This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

Upon entering the examination room, Caitlyn encounters a woman sitting alone and in distress. Caitlyn introduces herself as the hospital ethicist and tells the woman, Mrs. Dennis, that her aim is to help her reach a decision about whether to perform an autopsy on her recently deceased husband. Mrs. Dennis begins the encounter by telling the ethicist that she has to decide quickly, but that she is very torn about what to do. Mrs. Dennis adds, “My sons disagree about the (...) autopsy.” As a standardized patient, a specialized actor, the woman playing Mrs. Dennis has already delivered the same opening lines several times to different learners practicing their clinical ethics consultation skills. An SP encounter is a simulated patient encounter used for educational purposes that requires the standardization of verbal and behavioral responses. In the encounter, the simulator, or “patient,” uses a scripted medical history to enable the learner to employ a certain skill, say, the ability to perform a neurological exam. The use of standardized patients in the evaluation of clinical skills has become a staple in medical education. To tackle the challenge of teaching clinical ethics consultation skills, we have incorporated SP encounters into the curriculum of the Bioethics Program of The Union Graduate College and the Icahn School of Medicine at Mount Sinai. SP encounters are incorporated into one of our onsite classes, the Onsite Clinical Ethics Practicum, and they are part of the capstone examination, which all of our graduates must complete successfully. The inclusion of simulated encounters into the curriculum is one way in which we equip our students with the core competencies specified by the American Society for Bioethics and Humanities Task Force for clinical ethicists. (shrink)

Argumentation as the public exchange of reasons is widely thought to enhance deliberative interactions that generate and justify reasonable public policies. Adopting an argumentation-theoretic perspective, we survey the norms that should govern public argumentation and address some of the complexities that scholarly treatments have identified. Our focus is on norms associated with the ideals of correctness and participation as sources of a politically legitimate deliberative outcome. In principle, both ideals are mutually coherent. If the information needed for a correct deliberative (...) outcome is distributed among agents, then maximising participation increases information diversity. But both ideals can also be in tension. If participants lack competence or are prone to biases, a correct deliberative outcome requires limiting participation. The central question for public argumentation, therefore, is how to strike a balance between both ideals. Rather than advocating a preferred normative framework, our main purpose is to illustrate the complexity of this theme. (shrink)

Although considerable research indicates that mental energy is an important factor in many domains, including athletic performance (Cook & Davis, 2006), athletic mental energy (AME) has never been conceptualized and measured. Therefore, the aim of this study was to conceptualize and develop a reliable and valid instrument to assess athletic mental energy. In Study 1, a focus group interview established the initial framework of athletic mental energy. Study 2 used a survey to collect athletes’ experiences of athletic mental energy and (...) develop a scale draft titled “Athletic Mental Energy Scale (AMES).” In Study 3, we examined the psychometric properties and the underlying structure of AMES via item analysis, internal consistency, and exploratory factor analysis (EFA). In Study 4, we used confirmatory factor analysis (CFA) to examine AMES’s factorial validity; and examined concurrent and discriminant validity by examining correlations with athletes’ life stress, positive state of mind, and burnout. In study 5, we examined the measurement invariance of the 6-factor, 18-item AMES with Taiwanese and Malaysian samples. Study 6 examined the predictive validity by comparing AMES scores of successful and unsuccessful martial artists. Across these phases, results showed a 6-factor, 18-item AMES had adequate content validity, factorial structure, nomological validity, discriminant validity, predictive validity, measurement invariance, and reliability. We suggest future studies may use AMES to examine its relationships with athletes’ cognition, affect, and performance. The application of AMES in sport psychology was also discussed. (shrink)

