Ethical values in emergency medical services: A pilot study

Background Ambulance professionals often address conflicts between ethical values. As individuals’ values represent basic convictions of what is right or good and motivate behaviour, research is needed to understand their value profiles. Objectives To translate and adapt the Managerial Values Profile to Spanish and Swedish, and measure the presence of utilitarianism, moral rights and/or social justice in ambulance professionals’ value profiles in Spain and Sweden. Methods The instrument was translated and culturally adapted. A content validity index was calculated. Pilot tests were carried out with 46 participants. Ethical considerations This study conforms to the ethical principles for research involving human subjects and adheres to national laws and regulations concerning informed consent and confidentiality. Findings Spanish professionals favoured justice and Swedish professionals’ rights in their ambulance organizations. Both countries favoured utilitarianism least. Gender differences across countries showed that males favoured rights. Spanish female professionals favoured justice most strongly of all. Discussion Swedes favour rights while Spaniards favour justice. Both contexts scored low on utilitarianism focusing on total population effect, preferring the opposite, individualized approach of the rights and justice perspectives. Organizational investment in a utilitarian perspective might jeopardize ambulance professionals’ moral right to make individual assessments based on the needs of the patient at hand. Utilitarianism and a caring ethos appear as stark opposites. However, a caring ethos in its turn might well involve unreasonable demands on the individual carer’s professional role. Since both the justice and rights perspectives portrayed in the survey mainly concern relationship to the organization and peers within the organization, this relationship might at worst be given priority over the equal treatment and moral rights of the patient. Conclusion A balanced view on ethical perspectives is needed to make professionals observant and ready to act optimally – especially if these perspectives are used in patient care. Research is needed to clarify how justice and rights are prioritized by ambulance services and whether or not these organization-related values are also implemented in patient care.

Common values in assessing health outcomes from disease and injury: Disability weights measurement study for the Global Burden of Disease Study 2010

BACKGROUND Measurement of the global burden of disease with disability-adjusted life-years (DALYs) requires disability weights that quantify health losses for all non-fatal consequences of disease and injury. There has been extensive debate about a range of conceptual and methodological issues concerning the definition and measurement of these weights. Our primary objective was a comprehensive re-estimation of disability weights for the Global Burden of Disease Study 2010 through a large-scale empirical investigation in which judgments about health losses associated with many causes of disease and injury were elicited from the general public in diverse communities through a new, standardised approach. METHODS We surveyed respondents in two ways: household surveys of adults aged 18 years or older (face-to-face interviews in Bangladesh, Indonesia, Peru, and Tanzania; telephone interviews in the USA) between Oct 28, 2009, and June 23, 2010; and an open-access web-based survey between July 26, 2010, and May 16, 2011. The surveys used paired comparison questions, in which respondents considered two hypothetical individuals with different, randomly selected health states and indicated which person they regarded as healthier. The web survey added questions about population health equivalence, which compared the overall health benefits of different life-saving or disease-prevention programmes. We analysed paired comparison responses with probit regression analysis on all 220 unique states in the study. We used results from the population health equivalence responses to anchor the results from the paired comparisons on the disability weight scale from 0 (implying no loss of health) to 1 (implying a health loss equivalent to death). Additionally, we compared new disability weights with those used in WHO's most recent update of the Global Burden of Disease Study for 2004. FINDINGS 13,902 individuals participated in household surveys and 16,328 in the web survey. Analysis of paired comparison responses indicated a high degree of consistency across surveys: correlations between individual survey results and results from analysis of the pooled dataset were 0·9 or higher in all surveys except in Bangladesh (r=0·75). Most of the 220 disability weights were located on the mild end of the severity scale, with 58 (26%) having weights below 0·05. Five (11%) states had weights below 0·01, such as mild anaemia, mild hearing or vision loss, and secondary infertility. The health states with the highest disability weights were acute schizophrenia (0·76) and severe multiple sclerosis (0·71). We identified a broad pattern of agreement between the old and new weights (r=0·70), particularly in the moderate-to-severe range. However, in the mild range below 0·2, many states had significantly lower weights in our study than previously. INTERPRETATION This study represents the most extensive empirical effort as yet to measure disability weights. By contrast with the popular hypothesis that disability assessments vary widely across samples with different cultural environments, we have reported strong evidence of highly consistent results.

