We are printing in its entirety the discussion document which sets out a code of professional conduct for nurses published by the Royal College of Nursing in November 1976 together with commentaries by the Assistant Secretary of the British Medical Association, a professor of nursing studies, student nurses and a lawyer. The image of the nurse is still that of one of Florence Nightingale's young ladies or of a member of a religious order who is wholly dedicated to caring for (...) the sick. Today, as this document and the comments upon it show, 'dedication' is still part of the motive which leads a man or woman to become a nurse but in addition, and this is where the public may be ignorant or choose to be ignorant, nursing offers a career where intellectual achievement and the satisfaction of a demanding job bring their proper financial reward and place in the professional community. We are grateful to the Royal College of Nursing for permission to publish this document. (shrink)

Napolitano (The epistemology of fake news, Oxford University Press, 2021) argues that the Minimalist Account of conspiracy theories—i.e., which defines conspiracy theories as explanations, or theories, about conspiracies—should be rejected. Instead, she proposes to define conspiracy theories as a certain kind of belief—i.e., an evidentially self-insulated belief in a conspiracy. Napolitano argues that her account should be favored over the Minimalist Account based on two considerations: ordinary language intuitions and theoretical fruitfulness. I show how Napolitano’s account fails its own purposes (...) with respect to these two considerations and so should not be favored over the Minimalist Account. Furthermore, I propose that the Minimalist Account is the best conception of ‘conspiracy theory’ if we share Napolitano’s goal of advancing the understanding of conspiracy theories. (shrink)

Background If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical - trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the (...) 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. (shrink)

The use of platelet rich plasma as a novel treatment is discussed in the context of a qualitative research study comprising 38 interviews with sports medicine practitioners and other stakeholders working within the English Premier League during the 2013–16 seasons. Analysis of the data produced several overarching themes: conservatism versus experimentalism in medical attitudes; therapy perspectives divergence; conflicting versions of appropriate evidence; subcultures; community beliefs/practices; and negotiation of medical decision-making. The contested evidence base for the efficacy of PRP is presented (...) in the context of a broader professional shift towards evidence based medicine within sports medicine. Many of the participants while accepting this shift are still committed to casuistic practices where clinical judgment is flexible and does not recognize a context-free hierarchy of evidentiary standards to ethically justifiable practice. We also discuss a tendency in the data collected to consider the use of deceptive, placebo-like, practices among the clinician participants that challenge dominant understandings of informed consent in medical ethics. We conclude that the complex relation between evidence and ethics requires greater critical scrutiny for this emerging specialism within the medical community. (shrink)

The development of gene expression profiling and next-generation sequencing technologies have steered oncogenomics to the forefront of precision medicine. This created a need for harmonious cooperation between clinicians and researchers to increase access to precision oncology, despite multiple implementation challenges being encountered. The aim is to apply personalised treatment strategies early in cancer management, targeting tumour subtypes and actionable gene variants within the individual’s broader clinical risk profile and wellbeing. A knowledge-generating database linked to the South African Medical Research Council’s (...) Genomic Centre has been created for the application of personalised medicine, using an integrated service and research approach. Insights gained from patient experiences related to tumour heterogeneity, access to targeted therapies and incidental findings of pathogenic germline variants in tumour DNA, provided practice-changing evidence for the implementation of a cost-minimisation pathology-supported genetic testing strategy. Integrating clinical care with genomic research through data sharing advances personalised medicine and maximises precision oncology benefits. (shrink)

Undercover filming is a method commonly used by animal activist groups to expose animal cruelty and it is important to consider the effects of publically releasing video footage of cruel practices on the viewers’ mental health. Previously, we reported that members of the Australian public were emotionally distressed soon after viewing media broadcasts of cruelty to Australian cattle exported for slaughter in Indonesia in 2011. To explore if there were any long term impacts from exposure to media on this issue, (...) a self-selecting group of 15 people who were exposed to a documentary exposé of the cruelty were re-interviewed 12 months later. Nearly all recalled their strong initial reaction to the footage. Approximately one half of the respondents who initially had had a strong emotional reaction to the footage reported negative reactions that were still strong even after this period of time. They reported potential triggers for these feelings. Of the rest, some managed to internalise their feelings. Approximately one half of respondents were unaware of continued live export exposés, suggesting less prominent media coverage. Despite the aversion and repulsion reported after viewing the initial coverage, most respondents said they would choose to watch another broadcast of animal cruelty and nearly all supported undercover investigations as a means of revealing cruelty to animals. We conclude that many people viewing footage of cruelty to animals will have long term memory of this, but that they would prefer to be informed about the issues and not be protected from them. (shrink)

