Antimicrobial resistance is a major and increasing problem globally. Economics has engaged with this issue increasingly over the last 20 years. Much of this concerns assessments of the cost of various forms of resistance, but it also includes economic analyses of interventions and policies designed to contain resistance. Analysis has, however, thus far largely neglected possible distributional issues associated with such interventions and analysis. The article explores three normative bases for the conduct of economic analysis: welfarism; extra-welfarism focused on health (...) gain; and extra-welfarism focused on capability assessment. It then considers issues intrinsic to antimicrobial resistance in terms of the distributional implications and how these might be handled within economic analyses from each of the normative perspectives, before considering the actual focus of empirical studies on these distributional issues. The article concludes that the different normative starting points for economic analysis will affect how distributional issues are incorporated into analysis, but suggests that all analyses could benefit from greater discussion of these issues. (shrink)

Background There is broad international agreement from clinicians and academics that healthcare rationing should be undertaken as explicitly as possible, and the BMA have publicly supported the call for more accountable priority setting for some time. However, studies in the UK and elsewhere suggest that clinicians experience a number of barriers to rationing openly, and the information needs of patients at the point of provision are largely unknown. Methodology In-depth interviews were undertaken with NHS professionals working at the community level (...) of provision, and with patients and professionals receiving or providing treatment for morbid obesity and breast cancer (n=52). Results Nearly all patients wanted to know about healthcare rationing and had high expectations of their clinical professionals to provide all relevant information about treatment options. However, professionals did not always understand these information requirements, and cases of implicit rationing were common. The existence of relevant national guidance was not always known about, meaning that patients were often reliant on other sources of information about treatment options, which included the popular media, the internet, patient advocacy groups and informal networks of support. Discussion Clinical professionals need to understand patients' need for detailed information when it comes to rationing, and to understand that they are the main gateway for this to be provided. However, disclosure could be distressing for both patients and professionals, and thus the most sensitive and acceptable ways to make this information available requires further investigation. (shrink)

_Winner of the 2009 Goethe Award for Psychoanalytic Scholarship!_ Irwin Hirsch, author of _Coasting in the Countertransference,_ asserts that countertransference experience always has the potential to be used productively to benefit patients. However, he also observes that it is not unusual for analysts to 'coast' in their countertransferences, and to not use this experience to help treatment progress toward reaching patients' and analysts' stated analytic goals. He believes that it is quite common that analysts who have some conscious awareness of (...) a problematic aspect of countertransference participation, or of a mutual enactment, nevertheless do nothing to change that participation and to use their awareness to move the therapy forward. Instead, analysts may prefer to maintain what has developed into perhaps a mutually comfortable equilibrium in the treatment, possibly rationalizing that the patient is not yet ready to deal with any potential disruption that a more active use of countertransference might precipitate. This 'coasting' is emblematic of what Hirsch believes to be an ever present conflict between analysts’ self-interest and pursuit of comfortable equilibrium, and what may be ideal for patients’ achievement of analytic aims. The acknowledgment of the power of analysts’ self-interest further highlights the contemporary view of a truly two-person psychology conception of psychoanalytic praxis. Analysts’ embrace of their selfish pursuit of comfortable equilibrium reflects both an acknowledgment of the analyst as a flawed other, and a potential willingness to abandon elements of self-interest for the greater good of the therapeutic project. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:398 Feminist Studies 46, no. 2. © 2020 by Feminist Studies, Inc. Becky Thompson In the Slip Between Coasts Every morning the sea announces the day intimate crashing against the high stone wall we scan the waves for black dots floating becoming new moons and then arms waving rafts carrying the world Cartography in Greece after Zeina Hashem Beck’s “To Hamra” Here is the Oleander bush where a (...) family hid before their walk up the hill from Eftalou to Molyvos after eating eggs and croissants in my seaside room thirteen pairs of shoes lined up on the patio slate Here is seaweed beach where one raft landed in perched sea another behind carrying the elders and children Becky Thompson 399 stalled, taking in saltwater coast guard delayed in Petra sea ten, twenty, fifty minutes shouting and prayer finally a rescue exhaustion lining every pore They say memories fade, mine multiply, a cacophony tossing Here is the beach where the Syrian man strapping muscles and whimsical eyes gave me his salmon shirt with a finely made collar his friends ordered selfies called home saying yes began the climb to Mytilini defiant, alive There were moments of freedom jubilation in the air rest on the beach with dates and cool water children tossing stones into the sea lovers sitting close, feet in Europe cell phones that worked, telegraphing safety What does it mean to miss the intimacy of disaster? Now rescue teams mechanic pick-ups intercept rafts before shore whisk people away to Skala Sikamia then Moria no time to touch sand rest with the breeze Here is life jacket graveyard next to the dump perched between two hills above the seacoast 400 Becky Thompson a German couple toots up on a scooter taking photographs while eating nine-grain toast academics from the US talking postmodern flight a film crew from Barcelona picking through jackets amid ashes and twisted plastic crows memorize the wind as two garbage trucks trudge up the road bringing old fish and more jackets I wave at the sheepherder as I walk down the hill Save the people, bury the dead, photograph the remains, repeat Here is the hotel by the beach in Petra where children would run to the iron swing set let the arc carry them then jump off dance in the sprinklers the owner emerging mumbling generations handing us apricots and bottles of water Here is the computer store where the young Greek tells me he can’t copy my poems since he sees Arabic words menacing the page Here is my patience as I sit in his smoke ask him about his family and dancing Becky Thompson 401 eye his automatic weapon perched next to a wooden door Down the highway is a new bar next to Moria. Of course. Here is barbed wire that doubles as a fence a clothesline for diapers space to toss out rotten food Here is the highway lined with pickups and two-door sedans young Greek employment guarding people in tents Here is a baby carriage a young mother pushes that seconds as a grocery cart and shade for her five-year-old a step up from before when babies were in arms toddlers walking Here is the refugee people center where they built a strong swing set men lifting weights growing rings around their arms women stretching out in a new room eyeing the Lesvos sky Here are the streets of Mytilini looking like Beirut the Greeks who ran from Turkey the Turks who kicked out Afghans the Afghans who wish they were Syrian 402 Becky Thompson Syrians joined by Congolese— teachers, holy seers, and men selling hats. The sidewalk sparkles an atlas in transit.... (shrink)

