Qualitative comparative analysis (QCA) opens up two new forms of knowledge: (1) knowing about alternative pathways to one outcome (equifinality) and (2) perceiving nuances of necessary cause and sufficient cause. Several misunderstandings of QCA occur in the article by Lucas and Szatrowski (this volume, p. 1). First, there are minor problems with expressions. Second, there are differences between their philosophy of science (arguments 1, 2, and 3 below) and a realist approach. Third, they misinterpret what was meant by sufficient and (...) necessary cause (arguments 4 and 5 below). The minor problems with expressions arise in sections 2.2 and 3. In section 2.2, the authors define consistency, but here they miss out on two key points. First, they neglect to say that this particular measure of consistency is a measure of sufficiency of cause, not of necessary cause. Second, they ignore the way that the consistency level exists for each possible configuration of characteristics. A configuration can be shown in one row of a truth table, with n1 = 28, n2 = 17 within a larger sample of 155, and so on (see Byrne 2009:262). Using QCA’s definition of “consistency,” we can discern more about the pattern of causality than one might initially expect. This learning is possible whether N overall is 155, or just 39, or thousands of cases. The essential task is to simplify and rank the list of configurations (Ragin 2001, 2006). (shrink)

ABSTRACT:In a world filled with poverty, environmental degradation, and moral injustice, social enterprises offer a ray of hope. These organizations seek to achieve social missions through business ventures. Yet social missions and business ventures are associated with divergent goals, values, norms, and identities. Attending to them simultaneously creates tensions, competing demands, and ethical dilemmas. Effectively understanding social enterprises therefore depends on insight into the nature and management of these tensions. While existing research recognizes tensions between social missions and business ventures, (...) we lack any systematic analysis. Our paper addresses this issue. We first categorize the types of tensions that arise between social missions and business ventures, emphasizing their prevalence and variety. We then explore how four different organizational theories offer insight into these tensions, and we develop an agenda for future research. We end by arguing that a focus on social-business tensions not only expands insight into social enterprises, but also provides an opportunity for research on social enterprises to inform traditional organizational theories. Taken together, our analysis of tensions in social enterprises integrates and seeks to energize research on this expanding phenomenon. (shrink)

The increased competition for a share of the market of insured patients, which arose in the wake of failed comprehensive health care reform, has provoked questions about what, if any, standards will govern new “competitive” health care organizations. Managed care arrangements, which typically shift to providers and patients some or all of the financial risk for patient care, are of special concern because they can create incentives to withhold beneficial care from patients. Of course, fee-for-service medical practice creates incentives to (...) provide unnecessary services, and managed care can avoid that type of harm. Still, as Edmund Pellegrino has noted, “managed care, by its nature, places the good of the patient into conflict with … the good of all the other patients served by the plan; the good of the plan and the organization, themselves…; and the self-interest of the physician. (shrink)

This comprehensive reader represents the history, intellectual breadth and diversity of feminist theory.

This target article presents a plausible evolutionary scenario for the emergence of the neural preconditions for language in the hominid lineage. In pleistocene primate lineages there was a paired evolutionary expansion of frontal and parietal neocortex (through certain well-documented adaptive changes associated with manipulative behaviors) resulting, in ancestral hominids, in an incipient Broca's region and in a configurationally unique junction of the parietal, occipital, and temporal lobes of the brain (the POT). On our view, the development of the POT in (...) our ancestors resulted in the neuroanatomical substrate consistent with the ability for representations in modality-neutral association cortex and, as a result of structure-imposing interaction with Broca's area, the hierarchically structured Evidence from paleoneurology and comparative primate neuroanatomy is used to argue that Homo habilis (2.5–2 million years ago) was the first hominid to have the appropriate gross neuroanatomical configuration to support conceptual structure. We thus suggest that the neural preconditions for language are met in H. habilis. Finally, we advocate a theory of language acquisition that uses conceptual structure as input to the learning procedures, thus bridging the gap between it and language. (shrink)

The men and women who serve in the armed forces, in the words of Major General Joseph Caravalho, “sign a blank check, co-signed by their families, payable to the Army, Navy, Air Force, or Marines, up to and including their lives.” It is human nature to consider such a pact in polarized terms; the pact concludes in either a celebratory homecoming or funereal mourning. But in reality, surviving catastrophic injury may incur the greatest debt. The small but real possibility of (...) losing the ability to bear biological children due to genitourinary combat injury has been a topic of discussion in hushed tones, behind closed doors. But as policy changes move the conversation into the open, we must be fully aware of the far-reaching and long-term impacts of decisions on those who have sustained genitourinary injury. In January 2016, Secretary of Defense Ashton Carter outlined a set of reforms that would improve the quality of life for military families by recognizing the importance of maintaining fertility, even in the face of severe injury. This first promising step could build a solid foundation of insuring fertility preservation for wounded service members with genitourinary injury, and it could set a precedent beyond the military for insuring treatment for people who have lost their reproductive capacity. Thus, the ethical challenges raised by the new policy require careful analysis. (shrink)

This response to continuing commentary addresses brain-hand relationships in Cebus apella (as introduced in West-ergaard's commentary), the evolutionary and acquisition parallels between music and language (suggested by Lynch), and the potential behavioral linguistic consequences of the evolutionary neurobiology in Australopithecus africanus and Homo habilis (discussed by Tobias). Finally, we reiterate the importance of well informed, multidisciplinary approaches to the study of the emergence of human species-specific cognition, especially linguistic capacity.