Plasminogen activator inhibitor‐1 (PAI‐1) is a physiological inhibitor of urokinase (uPA), a serine protease known to promote cell migration and invasion. Intuitively, increased levels of PAI‐1 should be beneficial in downregulating uPA activity, particularly in cancer. By contrast, in vivo, increased levels of PAI‐1 are associated with a poor prognosis in breast cancer. This phenomenon is termed the “PAI‐1 paradox”. Many factors are responsible for the upregulation of PAI‐1 in the tumor microenvironment. We hypothesize that there is a breast cancer (...) predisposition to a more aggressive stage when PAI‐1 is upregulated as a consequence of Metabolic Syndrome (MetS). MetS exerts a detrimental effect on the breast tumor microenvironment that supports cancer invasion. People with MetS have an increased risk of coronary heart disease, stroke, peripheral vascular disease and hyperinsulinemia. Recently, MetS has also been identified as a risk factor for breast cancer. We hypothesize the existence of the “PAI‐1 cycle”. Sustained by MetS, adipocytokines alter PAI‐1 expression to promote angiogenesis, tumor‐cell migration and procoagulant microparticle formation from endothelial cells, which generates thrombin and further propagates PAI‐1 synthesis. All of these factors culminate in a chemotherapy‐resistant breast tumor microenvironment. The PAI‐1 cycle may partly explain the PAI‐1 paradox. In this hypothesis paper, we will discuss further how MetS upregulates PAI‐1 and how an increased level of PAI‐1 can be linked to a poor prognosis. BioEssays 29:1029–1038, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

The ability to learn the direction of causal relations is critical for understanding and acting in the world. We investigated how children learn causal directionality in situations in which the states of variables are temporally dependent (i.e., autocorrelated). In Experiment 1, children learned about causal direction by comparing the states of one variable before versus after an intervention on another variable. In Experiment 2, children reliably inferred causal directionality merely from observing how two variables change over time; they interpreted Y (...) changing without a change in X as evidence that Y does not influence X. Both of these strategies make sense if one believes the variables to be temporally dependent. We discuss the implications of these results for interpreting previous findings. More broadly, given that many real-world environments are characterized by temporal dependency, these results suggest strategies that children may use to learn the causal structure of their environments. (shrink)

Our intention here is to present the essential character of classical, sunnī kalām within a strictly formal perspective and to set out its basic aspects. It was conceived by the mutakallimīn as a rational, conceptual, and critical science and, although kalām differed in a number of basic concepts and constructs and in its analytic system, the topical organisation of the major compendia parallels that of metaphysics as understood in the contemporary Aristotelian tradition. The debates between kalām and falsafa need to (...) be examined within this context. Kalām, however, is theological in the strict sense of the term and it is as such that its problematic and its procedures are primarily to be understood. Thus seen, the object of kalām is to rationalise the cognitive content presented to Believers in the symbolic language of the koranic revelation. It has, then, four principal tasks, sc, to conceptualise, to order, to explain, and where possible to justify the primary doctrines of the community whose belief is held to be normative. Within this framework the differences that characterise the major schools as such and the various tendencies of individual masters within each school may readily be brought to light. On se propose ici de présenter, d'un point de vue strictement formel, la nature du kālam classique sunnite et d'identifier ses caractéristiques principales. II avait été conçu par les mutakallimin comme une science rationelle, conceptuelle et critique. L'organisation des matières dans ses traités reprend celle de la métaphysique dans la tradition aristotélicienne de l'époque, bien que le kalām s'en distingue par plusieurs de ses structures et concepts fondamentaux, ainsi que par son système analytique. C'est dans ce contexte qu'il faut considérer les debats qui s'instaurèrent entre kalām et falsafa. Le kalām, cependant, est d'ordre strictement théologique et c'est principalement dans ce cadre qu'il faut comprendre sa problématique et ses procédures. Le kalām a pour fonction de rationaliser le contenu cognitif offert aux croyants dans le langage symbolique de la révélation coranique. Il en résulte quatre tâches principales; il s'agit de conceptualiser, ordonner, expliquer et, dans le mesure du possible, justifier les doctrines principales reconnues par la communauté faisant référence en matière de croyance. Dans ce cadre, il sera possible de mettre en lumière les différences entre les principales écoles, ainsi que les tendances qui distinguent certains de leurs grands maîtres respectifs. (shrink)