In this study, Charles M. Sherover argues that there is a single, substantial line of development that can be traced from the work of Leibniz through Kant and Royce to Heidegger. Sherover traces a movement from deep within the roots of German idealism through Royce's insights into American pragmatism to the ethical ramifications of Heidegger's existential phenomenology, and then provides an analysis of the neglected ethical and political implications of Heidegger's Being and Time. The essays lead finally to Sherover's own (...) view of the self as a member of a moral and political community. Charles M. Sherover is Professor Emeritus of philosophy, Hunter College, City University of New York. He is the author of numerous books and articles, including Heidegger, Kant and Time and Time, Freedom and the Common Good. Gregory R. Johnson is Visiting Assistant Professor at the Pacific School of Religion. PRAISE FOR THE BOOK: "Sherover combines solid and original scholarship with well-argued conclusions of his own, seeking to lead us in the direction of a higher and fuller mode of authentic being in the world. This collection of essays is an excellent addition to the series, Studies in Philosophy and the History of Philosophy, edited by Jude P. Dougherty." -- Eugene Thomas Long, Review of Metaphysics. (shrink)

Most documented extinctions of vertebrates in the last 400 years have been island endemics. In this paper, we focus on the need to develop a historical framework to establish conservation priorities for insular faunas and, in particular, to test the validity of nominal endemics. We use the example of the islands of the North Pacific Coast of North America, a region that includes approximately one-half of all mammals endemic to North American islands north of Mexico. Few of these endemics have (...) been re-evaluated since their original descriptions, although many of these islands have been heavily impacted by habitat conversion, species introductions, over-exploitation, and secondary ripple effects. Evidence from molecular genetics and paleontology suggests that many taxa arrived in the region since the last glacial advance. Some of these nominal endemics show minimal differentiation, while others comprise multiple evolutionary lineages. The NPC may also have played an important role in the in situ diversification of some taxa during the Pleistocene. Evidence, such as new fossil discoveries and numerous described endemics, lends support for refugia hypotheses. However, these ideas cannot be tested until a better understanding of geographic variation and the evolutionary relationships of the fauna and flora of the North Pacific Coast is developed. This framework would provide significant insight into the dynamic biogeographic history of the region and help prioritize conservation efforts. (shrink)