Non-market use and non-use values for preserving ecosystem services over time : a choice experiment application to coral reef ecosystems in New Caledonia

Non-use values (i.e. economic values assigned by individuals to ecosystem goods and services unrelated to current or future uses) provide one of the most compelling incentives for the preservation of ecosystems and biodiversity. Assessing the non-use values of non-users is relatively straightforward using stated preference methods, but the standard approaches for estimating non-use values of users (stated decomposition) have substantial shortcomings which undermine the robustness of their results. In this paper, we propose a pragmatic interpretation of non-use values to derive estimates that capture their main dimensions, based on the identification of a willingness to pay for ecosystem protection beyond one's expected life. We empirically test our approach using a choice experiment conducted on coral reef ecosystem protection in two coastal areas in New Caledonia with different institutional, cultural, environmental and socio-economic contexts. We compute individual willingness to pay estimates, and derive individual non-use value estimates using our interpretation. We find that, a minima, estimates of non-use values may comprise between 25 and 40% of the mean willingness to pay for ecosystem preservation, less than has been found in most studies.

Basic personal values underlie and give coherence to political values: A cross national study in 15 countries

Do the political values of the general public form a coherent system? What might be the source of coherence? We view political values as expressions, in the political domain, of more basic personal values. Basic personal values (e.g., security, achievement, benevolence, hedonism) are organized on a circular continuum that reflects their conflicting and compatible motivations. We theorize that this circular motivational structure also gives coherence to political values. We assess this theorizing with data from 15 countries, using eight core political values (e.g., free enterprise, law and order) and ten basic personal values. We specify the underlying basic values expected to promote or oppose each political value. We offer different hypotheses for the 12 non-communist and three post-communist countries studied, where the political context suggests different meanings of a basic or political value. Correlation and regression analyses support almost all hypotheses. Moreover, basic values account for substantially more variance in political values than age, gender, education, and income. Multidimensional scaling analyses demonstrate graphically how the circular motivational continuum of basic personal values structures relations among core political values. This study strengthens the assumption that individual differences in basic personal values play a critical role in political thought.

A values analysis of attitudes towards the use of law to prevent obesity: How might these values inform public health law theory and practice?

This thesis asks whether values, like government duty, individual responsibility, community and social justice, influence the way that scholars and research participants think about the use of law to prevent obesity. It explores the way participants speak about values when expressing their support for or against a variety of government regulatory interventions, including taxation, food labelling reforms and advertising restrictions. This research contributes to our understanding of theories of public health law and public health ethics. The qualitative findings also have implications for policy development, in advocating for a variety of government interventions to prevent obesity.

Best individual template selection from deformation tensor minimization

We study the influence of the choice of template in tensor-based morphometry. Using 3D brain MR images from 10 monozygotic twin pairs, we defined a tensor-based distance in the log-Euclidean framework [1] between each image pair in the study. Relative to this metric, twin pairs were found to be closer to each other on average than random pairings, consistent with evidence that brain structure is under strong genetic control. We also computed the intraclass correlation and associated permutation p-value at each voxel for the determinant of the Jacobian matrix of the transformation. The cumulative distribution function (cdf) of the p-values was found at each voxel for each of the templates and compared to the null distribution. Surprisingly, there was very little difference between CDFs of statistics computed from analyses using different templates. As the brain with least log-Euclidean deformation cost, the mean template defined here avoids the blurring caused by creating a synthetic image from a population, and when selected from a large population, avoids bias by being geometrically centered, in a metric that is sensitive enough to anatomical similarity that it can even detect genetic affinity among anatomies.

Resolution of racemic gossypol and interaction of individual enantiomers with serum albumins and model peptides

Racemic gossypol has been resolved by HPLC separation of diastereomeric (−) norepinephrine adducts on a reverse-phase column. The binding constants for the interaction of the three gossypol forms (+, − and −) with human and bovine serum albumins have been determined by fluoresence quenching studies. The KD values demonstrate that all three forms bind equally effectively to the two proteins, suggesting an absence of chiral discrimination in albumin-gossypol interactions. Circular dichroism studies of (+)-gossypol binding to the model dibasic peptides, Boc-Lys-Pro-Aib-Lys-NHMe and gramicidin S, suggesting that distortions of binaphthyl geometry may occur only for specific orientations of interacting residues at the receptor site.

