Quality improvement (QI) is fundamental to maintaining high standards of health care. Significant debate exists concerning the necessity for an ethical approval system for those QI projects that push the boundaries, appearing more similar to research than QI. The authors discuss this issue identifying the core ethical issues in family medicine (FM), drawing upon the fundamental principles of medical ethics, including principles of autonomy, utility, justice and non-maleficence. Recent debate concerning the application of QI ethics boards is discussed with relevance (...) to primary care and issues such as general practitioner (GP) intentions, the impact of QI on patients and the use of confidential patient data and the impact of dissemination. The authors conclude that a system of QI ethical approval leaves many issues unresolved and potentially creates several barriers to implementing QI. To ensure ethical QI work is generated within FM it is essential for GPs to learn about and engage in more ethical reflection so that they can better judge and resolve these issues. (shrink)

This study presents the first neuroimaging investigation of female psychopathy in an incarcerated population. Prior studies have found that male psychopathy is associated with reduced limbic and paralimbic activation when processing emotional stimuli and making moral judgments. The goal of this study was to investigate whether these findings extend to female psychopathy. During fMRI scanning, 157 incarcerated and 46 non-incarcerated female participants viewed unpleasant pictures, half which depicted moral transgressions, and neutral pictures. Participants rated each picture on moral transgression severity. (...) Psychopathy was assessed using the Psychopathy Checklist-Revised (PCL-R) in all incarcerated participants. Non-incarcerated participants were included as a control group to derive brain regions of interest associated with viewing unpleasant vs. neutral pictures (emotion contrast), and unpleasant pictures depicting moral transgressions vs. unpleasant pictures without moral transgressions (moral contrast). Regression analyses in the incarcerated group examined the association between PCL-R scores and brain activation in the emotion and moral contrasts. Results of the emotion contrast revealed a negative correlation between PCL-R scores and activation in the right amygdala and rostral anterior cingulate. Results of the moral contrast revealed a negative correlation between PCL-R scores and activation in the right temporo-parietal junction. These results indicate that female psychopathy, like male psychopathy, is characterized by reduced limbic activation during emotion processing. In contrast, reduced temporo-parietal activation to moral transgressions has been less observed in male psychopathy. These results extend prior findings in male psychopathy to female psychopathy, and reveal aberrant neural responses to morally-salient stimuli that may be unique to female psychopathy. (shrink)

This article explores the reasons some pregnant women enter maternity homes with the plan to place their babies for adoption. The authors discuss changes in maternity homes over the twentieth century and report on findings from a survey of currently licensed homes in Texas. Next, the authors discuss the findings from fieldwork and in-depth interviews with residents of two maternity homes. They identify three major reasons why birth mothers enter maternity homes: the desire to escape abusive or stressful family lives, (...) the desire to avoid the stigma of placing a child for adoption, and the desire to provide their children, and in some cases themselves, with a stable and loving family life. The authors contend that entering a maternity home with the intention of placing their babies for adoption represents an effort on the part of birth mothers to reconfigure their own, often impoverished family lives. (shrink)

We study the effects of homeschool background and time use on academic performance among students at Patrick Henry College, a private religious institution with a 63-credit core classical liberal arts curriculum. Using ordinary least squares regression analysis, we examine four research questions: Does time use influence academic performance? Do homeschooled students perform differently than traditionally schooled students? Does parental education moderate the impact of homeschooling on academic performance? Does homeschooling moderate the impact of ACT scores on academic performance?