Seventeenth-century natural-law philosophers participated in colonizing and slave-trading companies, yet they discussed slavery as an abstraction. This dispassionate approach is commonly explained with the “distance thesis” that the practice of slavery was at some remove from Northwest Europe. I contest the thesis, with a specific focus on pre-Restoration English discourse and Hobbes's political theory. By laying out the salient context — English experience of Barbary-coast slavery and an inherited neo-Roman intellectual frame — I argue, first, that slavery was hardly a (...) distant phenomenon and, second, that Hobbes's discussion of slavery expressed ideas familiar in ordinary discourse. The conclusion contrasts the English neo-Roman outlook with Spanish neo-Aristotelianism. (shrink)

Settler-colonialism is founded in environmental racism, and environmental justice is foundational to all forms of decolonialization. Native American groups located in the Gulf Coast Region of the United States are particularly vulnerable to environmental justice issues such as climate change and oil spills due to their geographic location and reliance on the coastal region for economic and social resources. This study used the framework of historical oppression, resilience, and transcendence to explore the historic and contemporary forms of environmental injustice experienced (...) by a Native American tribe in the Gulf Coast region of the United States. This critical ethnography analyzeda series of individual, family, and focus group semi-structured qualitative interviews with a total of 208 participants. Following the critical ethnographic method, data were interpreted through reconstructive analysis using NVivo. Findings of this study reveal the continuing impact of the BP oil spill and difficulty accessing resources following the spill, complicated by the tribe’s lack of federal recognition. Additional themes include the continuing impact of coastal erosion, historical and contemporary land loss, geographic marginalization, and concerns about a loss of tribal identity when tribal members are forced to relocate. Lack of federal tribal recognition has exacerbated all of these issues for this tribe. This study supports national findings that Native American groups experience extensive historic and contemporary environmental injustices and contextualizes these findings for a Native American tribe in the Gulf Coast region of the United States. Recognizing Native American sovereignty is key to addressing the environmental justice issues described. (shrink)

Background Stroke is a worldwide problem with a limited number of approved treatments. Obtaining informed consent for acute stroke therapy is complicated by the breadth of information that must be communicated in a short period of time, the hectic nature of the emergency environment, the possible lack of understanding by the patient and/or family, and the critically time-sensitive nature of treatment for stroke. Complicating matters even further, patients are often unable to consent for themselves, placing the burden on surrogates to (...) infer patients’ wishes regarding treatment, and potentially limiting acute treatment by practitioners. Innovation An advance directive for acute stroke therapy was created, entitled COAST (Coordinating Options for Acute Stroke Therapy). This clinical initiative is being piloted at a large comprehensive stroke center, including the development of the advance directive form, integration of the form with electronic medical records, training healthcare providers, and outreach to patients. Conclusions COAST is an advance directive for stroke designed to make stroke care more efficient, optimize patients’ autonomy, improve the quality of healthcare, and streamline the ethical management of complex care decisions in acute stroke. The inherent benefit of COAST is in providing patients and their families with more information regarding stroke and its treatment options, allowing them to take a more active role in their care. (shrink)

The ArgumentThis paper applies the approach developed by the congnitive sciences to a classical field of social anthropology—i.e., the analysis of represetations and behaviors relative to misfortune in “traditional” societies.The initial argument is that the conceptual division and the modes of description and explanation of anthropology suffer from serious weaknesses: these concepts cannot serve to understand empirical phenomena ; they rely on a confused and erroneous conception of the different domains involved and the causalities between them; and they use simplistic (...) hypotheses about the existence and causal status of the entities that usually form the ultima ratio of anthropological reasoning. These entities would directly “cause” other individual representations or behaviors. This simplification also affects the analysis of states of belief in these entities, to which individuals would supposedly “adhere”.I argue here that the cognitivist approach, within a “methodological individualism” framework, provides a more adequate description of phenomena observed in the field. This enables the various levels and domains to be more finely defined. The analysis of “typical” utterances and inferences in a “tranditional” society, the Senufo of the Ivory Coast, is here used to clarify these anthropological problems. Two levels can be distinguished: a priori representations, which are underdetermined, enabling them to occur within valid inferences; perception and/or action, which obeys different cognitive constraints. The existential status of unobservable entities appearing in causal inferences is not equivalent depending on whether they are determined as antecedent or consequent.This paper suggests a theory of interpretive processes and beliefs having flexible references, because they are incomplete and domain-specific. It allows a comparison with facts observed in Western societies. It is also in contrast to the ordinary conception of religious states of belief — i.e., these states would be purely psychological, states of “adherence,” collective, autonomous, obligatory, part of a systemized set of knowledge; collective notions would here logically precede individual representations. (shrink)

