Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...) apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other. (shrink)

In this paper we discuss the epistemological positions of evolution theories. A sharp distinction is made between the theory that species evolved from common ancestors along specified lines of descent (here called the theory of common descent), and the theories intended as causal explanations of evolution (e.g. Lamarck's and Darwin's theory). The theory of common descent permits a large number of predictions of new results that would be improbable without evolution. For instance, (a) phylogenetic trees have been validated now; (b) (...) the observed order in fossils of new species discovered since Darwin's time could be predicted from the theory of common descent; (c) owing to the theory of common descent, the degrees of similarity and difference in newly discovered properties of more or less related species could be predicted. Such observations can be regarded as attempts to falsify the theory of common descent. We conclude that the theory of common descent is an easily-falsifiable & often-tested & still-not-falsified theory, which is the strongest predicate a theory in an empirical science can obtain. Theories intended as causal explanations of evolution can be falsified essentially, and Lamarck's theory has been falsified actually. Several elements of Darwin's theory have been modified or falsified: new versions of a theory of evolution by natural selection are now the leading scientific theories on evolution. We have argued that the theory of common descent and Darwinism are ordinary, falsifiable scientific theories. (shrink)

PurposeThe relation between fear of childbirth and gestational age is inconclusive, and self-reported need for help regarding this fear has never been investigated. This study aimed to determine the prevalence and course of FoC according to gestational age, to identify risk factors for the development of FoC, the influence of this fear on preferred mode of delivery, and self-reported need for help.MethodsNulliparous pregnant women of all gestational ages completed an online survey. The study consisted of a cross-sectional and a longitudinal (...) analysis. Women who completed the survey in the first or second trimester were approached again in their third trimester. The Wijma Delivery Expectancy Questionnaire Version A was used with a cut-off score ≥ 85 to define presence of fear of childbirth. Questionnaires indexing social support, anxiety, symptoms of depression, preferred mode of delivery, and self-reported need for help were included.ResultsIn total, 364 women were enrolled at T0, and 118 out of 184 eligible women were included in the longitudinal analysis. Point prevalence of FoC at T0 was 18.4% with no significant difference between trimesters. In the longitudinal sample, the prevalence of FoC decreased from 18.6% to 11.0%, p = 0.004. Although mean scores for FoC decreased significantly, p < 0.001, scores increased in 41 women. The presence of FoC was associated with elevated anxiety, less family support, prenatal care of the obstetrician by choice, preference for a cesarean section, and for pain relief. Women with FoC were more likely to actively seek for help compared to women without FoC.ConclusionWhile FoC is common in each trimester, prevalence decreases over the course of pregnancy. Women with FoC are often actively seeking for help, suggesting that this fear should be addressed better, and help should be offered accordingly. (shrink)

Ethnopedology is the study of local knowledge of soil and land management in an ecological perspective. It is an emerging hybrid discipline that is a component of ethnoecology and stands to offer much for land-based studies. This paper reviews the field of ethnopedology in Latin America and compares some of the many case studies from that region. Various literature sources are considered, including the ethnographical, ethnohistorical, archaeological, geographical, agronomic, ethnoecological, and development studies. Our review invokes the theory of ethnoecology that (...) focuses on the linkages between kosmos, corpus, and praxis of local land-users. The main topics covered are the ethnohistorical and archaeological evidence of ethnopedology, local soil and land classification, local land management systems, local perceptions and beliefs of soil and land resources, and local soil fertility management. After analysing past and present research trends, recommendations are given on how ethnopedological studies can contribute to enhance sustainable land use and management in Latin America. (shrink)

This study examines the specificvalues held by consumers towards organic andconventionally produced meat, with particularreference to moral issues surrounding foodanimal production. A quota sample of 30 femalesfrom both a rural and an urban area of Scotland, were interviewed. Overall, there was lowcommitment towards the purchase of organicmeats and little concern for ethical issues.Price and product appearance were the primarymeat selection criteria, the latter being usedas a predictor of eating quality. Manyattitude-behavior anomalies were identified,mainly as a result of respondents' cognitivedissonance and (...) lack of understanding regardingmeat production criteria underpinning meatquality marks, e.g., Soil Association label.Responsibilities for ethical issues appeared tobe delegated by the consumer to the meatretailer or government. This raises issuesabout educating consumers and bringingconsumers closer to understanding meatproduction systems. A conceptual framework isproposed that illustrates the significance ofconsumer involvement in how meat-purchasingdecisions are approached in terms of theevaluation of tangible and or intangiblequality attributes. The results also point tothe need for further research into thoseaspects of quality that individuals tend toaddress at the level of the citizen,rather than at the point of purchase. (shrink)

Much of the developing world, including Kenya, is rapidly urbanizing. Rising food and fuel prices in recent years have put the food security of the urban poor in a precarious position. In cities worldwide, urban agriculture helps some poor people gain access to food, but urban agriculture is less common in densely populated slums that lack space. In the Kibera slums of Nairobi, Kenya, households have recently begun a new form of urban agriculture called sack gardening in which vegetables such (...) as kale and Swiss chard are planted into large sacks filled with topsoil. This paper examines relationships among sack gardening, social capital, and food security in Kibera. We used a mixed methods approach, combining qualitative interviews with a household survey, as well as focus group discussions with both farmers and non-farmers. We present evidence that sack gardening increases social capital, especially for those households that undertake sack gardening in groups. We also find that sack gardening in the Kibera slums has a positive impact on household food security by improving household dietary diversity and by reducing the need to resort to painful coping mechanisms that are used during food shortages. (shrink)

We show that dynamical clustering, where a system segregates into distinguishable subsets of synchronized elements, and chimera states, where differentiated subsets of synchronized and desynchronized elements coexist, can emerge in networks of globally coupled robust-chaos oscillators. We describe the collective behavior of a model of globally coupled robust-chaos maps in terms of statistical quantities and characterize clusters, chimera states, synchronization, and incoherence on the space of parameters of the system. We employ the analogy between the local dynamics of a system (...) of globally coupled maps with the response dynamics of a single driven map. We interpret the occurrence of clusters and chimeras in a globally coupled system of robust-chaos maps in terms of windows of periodicity and multistability induced by a drive on the local robust-chaos map. Our results show that robust-chaos dynamics does not limit the formation of cluster and chimera states in networks of coupled systems, as it had been previously conjectured. (shrink)