Communication, recognition and social work: Aligning the ethical theories of Habermas and Honneth

The modern world is replete with ethical challenges of Orwellian proportions. The violation of human rights and misrecognition of identities are two of the most pressing examples. In this paper, the ethical theories of Habermas and Honneth are aligned as a way of addressing these specific challenges within social work. It is suggested that these theories are complementary, mutually rectifying and concordant at the meta-ethical level of analysis. The alignment is also justified, pargmatically, through the construction of three hypothetical vignettes demonstrating different kinds of practice dilemmas. The need for egalitarian communication and the imperative to recognise human identity in all its dimensions subsequently emerge as the two foundation stones for ethical deliberation in social work.

The effect of increased dietary fruit and vegetable consumption on endothelial activation, inflammation and oxidative stress in hypertensive volunteers

Background and aims

Public health campaigns recommend increased fruit and vegetable (FV) consumption as an effective means of cardiovascular risk reduction. During an 8 week randomised control trial among hypertensive volunteers, we noted significant improvements in endothelium-dependent vasodilatation with increasing FV consumption. Circulating indices of inflammation, endothelial activation and insulin resistance are often employed as alternative surrogates for systemic arterial health. The responses of several such biomarkers to our previously described FV intervention are reported here.
Methods and results

Hypertensive volunteers were recruited from medical outpatient clinics. After a common 4 week run-in period during which FV consumption was limited to 1 portion per day, participants were randomised to 1, 3 or 6 portions daily for 8 weeks. Venous blood samples for biomarker analyses were collected during the pre and post-intervention vascular assessments. A total of 117 volunteers completed the 12 week study. Intervention-related changes in circulating levels of high sensitivity C-reactive protein (hsCRP), soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), von Willebrand factor (vWF) and plasminogen activator inhibitor-1 (PAI-1) did not differ significantly between FV groups. Similarly, there were no significant between group differences of change in homeostasis model assessment (HOMA) scores.
Conclusions

Despite mediating a significant improvement in acetylcholine induced vasodilatation, increased FV consumption did not affect a calculated measure of insulin resistance or concentrations of the circulating biomarkers measured during this study. Functional indices of arterial health such as endothelium-dependent vasomotion are likely to provide more informative cardiovascular end-points during short-term dietary intervention trials.

Red meat consumption: An overview of the risks and benefits

Red meat is long established as an important dietary source of protein and essential nutrients including iron, zinc and vitamin B12, yet recent reports that its consumption may increase the risk of cardiovascular disease (CVD) and colon cancer have led to a negative perception of the role of red meat in health. The aim of this paper is to review existing literature for both the risks and benefits of red meat consumption, focusing on case-control and prospective studies. Despite many studies reporting an association between red meat and the risk of CVD and colon cancer, several methodological limitations and inconsistencies were identified which may impact on the validity of their findings. Overall, there is no strong evidence to support the recent conclusion from the World Cancer Research Fund (WCRF) report that red meat has a convincing role to play in colon cancer. A substantial amount of evidence supports the role of lean red meat as a positive moderator of lipid profiles with recent Studies identifying it as a dietary source of the anti-inflammatory long chain (LC) n-3 PUFAs and conjugated linoleic acid (CIA). In conclusion. moderate consumption of lean red meat as part of a balanced diet is unlikely to increase risk for CVD or colon cancer, but may positively influence nutrient intakes and fatty acid profiles, thereby impacting positively on long-term health. (C) 2009 Elsevier Ltd. All rights reserved

Patterns of alcohol consumption and ischaemic heart disease in culturally divergent countries: The Prospective Epidemiological Study of Myocardial Infarction (PRIME)

Objective: To investigate the effect of alcohol intake patterns on ischaemic heart disease in two countries with contrasting lifestyles, Northern Ireland and France.
Design: Cohort data from the Prospective Epidemiological Study of Myocardial Infarction (PRIME) were analysed. Weekly alcohol consumption, incidence of binge drinking (alcohol >50 g on at least one day a week), incidence of regular drinking (at least one day a week, and alcohol <50 g if on only one occasion), volume of alcohol intake, frequency of consumption, and types of beverage consumed were assessed once at inclusion. All coronary events that occurred during the 10 year follow-up were prospectively registered. The relation between baseline characteristics and incidence of hard coronary events and angina events was assessed by Cox's proportional hazards regression analysis.
Setting: One centre in Northern Ireland (Belfast) and three centres in France (Lille, Strasbourg, and Toulouse).
Participants: 9778 men aged 50-59 free of ischaemic heart disease at baseline, who were recruited between 1991 and 1994.
Main outcome measures: Incident myocardial infarction and coronary death ("hard" coronary events), and incident angina pectoris.
Results: A total of 2405 men from Belfast and 7373 men from the French centres were included in the analyses, 1456 (60.5%) and 6679 (90.6%) of whom reported drinking alcohol at least once a week, respectively. Among drinkers, 12% (173/1456) of men in Belfast drank alcohol every day compared with 75% (5008/6679) of men in France. Mean alcohol consumption was 22.1 g/day in Belfast and 32.8 g/day in France. Binge drinkers comprised 9.4% (227/2405) and 0.5% (33/7373) of the Belfast and France samples, respectively. A total of 683 (7.0%) of the 9778 participants experienced ischaemic heart disease events during the 10 year follow-up: 322 (3.3%) hard coronary events and 361 (3.7%) angina events. Annual incidence of hard coronary events per 1000 person years was 5.63 (95% confidence interval 4.69 to 6.69) in Belfast and 2.78 (95% CI 2.41 to 3.20) in France. After multivariate adjustment for classic cardiovascular risk factors and centre, the hazard ratio for hard coronary events compared with regular drinkers was 1.97 (95% CI 1.21 to 3.22) for binge drinkers, 2.03 (95% CI 1.41 to 2.94) for never drinkers, and 1.57 (95% CI 1.11 to 2.21) for former drinkers for the entire cohort. The hazard ratio for hard coronary events in Belfast compared with in France was 1.76 (95% CI 1.37 to 2.67) before adjustment, and 1.09 (95% CI 0.79 to 1.50) after adjustment for alcohol patterns and wine drinking. Only wine drinking was associated with a lower risk of hard coronary events, irrespective of the country.
Conclusions: Regular and moderate alcohol intake throughout the week, the typical pattern in middle aged men in France, is associated with a low risk of ischaemic heart disease, whereas the binge drinking pattern more prevalent in Belfast confers a higher risk.