In 1978, treatment and vaccination programs were recommended to control bovine trypanosomiasis and brucellosis in Ivory Coast. A single trypanocidal treatment of young calves dramatically reduced their mortality rate. A preliminary demonstration project was carried out in a limited area by the government agency SODEPRA, followed by demonstrations on nearly all the farms. The costs were covered by SODEPRA as one of their development projects. Over a period of time the farmers took charge of the treatments, both financially and physically. (...) In 1992, the trypanocidal treatments were still widely used. The reasons for this success could be its dramatic efficacy, the simple technology employed, the low cost that was progressively charged to the farmers, and the fact that this was a long term extension project with continuous farmer training. The brucellosis control program started with an initial vaccination of 1 to 10 year old females followed by an annual vaccination of 1 to 2 year old heifers. One year later, a 37% reduction in the abortion rate was observed. The vaccination were paid for and carried out by SODEPRA. The control program then stopped but, because of growing problems with brucellosis, vaccinations started again in 1992. There is still a question of how vaccinations will be accepted when the farmers are required to share the cost for the control of a largely inconspicuous disease. (shrink)

We present a mathematical model of two competing marine species that are harvested. We consider three models according to different levels of complexity, without and with species refuge and density-independent and density-dependent species movement between fishing area and refuge. We particularly study the effects of the fishing pressure on the outcome of the competition. We focus on conditions that allow an inferior competitor to invade as a result of fishing pressure. The model is discussed in relationship to the case of (...) the thiof and the octopus along the Atlantic West African coast. At the origin, the thiof was abundant and the octopus scarce in that region. Since, the fishing pressure has strongly increased in some fishing areas leading to the depletion of the thiof and the invasion of its competitor, the octopus. (shrink)

In this paper, we present a deterministic time discrete mathematical model based on multiregional periodic matrices to describe the dynamics of Sardina pilchardus in the Central Atlantic area of the Moroccan coast. This model deals with two stages (immature and mature) and three spatial zones where sardines are supposed to migrate from one zone to another. The population dynamics is described by an autonomous recurrence equation N ( t + 1) = A . N ( t ), where A is (...) a positive matrix whose entries are estimated using data collected during biannual acoustic surveys carried out from 2001 to 2003 onboard the Norwegian research vessel “Dr Fridtjof Nansen”. The dominant eigenvalue λ of A that gives the long-term growth rate of fish population is smaller than one. This agrees with the stock decrease observed in the data collected. We show that λ is highly sensitive to the recruitment rate and much less sensitive to the reproduction rate. These results can clearly be used to define an efficient scenario in order to fight for instance against a stock decrease. (shrink)

Cet article se propose d’analyser une source de l’administration coloniale en Gold Coast au début des années 1930. Rédigée par un responsable du Département médical, elle évoque le mécontentement d’une puis de plusieurs femmes médecins britanniques, affectées à des postes de Protection maternelle et infantile, c’est-à-dire une branche préventive de la médecine, qui les assigne à des tâches de care. Insatisfaites à la fois de leurs conditions de travail et de leurs salaires, ces doctoresses protestent par voie de pétition contre (...) cette affectation systématique en PMI et défient ainsi le consensus de l’époque, qui veut que les femmes aient à la fois des compétences particulières et une vocation naturelle pour ce domaine. (shrink)

