Protection of human participants is a fundamental facet of biomedical research. We report the activities of a health service research study in which there were three institutional review boards (IRBs), three legal departments and one research administration department providing recommendations and mandating changes in the study methods. Complying with IRB requirements can be challenging, but can also adversely affect study outcomes. Multiple protocol changes mandated from multiple IRBs created a research method that was not reflective of how substance use screening (...) would be performed in a clinical setting. There was direct conflict between the IRBs' perceptions of participants' protection with the researchers' need to use research methodology that assures the clinical relevancy of results. (shrink)

ABSTRACT The recent revival of interest in theory leads the writers to examine a particular moment when a curriculum and the institution in which it occurred was explained and justified. Max Horkheimer's inaugural address to the Institute for Social Research in 1931 is summarised. The points made by the new Director of the Institute are examined in relation not only to his proposal for an inter‐disciplinary curriculum, but also to the nature of the institution and to the general justification of (...) higher education. The article concludes with a number of comments on the relevance of these proposals to some modern higher education issues. (shrink)

The central claim of a Consummation Anyway model is that God could bring about eschatological consummation sans the fall—the intended telos of created humanity—apart from the incarnation of Christ. As such, the CA model is an alternative to an Incarnation Anyway model, according to which Christ’s incarnation is a necessary means by which a state of eschatological glory would be achieved sans the fall. This essay seeks to propose an argument for the CA model by drawing from the covenant theology (...) of the Reformed tradition, and it moves in four steps. Firstly, I shall summarize Marc Cortez’s recent arguments for IA, homing in on the major moves that are most relevant for sketching a CA model. Secondly, I will highlight the challenges Cortez has offered against those interested in defending a CA model. Thirdly, I shall sketch a Reformed account of the CA model that seeks to address Cortez’s objections. Fourthly, then, I’ll consider two potential objections against the sketch I have offered for CA, inspired by a recent argument offered by James T. Turner. Finally, I close with a brief conclusion that summarizes some salient features of the proposed thesis. This paper thus proposes at least one way in which the CA thesis could remain a real and live option within this debate. (shrink)

This essay engages with Oliver D. Crisp’s parsimonious model of divine simplicity while offering a defense of a maximal account of simplicity. Specifically, I clarify the way in with Reformed orthodox theologians, like Gisbertus Voetius, anticipate something like Crisp’s model, that pure actuality is an explication, rather than an entailment, of the doctrine of simplicity, and that the doctrine of simplicity remains consistent with epistemic modesty in relation to theological matters.

Over recent years, evidence has been accumulating in favour of the free radical theory of aging, first proposed by Harman. Despite this, an understanding of the mechanism by which cells might succumb to the effects of free radicals has proved elusive. This paper proposes such a mechanism, based on a previously unexplored hypothesis for the proliferation of mutant mitochondrial DNA: that mitochondria with reduced respiratory function, due to a mutation or deletion affecting the respiratory chain, suffer less frequent lysosomal degradation, (...) because they inflict free radical damage more slowly on their own membranes. Once such a mutation occurs in a mitochondrion of a non‐dividing cell, therefore, mitochondria carrying it will rapidly populate that cell, thereby destroying the cell's respiratory capability. The accumulation of cells that have undergone this transition results in aging at the organismal level. The consistency of the hypothesis with known facts is discussed, and technically feasible tests are suggested, of both the proposed mechanism and its overall contribution to mammalian aging. (shrink)

Voor wie geen troost kan vinden in het al-te-menselijke, valt hoop te putten uit de natuur. Daarvan getuigt ook Thomas Hardy’s gedicht op de nachtegaal. Het dier is verminkt door mensen, maar het zingt nog altijd en bezorgt de mens levensvreugde.

