The essays collected together in this volume, many of them written by leading scholars in the field, explore the commonsensical fact that our presence as..

This paper analyses how security affects well-being. Security is understood as someone’s sureness of enjoying some good in the future; well-being is treated as a matter of human flourishing. Security can contribute to our well-being in various ways: if we are in fact bound to enjoy a good, in principle this is positive for our flourishing in the future; if we also believe that we will enjoy this good, we can be more efficient in pursuing our well-being; if we also (...) feel secure, this supports our enjoyment of our physical and mental capacities. For some of these benefits to obtain fully, however, it is important that our beliefs and feelings align with the facts. Furthermore, mirroring security’s upsides, there are also ways in which security can hamper our flourishing: it can obstruct the change, surprise, and pleasurable fear that are sometimes required for a good life too. (shrink)

The transition towards sustainable and just food systems is ongoing, illustrated by an increasing number of initiatives that try to address unsustainable practices and social injustices. Insights are needed into what a just transition entails in order to critically engage with plural and potentially conflicting justice conceptualisations. Researchers play an active role in food system transitions, but it is unclear which conceptualisations and principles of justice they enact when writing about food system initiatives. To fill this gap this paper investigates: (...) Which conceptualisations of justice emerge from the literature related to food system initiatives and which principles of justice do authors use? We developed an initial framework for which we drew on political philosophy literature. We then undertook an extensive review of the food system transitions literature using this framework and were able to identify a range of recognition, distributive, and procedural justice conceptualisations and associated principles of justice. Recognised as subjects of justice were those with a particular role in the food system, people who are marginalised, Indigenous communities, those with experiences of negative consequences of the food system, future generations, and nonhumans. The identified conceptualisations and the developed framework can be used by those involved in food system initiatives to reflect on how they conceptualise justice. We challenge them to be more explicit about who they do and do not recognise as subjects of justice and which principles of justice they use. Such clarity is needed to reflexively enact a just transition towards sustainable and just food systems. (shrink)

The interaction between cavity modes and optical transitions leads to new coupled light-matter states in which the energy is periodically exchanged between the matter states and the optical mode. Here we present experimental evidence of optical strong coupling between modes of individual sub-wavelength metamaterial nanocavities and engineered optical transitions in semiconductor heterostructures. We show that this behaviour is generic by extending the results from the mid-infrared to the near-infrared. Using mid-infrared structures, we demonstrate that the light-matter coupling occurs at the (...) single resonator level and with extremely small interaction volumes. We calculate a mode volume of 4.9 × 10 from which we infer that only ~2,400 electrons per resonator participate in this energy exchange process. (shrink)

Recent studies showing that pontine burst cells carry a monocular code for rapid eye movements raise questions about the organisation of signals at more central levels. Evidence that the superior colliculus may also be involved in the coding of movements in depth is reviewed. Recent work showing that the global effect is a property of refixations in 3-D space is another indication that the oculomotor systems for direction and depth are centrally coupled.

The era of ‘big data’ studies and computational social science has recently given rise to a number of realignments within and beyond the social sciences, where otherwise distinct data formats – digital, numerical, ethnographic, visual, etc. – rub off and emerge from one another in new ways. This article chronicles the collaboration between a team of anthropologists and sociologists, who worked together for one week in an experimental attempt to combine ‘big’ transactional and ‘small’ ethnographic data formats. Our collaboration is (...) part of a larger cross-disciplinary project carried out at the Danish Technical University, where high-resolution transactional data from smartphones allows for recordings of social networks amongst a freshman class. With a parallel deployment of ethnographic fieldwork among the DTU students, this research set-up raises a number of questions concerning how to assemble disparate ‘data-worlds’ and to what epistemological and political effects? To address these questions, a specific social event – a lively student party – was singled out from the broader DTU dataset. Our experimental collaboration used recordings of Bluetooth signals between students’ phones to visualize the ebb and flow of social intensities at the DTU party, juxtaposing these with ethnographic field-notes on shifting party atmospheres. Tracing and reflecting on the process of combining heterogeneous data, the article offers a concrete case of how a ‘stitching together’ of digital and ethnographic data-worlds might take place. (shrink)