This article provides a brief background of key issues in physician burnout, a significant problem in the healthcare industry. The extent and severity of burnout are not well understood, and those seeking help are often stigmatized. A number of different approaches to alleviating burnout have been suggested, but the problem lacks any single or simple solution.We posit that an ethics committee may be well positioned to help address this issue because of its unique position within an institution. An ethics committee (...) serves the entire hospital staff regardless of department. As such it may be able to identify common elements in the development of burnout, and can serve as a conduit to administration in identifying these. An ethics committee can obtain information about the extent of burnout by conducting surveys to assess the extent and severity of burnout in an institution, and serve as a central resource to help address and alleviate it.Finally, an ethics committee may be able to act as an intermediary between practitioners and the administration, in advising the administration of the extent of the problem and offer suggestions for alleviating it. (shrink)

Background Central to the involvement of children in health research is the notion of risk. In this paper we present one of the factors, a matter of trust, that shaped Canadian parents' and children's perceptions and assessments of risk in child health research. Participants and methods Part of a larger qualitative research study, 82 parents took part an in-depth qualitative interview, with 51 parents having children who had participated in health research and 31 having children with no research history. 51 (...) children ranging from 6 to 19 years of age were also interviewed, with 28 having a history of participation in child health research and 23 having no history. Children also took part in 3 focus groups interviews. Themes emerged through a grounded theory analysis of coded interview transcripts. Findings The presence or absence of trust was not only perceived by parents and children as a contributing factor to involving children in health research, but also shaped their perceptions and assessments of risk. Three interrelated subthemes identified were: (1) relationships of trust; (2) placing trust in symbols of authority; and (3) the continuum of trust. Conclusions Our study reinforces that trust is an important factor when parents assess risk in child health research and shows that children use the language of trust in relation to risk. More discussion regarding trust in training researchers is warranted given the trust in researchers and institutions evident in this study. We also recommend further study of the continuum of trust in child health research. (shrink)

Several authors have analyzed the optimal k-majority rule based on a variety of criteria. Buchanan and Tullock argued that, in constitutional settings, the criterion should be that all changes meet the Pareto criterion; otherwise the status quo should be preferred (we call this the BT criterion). They then asserted that unanimity rule would be the preferred voting rule in this setting. In parliamentary settings, they claimed that a near majority rule would be preferred because it minimizes the sum of decision (...) costs and external costs. This article investigates both claims in an N-voter, two-alternative setting. We show the conditions under which unanimity rule is less likely to select BT preferred alternatives than other k-majority rules and prove that the difference in performance can be negligible when Nis large and certain weak conditions are met. Furthermore, if we define external costs as the expected number of losers from a BT-inferior vote, then external costs become negligible for a range of supermajority rules. This implies that unanimity rule and a range of supermajority rules should be equally preferred when decision costs are added. Finally, we show that the external cost function can actually increase for certain populations. Many of the broader conclusions should also hold for multiple alternatives. (shrink)

In this paper, we reconstruct Kant’s notion of the practically conditioned, introduced in the Dialectic of Pure Practical Reason, by drawing on Kant’s general account of the faculty of reason presented in the Transcendental Dialectic of the Critique of Pure Reason. We argue that practical reason’s activity of seeking the practically unconditioned for a given condition generates two different conceptions of the practically unconditioned and identify these as virtue and (the ideal of) happiness. We then account for how and why (...) reason proceeds to combine these two distinct ideas into the composite idea of the highest good. Last, we draw on our discussion to determine more precisely what Kant intends by the ‘supremacy’ of virtue within reason’s idea of the highest good. (shrink)

Sen’s Liberal paradox describes a conflict between weak Pareto, minimal liberalism, and either transitivity or a best element over a domain of individual preferences. This paper examines variants of that paradox with varying amounts of unconditional preferences. We define a notion of unconditional preferences under which, in the absence of Pareto, there can be no cycles. We then define a stronger condition, that makes an individual’s preferences for her own private attributes independent of all other attributes. Under this assumption, there (...) can be no cycles with or without Pareto. We also show there exists a social decision function satisfying those conditions. We then determine the probability of a cycle assuming a much weaker independence condition that does not restrict the domain. This probability converges to one as the number of non-private attributes within the social states increases. Finally, we use simulations to determine the probability that liberalism and Pareto conflict with best elements, maximal elements, and transitivity separately. (shrink)

Alea, Bluck, Mroz and Edwards examine how the communication of autobiographical stories via face‐to‐face vs. instant message (IM) influences the extent to which social bonds form between strangers. The results of their study show that the in‐person communication of strangers’ autobiographical memories leads to greater engagement and higher empathy rates in the listener of those stories. That is, sharing autobiographical memories face‐to‐face (compared to IM) is positively correlated with positive feelings and closeness in the listener of those stories.

