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1

Greggi, Marco. "Neutrality and Proportionality in VAT: Making Sense of an (Apparent) Conflict." Intertax 48, Issue 1 (January 1, 2020): 122–31. http://dx.doi.org/10.54648/taxi2020009.

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Neutrality and proportionality are two features of the European VAT that often come into play when judiciary is requested to rule on alleged frauds to the tax. According to the well settled case law of the European Court of Justice (ECJ) the right to deduct VAT can’t be granted when such a fraudulent operation occurs. In the EN.SA. case, to the opposite, the Court rules that neutrality is to be preserved even when the operation invoiced did not actually take place, if very specific circumstances are met: namely, that no loss for the national budget occurred, that the company invoiced was not actually planning to erode its tax liability for VAT purposes and that the non-existent operation was simulated for other commercial purposes (not directly affecting the tax due). This conclusion is made possible making the principles of proportionality (and reasonableness) to prevail over a mechanical application of the tax that would otherwise prevent the right to deduct the tax charged. VAT, neutrality, proportionality, reasonableness, fraud, carousel, invoice, administrative sanction.
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2

Zabłocki, Jan. ""Postumus" w "Noctes Atticae" Aulusa Gelliusa." Prawo Kanoniczne 40, no. 1-2 (June 5, 1997): 255–62. http://dx.doi.org/10.21697/pk.1997.40.1-2.13.

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Dalle informazioni trasmesse da Gellio da un lato risulta che la legge delle dodici tavole considerava postumus un bambino nato al massimo nel decimo mese. Dall’altro, pero, egli riporta che Marco Varro rivolgeva l’attenzione alla necessita di diseredare il postumus sia nato nel decimo che nell’undicesimo mese. Inoltre nel I secolo, il pretore Lucio Papirio assegno l’eredità al postumus nato nel tredicesimo mese. Nello stesso modo si comporto l’imperatore Adriano nel II secolo. Si pone, quindi, la domanda se non esistesse la regola formulata nelle dodici tavole che come erede del morto veniva considerato il bambino nato al massimo nel decimo mese, oppure tra le summenzionate fonti esiste una contraddizione. Sembra che non si tratti ne di uno né dell’altro. Queste apparenti contraddizioni si possono chiarire nel seguente modo. La legge delle dodici tavole stabiliva che come erede dei morto ab intestato veniva considerato il postumus nato al massimo nel decimo mese. Tale postumus, secondo questa legge, veniva trattato al pari dei figli nati durante la vita del padre, di conseguenza era un erede legittimo conformemente al diritto civile. Invece dalla decisione del pretore Lucio Papirio non risulta che egli applicasse il diritto civile. É solo noto che non concede la missio in bona all’agnato decidendo che la hereditas spettava al figlio nato dopo la morte del padre, anche se nel tredicesimo mese. Probabilmente tale soluzione risultava dall’applicazione del cosiddetto nuovo ordine pretorio ereditario, conformemente al quale dal padre ereditavano tutti i figli, non solo quelli che si trovavano sotto la patria potestas. Esso considerava prima di tutto il bene dei figli, e non le rigide norme del diritto civile. Poteva essere applicato anche in quei casi in cui il postumus fosse nato dopo dieci mesi dal momento della morte del padre e non poteva essere considerato un suus heres. La possibilitä che l’eredità venisse concessa dal pretore a coloro che erano nati nell’undicesimo mese era nota probabilmente gia a Marco Varro. Percio nella satira Testamentum consigliava di diseredare chiaramente al momento di fare il testamento tutti i postumi e coloro che erano nati nel decimo e undicesimo mese, per ogni evenienza. I dubbi furono definitivamente risolti dall‘imperatore Adriano che concedesse l‘erédita ad un nato nell’undicesimo mese.
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3

Filby, Michael P. "The Newmarket Racing Lad: Tradition and Change in a Marginal Occupation." Work, Employment and Society 1, no. 2 (June 1987): 205–24. http://dx.doi.org/10.1177/0950017087001002004.

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This paper describes the work of a widely seen but little known occupation, the racing lad. It relates some changes which have taken place in the organisation of work and the subjective responses to these of a significant minority of the occupation in the locality studied. Such changes as are apparent are accounted for in terms of developments in the local labour market which have served to erode the traditionalist framework within which work has been organised. At root, the core activity is seen to depend on some particularly intangible qualities which working class youngsters have typically brought to this form of work.
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4

Oliveira, Fernando Nascimento, and Myrian Petrassi. "Do financial crises erode potential output? A cross-country analysis of industrial and emerging economies." Journal of Economic Studies 45, no. 2 (May 14, 2018): 247–62. http://dx.doi.org/10.1108/jes-02-2017-0036.

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Purpose The purpose of this paper is to analyze empirically if financial crises have decreased potential output for a selected group of economies. Design/methodology/approach The authors estimate different country-specific stylized Phillips curves to verify if inflationary pressures were stronger on the recovery periods after financial crises, relative to the recovery periods after recessions. Findings The results, in general, do not show any clear empirical evidence that financial crises erode potential output. Moreover, there are no apparent differences in terms of the effects of financial crises over potential output between emerging and industrial economies. Research limitations/implications This paper sheds light on the widely debated issue of whether financial crises constitute adverse supply shocks that lead to impairment in an economy’s productive potential. In interpreting the results, the authors must first recognize that all of them are based on the reduced-form relationships. Thus, they are about correlations and not necessarily about true structural relationships. Practical implications The study is very important for policy makers and specially Central Banks worldwide. Social implications The loss of potential output is a very serious economic and social phenomenon. This paper sheds light on the debate if financial crisis lead to losses of potential output. Originality/value The paper is original in using more Phillips curves and because it studies also the behavior of emerging economies.
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5

Hernández, Sandra Bonnie Flórez, and Maria Susana Marlés Herrera. "Fake News and Democracy in Latin America." Politeja 19, no. 6(81) (February 24, 2023): 85–101. http://dx.doi.org/10.12797/politeja.19.2022.81.04.

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Diverse territories of Latin America are immersed in important situations today. The region is not only facing shortages, inequities, and inequalities a large part of the population has to live with, but also constant information, disinformation and fake news that permeate their minds and erode their freedom of decision and action in democratic processes. The scenario they are going through calls for a deep shake from its foundations, given the discourse of knowledge beyond a robust wave of information, coming from unusual sources, some of them disrupting the effort to ascertain the truth of the facts and being apparently at the service of economic and/or political hegemonies. This text proposes a comprehensive approach to fake news and the scope of influence they have on individual freedom with repercussions on the weak Latin American democracy.
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6

Ward, John O. "Rhetorical Theory and the Rise and Decline of Dictamen in the Middle Ages and Early Renaissance." Rhetorica 19, no. 2 (2001): 175–223. http://dx.doi.org/10.1525/rh.2001.19.2.175.

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This paper examines the links between Classical (Ciceronian) rhetorical theory and the teaching of medieval Latin prose composition and epistolography between the eleventh century and the renaissance, mainly in Italy. Classical rhetorical theory was not replaced by dictamen, nor was it the “research dimension” of everyday dictaminal activity. Rather Classical rhetorical theory, prose composition and epistolography responded to distinct market niches which appeared from time to time in different places as a consequence of social and political changes. Boncompagno's apparent setting aside of Ciceronian rhetorical theory in favour of stricter notarial and dictaminal procedures was in turn superseded by his successors who chose to enrich their notarial theory with studies of classical rhetoric. Classical rhetorical theory proved influential on dictaminal theory and practice. Dictamen was not ousted by classical rhetoric. It only really declined when growing lay literacy and the use of the vernacular combined with the autonomous professionalism of the legal training institutions to erode the privileged position occupied in medieval times by the dictatores.
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7

Kalb, Don. "Afterword." Focaal 2017, no. 79 (December 1, 2017): 67–73. http://dx.doi.org/10.3167/fcl.2017.790106.

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Commoning over time generates customs in common and therefore commonalities. The political mobilizations of the past years may well be understood as a form of urban commoning. However, while such mobilizations may sometimes understand themselves as anticapitalist, one should resist the apparently logical idea (1) that the use values off ered by an urban commons are inevitably the opposite of surplus value, (2) that the urban commons will not just in theory but in practice be “open for everyone,” (3) and that such commons are necessarily horizontalist and universalist, as the Left might claim. Historical fascism and the rise of the new Right in Europe and the United States show that there is an exclusivist and hierarchical commons against the market too.
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8

Luthfiana Arfani, Asyifa, and Aninditya Sri Nugraheni. "ANALYSIS OF THE POPULARITY OF THE USE OF STANDARD INDONESIAN AND SLANG LANGUAGE AMONG TEENAGERS IN YOGYAKARTA." Sunan Kalijaga International Journal on Islamic Educational Research 4, no. 1 (December 15, 2020): 95–108. http://dx.doi.org/10.14421/skijier.2020.41.07.

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Language has a vital role in this aspect of life. Language is a communication tool to convey ideas, ideas, and also one's desires to others. In its development, language has been influenced by several things, including the users of the language itself. At present, the Indonesian language has experienced various significant changes from year to year. Teenagers have a considerable influence on the development of language in a region because they are the main focus of the outside world in measuring the ability of a nation. Various problems began to emerge regarding the Indonesian language problem, which is currently starting to erode and replaced with slang. The purpose of this writing is none other than to know the extent of the development of the Indonesian language and to maintain the position of Indonesian, especially among teenagers today. An apparent influence on teenagers now is their obsession with the use of slang which they believe can make them look cooler and more contemporary. Some adolescents also claimed that they started to be ordinary with the current position of Indonesian. The pride that began to fade in the souls of adolescents must begin to be reinvested given how influential the role of adolescents in facing competition in the industry 4.0 today.
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9

Diamond, Joshua M., and Michael S. Ross. "Canopy gaps do not help establish pioneer species in a South Florida dry forest." Journal of Tropical Ecology 32, no. 2 (March 2016): 107–15. http://dx.doi.org/10.1017/s0266467416000109.