Objective `Safe' Grazing Capacities for South-West Queensland Australia: Development of a Model for Individual Properties

Few tools are available to assist graziers, land administrators and financiers in making objective grazing capacity decisions on Australian rangelands, despite existing knowledge regarding stocking rate theory and the impact of stocking rates on land condition. To address this issue a model for objectively estimating 'safe' grazing capacities on individual grazing properties in south-west Queensland was developed. The method is based on 'safe' levels of utilisation (15%-20%) by domestic livestock of average annual forage grown for each land system on a property. Average annual forage grown (kglha) was calculated as the product of the rainfall use efficiency (kglhdmm) and average annual rainfall (mm) for a land system. This estimate included the impact of tree and shrub cover on forage production. The 'safe' levels of forage utilisation for south- west Queensland pastures were derived from the combined experience of (1) re-analysis of the results of grazing trials, (2) reaching a consensus on local knowledge and (3) examination of existing grazing practice on 'benchmark' grazing properties. We recognise the problems in defining, determining and using grazing capacity values, but consider that the model offers decision makers a tool that can be used to assess the grazing capacity of individual properties.

Estimating daily methane production in individual cattle with irregular feed intake patterns from short-term methane emission measurements

Spot measurements of methane emission rate (n = 18 700) by 24 Angus steers fed mixed rations from GrowSafe feeders were made over 3- to 6-min periods by a GreenFeed emission monitoring (GEM) unit. The data were analysed to estimate daily methane production (DMP; g/day) and derived methane yield (MY; g/kg dry matter intake (DMI)). A one-compartment dose model of spot emission rate v. time since the preceding meal was compared with the models of Wood (1967) and Dijkstra et al. (1997) and the average of spot measures. Fitted values for DMP were calculated from the area under the curves. Two methods of relating methane and feed intakes were then studied: the classical calculation of MY as DMP/DMI (kg/day); and a novel method of estimating DMP from time and size of preceding meals using either the data for only the two meals preceding a spot measurement, or all meals for 3 days prior. Two approaches were also used to estimate DMP from spot measurements: fitting of splines on a 'per-animal per-day' basis and an alternate approach of modelling DMP after each feed event by least squares (using Solver), summing (for each animal) the contributions from each feed event by best-fitting a one-compartment model. Time since the preceding meal was of limited value in estimating DMP. Even when the meal sizes and time intervals between a spot measurement and all feeding events in the previous 72 h were assessed, only 16.9% of the variance in spot emission rate measured by GEM was explained by this feeding information. While using the preceding meal alone gave a biased (underestimate) of DMP, allowing for a longer feed history removed this bias. A power analysis taking into account the sources of variation in DMP indicated that to obtain an estimate of DMP with a 95% confidence interval within 5% of the observed 64 days mean of spot measures would require 40 animals measured over 45 days (two spot measurements per day) or 30 animals measured over 55 days. These numbers suggest that spot measurements could be made in association with feed efficiency tests made over 70 days. Spot measurements of enteric emissions can be used to define DMP but the number of animals and samples are larger than are needed when day-long measures are made.

Impact of wildfires and floods on property values: A before and after analysis

One of the most evident casualties of a natural disaster is the property market. The private and social costs from such events run into millions of dollars. In this paper, we use a unique dataset to examine the impact on residential house prices affected by natural disasters using a hedonic property (HP) values approach. For this purpose, we use data before and after a wildfire and floods from Rockhampton in central Queensland, Australia. The data is unique because one suburb was affected by wildfires and another was affected by floods. For the analysis, three suburbs namely Frenchville, Park Avenue and Norman Gardens are used. Frenchville was significantly affected by wildfires in the latter part of 2009 and to a lesser extent in 2012, while Park Avenue was affected by floods at the end of 2010, January 2011–2013. Norman Gardens, which was relatively unaffected, is used as a control site. This enables us to examine the before and after effects on property values in the three suburbs. The results confirm that soon after a natural disaster property prices in affected areas decrease even though the large majority of individual houses remain unaffected. Furthermore, the results indicate that the largely unaffected suburb may gain immediately after a natural disaster but this gain may disappear if natural disasters continue to occur in the area/region due to the stigma created. The results have several important policy decision and welfare implications which are briefly discussed in the paper.

