For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a re-clarification of the difference between a health status and an outcome measure, the paper presents an evaluative checklist for use by clinical audit and research staff to review outcome measures for (...) use in routine care settings. Central features include the user-centredness of the measure, its psychometric properties, feasibility of use and utility. The applicability of the checklist is illustrated for outcome measurement in diabetes and stroke care. A modified form of the checklist is proposed for use by the busy clinician as an aid to the critical review of research papers within the context of evidence-based practice and to aid health care practitioners' choice of which outcome measure(s) to use within routine clinical care. (shrink)

Can you think of a meme that made you laugh or a political post that made you angry? These examples illustrate how social media use (SMU) impacts how people feel. Similarly, how people feel when they initiate SMU may impact the emotional effects of SMU. Someone feeling happy may feel more positively during SMU, whereas someone feeling sad may feel more negatively. Using an experimental design, we examined whether following SMU, those in a happy mood would experience increases in positive (...) affect (PA) and those in a sad mood would experience increases in negative affect (NA). A large sample of college students (N = 703) were randomly assigned to a happy, sad, or neutral mood induction before SMU. PA and NA were assessed at baseline, post-mood induction, and after SMU. Contrary to hypotheses, after SMU, people in happy moods experienced decreases in PA, and those in sad moods experienced decreases in NA, reflecting SMU having a dampening effect on emotions. PA and NA were significantly lower after SMU compared to baseline and did not vary by condition. How young adults feel when they log onto SMU matters in understanding how SMU impacts PA and NA, but on average, emotional experiences are dampened. (shrink)

A Scientific Integrity Consortium developed a set of recommended principles and best practices that can be used broadly across scientific disciplines as a mechanism for consensus on scientific integrity standards and to better equip scientists to operate in a rapidly changing research environment. The two principles that represent the umbrella under which scientific processes should operate are as follows: Foster a culture of integrity in the scientific process. Evidence-based policy interests may have legitimate roles to play in influencing aspects of (...) the research process, but those roles should not interfere with scientific integrity. The nine best practices for instilling scientific integrity in the implementation of these two overarching principles are Require universal training in robust scientific methods, in the use of appropriate experimental design and statistics, and in responsible research practices for scientists at all levels, with the training content regularly updated and presented by qualified scientists. Strengthen scientific integrity oversight and processes throughout the research continuum with a focus on training in ethics and conduct. Encourage reproducibility of research through transparency. Strive to establish open science as the standard operating procedure throughout the scientific enterprise. Develop and implement educational tools to teach communication skills that uphold scientific integrity. Strive to identify ways to further strengthen the peer review process. Encourage scientific journals to publish unanticipated findings that meet standards of quality and scientific integrity. Seek harmonization and implementation among journals of rapid, consistent, and transparent processes for correction and/or retraction of published papers. Design rigorous and comprehensive evaluation criteria that recognize and reward the highest standards of integrity in scientific research. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

Investors with a pro-social or sustainability agenda increasingly attempt to influence firm managers to adopt socially responsible behavior, either through positive/reward tactics or negative/punishment tactics. This paper considers how investors can use each approach to differentially influence managers to make more CSR investments. The paper uses game theory with an all-pay contest structure to model how a large institutional investor could reward firms for CSR activities by creating a socially responsible investment fund (reward contest) or punish firms via shareholder activism (...) (punishment contest). We identify conditions under which the punishment contest induces a higher level of CSR activity among firms compared to the reward contest. Managers bearing substantial private costs stemming from the activism is one such condition. Spillover effects are seen as the other managers in the economy engage in CSR to avoid being punished by the investor’s activism. This level of engagement is not the case when rewards are used—only those managers with an expectation of being rewarded increase their CSR activity in that scenario. This suggests, for example, that incorporating thresholds or tiers (e.g. gold, silver, and bronze-level winners) can increase the effectiveness of reward contests. Implications for designing both positive and negative CSR inducements are explored. We also identify the ethical dilemmas that relate to such influence attempts. (shrink)