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Abstract:Canopy gaps create a temporary spatial heterogeneity, often allowing pioneer species to establish and grow in mature forests. In this study, we asked whether the above model holds for tropical dry forests in the Florida Keys. Six hundred and forty-eight canopy gaps in an extensive Key Largo forest were identified with a LiDAR digital canopy model. The structure and composition of juvenile trees were examined in 45 selected gaps in three stands of known age, and weighted averaging calibration and regression were applied to the data to determine the successional age optimum for each tree species, and the inferred age for each gap based on its sapling composition. Less than 1% of the forest area was recorded as canopy gaps in the LiDAR model. The inferred stand ages were about 70 y greater in canopy gaps in young forest than in the surrounding, unimpacted forest. This suggested that gap formation advanced succession rather than reversing or resetting it. The apparent lack of recruitment by early-successional species may be due to the small size of canopy gaps in this forest, and the minimal contrast between gap and understorey environments; light and water conditions in the small gaps may favour late-successional rather than pioneer species. Establishment of pioneer species may not take place without intense, large-scale disturbances such as fires and hurricanes that remove the entire canopy and consume or erode soils.
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10

Wielink, Michael. "Women and Communist China Under Mau Zedong:." General: Brock University Undergraduate Journal of History 4 (May 6, 2019): 128–42. http://dx.doi.org/10.26522/tg.v4i0.2126.

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The mid twentieth century was a tumultuous and transformative period in the history of China. Mao Zedong and the Communist Party seized control and established the People’s Republic of China on October 1, 1949, which was the culmination of over two decades of civil and international war. Mao Zedong’s famed political slogan: “Women Hold Up Half The Sky[1],” was powerful rhetoric, with the apparent emphasis on gender equality and inferred concepts of equality and sameness. Women did not achieve equality with men, nor did they attain egalitarian self-determination nor social autonomy. Nevertheless, when Chinese Communism under Chairman Mao is analyzed we discover women, both rural and urban, were able to challenge social, cultural, and economic gender stratification. Mao envisaged “women’s equality” as a dynamic force with an indelible power to help build a Chinese Communist State. This essay illustrates the ways in which women inextricably worked within Mao’s Communist nation building efforts to slowly erode gender inequalities. Yet despite the inability of full gender equality to be realized, this era allowed women to experience a broad range of experiences which contained the seeds of change toward breaking down gender inequality. Ultimately, Chinese women under Mao created a more fertile environment so the seeds of equality may continue to grow, perhaps bearing fruit of full “gender equality” in the future. [1] Xin Huang, The Gender Legacy of the Mao Era: Women's Life Stories in Contemporary China (Albany: State University of New York Press, 2018): 14.
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11

Martin, Louise F., Daniela Winkler, Thomas Tütken, Daryl Codron, Annelies De Cuyper, Jean-Michel Hatt, and Marcus Clauss. "The way wear goes: phytolith-based wear on the dentine–enamel system in guinea pigs ( Cavia porcellus )." Proceedings of the Royal Society B: Biological Sciences 286, no. 1912 (October 9, 2019): 20191921. http://dx.doi.org/10.1098/rspb.2019.1921.

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The effect of phytoliths on tooth wear and function has been contested in studies of animal–plant interactions. For herbivores whose occlusal chewing surface consists of enamel ridges and dentine tissue, the phytoliths might particularly erode the softer dentine, exposing the enamel ridges to different occlusal forces and thus contributing to enamel wear. To test this hypothesis, we fed guinea pigs ( Cavia porcellus ; n = 36 in six groups) for three weeks exclusively on dry or fresh forage of low (lucerne), moderate (fresh timothy grass) or very high (bamboo leaves) silica content representing corresponding levels of phytoliths. We quantified the effect of these treatments with measurements from micro-computed tomography scans. Tooth height indicated extreme wear due to the bamboo diet that apparently brought maxillary incisors and molars close to the minimum required for functionality. There were negative relationships between a cheek tooth's height and the depth of its dentine basin, corroborating the hypothesis that dentine erosion plays an important role in herbivore tooth wear. In spite of lower body mass, bamboo-fed animals paradoxically had longer cheek tooth rows and larger occlusal surfaces. Because ever-growing teeth can only change in shape from the base upwards, this is a strong indication that failure to compensate for wear by dental height-growth additionally triggered general expansive growth of the tooth bases. The results suggest that enamel wear may intensify after enamel has been exposed due to a faster wear of the surrounding dentine tissue (and not the other way around), and illustrate a surprising plasticity in the reactivity of this rodent's system that adjusts tooth growth to wear.
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S D, Sudeep. "Variations and Changes in Language Acqisition in Children." SMART MOVES JOURNAL IJELLH 8, no. 2 (February 28, 2020): 6. http://dx.doi.org/10.24113/ijellh.v8i2.10412.

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Children acquire language spontaneously without being explicitly taught how. Their mastery of sounds passes through stages determined by a progression from unmarked to more marked sounds, unmarked ones also being those most commonly found in languages and least likely to erode over time, as discovered by founding linguist Roman Jakobson. Their mastery of other aspects of grammar proceeds along with their ability to master rules, rather than simply memorize. It was once thought that children learned to speak simply by imitating adults: They hear adults saying words, and then they pick up words. However, modern linguists have found that it is something apparently innate to the species, and thus it proceeds according to basic aspects of linguistic structure. Most children start producing words from a time between the age eight and twelve months. Many children have ten words in their vocabulary at the age of fifteen months. They gradually pick up speed from that point onwards. An eighteen month old child may learn only one or two new words a day; whereas a four year old will acquire a dozen. Children do not just master a basket of words and expressions. There’s something more constrained and systematic going on. Words are just empty shells. There is no point in learning a new word if they don’t learn its meaning. Children are remarkably good at this too. They are able to learn a word’s meaning at the first time they hear it used. For instance; a child sees a cow running in a field and hear his/her mother say “cow” the child typically will figure out the right way that the word refers to the animal; not to its colour, or to its legs or to the fact that its running.
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Tucker-Kulesza, Stacey E., Gretchen F. Sassenrath, Tri Tran, Weston Koehn, and Lauren Erickson. "Site-Specific Erodibility in Claypan Soils: Dependence on Subsoil Characteristics." Applied Engineering in Agriculture 33, no. 5 (2017): 705–18. http://dx.doi.org/10.13031/aea.12120.

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Abstract. Soil erosion is a primary factor limiting the productive capacity of many crop production fields and contributing to sediment and nutrient impairments of water bodies. Loss of topsoil is especially critical for areas of limited topsoil depth, such as the claypan area of the central United States. More than a century of conventional agricultural practices have eroded the topsoil and, in places, exposed the unproductive clay layer. This clay layer is impervious, limiting water infiltration and root penetration, and severely restricting agricultural productivity. Previous studies have documented changes in topsoil thickness using apparent electrical conductivity (ECa). However, that methodology is limited by its shallow depth of measurement within the soil profile, and as such cannot adequately explore factors within the soil profile that potentially contribute to topsoil erosion. In this study, we identified areas of limited topsoil depth using crop yields and ECa. Two areas within the production field varying in crop production and ECa were selected for detailed measurements using Electrical Resistivity Tomography. This methodology allowed delineation of soil stratigraphy to a depth of 5.3 m. The erodibility of undisturbed soil samples from the two areas were measured in an Erosion Function Apparatus to obtain the critical shear stress, or the applied stress at which soil begins to erode. Based on resistivity measurement, the highly productive region of the field had a thick (1.0-2.0 m) soil layer of saturated clayey sand soil over a uniform sandy material, with minimal clay layer. This soil had a critical shear stress of 12 Pa. The extent of historical erosion was evident in the poorly-producing area, as only a thin band of topsoil material remained over a thicker clay layer. The unproductive area with exposed clay layer had a critical shear stress of 128 Pa, indicating it was more resistant to erosion than the highly productive region. The clay layer was found to extend to 1.3-1.5 m in depth in the soil profile in the poorly producing area. Below this layer was a layer with similar resistivity to the high-producing region. The data reveal the extent of historical erosion within the crop production field and highlight significant variability in measured soil properties within a field of identical production practices. While spatial variations in topsoil have long been considered in developing management practices to improve soil health and productive capacity, our results indicate the importance of identifying variability of subsoil characteristics to address long-term impacts on soil erosion and productivity. Keywords: Soil erosion, Soil electrical conductivity, Claypan soil, Productive capacity, Electrical resistivity tomography.
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Rudolph, Kurt W., William J. Devlin, and Jeff P. Crabaugh. "Upper Cretaceous Sequence Stratigraphy of the Rock Springs Uplift, Wyoming." Mountain Geologist 52, no. 3 (July 1, 2015): 13–157. http://dx.doi.org/10.31582/rmag.mg.52.3.13.

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Three scales of sedimentary cyclicity are observed in the Campanian to Maastrichtian-aged strata of southwestern Wyoming based on sedimentary stacking patterns, facies successions, paleontological data and geometric criteria from outcrop, and subsurface data. The largest scale of sequence stratigraphic interpretation is of 10-15 million years duration per cycle and is designated as second order. Second-order cyclicity is represented by profound sequence boundaries and maximum-flooding surfaces that are related to regional tectono-subsidence drivers. The 2nd-order sequence boundaries at the base of the Ericson Formation (Moxa Unconformity) and the base of the Fort Union Formation (Laramide Unconformity) locally erode thousands of feet of section on discrete structural highs, but also show evidence of uplift on a broader scale. Both unconformities terminate long successions of marine shoreline progradation. Second-order maximum flooding surfaces are present within thick marine mudstone successions of the Baxter-Niobrara and Lewis formations. These intervals represent the deepest water deposits in the Upper Cretaceous and are associated with important regional seals and source rocks. The large-scale tectono-cyclicity is composed of an aggregate of smaller-scale, 3rd- and 4th-order sequences and their component systems tracts. In addition to the second-order sequences described above, third-order sequence boundaries are interpreted at the base of the Blair Formation, base of the Chimney Rock Member of the Rock Springs Formation, and at the base of the Canyon Creek Member of the Ericson Formation. Third-order maximum flooding surfaces are in the middle Blair Formation, middle Black Butte Member of the Rock Springs Formation, and in the upper part of the Rusty Member of the Ericson Formation. At least 7 additional 4th-order sequences can be interpreted within these successions. The higher-order cycles are shorter in duration and smaller in magnitude (i.e., thinner and with a smaller degree of change in environments or bathymetry within a cycle). The sequence stratigraphic interpretation approach is observationally based and consistent across these scales. However, finer-scale sequence stratigraphic interpretations, especially at the 4th-order scale, are subject to additional subjectivity. An important challenge is to separate apparent cyclicity related to factors such as local to regional shifting of depocenters (autocyclicity) from regionally correlative cyclicity (allocyclicity) within the high-frequency sequences. Examples of this are provided, most clearly for the lower portion of the Blair Formation. Such considerations are important economically, as this is the scale that controls sandstone reservoir and mudstone seal architecture within petroleum fields. Standard systems tracts criteria using parasequence stacking patterns are extended to non-marine strata by use of the degree of amalgamation (net/gross) of the fluvial sandstones. This approach is demonstrated to be plausible via physical ties to shoreline systems using regional correlations and paleontology, and via estimates of accommodation change from geohistory analysis.
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Keathley, Kenneth. "Old-Earth or Evolutionary Creation? Discussing Origins with Reasons to Believe and BioLogos." Perspectives on Science and Christian Faith 72, no. 4 (December 2020): 244–46. http://dx.doi.org/10.56315/pscf12-20keathley.

