In their paper, “Helpful Lessons and Cautionary Tales: How Should COVID-19 Drug Development and Access Inform Approaches to Non-Pandemic Diseases?” Holly Fernandez Lynch and colleagues have present...

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

In recent years, there has been an escalation in cases of cyber violence, which has had a chilling effect on users' behavior toward social media sites. This article explores the causes behind cyber violence and provides empirical data for developing means for effective prevention. Using elements of the stimulus–organism–response theory, we constructed a model of cyber-violence behavior. A closed-ended questionnaire was administered to collect data through an online survey, which results in 531 valid responses. A proposed model was tested using (...) partial least squares structural equation modeling using SmartPLS 3.0, v. Research findings show that information inequality is a strong external stimulus with a significant positive impact on digital distrust and negative emotion. However, the effects of information overload on digital distrust and the adverse effects of communication overload on negative emotions should not be ignored. Both digital distrust and negative emotions have significant positive impacts on cyber violence and cumulatively represent 11.5% changes in cyber violence. Furthermore, information overload, communication overload, information inequality, and digital distrust show a 27.1% change in negative emotions. This study also presents evidence for competitive mediation of digital distrust by information overload, information inequality, and cyber violence. The results of this study have implications for individual practitioners and scholars, for organizations, and at the governmental level regarding cyber-violence behavior. To test our hypotheses, we have constructed an empirical, multidimensional model, including the role of specific mediators in creating relationships. (shrink)

Background:Suicide remains an important cause of premature deaths and draws much media attention. However, unsafe reporting and portrayal of suicides by the media have been associated with increased risk of suicidal behavior. Current evidence suggests that media capacity-building could potentially prevent suicide. However, there are still knowledge gaps in terms of a lack of data on effective strategies for improving awareness and safe reporting of suicide-related media content. This study aims to investigate the effectiveness of a workshop conducted with members (...) of the media community on the safe reporting of suicide-related content.Methods:An interventional single-arm pre and post pilot study was conducted on a sample of the Malaysian media community recruited through purposive and snowball sampling. The media safe reporting workshop was conducted by a suicide prevention expert with a media industry background. Thirty participants completed a self-reported evaluation questionnaire on their awareness and knowledge of reporting on suicide-related media content; before and after the interventional workshop.Results:There was a significant difference between the total scores before and after the intervention, with a large effect size. Post-intervention scores were significantly improved in 8 items, namely those related to the reporting of: (i) the content of any suicide note; (ii) headlines with methods of suicide; (iii) headlines with the location of suicide; (iv) cases of suspected suicide despite the unconfirmed cause of death; (v) suicide news to cater to readers’ interests; (vi) cause of suicide; (vii) details of the location of suicide; and (viii) the negative impact to media community when reporting suicide stories. In particular, there was an improvement in the majority of items for people from the media community with no lived experience of suicidal behavior.Conclusion:The media safe reporting workshop is a potentially effective intervention for improving awareness and knowledge measures relating to safe reporting on suicide among the media community, with a more pronounced effect in those without lived experience of suicidal behavior. Limitations in the sample size, generalizability, short-term evaluation, and lack of a control group warrant future larger, longer-term controlled, and more representative studies. (shrink)

Over the last 30 years, the growing role of political Islam has attracted attention from both the media and academia. Although it is given various names, such as "Islamic fundamentalism", "militant Islam", "political Islam", all this is due to the fact that a certain trend in Islamic movement is gaining more influence in politics and security in the global scale. The decisive moment in this was the overthrow in 1979 of the pro-Western Shah monarchy in Iran and the creation (...) of the first theocratic world in the modern world there. (shrink)

Debates in India following on from the Shah Bano case highlight the extent to which gender equality may be compromised by yielding to the dominant voices within a particular religion or cultural tradition. As the Indian Supreme Court noted in Danial Latifi & Anr v Union of India, the pursuit of gender justice raises questions of a universal magnitude. Responding to those questions requires an appeal to norms that claim a universal legitimacy. Liberal feminist demands for a uniform civil (...) code, however, have pitted feminist movements against proponents of minority rights and claims for greater autonomy for minority groups. Against the background of growing communal tensions, many feminists have argued for more complex strategies—strategies that encompass the diversity of women's lives and create a sense of belonging amongst women with diverse religious-cultural affiliations. Liberal theories of rights that abstract from the concrete realities of women's daily lives have not always addressed the institutions and procedures necessary to build that sense of belonging. This article examines the contribution made by discourse ethics theorists to debates on models of multicultural arrangements. It argues that deliberative models of democracy recognize the need for ‘difference-sensitive’ processes of inclusion, potentially assisting feminism in resolving the apparent conflict between the politics of multiculturalism and the pursuit of gender equality. (shrink)

