Evidence-based medicine (EBM) has thus far failed to adequately account for the appropriate incorporation of other potential warrants for medical decision making into clinical practice. In particular, EBM has struggled with the value and integration of other kinds of medical knowledge, such as those derived from clinical experience or based on pathophysiologic rationale. The general priority given to empirical evidence derived from clinical research in all EBM approaches is not epistemically tenable. A casuistic alternative to EBM approaches (...) recognizes that five distinct topics, 1) empirical evidence, 2) experiential evidence, 3) pathophysiologic rationale, 4) patient goals and values, and 5) system features are potentially relevant to any clinical decision. No single topic has a general priority over any other and the relative importance of a topic will depend upon the circumstances of the particular case. The skilled clinician must weigh these potentially conflicting evidentiary and non-evidentiary warrants for action, employing both practical and theoretical reasoning, in order to arrive at the best choice for an individual patient. (shrink)

Recent advances in the field of statistical learning have established that learners are able to track regularities of multimodal stimuli, yet it is unknown whether the statistical computations are performed on integrated representations or on separate, unimodal representations. In the present study, we investigated the ability of adults to integrate audio and visual input during statistical learning. We presented learners with a speech stream synchronized with a video of a speaker’s face. In the critical condition, the visual (e.g. /gi/) and (...) auditory (e.g. /mi/) signals were occasionally incongruent, which we predicted would produce the McGurk illusion, resulting in the perception of an audiovisual syllable (e.g. /ni/). In this way, we used the McGurk illusion to manipulate the underlying statistical structure of the speech streams, such that perception of these illusory syllables facilitated participants’ ability to segment the speech stream. Our results therefore demonstrate that participants can integrate audio and visual input to perceive the McGurk illusion during statistical learning. We interpret our findings as support for modality-interactive accounts of statistical learning. (shrink)

In light of recent advances in machine learning for medical applications, the automation of medical diagnostics is imminent. That said, before machine learning algorithms find their way into clinical practice, various problems at the epistemic level need to be overcome. In this paper, we discuss different sources of uncertainty arising for clinicians trying to evaluate the trustworthiness of algorithmic evidence when making diagnostic judgments. Thereby, we examine many of the limitations of current machine learning algorithms (with deep learning in (...) particular) and highlight their relevance for medical diagnostics. Among the problems we inspect are the theoretical foundations of deep learning (which are not yet adequately understood), the opacity of algorithmic decisions, and the vulnerabilities of machine learning models, as well as concerns regarding the quality of medical data used to train the models. Building on this, we discuss different desiderata for an uncertainty amelioration strategy that ensures that the integration of machine learning into clinical settings proves to be medically beneficial in a meaningful way. (shrink)

In recent years, the concept of “integrity” has been frequently discussed by scholars, and deployed by courts, in the domain of criminal procedure. In this paper, we are particularly concerned with how the concept has been employed in relation to the problem of the admissibility of evidence obtained improperly. In conceptualising and addressing this problem, the advocates of integrity rely on it as a standard of conduct for the criminal justice authorities and as a necessary condition for the state (...) authority to condemn and punish. We raise a series of challenges that need answering before integrity can perform these roles. Our aim is not to show that integrity is useless in normative theorising about the admissibility of evidence, and about the criminal process in general. Rather, it is to give guidance for the elaboration of a theory of integrity that is cogent, coherent, and has useful implications for the process of proof. (shrink)

Corballis suggests that apes lack voluntary control over their vocal production. However, recent evidence implicates voluntary control of vocalizations in apes, which suggests that intentional control of vocal communication predates the hominid-pongid split. Furthermore, the ease with which apes in captivity manipulate the visual attention of observers implies a common cognitive basis for joint attention in humans and apes.

