__Creating Safe, Equitable, Engaging Schools_ brings together the collective wisdom of more than thirty experts from a variety of fields to show how school leaders can create communities that support the social, emotional, and academic needs of all students._ It offers an essential guide for making sense of the myriad evidence‐based frameworks, resources, and tools available to create a continuous improvement system. Chapters illustrate how leaders can leverage the power of school-based teams to assess the needs of students (...) in their school and select appropriate interventions across a wide variety of domains, including social and emotional learning, trauma, restorative practices, cultural responsiveness, and student and family engagement. Filled with recommendations gleaned from research and ongoing work in every US state and territory, _Creating Safe, Equitable, Engaging Schools_ is a critical resource for understanding and adopting evidence-based practices and making programmatic decisions to ensure the ideal conditions for learning, growth, and development. (shrink)

The lottery problem is the problem of explaining why mere reflection on the long odds that one will lose the lottery does not yield knowledge that one will lose. More generally, it is the problem of explaining why true beliefs merely formed on the basis of statistical evidence do not amount to knowledge. Some have thought that the lottery problem can be solved by appeal to a violation of the safety principle for knowledge, i.e., the principle that if S (...) knows that p, not easily would S have believed that p without p being the case. Against the standard safety‐based solution, I argue that understanding safe belief as belief that directly covaries with the truth of what is believed in a suitably defined set of possible worlds forces safety theorists to make a series of theoretical choices that ultimately prevent a satisfactory solution to the problem. In this way, I analyze several safety principles that result from such choices—the paper thus gives valuable insights into the nature of safety—and explain why none solves the lottery problem, including their inability to explain away Gettierized lottery cases. On a more positive note, I show that there is a viable solution in terms of safety if we get rid of the unquestioned assumption that safe beliefs directly track the truth. The alternative is a conception of safe belief according to which what safe beliefs directly track is the appropriateness of the circumstances and, indirectly, the truth. The resulting safety principle, I argue, explains why mere statistical evidence is not a safe source of knowledge. (shrink)

There is no agreed minimum standard with regard to what is considered safe, competent nursing care. Limited resources and organizational constraints make it challenging to develop a minimum standard. As part of their everyday practice, nurses have to ration nursing care and prioritize what care to postpone, leave out, and/or omit. In developed countries where public healthcare is tax-funded, a minimum level of healthcare is a patient right; however, what this entails in a given patient’s actual situation is unclear. (...) Thus, both patients and nurses would benefit from the development of a minimum standard of nursing care. Clarity on this matter is also of ethical and legal concern. In this article, we explore the case for developing a minimum standard to ensure safe and competent nursing care services. Any such standard must encompass knowledge of basic principles of clinical nursing and preservation of moral values, as well as managerial issues, such as manpower planning, skill-mix, and time to care. In order for such standards to aid in providing safe and competent nursing care, they should be in compliance with accepted evidence-based nursing knowledge, based on patients’ needs and legal rights to healthcare and on nurses’ codes of ethics. That is, a minimum standard must uphold a satisfactory level of quality in terms of both professionalism and ethics. Rather than being fixed, the minimum standard should be adjusted according to patients’ needs in different settings and may thus be different in different contexts and countries. (shrink)

The focus of this chapter will be on the epistemic and normative questions at issue in debates about cancer screening, with a special focus on mammography as a case study. Such questions include: How do we know who needs to be screened? What are the benefits and harms of cancer screening, and what is the quality of evidence for each? How ought we to measure and compare these benefits and harms? What are the sources of uncertainty about our estimates (...) of benefit and harm? Why are such issues so contested? What are the major drivers of dissent and consensus on the data and their interpretation? How, if at all, do values play a role in debates surrounding mammography screening? In sum: In what ways does inductive risk, broadly conceived, 1 come into play in the science behind cancer screening, and mammography screening in particular? (shrink)

This essay presents a unified account of safety, sensitivity, and severe testing. S’s belief is safe iff, roughly, S could not easily have falsely believed p, and S’s belief is sensitive iff were p false S would not believe p. These two conditions are typically viewed as rivals but, we argue, they instead play symbiotic roles. Safety and sensitivity are both valuable epistemic conditions, and the relevant alternatives framework provides the scaffolding for their mutually supportive roles. The relevant alternatives (...) condition holds that a belief is warranted only if the evidence rules out relevant error possibilities. The safety condition helps categorise relevant from irrelevant possibilities. The sensitivity condition captures ‘ruling out’. Safety, sensitivity, and the relevant alternatives condition are typically presented as conditions on warranted belief or knowledge. But these properties, once generalised, help characterise other epistemic phenomena, including warranted inference, legal verdicts, scientific claims, reaching conclusions, addressing questions, warranted assertion, and the epistemic force of corroborating evidence. We introduce and explain Mayo’s severe testing account of statistical inference. A hypothesis is severely tested to the extent it passes tests that probably would have found errors, were they present. We argue Mayo’s account is fruitfully understood using the resulting relevant alternatives framework. Recasting Mayo’s condition using the conceptual framework of contemporary epistemology helps forge fruitful connections between two research areas—philosophy of statistics and the analysis of knowledge—not currently in sufficient dialogue. The resulting union benefits both research areas. (shrink)

