Profit Motive Research Articles

Spanish Imperial Vassalage and the Social Reproduction of Slavery in Colonial Cuba

Abstract With the social reproduction of slavery in colonial Cuba as its center point, this essay draws on the recent historiographical acknowledgment of the way vassalage mediated the often starkly drawn social distinctions between whites and enslaved people within colonial Spanish America. Inside the region’s emergent, capitalist political economy, feudal vassalage continued to define each social sector’s rights and responsibilities vis-á-vis the Spanish Crown. The rights of enslaved vassals derived from their potential contributions to the Spanish monarchy’s imperial survival, in their capacity to populate the extensive empire with loyal Catholic subjects and potential military defenders. These concerns also justified the Spanish monarchial state’s ability to intervene between its slaveholding vassals and its enslaved vassals, by limiting private property rights over enslaved people and operating in ways that did not fully conform to capitalist profit motives. Awareness of such sovereign-vassal interdependencies challenges historians to broaden their understanding of the relationship between capitalism and slavery to include the remnants of feudal social-political forms, even into the nineteenth century.

Print, Profit, and Perception: Ideas, Information and Knowledge in Chinese Societies, 1895–1949., edited by Pei-yin Lin and Weipin Tsai

ACKNOWLEDGEMENTS INTRODUCTION Pei-yin Lin & Weipin Tsai Chinese modernities revisited: globalization and localization Fluid modernity and ideas Print, profit and perceptions 1. CULTURAL CONNECTIONS IN A NEW GLOBAL SPACE: LI SHIZENG AND THE CHINESE FRANCOPHILE PROJECT IN THE EARLY TWENTIETH CENTURY Paul J. Bailey Early years in France Sino-French cultural interaction Li Shizeng's philosophy of work-study Conclusion 2. HEALTH AND HYGIENE IN LATE QING CHINA AS SEEN THROUGH THE EYES OF JAPANESE TRAVELERS Che-chia Chang Networks of travelers Categories of traveler First impressions: Dirty! Dirty! Dirty! Understanding the Japanese viewpoint Conclusion 3. MODERNITY THROUGH EXPERIMENTATION: LU XUN AND THE MODERN CHINESE WOODCUT MOVEMENT Elizabeth Emrich Alternative modernities and Lu Xun's Grabism Lu Xun in Shanghai and his Translations on Art Lu Xun and woodcut publications Humanism and social construction in woodblock prints Lu Xun and Woodcut Print Societies Conclusion 4. TECHNOLOGY, MARKETS, AND SOCIAL CHANGE: PRINT CAPITALISM IN EARLY TWENTIETH-CENTURY CHINA Tze-ki Hon Local initiatives and domestic factors in technology transfer Markets, circulation and profits National learning as cultural capital Professional geographers and public intellectuals Conclusion 5. MEDICAL ADVERTISING AND CULTURAL TRANSLATION: THE CASE OF SHENBAO IN EARLY TWENTIETH-CENTURY CHINA Max K. W. Huang Understanding the human body in early republican China Medical Advertising and Cultural Translation Conclusion 6. PLANET IN PRINT: THE SCIENTIFIC IMAGINATION IN ZHENG KUNWU'S FICTION DURING TAIWAN'S COLONIAL PERIOD Mei-e Huang From astronomical reports to fiction writing Scientific fantasy and humanistic reality Between science fiction and detective story Conclusion 7. SHAPING PERCEPTION OF THE SECOND WORLD WAR: A STUDY OF TEXTBOOKS IN TAIWAN IN THE 1940s Shi-chi Mike Lan Presentation of the War in Japanese colonial texts before 1945 The War in Chinese nationalist texts after 1945 Localizing the War in textbooks: Before and after 1945 Conclusion 8. ENVISIONING THE READING PUBLIC - PROFIT MOTIVES OF A CHINESE-LANGUAGE TABLOID IN WARTIME TAIWAN Pei-yin Lin Positioning the Chinese-language tabloids in colonial Taiwan Chinese literati-courtesan connections and Western exotica Appropriating and speculating about love From freedom of love to condemnation of unrestrained free love Alternative modernity and re-appropriation of love Conclusion 9. THE FIRST CASUALTY: TRUTH, LIES AND COMMERCIAL OPPORTUNISM IN CHINESE NEWSPAPERS DURING THE FIRST SINO-JAPANESE WAR Weipin Tsai War reporting in the West and in China in the second half of the nineteenth century Battle-ready and eager for the fight The war for readership In the newspapers' defense Conclusion BIBLIOGRAPHY