With its focus on evidence, psychology has grown into a mature, professional, and scientifically supported practice over the last decades. In general, psychotherapy and psychological counselling have shown to be more efficacious than waiting it out and a staggering 350 specific treatments have been scientifically supported as effective. Although, evidencebased treatments seem to work equally well, not all people benefit from evidence-based treatments, and it often remains unclear why. This raised the field-wide concern of what works for whom (...) and sparked a wealth of research on specific ingredients, common factors, process factors, and intra- and... (shrink)

We present a reference model for finding evidence of discrimination in datasets of historical decision records in socially sensitive tasks, including access to credit, mortgage, insurance, labor market and other benefits. We formalize the process of direct and indirect discrimination discovery in a rule-based framework, by modelling protected-by-law groups, such as minorities or disadvantaged segments, and contexts where discrimination occurs. Classification rules, extracted from the historical records, allow for unveiling contexts of unlawful discrimination, where the degree of burden over (...) protected-by-law groups is evaluated by formalizing existing norms and regulations in terms of quantitative measures. The measures are defined as functions of the contingency table of a classification rule, and their statistical significance is assessed, relying on a large body of statistical inference methods for proportions. Key legal concepts and reasonings are then used to drive the analysis on the set of classification rules, with the aim of discovering patterns of discrimination, either direct or indirect. Analyses of affirmative action, favoritism and argumentation against discrimination allegations are also modelled in the proposed framework. Finally, we present an implementation, called LP2DD, of the overall reference model that integrates induction, through data mining classification rule extraction, and deduction, through a computational logic implementation of the analytical tools. The LP2DD system is put at work on the analysis of a dataset of credit decision records. (shrink)

This paper investigates the integrity of financial analysts by examining their recommendation responses to large quarterly earnings surprises. Although there is no significant difference in recommendation changes between affiliated and unaffiliated analysts in response to positive earnings surprises, affiliated analysts are more reluctant than unaffiliated analysts to downgrade stock recommendations in response to negative earnings surprises. The evidence implies that conflicts of interest undermine the integrity of financial analysts. We further examine the effects of reputation concern and the Global (...) Research Analyst Settlement as informal and formal mechanisms, on restoring analysts’ integrity. The results show that the positive bias in recommendations remains prevalent for affiliated analysts from reputable investment banks and for the postreform period. Finally, evidence from market reactions suggests that investors fail to notice that analysts’ integrity is compromised by conflicts of interest and are misled by affiliated analysts. (shrink)

A common view in affective neuroscience considers emotions as a multifaceted phenomenon constituted by independent affective and motor components. Such dualistic connotation, obtained by rephrasing the classic Darwin and James’s theories of emotion, leads to the assumption that emotional expression is controlled by motor centers in the anterior cingulate, frontal operculum, and supplementary motor area, whereas emotional experience depends on interoceptive centers in the insula. Recent stimulation studies provide a different perspective. I will outline two sets of findings. First, affective (...) experiences can be elicited also following the stimulation of motor centers. Second, emotional expressions can be elicited by stimulating interoceptive regions. Echoing the original pragmatist theories of emotion, I will make a case for the notion that emotional experience emerges from the integration of sensory and motor signals, encoded in the same functional network. (shrink)

Research on language processing has shown that the disruption of conceptual integration gives rise to specific patterns of event-related brain potentials —N400 and P600 effects. Here, we report similar ERP effects when adults performed cross-domain conceptual integration of analogous semantic and mathematical relations. In a problem-solving task, when participants generated labeled answers to semantically aligned and misaligned arithmetic problems, the second object label in misaligned problems yielded an N400 effect for addition problems. In a verification task, when participants (...) judged arithmetically correct but semantically misaligned problem sentences to be “unacceptable,” the second object label in misaligned sentences elicited a P600 effect. Thus, depending on task constraints, misaligned problems can show either of two ERP signatures of conceptual disruption. These results show that well-educated adults can integrate mathematical and semantic relations on the rapid timescale of within-domain ERP effects by a process akin to analogical mapping. (shrink)

What drives Chinese MNEs’ global CSR integration and local CSR responsiveness? Drawing on institutional theory, we argue that both antecedents reflecting globally isomorphic patterns of adaptation and antecedents mirroring the distinct characteristics of China’s institutional context are relevant. We support our argument using fuzzy-set qualitative comparative analysis on a sample of 29 of China’s globally most influential companies. We find that state influence and global CSR associations affect global CSR integration, whereas presence in the West and internationalization through (...) mergers and acquisitions predict local CSR responsiveness. Our study thus suggests that home-country characteristics are an important co-determinant of the CSR approaches of emerging-market MNEs. We further find that multicultural experience in top management teams is associated with both global CSR integration and local CSR responsiveness, supporting notions of transnational CSR. (shrink)

