The evolutionary origin of human pair-bonds is uncertain. One hypothesis, supported by data from forgers, suggests that pair-bonds function to provision mothers and dependent offspring during lactation. Similarly, public health data from large-scale industrial societies indicate that single mothers tend to wean their children earlier than do women living with a mate. Here we examine relations between pair-bond stability, alloparenting, and cross-cultural trends in breastfeeding using data from 58 “traditional” societies in the Standard Cross-Cultural Sample (SCCS). Analyses show that stable (...) conjugal relationships were associated with significantly later weaning among the societies in the SCCS. The relationship between pair-bond stability and age at weaning was not mediated by women’s ability to provision themselves or women’s kin support. Availability of alloparental care was also inversely related to age at weaning, and the association was not significantly reduced after controlling for frequency of divorce. This study indicates that among a woman’s kin relationships, a pair-bond with a child’s father is especially supportive of breastfeeding. These cross-cultural findings are further evidence that human pair-bonds may have evolved to support lactation. (shrink)

BackgroundAccurate reporting on sex and gender in health research is integral to ensuring that health interventions are safe and effective. In Canada and internationally, governments, research organizations, journal editors, and health agencies have called for more inclusive research, provision of sex-disaggregated data, and the integration of sex and gender analysis throughout the research process. Sex and gender analysis is generally defined as an approach for considering how and why different subpopulations (e.g., of diverse genders, ages, and social locations) may experience (...) health conditions and interventions in different or similar ways.The objective of this study was to assess the extent and nature of reporting about sex and/or gender, including whether sex and gender analysis (SGA) was carried out in a sample of Canadian randomized controlled trials (RCTs) with human participants.MethodsWe searched MEDLINE from 01 January 2013 to 23 July 2014 using a validated filter for identification of RCTs, combined with terms related to Canada. Two reviewers screened the search results to identify the first 100 RCTs that were either identified in the trial publication as funded by a Canadian organization or which had a first or last author based in Canada. Data were independently extracted by two people from 10% of the RCTs during an initial training period; once agreement was reached on this sample, the remainder of the data extraction was completed by one person and verified by a second.ResultsThe search yielded 1433 records. We screened 256 records to identify 100 RCTs which met our eligibility criteria. The median sample size of the RCTs was 107 participants (range 12–6085). While 98% of studies described the demographic composition of their participants by sex, only 6% conducted a subgroup analysis across sex and 4% reported sex-disaggregated data. No article defined “sex” and/or “gender.” No publication carried out a comprehensive sex and gender analysis.ConclusionsFindings highlight poor uptake of sex and gender considerations in the Canadian RCT context and underscore the need for better articulated guidance on sex and gender analysis to improve reporting of evidence, inform policy development, and guide future research. (shrink)

This essay provides an explanation and interpretation of the undertreatment of pain by discussing some of the scientific, clinical, cultural, and philosophical aspects of this problem. One reason why pain continues to be a problem for medicine is that pain does not conform to the scientific approach to health and disease, a philosophy adopted by most health care professionals. Pain does not fit this philosophical perspective because (1) pain is subjective, not objective; (2) the causal basis of pain is often (...) poorly understood; (3) pain is often regarded as a mere symptom, not as a disease; (4) there often are no magic bullets for pain; (5) pain does not fit the expert knowledge model. In order for health care professionals to do a better job of treating pain, some changes need to occur in medical philosophy, education, and practice. (shrink)

Several standard conditions of adequacy for confirmation are considered and a conclusion of B. Skyrms regarding the converse-consequence condition is shown to be mistaken. Widely accepted conditions such as the entailment condition and the special consequence condition are shown to be open to counterexample, and confusion about these conditions is traced to confusion about the difference between two kinds of confirmation concepts--concepts of firmness and concepts of increase in firmness. The importance of concepts of the latter sort is stressed. Finally, (...) some suggestions are offered relating to the notion of selective confirmation. (shrink)