Objectives Prompt Mental Health Care (PMHC) is the Norwegian version of the England’s Improving Access to Psychological Therapies (IAPT). Both programs have been associated with substantial symptom reductions from pre- to post-treatment. The present study extends these findings by investigating symptom levels at 12 months post-treatment, as well as treatment outcome in relation to low- vs. high-intensity treatment forms. Design and Outcome Measures A prospective cohort design was used. All participants ( n = 1530) were asked to complete the Patient (...) Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 questionnaire (GAD-7) at baseline, before each session during treatment, at final treatment, and at 12 months post-treatment. Cohen’s d was used as effect size measure. Sensitivity analyses were conducted to examine the impact of the high missing data rates at post-treatment (≈44%) and 12 months post-treatment (≈58%). Results A large symptom reduction was seen from baseline to 12 months post-treatment for both PHQ ( d = −0.98) and GAD ( d = −0.94). Improvements observed at post-treatment were largely maintained at 12 months post-treatment (PHQ (Δ d = 0.10) and GAD (Δ d = 0.09). Recovery rates decreased only slightly from 49.5% at post-treatment to 45.0% at follow-up. Both low- and high-intensity treatment forms were associated with substantial and lasting symptoms reductions (−1.26 ≤ d ≤ −0.73). Sensitivity analyses did not substantially alter the main results. Conclusion The findings suggest long-lasting effects of the PMHC program and encourage the use of low-intensity treatment forms in PMHC like settings. (shrink)

‘Feuerbach resolves the religious essence into the human essence. But the human essence is no abstraction inherent in each single individual. In its reality it is the ensemble of social relations.’It is a common belief, shared both by Marxists and by critics of Marxism, that differences in the interpretation of this statement have important implications for the assessment of Marx's system of ideas. How we read it will affect our view of the unity of Marx's thought and of the continuity (...) of its development over his lifetime, and it will bear crucially on our appraisal of the epistemological status—metaphysical, scientific or mythopoeic—of the various elements of the Marxian system. Among Marxists, members of the Frankfurt School have emphasized the paternity of Marxian metaphysical humanism in Hegel's conception of man as a self-creating being, while Althusser and his disciples have seen in the extrusion from Marx's later work of any such ‘anthropomorphic’ notion a guarantee of the scientific character of his historical materialism. Among Marx's liberal critics, it is widely agreed that he espoused an essentialist view of man and, often enough, it is thought that this alone is sufficient to disqualify his system from scientific status. No consensus exists, however, as to the cognitive standing of the several components of Marx's thought. That agreement should be lacking as to the place in it of a conception of human nature is hardly surprising. Different construals of the role of a view of man will reflect divergent commitments, not only in the philosophy and methodology of social and historical inquiry, but in moral and political thought as well. (shrink)

‘Feuerbach resolves the religious essence into the human essence. But the human essence is no abstraction inherent in each single individual. In its reality it is the ensemble of social relations.’It is a common belief, shared both by Marxists and by critics of Marxism, that differences in the interpretation of this statement have important implications for the assessment of Marx's system of ideas. How we read it will affect our view of the unity of Marx's thought and of the continuity (...) of its development over his lifetime, and it will bear crucially on our appraisal of the epistemological status—metaphysical, scientific or mythopoeic—of the various elements of the Marxian system. Among Marxists, members of the Frankfurt School have emphasized the paternity of Marxian metaphysical humanism in Hegel's conception of man as a self-creating being, while Althusser and his disciples have seen in the extrusion from Marx's later work of any such ‘anthropomorphic’ notion a guarantee of the scientific character of his historical materialism. Among Marx's liberal critics, it is widely agreed that he espoused an essentialist view of man and, often enough, it is thought that this alone is sufficient to disqualify his system from scientific status. No consensus exists, however, as to the cognitive standing of the several components of Marx's thought. That agreement should be lacking as to the place in it of a conception of human nature is hardly surprising. Different construals of the role of a view of man will reflect divergent commitments, not only in the philosophy and methodology of social and historical inquiry, but in moral and political thought as well. (shrink)