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OLD-EARTH OR EVOLUTIONARY CREATION? Discussing Origins with Reasons to Believe and Bio-Logos by Kenneth Keathley, J. B. Stump, and Joe Aguirre, eds. Downers Grove, IL: InterVarsity Press, 2017. 256 pages. Paperback; $28.00. ISBN: 9780830852925. *In Old-Earth or Evolutionary Creation? Discussing Origins with Reasons to Believe and BioLogos, the main question comes down to, "When science and faith appear to conflict, how is the apparent conflict navigated?" In other words, which gives in and changes first, scriptural interpretation or acceptance of scientific findings? We (the reviewers) hold different opinions about several of the debates and specific arguments outlined in this book. Dr. Vukov is a philosopher and practicing Roman Catholic while Dr. Burns is an agnostic atheist and a molecular biologist. Our take on issues at the intersection of science and religion is bound to be divergent. *The book is structured as a dialogue between the two aforementioned groups, Reasons to Believe (RTB) and BioLogos, and is moderated by members of the Southern Baptist Convention (SBC). The chapters each focus on a particular aspect of the science surrounding evolution and how the debating groups respond to or critique the science and/or integrate it into their faiths. *Who are BioLogos and RTB? Both groups have similar mission statements. BioLogos "invites the church and the world to see the harmony between science and biblical faith as [they] present an evolutionary understanding of God's creation."1 RTB's mission is similar: the organization seeks "to spread the Christian gospel by demonstrating that sound reason and scientific research ... consistently support, rather than erode, confidence in the truth of the Bible and faith in the personal, transcendent God revealed in both Scripture and nature."2 In other words, both groups seek to promote science literacy among fellow Christians while also proselytizing nonbelievers. Generally speaking, however, RTB emphasizes the latter while BioLogos emphasizes the former. *RTB and BioLogos also share a common view of the "two books," that is, the book of nature and the book of scripture by which God reveals himself. This offers a starting point for their discussion. Since the "two books" are both aspects of God's revelation, they de facto cannot conflict with one another--while "they may be referring to different things ... they are not saying contrary things."3 *But of course, these two books do sometimes come into conflict, at least apparently. One virtue of old-earth or evolutionary creation is that several of the questions presented in it go beyond the kinds of conflicts covered in mainstream media dialogues. Rather than "did evolution take place?" you hear "what does it mean for a literal Adam and Eve if evolution is correct?" The former question, we (and RTB and BioLogos) believe, is settled, making the latter question the more interesting one. Many denominations, after all, put quite a bit of stock in there having been a historical first pair of humans in the form of Adam and Eve. The Fall of these humans, also a historical event by these interpretations, had consequences that were passed on to each member of the succeeding generations of humans, much as how genes are passed from one generation to the next. In these interpretations of the Fall, there is therefore a theological need for a single lineage of humans. Evolutionary theory, however, rejects the idea of a single human lineage having arisen from a single couple. It is clear then that something needs to give way: either a single pair of humans, Adam and Eve, did not exist literally as described (perhaps they were instead metaphorical placeholders for a small population of early humans) or there's something untrustworthy about the genetic models of how populations evolve. BioLogos opts for the former option, RTB for the latter. BioLogos's tendency to defer more to the book of nature than is RTB's is seen throughout the book. *Consider, for example, the evolution-specific lines of evidence debated in the book's pages. The debate between the two groups across the range of scientific evidence regarding humanity's place in an evolutionary framework is taken piecemeal across the chapters: each chapter is devoted to one topic, such as fossil evidence. One unfortunate effect of this organization is that the evidence for evolution is diluted. Indeed, when the scientific evidence regarding humanity's place in an evolutionary framework is taken as a set of convergent, predictive findings, there is a unified scientific theory into which human evolution fits quite well. *This organizational issue aside, however, we find the current field of genomics to be the most exciting body of evidence presented in the book. This body of evidence is also, perhaps, the most damning for RTB, who advocate for a "special creation" of humans, thus resisting the weight of evidence in favor of placing humans in the great causal chain of evolution by natural selection over the vast span of biological time. In this regard, RTB is simply not taking a scientific approach when arguing against the genomic evidence. At several points in the back and forth, it is highlighted that, for instance, there is approximately a zero percent chance that the human population was ever smaller than several thousand individuals. This is a known fact and all the evidence and models of population genetics agree on this. The only way around this would be to (1) invoke some form of miraculous intervention to allow for some other possibility (e.g., a single pair of humans) followed by another miracle to make the models based on evidence look otherwise or (2) suggest that the thousands of world-class evolutionary biologists, geneticists, statisticians, and bioinformaticians who build and use these models are seriously mistaken, without empirical evidence to suggest that they are. *It is fitting, then, that Francis Collins both founded BioLogos and was also the lead scientific administrator behind the Human Genome Project. Collins, we would presume, has found a way to do what RTB has not--to reconcile what the "book of nature" is telling him about creation and to use that knowledge to shape his interpretation of what is revealed by scripture. Again, what the two groups exemplify throughout their dialogue are differences in priority that are attributed to the "two books." BioLogos pushes for the incorporation of current scientific findings inside the framework of their evolving knowledge of the Christian faith, whereas RTB, by contrast, appears substantially more reluctant to accede to any alterations of their current interpretations of what they see revealed in the Bible. Both may formally recognize the two books. But RTB clearly sees the book of nature as written in a much smaller font than does BioLogos. *In their discussions, the topic of methodological naturalism (MN) also comes up with regularity. In the text, MN is defined (or rather, not defined) as "... a contingent value of most practicing scientists today" (p. 109). Colloquially, MN is simply the assumption that when you are applying a scientific test to interpret the results of an experiment, you rule out any supernatural explanations. For the methodological naturalist, you, as a scientist, should approach the cosmos as if it were composed exclusively of natural bits of matter and energy--no gods or spirits or divine interventions at play. Why do things this way? Well, it appears to work, and functionality alone is relatively strong evidence for its practical application as the way of doing science. It isn't that MN disproves anything supernatural. It is simply that supernatural explanations appear to be irrelevant. *There is, of course, plenty of room for disagreement about MN, and BioLogos and RTB are no exceptions. Obviously, as both are Christian groups, neither is comfortable with pure MN as the only way of viewing the universe, but they do have differences of opinion regarding its utility. J. B. Stump, writing for BioLogos, suggests that "... understanding of natural theology needs MN. It is another question, though, whether theological conclusions can be derived from purely scientific premises" (p. 111). This claim, however, is at odds with a belief that "[methodological naturalism] is not a necessary part of science" (p. 109), a view that is directly at odds with the current understanding of science as a process. What does a scientific process that incorporates the ineffable, unpredictable actions of nonnatural entities look like? Jeff Zweerink (RTB) argues that "For practical purposes, scientists must operate largely from a standpoint of methodological naturalism ... however, that does not completely exclude theological considerations" (p. 113). In RTB's view, the Bible is a source of testable scientific claims that can be assessed to reveal or support theological truths. Curiously, the two groups seem to agree on the utility of MN, but BioLogos sees it as a means of correcting their incomplete interpretations of faith while RTB sees it as a way to buttress their existing interpretations. *What is our take on the debates found in the book? It should be clear by now that we prefer BioLogos's approach to that of RTB's. But that's not to say that we agree completely with BioLogos, or indeed, with each other. One thing we do agree upon, however, is the value of intellectual humility in approaching these issues. And that also leads us to favor the approach of BioLogos. Indeed, with respect to the approaches to the integration of the science surrounding human origins and Christian faith as outlined by BioLogos and RTB, it is clear that the former is more readily able to accept their intellectual limits--or rather, accept that perhaps some of their prescientific beliefs and biblical interpretations might be mistaken or in need of revision. For some, this admission might be seen as a sign of weakness of faith and lacking in conviction. For others, this is a sign of a faith that is wholly human, an admission that no one has a perfect understanding of the revelations found in either of the "two books," and a presumption that one's position is destined to be readjusted as the two interplay. *Should you read this book? We commend the groups involved in the work (BioLogos, RTB, and the SBC) for their demonstration of vigorous intellectual engagement. It is a testament to their pursuit of knowledge that they are able to engage in good-faith argument on these contentious topics. Reading through this work will provide believers with a wide variety of positions regarding human origins and Christianity while also covering the scientific support underpinning our understanding of human evolution. For nonbelievers, this work might be of interest to provide perspective on how believers view the topics of debate. However, it contains much material about issues along the lines of "how many angels can fit on the head of a pin"-type Christian esoterica that are typically uninteresting and unconvincing to outsiders. In this regard, the debate presented here clearly targets the faithful. If you are a Christian who is interested in challenging your perspectives on what it might mean to think deeply about human origins and faith, this book is an excellent and rigorous starting point. *Notes *1BioLogos, "What We Believe," accessed February 18, 2019. https://biologos.org/about-us/what-we-believe/. *2Reasons to Believe, "Mission and Beliefs," accessed May 4, 2020, https://reasons.org/about. *3Kenneth Keathley, J. B. Stump, and Joe Aguirre, Old-Earth or Evolutionary Creation? Discussing Origins with Reasons to Believe and BioLogos (Downers Grove, IL: InterVarsity Press, 2017), 12. *Reviewed by Michael B. Burns, Assistant Professor of Biology at Loyola University Chicago, Chicago, IL 60660; and Joe Vukov, Assistant Professor of Philosophy at Loyola University Chicago, Chicago, IL 60660.
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Ratajczak-Mrozek, Milena, and Krystian Barłożewski. "How to change contracts into beneficial relationships – the results of empirical research." Kwartalnik Nauk o Przedsiębiorstwie 43, no. 2 (June 29, 2017): 51–57. http://dx.doi.org/10.5604/01.3001.0010.4679.