This article continues the themes developed in a previous paper looking at reparations for past wrongs in post-colonial Australia. It narrows the focus to examine the scope of the law of tort to provide reparations suffered as a result of colonisation and dispossession, with particular emphasis on the assimilation policies whose legacy is now known emphatically, although it ought not be exclusively, as the Stolen Generations. The search for more than just words is particularly topical in light of the Australian (...) Prime Minister's formal apology in early 2008. This highly symbolic step must not lose momentum. That momentum could be both political and legal. In the latter context, we explore here the concept of alien tort, in the light of current Australian tort jurisprudence, which has thus far proved inadequate to achieve compensation for the harms suffered. Taking a comparative approach, procedural and substantive developments are to better deliver justice consistent with community values. In particular, the greater acceptance of psychological harm as actionable tortious conduct in Canada and the United States is examined. The article further examines the scope for stolen children to bring suit under the US Alien Tort Claims Act 1789. While the Australian government enjoys sovereign immunity in the courts of the United States, non-state organisations such as churches that were complicit in the forcible removals may be subject to United States jurisdiction wherever they have a presence in that country. The procedural and substantive elements of such a claim are discussed. In particular, the relevant cause of action, the issue of forum non conveniens and the statute of limitations will be analysed to map out whether a claim could be developed and successfully prosecuted. © Springer Science + Business Media B.V. 2009. (shrink)

Sections R1 to R3 attempt to take the sting out of hostile commentaries. Sections R4 to R5 engage Berlin and Kay and the World Color Survey to correct the record. Section R6 begins the formulation of a new theory of colour as an engineering project with a technological developmental trajectory. It is recommended that the colour space be abandoned.

In this target article the following hypotheses are discussed: (1) Colour is autonomous: a perceptuolinguistic and behavioural universal. (2) It is completely described by three independent attributes: hue, brightness, and saturation: (3) Phenomenologically and psychophysically there are four unique hues: red, green, blue, and yellow; (4) The unique hues are underpinned by two opponent psychophysical and/or neuronal channels: red/green, blue/yellow. The relevant literature is reviewed. We conclude: (i) Psychophysics and neurophysiology fail to set nontrivial constraints on colour categorization. (ii) Linguistic (...) evidence provides no grounds for the universality of basic colour categories. (iii) Neither the opponent hues red/green, blue/yellow nor hue, brightness, and saturation are intrinsic to a universal concept of colour. (iv) Colour is not autonomous. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 39.1 (2001) 49-75 [Access article in PDF] Sensible Ends:Latent Teleology in Descartes' Account of Sensation Alison Simmons One of Descartes' hallmark contributions to natural philosophy is his denunciation of teleology. It is puzzling, then, to find him arguing in Meditation VI that human beings have sensations in order to preserve the union of mind and body (AT VII 83). 1 This appears (...) to be just the sort of teleological explanation that he proscribes. Descartes' Anglo-American commentators have had little to say about the teleological overtones of his claims about sensation. His French commentators acknowledge these overtones, but seem largely untroubled by them. 2 It is worth pausing to be troubled, for a closer analysis reveals that Descartes' famous proscription against teleology is not as simple as it is generally thought to be. In the first half of this essay, I argue that Descartes advocates a genuinely teleological conception of the senses. My aim is not to charge Descartes with employing illicit teleology, but to argue that there is a place for teleology even in his revisionist natural philosophy. Accordingly, in the second half of this essay, I argue that Descartes' assault on teleological explanation is [End Page 49] not a sweeping assault on finality, but a more directed attack on particular uses of ends in natural philosophy. Descartes' assault leaves standing a form of teleological explanation that proves crucial to his own treatment of sensation. 1. Descartes' Rejection of Teleological Explanation at a Glance A teleological explanation is one that purports to account for something in terms of its ends or its function relative to the ends of the system of which it is a part. Aristotle's physics provides many classic examples: plants produce leaves for the protection of their fruit; spiders spin webs in order to catch food; animals grow sharp front teeth and dull back teeth in order to facilitate biting and chewing respectively; eyes are for seeing. According to Aristotle, all natural phenomena are directed toward ends and no explanation is complete without a teleological component that specifies the end for the sake of which the phenomenon occurs. Indeed ends take explanatory priorityover other causes: "Both causes [the end and the matter] must be stated by the student of nature, but especially the end; for that is the cause of the matter, not vice versa." 3 And: [T]he causes concerned in natural generation are, as we see, more than one. There is the cause for the sake of which [the end], and the cause whence the beginning of motion comes [the efficient cause]. Now we must decide which of these two causes comes first, which second. Plainly, however, that cause is the first which we call that for the sake of which. For this is the account of the thing, and the account forms the starting-point.4In other words, Aristotle argues that natural substances have the matter they do, have the parts or organs they do, are organized as they are and act as they do for the sake of their ends. To explain why things are as they are, the natural philosopher must therefore explain the ways in which they contribute to ends.Among the late scholastic Aristotelians familiar to Descartes there is considerable debate concerning the causal efficacy of ends. Genuine final causation, in which something is said to be acted on by an end, is limited to the intentional behavior of rational agents who consciously recognize their ends: only something that recognizes an end can be "moved" by one. Even here the sort of causation involved is peculiar: a rational agent is "moved" by an end insofar as the end induces a "metaphorical motion" toward (or desire for) the end in the agent's will. 5 While these scholastic Aristotelians resist attributing final causation [End Page 50] to non-rational creatures, they nevertheless persist in attributing ends to them. When Toletus, Rubio, the Coimbrans and Suarez take up the question whether nature acts propter finem, each answers it affirmatively: natural... (shrink)