Basic Human Values in the Workplace

Työntekijöiden henkilökohtaisia arvoja ja niiden yhteyksiä asenteisiin ei ole juuri tutkittu. Tämän tutkimuksen tavoitteena oli selvittää, onko suomalaisessa metalliteollisuuden yrityksen henkilöstön (N=1314) arvojen rakenne S. H. Schwartzin arvoteorian mukainen. Lisäksi tutkittiin arvojen yhteyksiä organisaatiomuutosta koskeviin asenteisiin ja tiedon jakamiseen työyhteisössä. Arvomittarina käytettiin uutta 40-osioista Portrait Value Questionnairea (PVQ). Mittarin validiteetti osoitettiin ver-taamalla nyt kerätyn aineiston arvorakennetta aikaisemmalla mittarilla kerättyihin arvoteorian mukaisiin yliopisto-opiskelijoiden vastauksiin. Organisaatiomuutosta koskevien asenteiden ja tiedonjakamisen mittarit luotiin laadullisissa esitutkimuksissa. Tilastolliset analyysit osoittivat, että toimihenkilöiden ja työntekijöiden arvojen rakenteet noudattivat pääosin Schwartzin teoriaa, mutta turvallisuusarvot sijaitsivat molemmissa ryhmissä universalismin ja hyväntahtoisuuden joukossa. Universalismi ja hyväntahtoisuus ennustivat myönteistä asennetta organisaatiomuutoksia kohtaan, mutta perinteiden ja mielihyvän arvostaminen liittyivät kielteisiin muutosasenteisiin. Sosiaalisia normeja kunnioittavien eli yhdenmukaisuutta arvostavien henkilöiden muut arvot vaikuttivat muutosasenteisiin vähemmän kuin niillä, joille yhdenmukaisuus ei ollut tärkeää. Lisäksi suoriutumisarvon yhteys muutosasenteisiin oli yhdenmukaisuutta arvostavilla henkilöillä positiivinen, mutta niillä, jotka eivät arvostaneet yhdenmukaisuutta, yhteys oli negatiivinen. Itseohjautuvuutta arvostavat henkilöt pitivät työyhteisönsä tiedon jakamista heikompana, kun taas hyväntahtoisuutta ja yhdenmukaisuutta arvostavat pitivät sitä muihin nähden parempana. Suoriutumisarvo oli yhteydessä tiedonjakamiseen vain silloin, kun yhdenmukaisuus oli tärkeää. Työpaikkojen (N=19) keskiarvoja vertailtaessa havaittiin, että ne työpaikat, joissa arvostettiin paljon universalismia, hyväntahtoisuutta ja yhdenmukaisuutta sekä vähän valtaa ja suoriutumista saivat henkilöstöltään parhaat arvioinnit tiedon jakamisesta. Tutkimukseen osallistuneet henkilöt jaettiin työtehtäviensä perusteella kolmeen ammatilliseen ympäristöön: konven-tionaaliseen (mm. taloushallinto), realistiseen (mm. tuotanto) ja yrittäjämäiseen (mm. myynti). Yrittäjämäisessä ammatillisessa ympäristössä toimivat arvostivat enemmän kuin konventionaalisessa ympäristössä toimivat valtaa, itseohjautuvuutta ja suoriutumista. Realistisessa ympäristössä arvostettiin enemmän perinteitä ja mielihyvää kuin yrittäjämäisessä ympäristössä. Ryhmien väliset erot arvoissa johtuivat koulutuksesta, iästä ja sukupuolijakaumasta.

The sources of moral motivation : studies on empathy, guilt, shame and values

The goals of this study were to analyze the forms of emotional tendencies that are likely to motivate moral behaviors, and to find correlates for these tendencies. In study 1, students narratives of their own guilt or shame experiences were analyzed. The results showed that pure shame was more likely to motivate avoidance than reparation, whereas guilt and combination of guilt and shame were likely to motivate reparation. However, all types of emotion could lead to chronic rumination if the person was not clearly responsible for the situation. In study 2, the relations of empathy with two measures of guilt were examined in a sample of 13- to 16-year-olds (N=113). Empathy was measured using Davis s IRI and guilt by Tangney s TOSCA and Hoffman s semi-projective story completion method that includes two different scenarios, guilt over cheating and guilt over inaction. Empathy correlated more strongly with both measures of guilt than the two measures correlated with each other. Hoffman s guilt over inaction was more strongly associated with empathy measures in girls than in boys, whereas for guilt over cheating the pattern was the opposite. Girls and boys who describe themselves as empathetic may emphasize different aspect of morality and feel guilty in different contexts. In study 3, cultural and gender differences in guilt and shame (TOSCA) and value priorities (the Schwartz Value Survey) were studied in samples of Finnish (N=156) and Peruvian (N=159) adolescents. Gender differences were found to be larger and more stereotypical among the Finns than among the Peruvians. Finnish girls were more prone to guilt and shame than boys were, whereas among the Peruvians there was no gender difference in guilt, and boys were more shame-prone than girls. The results support the view that psychological gender differences are largest individualistic societies. In study 4, the relations of value priorities to guilt, shame and empathy were examined in two samples, one of 15 19-year-old high school students (N = 207), and the other of military conscripts (N = 503). Guilt was, in both samples, positively related to valuing universalism, benevolence, tradition, and conformity, and negatively related to valuing power, hedonism, stimulation, and self-direction. The results for empathy were similar, but the relation to the openness conservation value dimension was weaker. Shame and personal distress were weakly related to values. In sum, shame without guilt and the TOSCA shame scale are tendencies that are unlikely to motivate moral behavior in Finnish cultural context. Guilt is likely to be connected to positive social behaviors, but excessive guilt can cause psychological problems. Moral emotional tendencies are related to culture, cultural conceptions of gender and to individual value priorities.

