Two of the most important concepts in medicine are “curing” and “caring”. Patients should enter clinical trials with the understanding that they benefit from the treatment or that there may be some benefit to others. In many cancer trials, for example, the best that can be hoped for is a prolongation of life. Whether or not life is prolonged, we argue that there exists an obligation which can be termed a “bond of responsibility” to provide appropriate palliative care within the (...) patient’s own cultural context.The Declaration of Helsinki,1 the principal code governing the conduct of medical research, shows this “bond of responsibility” to be at its core. A number of statements stand out: “the health of my patient will be my first consideration”2 and “a physician shall only act in a patient’s best interest when providing medical care which might have the effect of weakening the physical and mental …. (shrink)

Déjà vu is the striking sense that the present situation feels familiar, alongside the realization that it has to be new. According to the Gestalt familiarity hypothesis, déjà vu results when the configuration of elements within a scene maps onto a configuration previously seen, but the previous scene fails to come to mind. We examined this using virtual reality technology. When a new immersive VR scene resembled a previously-viewed scene in its configuration but people failed to recall the previously-viewed scene, (...) familiarity ratings and reports of déjà vu were indeed higher than for completely novel scenes. People also exhibited the contrasting sense of newness and of familiarity that is characteristic of déjà vu. Familiarity ratings and déjà vu reports among scenes recognized as new increased with increasing feature-match of a scene to one stored in memory, suggesting that feature-matching can produce familiarity and déjà vu when recall fails. (shrink)

' a welcome guide for researchers to the merging fields of neuroscience, linguistics and psycholinguistics.' BRAIN'... an important and captivating book, one that has been long awaited by all researchers interested in language and the brain.' Trends in Cognitive Sciences, 1999. The Neurocognition of Language brings together experts on human language and the brain to present the first critical overview of the cognitive neuroscience of language, one of the fastest-moving and most exciting areas today. In-depth discussion of the representations and (...) structures of language, as well as of the cognitive architectures which underlie speaking, listening, and reading, will provide a basis for future brain imaging research. In addition, the existing brain imaging literature on word and sentence processing is critically reviewed, as well as contributions from brain lesion data. Finally, the book discusses the prospects and problems of brain imaging techniques for the study of language, presents some of the most recent and promising analytic procedures for relating brain imaging data to the higher cognitive functions, and contains a review of the neuroanatomical structure of Broca's language area. Uniquely interdisciplinary, this book will provide researchers and students in cognitive neuroscience with state-of-the-art reviews of the major language functions, while being of equal interest to researchers in linguistics and language who want to learn about the neural bases of language. It will be an essential purchase for anyone requiring an overview of our current understanding of the relation between language and the brain. (shrink)

There has been much philosophical interest regarding the ‘hierarchy of evidence’ used to determine which study designs are of most value for reporting on questions of effectiveness, prognosis, and so on. There has been much less philosophical interest in the choice of outcome measures with which the results of, say, an RCT or a cohort study are presented. In this paper, we examine the FDA’s recently published guidelines for assessing the psychometric adequacy of patient-reported outcome measures. We focus on their (...) recommendations for demonstrating content validity and also for how researchers should weigh up the sum of psychometric evidence when choosing these measures. We argue that questions regarding judgment and understanding meaning of these measures should play a more central role in determining their adequacy. (shrink)

In recent years, we have seen a new concern with ethics training for research and development professionals. Although ethics training has become more common, the effectiveness of the training being provided is open to question. In the present effort, a new ethics training course was developed that stresses the importance of the strategies people apply to make sense of ethical problems. The effectiveness of this training was assessed in a sample of 59 doctoral students working in the biological and social (...) sciences using a pre–post design with follow-up and a series of ethical decision-making measures serving as the outcome variable. Results showed not only that this training led to sizable gains in ethical decision making but also that these gains were maintained over time. The implications of these findings for ethics training in the sciences are discussed. (shrink)

Background Empirical studies of surrogate decision-making tend to assume that surrogates should make only a 'substituted judgement'—that is, judge what the patient would want if they were mentally competent. Objectives To explore what people want in a surrogate decision-maker whom they themselves select and to test the assumption that people want their chosen surrogate to make only a substituted judgement. Methods 30 undergraduate students were recruited. They were presented with a hypothetical scenario about their expected loss of mental capacity in (...) the future and asked to answer some questions about their choice of surrogate. These data were analysed qualitatively using thematic content analysis. Results Most respondents talked about choosing someone who was caring and competent in certain ways, giving interesting evidence for their judgements. Surprisingly few highlighted how well they thought their chosen surrogate knew their preferences and would be able to make a substituted judgement. Moreover, few specified that their chosen surrogate had similar attitudes and values to their own and so would make a similar decision to theirs in the circumstances presented. Some respondents also referred to the social role of their chosen surrogate or the social dynamics of their situation which influenced their choices, as well as to ideas of reciprocity and characteristics of honesty and loyalty. Conclusion In the event that they lose mental capacity, many people will not select a surrogate to decide about medical treatments on their behalf solely on the basis that they expect their surrogate to make a substituted judgement. (shrink)