This response clarifies the nature of reappropriation and the definition of language. It explicates the relationship between neural systems and language and between homology and evolutionary gradualism. Through a review of ape capacities in the realms of language and tool use, it distinguishes human language acquisition from nonhuman learning. Finally, it suggests the appropriate sorts of evidence on which to base further evolutionary arguments relevant to the origins of language.

Recent efforts to introduce competition, consistent with microeconomic theory, into the United States health care system raise questions of distributive justice. Similarities between microeconomic theory and libertarian philosophy suggest the possibility of confusing economic goals of efficiency and cost containment with social goals of equity of access to care. This paper raises the fear that if the two are confused, society may unwittingly abandon any serious effort to ensure that the poor have access to essential types of medical care, because (...) libertarian philosophy cannot justify placing any constraints, however beneficient, on the actual distribution of benefits and burdens of illness resulting from free trade. (shrink)

Following the seemingly endless debate over managed care liability, I cannot suppress thoughts of Yeats’s poem, “The Second Coming.” It is not the wellknown phrase, “Things fall apart; the centre cannot hold,” that comes to mind; although that could describe the feeling of a health-care system unraveling. The poem’s depiction of lost innocence — “The best lack all conviction, while the worst/Are full of passionate intensity” — does not allude to the legislature, the industry, the public, or the medical or (...) legal profession. What resonates is the poem’s evocation of humanity’s cyclical history of expectation and disappointment, with ideas as grand as justice and occupations as pedestrian as managed care. Writing in 1919, Yeats described the end of an era with images of war’s destructive forces. The poem expresses a universal desire for some miraculous rebirth or resolution of all problems: “Surely some revelation is at hand.” But instead, the brutish Sphinx-like creature emerges, possibly the Antichrist. New gods displace old gods in the cycle of civilization, and man must muddle on. (shrink)

Genomic research—including whole genome sequencing and whole exome sequencing—has a growing presence in contemporary biomedical investigation. The capacity of sequencing techniques to generate results that go beyond the primary aims of the research—historically referred to as “incidental findings”—has generated considerable discussion as to how this information should be handled—that is, whether incidental results should be returned, and if so, which ones.Federal regulations governing most human subjects research in the United States require the disclosure of “the procedures to be followed” in (...) the research as part of the informed consent process. It seems reasonable to assume—and indeed, many commentators have concluded—that genomic investigators will be expected to inform participants about, among other procedures, the prospect that incidental findings will become available and the mechanisms for dealing with them. Investigators, most of whom will not have dealt with these issues before, will face considerable challenges in framing meaningful disclosures for research participants.To help in this task, we undertook to identify the elements that should be included in the informed consent process related to incidental findings. We did this by surveying a large number of genomic researchers (n = 241) and by conducting in‐depth interviews with a smaller number of researchers (n = 28) and genomic research participants (n = 20). Based on these findings, it seems clear to us that routine approaches to informed consent are not likely to be effective in genomic research in which the prospect of incidental findings exists. Ensuring that participants’ decisions are informed and meaningful will require innovative approaches to dealing with the consent issue. We have identified four prototypical models of a consent process for return of incidental findings. (shrink)

Background Autism self-advocates’ views regarding genetic tests for autism are important, but critical questions about their perspectives arise.Methods We interviewed 11 autism self-advocates, recruited through autism self-advocacy websites, for 1 h each.Results Interviewees viewed genetic testing and its potential pros and cons through the lens of their own indiviudal perceived challenges, needs and struggles, especially concerning stigma and discrimination, lack of accommodations and misunderstandings from society about autism, their particular needs for services, and being blamed by others and by themselves (...) for autistic traits. Their views of genetic testing tended not to be binary, but rather depended on how the genetic test results would be used. Interviewees perceived pros of genetic testing both in general and with regard to themselves (e.g., by providing “scientific proof” of autism as a diagnosis and possibly increasing availability of services). But they also perceived disadvantages and limitations of testing (e.g., possible eugenic applications). Participants distinguished between what they felt would be best for themselves and for the autistic community as a whole. When asked if they would undergo testing for themselves, if offered, interviewees added several considerations (e.g., undergoing testing because they support science in general). Interviewees were divided whether a genetic diagnosis would or should reduce self-blame, and several were wary of testing unless treatment, prevention or societal attitudes changed. Weighing these competing pros and cons could be difficult.Conclusions This study, the first to use in-depth qualitative interviews to assess views of autism self-advocates regarding genetic testing, highlights key complexities. Respondents felt that such testing is neither wholly good or bad in itself, but rather may be acceptable depending on how it is used, and should be employed in beneficial, not harmful ways. These findings have important implications for practice, education of multiple stakeholders, research, and policy. (shrink)