Rural utility to low-carbon industry: Small hydropower and the industrialization of renewable energy in China

Small hydropower (SHP) is a renewable energy that provides electricity for many rural areas in the Global South that lack national grid access. In China, however, SHP has transformed from a community-focused rural utility into to a privatized low-carbon industry that earns revenues from the sale of electricity to the grid. This paper analyzes the policies that enabled this transformation of SHP in China, and the profit motivations and political incentives that shape plant construction and operation. I argue that privatizing and framing SHP as ‘low-carbon’ makes it more amenable to industrialization, because its value is based on the amount of electricity it generates, not its contribution to poverty alleviation and conservation. Data were collected from interviews with government officials, private investors, and farmers in Xinping county, located in Yunnan province in China’s southwest. I find that investors and officials are incentivized to build and operate large-scale SHP systems that have a high installed capacity, are situated in multiple-plant cascades, and that attempt to operate year-round, including during the dry season. Some of these plants reduce streamflow and irrigation water access for farmers. This case thus exposes the inequalities of privatizing and deploying rural renewable energy for low-carbon industrial growth in the absence of strong local environmental and social safeguards.

The effects of state-level pharmacist regulations on generic substitution of prescription drugs.

Substituting generic for brand name drugs whenever possible has been proposed to control prescription drug expenditure growth in the United States. This work investigates two types of state laws that regulate the procedures under which pharmacists substitute bioequivalent generic versions of brand name drugs. Mandatory substitution laws require pharmacists to use the generic as a default, and presumed consent laws allow them to assume that the patient agrees to the substitution. Both situations can be overruled by the patient. Using plausibly exogenous changes in states' laws, we use difference-in-differences and a discrete choice model to show that although the mandatory switching laws have little effect, the presumed consent laws reduce consumers' probability of purchasing brand name drugs by 3.2% points. The differential effectiveness of the laws is likely caused by pharmacists' profit motives. These results offer important implications for policies that seek to reduce drug expenditures by incentivizing the use of generic drugs.

WOKE UP ON QUESTION MARKInsomniac Dreams: Experiments with Time. By Vladimir Nabokov. Edited by Gennady Barabtarlo

A decade ago, a good deal of critical grumbling flared over the posthumous publication of a series of Nabokov’s preparatory notecards as a fragment of a novel, in embryo: The Original of Laura. Nabokov, dying, had ordered his executors to nix the notecards and the work they commenced, but his wife vacillated for years, and his son Dmitri, decades later, ushered the work into print. The breach by the executors, whether actuated by undiscerning love or, so sniped the Guardian, the profit motive, resulted in a volume that reviewers found handsome in presentation but slight and unremarkable as written – a little finger-exercise, not a breaking of ground. In an interview with the New York Times given the year before he died, Nabokov recounted a reading of the unfinished novel that he gave in his dreams while recovering from an illness at a hospital in Lausanne: ‘reading it aloud to a small dream audience in a walled garden. My audience consisted of peacocks, pigeons, my long dead parents, two cypresses, several young nurses crouching around and a family doctor so old as to be almost invisible’. The dream-audience – pastoral appearances, and ties of kinship, notwithstanding – did not laud, but Nabokov remained sanguine: ‘less success with my listeners than it will have, I hope, with intelligent reviewers when properly published’.

Competing teammates: food in New Zealand sports settings.

Despite the global popularity of sport, we know surprisingly little about food in sports settings. This two-phased study analysed the foods available in New Zealand sports settings. Phase one included a systematic literature review and 18 interviews with key informants from national and regional sporting organizations. Phase two involved 37 key informant interviews with stakeholders from two exemplar sports, rugby and netball and direct observations at netball and rugby venues. This study found most foods and beverages at New Zealand sports events were energy-dense and nutrient-poor. Caterers' control over food provision, socio-cultural attitudes which view unhealthy foods as normal, and a dominant profit motive, appear to be the key factors influencing the food environment in sports settings. Food environments in sport settings provide frequent opportunities to purchase and consume energy-dense, nutrient-poor foods. The research shows we have competing players in the sports context-unhealthy food and healthy physical activity. Achieving sustainable healthy change in sports settings will be challenging when the prevailing attitude normalizes the unhealthy environment. Nutrition policies in sports clubs are urgently needed to increase the availability of healthy food. This requires support from health agencies and leadership from national sports organizations. Given the international nature of the food industry and sport, these findings from New Zealand may assist other countries to better understand the nature of food in sport and adopt appropriate interventions to reduce the obesogenic environment that is sport.

