The food supply of the temperate lands of early-medieval western Europe, and the ways in which its peoples dealt with the central problem of feeding themselves, has been subjected to a variety of interpretations in recent years. Vern Bullough and Cameron Campbell's study of the medieval diet and female longevity concluded that early-medieval women suffered from iron deficiencies triggered jointly by poor nutrition and frequent childbearing and that these deficiencies contributed substantially to their average early age of death. Ann Hagen's (...) overview of Anglo-Saxon patterns of food production and consumption suggested that most of the early English population routinely lived at marginally adequate or outright substandard levels of nutrition. Similar conclusions were reached by Renée Doehaerd in her study of the early-medieval economy. Michel Rouche, on the other hand, asserted that the typical Carolingian—including the peasants—had access to a monotonous, but abundant, supply of foodstuffs and may have consumed an average of 6,000–9,000 calories per day. Richard Hodges likewise decided that Anglo-Saxon peasants were reasonably well fed, based on the heavy food rents per hide demanded during the reign of the West Saxon king Ina. (shrink)

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

This dialogue engages with the ethics of politics of capitalism, and enacts a debate between two participants who have divergent views on these matters. Beginning with a discussion concerning definitions of capitalism, it moves on to cover issues concerning our different understandings of the costs and benefits of global capitalist systems. This then leads into a debate about the nature and purposes of regulation, in terms of whether regulation is intended to make competition work better for consumers, or to prevent (...) negative outcomes for citizens. The conclusion speculates about the usefulness or otherwise of this Socratic method of dialogue. (shrink)

Supported decision-making has been promoted at a policy level and within international human rights treaties as a way of ensuring that people with disabilities enjoy the right to legal capacity on an equal basis with others. However, little is known about the practical issues associated with implementing supported decision-making, particularly in the context of dementia. This study aimed to understand the experiences of people with dementia and their family members with respect to decision-making and their views on supported decision-making. Thirty-six (...) interviews were undertaken with fifty-seven participants across three states in Australia. Interpretative Phenomenological Analysis was used as the methodological approach, with relational autonomy as a theoretical perspective. We identified two overarching themes relating to participants’ experiences with decision-making: “the person in relationship over time” and “maintaining involvement.” Participant views on the practical issues associated with supported decision-making are addressed under the themes of “facilitating decision-making,” “supported decision-making arrangements,” “constraints on decision-making,” and “safeguarding decision-making.” While participants endorsed the principles of supported decision-making as part of their overarching strategy of “maintaining involvement” in decision-making, they recognized that progressive cognitive impairment meant that there was an inevitable transition toward greater involvement of, and reliance upon, others in decision-making. Social and contextual “constraints on decision-making” also impacted on the ability of people with dementia to maintain involvement. These themes inform our proposal for a “spectrum approach” to decision-making involvement among people living with dementia, along with recommendations for policy and practice to assist in the implementation of supported decision-making within this population. (shrink)

Cheerfulness or serenity is one of the most important themes in Nietzsche’s philosophy. Throughout his writings, from first to last, he can be found wrestling with conceptions of cheerfulness and promoting a cheerful mode of philosophizing. Despite the importance and recurrence of the theme of cheerfulness in Nietzsche’s entire œuvre, there have been relatively few studies specifically devoted to it. An important debate on cheerfulness has recently taken place in the literature on Nietzsche between Robert Pippin and Lanier Anderson and (...) Rachel Cristy. Both sides of the debate have explored Nietzsche’s practice of cheerfulness in direct relation to Montaigne. According to Pippin, Nietzsche never succeeds in writing with the kind of cheerfulness of Montaigne. In contrast, Anderson and Cristy have contended that both Nietzsche and Montaigne conceive of cheerfulness as a complex, non-naïve spiritual state or attitude that is to be cultivated through the practice of philosophy as a way of life. According to Anderson and Cristy, this is a deep form of love of life that both Nietzsche and Montaigne practice and perhaps achieve at least in part by and through writing. In this essay, we aim to contribute to this debate by offering a threefold argument. First, we argue that Nietzsche conceives of cheerfulness not only as a psychological ideal, as a desirable state or attitude of the spirit, but also as an aesthetic ideal, as a desirable quality or style of thinking and writing. Second, we argue that, in addition to Montaigne, Ralph Waldo Emerson is an equally important but neglected influence on Nietzsche’s conception and practice of cheerfulness. Third, by reconstructing Nietzsche’s self-presentation as a cheerful thinker and writer in the 1886 prefaces and in Ecce homo, we conclude that it is possible to argue that starting from his middle writings Nietzsche thinks and writes cheerfully in some of his works, including a number of his most significant texts. (shrink)