An educational provision for young children with autism that offers intensive behavioural intervention based on the principles of Applied Behaviour Analysis (ABA), within an early years mainstream school setting in the UK, is described. The ABA Class at Westwood School is a collaborative project between the School of Psychology, Bangor University, two Local Education Authorities in North East Wales (Flintshire and Wrexham) and the local NHS Trust. Using two case examples, two important features of mainstream education for children with autism (...) are considered: access to the National Curriculum, and inclusion with peers in mainstream settings. Standardised test data on outcomes for these children over the initial 12 months of their educational placements are also provided. (shrink)

I examine how Heather Douglas’ account of values in science applies to the assessment of actual cases of scientific practice. I focus on the case of applied toxicologists’ acceptance of molecular evidence-gathering methods and evidential sources. I demonstrate that a set of social and institutional processes plays a philosophically significant role in changing toxicologists’ inductive risk judgments about different kinds of evidence. I suggest that Douglas’ inductive risk framework can be integrated with a suitable account of evidence, (...) such as Helen Longino’s contextual empiricism, to address the role of social context in the cases like the one examined here. I introduce such an integrated account and show how Longino’s contextual empiricism and inductive risk framework fruitfully complement each other in analyzing the novel aspects of the toxicology case. (shrink)

Evidence, as viewed through the lens of statistical significance, is not always as it appears! In the investigation of clinical research findings arising from statistical analyses, a fundamental initial step for the emerging fraud detective is to retrieve the source data for cross-examination with the study data. Recognizing that source data are not always forthcoming and that, realistically speaking, the investigator may be uninitiated in fraud detection and investigation, this paper will highlight some key methodological procedures for providing a (...) sounder evidence base for withdrawing from a study on grounds of integrity. The promotion of patient safety is paramount. However, there is a broader rationale for disseminating these ideas. This includes empowering researchers to optimize their personal integrity, make informed choices regarding membership of future research collaborations and successfully voice their concerns to journal editors, particularly where a conflict of interests can render such dialogues particularly difficult. Recommendations will be supported by topical case studies and practical steps involving data exploration, testing of baseline data and application of Benford’s Law. While this paper has a clinical focus, the advice provided is transferrable to a wide range of multidisciplinary research settings outside of Medicine. (shrink)

Patients trust physicians to prescribe based on their fiduciary duty to act in the best interests of their patients, and physicians prescribe based on confidence in research data and clinical guidelines. Recent reports erode confidence in evidence-based medicine. Through self-regulation and a willingness to change, the medical profession can assert its status as a profession distinct from outside influence, serving one interest: the healthcare of patients and the public.

Primary progressive aphasia is a degenerative disease affecting language while leaving other cognitive facilities relatively unscathed. The agrammatic subtype of PPA is characterized by agrammatic language production with impaired comprehension of noncanonical filler-gap syntactic structures, such as object-relatives [e.g., The sandwich that the girl ate was tasty], in which the filler is displaced from the object position within the relative clause to a position preceding both the verb and the agent and is replaced by a gap linked with the filler. (...) One hypothesis suggests that the observed deficits of these structures reflect impaired thematic integration, including impaired prediction of the thematic role of the filler and impaired thematic integration at the gap, but spared structure building. In the current study, we examined the on-line comprehension of object-relative and subject-relative clauses in healthy controls and individuals with agrammatic and logopenic PPA using eye-tracking. Eye-movement patterns in canonical subject-relative clause structures were essentially spared in both PPA groups. In contrast, eye-movement patterns in noncanonical object-relative clauses revealed delayed thematic prediction in both agrammatic and logopenic PPA, on-time structure building in both groups, and abnormal thematic integration in agrammatic, but not logopenic, PPA. We argue that these results are consistent with the hypothesis that agrammatic comprehension deficits reflect impaired thematic integration. (shrink)

