It is widely believed that health policy should take care to ensure that persons are informed about the expected risks as well as the anticipated advantages of medical procedures. This is often justified by a concern for the moral value of personal autonomy, as it is widely believed that to the extent that a person makes decisions on the basis of false beliefs or ignorance her autonomy with respect to them is compromised. This essay argues against this widespread claim. A person’s autonomy with respect to her decisions will not be compromised by either ignorance or false beliefs. However, it does not follow that there is no reason to provide persons with the opportunity to have access to the available information relevant to their decisions concerning their medical treatment. The epistemic requirements for a person to give her consent to her treatment are more stringent than those that must be met for her to be autonomous with respect to her consent. Consent, not autonomy, can be undermined by ignorance or false belief. It is a concern for consent, not a concern for autonomy, that justifies providing people with information about their prospective medical procedures.

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPA) are drug-resistant pathogens causing high mortality rates with limited treatment options. Understanding the incidence of these organisms and laboratory knowledge of testing protocols is important for controlling their spread in healthcare settings. This project assessed how often Veterans Affairs (VA) healthcare facilities identify CRAB and CRPA and testing practices used. Method: An electronic survey was distributed to 126 VA acute care facilities September-October 2023. The survey focused on CRAB and CRPA incidence, testing and identification, and availability of testing resources. Responses were analyzed by complexity of patients treated at VA facilities (High, Medium, Low) using Fisher’s exact tests. Result: 77 (61.1%) facilities responded, most in urban settings (85.4%). Most respondents were lead or supervisory laboratory technologists (84.2%) from high complexity facilities (69.0%). Few facilities detected CRAB ≥ once/month (4.4%), with most reporting that they have not seen CRAB at their facility (55.0%). CRPA was detected more frequently: 19% of facilities with isolates ≥ once/month, 29.2% a few times per year, and 26.9% reporting had not seen the organism. No differences in CRAB or CRPA incidence was found by facility complexity. Nearly all facilities, regardless of complexity, utilize the recommended methods of MIC or disk diffusion to identify CRAB or CRPA (91.9%) with remaining facilities reporting that testing is done off-site (7.8%). More high complexity facilities perform on-site testing compared to low complexity facilities (32.0% vs 2.7%, p=0.04). 83% of laboratories test for Carbapenemase production, with one-fourth using off-site reference labs. One-fourth of facilities perform additional antibiotic susceptibility testing for CRAB and CRPA isolates, most of which test for susceptibility to combination antibiotics; no differences between complexities were found. Agreement that sufficient laboratory and equipment resources were available was higher in high complexity than in medium complexity facilities (70.7% vs 33.3%, p=0.01), but not low complexity facilities (43.8%). Conclusion: Having timely and accurate testing protocols for CRAB and CRPA are important to quickly control spread and reduce associated mortality. This study shows that most VA protocols follow recommended testing and identification guidelines. Interestingly, there was no difference in CRAB or CRPA incidence for facilities providing higher vs lower complexity of care. While high and low complexity facilities generally reported sufficient resources for CRAB and CRPA evaluation, some medium-complexity labs, who may feel more compelled than low-complexity labs to bring testing in house, reported that additional resources would be required.

While grain farming has seen a major shift toward organic production in recent years, the USA continues to lag behind with domestic demand continuing to outpace domestic supply, making the USA an all-around net importer. The Midwestern USA is poised to help remedy this imbalance; however, farmers continue to slowly transition to organic production systems. Existing literature has identified three prevalent narratives that farmers use to frame their organic transition: environmentalism, farm-family legacy and economic factors, in addition to a four and untested religiosity narrative. This study sought to better understand how these different narratives frame grain farmers’ thought processes for transitioning from conventional production systems to certified organic production systems. We co-created narratives around organic production with farmers, which resulted in four passages aligned with the literature: farm-family legacy, economic values, environmental values and Christianity and stewarding Eden. Then, we mailed a paper survey to conventional, in transition and certified organic Indiana grain farmers in order to test how these different narratives motivated organic production. We found that the most prevalent narrative around organic production is the farm-family legacy, which specifically resonated with midsize farmers. We also found that the religious stewardship narrative resonated with a substantial number of organic and mixed practice farmers, which is likely due to Amish farmers within the sample. These results shed light on the role that narratives and associated values play in organic practice use and can inform the organic efforts of agricultural professionals.

Local HII environment metallicities of 65 supernovae (SNe), obtained with INT/IDS, have been determined using the N2 and O3N2 strong emission line methods. Resulting cumulative distribution functions reveal a narrower distribution for Ib SNe (standard deviation σ ∼ 0.06 dex) compared to Ic and IIP distributions (σ ∼ 0.15 dex). This narrow distribution of Ib SNe is confirmed with an extended dataset using data from Galbany et al. (2018). Statistical tests confirm a statistically significant difference between the Ib and II-P metallicity distributions with < 5% probability that they result from the same progenitors. This narrow distribution suggests a lack of Type Ib SNe in low metallicity environments and points towards single star progenitors for these Type Ib SNe, rather than binaries. It also suggests that single massive stars at low metallicity are not commonly able to produce helium-rich Type Ib supernovae.

Many people attempt to give meaning to their lives by pursuing projects that they believe will bear fruit after they have died. Knowing that their death will preclude them from protecting or promoting such projects people who draw meaning from them will often attempt to secure their continuance by securing promises from others to serve as their caretakers after they die. But those who rely on such are faced with a problem: None of the four major accounts that have been developed to explain directed promissory obligation (the Authority View, the Trust View, the Assurance View, and the Reliance View) support the view that we are obligated to keep our promises to persons who are now dead. But I will provide hope for those who wish to use such promises to protect the meaning with which they have endowed their lives. I will argue that while we cannot wrong a person who is now dead by breaking a promise made to her during her life, we could wrong the living by so doing. We thus (might) have reason to keep the promises that we made to those who are now dead.