Until recently, medicine has had little to offer most of the millions of patients suffering from rare and ultrarare genetic conditions. But the development in 2019 of Milasen, the first genetic intervention developed for and administered to a single patient suffering from an ultrarare genetic disorder, has offered hope to patients and families. In addition, Milasen raised a series of conceptual and ethical questions about how individualised genetic interventions should be developed, assessed for safety and efficacy and financially supported. The (...) answers to these questions depend in large part on whether individualised therapies are understood as human subjects research or clinical innovation, different domains of biomedicine that are regulated by different modes of oversight, funding and professional norms. In this article, with development and administration of the drug Milasen as our case study, we argue that at least some individualised genetic therapies are not, as some have argued, either research or treatment. Instead, they are research-treatment hybrids, a category that has both epistemological and pragmatic repercussions for funding, ethics oversight and regulation. (shrink)

Our aim is to explore and develop notions of objectivity that are useful and appropriate for critical realist empirical research. In Part I, we provided an initial definition that introduced the idea that objectivity is a value that must be chosen but that its significance is rooted in a series of other epistemological and ontological matters. We also addressed why it is worthwhile in realist terms to develop the notion of objectivity, and began to develop a revision of the concept (...) to recognise the role of subjectivities. This, we maintain, is an important clarification in developing social research. Part II explores the linkages between objectivity and situated action. In Part II we argue that the growth of knowledge requires engagement and critical analysis. We develop the idea that if subjects are engaged through multiple standpoints, then objectivity becomes significant as a lever of agency in the service of dialogue and debate and of transformations. Again, our aim is to be of use to practical researchers by providing underlying arguments. Specifically, we argue that objectivity is a bridge between the subjectivities of subjects and the rest of the real world. In so doing, the paper works through various desirable characteristics of an adequate theorisation of knowledge that could make objectivity part of the ontological underpinnings as well as the daily practices of a realist researcher. Objectivity thus links philosophical work to the everyday work of realist researchers. (shrink)

Our aim is to explore and develop notions of objectivity that are useful and appropriate for critical realist empirical research. Part I explores the values associated with objectivity, Part II the linkages between objectivity and situated action. The introductory section of Part I explains why it is worthwhile in realist terms to develop the notion of objectivity; that is, develop it as opposed to remaining content with murky hidden notions or connotations that the term ‘objectivity’ brings to mind and that (...) tend to cause confusion in how it is accepted and rejected. This is important as a clarification exercise for social research. In Part II, we argue that the growth of knowledge requires engagement and critical analysis. We develop the idea that if subjects are engaging objectively with reality and its multiple standpoints, then the results will tend to be transformative. Again, our aim is to be of use to practical researchers by providing underlying arguments. Specifically, we argue that objectivity is a bridge between the subjectivities of subjects and the rest of the real world. (shrink)

Placebo-controlled surgical trials can provide important information about the efficacy of surgical interventions. However, they are ethically contentious as placebo surgery entails the risk of harms to recipients, such as pain, scarring or anaesthetic misadventure. This has led to claims that placebo-controlled surgical trials are inherently unethical. On the other hand, without placebo-controlled surgical trials, it may be impossible to know whether an apparent benefit from surgery is due to the intervention itself or to the placebo effect.

On one hand, Chinese consumers are well known for conspicuous consumption and the adoption of luxury products and named brands. On the other hand, they also have a bad reputation for buying counterfeit products. Their simultaneous preferences for two contrasting types of product present a paradox that has not been addressed in the literature. This study attempts to present an explanation of this paradox by examining the effects of traditional Chinese cultural values and consumer values on consumers’ deontological judgment of (...) pirated CDs and the amount of social benefits they perceive they gain from them. We interviewed 300 Hong Kong Chinese consumers, and found that face consciousness increased materialism and risk aversion, thereby producing a favorable deontological judgment of pirated CDs. Face consciousness also has a direct effect on the amount of social benefits perceived in pirated CDs. Both favorable deontological judgment and perceived social benefits contributed to a strong intention to buy pirated CDs. The results are discussed in a cultural perspective. (shrink)

