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

This study examines the outcomes of a four-year faculty learning community (FLC) that aimed to transform departmental ethics curriculum by supporting Earth Sciences faculty members as they ethically inquired into their teaching of ethics and refined existing courses in alignment with an Integrated Community-Engaged Learning and Ethical Reflection (ICELER) framework. We present ethnographic case studies that unpack processes through which three faculty members transformed undergraduate courses. We assembled case studies by triangulating interview data, course artifacts, and faculty reflections. We examine (...) how faculty (1) built awareness around teaching ethics, (2) took responsibility for and made judgments about teaching ethics, (3) experimented by designing and implementing ICELER-inspired courses, and (4) interrogated the outcomes of their ethics teaching, utilizing findings to enhance awareness and revise courses. The paper closes by introducing a model detailing how instructors inquire into ethics teaching and how model components might inspire future educational practice and research. (shrink)

Genic selectionists (Williams 1966; Dawkins 1976) defend the view that genes are the (unique) units of selection and that all evolutionary events can be adequately represented at the genic level. Pluralistic genic selectionists (Sterelny and Kitcher 1988; Waters 1991; Dawkins 1982) defend the weaker view that in many cases there are multiple equally adequate accounts of evolutionary events, but that always among the set of equally adequate representations will be one at the genic level. We describe a range of cases (...) all involving stable equilibria actively maintained by selection. In these cases genotypic models correctly show that selection is active at the equilibrium point. In contrast, the genic models have selection disappearing at equilibrium. For deterministic models this difference makes no difference. However, once drift is added in, the two sets of models diverge in their predicted evolutionary trajectories. Thus, contrary to received wisdom on this matter, the two sets of models are not empirically equivalent. Moreover, the genic models get the facts wrong. (shrink)

Progressives have advocated reforms of rules governing corporations to achieve greater distributive justice, but Maitland (2001) hasargued that corporate rules are distributively neutral and that changing the rules will have no long run impact on distributive justice. These different conclusions stem from the use of two different methods of economic analysis, partial equilibrium and general equilibrium models. A change in the rules governing corporations in a “large” sector of the economy is appropriately analyzed using a general equilibrium analysis, supporting the (...) conclusion that changes in the rules may affect distributive justice in the long run. However, a partial equilibrium analysis of a change in the rules of corporations affecting a “small” part of the economy such as asingle firm or even all firms in a small state supports the claim that such changes cannot affect distributive justice. (shrink)

Medical decision making often utilizes subjective observations to arrive at concrete judgments. The decisions frequently affect who receives scarce medical treatments and, thus, who lives or dies. In this paper, a model health status index is described. It is specific for the problem of choosing patients for hemodialysis or transplantation. Such a health status index may be designed for any medical decision involving such issues as drug treatment priorities, identification of salvageable patients, and selection of patients for scarce medical treatment. (...) This index (1) incorporates a physician''s own medical criteria and values, (2) can be modified as the data base improves, (3) assures consistency from decision to decision, and (4) can be developed and used without the help of a mathematician or computer. (shrink)