Why, when asking oneself whether to believe that p, must one immediately recognize that this question is settled by, and only by, answering the question whether p is true? Truth is not an optional end for first-personal doxastic deliberation, providing an instrumental or extrinsic reason that an agent may take or leave at will. Otherwise there would be an inferential step between discovering the truth with respect to p and determining whether to believe that p, involving a bridge premise that (...) it is good to believe the truth with respect to p. But there is no such gap between the two questions within the first-personal deliberative perspective; the question whether to believe that p seems to collapse into the question whether p is true. (shrink)

This experiment investigated the effect of format (line vs. bar), viewers’ familiarity with variables, and viewers’ graphicacy (graphical literacy) skills on the comprehension of multivariate (three variable) data presented in graphs. Fifty-five undergraduates provided written descriptions of data for a set of 14 line or bar graphs, half of which depicted variables familiar to the population and half of which depicted variables unfamiliar to the population. Participants then took a test of graphicacy skills. As predicted, the format influenced viewers’ interpretations (...) of data. Specifically, viewers were more likely to describe x–y interactions when viewing line graphs than when viewing bar graphs, and they were more likely to describe main effects and “z–y” (the variable in the legend) interactions when viewing bar graphs than when viewing line graphs. Familiarity of data presented and individuals’ graphicacy skills interacted with the influence of graph format. Specifically, viewers were most likely to generate inferences only when they had high graphicacy skills, the data were familiar and thus the information inferred was expected, and the format supported those inferences. Implications for multivariate data display are discussed. (shrink)

This important and comprehensive work of 18th-century Islamic religious thought written in Arabic by a pre-eminent South Asian scholar provides an extensive and detailed picture of Muslim theology and interpretive strategies on the eve of the modern period.

Believing that p, assuming that p, and imagining that p involve regarding p as true—or, as we shall call it, accepting p. What distinguishes belief from the other modes of acceptance? We claim that conceiving of an attitude as a belief, rather than an assumption or an instance of imagining, entails conceiving of it as an acceptance that is regulated for truth, while also applying to it the standard of being correct if and only if it is true. We argue (...) that the second half of this claim, according to which the concept of belief includes a standard of correctness, is required to explain the fact that the deliberative question whether to believe that p is transparent to the question whether p. This argument raises various questions. Is there such a thing as deliberating whether to believe? Is the transparency of the deliberative question whether to believe that p the same as the transparency of the factual question whether I do believe that p? We will begin by answering these questions and then turn to a series of possible objections to our argument. (shrink)

تشخيص فكري ومعرفي لمفهوم الأسرة ومكانتها في الفكر الإسلامي، وتفحّصٌ علمي ومنهجي لأسس البناء الأسري ومقاصده، وكشفٌ عن تأثير التحوّلات الاجتماعية في الأسرة والتحديات التي تواجهها، وتتبعٌ لانعكاسات الفكر الغربي في المنظومة القيمية للأسرة، وتبيّنٌ لبعض التجارب والخبرات في مجال المحافظة على دور الأسرة، لا سيما بعد هيمنة النموذج المعرفي الغربي، ومحاولة طمسه للخصوصيات الثقافية والمجتمعية. حاولت بحوث هذا الكتاب أن تجيب عن تساؤلات معرفية ومجتمعية مهمة مثل: ما أهم التحديات التي تواجه الأسرة المسلمة في الراهن المعاصر وكيفية مواجهتها، وما (...) التغيرات التي طرأت على الأسرة المسلمة في ظل التطورات والتسارعات المجتمعية والاقتصادية والتقنية إلخ، وما التصوّر الإسلامي لدور الأسرة في بناء المجتمع، وما دور مؤسسات المجتمع المدني في الحد من تأثير الاستلاب الثقافي، وما الإسهام الذي قدمته حركات الإصلاح الإسلامية في مجال المحافظة على الدور المحوري للأسرة في تشكيل الشخصية الإسلامية القادرة على تفعيل النهوض الحضاري؟ وقد أسهم المشاركون في هذا العمل الجماعي، الذين بلغ عددهم واحداً وعشرين باحثاً، في محاورة هذه الأسئلة المعرفية، وفي التأسيس لمنظومة معرفية مجتمعية قادرة على الإسهام في البناء الحضاري، وفي توجيه دفة الأسرة بما ينسجم مع التوجيهات الربانية والفطرة الإنسانية. (shrink)