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The aim of the article is to provide answers to two research questions. Firstly, what in business practice is needed to convert a contact into beneficial relationship. And secondly, whether numerous personal contacts, the so-called “connections” are sufficient to achieve sustained success in creating business relationships. The authors responded the questions by using the results of research conducted among 419 companies. As a result they proposed a scheme of the development process from contact to a beneficial relationship. Introduction Relationships are formed between entities conducting business as an effect of repeated interactions. Although crucial to the business, the notion of relationships is often not entirely understood, due to the fact that relationships are not limited to formal relations between companies. In practice of running business, relationships are seen as a remedy for the lack of opportunities for the development of the company, ensuring the expansion and success of the business. This, in turn, promotes the belief in the need to establish numerous contacts, which then have to transform into relationships being the source of many benefits. But in practice the transformation of contacts into relationships is not so simple. Hence, two research questions arise, the answer to which will be given by this article. First, what in practice of doing business is needed to transform a contact into a beneficial relationship? Second, are numerous contacts, i.e. so-called “connections” sufficient to achieve sustainable success in building business relationships? This paper will present the results of the research conducted among 419 companies of different sizes in Poland. The research “The global and local dimension of business networks” was carried out from November 2014 to June 2015. The structure of the analysed companies corresponds to the general structure of companies in Poland – 87 percent of them are small and medium-sized companies (the remaining 13 percent are large entities) and 74 percent are private entities with national capital. In the survey, we asked the representatives of management of companies about the characteristics and benefits of relationships connecting their companies with their most important key customers and key suppliers. This enabled indication of the essential conditions necessary for the creation of beneficial relationships. The essence of relationships between companies A relationship is a phenomenon that is formed during a long time and is developed through repeated interactions between entities [Easton, 1992]. Thus, a relationship is defined as an interdependent process of continuous interaction and exchange between at least two entities within a business network [Holmund, Törnroos, 1997] or as a mutual orientation of two companies towards each other, which means that the companies are prepared to work together and expect such actions from each other [Johanson, Mattsson, 1987]. During the process of development of a relationship, the entities create strong and wide, social, economic, service, and technological bonds, in order to reduce total costs over time, and to increasethe added value, thus achieving mutual benefits [Anderson, Narus, 1991]. An important characteristic of relationships is the fact that they need a longer time to be formed. The emergence of a relationship takes time and effort on the part of both entities [Forsgren, et al., 2015, Håkansson, Ford, 2002, Szymura- Tyc, 2015]. A long-term nature can be described as a reciprocal expectation on the part of entities that the relationship will continue [Ratajczak-Mrozek, 2009], although unexpected events can always lead to its break. Another typical features describing the real relationships, as opposed to usual contacts, include trust, commitment, and also loyalty [Leszczyński, 2014, Morgan, Hunt, 1994, Farrelly, Quester, 2003]. These features are related to the concept of the quality of a relationship, taking into account that from the perspective of the company, not every relationship is equally important. Relationships are developed only with a limited number of entities [Håkansson, Waluszewski, 1992], and there is also the claim that an average company has ten important relationships [Håkansson, Henders, 1992], and a limited number of relationships stems from the investments that are required in order to develop them [Ford, Håkansson, 2006]. These investments involve commitment of resources, including financial resources, as well as time. The assumption concerning a limited number of important business relationships means that the interactions themselves may or may not lead to the development of a relationship [Blois, 1997]. Hence, more important is the question about the conditions of transferring individual interactions, embodied by the network of one-off contacts, into relationships that bring benefits. Key features and benefits of relationships between companies To answer the question on what is necessary to transform a contact into a beneficial relationship in practice of running the business, the answers obtained from 419 companies, as mentioned above, have been analysed. The method applied involved a survey delivered by post and via the Internet, with both questionnaires including the same research questions, and the companies could receive the questionnaire only once. The address list has been prepared on the basis of a nationwide company database Kompass Poland, and the sampling frame included companies from all around Poland, representing all sectors and all sizes of companies. The sample was selected at random. The return rate of 11.8 percent was obtained in the case of surveys by post, and 2.4 for Internet surveys, which led to the total of 419 responses. The questions about key relationships of companies were answered by the representatives of management, which was to provide representative opinions on important relationships from the perspective of the entire company. In the first phase, the characteristics of relationships have been analysed (see Figure 1), which enables identification of the most important areas distinguishing the relationships from all contacts of the company, and allows to indicate what is necessary to convert contacts into relationships. It is widely believed that the formation of relationships takes time. The presented research confirms this dependency. For a relationship to be established, it is essential to develop informal standards of cooperation and trust, and it usually takes time. What is more, the fact of building trust is proved not only by the duration of interactions, but also by the conviction about the long-term attitude of the partners towards joint activities. It must be emphasised that these conditions apply both to the relationships with customers, as well as with suppliers. Also the quality of what is going on in the course of cooperation is important. A relationship connected with routine assignments once in a while will not necessarily bring a wide spectrum of benefits. Among other things, the transformation of a contact into a relationship can be accelerated by a frequent and regular cooperation. Whereas, it is essential for this frequency to be related not only with keeping contacts, but with actual offering of benefits. The research conducted shows that each time 59 percent of relationships, both with key customers and suppliers, is based on the economic calculation (not excluding, however, at the same time, the importance of other factors), which indicates that the relationship is not only an idealistic vision of cooperation. Generally, the companies guided by maximising profits are looking for the most economical and financially beneficial solutions. Thus, the question arises, what might be the motives of the companies to maintain the remaining 40 percent of relationships? If in their case the most important is not the simple economic calculation, than they must be associated with other than strictly direct financial benefits. Relationships can bring not only financial benefits but also imply the improvement of flexibility and speed of operation, reduction of transaction costs, risks, and uncertainty by the creation of routine proceedings, unwritten principles of cooperation, trust and mutual adaptation. As a consequence, the closer the cooperation is, the more difficult it becomes to change the partner. On the other hand, if for almost 60 percent of the companies the economic factor plays an important role, in their case it can mean either the lack of place for other reasons to build relationships or the lack of differences in the perception of the existing key business partners. The latter creates a special market opportunity for those companies, that have already possessed the ability to build long-term business relationships based on non-financial factors, as it allows to stand out against the closest competitors. In this context, the research conducted showed the main benefits achieved by the companies thanks to relationships with key customers and suppliers, which is the second stage of the research (Figure 2). Apparently, there is a certain group of common benefits for all relationships, regardless of the type of a partner. They are related to the widely understood development (which may be supported in terms of economics, technology, competence, reputation), creation of new products, trust, and risk mitigation associated therewith. Moreover, in the case of key customer relationships, there are benefits associated with sales – directly, its growth and factors supporting it (recommendations and prestige). In turn, in the case of relationships with key suppliers, there are benefits related with the costs of operation (directly, reduction of costs, greater flexibility, and an increase in the margin). The broad range of benefits achieved by relationships at the same time indicates the key condition that must be satisfied to convert the contacts into relationships. If one of the parties does not achieve benefits, it means that there is no interest in the development of long-term and close relationships. In such a case, the relation is a rather forced contact (for example, due to the lack of alternatives in choosing a supplier, impossibility of allowing oneself to lose the customer providing revenues). Hence, for a contact to result in a relationship, it is necessary to appropriately identify and offer benefits sought by the other party. Speaking of relationships, the importance of having connections in the business is often emphasized. Meanwhile, the research conducted shows that the personal contacts are of a limited importance and in the absence of significant benefits, business relationships gradually erode. Bearing in mind the respondents’ answers, it should rather be stated that it is the effort made in the longer period to maintain mutually beneficial relationships, including frequent contacts with customers, that promotes the widening and deepening of the existing connections, which consequently sometimes also have the chance to be continued on the business and non-business grounds. In the above situation, contacts between people play a role in creating quality of the already existing relationships. It will be expressed in the way of communication, the depth and scope of cooperation, the distinguishing feature of which will be, in particular, the informal, direct and quick solving of emerging conflicts of interest or current problems. It should be remembered that the condition for this is the presence of benefits valued by both parties. Otherwise, the effort made sooner or later will begin to be perceived by one or the other side as unjustified. It is worth to note here that due to the dominant share of financial benefits in business relationships indicated in the research, the time horizon within which the parties assess the relationships, can be relatively short. And this in turn may affect the growth of their dynamics, and can cause their low resistance to changing conditions. Therefore, as indicated above, numerous contacts do not have to convert into numerous and durable relationships of the company at all. Wide personal contacts are good as a starting point, enable breaking through formal barriers associated with complex organisational structures or the lack of resources, and establishing the first contact between the companies, but not necessarily translate into real and beneficial relationships. On the other hand, business relationships do not have to be permanent, especially if they are based only on achieving financial benefits. The process of developing a contact into a beneficial relationship Building relationships takes time and requires orientation towards a long-term cooperation. For a contact to develop into a relationship, one needs to remember about the benefits that can be offered and which are important to the future or existing partner. But such benefits cannot be provided to all customers and suppliers, thus, it is important to be selective. It does not mean being closed to new contacts, on the contrary. It is important, however, to search for such contacts for which a high potential to build relationships based on mutual benefits can be indicated. Selectivity is not just a matter of choosing of those with whom direct contacts will be established, but relates also to the scope of time and effort necessary to be borne in order to transform particular contacts into established relationships. It may be considered that the expected benefits will be greater in the case of sustained involvement in several selected contacts and building business bonds with them, than in the case of blind devotion to establishing numerous contacts, and then making cursory attempts to “build relationships” with everybody. In this context, a considerable involvement of time and resources in building bonds with customers and suppliers that are guided only by the economic calculation (in this case the only criterion will always be a lower price), who, guided by undisclosed premises showed a lack of loyalty or turned out to be opportunist entities, who value immediate benefits more than long-term cooperation, may be found doubtful. Based on the survey, several key conditions necessary for the transformation of the established contact with a potential partner into a long-term beneficial relationship can be distinguished. They include the selectivity in relation to contacts, focusing on the target group (not – the more the better), discovering of this group and offering significant benefits to them, and then devoting time and keeping appropriate frequency of contacts. At the same time, these conditions are reflected in the process of developing relationships, which can be divided into four main stages, as shown in Figure 3. How might this process look like in practice, for example, in relation to a company providing B2B (business-tobusiness) services? The first stage can pose some difficulties, especially when one does not have extensive““connections”, and the target group, which can be offered the most benefits, while maximising one’s own, has not been precisely defined. After gaining interest in a potential partner that meets certain criteria, where the personal contacts can turn out to be helpful, the company oriented towards building longterm relationships will be more focused on awakening and increasing confidence than on maximising their financial benefits in the short-term. Due to the lack of previous experience in working together, and the risk associated therewith, the first contacts may be limited to rather small assignments. The development of the relationship at this stage will be promoted by considerable commitment, frequent contacts between people, ensuring that certain benefits have been achieved, which in turn should build trust, which will allow for the continuation of cooperation and obtaining new, possibly larger assignments. They will be an opportunity to strengthen cooperation, mutual matching, simplifying and making the operations more routine, which will greatly reduce the costs incurred and will improve the profitability of orders. In turn, a well-established cooperation will promote building relationships aiming at achieving objectives other than purely financial (Figure 2). Summary and managerial implications The suggestions presented in this article are not a guarantee of success and building beneficial, long-term relationships with every business partner. The results of the research indicate, however, that the orientation towards the simultaneous achievement of financial and nonfinancial benefits by both sides of the relationship is not common, and therefore, it may become a significant factor differentiating the company from others operating on the given market. Above all, however, this will require time, added value offered to the other partner, selection of and concentration on the most prospective partners, and effort spent on searching for mutually beneficial solutions and maintenance of proper daily contacts. Sometimes, despite the efforts undertaken, there may appear disappointment, frustration and discouragement. This is due to the fact that the assessment of the benefits arising from business relationships may change together with changing circumstances, and even despite the best efforts of one of the partners, the overall balance of benefits may lead the other party to decide to terminate or limit the existing relationship. Potential benefits of permanent business relationships, indicated by the surveyed respondents, however, are high enough to fully justify this effort. On the other hand, it may be so large that despite its efforts the entity will be able to create only few or one strong relationship with its business partner. It is, therefore, recommended for this partner to be significant or at least with a large development potential. It is important to recognise that a personal feeling and gaining a direct contact to a decision-maker of a potential business partner does not necessarily mean that there will be a commercial transaction completed, and even more, that one managed to establish a lasting business relationship. As shown in the article, there is still a long way to go, and requires crossing a number of stages of the defined process of developing the contact into the beneficial relationship.
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Williams, Gary W., and Oral Capps. "The apparent conflict of Norwegian pelagic fisheries management and Norwegian seafood council export promotion." International Food and Agribusiness Management Review, February 25, 2022, 1–22. http://dx.doi.org/10.22434/ifamr2021.0059.

