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)

PurposeThe purported benefits and risks of immediately sequential bilateral cataract surgery have been well described, yet the procedure remains controversial among UK ophthalmologists. As many of the controversies of ISBCS are underpinned by ethical dilemmas, the aim of this work was to explore the ethical perspectives of ISBCS from a variety of stakeholder viewpoints.MethodA semi-structured independent stakeholder meeting was convened at the Royal College of Ophthalmologists London headquarters in June 2018. In total, 29 stakeholders attended the meeting. The professional characteristics (...) of stakeholders included but were not limited to: ophthalmologists, patients, religious leaders, ethicists, lawyers and commissioners. Thematic qualitative analysis using methodology proposed by Braun and Clarke was conducted on the resultant transcript of the discussion.ResultsThemes identified include: beneficence and non-maleficence ; autonomy ; distributive justice.ConclusionThis analysis provides a reference point for the ethical factors surrounding ISBCS. The stakeholders concluded that this approach was an ethical undertaking provided patient autonomy was appropriately attained. This requires a patient’s interpretation of the risk-benefit balance, which must include an understanding of the low but unquantifiable risk of severe complications. A surgeon must aim to minimise risks through the adaption of accepted surgical protocols and by performing appropriate patient selection. Currently, cost savings to healthcare that may occur following the implementation of ISBCS should be considered a secondary benefit of the protocol. (shrink)

PurposeThe purported benefits and risks of immediately sequential bilateral cataract surgery have been well described, yet the procedure remains controversial among UK ophthalmologists. As many of the controversies of ISBCS are underpinned by ethical dilemmas, the aim of this work was to explore the ethical perspectives of ISBCS from a variety of stakeholder viewpoints.MethodA semi-structured independent stakeholder meeting was convened at the Royal College of Ophthalmologists London headquarters in June 2018. In total, 29 stakeholders attended the meeting. The professional characteristics (...) of stakeholders included but were not limited to: ophthalmologists, patients, religious leaders, ethicists, lawyers and commissioners. Thematic qualitative analysis using methodology proposed by Braun and Clarke was conducted on the resultant transcript of the discussion.ResultsThemes identified include: beneficence and non-maleficence ; autonomy ; distributive justice.ConclusionThis analysis provides a reference point for the ethical factors surrounding ISBCS. The stakeholders concluded that this approach was an ethical undertaking provided patient autonomy was appropriately attained. This requires a patient’s interpretation of the risk-benefit balance, which must include an understanding of the low but unquantifiable risk of severe complications. A surgeon must aim to minimise risks through the adaption of accepted surgical protocols and by performing appropriate patient selection. Currently, cost savings to healthcare that may occur following the implementation of ISBCS should be considered a secondary benefit of the protocol. (shrink)

In this article I consider instances in visual culture in which artists and filmmakers aestheticize women with damaged, missing or anomalous limbs. I focus upon Joel Peter Witkin’s photomontage Las Meninas (1987), Peter Greenaway’s film “A Zed and Two Noughts” (1985), Alison Lapper Pregnant a statue by Marc Quinn, Mathew Barney’s film “Cremaster” (2002), David Cronenberg’s “Crash” (1996), Luis Buñuel’s “Tristana” (1970) and David Lynch’s short film “The Amputee” (1973). I argue that although the artists and filmmakers reveal, rather (...) than disguise the damaged, anomalous or missing limb(s) of the women, thus valorising their particular embodiment, these women are paradoxically still portrayed as deviant and monstrous. (shrink)

ABSTRACT Drawing inspiration from Fred Dretske, L. S. Carrier, John A. Barker, and Robert Nozick, we develop a tracking analysis of knowing according to which a true belief constitutes knowledge if and only if it is based on reasons that are sensitive to the fact that makes it true, that is, reasons that wouldn’t obtain if the belief weren’t true. We show that our sensitivity analysis handles numerous Gettier-type cases and lottery problems, blocks pathways leading to skepticism, and validates the (...) epistemic closure thesis that correct inferences from known premises yield knowledge of the conclusions. We discuss the plausible views of Ted Warfield and Branden Fitelson regarding cases of knowledge acquired via inference from false premises, and we show how our sensitivity analysis can account for such cases. We present arguments designed to discredit putative counterexamples to sensitivity analyses recently proffered by Tristan Haze, John Williams and Neil Sinhababu, which involve true statements made by untrustworthy informants and strange clocks that sometimes display the correct time while running backwards. Finally, we show that in virtue of employing the paradox-free subjunctive conditionals codified by Relevance Logic theorists instead of the paradox-laden subjunctive conditionals codified by Robert Stalnaker and David Lewis. (shrink)

In a recent very interesting and important challenge to tracking theories of knowledge, Williams & Sinhababu claim to have devised a counter-example to tracking theories of knowledge of a sort that escapes the defense of those theories by Adams & Clarke. In this paper we will explain why this is not true. Tracking theories are not undermined by the example of the backward clock, as interesting as the case is.

1. The Situation in Cognition 2. Situated Cognition: A Potted Recent History 3. Extensions in Biology, Computation, and Cognition 4. Articulating the Idea of Cognitive Extension 5. Are Some Resources Intrinsically Non-Cognitive? 6. Is Cognition Extended or Only Embedded? 7. Letting Nature Take Its Course.