In reply to Wierzbicka's advocacy of semantic primitives we argue that talk of the semantic primitives repeats the fallacies addressed in the target article at a higher level. In reply to Malcolm's plea for a Wittgensteinian grammar of colour words, we argue that he uses words like “we” and “us” too easily, falling into the trap of “silly relativism.” In reply to McManus's science of word counts, we reiterate the nineteenth-century criticism that this method is based on an illegitimate application (...) of seemingly rigorous statistical methods. (shrink)

To describe the content of practice guidelines on euthanasia and assisted suicide (EAS) and to compare differences between settings and guidelines developed before or after enactment of the euthanasia law in 2002 by means of a content analysis. Most guidelines stated that the attending physician is responsible for the decision to grant or refuse an EAS request. Due care criteria were described in the majority of guidelines, but aspects relevant for assessing these criteria were not always described. Half of the (...) guidelines described the role of the nurse in the performance of euthanasia. Compared with hospital guidelines, nursing home guidelines were more often stricter than the law in excluding patients with dementia (30% vs 4%) and incompetent patients (25% vs 4%). As from 2002, the guidelines were less strict in categorically excluding patients groups (32% vs 64%) and in particular incompetent patients (10% vs 29%). Healthcare institutions should accurately state the boundaries of the law, also when they prefer to set stricter boundaries for their own institution. Only then can guidelines provide adequate support for physicians and nurses in the difficult EAS decision-making process. (shrink)

Guido de Ruggiero (1888-1948) was perhaps the greatest Italian intellectual historian in the twentieth century. He was a fierce champion of liberalism, an ardent opponent of Fascism, an insightful critic and interpreter of his contemporaries, and a formidable philosopher in his own right. Idealism & Experience: The Philosophy of Guido de Ruggiero comprises eight new critical essays, as well as English translations of five of de Ruggiero's most important shorter writings, which chart the development of his thought between 1914 and (...) 1946. Taken together, these essays reveal the range, richness and philosophical sophistication of de Ruggiero's ideas, enabling Anglophone readers to appreciate their enduring relevance in our own troubled times. (shrink)