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The Norwegian government operates pelagic fishery management systems designed to avoid overfishing and foster sustainable annual landings while at the same time managing an export promotion program designed to increase foreign sales of herring and mackerel. Simultaneously promoting foreign sales of pelagic fish and limiting the availability of those fish for sale are policies in apparent conflict. This research demonstrates, however, that effective limits on the availability of pelagic fish for export tend to complement the profitenhancing export promotion objectives of the Norwegian Seafood Council (NSC) for the Norwegian herring and mackerel industries. Assuming highly (but not perfectly) effective limits on herring and mackerel exports arising from their respective fishery management systems over the 2003 to 2018 period of analysis, NSC herring and mackerel export promotion contributed 5-7% to Norwegian herring export revenue and industry profit, respectively and 11-15% to Norwegian mackerel export revenue and industry profit, respectively. Less effective limitation on Norwegian herring and mackerel export supplies would erode the respective industry revenue and profit gains from NSC export promotion. In essence, the NSC effectively exploits the limits on herring and mackerel export availability imposed by Norwegian fishery management systems for the benefit of Norwegian herring and mackerel industries.
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Metawe, Mohamed. "Populism and domestic/international politics: theory and practice." Review of Economics and Political Science ahead-of-print, ahead-of-print (May 20, 2020). http://dx.doi.org/10.1108/reps-11-2019-0146.

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Purpose This paper aims to contend that populism is damaging to both domestic and international politics; not only does it erode liberal democracy in established democracies but also fuels authoritarianism in despotic regimes and aggravates conflicts and crises in international system. Design/methodology/approach The research is divided into two main sections. First, it examines how populist mobilization affects liberal democracy, and refutes the claims that populism is beneficial and reinforcing to democracy. Second, it attempts to demonstrate how populism is damaging to domestic politics (by undermining liberal democracy and supporting authoritarianism) as well as international relations (by making interstate conflicts more likely to materialize). Theoretically, populism is assumed to be a strategy used by politicians to maximize their interest. Hence, populism is a strategy used by politicians to mobilize constituents using the main features of populist discourse. Findings The research argues that populism has detrimental consequences on both domestic and international politics; it undermines liberal democracy in democratic countries, upsurges authoritarianism in autocratic regimes and heightens the level of conflict and crises in international politics. Populism can lead to authoritarianism. There is one major undemocratic trait shared by all populist waves around the world, particularly democracies; that is anti-pluralism/anti-institutions. Populist leaders perceive foreign policy as the continuation of domestic politics, because they consider themselves as the only true representatives of the people. Therefore, populist actors abandon any political opposition as necessarily illegitimate, with repercussions on foreign policy. Originality/value Some scholars argue that populism reinforces democracy by underpinning its ability to include marginalized sectors of the society and to decrease voter apathy, the research refuted these arguments. Populism is destructive to world democracy; populists are reluctant to embrace the idea of full integration with other nations. Populists reject the idea of open borders, and reckon it an apparent threat to their national security. The research concludes that populists consider maximizing their national interests on the international level by following confrontational policies instead of cooperative ones.
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Che, Jenny W., Keith A. Daniels, Liisa K. Selin, and Raymond M. Welsh. "Heterologous Immunity and Persistent Murine Cytomegalovirus Infection." Journal of Virology 91, no. 2 (November 2, 2016). http://dx.doi.org/10.1128/jvi.01386-16.

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ABSTRACT One's history of infections can affect the immune response to unrelated pathogens and influence disease outcome through the process of heterologous immunity. This can occur after acute viral infections, such as infections with lymphocytic choriomeningitis virus (LCMV) and vaccinia virus, where the pathogens are cleared, but it becomes a more complex issue in the context of persistent infections. In this study, murine cytomegalovirus (MCMV) was used as a persistent infection model to study heterologous immunity with LCMV. If mice were previously immune to LCMV and then infected with MCMV (LCMV+MCMV), they had more severe immunopathology, enhanced viral burden in multiple organs, and suppression of MCMV-specific T cell memory inflation. MCMV infection initially reduced the numbers of LCMV-specific memory T cells, but continued MCMV persistence did not further erode memory T cells specific to LCMV. When MCMV infection was given first (MCMV+LCMV), the magnitude of the acute T cell response to LCMV declined with age though this age-dependent decline was not dependent on MCMV. However, some of these MCMV persistently infected mice with acute LCMV infection (7 of 36) developed a robust immunodominant CD8 T cell response apparently cross-reactive between a newly defined putative MCMV epitope sequence, M57727–734, and the normally subdominant LCMV epitope L2062–2069, indicating a profound private specificity effect in heterologous immunity between these two viruses. These results further illustrate how a history of an acute or a persistent virus infection can substantially influence the immune responses and immune pathology associated with acute or persistent infections with an unrelated virus. IMPORTANCE This study extends our understanding of heterologous immunity in the context of persistent viral infection. The phenomenon has been studied mostly with viruses such as LCMV that are cleared, but the situation can be more complex with a persistent virus such as MCMV. We found that the history of LCMV infection intensifies MCMV immunopathology, enhances MCMV burden in multiple organs, and suppresses MCMV-specific T cell memory inflation. In the reverse infection sequence, we show that some of the long-term MCMV-immune mice mount a robust CD8 T cell cross-reactive response between a newly defined putative MCMV epitope sequence and a normally subdominant LCMV epitope. These results further illustrate how a history of infection can substantially influence the immune responses and immune pathology associated with infections with an unrelated virus.
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Mudie, Ella. "Unbuilding the City: Writing Demolition." M/C Journal 20, no. 2 (April 26, 2017). http://dx.doi.org/10.5204/mcj.1219.