Since the introduction of photography by commercial studio photographers and the colonial state in Kenya, this global medium has been intensely debated and contested among Muslims on the cosmopolitan East African coast. This book does not only explore the making, circulation, and consumption of popular photographs, but also the other side, their rejection and obliteration, an essential aspect of a medium's history that should not be neglected. It deals with various »social spaces of refusal« in the local Muslim milieu and (...) in that of »traditional« spirit mediums in which visibility was contested in various and creative ways. It focuses on the »aesthetics of withdrawal«: the various ways and techniques that process the photographic act as well as the photographic image to theatricalize the surface of the image in new ways by veiling, masking, and concealing. In a fragmented historical perspective, Heike Behrend seeks to complement, decenter, and counter the history of photography as it has been told by the West and to narrate another history beginning with preceding local media such as textiles and spirit possession. (shrink)

When the Anglican Church Missionary Society started work on the East African coast in 1874 it had no intention of working among Muslims, nor did it mention Islam as a motivation for its desire to work with the people of the interior. This was due largely to the fact that members of the mission thought Islam in the region was stagnant and posed no threat to their work. As the organisation expanded inland, and as missionaries observed the Muslims of the (...) region, its attitudes and strategies towards Islam started to change. This article explores the reasons for these changes and discusses the early relations between missionaries and Muslims. (shrink)

In this paper, we present a deterministic time discrete mathematical model based on multiregional periodic matrices to describe the dynamics of Sardina pilchardus in the Central Atlantic area of the Moroccan coast. This model deals with two stages (immature and mature) and three spatial zones where sardines are supposed to migrate from one zone to another. The population dynamics is described by an autonomous recurrence equation N(t + 1) = A.N(t), where A is a positive matrix whose entries are estimated (...) using data collected during biannual acoustic surveys carried out from 2001 to 2003 onboard the Norwegian research vessel “Dr Fridtjof Nansen”. The dominant eigenvalue λ of A that gives the long-term growth rate of fish population is smaller than one. This agrees with the stock decrease observed in the data collected. We show that λ is highly sensitive to the recruitment rate and much less sensitive to the reproduction rate. These results can clearly be used to define an efficient scenario in order to fight for instance against a stock decrease. (shrink)

Coastal environments are increasingly shown to have a positive effect on our health and well-being. Various mechanisms have been suggested to explain this effect. However, so far little focus has been devoted to emotions that might be relevant in this context, especially for people who are directly or indirectly exposed to the coast on a daily basis. Our preregistered qualitative study explored how coastal residents experience the emotions they feel at the coast and how they interpret the effect these emotions (...) have on them. We conducted semi-structured interviews with a purposive sample of eight Belgian coastal residents aged 21–25 years old. The interviews were analyzed with the approach of interpretative phenomenological analysis. Five superordinate themes were identified and indicate that, for our participants, the coast represents a safe haven in which they can experience emotional restoration, awe, and nostalgia. These emotional states are accompanied with adaptive emotion regulating strategies, such as reflection and positive reappraisal, that may facilitate coping with difficult thoughts and feelings. Our study demonstrates the importance of investigating specific emotions and related processes triggered at the coast and how these could contribute to the therapeutic value of the coast. (shrink)

How did one group of indigenous societies, on the Northwest Coast of North America, manage to live sustainably with their ecosystems for over two thousand years? Can the answer to this question inform the current debate about sustainability in today’s social ecological systems? The answer to the first question involves identification of the key institutions that characterized those societies. It also involves explaining why these institutions, through their interactions with each other and with the non-human components, provided both sustainability and (...) its necessary corollary, resilience. Answering the second question involves investigating ways in which key features of today’s social ecological systems can be changed to move toward sustainability, using some of the rules that proved successful on the Northwest Coast of North America. Ronald L. Trosper shows how human systems connect environmental ethics and sustainable ecological practices through institutions. (shrink)

Genetically modified cassava is currently being developed to address problems of diseases that threaten the food security of farmers in developing countries. The technologies are aimed at smallholder farmers, in hopes of reducing the vulnerability of cassava production to these diseases. In this paper we examine barriers to farmers’ voice in the development of GM cassava. We also examine the role of a translational research process to enhance farmers’ voice, to understand the sources of vulnerability farmers in a group in (...) Kenya’s Coast face, and to determine if their concerns are consistent with those of the scientists in agriculture addressing farmers’ needs. A two-way communication participatory process provided insights into the complex vulnerability context of farmers, their primary concerns with processing and markets of cassava in order to improve livelihoods, the lack of networks with two way communication flows, and the lack of information on GM technologies. The translational research engaged farmers and scientists in an iterative process where scientists are learning what farmers need, and farmers are learning about the potential benefits and risks from GM technologies, while at the same time expressing their concerns. (shrink)