There is evidence that people with schizophrenia have difficulties in some (recently evolved) competencies for processing social information. However, a case can be made that vulnerabilities can also lie in (previously evolved) threat and safeness processing systems. Evolutionary models may need to consider interactions between genetic sensitivities, early experiences of threat/safeness, and later cognitive vulnerabilities. Psychological treatments must address issues of experienced threat and safeness before working on more cognitive competencies.

Although there is evidence that supports the safety of planned home birth for healthy women, less than 1 percent of women in the United States choose to have their baby at home. An ethnographic study of the experience of planned home birth provided rich descriptions of women’s experiences planning, preparing for, and having a home birth. This article describes findings related to how women make the decision to have a planned home birth. For these women, being safe emerged (...) as central in making the decision. For them, being safe included four factors: avoiding technological birth interventions, knowing the midwife and the midwife knowing them, feeling comfortable and protected at home, and knowing that backup hospital medical care was accessible if needed. (shrink)

BackgroundHealthcare professionals are exposed to advertisements for prescription drugs in medical journals. Such advertisements may increase prescriptions of new drugs at the expense of older treatments even when they have no added benefits, are more harmful, and are more expensive. The publication of medical advertisements therefore raises ethical questions related to editorial integrity.MethodsWe conducted a descriptive cross-sectional study of all medical advertisements published in the Journal of the Danish Medical Association in 2015. Drugs advertised 6 times or more were compared (...) with older comparators: comparative evidence of added benefit; Defined Daily Dose cost; regulatory safety announcements; and completed and ongoing post-marketing studies 3 years after advertising.ResultsWe found 158 medical advertisements for 35 prescription drugs published in 24 issues during 2015, with a median of 7 advertisements per issue. Four drug groups and 5 single drugs were advertised 6 times or more, for a total of 10 indications, and we made 14 comparisons with older treatments. We found: ‘no added benefit’ in 4 of 14 comparisons, ‘uncertain benefits’ in 7, and ‘no evidence’ in 3 comparisons. In no comparison did we find evidence of ‘substantial added benefit’ for the new drug; advertised drugs were 2 to 196 times more expensive per Defined Daily Dose; 11 safety announcements for five advertised drugs were issued compared to one announcement for one comparator drug; 20 post-marketing studies were requested for the advertised drugs versus 10 studies for the comparator drugs, and 7 studies assessed both an advertised and a comparator drug at 3 year follow-up.Conclusions and relevanceIn this cross-sectional study of medical advertisements published in the Journal of the Danish Medical Association during 2015, the most advertised drugs did not have documented substantial added benefits over older treatments, whereas they were substantially more expensive. From January 2021, the Journal of the Danish Medical Association no longer publishes medical advertisements. (shrink)

The COVID-19 pandemic has exacerbated the drug poisoning epidemic in a number of ways: individuals use alone more often, there is decreased access to harm reduction services and there has been an increase in the toxicity of the unregulated drug supply. In response to the crisis, clinicians, policy makers and people who use drugs have been seeking ways to prevent the worst harms of unregulated opioid use. One prominent idea is safe supply. One form of safe supply enlists (...) clinicians to prescribe opioids so that people have access to drugs of known composition and strength. In this paper, we assess the ethical case for clinicians providing this service. As we describe, there is much that is unknown about safe supply. However, given the seriousness of the overdose death epidemic and the current limited evidence for safe supply’s efficacy, we argue that it is ethically permissible for clinicians to begin prescribing opioids for some select patients. (shrink)

This essay is an accessible introduction to the proof paradox in legal epistemology. -/- In 1902 the Supreme Judicial Court of Maine filed an influential legal verdict. The judge claimed that in order to find a defendant culpable, the plaintiff “must adduce evidence other than a majority of chances”. The judge thereby claimed that bare statistical evidence does not suffice for legal proof. -/- In this essay I first motivate the claim that bare statistical evidence does not (...) suffice for legal proof. I then introduce and motivate a knowledge-centred explanation of this fact. The knowledge-centred explanation rests on two premises. The first is that legal proof requires knowledge of culpability. The second is that one cannot attain knowledge that p from bare statistical evidence that p. To motivate the second premise, I suggest that beliefs based on bare statistical evidence fail to be safe—they could easily be wrong—and bare statistical evidence cannot eliminate relevant alternatives. -/- I then cast doubt on the first premise; I argue that legal proof does not require knowledge. I thereby dispute the knowledge-centred explanation of the inadequacy of bare statistical evidence for legal proof. Instead of appealing to the nature of knowledge, I suggest we should seek a more direct explanation by appealing to those more foundational epistemic properties, such as safety or eliminating relevant alternatives. (shrink)