BackgroundThe ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines are widely endorsed but compliance is limited. We sought to determine whether journal-requested completion of an ARRIVE checklist improves full compliance with the guidelines.MethodsIn a randomised controlled trial, manuscripts reporting in vivo animal research submitted to PLOS ONE (March–June 2015) were randomly allocated to either requested completion of an ARRIVE checklist or current standard practice. Authors, academic editors, and peer reviewers were blinded to group allocation. Trained reviewers performed outcome adjudication (...) in duplicate by assessing manuscripts against an operationalised version of the ARRIVE guidelines that consists 108 items. Our primary outcome was the between-group differences in the proportion of manuscripts meeting all ARRIVE guideline checklist subitems.ResultsWe randomised 1689 manuscripts (control: n = 844, intervention: n = 845), of which 1269 were sent for peer review and 762 (control: n = 340; intervention: n = 332) accepted for publication. No manuscript in either group achieved full compliance with the ARRIVE checklist. Details of animal husbandry (ARRIVE subitem 9b) was the only subitem to show improvements in reporting, with the proportion of compliant manuscripts rising from 52.1 to 74.1% (X2 = 34.0, df = 1, p = 2.1 × 10−7) in the control and intervention groups, respectively.ConclusionsThese results suggest that altering the editorial process to include requests for a completed ARRIVE checklist is not enough to improve compliance with the ARRIVE guidelines. Other approaches, such as more stringent editorial policies or a targeted approach on key quality items, may promote improvements in reporting. (shrink)

Most people in the United States agree they want some income inequality but debate exactly how much is fair. High‐status people generally prefer more inequality than low‐status individuals. Here we examine how much preferences for inequality are (or are not) driven by self‐interest. Past work has generally investigated this idea in two ways: The first is by stratifying preferences by income, and the second is by randomly assigning financial status within lab‐constructed scenarios. In this paper, we develop a method that (...) combines both experimental control and the social experience of inequality—a simulated society experiment. Across two experiments (N = 138, observations = 690), participants voted on the distribution of rewards—first behind a veil of ignorance, and then when they were randomly assigned a status within a game of chance. Status varied repeatedly across five rounds, allowing us to measure dynamic preferences. Under the veil of ignorance, people preferred inequality favoring the top status. When the veil of ignorance disappeared, self‐interest immediately influenced inequality preferences. Those who randomly landed in top positions were satisfied with the status quo established under the veil of ignorance, whereas those who randomly landed in bottom positions wanted more equality. Yet these preferences were not stable; decisions about the optimal level of inequality changed according to changes in social status. Our results also showed that, when inequality grows in a society, preferences regarding inequality become polarized by social status. Individuals in low‐status positions, particularly, tend to demand more equality. (shrink)

Recording and manipulating neuronal ensemble activity is a key requirement in advanced neuromodulatory and behavior studies. Devices capable of both recording and manipulating neuronal activity brain-computer interfaces should ideally operate un-tethered and allow chronic longitudinal manipulations in the freely moving animal. In this study, we designed a new intracortical BCI feasible of telemetric recording and stimulating local gray and white matter of visual neural circuit after irradiation exposure. To increase the translational reliance, we put forward a Göttingen minipig model. (...) The animal was stereotactically irradiated at the level of the visual cortex upon defining the target by a fused cerebral MRI and CT scan. A fully implantable neural telemetry system consisting of a 64 channel intracortical multielectrode array, a telemetry capsule, and an inductive rechargeable battery was then implanted into the visual cortex to record and manipulate local field potentials, and multi-unit activity. We achieved a 3-month stability of the functionality of the un-tethered BCI in terms of telemetric radio-communication, inductive battery charging, and device biocompatibility for 3 months. Finally, we could reliably record the local signature of sub- and suprathreshold neuronal activity in the visual cortex with high bandwidth without complications. The ability to wireless induction charging combined with the entirely implantable design, the rather high recording bandwidth, and the ability to record and stimulate simultaneously put forward a wireless BCI capable of long-term un-tethered real-time communication for causal preclinical circuit-based closed-loop interventions. (shrink)

The communicative aspects of the contents of consciousness are analyzed in the framework of a neural network model of animal communication. We discuss some issues raised by Gray, such as the control of the contents of consciousness, the adaptive value of consciousness, conscious and unconscious behaviors, and the nature of a model's consciousness.