Conscience plays a crucial role in identifying, applying, and initiating actions chosen as right or wrong. In this paper, we pursue an answer to the question, Can bad conscience, as Nietzsche defines it, be overcome to form the ground for the creation of good conscience? Nietzsche identifies Christianity as the source of that which has to be overcome to help re-define human existence--overcoming self-destructive, bad conscience. To understand whether someone could (or even should) overcome and redefine his or her existence, (...) that is create good conscience like Nietzsche's Ubermensch, it is useful to consider the struggles of Allie Fox, the hero in Peter Weir's movie Mosquito Coast (1986). (shrink)

This is a compilation of papers presented at the Seventeenth Annual Meeting of the West Coast Conference on Formal Linguistics, held February 20-22, 1998 in Vancouver, Canada, hosted by the University of British Columbia Department of Linguistics. The conference drew a large number of participants, from around the world. The fifty papers in this volume address theoretical issues in Syntax, Phonology, the Syntax-Semantics and Syntax-Phonology interfaces, and Language Acquisition, and provide an exciting view of current theory in these areas.

Refrigeration has become so well established over the last 125 years that today a crude ice maker becomes a boon for primitive people in the jungle or desert. Only a total dislocation in energy sources will quickly loosen the connections between people and cooling. A few centuries ago, Hippocrates observed: ‘most men would rather run the hazards of their lives or health than be deprived of the pleasure of drinking out of ice’ … In the U.S.A. [today], 750 million frozen (...) Eskimo Pies are sold annually and seven ice cream plants are said to be operating in Moscow … Like the men of Hippocrates, a lot of people will resist any curtailment in food and freezing operations. They have come to expect these for survival in our present social and industrial orders.These remarks, asserting the extent to which the people of the United States of America regarded refrigeration not as an optional luxury but as a necessity for survival even at the height of the energy crisis of the late 1970s, formed part of a contribution to a massive 11-volume international compendium, Alternative Energy Sources, produced in 1978 in response to Western concerns about rising oil prices and falling reserves. An enthusiastic advocate for geothermal energy, the contributor's perception provides a vivid contextual starting point for our study of Paul Theroux's novel The Mosquito Coast . In this novel the central narrative focuses upon a New England family's rejection of post-war American consumer society with its imperative to ‘build automobiles that would fail within five years and refrigerators that would fail in ten’. The novel indeed explores some of those very kinds of alternative energy sources which had been exciting scientists and inventors since the early 1970s when journals such as The Ecologist had begun to prophesy an end to energy-driven economic growth in the western world. (shrink)

Benefit sharing in health research has been the focus of international debates for many years, particularly in developing countries. Whilst increasing attention is being given to frameworks that can guide researchers to determine levels of benefits to participants, there is little empirical research from developing countries on the practical application of these frameworks, including in situations of extreme poverty and vulnerability. In addition, the voices of those who often negotiate and face issues related to benefits in practice - frontline researchers (...) and fieldworkers - are rarely included in these debates. Against this background, this paper reports on experiences of negotiating research participation and benefits as described by fieldworkers, research participants and researchers in two community based studies. (shrink)

According to Hubert L. Dreyfus, Heidegger's central innovation is his rejection of the idea that intentional activity and directedness is always and only a matter of having representational mental states. This paper examines the central passages to which Dreyfus appeals in order to motivate this claim. It shows that Dreyfus misconstrues these passages significantly and that he has no grounds for reading Heidegger as anticipating contemporary anti-representationalism in the philosophy of mind. The misunderstanding derives from lack of sensitivity to Heidegger's (...) own intellectual context. The otherwise laudable strategy of reading Heidegger as a philosopher of mind becomes an exercise in finding a niche for Heidegger in Dreyfus's own unquestioned present. Heidegger is thereby mapped on to an intellectual context which, given its naturalistic commitments, is foreign to him. The paper concludes by indicating the direction in which a more historically sensitive, and thus accurate, interpretation of Heidegger must move. (shrink)

First Published in 1968. Routledge is an imprint of Taylor & Francis, an informa company.