Profit Motive, Stakeholder Needs and Economic Dimension of Corporate Social Responsibility: Analysis on The Moderating Role of Religiosity

Economic dimension of corporate social responsibility (CSR) represent the main aim of establishing all forms of business organizations. The outcome from all transactions translate into the process of attaining continuity, growth, satisfactory returns, maximization of shareholders wealth and provision of goods and services to the community. Achievement of all these goals depends on how managers are able to perfect the profit motive objective and satisfy the needs of all stakeholders. A total of 164 respondents who are the managers responsible for decision making on all corporate social responsibility activities were engaged in answering the questionnaire for this study. The managers were representing different sub sectors of the Nigerian financial sector. A statistical analysis on the data was done by using the partial least square approach (PLS-SEM). Results from the analysis revealed that both profit motive and stakeholder needs are positively related with the economic dimension of CSR. Religiosity of managers is also positively related with ability of managers to attain economic responsibilities they were employed to achieve. With the role of religiosity as a significant moderating factor managers are expected to align CSR activities with accepted religious values that instills hard work, trust and assistance to stakeholders to fulfill the overall economic dimension of corporate social responsibility.

The privilege of knowing better: Female millennial demographics and the representation of homophobia on teen TV

Abstract The 2010–11 seasons of 90210 (2008–13), Degrassi (2010–15), Glee (2009–15) and Pretty Little Liars (2010–17) represent homophobia as arising from closeted teens, cisgender male ‘jocks’, racialized characters and immigrants. Rather than locating homophobia and heteronormativity within the social fabric and minds of all who have been steeped in American and Canadian hegemonic beliefs, homophobic characters are framed as rare, anachronistic and out-of-step with the seemingly post-homophobia ethos they exist within. Drawing on media trade publications, I place these patterns for representing homophobia in their market context, arguing that profit motives encourage representations of gay teens and homophobia that suggest homophobic beliefs are the domain of ‘others’, apart from the privileged viewer of teen TV: affluent, educated, female, white and non-white millennials aged 18–34. The target viewers are invited to see themselves as innocent and enlightened in relation to homophobic others, while prescribing a cure to homophobia that emphasizes individual change over social change.

Natural Gas From US Shales Holding Down Prices in United States and Abroad

Because the shale revolution in oil rolls on and on, undercutting international attempts to defuse it and defending us from imports, more and more associated gas from oil production continues to be produced, keeping gas prices low. Saudi Arabia and others have allowed oil prices to hike, and the current $70 a barrel is plenty to give many shale producers a sufficient profit motive.

Retaining Doctors in Rural Bangladesh: A Policy Analysis.

Background: Retaining doctors in rural areas is a challenge in Bangladesh. In this study, we analyzed three rural retention policies: career development programs, compulsory services, and schools outside major cities – in terms of context, contents, actors, and processes. Methods: Series of group discussions between policy-makers and researchers prompted the selection of policy areas, which were analyzed using the policy triangle framework. We conducted document and literature reviews (1971-2013), key informant interviews (KIIs) with relevant policy elites (n=11), and stakeholder analysis/position-mapping. Results: In policy-1, we found, applicants with relevant expertise were not leveraged in recruitment, promotions were often late and contingent on post-graduation. Career tracks were porous and unplanned: people without necessary expertise or experience were deployed to high positions by lateral migration from unrelated career tracks or ministries, as opposed to vertical promotion. Promotions were often politically motivated. In policy-2, females were not ensured to stay with their spouse in rural areas, health bureaucrats working at district and sub-district levels relaxed their monitoring for personal gain or political pressure. Impractical rural posts were allegedly created to graft money from applicants in exchange for recruitment assurance. Compulsory service was often waived for political affiliates. In policy-3, we found an absence of clear policy documents obligating establishment of medical colleges in rural areas. These were established based on political consideration (public sector) or profit motives (private sector). Conclusion: Four cross-cutting themes were identified: lack of proper systems or policies, vested interest or corruption, undue political influence, and imbalanced power and position of some stakeholders. Based on findings, we recommend, in policy-1, applicants with relevant expertise to be recruited; recruitment should be quick, customized, and transparent; career tracks (General Health Service, Medical Teaching, Health Administration) must be clearly defined, distinct, and respected. In policy-2, facilities must be ensured prior to postings, female doctors should be prioritized to stay with the spouse, field bureaucrats should receive non-practising allowance in exchange of strict monitoring, and no political interference in compulsory service is assured. In policy-3, specific policy guidelines should be developed to establish rural medical colleges. Political commitment is a key to rural retention of doctors.