Precise and timely diagnosis of Parkinson’s disease is important to control its progression among subjects. Currently, a neuroimaging technique called dopaminergic imaging that uses single photon emission computed tomography (SPECT) with 123I-Ioflupane is popular among clinicians for detecting Parkinson’s disease in early stages. Unlike other studies, which consider only low-level features like gray matter, white matter, or cerebrospinal fluid, this study explores the non-linear relation between different biomarkers (SPECT + biological) using deep learning and multivariate logistic regression. Striatal binding (...) ratios are obtained using 123I-Ioflupane SPECT scans from four brain regions which are further integrated with five biological biomarkers to increase the diagnostic accuracy. Experimental results indicate that this investigated approach can differentiate subjects with 100% accuracy. The obtained results outperform the ones reported in the literature. Furthermore, logistic regression model has been developed for estimating the Parkinson’s disease onset probability. Such models may aid clinicians in diagnosing this disease. (shrink)

The aim of this study was to reflect on the origins and meanings of names describing investment practices that integrate a consideration of environmental, social and corporate governance issues in the academic literature. A review of 190 academic papers spanning the period from 1975 to mid-2009 was conducted. This exploratory study evaluated the associations and disassociations of the primary name assigned to this genre of investment with variables grouped into five domains, namely Primary Ethical Position, Investment Strategy, Publication Date, Regions (...) Covered and Periodical Type. The study indicated that papers coded as expressing a deontological ethical position were more frequently associated with the name Ethical Investment , whereas those with an ambiguous ethical position were less frequently associated with Ethical Investment . Three investment strategies (positive screening, best-in-class and cause-based investing) were unusually associated with the primary name Responsible Investment . A strong preference for the name Ethical Investment was noted in the United Kingdom, and contrasted starkly with an apparent aversion for this name in the United States. The name Ethical Investment is significantly more frequently used in journals dealing with ethics, business ethics and philosophy than in finance, economic and investment journals. Finally, the study yielded some weak hints that the name Responsible Investment might perhaps be linked to an egoist ethical position. On the basis of this, and because these have already been substantively linked through the Principles for Responsible Investment in the popular discourse, we follow the heuristic tradition set by Sparkes (Business Ethics Eur Rev 10:194–201, 2001 ), and propose that Responsible Investment be defined as ‘Investment practices that integrate a consideration of ESG issues with the primary purpose of delivering higher-risk-adjusted financial returns’. (shrink)

Editors’ Note: A major goal of Science and Engineering Ethics is to promote discussion of the ethical issues raised by various aspects of science and engineering, both within the pages of this journal and beyond. We are beginning a series of case presentations and discussions in the Educational Forum. We invite readers to respond to the case and accompanying commentaries, and to submit other cases and commentaries for future publication. We look forward to hearing from you. — S. J. Bird, (...) R. E. Spier. (shrink)

This paper provides a philosophical critique of professional stereotypes in medicine. In the course of this critique, we also offer a detailed analysis of the concept of care in health care. The paper first considers possible explanations for the traditional stereotype that caring is a province of nurses and women, while curing is an arena suited for physicians and men. It then dispels this stereotype and fine tunes the concept of care. A distinction between ‘caring for’ and ‘caring about’ is (...) made, and concomitant notions of parentalism are elaborated. Finally, the paper illustrates, through the use of cases, diverse models of caring. Our discussion reveals the complexity of care and the alternative modes of caring in health care. (shrink)