Loop regions in proteins have traditionally been described as ‘random coil’, although they are known to adopt well‐defined conformations in most globular proteins. In this contribution we summarize the results of detailed analysis of the structures and sequences of these loop regions in proteins of known three‐dimensional structure. We also describe how these results can be used as an aid to protein design, modification and modelling.

To date, research into socially responsible investment (SRI), and in particular the socially responsible investment funds industry, has focused on whether investing in SRI assets has any differential impact on investor returns. Prior findings generally suggest that, on a risk-adjusted basis, there is no difference in performance between SRI and conventional funds. This result has led to questions about whether SRI funds are really any different from conventional funds. This paper examines whether the portfolio allocation across industry sectors and the (...) stock-picking ability of SRI managers are different when compared to conventional fund managers. The study finds that SRI funds exhibit different industry betas consistent with different portfolio positions, but that these differences vary from year to year. It is also found that there is little difference in stock-picking ability between the two groups of fund managers. (shrink)

Florida International University, USA edwardj{at}fiu.edu ' + u + '@ ' + d + ' '/ /- -> Several authors have analyzed the optimal k -majority rule based on a variety of criteria. Buchanan and Tullock argued that, in constitutional settings, the criterion should be that all changes meet the Pareto criterion; otherwise the status quo should be preferred. They then asserted that unanimity rule would be the preferred voting rule in this setting. In parliamentary settings, they claimed that a (...) near majority rule would be preferred because it minimizes the sum of decision costs and external costs. This article investigates both claims in an N -voter, two-alternative setting. We show the conditions under which unanimity rule is less likely to select BT preferred alternatives than other k -majority rules and prove that the difference in performance can be negligible when N is large and certain weak conditions are met. Furthermore, if we define external costs as the expected number of losers from a BT-inferior vote, then external costs become negligible for a range of supermajority rules. This implies that unanimity rule and a range of supermajority rules should be equally preferred when decision costs are added. Finally, we show that the external cost function can actually increase for certain populations. Many of the broader conclusions should also hold for multiple alternatives. Key Words: constitutional design • Pareto criterion • external costs • social contract. (shrink)

Notable in cross-cultural comparisons is the variable span of time between when children become economically self-sufficient and when they initiate their own reproductive careers. That variation is of interest because it shapes the age range of children reliant on others for support and the age range of children available to help out, which in turn affects the competing demands on parents to support multiple dependents of different ages. The age at positive net production is used as a proxy to estimate (...) the close of juvenile economic dependence among a group of Maya subsistence agriculturalists. Maya children produce more than they consume by their early to mid teens but remain in their natal households for a number of years before leaving home and beginning families of their own. The Maya results contrast markedly with those from several groups of hunter-gatherers and horticulturalists for whom we have similar data. Even in the Maya case, where children are self-sufficient at a relatively young age, parents are unable to support their children without help from others. The production surplus of older children appears to help underwrite the cost of large Maya families and subsidize their parents’ continued reproduction. (shrink)

This collection brings together fourteen contributions by authors from around the globe. Each of the contributions engages with questions about how local and global bioethical issues are made to be comparable, in the hope of redressing basic needs and demands for justice. These works demonstrate the significant conceptual contributions that can be made through feminists' attention to debates in a range of interrelated fields, especially as they formulate appropriate responses to developments in medical technology, global economics, population shifts, and poverty.