Does Merit Have a Future?

Cathy N. davidson'Sthe new education: how to revolutionize the university to prepare students for a world in fluxchallenges us to address nonacademics, and to update our teaching, by focusing on the big picture. She calls on us to rise above departmental politics and the tribalism of disciplinary debates. Instead of engaging in those familiar struggles, we should be talking with our neighbors and our elected representatives about the advantages of eliminating letter grades; the virtues of pedagogies that are learner-centered, collaborative, and project-based; the perils of specialization; the damage that departments do by stifling change; the promise of educational technology if divorced from the profit motive; the myth that STEM degrees lead directly to career success; and, of course, the need for public reinvestment in higher education. Each of these talking points draws energy from Davidson's contention that digital media have rendered industrial models of education obsolete.

Environmental Governance – From Public to Private?

This paper analyzes the expanded role of private actors and markets in environmental governance. The public goods dimension of environmental services renders privatization and trading challenging. To illustrate the key issues involved, a series of privatization efforts and market creations are reviewed. Despite the focus on privatization, the empirical material shows that the role of the state is still very pronounced. It defines the commodities and property rights, and plays a key role in setting up and regulating the markets. In the case of payments for ecosystem services, public authorities even appear as the dominant ‘trader’. Privatization and markets may reduce costs of delivering the service, while this is not universally true. Moreover, the service delivered often is transformed to make trade possible. Finally, high transaction costs may prohibit the creation of markets. The conflict between public goods delivery and private profit motive makes public control both important and difficult. Finally, several distributional issues following this neo-liberal development are highlighted.

Less Is More: A Minimalist Approach to Endoscopy

A substantial literature documents inappropriate usage of gastrointestinal endoscopy in a variety of clinical settings. Overusage of endoscopy appears to be common, and 30% or more of procedures performed in some clinical settings have questionable indications. The potential reasons for overuse of endoscopy are multiple, and include cancer phobia, fear of medical malpractice litigation, profit motive, the investigation of "incidentalomas" found on other imaging, and underappreciation of the delayed harms of endoscopy, among other reasons. Clinical guidelines, which should limit overuse of endoscopy, may instead serve to promote it, if authors opt to be "conservative," recommending endoscopy in situations of unclear utility. Several strategies may decrease overuse of endoscopy, including careful attention to risk stratification when choosing patients to screen, adherence to guidelines for surveillance intervals for colonoscopy, the use of quality indicators to identify outliers in endoscopy utilization, and education on appropriate indications and the risks of overuse at the medical student, residency, and fellowship levels.

Determinants of Entrepreneurial University Culture Under Unfavorable Conditions: Findings from a Developing Country

This qualitative research examines entrepreneurial cultures of private and public sector universities in an apparently hostile economy such as Pakistan, and how it is affected by a nexus of its internal and external environmental factors. The phenomenon is explored through viewpoints and understanding of the social actors who experience it firsthand through 32 interviews with faculty members of 4 public and 4 private sector universities. A top-down, government-pull model approach driven by visionary leaders was found more viable and suggested in promoting entrepreneurial culture rather than bottom-up, university-push model approach. Furthermore, to achieve entrepreneurial cultures, private universities are restrained by profit motives, whereas public ones are inhibited by administrative procedures. The proposed framework offers empirical guidelines for the purposes of contextualizing entrepreneurial university culture and its underlying factors under unfavorable conditions.

Strategic incentives for complementary producers to innovate for efficiency and support sustainability

Process innovation that increases operational efficiency through a step change improvement in resource utilisation and waste reduction can help boost manufacturing profitability but also offer broader social and environmental benefits. Business owners, though, might be reluctant to make investments in process innovation unless they serve a pure profit motive. While not guided by altruistic intentions, the owners might nonetheless see a strategic benefit in providing their managers with remuneration incentives supported by public commitments to increase innovation effort for more efficient, lean and sustainable operations. We model such a possibility amongst producers controlling the supply of essential complementary components that go into the assembly of competitively produced composite finished goods. We demonstrate the ruinous effect of independent strategic delegation to managers of powerful complementary producers. Instead, collaboration amongst the owners of the complementary producers to establish common managerial incentives can increase innovative effort to raise efficiency that benefits the whole industry supply chain, end consumers, and social welfare. Government-backed voluntary agreements with sector-wide commitments may be helpful in encouraging process innovation to support lean supply chains and sustainability.

