The Outlandish, the Realistic, and the Real: Contextual Manipulation and Agent Role Effects in Trolley Problems

Hypothetical trolley problems are widely used to elicit moral intuitions, which are employed in the development of moral theory and the psychological study of moral judgments. The scenarios used are outlandish, and some philosophers and psychologists have questioned whether the judgments made in such unrealistic and unfamiliar scenarios are a reliable basis for theory-building. We present two experiments that investigate whether differences in moral judgment due to the role of the agent, previously found in a standard trolley scenario, persist when the structure of the problem is transplanted to a more familiar context. Our first experiment compares judgments in hypothetical scenarios; our second experiment operationalizes some of those scenarios in the laboratory, allowing us to observe judgments about decisions that are really being made. In the hypothetical experiment, we found that the role effect reversed in our more familiar context, both in judgments about what the actor ought to do and in judgments about the moral rightness of the action. However, in our laboratory experiment, the effects reversed back or disappeared. Among judgments of what the actor ought to do, we found the same role effect as in the standard hypothetical trolley scenario, but the effect of role on moral judgments disappeared

Health Worker Compliance with a ‘Test And Treat’ Malaria Case Management Protocol in Papua New Guinea

The Papua New Guinea (PNG) Department of Health introduced a 'test and treat' malaria case management protocol in 2011. This study assesses health worker compliance with the test and treat protocol on a wide range of measures, examines self-reported barriers to health worker compliance as well as health worker attitudes towards the test and treat protocol. Data were collected by cross-sectional survey conducted in randomly selected primary health care facilities in 2012 and repeated in 2014. The combined survey data included passive observation of current or recently febrile patients (N = 771) and interviewer administered questionnaires completed with health workers (N = 265). Across the two surveys, 77.6% of patients were tested for malaria infection by rapid diagnostic test (RDT) or microscopy, 65.6% of confirmed malaria cases were prescribed the correct antimalarials and 15.3% of febrile patients who tested negative for malaria infection were incorrectly prescribed an antimalarial. Overall compliance with a strictly defined test and treat protocol was 62.8%. A reluctance to test current/recently febrile patients for malaria infection by RDT or microscopy in the absence of acute malaria symptoms, reserving recommended antimalarials for confirmed malaria cases only and choosing to clinically diagnose a malaria infection, despite a negative RDT result were the most frequently reported barriers to protocol compliance. Attitudinal support for the test and treat protocol, as assessed by a nine-item measure, improved across time. In conclusion, health worker compliance with the full test and treat malaria protocol requires improvement in PNG and additional health worker support will likely be required to achieve this. The broader evidence base would suggest any such support should be delivered over a longer period of time, be multi-dimensional and multi-modal

Long‑term acceptability, durability and bio‑efficacy of ZeroVector® durable lining for vector control in Papua New Guinea

Background This study examined the acceptability, durability and bio-efficacy of pyrethroid-impregnated durable lining (DL) over a three-year period post-installation in residential homes across Papua New Guinea (PNG). Methods ZeroVector® ITPS had previously been installed in 40 homes across four study sites representing a cross section of malaria transmission risk and housing style. Structured questionnaires, DL visual inspections and group interviews (GIs) were completed with household heads at 12- and 36-months post-installation. Three DL samples were collected from all households in which it remained 36-months post-installation to evaluate the bio-efficacy of DL on Anopheles mosquitoes. Bio-efficacy testing followed WHO guidelines for the evaluation of indoor residual spraying. Results The DL was still intact in 86 and 39% of study homes at the two time periods, respectively. In homes in which the DL was still intact, 92% of household heads considered the appearance at 12-months post installation to be the same as, or better than, that at installation compared to 59% at 36-months post-installation. GIs at both time points confirmed continuing high acceptance of DL, based in large part of the perceived attractiveness and functionality of the material. However, participants frequently asserted that they, or their family members, had ceased or reduced their use of mosquito nets as a result of the DL installation. A total of 16 houses were sampled for bio-efficacy testing across the 4 study sites at 36-months post-installation. Overall, combining all sites and samples, both knockdown at 30 min and mortality at 24 h were 100%. Conclusions The ZeroVector® DL installation remained highly acceptable at 36-months post-installation, the material and fixtures proved durable and the efficacy against malaria vectors did not decrease. However, the DL material had been removed from over 50% of the original study homes 3 years post-installation, largely due to deteriorating housing infrastructure. Furthermore, the presence of the DL installation appeared to reduce ITN use among many participating householders. The study findings suggest DL may not be an appropriate vector control method for large-scale use in the contemporary PNG malaria control programme