The intuitive notion of evidence has both semantic and syntactic features. In this paper, we develop an evidence logic for epistemic agents faced with possibly contradictory evidence from different sources. The logic is based on a neighborhood semantics, where a neighborhood N indicates that the agent has reason to believe that the true state of the world lies in N. Further notions of relative plausibility between worlds and beliefs based on the latter ordering are then defined in (...) terms of this evidence structure, yielding our intended models for evidence-based beliefs. In addition, we also consider a second more general flavor, where belief and plausibility are modeled using additional primitive relations, and we prove a representation theorem showing that each such general model is a p-morphic image of an intended one. This semantics invites a number of natural special cases, depending on how uniform we make the evidence sets, and how coherent their total structure. We give a structural study of the resulting ‘uniform’ and ‘flat’ models. Our main result are sound and complete axiomatizations for the logics of all four major model classes with respect to the modal language of evidence, belief and safe belief. We conclude with an outlook toward logics for the dynamics of changing evidence, and the resulting language extensions and connections with logics of plausibility change. (shrink)

Behind the playful title of this book there is a serious theory about the origin of religions, as well as an argument concerning their usefulness and the truth claims they make. Anyone familiar with Shults's work will recognize this book as a companion to his Theology after the Birth of God—and, to a lesser extent, Iconoclastic Theology: Gilles Deleuze and the Secretion of Atheism—repeating the basic argument but adding an avalanche of more recent research, engaging some different interlocutors, and outlining (...) the virtues of computer modeling as an avenue of inquiry.1 The first and last chapters detail the core of Shults's theory and the evidence for it; the inner ten... (shrink)

What is possible, according to the empiricist conception, is what our evidence positively allows; and what is necessary is what it compels. These notions, along with logical possibility, are the only defensible notions of possibility and necessity. In so far as nomic and metaphysical possibilities are defensible, they fall within empirical possibility. These empirical conceptions are incompatible with traditional possible world semantics. Empirically necessary propositions cannot be defined as those true in all possible worlds. There can be empirical possibilities (...) without empirical necessities. The duality of possibility and necessity can be degenerate and can even be falsified. (shrink)

Recently, Del Ratzsch proposed a new version of the design argument. He argues that belief in a designer is often formed non-inferentially, much like perceptual beliefs, rather than formed by explicit reasoning. Ratzsch traces his argument back to Thomas Reid (1710-1796) who argues that beliefs formed in this way are also justified. In this paper, I investigate whether design beliefs that are formed in this way can be regarded as knowledge. For this purpose, I look closer to recent scientific study (...) of how design beliefs are formed. I argue that the science strongly suggest that people easily form false beliefs. As a result, design beliefs can only constitute knowledge if subjects have additional reasons or evidence for design. (shrink)

As courts become increasingly technologically sophisticated, it can be expected that the use of the latest visualisation techniques will also increase to make the most of this technology. In particular, the use of computer-generated animations can be expected to become more dominant. There is, however, very little research into the effects of animated evidence on jurors and other members of the judicial process. This paper investigates whether there is a difference in the quality and robustness of memories formed by (...) either hearing an oral testimony or seeing an animated version of it. Also, the paper investigates whether different opinions and attitudes are produced when testimony is presented as an animation as opposed to being verbally presented. Preliminary results reported here indicate that there is indeed a difference in attitude (and therefore potential bias) when animations are used instead of verbal testimony, but that this difference is only apparent in the long term (four weeks or more after the presentation of the animated evidence). The results point to the need for improved knowledge structures for mapping verbal testimony into animations, where issues of implicit knowledge and potential bias are explicitly referenced in the knowledge structure. The paper argues that, until and unless such issues are addressed, it is not safe to use animations in court except to present purely factual information. (shrink)