This study examines the family environments and hormone profiles of 316 individuals aged 2 months-58 years residing in a rural village on the east coast of Dominica, a former British colony in the West Indies. Fieldwork was conducted over an eight-year period (1988–1995). Research methods and techniques include radioimmunoassay of cortisol and testosterone from saliva samples (N=22,340), residence histories, behavioral observations of family interactions, extensive ethnographic interview and participant observation, psychological questionnaires, and medical examinations.Analyses of data indicate complex, sex-specific effects (...) of family environment on endocrine function. Male endocrine profiles exhibit greater sensitivity to presence of father than do female endocrine profiles. Father-absent males tend to have (a) low cortisol levels during infancy, (b) high or abnormal cortisol profiles during childhood and adolescence, and (c) high cortisol and low testosterone levels during adulthood compared with those of males raised with a resident father. These results indicate that early family environment has significant effects on endocrine response throughout male life histories. (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and medicine, (...) truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

Several US states are enacting 'right-to-die' laws, in the wake of the Karen Quinlan case. But the way such a law is drafted may cast doubt on a patient's existing common law right to control all aspects of his own treatment; it may give legal sanction to a lower standard of medical care that society at present expects from doctors; and it may lead to conflict between the patient's directive and his doctor's clinical judgement which cannot readily be resolved. (...) The laws themselves are categorised as a) legalising active killing or b) defining rights of patients to control treatment or c) assigning to others the rights to control treatment where the patient is not competent. The California law is discussed critically. The conclusion is that such legislation is not a satisfactory answer to the ethical problem of euthanasia. (shrink)

This study suggests that news obituaries have a role to play in educating practical reason using The New York Times’ Overlooked project to illustrate. The argument draws from virtue ethicist Alasdair MacIntyre’s book Ethics in the Conflicts of Modernity. A close reading of Overlooked’s15 initial obituaries used the biographies in MacIntyre’s book as templates. The analysis concluded that the articles on LGBTQ activist Marsha P. Johnson and novelist Charlotte Brontë illustrated lives that were happy in an Aristotelian sense despite (...) misfortune. The articles on journalist Ida B. Wells and mathematician Ada Lovelace illustrated incomplete lives despite overall directedness. The articles on novelist Nella Larsen and Brooklyn Bridge supervisor Emily Warren Roebling illustrated the challenge of reconciling different aspects of one’s life to achieve unity of character. This finding was closely tied to how structural injustice prevents or distorts the kinds of relationships MacIntyre says agents need to flourish. (shrink)

[opening paragraph]: I have great respect for efforts by Francisco Varela, Jonathan Shear and company to create a systematic phenomenology. In support of their efforts it should be noted that there is no need to start from scratch. We already have a systematic study of human conscious experience, and it is called ‘psychology'. True, many academic psychologists deny this rather obvious fact, but if we look at what they do rather than what they say, we find that they are always (...) studying the things people can report with accuracy. But the things we humans can report accurately are the same things we experience as conscious! Reportability is the generally accepted index of consciousness. In point of fact, therefore, psychologists are always asking people about their conscious experiences. (shrink)

This article examines the impact that the interplay between workplace, the welfare state and global working life has on female workers when they become pregnant. By focusing on two highly educated Norwegian female workers, it explores how this change process takes place in two companies operating in the global market located in different countries: Norway and the US. Pregnancy contributes to transforming the neutralized bodiless female worker into an embodied worker with gender. The female workers' experiences and negotiations represent forms (...) of global action on local stages. This is illustrated by four processes: `married to work', `pregnant and still married to work', `negotiating separation from work' and `excluding mothering'. The findings indicate the significance of taking welfare state and workplace policy approaches into consideration in studies of global effects on employees. (shrink)

Social standards have become important tools in corporate governance. They are often presented as voluntary initiatives in CSR and are generally based on the principle of multi-stakeholder collaboration as a means to gain legitimacy. Yet, based on a case study of a company in the textile industry, the paper shows that not all CSR standards are equally valued and that the adoption of particular CSR standards can be the result of external constraints on managerial discretion, e.g. emerging from business partners (...) and activist groups. (shrink)

At the threshold of the Twenty-First Century, Humankind is facing a new Era. After 6 million years of genomic independent existence and after 2 million years of increased capacity in learning and transmitting information among the members of the group and from one generation to the next which supported an enduring technological tradition, we are now facing the effects of a dramatic and accelerated population growth. In the last two centuries human population size increased from one billion in 1835, to (...) 2.5 billion by 1950. This number then doubled in only 45 years to almost 6 billion. This unprecedented increase in numbers, affecting specific geographical areas, has accentuated the deterioration of the natural environment caused by the misuse of natural resources and the depletion of fertile soils due to the clearance of forests, climatic changes and pollution. (shrink)