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IntroductionUtopian and forward looking in tenor, official narratives of urban renewal and development implicitly promote normative ideals of progress and necessary civic improvement. Yet an underlying condition of such renewal is frequently the very opposite of building: the demolition of existing urban fabric. Taking as its starting point the large-scale demolition of buildings proposed for the NSW Government’s Sydney Metro rail project, this article interrogates the role of literary treatments of demolition in mediating complex, and often contradictory, responses to transformations of the built environment. Case studies are drawn from literary texts in which demolition and infrastructure development are key preoccupations, notably Louis Aragon’s 1926 Surrealist document of a threatened Parisian arcade, Paris Peasant, and the non-fiction accounts of the redevelopment of London’s East End by British writer Iain Sinclair. Sydney UnbuiltPresently, Australia’s biggest public transport project according to the NSW Government website, the Sydney Metro is set to revolutionise Sydney’s rail future with more than 30 metro stations and a fleet of fully-automated driverless trains. Its impetus extends at least as far back as the Liberal-National Coalition’s landslide win at the 2011 New South Wales state election when Barry O’Farrell, then party leader, declared “NSW has to be rebuilt” (qtd in Aston). Infrastructure upgrades became one of the Coalition’s key priorities upon forming government. Following a second Coalition win at the 2015 election, the state of NSW, or the city of Sydney more accurately, remains today deep amidst widespread building works with an unprecedented number of infrastructure, development and urban renewal projects simultaneously underway.From an historical perspective, Sydney is certainly no stranger to demolition. This was in evidence in Demolished Sydney, an exhibition at the Museum of Sydney that captured the zeitgeist of 2016 with its historical survey of Sydney’s demolished architecture. As the exhibition media release pointed out: “Since 1788 Sydney has been built, unbuilt and rebuilt as it has grown from Georgian town to Victorian city to the global urban centre it is today” (Museum of Sydney). What this evolutionist narrative glosses over, however, is the extent to which the impact of Sydney’s significant reinventions of itself through large-scale redevelopment are often not properly registered until well after such changes have taken place. With the imminent commencement of Sydney Metro Stage 2 CBD works, the city similarly stands to lose a number of buildings that embody the civic urban ideals of an earlier era, the effects of which are unlikely to be fully appreciated until the project’s post-demolition phase. The revelation, over the past year, of the full extent of demolition required to build Sydney Metro casts a spotlight on the project and raises questions about its likely impact in reconfiguring the character of Sydney’s inner city. An Environmental Impact Statement Summary (EISS) released by the NSW Government in May 2016 confirms that 79 buildings in the CBD and surrounding suburbs are slated for demolition as part of station development plans for the Stage 2 Chatswood to Sydenham line (Transport for NSW). Initial assurances were that the large majority of acquisitions would be commercial buildings. Yet, the mix also comprises some locally-heritage listed structures including, most notably, 7 Elizabeth Street Sydney (Image 1), a residential apartment tower of 54 studio flats located at the top end of the Sydney central business district.Image 1: 7 Elizabeth Street Sydney apartment towers (middle). Architect: Emil Sodersten. Image credit: Ella Mudie.As the sole surviving block of CBD flats constructed during the 1930s, 7 Elizabeth Street had been identified by the Australian Institute of Architects as an example of historically significant twentieth-century residential architecture. Furthermore, the modernist block is aesthetically significant as the work of prominent Art Deco architect Emil Sodersten (1899-1961) and interior designer Marion Hall Best (1905-1988). Disregarding recommendations that the building should be retained and conserved, Transport for NSW compulsorily acquired the block, evicting residents in late 2016 from one of the few remaining sources of affordable housing in the inner-city. Meanwhile, a few blocks down at 302 Pitt Street the more than century-old Druids House (Image 2) is also set to be demolished for the Metro development. Prior to purchase by Transport for NSW, the property had been slated for a state-of-the-art adaptive reuse as a boutique hotel which would have preserved the building’s façade and windows. In North Sydney, a locally heritage listed shopfront at 187 Miller Street, one of the few examples of the Victorian Italianate style remaining on the street, faces a similar fate. Image 2. Druids House, 302 Pitt Street Sydney. Image credit: Ella Mudie.Beyond the bureaucratic accounting of the numbers and locations of demolitions outlined in the NSW Government’s EISS, this survey of disappearing structures highlights to what extent, large-scale transport infrastructure projects like Sydney Metro, can reshape what the Situationists termed the “psychogeography” of a city; the critical manner in which places and environments affect our emotions and behaviour. With their tendency to erase traces of the city’s past and to smooth over its textures, those variegations in the urban fabric that emerge from the interrelationship of the built environment with the lived experience of a space, the changes wrought by infrastructure and development thus manifest a certain anguish of urban dynamism that is connected to broader anxieties over modernity’s “speed of change and the ever-changing horizons of time and space” (Huyssen 23). Indeed, just as startling as the disappearance of older and more idiosyncratic structures is the demolition of newer building stock which, in the case of Sydney Metro, includes the slated demolition of a well-maintained 22-storey commercial office tower at 39 Martin Place (Image 3). Completed in just 1972, the fact that the lifespan of this tower will amount to less than fifty years points to the rapid obsolescence, and sheer disposability, of commercial building stock in the twenty first-century. It is also indicative of the drive towards destruction that operates within the project of modernism itself. Pondering the relationship of modernist architecture to time, Guiliana Bruno asks: can we really speak of a modernist ruin? Unlike the porous, permeable stone of ancient building, the material of modernism does not ‘ruin.’ Concrete does not decay. It does not slowly erode and corrode, fade out or fade away. It cannot monumentally disintegrate. In some way, modernist architecture does not absorb the passing of time. Adverse to deterioration, it does not age easily, gracefully or elegantly. (80)In its resistance to organic ruination, Bruno’s comment thus implies it is demolition that will be the fate of the large majority of the urban building stock of the twentieth century and beyond. In this way, Sydney Metro is symptomatic of far broader cycles of replenishment and renewal at play in cities around the world, bringing to the fore timely questions about demolition and modernity, the conflict between economic development and the civic good, and social justice concerns over the public’s right to the city. Image 3: 39 Martin Place Sydney. Image credit: Ella Mudie.In the second part of this article, I turn to literary treatments of demolition in order to consider what role the writer might play in giving expression to some of the conflicts and tensions, as exemplified by Sydney Metro, that manifest in ‘unbuilding’ the city. How might literature, I ask, be uniquely placed to mobilise critique? And to what extent does the writer—as both a detached observer and engaged participant in the city—occupy an ambivalent stance especially sensitive to the inherent contradictions and paradoxes of the built environment’s relationship to modernity?Iain Sinclair: Calling Time on the Grand Projects For more than two decades, British author Iain Sinclair has been mapping the shifting terrain of London and its edgelands across a spectrum of experimental fiction and non-fiction works. In addition to the thematic attention paid to neoliberal capitalist processes of urban renewal and their tendency to implode established ties between place, memory and identity, Sinclair’s hybrid documentary-novels are especially pertinent to the analysis of “writing demolition” for their distinct writerly approach. Two recent texts, Ghost Milk: Calling Time on the Grand Project (2011) and London Overground: A Day’s Walk around the Ginger Line (2015), highlight an intensification of interest on Sinclair’s part in the growing influence exerted by global finance, hyper consumerism and security fears on the reterritorialisation of the English capital. Written in the lead up to the 2012 London Olympics, Ghost Milk is Sinclair’s scathing indictment of the corporate greed that fuelled the large-scale redevelopment of Stratford and its surrounds ahead of the Games. It is an angry and vocal response to urban transformation, a sustained polemic intensified by the author’s local perspective. A long-term resident of East London, in the 1970s Sinclair worked as a labourer at Chobham Farm and thus feels a personal assault in how Stratford “abdicated its fixed identity and willingly prostituted itself as a backdrop for experimental malls, rail hubs and computer generated Olympic parks” (28). For Sinclair, the bulldozing of the Stratford and Hackney boroughs was performed in the name of a so-called civic legacy beyond the Olympic spectacle that failed to culminate in anything more than a “long march towards a theme park without a theme” (11), a site emblematic of the bland shopping mall architecture of what Sinclair derisorily terms “the GP [Grand Project] era” (125).As a literary treatment of demolition Ghost Milk is particularly concerned with the compromised role of language in urban planning rhetoric. The redevelopment required for the Olympics is backed by a “fraudulent narrative” (99), says Sinclair, a conspiratorial co-optation of language made to bend in the service of urban gentrification. “In many ways,” he writes, “the essential literature of the GP era is the proposal, the bullet-point pitch, the perversion of natural language into weasel forms of not-saying” (125). This impoverishment and simplification of language, Sinclair argues, weakens the critical thinking required to recognise the propagandising tendencies underlying so many urban renewal programs.The author’s vocal admonishment of the London Olympics did not go unnoticed. In 2008 a reading from his forthcoming book Hackney, That Rose-Red Empire (2009), at a local library was cancelled out of fear of providing a