Many theorists hold that outright verdicts based on bare statistical evidence are unwarranted. Bare statistical evidence may support high credence, on these views, but does not support outright belief or legal verdicts of culpability. The vignettes that constitute the lottery paradox and the proof paradox are marshalled to support this claim. Some theorists argue, furthermore, that examples of profiling also indicate that bare statistical evidence is insufficient for warranting outright verdicts.I examine Pritchard's and Buchak's treatments of these (...) three kinds of case. Pritchard argues that his safety condition explains the insufficiency of bare statistical evidence for outright verdicts in each of the three cases, while Buchak argues that her treatment of the distinction between credence and belief explains this. In these discussions the three kinds of cases – lottery, proof paradox, and profiling – are treated alike. The cases are taken to exhibit the same epistemic features. I identity significant overlooked epistemic differences amongst these three cases; these differences cast doubt on Pritchard's explanation of the insufficiency of bare statistical evidence for outright verdicts. Finally, I raise the question of whether we should aim for a unified explanation of the three paradoxes. (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)

American medicine has long sought to control the standard of care that physicians are expected to provide to their patients. One effort to insulate the standard of care from external interference, called a “safe harbors” approach, would enable physicians to avoid liability for malpractice if they adhered to medical practice guidelines. The idea is to eliminate the “battle of experts” and reduce defensive medicine by requiring judges and juries to accept guidelines as conclusive evidence of the standard of (...) care. Yet current efforts to improve the guideline development process, including the use of evidence-based guidelines, are unlikely to be able to overcome the shortcomings that led a similar safe harbors initiative to fail in the early 1990s. Moreover, there is no adequate justification for conferring this degree of self-regulatory power on the medical profession. (shrink)

Institutional corruption is a normative concept of growing importance that embodies the systemic dependencies and informal practices that distort an institution’s societal mission. An extensive range of studies and lawsuits already documents strategies by which pharmaceutical companies hide, ignore, or misrepresent evidence about new drugs; distort the medical literature; and misrepresent products to prescribing physicians. We focus on the consequences for patients: millions of adverse reactions. After defining institutional corruption, we focus on evidence that it lies behind the (...) epidemic of harms and the paucity of benefits. (shrink)

Over the past 35 years, patients have suffered from a largely hidden epidemic of side effects from drugs that usually have few offsetting benefits. The pharmaceutical industry has corrupted the practice of medicine through its influence over what drugs are developed, how they are tested, and how medical knowledge is created. Since 1906, heavy commercial influence has compromised congressional legislation to protect the public from unsafe drugs. The authorization of user fees in 1992 has turned drug companies into the FDA's (...) prime clients, deepening the regulatory and cultural capture of the agency. Industry has demanded shorter average review times and, with less time to thoroughly review evidence, increased hospitalizations and deaths have resulted. Meeting the needs of the drug companies has taken priority over meeting the needs of patients. Unless this corruption of regulatory intent is reversed, the situation will continue to deteriorate. We offer practical suggestions including: separating the funding of clinical trials from their conduct, analysis, and publication; independent FDA leadership; full public funding for all FDA activities; measures to discourage R&D on drugs with few, if any, new clinical benefits; and the creation of a National Drug Safety Board. (shrink)

Self-driving cars promise solutions to some of the hazards of human driving but there are important questions about the safety of these new technologies. This paper takes a qualitative social science approach to the question ‘how safe is safe enough?’ Drawing on 50 interviews with people developing and researching self-driving cars, I describe two dominant narratives of safety. The first, safety-in-numbers, sees safety as a self-evident property of the technology and offers metrics in an attempt to reassure the (...) public. The second approach, safety-by-design, starts with the challenge of safety assurance and sees the technology as intrinsically problematic. The first approach is concerned only with performance—what a self-driving system does. The second is also concerned with why systems do what they do and how they should be tested. Using insights from workshops with members of the public, I introduce a further concern that will define trustworthy self-driving cars: the intended and perceived purposes of a system. Engineers’ safety assurances will have their credibility tested in public. ‘How safe is safe enough?’ prompts further questions: ‘safe enough for what?’ and ‘safe enough for whom?’. (shrink)

Iowa Gambling Task (IGT) is one of the most widely used tools to assess economic decision-making. However, the research tradition on aging and the Iowa Gambling Task (IGT) has been mainly focused on the overall performance of older adults in relation to younger or clinical groups, remaining unclear whether older adults are capable of learning along the task. We conducted a meta-analysis to examine older adults’ decision-making on the IGT, to test the effects of aging on reversal learning (45 studies) (...) and to provide normative data on total and block net scores (55 studies). From the accumulated empirical evidence, we found an average total net score of 7.55 (± 25.9). We also observed a significant reversal learning effect along the blocks of the IGT, indicating that older adults inhibit the prepotent response towards immediately attractive options associated with high losses, in favor of initially less attractive options associated with long-run profit. During block 1, decisions of older adults led to a negative gambling net score, reflecting the expected initial pattern of risk-taking. However, the shift towards more safe options occurred between block 2 (small-to-medium effect size) and blocks 3, 4, 5 (medium-to-large effect size). These main findings highlight that older adults are able to move from the initial uncertainty, when the possible outcomes are unknown, to decisions based on risk, when the outcomes are learned and may be used to guide future adaptive decision-making. (shrink)