A self-fulfilling prophecy in neuroprognostication occurs when a patient in coma is predicted to have a poor outcome, and life-sustaining treatment is withdrawn on the basis of that prediction, thus directly bringing about a poor outcome for that patient. In contrast to the predominant emphasis in the bioethics literature, we look beyond the moral issues raised by the possibility that an erroneous prediction might lead to the death of a patient who otherwise would have lived. Instead, we focus on the (...) problematic epistemic consequences of neuroprognostic SFPs in settings where research and practice intersect. When this sort of SFP occurs, the problem is that physicians and researchers are never in a position to notice whether their original prognosis was correct or incorrect, since the patient dies anyway. Thus, SFPs keep us from discerning false positives from true positives, inhibiting proper assessment of novel prognostic tests. This epistemic problem of SFPs thus impedes learning, but ethical obligations of patient care make it difficult to avoid SFPs. We then show how the impediment to catching false positive indicators of poor outcome distorts research on novel techniques for neuroprognostication, allowing biases to persist in prognostic tests. We finally highlight a particular risk that a precautionary bias towards early withdrawal of life-sustaining treatment may be amplified. We conclude with guidelines about how researchers can mitigate the epistemic problems of SFPs, to achieve more responsible innovation of neuroprognostication for patients in coma. (shrink)

Introduction: In The Netherlands, physicians have to be convinced that the patient suffers unbearably and hopelessly before granting a request for euthanasia. The extent to which general practitioners (GPs), consulted physicians and members of the euthanasia review committees judge this criterion similarly was evaluated. Methods: 300 GPs, 150 consultants and 27 members of review committees were sent a questionnaire with patient descriptions. Besides a “standard case” of a patient with physical suffering and limited life expectancy, the descriptions included cases in (...) which the request was mainly rooted in psychosocial or existential suffering, such as fear of future suffering or dependency. For each case, respondents were asked whether they recognised the case from their own practice and whether they considered the suffering to be unbearable. Results: The cases were recognisable for almost all respondents. For the “standard case” nearly all respondents were convinced that the patient suffered unbearably. For the other cases, GPs thought the suffering was unbearable less often (2–49%) than consultants (25–79%) and members of the euthanasia review committees (24–88%). In each group, the suffering of patients with early dementia and patients who were “tired of living” was least often considered to be unbearable. Conclusions: When non-physical aspects of suffering are central in a euthanasia request, there is variance between and within GPs, consultants and members of the euthanasia committees in their judgement of the patient’s suffering. Possible explanations could be differences in their roles in the decision-making process, differences in experience with evaluating a euthanasia request, or differences in views regarding the permissibility of euthanasia. (shrink)

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

Researchers are increasingly applying neuroscience technologies that probe or manipulate the brain to improve educational outcomes. However, their use remains fraught with ethical controversies. Here, we investigate the acceptability of neuroscience applications to educational practice in two groups of young adults: those studying bioscience who will be driving future basic neuroscience research and technology transfer, and those studying education who will be choosing among neuroscience-derived applications for their students. Respondents rated the acceptability of six scenarios describing neuroscience applications to education (...) spanning multiple methodologies, from neuroimaging to neuroactive drugs to brain stimulation. They did so from two perspectives (student, teacher) and for three recipient populations (low-achieving, high-achieving students, students with learning disabilities). Overall, the biosciences students were more favorable to all neuroscience applications than the education students. Scenarios that measured brain activity (i.e., EEG or fMRI) to assess or predict intellectual abilities were deemed more acceptable than manipulations of mental activity by drug use or stimulation techniques, which may violate body integrity. Enhancement up to the norm for low-achieving students and especially students with learning disabilities was more favorably viewed than enhancement beyond the norm for high-achieving students. Finally, respondents rated neuroscientific applications to be less acceptable when adopting the perspective of a teacher than that of a student. Future studies should go beyond the acceptability ratings collected here to delineate the role that concepts of access, equity, authenticity, agency and personal choice play in guiding respondents’ reasoning. (shrink)