Medicine has traditionally been regarded as a rewarding career both financially and socially. How true, however, is that tradition in today's world of rising costs and decreasing revenues? The educational debt of the physician-in-training is steadily increasing, and currently does not affect specialty choice. As the cost of medical education continues to rise, the applicant pool begins to shrink, thereby possibly affecting the quality of future physicians. Once the physician has completed training however, the majority enjoy a positive return on (...) investment. Their incomes generally fail to remain ahead of inflation, and therefore, have remained within a narrow band of $40,000 in 1970 dollars. Finally, the demand for physician services cannot be attributed solely to either the consumer (patient) or to the supplier (physician). Rather, the demand for medical services appears to be a unique combination of the two. In conclusion, medicine still is an attractive career path, but the choices and consequences are becoming much more demanding. (shrink)

argue that natural selection does not explain the genotypic arid phenotypic properties of individuals. On this view, natural selection explains the adaptedness of individuals, not by explaining why the individuals that exist have the adaptations they do, but rather by explaining why the individuals that exist are the ones with those adaptations. This paper argues that this ‘Negative’ view of natural selection ignores the fact that natural selection is a cumulative selection process. So understood, it explains how the genetic sequences (...) that individuals inherit and that are responsible for their complex (and co-adapted) adaptations first arose in the gene-pool. (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)

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)

The Court of Justice of the European Union and the way in which it works can be seen as a microcosm of how a multilingual, multicultural supranationalisation process and legal order can be constructed—the Court is a microcosm of the EU as a whole and in particular of EU law. The multilingual jurisprudence produced by the CJEU is necessarily shaped by the dynamics within that institution and by the ‘cultural compromises’ at play in the production process. The resultant texts, which (...) make up that jurisprudence, are hybrid in nature and inherently approximate. On the one hand, that approximation can lead to discrepancies between language versions of the Court’s case law and thus jeopardise the uniform application of EU law. On the other hand, that approximation and hybridity define EU law as a distinct, supranational legal order. This paper analyses the operation of the CJEU and considers whether a linguistic cultural compromise exists within that institution which exercises a formative influence on the character of its ‘output’—i.e. its jurisprudence—and what that may mean for our understanding of the development of EU law. (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)

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 framework of effective field theory is a natural one in which to understand the claim that the spacetime of general relativity is an emergent low-energy phenomenon. I argue for a pragmatic understanding of EFT, given that the appropriate conception of emergence it suggests is necessarily epistemological in a sense. Analogue models of spacetime are examples of the top-down approach to EFT. They offer concrete illustrations of spacetime emergent within an EFT, and lure us toward a strong analogy between condensed (...) matter physics and GR. I argue that we should be wary of this strong analogy, not least because the pragmatic view of EFT places limits on how much we can legitimately draw from it. On the other hand, programs that treat GR as an EFT and calculate quantum corrections are an example of the bottom-up approach and are explicitly pragmatic in character. I explore what we may learn about the nature of emergent spacetime by comparing these two approaches. (shrink)

The manipulationist account of causation provides a conceptual analysis of cause-effect relationships in terms of hypothetical experiments. It also explains why and how experiments are used for the empirical testing of causal claims. This paper attempts to apply the manipulationist account of causation to a broader range of experiments—a range that extends beyond experiments explicitly designed for the testing of causal claims. I aim to show that the set of causal inferences afforded by an experiment is determined solely on the (...) basis of contrasting case structures that I call “experimental series”, and that the conditions that suffice for causal inference obtain quite commonly, even among “ordinary” experiments that are not explicitly designed for the testing of causal claims. (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)

Roughly 20 percent of organic cropland wasdevoted to produce compared to only 3 percent forconventional agriculture in 1995. At the otherextreme, only 6 percent of organic cropland was incorn production while 25 percent of all croplandproduced corn. Only 30 percent of all organicfarmland was in pasture and rangeland compared to 66percent of all farmland. Clearly, these differencesreflect the greater importance of meat and dairyproduction in agriculture overall than in the organicsubsector. In recent years, the organic industry hasgrown not only in (...) volume but in products offered,moving well beyond fresh produce into dairy, snacks,and frozen foods. The estimated growth in retail salesof organic foods averaged over 20 percent a year forthe last eight years compared to only two percent inthe food industry overall, reaching an estimated $4.5billion in 1998. The mix of commodities produced atthe farm level have and will continue to change inresponse to several dynamic forces, including consumerdemand, regulation, and consolidations, mergers, andmainstream entrants at the farm, manufacturing, andretail levels. Consumer demand for organic foods hasbeen spurred by a number of factors including concernsover pesticide residues on foods, food produced usinggenetically modified organisms (GMOs), and hormones indairy and meat products. These concerns coupled withthe overall increase in demand for convenience foodsexplain the phenomenal recent growth of over 70 percent in sales of organic snacks, candy, and frozenfoods. The result has been increased demand forGMO-free grains for snacks, cereals, soy products, andfeed for dairy cows. The recent allowance by USDA forthe labeling of meat and poultry as organic willaccelerate already heightened demand for organic grainand feed from the organic dairy industry. Although thefastest growth in organic foods has been in categoriesother than produce, clearly produce plays an importantrole in the consumers decision on where to shop, anddemand should increase with the overall increase inthe number of organic consumers. Market outlets nowinclude sophisticated natural food store chains,gourmet specialty stores, and e-commerce, allowing fora broadened array of products. Mainstream agriculturalproducers, manufacturers, and supermarket chains haveentered the organic marketplace at a time of lowprices for commodities at the farm gate, fiercecompetition for retail shelf space, and increasinglysophisticated targeting of consumers. Inevitably,these changes in food products offered and in retailoutlets will lead to an organic agriculture thatincreasingly resembles the conventional foodindustry. (shrink)