Discussions of surface pattern in Islamic art resonate within broader tensions about the role of figural representation in communicating meaning. The question of whether geometric pattern communicates—whether it functions as a language without a code—reflects broader tensions about the relationship between secular and spiritual communication. Poised between discussions of modernism and Islam, the attribution of linguistic capacity to geometry serves as a measure for the possibility of abstracting pure reason from the religious roots of representationalism. This paper explores this question (...) in four parts. First, it examines the articulation of geometric meaning in Islamic discourses. It then explores European discussions of geometry between language and ornament poised between a search for universal reason and universal spiritualism, both in modernist painting and in modern exhibitions. The final section the expressive capacity of artistic responses to historical Islamic isometric geometries in the adaptive reuse of historical Iranian arts as contemporary abstraction in the sculptures of Monir Shahroudy Farmanfarmaian and in the popular transformation prints of M. C. Escher. It argues that the frequent recognition of intrinsic meaning in geometry, expressed in both premodern Islamic and modern secular interpretations, undermines art historical expectations of theorization as a necessary intermediary for communication. Geometry thereby functions as a language without a code. (shrink)

Bringing together the expertise of rhetoricians in English and communication as well as media studies scholars, Arguments about Animal Ethics delves into the rhetorical and discursive practices of participants in controversies over the use of nonhuman animals for meat, entertainment, fur, and vivisection. Both sides of the debate are carefully analyzed, as the contributors examine how stakeholders persuade or fail to persuade audiences about the ethics of animal rights or the value of using animals.

This volume comprises papers presented at a conference marking the 50th anniversary of Joachim Wach's death, and the centennial of Mircea Eliade's birth.

Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the Science, Health and (...) Policy-relevant Ethics in Singapore Initiative. It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts. It also describes a set of substantive and procedural values that can be weighed up in addressing these concerns, and a step-by-step process for identifying, considering, and resolving the ethical issues arising from big data uses in health and research. This Framework is subsequently applied in the papers published in this Special Issue. These papers each address one of six domains where big data is currently employed: openness in big data and data repositories, precision medicine and big data, real-world data to generate evidence about healthcare interventions, AI-assisted decision-making in healthcare, public-private partnerships in healthcare and research, and cross-sectoral big data. (shrink)

Whereas previous research has focused on the link between workload and task performance, less is known about the intervening mechanisms influencing this relationship. In the present study, we test the moderating roles of daily recovery and total sleep time in the relationship between work pressure and daily task performance. Using performance and recovery theories, we hypothesized that work pressure relates positively to daily task performance, and that both daily recovery in the form of psychological detachment and relaxation, and total sleep (...) time independently enhance this relationship. Our hypotheses were tested in a 30-day diary study with 110 officer cadets on a cross-Atlantic voyage on a Naval sail ship. The results of multilevel modeling lend support to all three hypotheses. Taken together, our findings suggest that recovery and sleep duration between shifts play a key role in the relationship between daily work pressure and task performance. We discuss the implications of these findings for the stressor-detachment model. (shrink)

Making research data readily accessible during a public health emergency can have profound effects on our response capabilities. The moral milieu of this data sharing has not yet been adequately explored. This article explores the foundation and nature of a duty, if any, that researchers have to share data, specifically in the context of public health emergencies. There are three notable reasons that stand in opposition to a duty to share one’s data, relating to: (i) data property and ownership, (ii) (...) just distribution of benefits and burdens and (iii) the contemporary ethos of science. We argue each reason can be successfully met with corresponding rationale in favour of data sharing. Further support for data sharing has been echoed in policies of health agencies, funding bodies and academic institutions; in documents on the ethical conduct of biomedical research; and in discussions on the nature of public health. From this, we ascertain that sharing data is the morally sound default position. This article then highlights the key roles reciprocity and solidarity play in supporting the practice of data sharing. We conclude with recommendations to regard public health research data as a common-pool resource in order to build a framework for stable data sharing management. (shrink)

Many scientists and philosophers of science are troubled by the relative isolation of developmental from evolutionary biology. Reconciling the science of development with the science of heredity preoccupied a minority of biologists for much of the twentieth century, but these efforts were not corporately successful. Mainly in the past fifteen years, however, these previously dispersed integrating programmes have been themselves synthesized and so reinvigorated. Two of these more recent synthesizing endeavours are evolutionary developmental biology and developmental systems theory. While the (...) former is a bourgeoning and scientifically well-respected biological discipline, the same cannot be said of DST, which is virtually unknown among biologists. In this review, we provide overviews of DST and EDB, summarize their key tenets, examine how they relate to one another and to the study of epigenetics, and survey the impact that DST and EDB have had on biological theory and practice. (shrink)

Current brain research gives us the knowledge we need to create an Integral Society in every public school in America, pre-K through 12th and college level as well. The needed instructional strategies and curriculum development practices have been clearly described (Kovalik and Olsen, 2004) and are well within the grasp of current teachers. What is missing is the political will to implement what we know.