Background: The traditional approach to resolving ethics concerns may not address underlying organisational issues involved in the evolution of these concerns. This represents a missed opportunity to improve quality of care “upstream”. The purpose of this study was to understand better which organisational issues may contribute to ethics concerns. Methods: Directed content analysis was used to review ethics consultation notes from an academic children’s hospital from 1996 to 2006 (N = 71). The analysis utilised 18 categories of organisational issues derived (...) and modified from published quality improvement protocols. Results: Organisational issues were identified in 68 of the 71 (96%) ethics consult notes across a range of patient settings and reasons for consultation. Thirteen of the 18 categories of organisational issues were identified and there was a median of two organisational issues per consult note. The most frequently identified organisational issues were informal organisational culture (eg, collective practices and approaches to situations with ethical dimensions that are not guided by policy), policies and procedures (eg, staff knows policy and/or procedural guidelines for an ethical concern but do not follow it) and communication (eg, communication about critical information, orders, or hand-offs repeatedly does not occur among services). Conclusions: Organisational issues contribute to ethical concerns that result in clinical ethics consults. Identifying and addressing organisational issues such as informal culture and communication may help decrease the recurrence of future similar ethics concerns. (shrink)

It is no surprise that the phenomenal qualities of our sensory experience pose recalcitrant philosophical problems for a physical materialist metaphysics. The colors of flowers as we experience them by sight, the taste of a ripe peach, and the smell of fresh-cut grass are undeniably part of the experienced world; yet in their phenomenal mode, they do not seem well-placed in the physicist's world of particles and energy fields. It seems, prima facie, that the metaphysical programs found in earlier science (...) and philosophy were better suited to accommodate these qualities: in the hylomorphic world of the Aristotelians, colors were "real qualities" existing as such in flowers; in the dualistic world of Descartes, colors were displaced from things like flowers to the immaterial mind of the perceiver. The dissertation argues that this intuition about our philosophical heritage is both philosophically confused and historically inaccurate. It betrays a misconception about phenomenal qualities and the problems they pose which results from a failure to distinguish phenomenal qualities from a special subset of sensible qualities that we have come to call "secondary" qualities. Disentangled from the primary-secondary quality distinction, phenomenal qualities include all sensible qualities insofar as they form the experiential contents of our sensory perceptions. So considered, phenomenal qualities invite difficult questions about the representational nature and ontological status of our sensory experience even within the Aristotelian and Cartesian metaphysics. By examining Descartes' and the Aristotelians' theories of sense perception with a focus on these questions we achieve a better understanding of "the problem" of phenomenal qualities, better interpretations of these historical theories of sense perception, and suggestions for reshaping the problem space within which we think philosophically about phenomenal qualities today. (shrink)

A total of 1918 loci, detected by the hybridization of 938 expressed sequence tag unigenes from 26 Triticeae cDNA libraries, were mapped to wheat homoeologous group 4 chromosomes using a set of deletion, ditelosomic, and nulli-tetrasomic lines. The 1918 EST loci were not distributed uniformly among the three group 4 chromosomes; 41, 28, and 31% mapped to chromosomes 4A, 4B, and 4D, respectively. This pattern is in contrast to the cumulative results of EST mapping in all homoeologous groups, as reported (...) elsewhere, that found the highest proportion of loci mapped to the B genome. Sixty-five percent of these 1918 loci mapped to the long arms of homoeologous group 4 chromosomes, while 35% mapped to the short arms. The distal regions of chromosome arms showed higher numbers of loci than the proximal regions, with the exception of 4DL. This study confirmed the complex structure of chromosome 4A that contains two reciprocal translocations and two inversions, previously identified. An additional inversion in the centromeric region of 4A was revealed. A consensus map for homoeologous group 4 was developed from 119 ESTs unique to group 4. Forty-nine percent of these ESTs were found to be homoologous to sequences on rice chromosome 3, 12% had matches with sequences on other rice chromosomes, and 39% had no matches with rice sequences at all. Limited homology was found between wheat ESTs on homoeologous group 4 and the Arabidopsis genome. Forty-two percent of the homoeologous group 4 ESTs could be classified into functional categories on the basis of blastX searches against all protein databases. (shrink)