This paper challenges the traditional assumption that descriptive and prescriptive sciences are essentially distinct by presenting a study on the implicit normativity of the production and presentation of biomedical scientific facts within evidence-based medicine. This interdisciplinary study serves as an illustration of the potential worth of the concept of implicit normativity for bioethics in general and for integrated empirical ethics research in particular. It demonstrates how both the production and presentation of scientific information in an evidence-based decision-support contain (...) implicit presuppositions and values, which pre-structure the moral environment of the clinical process of decision-making. As a consequence, the evidence-based decision support did not only support the clinical decision-making process; it also transformed it in a morally significant way. This phenomenon undermines the assumption within much of the literature on patient autonomy that information disclosure is a conditional requirement before patient autonomy even starts; patient autonomy is already influenced during the production and presentation of information. These results imply an increased responsibility of those who produce and present evidence-based facts(i.e. scientists in general and physicians in particular). The insights of this study not only involve a different focus on both theory and practice of patient autonomy and informed consent, but they also call for a broader scope of morality than does traditional empirical research in bioethics. The concept of implicit normativity within integrated empirical ethics research calls for a strong cooperation between bioethicists and descriptive scientists, i.e., a cooperation that goes beyond the discipline-specific epistemic values and that takes place during all phases of the research process. (shrink)

Credible and well-functioning governance is crucial for the value creation of firms. Recently, private sectors have undergone substantial changes by focusing on good governance as a tool to enhance value, reputation, and image. The primary features of firms with good governance include greater emphasis on accountability practices, proper implementation of a corporate integrity system, and sound internal controls in place to avoid risk and to ensure policy and procedures that are complied. Government linked companies (GLCs) as the backbone of the (...) Malaysian Government have been harshly criticised for not being able to create value(s) despite receiving high priority in the process of getting government projects. Therefore, this study aims to examine the role of good governance systems, which are reflected through accountability systems, corporate integrity systems, and internal control systems towards value creation of Malaysian GLCs. This study collected primary data based on a set of questionnaire survey among 100 GLCs in Malaysia. Based on the regression analysis, this study found that corporate integrity systems and internal control systems were vital elements in ensuring value creation in GLCs. (shrink)

Innovations in Evidence and Proof' brings together leading scholars and law teachers from the US, Australia, Canada, South Africa, and the UK to explore the latest developments in evidence scholarship.--Résumé de l'éditeur.

Here we review 37 modern neuroimaging studies in an attempt to address this question posed by Halstead (1947) as he and other icons of the last century endeavored to understand how brain and behavior are linked through the expression of intelligence and reason. Reviewing studies from functional (i.e., functional magnetic resonance imaging, positron emission tomography) and structural (i.e., magnetic resonance spectroscopy, diffusion tensor imaging, voxel-based morphometry) neuroimaging paradigms, we report a striking consensus suggesting that variations in a distributed network predict (...) individual differences found on intelligence and reasoning tasks. We describe this network as the Parieto-Frontal Integration Theory (P-FIT). The P-FIT model includes, by Brodmann areas (BAs): the dorsolateral prefrontal cortex (BAs 6, 9, 10, 45, 46, 47), the inferior (BAs 39, 40) and superior (BA 7) parietal lobule, the anterior cingulate (BA 32), and regions within the temporal (BAs 21, 37) and occipital (BAs 18, 19) lobes. White matter regions (i.e., arcuate fasciculus) are also implicated. The P-FIT is examined in light of findings from human lesion studies, including missile wounds, frontal lobotomy/leukotomy, temporal lobectomy, and lesions resulting in damage to the language network (e.g., aphasia), as well as findings from imaging research identifying brain regions under significant genetic control. Overall, we conclude that modern neuroimaging techniques are beginning to articulate a biology of intelligence. We propose that the P-FIT provides a parsimonious account for many of the empirical observations, to date, which relate individual differences in intelligence test scores to variations in brain structure and function. Moreover, the model provides a framework for testing new hypotheses in future experimental designs. (shrink)

This paper proposes a methodological synthesis in order to study multimodal media discourse and argumentation in the context of the so-called ‘refugee crisis’ in Greece. It follows the framework of Multimodal Critical Discourse Analysis, integrating this with argumentation studies, with a particular emphasis on the analysis of inference. Our data come from the Greek newspapers Kathimerini and Ta Nea. We contend that the proposed methodological synergy enables scrutiny of (a) racist conceptualizations cultivated by the representation of migrants and refugees in (...) headlines and photographs in newspaper articles along with (b) the argumentative potential that is implicitly sustained in these multimodal representations. (shrink)

