteem lowered the influence of the materialism of peers on the materialism of teens. The results were not significant when other role models were analyzed. The results obtained in the presented studies indicate that the self-esteem of teens may have an important role in resisting the influence of materialism role models of peers. Practical implications of the studies for the psychological health of teens are also discussed. (shrink)

Introduces teens to the benefits of working with and caring for animals, and includes personal experiences of teens who have become involved with animals in a ...

Teens' experiences with reproductive health care have been ignored by both the “social problems” moral discourse on teen pregnancy and feminist critiques of medicalization. These perspectives are both gendered and racialized in ways that marginalize African American teen mothers. Interview data with 51 poor African American teen mothers suggest that their reproductive experiences occur within very different contexts than those that have inspired feminist criticisms of medicalization. Before their pregnancies, teens are largely denied access to formal health (...) care services and reproductive information and knowledge, and once pregnant, like adult women, they alternately embrace and resist specific aspects of medical care. Their perspectives provide insights into women's experiences with the formal medical system from an understudied social location, and their narratives expand our understanding of how women's and girls' sexuality is socially constructed as problematic and managed, controlled, and regulated in particular ways depending on their social locations. (shrink)

Zika infection in pregnant women is associated with an elevated probability of giving birth to a child with microcephaly and multiple other disabilities. Public health messaging on Zika prevention has predominantly targeted women who know they are pregnant or intend to become pregnant, but not teenage females for whom unintended pregnancy is more likely. Vulnerabilities among this population to reproductive risks associated with Zika are further amplified by restrictive abortion laws in several Zika-impacted states. Key to prevention is enhanced, targeted (...) public health messaging centered on teens nationally and particularly in certain high-risk regions. (shrink)

Through the analysis of the contents of the most recent and popular teen dramas, of the diffusion of online pornography and of data from surveys on adolescent sexuality, we hypothesise how today's adolescents live an increasingly carefree sexual behaviour with respect to the choice of sexual objects, more free from ethical and social norms, in a completely changed relationship with an adult world no longer seen as a more or less controversial reference point. This panorama urges us to renew (...) the theoretical lenses through which we look at an adolescence that is completely different from previous ones with regard to its relationship with sexuality. (shrink)