In this article, we present results from a literature review of intrinsic, instrumental, and relational values of nature conducted for the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services, as part of the Methodological Assessment of the Diverse Values and Valuations of Nature. We identify the most frequently recurring meanings in the heterogeneous use of different value types and their association with worldviews and other key concepts. From frequent uses, we determine a core meaning for each value type, which is (...) sufficiently inclusive to serve as an umbrella over different understandings in the literature and specific enough to help highlight its difference from the other types of values. Finally, we discuss convergences, overlapping areas, and fuzzy boundaries between different value types to facilitate dialogue, reduce misunderstandings, and improve the methods for valuation of nature's contributions to people, including ecosystem services, to inform policy and direct future research. © 2023 The Author(s). Published by Oxford University Press on behalf of the American Institute of Biological Sciences. (shrink)

There is a lack of published evidence which demonstrates the impacts of public engagement in science and technology policy. This might represent the failure of PE to achieve policy impacts or indicate a lack of effective procedures for discerning the uptake by policy makers of PE-derived outputs. While efforts have been made to identify and categorize different types of policy impact, research has rarely attempted to link policy impact with PE procedures, political procedures, or the connections between them. In this (...) article, we propose a simple conceptual model to capture this information, based on semistructured interviews with both policy makers and PE practitioners. A range of criteria are identified to increase the policy impact of PE. The role of PE practitioners in realizing impacts through their interactions with policy makers in the informal “in-between” spaces of public engagement is emphasized. However, the potential contradictions between the pursuit of policy impacts and the more traditional conceptualizations of PE effectiveness are discussed. The main barrier to the identification of policy impacts from PE may lie within policy processes themselves. Political institutions have responsibility to establish formalized procedures for monitoring the uptake and use of evidence from PE in their decision-making processes. (shrink)

Purpose: Explore public attitudes towards the trade-offs between justice and medical outcome inherent in organ allocation decisions.Background: The US Task Force on Organ Transplantation recommended that considerations of justice, autonomy and medical outcome be part of all organ allocation decisions. Justice in this context may be modeled as a function of three types of need, related to age, clinical urgency, and quality of life.Methods: A web-based survey was conducted in which respondents were asked to choose between two hypothetical patients who (...) differed in clinical urgency , age, pretransplant and post-transplant quality of life, and life expectancy.Results: A pool of 1600 people were notified via email about the survey; 623 responded. Respondents preferred giving organs to younger people up to an age difference of <15.4 years and more clinically urgent people up to a difference in urgency of <2.54 months . Priority varied with the quality of life of the worst-off patient and the relative status of the patients. If both had worse than average quality of life, respondents preferred the better-off patient. When both had better than average quality of life, they preferred the worse-off patient. In analysis according to age versus clinical urgency, the older the patient, the more urgency needed to receive priority. In quality of life versus clinical urgency, the better the control’s quality of life, the more urgency the competing patient required. The worse the patient’s post-transplant outcome, the more urgency needed to receive priority.Conclusions: It appears that clinical urgency is only one of many factors influencing attitudes about allocation decisions and that respondents may invoke different principles of fairness depending the relative clinical status of patients. (shrink)