The treatment of non-malarial febrile illness in Papua New Guinea: findings from cross sectional and longitudinal studies of health worker practice

The Papua New Guinea Department of Health recently shifted from a presumptive to a ‘test and treat’ malaria case management policy. This shift was supported by the widespread introduction of malaria rapid diagnostic tests in health facilities across the country. Health workers received training and job-aids detailing how to conduct and interpret a malaria rapid diagnostic test and how to treat test positive cases; however, little instruction on treating non-malaria febrile cases was provided. Accordingly, this study examined health worker case management of non-malarial febrile patients in the 12-month period immediately following the introduction of the revised malaria case management policy. Methods Data were collected from a country-wide cross-sectional survey of febrile case management at randomly selected health facilities and from longitudinal surveillance at sentinel health facilities. Analysis was restricted to febrile patients who tested negative for malaria infection by rapid diagnostic test (N=303 and 5705 outpatients, respectively). Results and Discussion 96.8% of non-malarial febrile patients received a diagnosis in the longitudinal sample, compared to 52.4% of the cross-sectional sample. Respiratory tract infections were the most commonly reported diagnoses. Over 90% of patients in both samples were prescribed one or more medications, most commonly an analgesic (71.3 & 72.9% of the longitudinal and cross-sectional samples, respectively), some form of antibiotic (72.7 & 73.4%, respectively) and/or an anthelminthic (17.9 & 16.5%, respectively). Prescribing behaviour was adherent with the recommendations in the standard treatment guidelines in fewer than 20% of cases (longitudinal sample only). Conclusion Many non-malarial febrile patients are not provided with a diagnosis. When diagnoses are provided they are typically some form of respiratory tract infection. Antibiotics and analgesics are widely prescribed, although medications prescribed rarely adhere to the Papua New Guinea standard treatment guidelines. These findings indicate that Papua New Guinea health workers require support for non-malarial febrile illness case management

Weepie

WEEPIE is an early and unpublished play by Chris Goode, called by The Guardian, ‘British theatre’s greatest maverick talent’. It tells the true story of a murder perpetrated by two nineteen-year-olds in January of 1994, two years before the play was written. The victim, Mohammed el-Sayed, was unknown to his murderers; he was chosen by them because he was the tenth motorist to pull up at the lights where the boys waited with their knife. There was no racial motive. The murderers were students at a crammer in Oxford where their enthusiasm for the military and the SAS became an obsession with killing and death

LOCSET phase locking : operation, diagnostics, and applications

The aim of this dissertation is to discuss the theoretical and experimental work recently done with the Locking of Optical Coherence via Single-detector Electronic-frequency Tagging (LOCSET) phase locking technique developed and employed here are AFRL. The primary objectives of this effort are to detail the fundamental operation of the LOCSET phase locking technique, recognize the conditions in which the LOCSET control electronics optimally operate, demonstrate LOCSET phase locking with higher channel counts than ever before, and extend the LOCSET technique to correct for low order, atmospherically induced, phase aberrations introduced to the output of a tiled array of coherently combinable beams. The experimental work performed for this effort resulted in the coherent combination of 32 low power optical beams operating with unprecedented LOCSET phase error performance of λ/71 RMS in a local loop beam combination configuration. The LOCSET phase locking technique was also successfully extended, for the first time, into an Object In the Loop (OIL) configuration by utilizing light scattered off of a remote object as the optical return signal for the LOCSET phase control electronics. Said LOCSET-OIL technique is capable of correcting for low order phase aberrations caused by atmospheric turbulence disturbances applied across a tiled array output