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

The Monographs produced by the International Agency for Research on Cancer (IARC) apply rigorous procedures for the scientific review and evaluation of carcinogenic hazards by independent experts. The Preamble to the IARC Monographs, which outlines these procedures, was updated in 2019, following recommendations of a 2018 expert Advisory Group. This article presents the key features of the updated Preamble, a major milestone that will enable IARC to take advantage of recent scientific and procedural advances made during the 12 years since (...) the last Preamble amendments. The updated Preamble formalizes important developments already being pioneered in the Monographs Programme. These developments were taken forward in a clarified and strengthened process for identifying, reviewing, evaluating and integrating evidence to identify causes of human cancer. The advancements adopted include strengthening of systematic review methodologies; greater emphasis on mechanistic evidence, based on key characteristics of carcinogens; greater consideration of quality and informativeness in the critical evaluation of epidemiological studies, including their exposure assessment methods; improved harmonization of evaluation criteria for the different evidence streams; and a single-step process of integrating evidence on cancer in humans, cancer in experimental animals and mechanisms for reaching overall evaluations. In all, the updated Preamble underpins a stronger and more transparent method for the identification of carcinogenic hazards, the essential first step in cancer prevention. (shrink)

BackgroundObtaining informed consent for intravenous thrombolysis in acute ischemic stroke can be challenging, and little is known about if and how the informed consent procedure is performed by neurologists in clinical practice. This study examines the procedure of informed consent for intravenous thrombolysis in acute ischemic stroke in high-volume stroke centers in the Netherlands.MethodsIn four high volume stroke centers, neurology residents and attending neurologists received an online questionnaire concerning informed consent for thrombolysis with tissue-type plasminogen activator (tPA). The respondents were (...) asked to report their usual informed consent practice for tPA treatment and their considerations on whether informed consent should be obtained.ResultsFrom the 203 invited clinicians, 50% (n = 101) completed the questionnaire. One-third of the neurology residents (n = 21) and 21% of the neurologists (n = 8) reported that they always obtain informed consent for tPA treatment. If a patient is not capable of providing informed consent, 30% of the residents (n = 19) reported that they start tPA treatment without informed consent. In these circumstances, 53% of the neurologists (n = 20) reported that the resident under their supervision would start tPA treatment without informed consent. Most neurologists (n = 21; 55%) and neurology residents (n = 45; 72%) obtained informed consent within one minute. None of the respondents used more than five minutes for informed consent. Important themes regarding obtaining informed consent for treatment were patients’ capacity, and medical, ethical and legal considerations.ConclusionThe current practice of informed consent for thrombolysis in acute ischemic stroke varies among neurologists and neurology residents. If informed consent is obtained, most clinicians stated to obtain informed consent within one minute. In the future, a shortened information provision process may be applied, making a shift from informed consent to informed refusal, while still considering the patient’s capacity, stroke severity, and possible treatment delays. (shrink)

In its comprehensive overview of Alain Locke's pragmatist philosophy this book captures the radical implications of Locke's approach within pragmatism, the critical temper embedded in Locke's works, the central role of power and empowerment of the oppressed and the concept of broad democracy Locke employed.

This initial volume in a series of new translations of Plato’s works includes a general introduction and interpretive comments for the dialogues translated: the _Euthyphro, Apology, Crito, Meno, Gorgias, _and _Menexenus. _ _ _“Allen’s work is very impressive. The translations are readable, lucid, and highly accurate. The general introduction is succinct and extremely clear. The discussion of the dating of the dialogues is enormously useful; there has previously been no brief account of these issues to which one could refer the (...) student. Finally, the particular introductions are first rate: fine jobs of clear philosophical and historical explanation—succinct and yet sophisticated, both close to the text and philosophically incisive.”—Martha Nussbaum, _Brown University_ “This is an important work that deserves our respect and attention.”—_Ethics _ _ _“This and the promised succeeding volumes will probably become the standard English version of the complete dialogues…. The commentaries take advantage of the best scholarship, judge judiciously between divergent views, and often introduce new and brilliant interpretations. This is true both in the area of philosophy and in that of literary criticism.”—Anthony C. Daly, S.J., _Modern Schoolman_ _ _“Allen is a superb translator, whose elegantly simple yet precise language gives access to Plato both as a philosopher and as a literary artist.”—_Library Journal__ _ “An important event in the world of scholarship.”—_London Review of Books_ _ _R.E. Allen is professor of classics and philosophy at Northwestern University. (shrink)