Heating values of mature trees.

The effective heating values of the above and below ground biomass components of mature Scots pine (Pinus sylvestris), Norway spruce (Picea abies), downy birch (Betula pubescens), silver birch (Betula pendula), grey alder (Alnus incana), black alder (Alnus glutinosa) and trembling aspen (Populus tremula) were studied. Each sample tree was divided into wood, bark and foliage components. Bomb calorimetry was used to determine the calorimetric heating values. The species is a significant factor in the heating value of individual tree components. The heating value of the wood proper is highest in conifers. Broad-leaved species have a higher heating value of bark than conifers. The species factor diminishes when the weighted heating value of crown, whole stems or stump-root-system are considered. The crown material has a higher heating value per unit weight in comparison with fuelwood from small-sized stems or wholetrees. The additional advantages of coniferous crown material are that it is a non-industrial biomass resource and is readily available. The variability of both the chemical composition and the heating value is small in any given tree component of any species. However, lignin, carbohydrate and extractive content were found to vary from one part of the tree to another and to correlate with the heating value.

A imposição de limites ao exercício da liberdade individual como decorrência imediata da produção de normas de convívio

A coesão de organismos sociais humanos é mantida por meio da imposição de limites ao exercício do livre arbítrio por parte dos indivíduos e das coletividades de indivíduos que os integram e compõem. Esse objetivo é alcançado pela atuação de quatro mecanismos que se influenciam mutuamente: a ética, a moral, o direito e as convenções sociais decorrentes da assimilação de novos conhecimentos. Os limites impostos ao comportamento instituídos no âmbito desses mecanismos serão aplicados tanto ao relacionamento entre indivíduos como ao relacionamento entre comunidades e aos contatos entre estas e aqueles. Tais limites apresentarão algumas características comuns, qualquer que seja o meio onde se desenvolvam: a sensação de legitimidade com que são vistos pelos alcançados; a forma ao mesmo tempo universal e heterogênea por meio da qual se aplicam aos integrantes do meio social em que são estabelecidos; a presença de instrumentos de coerção a eles correlacionados; o caráter dinâmico que faz com que se encontrem em permanente mutação; e o fato de que constituem criações coletivas. Esses limites serão originados de procedimentos específicos para cada período, cultura ou espaço territorial em que se vejam implantados. Não serão permanentemente compatíveis com os valores do meio social no qual são instituídos, mas em todos os casos tenderão a evoluir no sentido de se ajustarem a esses valores. Desse último fenômeno resulta uma estreita vinculação entre o teor de juízos coletivos e o conteúdo dos limites estabelecidos pelo meio social para o comportamento humano, o que acarreta na errônea concepção de que sociedades distintas, por se fundarem em apreciações valorativas igualmente discrepantes, não apresentam traços em comum. Demonstrar que essa última conclusão se afasta da realidade, a partir da premissa de que em qualquer meio social se busca o estabelecimento de limites ao comportamento humano, constitui o objetivo central do presente estudo.

Values and actions in aversion

Model-based and model-free controllers can, in principle, learn arbitrary actions to optimize their behavior, at least those actions that can be expressed and explored. Indeed, these are often referred to as instrumental controllers because their choices are learned to be instrumental for the delivery of desired outcomes. Although this flexibility is very powerful, it comes with an attendant cost of learning. Evolution appears to have endowed everything from the simplest organisms to us with powerful, pre-specified, but inflexible alternatives. These responses are termed Pavlovian, after the famous Russian physiologist and psychologist Pavlov. The responses of the Pavlovian controller are determined by evolutionary (phylogenetic) considerations rather than (ontogenetic) aspects of the contingent development or learning of an individual. These responses directly interact with instrumental choices arising from goal-directed and habitual controllers. This interaction has been studied in a wealth of animal paradigms, and can be helpful, neutral, or harmful, according to circumstance. Although there has been less careful or analytical study of it in humans, it can be interpreted as underpinning a wealth of behavioral aberrations. © 2009 Elsevier Inc. All rights reserved.