The Fontan Outcomes Network was created to improve outcomes for children and adults with single ventricle CHD living with Fontan circulation. The network mission is to optimise longevity and quality of life by improving physical health, neurodevelopmental outcomes, resilience, and emotional health for these individuals and their families. This manuscript describes the systematic design of this new learning health network, including the initial steps in development of a national, lifespan registry, and pilot testing of data collection forms at 10 congenital heart centres.

In five field experiments from 1986 to 1988, herbicides were evaluated alone and in combinations for weed control in water-seeded rice. Combinations of bensulfuron with either molinate or thiobencarb applied into the paddy water at the 2-leaf stage of rice, controlled all broadleaf and sedge weeds, and 92% or more early watergrass. These combinations were equivalent to a commercial standard of molinate at the 2-leaf stage followed by a separate application of bentazon to the drained paddy at midtillering.

A rainfall simulator was used to deliver the equivalent of 1.3 cm of water in 0.25 h at 0, 3, 6, 12, 24, and 48 h after POST applications of asulam to johnsongrass in greenhouse and field studies. Johnsongrass control responses were similar when asulam was applied with either a crop oil concentrate or a commercially blended organosilicone/crop oil concentrate premix. Rainfall 24 h after asulam application reduced johnsongrass control in greenhouse studies. Maximum visual johnsongrass control of 80, 69, and 69% was obtained in field studies when rainfall occurred 20, 14, and 8 h after asulam application, respectively. Based on reductions in johnsongrass dry weight, rainfree periods needed to insure maximum performance with asulam in field studies ranged from 3 to 16 h. Variation in critical rainfree periods was related to plant growth stage when asulam was applied and environmental conditions and is indicative of the inconsistency in johnsongrass control commonly observed with asulam.

In field studies conducted under weed-free conditions, soybean yield was not adversely affected with POST applications of AC 263,222 at 18 g ha−1. At 36 g ha−1, soybean height at maturity was reduced in three of five studies and soybean yield in two of five studies. Application of 9 g ha−1 of AC 263,222 to sicklepod at cotyledon to four-leaf (early POST) or at a maximum size of five-leaf (late POST) provided 30 to 48% control. Control was 54 to 73% with AC 263,222 at 9 g ha−1 applied early POST followed by late POST. Regardless of application rate or timing, sicklepod control with AC 263,222 generally was inferior to the standard treatments of pendimethalin plus imazaquin PPI followed by imazaquin late POST or pendimethalin PPI and metribuzin PRE followed by chlorimuron late POST. Compared with the weed-free check, soybean yield was reduced when AC 263,222 was applied at 9 g ha−1 early POST followed by late POST in one of two studies and in two of three studies when applied at 18 g ha−1 early POST.

Field studies were conducted over 3 yr to evaluate rhizome johnsongrass control with asulam applied POST at 3.7 kg ai/ha 3 d before fertilization (DBF) or 0, 3, 7, 10, or 14 d after fertilization (DAF). Liquid fertilizer (18-6-12) was applied with injector knives at 0, 112, or 224 kg N/ha 5 cm on each side of a 60-cm line of rhizome johnsongrass present on 1.8-m-wide conventional sugarcane beds. Johnsongrass response to timing of asulam application after fertilization varied among years but was not affected by fertilizer rate. Johnsongrass control with asulam applied 3 DBF was greater than applications made 0, 3, or 7 DAF. With one exception, differences in johnsongrass control following fertilization and asulam application times were also reflected in the biomass of treated johnsongrass and its regrowth harvested 6 and 10 wk after asulam application, respectively. Reduced johnsongrass control associated with asulam application following fertilization was related to stress from root/rhizome injury during fertilizer placement rather than the quantity of fertilizer applied.

Mapping the diversity of SNe to progenitor properties is key to our understanding of stellar evolution and explosive stellar death. Investigations of the immediate environments of SNe allow statistical constraints to be made on progenitor properties such as mass and metallicity. Here, we review the progress that has been made in this field. Pixel statistics using tracers of e.g. star formation within galaxies show intriguing differences in the explosion sites of, in particular SNe types II and Ibc (SNe II and SNe Ibc respectively), suggesting statistical differences in population ages. Of particular interest is that SNe Ic are significantly more associated with host galaxy Hα emission than SNe Ib, implying shorter lifetimes for the former. In addition, such studies have shown (unexpectedly) that the interacting SNe IIn do not explode in regions containing the most massive stars, which suggests that at least a significant fraction of their progenitors arise from the lower end of the core-collapse SN mass range. Host H ii region spectroscopy has been obtained for a significant number of core-collapse events, however definitive conclusions on differences between distinct SN types have to-date been elusive. Single stellar evolution models predict that the relative fraction of SNe Ibc to SNe II should increase with increasing metallicity, due to the dependence of mass-loss rates on progenitor metallicity. We present a meta-analysis of all current host H ii region oxygen abundances for CC SNe. It is concluded that the SN II to SN Ibc ratio shows little variation with oxygen abundance, with only a suggestion that the ratio increases in the lowest bin. Radial distributions of different SNe are discussed, where a central excess of SNe Ibc has been observed within disturbed galaxy systems, which is difficult to ascribe to metallicity or selection effects. Environment studies are also being undertaken for SNe Ia, where constraints can be made on the shortest delay times of progenitor systems. It is shown that ‘redder’ SNe Ia are more often found within star-forming regions. Environment studies are evolving to enable studies at higher spatial resolutions than previously possible, while in addition the advent of wide-field integral field unit instruments allows galaxy-wide spectral analyses which will provide fruitful results to this field. Some example contemporary results are shown in that direction.