If non-human animals have high moral status, then we commit a grave moral error by eating them. Eating animals is thus morally risky, while many agree that it is morally permissible to not eat animals. According to some philosophers, then, non-animal ethicists should err on the side of caution and refrain from eating animals. I argue that this precautionary argument assumes a false dichotomy of dietary options: a diet that includes farm-raised animals or a diet that does not include animals (...) of any kind. There is a third dietary option, namely, a diet of plants and non-traditional animal protein, and there is evidence that such a diet results in the least amount of harm to animals. It follows therefore that moral uncertainty does not support the adoption of a vegetarian diet. (shrink)

We are likely to have immersive virtual reality and ubiquitous augmented reality in the coming decades. At least some people will use extended reality or “the metaverse” to work, play and shop. In order to achieve the best possible versions of this virtual future, however, we will need to learn from three decades of regulating the Internet. The new virtual world cannot consist of walled corporate fiefdoms ruled only by profitmaximization. The interests of workers, consumers and citizens in virtuality require (...) proactive legislation and oversight. -/- This white paper first addresses the central question the metaverse poses, whether virtual life is inherently more alienating and less authentic than face-to-face life experiences. This question is both a philosophical question about the nature of the good life and an empirical question about the accumulating evidence about the impacts of the digital on subjective well-being. -/- . (shrink)

Over the past year media outlets and scientific and bioethics journals have reported about several medical and scientific innovations touted as having the potential to fundamentally change not only how diseases and disorders are diagnosed and treated but even how to alter the genomes of future generations. The purported “miracle” blood-testing technology of Theranos and the potential use of the genome editing technology CRISPR-Cas9 to modify human and nonhuman organisms reflect dramatic advances in scientific understanding about the biological mechanisms of (...) humans and other living organisms. Yet evidence about whether these and other innovative biomedical technologies are safe and effective and lead to improved health outcomes for patients young and old is often in dispute. How to assess the safety and effectiveness of innovative biomedical technologies, who should be involved in that effort, and how to define risks and benefits of those technologies are questions at the intersection of values, interests, and politics. (shrink)

Competent risk management is central to the ethical conduct and profitability of organisations including universities. Recent UK research highlights the risks of physical and psychological harm and emotional distress for researchers and the importance of developing strategies to deal with these issues prior to data being collected. Actual numbers of incidents of researcher harm in Australian universities are unavailable; however anecdotal evidence and Bloor et al.’s ( 2010 ) case studies suggest that this is a significant issue. They recommended (...) risk management practices such as training about researcher safety, pre-trip security briefings, established call-back systems, working in pairs, and compulsory de-briefings are recommended. Yet Australian universities do little to protect the safety of field researchers when they collect data in private locations, such as participants’ homes and when dealing with emotionally challenging content. This is at odds with the duty of care requirements on employers in current state based occupational health and safety (OHS) laws where breaches attract considerable penalties. The failure to adequately address the potential safety hazards and manage the risks associated with data collection places Australian universities in a vulnerable position, and possibly at risk of litigation, in their duty to adequately protect researchers. The paper presents a review of the international literature and draws on the UK research. Conceptual modelling is provided to illustrate the risk to universities if researchers are harmed in the field. Finally, the paper concludes with a call for further research to develop robust policy and practice that protects the field researcher. (shrink)

BackgroundDepressive disorders are a common form of psychiatric illness and cause significant disability. Regulation authorities, the medical profession and the public require high safety standards for antidepressants to protect vulnerable psychiatric patients. Ketamine is a dissociative anaesthetic and a derivative of a hallucinogen. Its abuse is a major worldwide public health problem. Ketamine is a scheduled drug and its usage is restricted due to its abuse liability. Recent clinical trials have reported that ketamine use led to rapid antidepressant effects in (...) patients suffering from treatment-resistant depression. However, various flaws in study designs, and possible biased reporting of results, may have influenced those findings. Further analyses of ketamine use are needed to ensure patient safety.DiscussionThe use of ketamine in research and treatment of depressive disorders is controversial. Recently, mental health professionals raised ethical concerns about an ongoing ketamine trial in the UK. Also, a Canadian agency reviewed the existing evidence and did not recommend prescribing ketamine to treat depressive disorders. Findings obtained from tightly controlled research settings cannot be easily translated to clinical practice as substance abuse is commonly comorbid with depressive disorders. An effective antidepressant should reduce severity of depressive symptoms without liability problems. Although the US FDA has not approved the use of ketamine to treat depressive disorders, some psychiatrists offer off-label repeat prescription of ketamine. Prescribing ketamine for treating depressive disorders requires substantial empirical evidence. Clinicians should also consider research findings on ketamine abuse. Depressive disorders can be chronic conditions and the current evidence does not rule out the risk of substance abuse after repeat prescription of ketamine. Off-label ketamine use in treating depressive disorders may breach ethical and moral standards, especially in countries seriously affected by ketamine abuse. This article presents two real-world clinical vignettes which highlight ethical principles and theories, including autonomy, nonmaleficience, fidelity and consequentialism, as related to off-label ketamine use.ConclusionWe urge clinicians to minimise the risk of harming patients by considering the empirical evidence on ketamine properties and attempting all standard antidepressant therapies before considering the off-label use of ketamine. (shrink)