BackgroundIn Australia, the peer review process for competitive funding is usually conducted by a peer review group in conjunction with prior assessment from external assessors. This process is quite mysterious to those outside it. The purpose of this research was to throw light on grant review panels (sometimes called the ‘black box’) through an examination of the impact of panel procedures, panel composition and panel dynamics on the decision-making in the grant review process. A further purpose was to compare experience (...) of a simplified review process with more conventional processes used in assessing grant proposals in Australia.MethodsThis project was one aspect of a larger study into the costs and benefits of a simplified peer review process. The Queensland University of Technology (QUT)-simplified process was compared with the National Health and Medical Research Council’s (NHMRC) more complex process. Grant review panellists involved in both processes were interviewed about their experience of the decision-making process that assesses the excellence of an application. All interviews were recorded and transcribed. Each transcription was de-identified and returned to the respondent for review. Final transcripts were read repeatedly and coded, and similar codes were amalgamated into categories that were used to build themes. Final themes were shared with the research team for feedback.ResultsTwo major themes arose from the research: (1) assessing grant proposals and (2) factors influencing the fairness, integrity and objectivity of review. Issues such as the quality of writing in a grant proposal, comparison of the two review methods, the purpose and use of the rebuttal, assessing the financial value of funded projects, the importance of the experience of the panel membership and the role of track record and the impact of group dynamics on the review process were all discussed. The research also examined the influence of research culture on decision-making in grant review panels. One of the aims of this study was to compare a simplified review process with more conventional processes. Generally, participants were supportive of the simplified process.ConclusionsTransparency in the grant review process will result in better appreciation of the outcome. Despite the provision of clear guidelines for peer review, reviewing processes are likely to be subjective to the extent that different reviewers apply different rules. The peer review process will come under more scrutiny as funding for research becomes even more competitive. There is justification for further research on the process, especially of a kind that taps more deeply into the ‘black box’ of peer review. (shrink)

In this paper, we examine the drivers involved in an alternative business model: cross-sector social partnerships between for-profit, predominantly multinational corporations and nonprofit organizations. We explore these cross-sector social partnerships from the perspective of these primary stakeholders, examining the questions of power differentials and the definitions and determinants of success. In order more deeply to understand these drivers, we review the evolution of the concept of “value” and the perception of the value that each stakeholder brings to the partnership. We (...) then describe and offer the results of an empirical, qualitative study of 18 CSSPs, where we analyze each partner's representations of success, outcomes sought and distinctions in determinants of value within the partnerships. (shrink)

The aesthetics of imperfection emphasises spontaneity, disruption, process and energy over formal perfection and is often ignored by many commentators or seen only in improvisation. This comprehensive collection is the first time imperfection has been explored across all kinds of musical performance, whether improvisation or interpretation of compositions. Covering music, visual art, dance, comedy, architecture and design, it addresses the meaning, experience, and value of improvisation and spontaneous creation across different artistic media. A distinctive feature of the volume is that (...) it brings together contributions from theoreticians and practitioners, presenting a wider range of perspectives on the issues involved. Contributors look at performance and practice across Western and non-Western musical, artistic and craft forms. Composers and non-performing artists offer a perspective on what is 'imperfect' or improvisatory within their work, contributing further dimensions to the discourse. The Aesthetics of Imperfection in Music and the Arts features 39 chapters organised into eight sections and written by a diverse group of scholars and performers. They consider divergent definitions of aesthetics, employing both 18th-century philosophy and more recent socially and historically situated conceptions making this an essential, up-to-date resource for anyone working on either side of the perfection-imperfection debate. (shrink)

Patient outcome after serious brain injury is highly variable. Following a period of coma, some patients recover while others progress into a vegetative state (unresponsive wakefulness syndrome) or minimally conscious state. In both cases, assessment is difficult and misdiagnosis may be as high as 43%. Recent advances in neuroimaging suggest a solution. Both functional magnetic resonance imaging and electroencephalography have been used to detect residual cognitive function in vegetative and minimally conscious patients. Neuroimaging may improve diagnosis and prognostication. These techniques (...) are beginning to be applied to comatose patients soon after injury. Evidence of preserved cognitive function may predict recovery, and this information would help families and health providers. Complex ethical issues arise due to the vulnerability of patients and families, difficulties interpreting negative results, restriction of communication to “yes” or “no” answers, and cost. We seek to investigate ethical issues in the use of neuroimaging in behaviorally nonresponsive patients who have suffered serious brain injury. The objectives of this research are to: (1) create an approach to capacity assessment using neuroimaging; (2) develop an ethics of welfare framework to guide considerations of quality of life; (3) explore the impact of neuroimaging on families; and, (4) analyze the ethics of the use of neuroimaging in comatose patients. (shrink)

Erratum to: Bioethical InquiryDOI 10.1007/s11673-012-9391-xLobna Rouhani, University of Melbourne, is a co-author of the article “Genetic Research and Aboriginal and Torres Strait Islander Australians” (2012, 419–432) that was published in the Journal of Bioethical Inquiry’s 9(4) symposium “Cases and Culture.” Her name was omitted from the publication and she should be credited as the third author of this article.