public platform for his negative views. In Ghost Milk Sinclair reflects upon the treatment of his not yet published docu-novel as “found guilty, with no right of reply, of being political but somehow outside politics” (115). Confronted with the type of large-scale change that underpins such projects as the Olympic Games, or the Sydney Metro closer to home, Sinclair’s predicament points to the ambiguous position of influence occupied by writers. On the one hand, influence is limited in so far as authors play no formal part in the political process. Yet, when outspoken critique resonates words can become suddenly powerful, radically undermining the authority of slick environmental impact statements and sanctioned public consultation findings. In a more poetic sense, Sinclair’s texts are further influential for the way in which they offer a subjective mythologising of the city as a counterpoint to the banal narratives of bureaucratised urbanism. This is especially apparent in London Overground: A Day’s Walk around the Ginger Line (2015), in which Sinclair recounts a single-day street-level pedestrian exploration of the 35-mile and 33-station circuit of the new London Overground railway line. Surveying with disapproval the “new bridges, artisan bakeries, blue-bike racks and coffee shops” (20) that have sprung up along the route of the elevated railway, the initial gambit of the text appears to be to critique the London Overground as a “device for boosting property values” (23). Rail zone as “generator for investment” (31), and driver of the political emasculation of suburbs like Hackney and Shoreditch. Yet as the text develops the narrator appears increasingly drawn to the curious manner in which the Overground line performs an “accidental re-mapping of London” (24). He drifts, then, in search of: a site in which to confront one’s shadow. In a degraded form, this was the ambition behind our orbital tramp. To be attentive to the voices; to walk beside our shadow selves. To reverse the polarity of incomprehensible public schemes, the secret motors of capital defended and promoted by professionally mendacious politicians capable of justifying anything. (London Overground 127)Summoning the oneiric qualities of the railway and its inclination to dreaming and reverie, Sinclair reimagines it as divine oracle, a “ladder of initiation” (47) bisecting resonant zones animated by traces of the visionary artists and novelists whose sensitivity to place have shaped the perception of the London boroughs in the urban imaginary. It is in this manner that Sinclair’s walks generate “an oppositional perspective against the grand projects of centralized planning and management of space” (Weston 261). In a kind of poetic re-enchantment of urban space, texts like Ghost Milk and London Overground shatter the thin veneer of present-day capitalist urbanism challenging the reader to conceive of alternative visions of the city as heterogeneous and imbued with deep historical time.Louis Aragon: Demolition and ModernityWhile London Overground was composed after the construction of the new railway circuit, the pre-demolition phase of a project is, by comparison, a threshold moment. Literary responses to impending demolition are thus shaped in an unstable context as the landscape of a city becomes subject to unpredictable changes that can unfold at a very swift pace. Declan Tan suggests that the writing of Ghost Milk in the lead up to the London Olympics marks Sinclair’s disapproval as “futile, Ghost Milk is knowingly written as a documentary of near-history, an archival treatment of 2012 now, before it happens.” Yet, paradoxically it is the very futility of Sinclair’s project that intensifies the urgency to record, sharpening his polemic. This notion of writing a “documentary of near-history” also suggests a certain breach in time, which in the case of Louis Aragon’s Paris Peasant is mined for its revolutionary energies.First published in book form in 1926, Paris Peasant is an experimental Surrealist novel comprising four collage-like fragments including Aragon’s famous panegyric on the Passage de l’Opéra, a nineteenth-century Parisian arcade slated for demolition to make way for a new access road to the Boulevard Haussmann. Reading the text in the present era of Sydney Metro works, the predicament of the disappearing Opera Arcade resonates with the fate of the threatened Art Deco tower at 7 Elizabeth Street, soon to be razed to build a new metro station. Critical of the media’s overall neglect of the redevelopment, Aragon’s text pays sympathetic attention to the plight of the arcade’s business owners, railing against the injustices of their imminent eviction whilst mourning the disappearance of one of the last vestiges of the more organic configuration of the city that preceded the Haussmann renovation of Paris:the great American passion for city planning, imported into Paris by a prefect of police during the Second Empire and now being applied to the task of redrawing the map of our capital in straight lines, will soon spell the doom of these human aquariums. (Aragon 14)In light of these concerns it is tempting to cast Paris Peasant as a classic anti-development polemic. However, closer interrogation of the narrator’s ambivalent stance points to a more complicated attitude towards urban renewal. For, as he casts a forensic eye across the arcade’s shops it becomes apparent that these threatened sites hold a certain lure of attraction for the Surrealist author. The explanatory genre of the guide-book is subverted in a highly imaginative inventory of the arcade interiors. Touring its baths, brothels and hair salon, shoe shine parlour, run-down theatre, and the Café Certa—meeting place of the Surrealists—the narrator’s perambulation provides a launching point for intoxicated reveries and effervescent flights of fancy. Finally, the narrator concedes: “I would never have thought of myself as an observer. I like to let the winds and the rain blow through me: chance is my only experience, hazard my sole experiment” (88). Neither a journalist nor an historian, Paris Peasant’s narrator is not concerned merely to document the Opera Arcade for posterity. Rather, his interest in the site resides in its liminal state. On the cusp of being transformed into something else, the ontological instability of the arcade provides a dramatic illustration of the myth of architecture’s permanency. Aragon’s novel is concerned then, Abigail Susik notes, with the “insatiable momentum of progress,” and how it “renders all the more visible what could be called the radical remainders of modernity: the recently ruined, lately depleted, presently-passé entities that, for better and for worse, multiply and accumulate in the wake of accelerated production and consumption in industrial society” (34). Drawing comparison with Walter Benjamin’s sprawling Arcades Project, a kaleidoscopic critique of commodity culture, Paris Vaclav similarly characterises Paris Peasant as manifesting a distinct form of “political affect: one of melancholy for the destruction of the arcades yet also of a decidedly non-conservative devotion to aesthetic innovation” (24).Sensitive to the contradictory nature of progress under late capitalist modernity, Paris Peasant thus recognises destruction as an underlying condition of change and innovation as was typical of avant-garde texts of the early twentieth century. Yet Aragon resists fatalism in his simultaneous alertness to the radical potential of the marvellous in the everyday, searching for the fault lines in ordinary reality beneath which poetic re-enchantment challenges the status quo of modern life. In this way, Aragon’s experimental novel sketches the textures and psychogeographies of the city, tracing its detours and shifts in ambience, the relationship of architecture to dreams, memory and fantasy; those composite layers of a city that official documents and masterplans rarely ascribe value to and which literary authors are uniquely placed to capture in their writings on cities. ConclusionUnable to respond within the swift publication timeframes of journalistic articles, the novelist is admittedly not well-placed to halt the demolition of buildings. In this article, I have sought to argue that the power and agency of the literary response resides, rather, in its long view and the subjective perspective of the author. At the time of writing, Sydney Metro is poised to involve a scale of demolition that has not been seen in Sydney for several decades and which will transform the city in a manner that, to date, has largely passed uncritiqued. The works of Iain Sinclair and Louis Aragon’s Paris Peasant point to the capacity of literary texts to deconstruct those broader forces that increasingly reshape the city without proper consideration; exposing the seductive ideology of urban renewal and the false promises of grand projects that transform multifaceted cityscapes into homogenous non-places. The literary text thus makes visible what is easily missed in the experience of everyday life, forcing us to consider the losses that haunt every gain in the building and rebuilding of the city.ReferencesAragon, Louis. Paris Peasant. Trans. Simon Taylor Watson. Boston: Exact Change, 1994. Aston, Heath. “We’ll Govern for All.” Sydney Morning Herald 27 Mar. 2011. 23 Feb. 2017 <http://www.smh.com.au/nsw/state-election-2011/well-govern-for-all-20110326-1cbbf.html>. Bruno, Guiliana. “Modernist Ruins, Filmic Archaeologies.” Ruins. Ed. Brian Dillon. London: Whitechapel Gallery, 2011. 76-81.Huyssen, Andreas. Present Pasts: Urban Palimpsests and the Politics of Memory. Stanford: Stanford UP, 2003.Museum of Sydney. Demolished Sydney Media Release. Sydney: Sydney Living Museums 20 Oct. 2016. 25 Feb. 2017 <http://sydneylivingmuseums.com.au/2016/12/05/new-exhibition-demolished-sydney>.Paris, Vaclav. “Uncreative Influence: Louis Aragon’s Paysan de Paris and Walter Benjamin’s Passagen-Werk.” Journal of Modern Literature 37.1 (Autumn 2013): 21-39.Sinclair, Iain. Ghost Milk: Calling Time on the Grand Project. London: Penguin, 2012. ———. Hackney, That Rose Red Empire. London: Hamish Hamilton, 2009.———. London Overground: A Day’s Walk around the Ginger Line. London: Hamish Hamilton, 2015.Susik, Abigail. “Paris 1924: Aragon, Le Corbusier, and the Question of the Outmoded.” Wreck: Graduate Journal of Art History, Visual Art, and Theory 2.2 (2008): 29-44.Tan, Declan. “Review of Ghost Milk: Calling Time on the Grand Project by Iain Sinclair.” Huffington Post 15 Dec. 2011; updated 14 Feb. 2012. 21 Feb 2017 <http://www.huffingtonpost.co.uk/declan-tan/ghost-milk-ian-sinclair-review_b_1145692.html>. Transport for NSW, Chatswood to Sydenham: Environmental Impact Statement Summary. 25 Mar. 2017 <http://www.sydneymetro.info>. Sydney: NSW Government, May-June 2016.Weston, David. “Against the Grand Project: Iain Sinclair’s Local London.” Contemporary Literature 56.2 (Summer 2015): 255-79.
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21