Academic Publishing and its Digital Binds: Beyond the Paywall towards Ethical Executions of Code

In this article we explore various constraints and potentials of academic publishing in the digital age. Advancement of digital platforms and their expansive reach amplify the underlying tensions of institutional and scholarly change. A key affordance of these platforms is that of speed: rapidly distributing the outputs of a precaritised profession and responding to pressures to publish as well as the profit motive of publishers. On the one hand, these systems make possible alternative modes of contributory content and peer-production for supporting the commons. On the other, they turn all too readily into privatising devices for contracting labour and profit in the corporate sector and, within the academy, for accentuating subtle power effects. Drawing upon platform studies and integrating insights from political philosophy and property law, our article seeks to problematise neat binaries of possession and dispossession associated with the sector. We examine in particular how co-existing and emergent socio-technical circuits—what we term digital binds—modulate the political economy of academic publishing on a number of scales. These entangled binds constrain but also indicate mechanisms for opening up new possibilities. We introduce three ethical executions of code towards this end: dissuading, detouring, and disrupting. Together, these mechanisms show how mutually beneficial boundaries can be drawn for designing otherwise: by blocking dominant systems and bargaining for fairer practices; exploring sanctioned and unsanctioned systems which offer more diverse publishing pathways; and, disrupting systemic processes and profits towards more inclusive and equitable conditions.

The challenges of interventions to promote healthier food in independent takeaways in England: qualitative study of intervention deliverers\u2019 views

BackgroundMuch of the food available from takeaways, pubs and restaurants particularly that sold by independent outlets, is unhealthy and its consumption is increasing. These food outlets are therefore important potential targets for interventions to improve diet and thus prevent diet related chronic diseases. Local authorities in England have been charged with delivering interventions to increase the provision of healthy food choices in independent outlets, but prior research shows that few such interventions have been rigorously developed or evaluated. We aimed to learn from the experiences of professionals delivering interventions in independent food outlets in England to identify the operational challenges and their suggestions for best practice.MethodsWe used one-to-one semi-structured qualitative interviews to explore the views and experiences of professionals who were either employees of, or contracted by, a local authority to deliver interventions to increase the provision of healthier food choices in independent food outlets. Purposive sampling was used to recruit a sample which included men and women, from a range of professional roles, across different areas of England. Interviews were informed by a topic guide, and proceeded until no new themes emerged. Interviews were recorded, transcribed verbatim and analysed using the Framework method.ResultsWe conducted 11 individual interviews. Participants focussed on independent takeaways and their unhealthy food offerings, and highlighted the advantages and disadvantages of intervention delivery methods, their evaluation and impact.The main barriers to implementation of interventions in independent takeaways were identified as limited funding and the difficulties of engaging the food outlet owner/manager. Engagement was thought to be facilitated by delivering intensive, interactive and tailored interventions, clear and specific information, and incentives, whilst accounting for practical, primarily financial, constraints of food businesses. Alternative intervention approaches, targeting suppliers or customers, were suggested.ConclusionsParticipants emphasised independent takeaways as particularly challenging, but worthwhile intervention targets. Participants perceived that interventions need to take account of the potentially challenging operating environment, particularly the primacy of the profit motive. Upstream interventions, engaging suppliers, as well as those that drive consumer demand, may be worth exploring. Rigorous, evidence-informed development and evaluation of such interventions is needed.

The Undeniable Import of Marcel’s Hope

The contemporary man’s inclination to transcendence and the ontological is threatened to collapse due to technology, bureaucracy, and the “problematical.” With the pervasiveness of both public and private organizations’ processes focusing on profit and selfish motives, discounting human and spiritual formation, man’s descent to desolation is certain. Hence, “alienation” from himself and the loss of all the wonder, thrill, curiosity, and enthusiasm for all values of life is conceivable. Gabriel Marcel, who experienced the devastation and desolation of the two world wars and, the many excruciating events, such as death and suffering with his family, describes his situation as a “broken world.” But because of the profound love and hope that he and his family shared with one another, he was able to keep going in his life. These experiences made him triumphantly confront the relations among death, love, and hope in his life. Accordingly, with man’s situation today that are closing his inclination towards transcendence and the ontological, this paper aims to ascertain the import of Marcel’s hope. From several Marcellian themes, which are preliminary and interrelated in the discourse of hope, to hope itself, this paper further poses the proposition that hope is undeniable in man’s life addressing the many sways for desolation.