Since the 1970s, estrogen have sometimes been used in adolescent girls to reduce very tall adult expected height. Worries about long-term effects have led to a proposal to link treatment data with cancer registers. How should one deal with informed consent for such a study? We designed a qualitative study with semi-structured telephone interviews. From 1200 women who were to be followed-up in cancer registers, we randomly selected 22 women. Major themes were a wish to be involved and a positive (...) attitude to the proposed register research. The women did not express worry after reading the study protocol, but did convey considerable frustration that this research had not been initiated earlier. Active consent was not seen as crucial. We found strong interest in a high participation rate and a concern over missing data. The selection of information and consent or the decision to go ahead without consent in register follow-up is a delicate balancing act. Study participants wish to be contacted, but acknowledge the primary goal of answering important questions. Our study provides support for safeguarding privacy in epidemiological linkage studies and in follow-up of medical treatment without losing the scientific value by requesting for informed consent. (shrink)

Experiments are described, using electroencephalography (EEG) and simple tests of performance, which support the hypothesis that collapse of a quantum field is of importance to the functioning of the brain. The theoretical basis of our experiments is derived from Penrose (1989) who suggested that conscious decision-making is a manifestation of the outcome of quantum computation in the brain involving collapse of some relevant wave function. He also proposed that collapse of any wave function depends on a gravitational criterion. As different (...) brain areas are known to subserve different functions, we argue that `Penrose collapse' must occur in a particular brain area when performing a task that uses it. Further, taking an EEG from the area should amplify the gravitational prerequisite for collapse, so affecting task performance. There are no non-quantum theories which could lead one to expect that taking an EEG could directly affect task performance by subjects. The results of both pilot and main experiments indicated that task performance was indeed influenced by taking an EEG from relevant brain areas. Control experiments suggested that the influence was quantum mechanical in origin, and was not due to any experimental artefact. The results are statistically significant and merit attempts at replication in an independent laboratory, preferably with more sophisticated equipment than was available to us. (shrink)

This collective paper on radicalization and violent extremism part of the ‘Philosophy of education in a new key’ initiative by Educational Philosophy and Theory brings together some of the leading contemporary scholars writing on the most pressing epistemological, ethical, political and educational issues facing post-9/11 scholarship on radicalization and violent extremism. Its overall aim is to move beyond the ‘conventional wisdom’ associated with this area of scholarly research best represented by its many slogans, metaphors and other thought-terminating clichés. By providing (...) conceptual lenses on issues previously compartmentalized primarily [or even exclusively] in security and intelligence studies or at the fringes of scholarly interest, radicalization and violent extremism turn out to be much more complex than ‘radicalization studies’ has been eager to acknowledge. (shrink)

The effects of school inspections on school improvement have been investigated only to a limited degree. The investigation reported on in this article is meant to expand our knowledge base regarding the impact of school inspections on school improvement. The theoretical framework for this research is partly based on the policy theory behind the Dutch Educational School Supervision Act (the latter includes assumptions about how school inspections lead to school improvement). Interviews and a survey with school inspectors gave insight into (...) how school inspectors implement the Supervision Act and how they assess schools, and stimulate schools to improve. The results of ten case studies showed that all schools started to improve after a school visit. The innovation capacity of the school and the school environment do not seem to contribute to school improvement after school inspections. No effects were found on school-improvement processes of the number of insufficient scores that schools received from inspectors, the extent of feedback and suggestions for improvement, and the number of agreements. The provision of feedback about weaknesses, the assessment of these weak points as unsatisfactory, and the agreements between an inspector and the school regarding improvement activities do appear to make a difference in promoting school improvement. (shrink)

The current research investigates a combination of two instructional approaches, tutored problem solving and worked examples. Tutored problem solving with automated tutors has proven to be an effective instructional method. Worked‐out examples have been shown to be an effective complement to untutored problem solving, but it is largely unknown whether they are an effective complement to tutored problem solving. Further, while computer‐based learning environments offer the possibility of adaptively transitioning from examples to problems while tailoring to an individual learner, the (...) effectiveness of such machine‐adapted example fading is largely unstudied. To address these research questions, one lab and one classroom experiment were conducted. Both studies compared a standard Cognitive Tutor with two example‐enhanced Cognitive Tutors, in which the fading of worked‐out examples occurred either in a fixed way or adaptively. Results indicate that the adaptive fading of worked‐out examples leads to higher transfer performance on delayed posttests than the other two methods. (shrink)

Many theories of complex cognitive-motor skill learning are built on the notion that basic cognitive processes group actions into easy-to-perform sequences. The present work examines predictions derived from laboratory-based studies of motor chunking and motor preparation using data collected from the real-time strategy video game StarCraft 2. We examined 996,163 action sequences in the telemetry data of 3,317 players across seven levels of skill. As predicted, the latency to the first action is delayed relative to the other actions in the (...) group. Other predictions, inspired by the memory drum theory of Henry and Rogers, received only weak support. (shrink)