Verb extension is a crucial gauge of the acquisition of verb meaning. In English, studies suggest that young children show conservative extension. An important test of whether an early conservative extension is a general phenomenon or a function of the input language is made possible by Chinese, a language in which verbs are more frequent and acquired earlier. This study tested whether 3-year-old Chinese children extended a group of familiar verbs that specify various ways tocarryobjects. Shown videos that portrayed typical, (...) mid-typical, or atypical carrying actions (as verified by Chinese adults), children were asked to judge whether they were examples of specific Chinese carry verbs. Children’s verb extensions were mostly limited to typical exemplars, suggesting that an early conservative extension may be universal. Furthermore, extension breadth was related to the onset of verb production: verbs acquired earlier elicited more extension judgments than those acquired later. (shrink)

This article is the fourth dialogue in a series in which two characters, a pro‐business experienced manager and a critical management academic idealist, debate contemporary management. In this dialogue, the discussion concerns the curriculum of business and management courses. Though as usual there is little agreement between the two participants, the discussion clearly shows just how difficult it will be to change business education without also changing the market position of business schools. Other topics concern the sort of economic assumptions (...) embedded in much of the curriculum, and the relationship between practical skills and political descriptions of capitalism. (shrink)

It is shown that the lattice-theoretic distributive law does not fail to hold in the two slit-experiment for the general case offinite slit widths and for a position measurement which localizes the observed particle to afinite region of the screen. Comments are made on previous and less general discussions of the case considered.

The resting-state human electroencephalogram power spectrum is dominated by alpha and theta oscillations, and also includes non-oscillatory broadband activity inversely related to frequency. Gratton proposed that alpha and theta oscillations are both related to cognitive control function, though in a complementary manner. Alpha activity is hypothesized to facilitate the maintenance of representations, such as task sets in preparation for expected task conditions. In contrast, theta activity would facilitate changes in representations, such as the updating of task sets in response to (...) unpredicted task demands. Therefore, theta should be related to reactive control, while alpha may be more relevant to proactive control. Less is known about the possible relationship between 1/f activity and cognitive control, which was analyzed here in an exploratory fashion. To investigate these hypothesized relationships, we recorded eyes-open and eyes-closed resting-state EEG from younger and older adults and subsequently tested their performance on a cued flanker task, expected to elicit both proactive and reactive control processes. Results showed that alpha power and 1/f offset were smaller in older than younger adults, whereas theta power did not show age-related reductions. Resting alpha power and 1/f offset were associated with proactive control processes, whereas theta power was related to reactive control as measured by the cued flanker task. All associations were present over and above the effect of age, suggesting that these resting-state EEG correlates could be indicative of trait-like individual differences in cognitive control performance, which may be already evident in younger adults, and are still similarly present in healthy older adults. (shrink)

Background/ObjectiveSeveral studies have examined the impact of Parkinson’s disease on the quality of couples’ relationships. To date, few studies have explored how couples experience their relationship dynamic by taking into account the disease stage. The objectives of this study were to understand the experience of each partner and to study the mechanisms that underlie their couple organization in the advanced stage of PD.MethodsSemistructured individual interviews conducted with fifteen patients and their partners were the subject of a dyadic interpretative phenomenological analysis.ResultsThree (...) themes were identified from the analysis: the first, “A Closeness That Separates,” allows the identification of different patterns of interactions that lead to emotional distancing between the partners; the second, “The Adversity Is Not Unbearable, But Going It Alone Would Be,” emphasizes the importance of how the assisting partner provides support; and the third, “Be Prepared for Anything and Facing an Uncertain Future,” reveals the extent and modes of the dyadic regulation of the emotions linked to what the future may hold.ConclusionPsychological support is important to help couples express both their feelings and their respective needs in the evolving context of PD. (shrink)

In this study, we developed and validated an instrument that researchers can use to measure the collective effort of principals and teachers who excise their own unique leadership to genera...