Davis Press: Should You Publish Meccan Madness?

You are the owner/editor of your own publishing firm, Davis Press. You encounter a dilemma when, in 2010, you are given the opportunity to publish a novel set in the Islamic holy city of Mecca. Given the angry fallout after the publication of Salman Rushdie's The Satanic Verses, the Iraq War, and the controversy of Qur'an desecration at the US naval base prison at Guantanamo Bay, publishing the novel presents a host of ethical dilemmas. This case discusses the ethics of a free press and challenges the profit motive in the face of jeopardizing political and religious world affairs. Excerpt UVA-E-0421 Rev. Jan. 8, 2021 Davis Press: Should You Publish Meccan Madness? After 25 years of career success in a leading US publishing firm, you harnessed the monetary and human resources to launch your own publishing firm, Davis Press. Your company has created a niche for itself in high-adventure, factually based fiction, and, as a risk-taker, you have profited from the national resurgence in adventure novel sales. It is late 2010, and you are currently celebrating Davis Press's sixth year since inception and its first year in the black. Earlier in the year, author Jonathan Taajwar had submitted a manuscript to Davis Press called Meccan Madness. The editorial staff reviewed the book, and it has been and found it to be a fascinating and riveting novel about a Muslim woman who attempts to lead an underground movement to take control of the Kaaba, the holy sanctuary at Mecca. You are sure the book would be a bestseller, which would give a large and welcome boost to your bottom line. Your confidence in the success of Meccan Madness is also, however, the very reason for your serious concern about publishing it under the Davis Press name. You are well aware that the novel's basic premise makes it controversial, as does the fact that Taajwar is a self-professed lapsed Muslim. Needless to say, any publication critical of Islam would be badly received, primarily by people of the Islamic faith. Although the tragedy of September 11, almost four years earlier, had created interest in learning about the Islamic faith and consequently would probably boost sales, it had also created a far more volatile climate that could mean a potentially hostile reception to Taajwar's novel. In addition, the Iraq War, waged by America in the spring of 2003, had created a lot of anti-American sentiment not only in Iraq but also in many other Muslim countries. . . .

“Do-it-yourself”: Vaccine rejection and complementary and alternative medicine (CAM)

In this article, we elucidate a symbiotic relationship between complementary and alternative medicine (CAM) and rejection of, or hesitancy towards, vaccination. In Fremantle, Western Australia, and Adelaide, South Australia, we conducted in-depth interviews from September 2013–December 2015 with 29 parents who had refused or delayed some or all of their children's vaccines. Our qualitative analysis found that for many, their do-it-yourself ethic and personal agency was enhanced by self-directed CAM use, alongside (sometimes informal) CAM practitioner instruction. Reifying ‘the natural,’ these parents eschewed vaccines as toxic and adulterating, and embraced CAM as a protective strategy for immune systems before, during and after illness. Users saw CAM as harm-free, and when it came to experiences that non-users might interpret as demonstrating CAM's ineffectiveness, they rationalised to the contrary. They also generally glossed over its profit motive. CAM emerged as part of an expert system countering Western medicine. CAM's faces were trusted and familiar, and its cottage capitalism appeared largely free from the taint of “Big Pharma.” A few parents employed a scientific critique of CAM modalities – and a minority were dubious of its profit motive – but others rejected the epistemology underpinning biomedicine, framing CAM as a knowledge not poisoned by avarice; a wisdom whose very evidence-base (anecdote and history) was demeaned by an arrogant scientific process only permitting belief in that which could be quantified. However, all parents engaged with Western medicine for broken bones and, sometimes, medical diagnoses. Our analysis suggests that pro-vaccination health professionals, policymakers and information-providers seeking to address the role of CAM in vaccine rejection face significant challenges due to the epistemic basis of some parents' decisions. However, we make some suggestions for professional practice and policy to enhance trust in vaccination.