Summary The enthusiasm of Renaissance humanists for classical learning greatly influenced the development of botany in the late fifteenth and sixteenth centuries. Humanist scholars restored the treatises of Theophrastus, Pliny, Galen and Dioscorides on botany and materia medica to general circulation and argued for their use as textbooks in Renaissance universities. Renaissance botanists' respect for classical precepts and models of the proper methods for studying plants temporarily discouraged the use of naturalistic botanical illustration, but encouraged other techniques for collecting and (...) communicating new observations: herbaria, botanical gardens and field trips. (shrink)

British Journal for the History of Philosophy, Volume 21, Issue 1, Page 207-209, January 2013.

The author contends that overworking residents cannot be ethically justified. There is evidence that overwork is detrimental both to the resident and to the patient. In addition, thu argument that working long hours is essential to maintain medicine's status as a profession is analyzed. The claim cannot be supported by definitions of professionalism. Although Flexner's definition does specify altruism as an essential component, it does not justify long working hours for residents. Altruism is obligatory in some limited cases, but only (...) when it is required to fulfill some contractual obligation. Keywords: professionalism, altruism, residency, medical education CiteULike Connotea Del.icio.us What's this? (shrink)

Is it possible to take the enterprise of physics seriously while also holding the belief that the world contains an order beyond the reach of that physics? Is it possible to simultaneously believe in objective laws of nature and in miracles? Is it possible to search for the truths of physics while also acknowledging the limitations of that search as it is carried out by limited human knowers? As a philosopher, as a Christian, and as a participant in the physics (...) of his day, Leibniz had an interesting view that bears on all of these questions. This paper examines the status of laws of nature in Leibniz's philosophy and how the status of these laws fits into his larger philosophical picture of the limits of human knowledge and the wise and omniscient God who created the actual world. (shrink)

ObjectivesThis pilot study sought to develop and evaluate a novel online group-based intervention to help breast cancer survivors make healthy lifestyle changes intended to yield not only beneficial physical outcomes but also greater behavioral, and psychosocial well-being.MethodsAn exploratory single-arm, mixed-method triangulation design was employed to evaluate the feasibility and preliminary effectiveness of the HLM-ABC intervention for overweight BCSs. Fourteen women participated in the 10-week intervention and completed quantitative measures of the above-mentioned outcomes at baseline, post-treatment, 6-month, and 12-month follow-up time (...) points. Qualitative data were obtained post-treatment via semi-structured interviews and a treatment satisfaction questionnaire.ResultsParticipants lost an average of 2.83% of their baseline weight by 1-year follow-up, equal to a small effect size. Despite achieving only modest weight loss, participants achieved meaningful gains in the form of increased physical activity, discovery of gratifying movement, more intuitive eating habits, greater bodily and emotional awareness, and positive shifts in beliefs about being able to make healthy choices regarding food and physical activity. Furthermore, they demonstrated a slight improvement in body image and described feeling more self-compassionate, empowered, and acknowledging of variables beyond control that can present barriers to change.ConclusionAfter completing a 10-week online program, participants achieved meaningful and lasting changes on a number of healthful indicators, even when this did not correspond with a significant reduction in weight. Findings highlight the complex, multifaceted nature of “health” and lend support for promotion of healthier lifestyle following cancer treatment that encompasses not only physical weight, but also behavior, psychosocial well-being, and circumstances such as life-preserving hormonal treatments. (shrink)

It is a rather safe statement to claim that the social dimensions of the scientific process are accepted in a fair share of studies in the philosophy of science. It is a somewhat safe statement to claim that the social dimensions are now seen as an essential element in the understanding of what human cognition is and how it functions. But it would be a rather unsafe statement to claim that the social is fully accepted in the philosophy of mathematics. (...) And we are not quite sure what kind of statement it is to claim that the social dimensions in theories of mathematics education are becoming more prominent, compared to the psychological dimensions. In our contribution we will focus, after a brief presentation of the above claims, on this particular domain to understand the successes and failures of the development of theories of mathematics education that focus on the social and not primarily on the psychological. (shrink)

Humility, properly understood as a sense of one's limits, is one of the goods internal to the practice of health care. Humility in Christian tradition has both a relational aspect and an epistemological aspect. Each of these is evident in the practice of medicine. In its relational aspect, humility includes reverance or awe for the grace and strength of patients and their care-givers, a sense that the care-provider is not self-sufficient but needs the care-receiver, and recognition of the worth of (...) those who are oppressed and outcast. In its epistemological aspect, humility is exhibited in respect for the meaning system of the patient and recognition of the limits of medical paradigms and their need for correction from the patient's perspective. The power wielded by the profession of medicine in contemporary society does not preclude the exercise of humility within the profession. Keywords: epistemology, humility, internal goods, practice of medicine, virtue CiteULike Connotea Del.icio.us What's this? (shrink)