There are several models of the use of geometric and feature cues in reorientation. The adaptive combination approach posits that people integrate cues with weights that depend on cue salience and learning, or, when discrepancies are large, they choose between cues based on these variables. In a new paradigm designed to evaluate integration and choice, disoriented participants attempted to return to a heading direction, in a trapezoidal enclosure in which feature and geometric cues both unambiguously specified a heading, but (...) later the feature was moved. With discrepancies greater than 90 degrees, participants choose geometry. With smaller discrepancies, integration appeared in three of five situations; otherwise, participants used geometry alone. Variation depended on direction of feature movement and whether the nearest corner was acute or obtuse. The results have implications for contrasting adaptive combination and modularity theory, and for future research, offering a new paradigm for reorientation research, and for testing cue integration more broadly. (shrink)

The perception of brightness differences in Ehrenstein figures and of illusory contours in phase-shifted line gratings was investigated as a function of the contrast polarity of the inducing elements. We presented either continuous lines or line-like arrangements composed of aligned dashes or dots whose spacing was varied. A yes/no procedure was used in which naive observers had to decide whether or not they perceived a brightness difference in a given Ehrenstein figure or an illusory contour in a phase-shifted line grating. (...) The results show that brightness differences are perceived to some extent in Ehrenstein figures with inducers of opposite polarity of contrast; however, the percentage of yes response was systematically lower and response times were longer than for figures with inducers of the same polarity. Phase-shifted line gratings with lines of opposite polarity of contrast yielded stronger illusory contours and shorter response times than those with lines of the same polarity. When the sign of contrast was not the same within a given line of induction, neither differences in brightness nor illusory contours were perceived. The results suggest that the mechanisms that lead to apparent differences in brightness are more sensitive to input of the same contrast polarity, the mechanisms generating illusory contours more sensitive to input of opposite polarity. The data are discussed in the light of a multistage approach to illusory form perception and some implications for cortical models of illusory contour integration are discussed. (shrink)

It has recently been argued that successful evidence-based policy should rely on two kinds of evidence: statistical and mechanistic. The former is held to be evidence that a policy brings about the desired outcome, and the latter concerns how it does so. Although agreeing with the spirit of this proposal, we argue that the underlying conception of mechanistic evidence as evidence that is different in kind from correlational, difference-making or statistical evidence, does not correctly (...) capture the role that information about mechanisms should play in evidence-based policy. We offer an alternative account of mechanistic evidence as information concerning the causal pathway connecting the policy intervention to its outcome. Not only can this be analyzed as evidence of difference-making, it is also to be found at any level and is obtainable by a broad range of methods, both experimental and observational. Using behavioral policy as an illustration, we draw the implications of this revised understanding of mechanistic evidence for debates concerning policy extrapolation, evidence hierarchies, and evidence integration. (shrink)

We propose a Bayesian framework for the attribution of knowledge, and apply this framework to generate novel predictions about knowledge attribution for different types of “Gettier cases”, in which an agent is led to a justified true belief yet has made erroneous assumptions. We tested these predictions using a paradigm based on semantic integration. We coded the frequencies with which participants falsely recalled the word “thought” as “knew” (or a near synonym), yielding an implicit measure of conceptual activation. Our (...) experiments confirmed the predictions of our Bayesian account of knowledge attribution across three experiments. We found that Gettier cases due to counterfeit objects were not treated as knowledge (Experiment 1), but those due to intentionally-replaced evidence were (Experiment 2). Our findings are not well explained by an alternative account focused only on luck, because accidentally-replaced evidence activated the knowledge concept more strongly than did similar false belief cases (Experiment 3). We observed a consistent pattern of results across a number of different vignettes that varied the quality and type of evidence available to agents, the relative stakes involved, and surface details of content. Accordingly, the present findings establish basic phenomena surrounding people’s knowledge attributions in Gettier cases, and provide explanations of these phenomena within a Bayesian framework. (shrink)