Current formal dialectical models postulate normative rules that enable discussants to conduct dialogical interactions without committing fallacies. Though the rules for conducting a dialogue are supposed to apply to interactions between actual arguers, they are without exception theoretically motivated. This creates a gap between model and reality, because dialogue participants typically leave important content-related elements implicit. Therefore, analysts cannot readily relate normative rules to actual debates in ways that will be empirically confirmable. This paper details a new, data-driven method for (...) describing discussants’ actual reply structures, wherein corpus studies serve to acknowledge the complexity of natural argumentation. Rather than refer exclusively to propositional content as an indicator of arguing pro/contra a given claim, the proposed approach to dialogue structure tracks the sequence of dialogical moves itself. This arguably improves the applicability of theoretical dialectical models to empirical data, and thus advances the study of dialogue systems. (shrink)

t. 1. Dialog s V. V. Davydovym -- t. 2. Nereshennye problemy razvivai︠u︡shchego obrazovanii︠a︡.

Writing the Mughal World: Studies on Culture and Politics. Muzzafar Alam and Sanjay Subrahmanyam. New York: Columbia University Press, 2011. Pp. xviii + 516. $89.50, £62 ; $29.50, £20.50.

Standard models of adolescent risk taking posit that the cognitive abilities of adolescents and adults are equivalent, and that increases in risk taking that occur during adolescence are the result of socio emotional differences in impulsivity, sensation seeking, and lack of self-control. Fuzzy-trace theory incorporates these socio emotional differences. However, it predicts that there are also cognitive differences between adolescents and adults, specifically that there are developmental increases in gist-based intuition that reflects understanding. Gist understanding, as opposed to verbatim-based analysis, (...) generally has been hypothesized to have a protective effect on risk taking in adolescence. Gist understanding is also an essential element of informed consent regarding risks in medical decision- making. Evidence thus supports the argument that adolescents’ status as mature minors should be treated as an exception rather than a presumption, because accuracy in verbatim analysis is not mature gist understanding. Use of the exception should be accompanied by medical experts’ input on the bottom-line gist of risks involved in treatment. (shrink)

It is common for philosophers to claim that doxastic voluntarism, the view that an agent can form beliefs voluntarily, is false, and therefore that agents do not have the kind of control over their beliefs required for a straightforward application of deontological concepts such as obligation or duty in the domain of epistemology. The role that the denial of doxastic voluntarism plays in an argument to the effect that agents do not have obligations with respect to belief is simply this.

Why, when asking oneself whether to believe that p, must one immediately recognize that this question is settled by, and only by, answering the question whether p is true? Truth is not an optional end for first-personal doxastic deliberation, providing an instrumental or extrinsic reason that an agent may take or leave at will. Otherwise there would be an inferential step between discovering the truth with respect to p and determining whether to believe that p, involving a bridge premise that (...) it is good (in whichever sense of good one likes, moral, prudential, aesthetic, allthings-considered, etc.) to believe the truth with respect to p. But there is no such gap between the two questions within the first-personal deliberative perspective; the question whether to believe that p seems to collapse into the question whether p is true. (shrink)

Taylor and Francis Ltd TSEP_A_151217.sgm..

When we deliberate whether to believe some proposition, we feel immediately compelled to look for evidence of its truth. Philosophers have labelled this feature of doxastic deliberation 'transparency'. I argue that resolving the disagreement in the ethics of belief between evidentialists and pragmatists turns on the correct explanation of transparency. My hypothesis is that it reflects a conceptual truth about belief: a belief that p is correct if and only if p. This normative truth entails that only evidence can be (...) a reason for belief. Although evidentialism does not follow directly from the mere psychological truth that we cannot believe for non-evidential reasons, it does follow directly from the normative conceptual truth about belief which explains why we cannot do so. (shrink)

Examining the coverage of the 2016 US Presidential election of the highest circulating New Zealand newspaper—the New Zealand Herald (NZH)—this study argues that this newspaper sets agenda against Donald Trump—the Republican Party candidate in the 2016 US election. Examining all news, editorials and photographs published in NZH, it discursively argues that this newspaper overshadowed and dehumanized Trump and especially his leadership ability. The other major candidate—the Democratic Party candidate Hillary Clinton—was applauded in the coverage. The NZH repeatedly focused upon the (...) activities of Trump through news, views and images to dehumanize him. The repetition, therefore, does not necessarily mean that a particular media outlet favors a particular candidate. It also argues that the media outlet of a distant nation that cannot influence its reader to vote for a particular candidate may still set the agenda in favor of a candidate. (shrink)