Çağımızın seçkin kültür ve düşünce tarihçilerinden Frank Turner’ın Yale Üniversite’sinde verdiği derslerden oluşan Rousseau’dan Nietzsche’ye Avrupa Düşünce Tarihi, Aydınlanma döneminden yirminci yüzyılın başına dek Avrupa’da yaşanan radikal değişimi fikir akımları ve öncü figürler üzerinden anlatıyor. Oxford Today’in editörü Richard Lofthouse tarafından derlenen bu dersler, farklı disiplinleri ustaca bir araya getirerek döneme dair kapsamlı bir bakış açısı sunuyor. Yale’in en sevilen hocalarından Turner’ın açık, akıcı ve öğretici üslubu sayesinde düşünce tarihinin zorlu dönemeçlerinde kolaylıkla yol alacak, dersler bittikten sonra kitabın sonundaki okuma (...) listesini takip ederek daha fazlasını öğrenmek isteyeceksiniz. (shrink)

Since the turn of the century there has been a strong trend to break through the wall which has separated philosophy from the “special sciences” and to investigate the problems which require a good judgment in both philosophy and science. The evolution of science itself and the increasing relevance of science in human life have given immense momentum to this trend. But this momentum could not be appreciated in its actual strength because scientists who wanted to raise their voices had (...) trouble in finding a Journal where they could communicate with the people who were interested, for almost all the scientific journals were devoted exclusively to technical papers. In founding Philosophy of Science Dr. Malisoff started the construction of a channel by which this important flow of scientific investigation could reach its public. This line of thought found in the journal a possibility of self-expression and it became a real force in the life of the community of scientists and scholars, and even of educated men in general. From the first volume, papers were published which have later been quoted in every discussion about the philosophy of science. I mention, as an example only, R. Carnap's paper on Testability and Meaning. Nobody who has wanted information and stimulation in this modern field of investigation could get it without looking into Malisoff's Philosophy of Science. (shrink)

During the set-up phase of an international study of genetic influences on outcomes from sepsis, we aimed to characterise potential differences in ethics approval processes and outcomes in participating European countries. Between 2005 and 2007 of the FP6-funded international Genetics Of Sepsis and Septic Shock project, we asked national coordinators to complete a structured survey of research ethic committee approval structures and processes in their countries, and linked these data to outcomes. Survey findings were reconfirmed or modified in 2017. Eighteen (...) countries participated in the study, recruiting 2257 patients from 160 ICUs. National practices differed widely in terms of composition of RECs, procedures and duration of the ethics approval process. Eight countries used a single centralised process for approval, seven required approval by an ethics committee in each participating hospital, and three required both. Outcomes of the application process differed widely between countries because of differences in national legislation, and differed within countries because of interpretation of the ethics of conducting research in patients lacking capacity. The RECs in four countries had no lay representation. The median time from submission to final decision was 1.5 months; in nine approval was received within 1 month; six took over 6 months, and in one 24 months; had all countries been able to match the most efficient approvals processes, an additional 74 months of country or institution-level recruitment would have been available. In three countries, rejection of the application by some local RECs resulted in loss of centres; and one country rejected the application outright. The potential benefits of the single application portal offered by the European Clinical Trials Regulation will not be realised without harmonisation of research ethics committee practices as well as national legislation. (shrink)

Negative acknowledgement is an impression management technique that uses the admission of an unfavourable quality to mitigate a negative response. Although the technique has been clearly demonstrated, the underlying process is not well understood. The current research identifies a key mediator and moderator while also demonstrating that the effect extends beyond the specific acknowledged domain to the overall evaluation of a target object. The results of study 1 indicate that negative acknowledgement works through mitigating negatively valenced cognitive responses. People who (...) are presented with a negative acknowledgement are less likely to counterargue when forming an evaluation. The results of study 2 reveal that individual differences in need for structure impact the effectiveness of the technique. People who are high in need for structure are more susceptible to the effect presumably because of their desire for easy-to-use information that aids the formation and maintenance of simple knowledge structures. (shrink)

This essay analyzes two contrasting conceptions of ethics set forth in Muslim fundamental theology (kalām), namely, those of the Mu'tazilites and the Ash'arites of the fourth and fifth centuries a.h. (tenth and eleventh centuries c.e.). After set- ting forth a brief statement on the already well-studied position of the Mu'tazi- lites on human actions, the author devotes the rest of this essay to the less-studied position on human actions of the Ash'arites. Of special interest is his analysis of God's creation (...) (khalq) of actions and man's performance (kasb) of them. (shrink)