Purpose: Explore public attitudes towards the trade-offs between justice and medical outcome inherent in organ allocation decisions.Background: The US Task Force on Organ Transplantation recommended that considerations of justice, autonomy and medical outcome be part of all organ allocation decisions. Justice in this context may be modeled as a function of three types of need, related to age, clinical urgency, and quality of life.Methods: A web-based survey was conducted in which respondents were asked to choose between two hypothetical patients who (...) differed in clinical urgency , age, pretransplant and post-transplant quality of life, and life expectancy.Results: A pool of 1600 people were notified via email about the survey; 623 responded. Respondents preferred giving organs to younger people up to an age difference of <15.4 years and more clinically urgent people up to a difference in urgency of <2.54 months . Priority varied with the quality of life of the worst-off patient and the relative status of the patients. If both had worse than average quality of life, respondents preferred the better-off patient. When both had better than average quality of life, they preferred the worse-off patient. In analysis according to age versus clinical urgency, the older the patient, the more urgency needed to receive priority. In quality of life versus clinical urgency, the better the control’s quality of life, the more urgency the competing patient required. The worse the patient’s post-transplant outcome, the more urgency needed to receive priority.Conclusions: It appears that clinical urgency is only one of many factors influencing attitudes about allocation decisions and that respondents may invoke different principles of fairness depending the relative clinical status of patients. (shrink)

The aim of this study was to examine to what extent patients remained silent to the health care system after they experienced abusive or wrongful incidents in health care. Female patients visiting a women’s clinic in Sweden (n = 530) answered the Transgressions of Ethical Principles in Health Care Questionnaire (TEP), which was constructed to measure patients’ abusive experiences in the form of staff’s transgressions of ethical principles in health care. Of all the patients, 63.6% had, at some point, experienced (...) staff’s transgressions of ethical principles, and many perceived these events as abusive and wrongful. Of these patients, 70.3% had remained silent to the health care system about at least one transgression. This silence is a loss of essential feedback for the health care system and should not automatically be interpreted as though patients are satisfied. (shrink)

Background: Discussing treatment risks has become increasingly important in medical communication. Still, despite regulations, physicians must decide how much and what kind of information to present. Objective: To investigate patients’ preference for information about a small risk of a complication of colonoscopy, and whether medical and personal factors contribute to such preference. To propose a disclosure policy related to our results. Design: Vignettes study. Setting: Department of Gastroenterology, Academic Medical Centre, the Netherlands. Patients: 810 consecutive colonoscopy patients. Intervention: A home-sent (...) questionnaire containing three vignettes. Vignettes varied in the indication for colonoscopy, complication severity and level of risk. Patients were invited to indicate their wish to be informed and the importance of such information. In addition, sociodemograhic, illness-related and psychological characteristics were assessed. Main outcome measurements: Wish to be informed and importance of information. Results: Of 810 questionnaires, 68% were returned. Patients generally wished to be informed about low-risk complications, regardless of the indication for colonoscopy or the severity of the complication. The level of risk did matter, though (OR = 2.48, SE = 0.28, p = 0.001). The information was considered less important if done for population screening purposes or diagnosis of colon cancer, if the complication was less severe (bleeding) and if the risk was smaller (0.01% and 0.1%). Patients’ information preference was also related to age, mood and coping style. Limitations: Difficulty of vignettes. Conclusions: Patients generally wish to be informed about all possible risks. However, this might become uninformative. A stepwise approach is suggested. (shrink)

Mood has varied effects on cognitive performance including the accuracy of face recognition . Three experiments are presented here that explored face recognition abilities in mood-induced participants. Experiment 1 demonstrated that happy-induced participants are less accurate and have a more conservative response bias than sad-induced participants in a face recognition task. Using a remember/know/guess procedure, Experiment 2 showed that sad-induced participants had more conscious recollections of faces than happy-induced participants. Additionally, sad-induced participants could recognise all faces accurately, whereas, happy- and (...) neutral-induced participants recognised happy faces more accurately than sad faces. In Experiment 3, these effects were not observed when participants intentionally learnt the faces, rather than incidentally learnt the faces. It is suggested that happy-induced participants do not process faces as elaborately as sad-induced participants. (shrink)