Is there a rational and ethical basis for efforts to rescue individuals in dire straits? When does rescue have ethical support, and when does it reflect an irrational impulse? This paper defines a Rule of Rescue and shows its intuitive appeal. It then proceeds to argue that this rule lacks support from standard principles of justice and from ethical principles more broadly, and should be rejected in many situations. I distinguish between agent-relative and agent-neutral reasons, and argue that the Rule (...) of Rescue qualifies only in a narrow range of cases where agent-relative considerations apply. I conclude that it would be wise to set aside the Rule of Rescue in many cases, especially those involving public policies, where it has only weak normative justification. The broader implications of this analysis are noted. (shrink)

Male and female participants were instructed to produce an altered response pattern on an Implicit Association Test measure of gender identity by slowing performance in trials requiring the same response to stimuli designating own gender and self. Participants’ faking success was found to be predictable by a measure of slowing relative to unfaked performances. This combined task slowing (CTS) indicator was then applied in reanalyses of three experiments from other laboratories, two involving instructed faking and one involving possibly motivated faking. (...) Across all studies involving instructed faking, CTS correctly classified 75% of intentionally faking participants. Using the CTS index to adjust faked Implicit Association Test scores increased the correlation of CTS-adjusted measures with known group membership, relative to unadjusted (i.e., faked) measures. (shrink)

This discussion paper aims to explore potential ethical and moral implications of (patient) centredness in nursing and healthcare. Healthcare is experiencing a philosophical shift from a perspective where the health professional is positioned as the expert to one that re‐centres care and service provision central to the needs and desires of the persons served. This centred approach to healthcare delivery has gained a moral authority as the right thing to do. However, little attention has been given to its moral and (...) ethical theoretical grounding and potential implications for nurses, persons served and the healthcare system. Based upon a review of academic and grey literature, centredness is proposed as a value‐laden concept in nursing inquiry. Potential moral and ethical implications of centredness on nurses/healthcare providers, persons served and the healthcare system are discussed. These challenges are then considered within the context of normative and relational ethical theories. These perspectives may offer guidance relative to how one should act in those circumstances as well as an understanding as to how interdependency and engagement with the other person(s) can help navigate the challenges of a centred care approach. Viewing centredness through an ethical theoretical lens provides a valuable discourse to nursing in efforts to expand the knowledge base and integrate centred approaches into practice and policy. (shrink)

Contributed articles on psychological aspect of Hindu philosophical system.

A caregiver from the dominant U.S. culture and a patient from a very different culture can resolve cross‐cultural disputes about treatment, not by compromising important values, but by focusing on the patient's goals.

Objectives: Hospital ethics committees increasingly affect medical care worldwide, yet there has been little evaluation of these bodies. Israel has the distinction of having ethics committees legally required by a Patients' Rights Act. We studied the development of ethics committees in this legal environment.Design: Cross-sectional national survey of general hospitals to identify all ethics committees and interview of ethics committee chairpersons.Setting: Israel five years after the passage of the Patients' Rights Act.Main measurements: Patients' rights and informal ethics committee structure and (...) function.Results: One-third of general hospitals have an ethics committee, with committees concentrated in larger facilities. Hospitals without committees tended to lack any structure to handle ethics issues. Committees tend to be interdisciplinary and gender-mixed but ethnic mix was poor. Confidentiality is the rule, however, legal liability is a concern. One-third of patients' rights ethics committees never convened and most committees had considered fewer than ten consults. Access to the consultation process and the consultation process itself varied substantially across committees. Some patients' rights ethics committees attempted to solve cases, others only rendered decisions. Informal committees often refused to consider cases within Patients' Rights Act jurisdiction.Conclusions: Despite statutory requirement, many Israeli patients and clinicians do not have access to ethics committees. The scant volume of cases shows serious discrepancies between practice and Patients' Rights Act regulations, suggesting the need for education or revision of the law. Heterogeneity in committee function demonstrates need for substantial improvement. (shrink)