Advances in life-saving technologies in the past few decades have challenged our traditional understandings of death. Traditionally, death was understood to occur when a person stops breathing, their heart stops beating and they are cold to the touch. Today, physicians determine death by relying on a diagnosis of ‘total brain failure’ or by waiting a short while after circulation stops. Evidence has emerged, however, that the conceptual bases for these approaches to determining death are fundamentally flawed and depart substantially from (...) the established biological conception of death. We argue that the current approach to determining death consists of two different types of unacknowledged legal fictions. These legal fictions were developed for practices that are largely ethically legitimate but need to be reconciled with the law. The considerable debate over the determination of death in the medical and scientific literature has not informed the public that vital organs are being procured from still-living donors and it seems unlikely that this information can remain hidden for long. Given the instability of the status quo and the difficulty of making the substantial legal changes required by complete transparency, we argue for a second-best policy solution: acknowledging the legal fictions involved in determining death to move in the direction of greater transparency. This may someday result in more substantial legal change to directly confront the challenges raised by life-sustaining and life-preserving technologies without the need for fictions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:From Impatience to EmpathyStephanie Pierce and Kavita Shah AroraWe gave J.H. a label the first time we met her, as many often do—“Uncooperative.” She was a patient with autism and intellectual delay who had presented to the emergency department (ED) with vaginal bleeding. After receiving the gynecology consult request from the emergency medicine physicians, we were already mentally formulating our recommendations based on the information they told us (...) over the phone. “Does not cooperate with exam,” “no acute surgical intervention is currently warranted,” and “recommend outpatient follow–up.”When we arrived in her room, she was sitting in the hospital bed surrounded by a protective shield of caregivers from her group home. We introduced ourselves as the gynecology team but it was obvious that J.H. could not communicate verbally. Upon speaking with her caregivers we learned that she had Cowden syndrome, a genetic disease that confers significantly increased risks for several types of cancer including endometrial, thyroid, and breast cancers. J.H. had also been having heavy vaginal bleeding, which was difficult for her caregivers to manage, and this was the reason she was brought into the emergency department. After attempting to gain as much information as we could from the caregivers, we started to perform an abdominal exam, which made J.H. extremely agitated. We quickly stopped the exam and the caregivers helped to calm J.H. We remember our mixture of emotions—bewilderment at the agitation and commotion in the exam room full of people, frustration at not being able to complete our exam fully, and annoyance that this “difficult patient” was taking up our limited time between surgical cases. Thankfully, these knee–jerk reactions were quickly replaced by feelings of concern for the patient and the realization of how frightening an experience this must be for her—being in a strange place with white walls and unfamiliar people, unable to communicate her thoughts.J.H.’s mother, her surrogate decision–maker, was not at the hospital that day but the caregivers told us that she had expressed a strong desire for her daughter to have a prophylactic hysterectomy due to her lifetime risk for developing uterine cancer as well as a permanent solution to the bleeding concerns. What had initially started as a simple ED consult was now turning into a complex question. The ethical and legal dilemma was obvious—whether to perform a major surgery that would irreversibly sterilize a patient who could not consent on her own behalf in order to minimize the potential risk of cancer later in life. While medical management could improve the bleeding and potentially reduce the risk of cancer, frequent exams would be necessary [End Page 19] to ensure that the medication was working and that premalignant changes were not occurring in J.H.’s uterus. However, based on our experience in the emergency department, J.H. would need anesthesia for such exams and it was doubtful the medications would completely normalize her elevated risk of uterine malignancy. We knew that in order to address this question, we would need to see J.H. again along with her mother to have a frank discussion about the risks and benefits of such a decision, and so we made plans to see her in our outpatient clinic.Several days later, J.H., her mother, and the group home caregivers arrived in the office. Anticipating a complex discussion, we had requested a representative from the hospital ethics committee to join us at the visit. We didn’t know what to expect meeting J.H.’s mother for the first time but as we sat in the room talking, it was obvious that she was truly trying to act in her daughter’s best interest. Similarly, it was touching to watch the faces of the caregivers from the group home as they nodded in solidarity with J.H.’s mother, also clearly wanting what was best for her and supporting her mother in this difficult decision. J.H., meanwhile, seemed content to sit silently with us during the discussion, surrounded as she was by people who cared deeply for her well–being.After extensive partnership with the ethics consultants... (shrink)