Moorthy, Gyan. "The Care Children Deserve." Voices in Bioethics 7 (July 1, 2021). http://dx.doi.org/10.52214/vib.v7i.8533.

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Photo by Chris Carzoli on Unsplash INTRODUCTION l. The Need for a Children’s Hospital El Paso, Texas did not receive a children’s hospital until 2012, much later than would be expected given its demographics and geographic isolation. By that time, there were already nearly 250 children’s hospitals spread across the United States, some in areas far smaller, far older, and in far closer proximity to other urban centers.[1] Without accounting for its substantial population of undocumented immigrants,[2] El Paso is the country’s 22nd largest city (and situated in its 70th most populous county).[3] The nearest American city of comparable size is Phoenix, AZ, located about 350 miles away. Moreover, El Paso has a decidedly young demographic skew: more than 28 percent of the population is under the age of 18, compared to 26.5 percent of the population in Texas and 23.1 percent of the population nationally.[4] This gap is expected to widen in the coming years.[5] El Paso children also have less access to care than children in cities with comparable populations and population structures. Though the situation has improved in the last decade, El Paso contains several Health Professional Shortage Areas (HPSAs) for primary care, dental health, and mental health. This is in addition to many Medically Underserved Areas (MUAs) for primary care, specialty care, dental health, and mental health.[6] This means that El Paso children wait longer for their appointments and are often seen by tired and overworked providers. Before the El Paso Children’s Hospital (EPCH) opened its doors if these children needed advanced care, they had to leave the city, and many simply did not have the resources to do so. It is more difficult to assess the quality of the care that they were able to receive locally, as few systematic reviews of pediatric outcomes in the region were conducted during that period. Nevertheless, several El Paso physicians look back and describe an “unacceptably low” standard of care.[7] Regardless, access and quality are interrelated, and children’s hospitals tend to promote both.[8] ll. Why Did It Take So Long? There are several reasons why El Paso did not receive a children’s hospital until years after the need for it became apparent to forward-thinking physicians and other interested parties, including select parent groups. a. There were no wealthy benefactors willing to establish a children’s hospital endowment, forcing the hospital’s proponents to ask the taxpayers to issue $120 million in bonds for the project.[9] However, El Paso is fairly poor. The median annual household income is approximately $42,000, more than $17,000 below the state average and $25,000 below the national average.[10] Property values are low, and Texas does not do much to redistribute funds from wealthier to poorer parts of the state, so resources for community development are limited and spending priorities must be chosen carefully. b. The wealthier, less-Hispanic parts of El Paso were reluctant to fund a project that was billed primarily as a means of assisting poor, Hispanic children. c. Two previous children’s hospital projects had fallen through after their for-profit sponsors pulled out, and some El Pasoans were hesitant to try again. d. Tenet Healthcare, the owners of El Paso’s largest for-profit hospital network, opposed the project. They feared competition for the basic services they provided in their “children’s wing,” and perhaps knew that they might no longer get away with providing substandard pediatric care. When, over their objections, the project appeared on the ballot they launched a vigorous advertisement campaign against it. Some physicians joined them. e. Low levels of education and civic engagement in El Paso, coupled with an underdeveloped sense of entitlement, led to complacency. There was a lack of political will for a big project like the children’s hospital because many El Pasoans did not think that they deserved better than what they were getting. They were accustomed to a certain quality of care and a certain level of access to care. If they were not content with the status quo, they were at least tolerant of it. This last point is worth elaborating upon. Fewer than 24 percent of El Pasoans complete a bachelor’s degree, compared to nearly 32 percent of Texans and nearly 35 percent of Americans.[11] The city’s high school graduation rate is just above 75 percent, nearly 10 percent below the corresponding national and state rates.[12] Additionally, the majority of available jobs are low-paying and physically demanding, so many well-educated El Pasoans choose to make their lives elsewhere (“brain drain”).[13] Poverty and limited English proficiency compound upon low levels of education to lower access to the instruments of democracy and erode democratic culture, and they make the population more susceptible to manipulation by powerful interests – on any side. Tenet Healthcare’s advertising campaign was better funded than the campaign for the children’s hospital, and physicians and experts lined up on both sides which created confusion. In addition, and perhaps counterintuitively, given El Paso’s poor and largely Hispanic population (>80 percent),[14], [15] trust in the healthcare system is high.[16] One possible explanation is exceptional quality of care, though all the facts suggest this is not the case. Other explanations include a high degree of physician-patient ethnic concordance, a cultural deference to authority, and underentitelment, that is, the belief that one deserves less than what dispassionate others conclude s/he deserves. Any population can grow accustomed to the status quo and poverty, lack of education, and membership in an otherwise vulnerable group can prevent information filtering in from outside the city – nationwide trends – from really “taking hold.” However, in El Paso, the situation is still more complicated. Many El Pasoans have family in Mexico and cross the border regularly for shopping or recreation. In many ways, El Paso and Ciudad Juárez form a single community, and even El Pasoans who have been in the country their entire lives tend to maintain a strong connection to Mexico. This is relevant because the quality of medical care in Mexico (though improving) is low,[17] and expectations for what the government (or any large entity) will do for the common man lower still.[18] El Paso voters ultimately made the decision to fund the construction of a children’s hospital, though by a margin of less than 2 percent and with fewer than 12 percent of eligible voters weighing in.[19] The El Paso Children’s Hospital has more than delivered on its community health improvement promises. It has reduced pediatric outmigration for subspecialty and surgical care by more than 80 percent, substantially increased the county’s physician workforce, and launched several successful preventive health and health education programs. In addition, it has promoted cutting-edge research on a slew of pediatric conditions and helped to increase the city’s physician retention rate.[20] But there have been some serious hiccoughs along the way, including a bankruptcy crisis in 2015 that caused almost half of the hospital’s board to resign,[21] and there is still a lot of work to be done.[22] lll. A Better Approach to Building Children’s Hospitals The difficulty in opening a children’s hospital in El Paso serves as an important starting point for a discussion on the principles of ethical governance. Most agree that when the private sector fails to address an important community need, it is the responsibility of the government to intervene. However, people differ on what they consider an “important community need” and the precise role of government in filling needs. They may also prefer that government intervention occur at the local, state or federal level, or some combination of the three, depending on the issue before them. Five separate feasibility studies were conducted in the lead-up to the 2007 vote. All agreed that El Paso needed a children’s hospital.[23] ,But none discussed how much it needed a children’s hospital, i.e., what trade-offs would be appropriate for the community to make in order to build one. Nor could they. People will always prioritize differently. Perhaps a delay in funding a children’s hospital would allow for a restructuring of the school system. Americans usually prefer to decide such issues at the ballot box, either directly or through their representatives. However, for projects like a children’s hospital, where not all community members are informed enough on the pertinent issues to perform a cost/benefit analysis, and the risks of not acting can be severe, some other mechanism, or some supplementary mechanism, of deciding on the issue is more appropriate. In determining whether and what types of state intervention are justified, ethicists weigh several competing concerns: beneficence (the good that is likely to come to the community, folding in the harm to certain stakeholders), justice (in this case, for children, in terms of access to and quality of care) and autonomy (of the voters). However, in many communities across the country, after the need for a children’s hospital is demonstrated[24] if local voters and their representatives weigh in at all, it need only be to decide on zoning and other logistical issues because wealthy benefactors are willing to foot the bill.[25] In communities like El Paso, where no such benefactors make themselves known, voters or their representatives are asked to make a much more difficult decision: whether to fund a children’s hospital by raising taxes on themselves. That may not be fair to them, especially if their community is already poor, and it is certainly not fair to the children whose health and quality of life are at stake. Though El Paso did eventually vote to fund a children’s hospital, similarly situated communities may vote differently, and their children could suffer as a result, just as El Paso children suffered during the delay. Communities like El Paso may also be in a poor position to make truly autonomous decisions on this issue. Poverty and lack of education can lead to confusion or ambivalence owing to lack of information or access to the tools necessary to become informed. For-profit hospital chains unwilling to establish their own children’s hospitals, and others who stand to lose out, can use their considerable power to unduly influence the debate, which can also be inaccurately cast as one about redistributing resources from wealthy white households to poor, “undeserving” ethnic minorities. But one need not accept an argument about diminished community autonomy to conclude that some form of state or federal intervention to tip the scales on specific children’s hospital projects is ethically permissible. This is partially because the autonomy concern, with respect to the children’s hospital issue, is a red herring. As noted above, voters and local officials in most communities barely weigh in on children’s hospital projects at all. Projects which, it is important to stress, concern the welfare of a non-voting vulnerable group and so maybe should not be subject to majoritarianism to begin with! Moreover, if a state or the federal government were to establish a uniform process for determining whether a community needs a children’s hospital, e.g. delegating authority to a health planning agency that performs regular and transparent health infrastructure assessments and proactively issues “certificates of need” (as opposed to issuing them only after an application by interested parties), the democratic process is respected more than if a children’s hospital were simply foisted upon a community by wealthy benefactors. If the state or federal government were also to help qualifying local communities obtain their children’s hospitals, much local hesitancy about the hospital would shrink. One may wonder whether this is just “kicking the problem up to another level of government.” There is, after all, no assurance that political will for building children’s hospitals in needy communities will be higher at the state or federal level than at the local level. It may even be lower, as state and federal officials are more emotionally removed from the conditions on the ground. However, a key difference is that the reliance on a single governmental agency – one that has the resources to perform thorough, less biased assessments – removes a lot of the extraneous variables with bearing on the success of a children’s hospital project. Such an agency focuses only on the first part of the project, establishing that the hospital is necessary. This is a lower hurdle to clear, and it provides momentum for the next parts of the process, which may include varying degrees of state or federal government intervention, all of which could also be managed by a different agency. This system also makes capture by powerful interests difficult. Not only do these interests often appear less powerful at the state or federal level than locally, but a health planning agency applies objective criteria in making its determinations, and the next steps occur “in a different house.” Finally, state or federal involvement leads to parity across communities and sounder resource management because children’s hospitals generally serve areas outside the communities in which they are situated. Once a certificate of need has been issued to a community indicating that it needs a children’s hospital, the state[26] may (1) build the hospital using its own funds or funds appropriated to it for that purpose by the federal government or (2) let the local community take the lead, providing subsidies on a sliding scale to ensure that the communities which struggle to afford a children’s hospital still get one. For a variety of political and budgetary reasons, this latter route is more realistic, and it has the advantage of building local community buy-in, which could be important if the children’s hospital is to successfully recruit personnel, receive referrals from local physicians and actively participate in the local medical education/research enterprises. A certificate of need issued by an impartial government agency as part of its mandate might itself be enough to persuade a local community to take action. It could spur proponents to organize, if they had not done so earlier, and could be used as ammunition in their advertisement campaigns. But if the community is still apathetic or hesitant, the state can launch educational initiatives, including those aimed at changing underentitlement, and help it negotiate with for-profit hospital chains to see if they can be incentivized to take a children’s hospital project on. The state may also consider issuing different types of certificates of need and, for the highest level, require that the community build a children’s hospital, in the same way, that it (often) requires it to have police or fire protection. Subsidies would almost certainly have to be offered for this to be politically viable (and ethically acceptable). CONCLUSION There are several issues with this framework, including precisely how a financially infeasible but necessary children’s hospital can be made feasible. Details will have to be filled in. Nevertheless, it is something worth investigating. It could significantly improve the current situation, in which communities like El Paso are essentially left to fend for themselves. Disclaimer: The author has family associated with the El Paso Children’s Hospital. Chetan Moorthy and Sadhana Chheda are his parents. Chheda served as Board Secretary and works at Children’s as a neonatologist. Moorthy contracts with Children’s to provide radiology services. Both have practiced in El Paso for decades, and their experience is drawn upon to support some of the article’s claims, particularly those for which no hard data has been collected. [1] Casimir, Georges. 2019. “Why Children’s Hospitals Are Unique and So Essential.” Frontiers in Pediatrics 7 (July). https://doi.org/10.3389/fped.2019.00305. [2] Pew Research Center’s Hispanic Trends Project. 2019. “Metro Area U.S. Unauthorized Immigrant Population Estimates, 2016 and 2007.” Pew Research. March 11, 2019. https://www.pewresearch.org/hispanic/interactives/unauthorized-immigrants-by-metro-area-table/. [3] “City and Town Population Totals: 2010-2019.” 2020. United States Census Bureau. https://www.census.gov/data/tables/time-series/demo/popest/2010s-total-cities-and-towns.html. [4] “El Paso, Texas: Demographic Profile.” 2017. EPTX. 2017. https://www.elpasotexas.gov/economic-development/business-services/data-and-statistics/population. [5] “Community Health Needs Assessment 2014.” 2014. El Paso Children’s Hospital. https://elpasochildrens.org/wp-content/uploads/2019/08/epch-chna-report-final-9-29-14-v3.pdf. [6] Ibid. [7] Moorthy, Chetan, and Sadhana Chheda. 2020. Conditions in El Paso, Texas: Physician Services and Patient Perceptions. Interview by Gyan Moorthy. In-Person. [8] “All Children Need Children’s Hospitals.” n.d. National Association of Children’s Hospitals and Related Institutions. Accessed November 29, 2020. https://www.upstate.edu/gch/pdf/academics/allchildren.pdf. [9] Schalden, Mary. 2015. “Children’s Hospital Timeline.” El Paso Times, October 5, 2015. https://www.elpasotimes.com/story/news/2015/10/05/childrens-hospital-timeline/73394588/. [10] “El Paso, Texas: Demographic Profile.” 2017. [11] Ibid. [12] “High School Graduation Rate Data for El Paso, TX.” 2018. Open Data Network. 2018. https://www.opendatanetwork.com/entity/1600000US4824000/El_Paso_TX/education.graduation_rates.percent_high_school_graduate_or_higher?year=2018. [13] Anderson, Lindsey. 2015. “More People Leave El Paso for Elsewhere than Other Major Cities.” El Paso Times, July 22, 2015. https://www.elpasotimes.com/story/news/local/2015/07/22/more-people-leave-el-paso-elsewhere-than-other/71987220/. [14] “El Paso, Texas: Demographic Profile.” 2017. [15] Armstrong, Katrina, Karima L. Ravenell, Suzanne McMurphy, and Mary Putt. 2007. “Racial/Ethnic Differences in Physician Distrust in the United States.” American Journal of Public Health 97 (7): 1283–89. https://doi.org/10.2105/AJPH.2005.080762. [16] Moorthy, Chetan, and Sadhana Chheda. 2020. [17] Barber, Ryan M., Nancy Fullman, Reed J. D. Sorensen, Thomas Bollyky, Martin McKee, Ellen Nolte, Amanuel Alemu Abajobir, et al. 2017. “Healthcare Access and Quality Index Based on Mortality from Causes Amenable to Personal Health Care in 195 Countries and Territories, 1990–2015: A Novel Analysis from the Global Burden of Disease Study 2015.” The Lancet 390 (10091): 231–66. https://doi.org/10.1016/S0140-6736(17)30818-8. [18] Lagos, Lorenzo Felipe. 2012. “Institutional Trust: The Case Study of Mexican State Institutions.” Student Perspectives on Institutions, Choices, and Ethics 7 (4): 39. [19] “Final Election Results (2007).” 2007. El Paso County Elections Department. https://el-paso-county-elections.s3.amazonaws.com/documents/files/000/000/300/original/ELECTION_RESULTS_FINAL.pdf?1450312070. [20] “2018 Annual Community Benefit Report.” 2018. El Paso Children’s Hospital. https://elpasochildrens.org/wp-content/uploads/2018/11/epch_communityreport_2018_small.pdf. [21] Flores, Aileen B. 2015. “Taxpayers Still Owe $116M for Construction of El Paso Children’s Hospital.” El Paso Times, May 27, 2015. https://www.elpasotimes.com/story/news/local/2015/05/27/taxpayers-still-owe-116m-construction-childrens-hospital/31261601/. [22] Moorthy, Chetan, and Sadhana Chheda. 2020. [23] “History of El Paso Children’s Hospital.” 2020. El Paso Children’s Hospital. 2020. https://elpasochildrens.org/about-us/. [24] In many states, a “certificate of need” must be obtained before new healthcare facilities can be created. See Mercatus Center. 2015. “How State Certificate-of-Need (CON) Laws Affect Access to Health Care.” Medium. December 23, 2015. https://medium.com/concentrated-benefits/how-state-certificate-of-need-con-laws-impact-access-to-health-care-b8d3ec84242f for more. Certificates of need may slow the founding of hospitals in some areas, but they could also spur it when political will is low or absent. [25] Moorthy, Chetan, and Sadhana Chheda. 2020. [26] Given federal/state separation of powers, it is very unlikely that the federal government would be directly involved at this step.
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