While children’s experiences of online risks and harm is a growing area of research in New Zealand, public discussion on the matter has largely been informed by mainstream media’s fixation on the dangers of technology. At best, debate on risks online has relied on overseas evidence. However, insights reflecting the New Zealand context and based on representative data are still needed to guide policy discussion, create awareness, and inform the implementation of prevention and support programmes for children. This research (...) report presents findings from a quantitative study regarding different aspects related to risks and online safety. It looks at the online experiences that children find bothersome and upsetting and explores the hurtful behaviours they encounter or engage in, both online and in person. Evidence regarding exposure to different types of potentially harmful online content is also presented. Another relevant contribution is the insights related to excessive internet use.The findings presented in this report are based on data from 2,061 New Zealand children aged 9-17. We hope the findings will contribute to the development of policies, practices and services designed to support New Zealand children to safely take advantage of the opportunities available to them online. (shrink)

One of harm reduction’s most salient features is its pragmatism. Harm reduction purports to distinguish itself from dominant prohibitionist and abstinence-based policy paradigms by being grounded in what is realistic, in contrast with the moralism or puritanism of prohibition and abstention. This is reflected in the meme “harm reduction works”, popular both in institutional and grassroots settings. The idea that harm reduction is realistic and effective has meant different things among the main actors who seek to shape harm reduction policy. (...) Drawing on scholarly literature about harm reduction, as well as examples from recent harm reduction advocacy efforts in relation to drug policy in Canada, this paper argues that harm reduction distinguishes itself through a unique “way of knowing”. Grassroots harm reduction advocates, particularly as they argue through human rights frameworks, do more than simply make claims for the provision of particular services—like needle exchange, safe consumption sites, safe supply and the like—on the basis that these are realistic paths toward the health and well-being of people who use drugs. Rather, as they marshal lived experience in support of these policy changes through peer-driven initiatives in contexts of prohibition, they make particular claims about what constitute valid, methodologically rigorous evidence bases for action in contexts where policies to date have been driven by ideology and have developed in ways that have excluded and marginalized those most affected from policymaking. In doing so, they advocate for the centrality of people who use drugs not only in policy-making processes, but in evidence production itself. (shrink)

Do privacy rights restrict what is permissible to infer about others based on statistical evidence? This paper replies affirmatively by defending the following symmetry: there is not necessarily a morally relevant difference between directly appropriating people’s private information—say, by using an X-ray device on their private safes—and using predictive technologies to infer the same content, at least in cases where the evidence has a roughly similar probative value. This conclusion is of theoretical interest because a comprehensive justification of (...) the thought that statistical inferences can violate privacy rights is lacking in the current literature. Secondly, the conclusion is of practical interest due to the need for moral assessment of emerging predictive algorithms. (shrink)

As a generation of ‘digital natives,’ secondary students who were born from 2002 to 2010 have various approaches to acquiring digital knowledge. Digital literacy and resilience are crucial for them to navigate the digital world as much as the real world; however, these remain under-researched subjects, especially in developing countries. In Vietnam, the education system has put considerable effort into teaching students these skills to promote quality education as part of the United Nations-defined Sustainable Development Goal 4 (SDG4). This issue (...) has proven especially salient amid the COVID−19 pandemic lockdowns, which had obliged most schools to switch to online forms of teaching. This study, which utilizes a dataset of 1061 Vietnamese students taken from the United Nations Educational, Scientific, and Cultural Organization (UNESCO)’s “Digital Kids Asia Pacific (DKAP)” project, employs Bayesian statistics to explore the relationship between the students’ background and their digital abilities. Results show that economic status and parents’ level of education are positively correlated with digital literacy. Students from urban schools have only a slightly higher level of digital literacy than their rural counterparts, suggesting that school location may not be a defining explanatory element in the variation of digital literacy and resilience among Vietnamese students. Students’ digital literacy and, especially resilience, also have associations with their gender. Moreover, as students are digitally literate, they are more likely to be digitally resilient. Following SDG4, i.e., Quality Education, it is advisable for schools, and especially parents, to seriously invest in creating a safe, educational environment to enhance digital literacy among students. (shrink)