The paper uses insights from the so-called rape in disguise case study to describe forensic DNA practices in the Netherlands in late 1980s. It describes how "reliabilities" of forensic DNA practices were achieved. One such reliability - convincing evidence - proliferates body parts through time and space. Then, attention shifts to the individual who was suspected of having committed the rape. He was asked to deliver tissue for DNA typing, but refused to do so. Hence DNA typing could not (...) be used to connect the suspect to a cervical smear collected from the body of the victim. His refusal and the legal impossibility to use force to obtain his biological material led first to questions in the Dutch parliament and then to the Dutch forensic DNA law. Other legal measures enacted after this are also described. I argue that, by means of the various Dutch forensic DNA laws and new forensic genetic techniques, the application of forensic DNA practices have shifted from identification and evidence to a tool for criminal investigation and prevention of future crimes. In the final part of the paper, the right to inviolability of the body and its synonym bodily integrity are emphasised. I argue that despite the various forensic DNA laws, bodily integrity of obtained tissue for DNA typing is still at stake as the result of convincing evidence. (shrink)

This book offers an integrated historical and philosophical examination of the origin of genetics. The author contends that an integrated HPS analysis helps us to have a better understanding of the history of genetics, and sheds light on some general issues in the philosophy of science. This book consists of three parts. It begins with historical problems, revisiting the significance of the work of Mendel, de Vries, and Weldon. Then it turns to integrated HPS problems, developing an exemplar-based analysis of (...) the development and the progress in early genetics. Finally, it discusses philosophical problems: conceptual change, evidence, and theory choice. Part I lays out a new historiography, serving as a basis for the discussions in part II and part III. Part II introduces a new integrated HPS method to analyse and interpret the historiography in Part I and to re-examine the philosophical issues in Part III. Part III develops new philosophical accounts which will in turn make a better sense of the history of scientific practice more generally. This book provides a practical defence of integrated HPS: the best way to defend integrated HPS is to do it. (shrink)

This integral investigation explored phenomenological and neurophysiologic, individual and collective dimensions of Christian Trinitarian meditation experiences in a volunteer, convenience sample of 10 practicing Christians, 6 men and 4 women, with a mean age of 48 years and an age range from 21 to 85 years. Participants meditated for a minimum period of 15 minutes, during which neurophysiologic data in the form of electroencephalographic (EEG), electromyographic (EMG), blood volume pulse (BVP) and respiratory activity were recorded. A phenomenological analysis indicated that (...) the meditation process generally involved a movement from body to mind to spirit as evident in reports of an increasingly relaxed, contented and focused state of consciousness characterised by Christian Trinitarian imagery, wonder, surrender, peace, bliss, openness and formlessness. The neuropsychological findings indicated significant increases, from baseline to meditation recordings, in the alpha and beta range, accompanied by increasing mean trends in the theta and gamma range, and decreasing mean trends in the delta range, EMG, BVP and respiration. Integrative findings indicated the practical theological value of small doses of Christian Trinity meditation to enhance spiritual life for those forms of waking, thinking, conscious behaviour needed in everyday world involvement and healing. Findings were discussed in relation to further integrative investigations and interventions with practical theological implications. (shrink)

This article analyses domestic and foreign reactions to a 2008 report in the British Medical Journal on the complementary and, as argued, synergistic relationship between palliative care and euthanasia in Belgium. The earliest initiators of palliative care in Belgium in the late 1970s held the view that access to proper palliative care was a precondition for euthanasia to be acceptable and that euthanasia and palliative care could, and should, develop together. Advocates of euthanasia including author Jan Bernheim, independent from but (...) together with British expatriates, were among the founders of what was probably the first palliative care service in Europe outside of the United Kingdom. In what has become known as the Belgian model of integral end-of-life care, euthanasia is an available option, also at the end of a palliative care pathway. This approach became the majority view among the wider Belgian public, palliative care workers, other health professionals, and legislators. The legal regulation of euthanasia in 2002 was preceded and followed by a considerable expansion of palliative care services. It is argued that this synergistic development was made possible by public confidence in the health care system and widespread progressive social attitudes that gave rise to a high level of community support for both palliative care and euthanasia. The Belgian model of so-called integral end-of-life care is continuing to evolve, with constant scrutiny of practice and improvements to procedures. It still exhibits several imperfections, for which some solutions are being developed. This article analyses this model by way of answers to a series of questions posed by Journal of Bioethical Inquiry consulting editor Michael Ashby to the Belgian authors. (shrink)