Cross-sector social partnerships (CSSPs) are relevant units of analysis for understanding sustainable business models (SBMs). This research examines how organizations value their motivations to participate in large sustainability-focused partnerships, how they perceive the value captured, and their structures implemented to address sustainability partnerships. Two hundred and twenty-four organizations partnering within four large sustainability CSSPs were surveyed using an augmented resource-based view (RBV) theoretical framework. Results show that partners were motivated by and captured value related to sustainability-, organizational-, and human-oriented resources, (...) and that organizations prefer more informal than formal structural elements to implement their partnerships’ sustainability strategies. Contributions to SBM and CSSP fields are revealed. SBM thinking is a provocation toward seeking integrated sustainable value creation, helping show the value of large CSSPs. Conversely, by conceiving of large, pluralistic CSSPs as “collaborative SBMs,” we extend the idea of the “business model” to the societal level, exploring how value is captured in partnership. (shrink)

Change-blindness occurs when large changes are missed under natural viewing conditions because they occur simultaneously with a brief visual disruption, perhaps caused by an eye movement, a flicker, a blink, or a camera cut in a film sequence. We have found that this can occur even when the disruption does not cover or obscure the changes. When a few small, high-contrast shapes are briefly spattered over a picture, like mudsplashes on a car windscreen, large changes can be made simultaneously in (...) the scene without being noticed. (shrink)

Bioethicists in healthcare institutions have the skills and insights and can and must facilitate and promote measures that address deeply ingrained structural issues that exacerbate health inequity...

Taking debates about the roles of structure and agency in health as a lens, this essay asks how Critical Realist and Feminist Intersectional approaches might inform health interventions research. Despite recognition of multiple determinants of health, health problems are often thought of as individual and interventions, in turn, target risky individual behaviours. Such approaches are rooted in a liberal model of personhood. This paper critiques enduring individualist assumptions linked to Western liberal underpinnings embedded in health interventions. It posits the need (...) to include a robust conception of the social world in which change depends on shifting power relations, and individual agency is shaped by power as well as individual will. We propose preliminary steps for undertaking critical realist intersectional interventions research. (shrink)

Both language and genes evolve by transmission over generations with opportunity for differential replication of forms. The understanding that gene frequencies change at random by genetic drift, even in the absence of natural selection, was a seminal advance in evolutionary biology. Stochastic drift must also occur in language as a result of randomness in how linguistic forms are copied between speakers. Here we quantify the strength of selection relative to stochastic drift in language evolution. We use time series derived from (...) large corpora of annotated texts dating from the 12th to 21st centuries to analyse three well-known grammatical changes in English: the regularization of past-tense verbs, the introduction of the periphrastic ’do’, and variation in verbal negation. We reject stochastic drift in favour of selection in some cases but not in others. In particular, we infer selection towards the irregular forms of some past-tense verbs, which is likely driven by changing frequencies of rhyming patterns over time. We show that stochastic drift is stronger for rare words, which may explain why rare forms are more prone to replacement than common ones. This work provides a method for testing selective theories of language change against a null model and reveals an underappreciated role for stochasticity in language evolution. (shrink)

Background In May 2020, England moved to an opt-out organ donation system, meaning adults are presumed to be an organ donor unless within an excluded group or have opted-out. This change aims to improve organ donation rates following brain or circulatory death. Healthcare staff in the UK are supportive of organ donation, however, both healthcare staff and the public have raised concerns and ethical issues regarding the change. The #options survey was completed by NHS organisations with the aim of understanding (...) awareness and support of the change. This paper analyses the free-text responses from the survey. Methods The #options survey was registered as a National Institute of Health Research (NIHR) portfolio trial [IRAS 275992] 14 February 2020, and was completed between July and December 2020 across NHS organisations in the North-East and North Cumbria, and North Thames. The survey contained 16 questions of which three were free-text, covering reasons against, additional information required and family discussions. The responses to these questions were thematically analysed. Results The #options survey received 5789 responses from NHS staff with 1404 individuals leaving 1657 free-text responses for analysis. The family discussion question elicited the largest number of responses (66%), followed by those against the legislation (19%), and those requiring more information (15%). Analysis revealed six main themes with 22 sub-themes. Conclusions The overall #options survey indicated NHS staff are supportive of the legislative change. Analysis of the free-text responses indicates that the views of the NHS staff who are against the change reflect the reasons, misconceptions, and misunderstandings of the public. Additional concerns included the rationale for the change, informed decision making, easy access to information and information regarding organ donation processes. Educational materials and interventions need to be developed for NHS staff to address the concepts of autonomy and consent, organ donation processes, and promote family conversations. Wider public awareness campaigns should continue to promote the positives and refute the negatives thus reducing misconceptions and misunderstandings. Trial registration National Institute of Health Research (NIHR) [IRAS 275992]. (shrink)

Despite concerns about the relationships between health professionals and the medical device industry, the issue has received relatively little attention. Prevalence data are lacking; however, qualitative and survey research suggest device industry representatives, who are commonly present in clinical settings, play a key role in these relationships. Representatives, who are technical product specialists and not necessarily medically trained, may attend surgeries on a daily basis and be available to health professionals 24 hours a day, 7 days a week, to provide (...) advice. However, device representatives have a dual role: functioning as commissioned sales representatives at the same time as providing advice on approaches to treatment. This duality raises the concern that clinical decision-making may be unduly influenced by commercial imperatives. In this paper, we identify three key ethical concerns raised by the relationship between device representatives and health professionals: impacts on healthcare costs, the outsourcing of expertise and issues of accountability and informed consent. These ethical concerns can be addressed in part through clarifying the boundary between the support and sales aspects of the roles of device representatives and developing clear guidelines for device representatives providing support in clinical spaces. We suggest several policy options including hospital provision of expert support, formalising clinician conduct to eschew receipt of meals and payments from industry and establishing device registries. (shrink)