Research in nonindustrial small-scale societies challenges the common perception that human childhood is universally characterized by a long period of intensive adult investment and dedicated instruction. Using return rate and time allocation data for the Savanna Pumé, a group of South American hunter-gatherers, age patterns in how children learn to become productive foragers and from whom they learn are observed across the transition from childhood to adolescence. Results show that Savanna Pumé children care for their siblings, are important economic contributors, (...) learn by doing rather than by instruction, and spend their time principally in the company of other children. This developmental experience contrasts with that of children in postindustrial societies, who are dependent on adults, often well past maturity; learn in formal settings; and spend much of their time in the company of adults. These differences raise questions about whether normative behaviors observed in postindustrial societies are representative of human children. This comparison also identifies the potential mismatch between hunter-gatherer and postindustrial societies in the extent to which children may be well adapted to learn from and teach each other. In particular, spending time in autonomous work and play groups develops the cooperation and coordination skills that are foundational to human subsistence and growing up to be socially and productively adept adults and parents. (shrink)

The evolution of cooperative breeding is complex, and particularly so in humans because many other life history traits likely evolved at the same time. While cooperative childrearing is often presumed ancient, the transition from maternal self-reliance to dependence on allocare leaves no known empirical record. In this paper, an exploratory model is developed that incorporates probable evolutionary changes in birth intervals, juvenile dependence, and dispersal age to predict under what life history conditions mothers are unable to raise children without adult (...) cooperation. The model’s outcome variable (net balance) integrates dependent children’s production and consumption as a function of varying life history parameters to estimate the investment mothers or others have to spend subsidizing children. Results suggest that maternal-juvenile cooperation can support the early transition toward a reduction in birth intervals, a longer period of juvenile dependence, and having overlapping young. The need for adult cooperation is most evident when birth intervals are short and age at net production is late. Findings suggest that the needs of juveniles would not have been an early selective force for adult cooperation. Rather, an age-graded division of labor and the mutual benefits of maternal-juvenile cooperation could be an important, but overlooked step in the evolution of cooperative breeding. (shrink)

Attention has been given to cross-cultural differences in adolescent growth, but far less is known about developmental variability during juvenility (ages 3–10). Previous research among the Pumé, a group of South American foragers, found that girls achieve a greater proportion of their adult stature during juvenility compared with normative growth expectations. To explain rapid juvenile growth, in this paper we consider girls’ activity levels and energy expended in subsistence effort. Results show that Pumé girls spend far less time in subsistence (...) tasks in proportion to their body size compared with adults, and they have lower physical activity levels compared with many juveniles cross-culturally. Low activity levels help to explain where the extra energy comes from to support rapid growth in a challenging environment. We suggest that activity levels are important to account for the variation of resource and labor transfers in mediating energy availability. (shrink)

Using qualitative data based on interviews with 22 married infertile couples living in western New York State, we describe the ways in which husbands and wives interact in the process of constructing their infertility. The wives experienced infertility as a cataclysmic role failure. Husbands tended to see infertility as a disconcerting event but not as a tragedy. Couples tended to see infertility as a problem for wives. Frustration and lack of communication were typical consequences of the confrontation of husbands' and (...) wives' perspectives on infertility. Interactions with medical professionals tended to reinforce these consequences. These interactions between wives, husbands, and medical professionals may lead to taking wrong directions in treatment and to ignoring treatment options. Some of the problems we describe could be lessened by adopting a model of couple-centered treatment in a setting that incorporated routine counseling. (shrink)

This essay considers and rejects both the irrationalist and the supra-rationalist interpretations of Kierkegaard, arguing that a new category---Kierkegaard as “anti-rationalist”---is needed. The irrationalist reading overemphasizes the subjectivism of Kierkegaard’s thought, while the suprarationalist reading underemphasizes the degree of tension between human reason (as corrupted by the will’s desire to be autonomous and self-sustaining) and Christian faith. An anti-rationalist reading, I argue, is both faithful to Kierkegaard’s metaphysical and alethiological realism, on the one hand, and his emphasis on the continuing (...) opposition between reason and faith, on the other, as manifested in the ongoing possibility of offense (reason’s rejection of the Christian message) in the life of the Christian. (shrink)