The politics of ethical foreign policy::A responsibility to protect whom?

Ethical foreign policy persists as a problem of international relations, especially regarding humanitarian intervention. However, despite apparent international upheavals, the debate about the ethics of humanitarian intervention has remained fundamentally unchanged. To escape the limits of this debate, this article deconstructs British claims to ethical foreign policy since 1997, reading these claims against themselves and against contemporary humanitarian intervention literature. It finds that Britain’s ethical framework, the ‘doctrine of international community’, which justifies interventions in Kosovo, Sierra Leone and Afghanistan, is undone by the anomalous, yet exemplary, invasion of Iraq. This demonstrates the politics of ethical foreign policy: first, that any intervention, no matter how ‘ethical’ or ‘right’, produces suffering and death; and, second, that we cannot know for sure whether we are doing the right thing by intervening. Embracing, rather than effacing, the political nature of ethical foreign policy opens up a more intellectually honest and positive potential future for relating to the foreign in a responsible manner.

Mandated prevention in child welfare: Considerations from a framework shaping ethical inquiry

Summary: This article outlines a framework for approaching ethical dilemmas arising from the development, evaluation and implementation of child welfare policies. As such, it is relevant to policy-makers, social researchers and social workers. The central tenets of the framework are developed by drawing on ideas from moral philosophy and critical social theory. These ideas are presented as axioms, theorems and corollaries, a format which has been employed in the social sciences to offer a rational justification for a set of claims. • Findings: This process of reasoning leads to four principle axioms that are seen to shape the ethical scrutiny of social policy: 1) problematizing knowledge; 2) utilizing structured forms of inquiry to enhance understanding; 3) engendering enabling communication with those affected by the ethical concern; and 4) enhancing self-awareness. • Applications: The four axioms are then applied, by way of example, to the current and contentious, 'third way' policy of mandated prevention in child welfare, where the aim is to obviate deleterious outcomes in later life. It is argued that the framework can be applied beyond this specific concern to other pressing, ethical challenges in child welfare.

Oily fish consumption, dietary docosahexaenoic acid and eicosapentaenoic acid intakes, and associations with neovascular age-related macular degeneration

Background: Fish intake, the major source of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), may reduce the risk of age-related macular degeneration (AMD). Objective: We investigated the association of oily fish and dietary DHA and EPA with neovascular AMD (NV-AMD). Design: Participants aged =65 y in the cross-sectional population-based EUREYE study underwent fundus photography and were interviewed by using a food-frequency questionnaire. Fundus images were graded by the International Classification System for Age Related Maculopathy. Questionnaire data were converted to nutrient intakes with the use of food-composition tables. Survey logistic regression was used to calculate odds ratios (ORs) and 95% CIs of energy-adjusted quartiles of EPA or DHA with NV-AMD, taking into account potential confounders. Results: Dietary intake data and fundus images were available for 105 cases with NV-AMD and for 2170 controls without any features of early or late AMD. Eating oily fish at least once per week compared with less than once per week was associated with a halving of the odds of NV-AMD (OR = 0.47; 95% CI: 0.33, 0.68; P = 0.002). Compared with the lowest quartile, there was a significant trend for decreased odds with increasing quartiles of either DHA or EPA. ORs in the highest quartiles were 0.32 (95% CI: 0.12, 0.87; P = 0.03) for DHA and 0.29 (95% CI: 0.11, 0.73; P = 0.02) for EPA. Conclusions: Eating oily fish at least once per week compared with less than once per week was associated with a halving of the OR for NV-AMD. © 2008 American Society for Nutrition.

The Impact of Ethical Orientation and Gender on Final Year Undergraduate Auditing Students’ Ethical Judgments

This study considers the possibility of auditing students’ ethical judgment being affected by two factors, namely ethical orientation and gender. While tests revealed that more idealistic students judged some unethical situations more strictly than less idealistic students, overall no significant relationship was found between ethical orientation and ethical judgment. The study also reported no significant relationship between gender and ethical judgment. Furthermore, males were as likely as females to be classified as high idealists. Overall, the findings from the current study inform auditing educators that discriminating among students on the basis of ethical orientation and gender may not assist in stimulating students’ discussion and resolution of ethical dilemmas.