The creative thinking and ability of top management team members is important in coping with rapid changes in the external environment and improving the competitive advantage of an organization. This research focuses on the CEO–TMT interface to explain how CEOs influence TMT characteristics, which in turn affects TMT outcomes. Based on social learning theory, this study examines the associations among CEO ethical leadership, TMT cohesion and TMT creativity in a Chinese context using a total of 91 top management teams. To (...) verify the reliability and validity of the constructs, a series of confirmatory factor analyses (CFAs) were run. The results showed that the hypothesized model captured distinct constructs and fits the data well. Multistep regression method was used to test hypotheses. The results indicated that (a) CEO ethical leadership has a positive effect on TMT creativity; (b) TMT cohesion plays a mediating role in the relationship between CEO ethical leadership and TMT creativity; and (c) power distance plays a moderating role in the relationship between CEO ethical leadership and TMT creativity. The greater the power distance, the weaker the positive relationship between CEO ethical leadership and TMT creativity. This study demonstrates the value of CEO ethical leadership and advocates the importance of establishing team cohesion and building a psychologically safe environment to motivate top managers within an organization to share information and knowledge to improve creativity. (shrink)

This paper proposes an extended version of the interventionist account for causal inference in the practical context of biological mechanism research. This paper studies the details of biological mechanism researchers’ practices of assessing the evidential legitimacy of experimental data, arguing why quantity and variety are two important criteria for this assessment. Because of the nature of biological mechanism research, the epistemic values of these two criteria result from the independence both between the causation of data generation and the causation in (...) question and between different interventions, not techniques. The former independence ensures that the interventions in the causation in question are not affected by the causation that is responsible for data generation. The latter independence ensures the reliability of the final mechanisms not only in the empirical but also the formal aspects. This paper first explores how the researchers use quantity to check the effectiveness of interventions, where they at the same time determine the validity of the difference-making revealed by the results of interventions. Then, this paper draws a distinction between experimental interventions and experimental techniques, so that the reliability of mechanisms, as supported by the variety of evidence, can be safely ensured in the probabilistic sense. The latter process is where the researchers establish evidence of the mechanisms connecting the events of interest. By using case studies, this paper proposes to use ‘intervention’ as the fruitful connecting point of literature between evidence and mechanisms. (shrink)

Owing to the adverse impact of the COVID-19 pandemic on world economies, it is expected that information flows between commodities and uncertainties have been transformed. Accordingly, the resulting twisted risk among commodities and related uncertainties is presumed to rise during stressed market conditions. Therefore, investors feel pressured to find safe haven investments during the pandemic. For this reason, we model a mixture of asymmetric and non-linear bi-directional causality between global commodities and uncertainties at different frequencies through the information flow (...) theory. Consequently, we utilise the complete ensemble empirical mode decomposition with adaptive noise and the Rényi effective transfer entropy techniques to establish the dynamic flow of information. The intrinsic mode functions from the CEEMDAN are carefully extracted into multi-frequencies through cluster analysis to reconstruct the series into high, medium, and low frequencies in addition to the residue. We utilise daily data from December 31st, 2019, to March 31st, 2021, to provide insights into the COVID-19 pandemic. The correlation coefficients and variances demonstrate that the high frequency which measures the short-term dynamics is the dominant frequency, suggesting short-lived market fluctuations relative to real economic growth for institutional investors. Moreover, outcomes from the multi-frequency entropy indicate a negative bi-directional causality of information flow between global commodities and uncertainties, especially in the long term. Generally, the findings present pertinent inferences for portfolio diversification, policy decisions, and risk management schemes for global commodities and markets volatilities. We, therefore, advocate that market volatilities act as effective hedges for global commodities, and they clearly act as balancing assets rather than substitutes in the long-term dynamics of the COVID-19 pandemic. Investors who delayed in investing within financial markets of commodities and market volatilities are likely to minimise their portfolio risks. (shrink)

We investigated if emotion regulation can be improved through self-regulation training on non-emotional brain regions, as well as how to change the brain networks implicated in this process. During the training period, the participants were instructed to up-regulate their right dorsolateral prefrontal cortex activity according to real-time functional near-infrared spectroscopy neurofeedback signals, and there was no emotional element. The results showed that the training significantly increased emotion regulation, resting-state functional connectivity within the emotion regulation network and frontoparietal network, and rsFC (...) between the ERN and amygdala; however, training did not influence the rsFC between the FPN and the amygdala. However, self-regulation training on rDLPFC significantly improved emotion regulation and generally increased the rsFCs within the networks; the rsFC between the ERN and amygdala was also selectively increased. The present study also described a safe approach that may improve emotion regulation through self-regulation training on non-emotional brain regions. (shrink)