Dispersal of individuals from their natal communities at sexual maturity is an important determinant of kin association. In this paper we compare postmarital residence patterns among Pumé foragers of Venezuela to investigate the prevalence of sex-biased vs. bilateral residence. This study complements cross-cultural overviews by examining postmarital kin association in relation to individual, longitudinal data on residence within a forager society. Based on cultural norms, the Pumé have been characterized as matrilocal. Analysis of Pumé marriages over a 25-year period finds (...) a predominant pattern of natalocal residence. We emphasize that natalocality, bilocality, and multilocality accomplish similar ends in maximizing bilateral kin affiliations in contrast to sex-biased residential patterns. Bilateral kin association may be especially important in foraging economies where subsistence activities change throughout the year and large kin networks permit greater potential flexibility in residential mobility. (shrink)

This research presents the results of an exploratory empirical study that assessed perceived organizational preparedness for coping with a major crisis or disaster. A scale was developed and tested to measure perceptions of organizational preparedness. Hypotheses were tested to examine variations in perception of crisis preparedness. Potential for occurrence of crises was also examined and demographics collected. Findings indicate that top-level and middle-level managers have a higher level of perceived preparedness than employees, no differences in perceived preparedness based on size (...) of the city where organizations operate, government organizations expressed a higher perception of crisis preparedness than for-profit organizations, and the highest perception of preparedness was exhibited by organizations employing more than 500 employees. (shrink)

This article is a commentary response to the study results outlined in “The State of Teacher Training in Philosophy.” In recognition of the study’s determination that 70 percent of the jobs new philosophers will apply for are non-tenure track, our graduate programs must provide training in teaching excellence and the fostering of student learning, or what I call pedagogical areté. I will argue that achieving this teaching excellence requires 1) Familiarity with cognitive neuroscience advancements on how people learn, 2) Knowledge (...) of today’s college students, and 3) Practiced methods for scaffolding and assessment of student learning. My claim is that pedagogic excellence is both a role-related moral obligation and a duty we owe to society—what Lee Shulman characterizes as the pedagogical imperative. This increased focus on pedagogical proficiency creates an opportunity for philosophy to establish and solidify its disciplinary value. (shrink)

In spite of a continuing long and rich history of caring for patients, many nurses have not been satisfied with their work. One cause among others for this dissatisfaction is that nurses often do not care for one another. The philosophy of a Buddhist Sangha, or community, is similar to the philosophy of western communitarian ethics. Both philosophies emphasize the importance of people working together harmoniously towards a common good. In this article, unsatisfactory nurse-nurse relationships have been considered and a (...) model for communitarian nursing practice has been suggested based on a Buddhist Sangha. (shrink)

In the superannuation/pension industry, ordinary investors entrust their retirement savings to the trustees of the superannuation plan. Investors rely on the trustees to ensure that ethical business and risk management practices are implemented to protect their retirement savings. Governance practices ensure the monitoring of ethical risk management (Drennan, L. T.: 2004, Journal of Business Ethics 52, 257-266). The Australian superannuation industry presents a unique scenario. Legislation requires employers to contribute a minimum of 9% of the employees wage to retirement savings. (...) However, there are no legislated governance standards, although there are standards of recommended governance practices. In this article, we examine the level of voluntary adoption of governance practices by the trustees of Australian public sector and industry superannuation funds. We also assess whether superannuation governance practices are associated with performance and volatility /riskiness of returns. Survey results show that the majority of superannuation plans adopt recommended governance practices supporting the concept of ethical management of the member's retirement savings. The examination of governance principles that impact returns and risk shows that board size and regular review of conflicts are positively associated with return. Superannuation plans with higher volatility in returns meet more frequently. (shrink)

Community-based mental health care providers are increasingly contacted by external researchers for research study recruitment. Unfortunately, many do not possess the resources or personn...

To make possible the integration proposed by Domjan et al., psychologists first need to close the research gap between behavioral ecology and the study of Pavlovian conditioning. I suggest two strategies, namely, to adopt more behavioral ecological approaches to social behavior or to co-opt problems already addressed by behavioral ecologists that are especially well suited to the study of Pavlovian conditioning.