Background Research in children is essential for them to benefit from the outcomes of research but involvement must be weighed against potential harms. In many countries and circumstances, medical research legally requires parental consent until the age of 18 years, with poorly defined recommendations for assent prior to this. However, there is little research exploring how these decisions are made by families and the ethical implications of this. Aim To explore key ethical debates in decision-making for participation of children and (...) adolescents in a human papillomavirus (HPV) vaccine trial. Methods Semi-structured interviews were undertaken with Tanzanian girls (aged 9–16 years) who had participated in an HPV vaccine trial (n = 13), their parents or guardians (n = 12), and girls together with their parents (in paired parent-child interviews) (n = 6). The interviews were analysed using thematic analysis. Interview data came from a qualitative acceptability study undertaken as part of the Dose Reduction Immunobridging and Safety Study of Two Human Papillomavirus (HPV) Vaccines in Tanzanian Girls (DoRIS) trial. Results Girls and parents desired collaborative decision-making, with parents ultimately making the decision to consent. However, girls wanted a larger part in decision-making. Decisions to consent involved many people, including extended social networks, the trial team, media outlets and healthcare professionals and this resulted in conflicts to be negotiated. Deciding where to place trust was central in participants and parents considering decisions to consent and overcoming rumours about trial involvement. Conclusions Existing models of decision-making help to understand dynamics between parents, adolescents and researchers but neglect the important wider social impacts and the fundamental nature of trust. Children’s roles in discussions can be evaluated using the principles of consent: autonomy, freedom and information. Concepts such as relational autonomy help to explain mechanisms families use to negotiate complex consent decisions. Whilst interviewees supported the maintenance of legal parental consent, researchers must design consent processes centring the child to ensure that whole family decision-making processes are supported. (shrink)

Mental disorders such as depression and anxiety are increasingly common. Yet there are too few specialists to offer help to everyone, and negative attitudes to psychological problems and their treatment discourage people from seeking it. As a result, many people never receive help for these problems. The Oxford Guide to Low Intensity CBT Interventions marks a turning point in the delivery of psychological treatments for people with depression and anxiety. Until recently, the only form of psychological intervention available for patients (...) with depression and anxiety was traditional one-to-one 60 minute session therapy - usually with private practitioners for those patients who could afford it. Now Low Intensity CBT Interventions are starting to revolutionize mental health care by providing cost effective psychological therapies which can reach the vast numbers of people with depression and anxiety who did not previously have access to effective psychological treatment. The Oxford Guide to Low Intensity CBT Interventions is the first book to provide a comprehensive guide to Low Intensity CBT interventions. It brings together researchers and clinicians from around the world who have led the way in developing evidence-based low intensity CBT treatments. It charts the plethora of new ways that evidence-based low intensity CBT can be delivered: for instance, guided self-help, groups, advice clinics, brief GP interventions, internet-based or book-based treatment and prevention programs, with supported provided by phone, email, internet, sms or face-to-face. These new treatments require new forms of service delivery, new ways of communicating, new forms of training and supervision, and the development of new workforces. They involve changing systems and routine practice, and adapting interventions to particular community contexts. The Oxford Guide to Low Intensity CBT Interventions is a state-of-the-art handbook, providing low intensity practitioners, supervisors, managers commissioners of services and politicians with a practical, easy-to-read guide - indispensible reading for those who wish to understand and anticipate future directions in health service provision and to broaden access to cost-effective evidence-based psychological therapies. (shrink)

Baxter International Inc. is a global, diversified healthcare company based in Deerfield, IL. In 2011, Baxter had sales of $13.9 billion and employed approximately 48,500 people worldwide. Baxter is also recognized for its efforts toward environmental/sustainability performance and reporting. The company defines sustainability as ‘a long-term approach to including our social, economic and environmental responsibilities among our business priorities. Baxter’s efforts in this area align with and support our mission of saving and sustaining lives.’ This case study attempts to analyze (...) the progress of the company on its journey along the path toward sustainability. The formal environmental initiatives at Baxter were started in the 1970s. The acquisition of American Hospital Supply Corporation intensified the environmental challenges for the company. A new environmental course was set in the 1990s that led to the development of the State-of-the-Art Environmental Standards. At this time, the company started measuring its efforts and began publishing an Environmental Financial Statement in its annual public Environmental Report. In 2005, an executive level Sustainability Steering Committee was proposed and subsequently created in 2006 to accelerate the integration of sustainability within all facets of the organization. This case study articulates the evolution of Sustainability at Baxter Inc. As a result of its efforts, Baxter has received numerous awards and accolades for its efforts in sustainability performance and reporting. For example, in 2011 NewsweekMagazine ranked Baxter the 4th greenest company in the United States. Going forward, it would be noteworthy to see whether Baxter can keep up its momentum and continue to be a sustainability leader. (shrink)

This book presents a collection of contemporary discourses that reconsider the relationship of democracy as a political ideology and American ideal and education as the foundation of preparing democratic citizens in America.