The threat simulation theory of dreaming states that dream consciousness is essentially an ancient biological defence mechanism, evolutionarily selected for its capacity to repeatedly simulate threatening events. Threat simulation during dreaming rehearses the cognitive mechanisms required for efficient threat perception and threat avoidance, leading to increased probability of reproductive success during human evolution. One hypothesis drawn from TST is that real threatening events encountered by the individual during wakefulness should lead to an increased activation of the system, a threat simulation (...) response, and therefore, to an increased frequency and severity of threatening events in dreams. Consequently, children who live in an environment in which their physical and psychological well-being is constantly threatened should have a highly activated dream production and threat simulation system, whereas children living in a safe environment that is relatively free of such threat cues should have a weakly activated system. We tested this hypothesis by analysing the content of dream reports from severely traumatized and less traumatized Kurdish children and ordinary, non-traumatized Finnish children. Our results give support for most of the predictions drawn from TST. The severely traumatized children reported a significantly greater number of dreams and their dreams included a higher number of threatening dream events. The dream threats of traumatized children were also more severe in nature than the threats of less traumatized or non-traumatized children. (shrink)

The paper attempts to give an account of the introspective self-knowledge of our own experiences which is in line with representationalism about phenomenal consciousness and the transparency of experience. A two-step model is presented. First, a demonstrative thought of the form ‚I am experiencing this’ is formed which refers to what one experiences, by means of attention. Plausibly, this thought is knowledge, since safe. Second, a non-demonstrative thought of the form ‚I am experiencing a pain’ occurs. This second self-ascription (...) is justified inferentially, on the basis of the first, demonstrative thought. Thus, an account of introspective experiential self-knowledge can be developed which is richer and more adequate to the phenomena than pure reliabilism and Dretske’s displaced perception model. There is really such a thing as introspection, but no inner sense. (shrink)

This paper examines the spillover effect between bitcoin, gold, crude oil, and major stock markets by using the MSV model with dynamic correlation and Granger causality. The empirical results of the DC-GC-MSV model are logically correct and convergent. The DIC test result has proved that the DC-GC-MSV model is better and more accurate. Bitcoin has no significant Granger causality spillover effect than other assets. As a safe haven product for stock assets, gold price has one-way spillover effect from stock (...) market volatility. Moreover, crude oil has the highest correlation with the stock market. In the recent COVID-19 epidemic and the sluggish economic environment, investors need to consider a balanced asset allocation among low-correlation assets, medium-correlation assets, and high-correlation assets to reduce risks. (shrink)

Detecting and correcting execution errors is crucial for safe and efficient goal-directed behavior. Despite intensive investigations on error processing, the cognitive foundations of this process remain unclear. Based on the presumed relation between executive attention and error processing, we implemented a seven-day EA intervention by adopting the Posner cueing paradigm to test the potential causal link from EA to error processing in healthy adults. The experimental group was trained on the Posner cueing paradigm, with a ratio of invalid cue (...) trials to valid cue trials of 5:1 and a corresponding ratio of 1:1 in the active control group. We found that the EA intervention improved EA across intervention sessions. Critically, after the EA intervention, the HEA group showed that post-error accuracy was restored to the same level as the post-correct accuracy. However, post-error slowing and the flanker effect were not modulated by the EA intervention. Furthermore, we observed that the changes in the accuracy of VC trials positively predicted the changes in PEA and that the two groups were classified according to the changes in PEA with a 61.3% accuracy. Based on these results, we propose that EA causally drives error processing. And the capabilities of the “actively catch” more attention resources and the automatic mismatch processing developed after EA intervention is transferable to error processing, thereby directly resulting in the gains in post-error adjustments. Our work informs the potential cognitive mechanisms underlying this causal link. (shrink)

Nurses in Ghana believe that training, practise, practitioner and policy reforms are required for total nursing profession reform to be effective. Their views for role reformation in the nursing profession, which is currently needed, are not only academic but also clinically relevant in the pursuit of health equity and quality nursing care. We explored and described nurses’ views on their roles in the profession using data collected from 24 professional nurses in three regional hospitals in Ghana. Using an inductive descriptive (...) qualitative design, data were gathered and analysed using a qualitative content analysis to describe the views of the nurses. Four major themes, namely practise reforms, practitioner reforms, training reforms and policy reforms have emerged in relation to role reformation in the nursing profession. Three strategic areas, practitioner attitudes, new training modalities and policy realignment, must be reviewed and remodelled for better positioning of the nursing profession before its entire role reformation. (shrink)