In this paper we continue an ongoing dialogue that has as its goal the critical appraisal of theoretical perspectives on culture and health, in an effort to move forward scholarship on culture and health. We draw upon a programme of scholarship to explicate theoretical tensions and challenges that are manifest in the discourses on culture and health and to explore the possibilities Bourdieu's theoretical perspective offers for reconciling them. That is, we hope to demonstrate the need to move beyond descriptions (...) ‘of’ culture to an understanding of cultures as dynamic, and to show ways cultural practices create contexts that have the potential to foster or impede health.In our early research, largely undertaken in Canada's multicultural context, we sought to make visible the ways in which culture shaped conceptions of health and influenced health practices of immigrant groups. In recent years this focus has expanded to include populations that reflect the cultural and social diversity of our region. From the outset we attempted to move towards a conception of culture as negotiated, unifying, transformative and dynamic. While this position continues to hold appeal we are continually reminded that, despite our leanings towards constructivism, there is salience to the notion of culture as having enduring elements. It is this tension between the view of culture as embodied and enduring and culture as constructed and dynamic that we seek to examine.We explore whether Bourdieu's theoretical perspective offers promise for reconciling these apparently competing views. Using exemplars from our research we share insights that Bourdieu's work has offered to our analyses, thereby enabling us to move towards a view of culture that holds in tension these apparently contradictory positions of culture as both essence (albeit unstable, negotiated) and constructed. (shrink)

This paper reports the introduction of electronic handsets, like those used on the television show 'Who Wants To Be A Millionaire?' into the teaching of philosophical logic. Logic lectures can provide quite a formidable challenge for many students, occasionally to the point of making them ill. Our rationale for introducing handsets was threefold: to get the students thinking and talking about the subject in a public environment; to make them feel secure enough to answer questions in the lectures because the (...) system enabled them to do this anonymously; and to build their confidence about their learning by their being able to see how they were progressing in relation to the rest of the students in the class. We have achieved all of these and more. Our experience has revealed that the use of handsets encourages a more dynamic form of student interaction in an environment - the lecture - that can, in the wrong hands, be utterly enervating, but they also provide an opportunity for the lecturer to respond to students' difficulties at the time when they really matter. In this paper, we discuss our case of rapid adoption, our grounds for judging it a success, and what that success seems to have depended on. (shrink)

Although activated spinal cord glia contribute importantly to neuropathic pain, how nerve injury activates glia remains controversial. It has recently been proposed, on the basis of genetic approaches, that toll-like receptor 4 may be a key receptor for initiating microglial activation following L5 spinal nerve injury. The present studies extend this idea pharmacologically by showing that TLR4 is key for maintaining neuropathic pain following sciatic nerve chronic constriction injury. Established neuropathic pain was reversed by intrathecally delivered TLR4 receptor antagonists derived (...) from lipopolysaccharide. Additionally, -naltrexone, -naloxone, and -naloxone, which we show here to be TLR4 antagonists in vitro on both stably transfected HEK293-TLR4 and microglial cell lines, suppressed neuropathic pain with complete reversal upon chronic infusion. Immunohistochemical analyses of spinal cords following chronic infusion revealed suppression of CCI-induced microglial activation by -naloxone and -naloxone, paralleling reversal of neuropathic pain. Together, these CCI data support the conclusion that neuron-to-glia signaling through TLR4 is important not only for initiating neuropathic pain, as suggested previously, but also for maintaining established neuropathic pain. Furthermore, these studies suggest that the novel TLR4 antagonists -naloxone and -naloxone can each fully reverse established neuropathic pain upon multi-day administration. This finding with -naloxone is of potential clinical relevance. This is because -naloxone is an antagonist that is inactive at the -opioid selective receptors on neurons that produce analgesia. Thus, these data suggest that -opioid antagonists such as -naloxone may be useful clinically to suppress glial activation, yet -opioid agonists suppress pain. (shrink)

In three studies, factors influencing the incidence of fraudulent financial reporting were assessed. We examined (1) the effects of personal values and (2) codes of corporate conduct, on whether managers misrepresented financial reports. In these studies, executives and controllers were asked to respond to hypothetical situations involving fraudulent financial reporting procedures. The occurrence of fraudulent reporting was found to be high; however, neither personal values, codes of conduct, nor the interaction of the two factors played a significant role in fraudulent (...) financial reporting. (shrink)

Despite the lack of invariance problem (the many‐to‐many mapping between acoustics and percepts), human listeners experience phonetic constancy and typically perceive what a speaker intends. Most models of human speech recognition (HSR) have side‐stepped this problem, working with abstract, idealized inputs and deferring the challenge of working with real speech. In contrast, carefully engineered deep learning networks allow robust, real‐world automatic speech recognition (ASR). However, the complexities of deep learning architectures and training regimens make it difficult to use them to (...) provide direct insights into mechanisms that may support HSR. In this brief article, we report preliminary results from a two‐layer network that borrows one element from ASR, long short‐term memory nodes, which provide dynamic memory for a range of temporal spans. This allows the model to learn to map real speech from multiple talkers to semantic targets with high accuracy, with human‐like timecourse of lexical access and phonological competition. Internal representations emerge that resemble phonetically organized responses in human superior temporal gyrus, suggesting that the model develops a distributed phonological code despite no explicit training on phonetic or phonemic targets. The ability to work with real speech is a major advance for cognitive models of HSR. (shrink)

In this article, we focus on the concept of leadership ethics and make observations about transformational, transactional and servant leadership. We consider differences in how each definition of leadership outlines what the leader is supposed to achieve, and how the leader treats people in the organization while striving to achieve the organization's goals. We also consider which leadership styles are likely to be more popular in organizations that strive to maximize short run profits. Our paper does not tout or degrade (...) any of these leadership theories. Instead, it points out which theories allow reason to play more than a minimal role in ethical decision-making, as well as those that are most consistent with a firm's desire to achieve efficiency in the short run. We explain our view that the way leadership is practiced in large, bureaucratic organizations suggests that ethics is often absent from the leader's decision-making process. Consequently, we suggest that before we engage in a meaningful dialogue about what kind of leaders we might really want in business, we must consider how much short-run profit we are willing to forego in exchange for more ethical corporate cultures. (shrink)

Interactive narratives are inextricable from the way that we understand our encounters with digital technology. This is based upon the way that these encounters are processually formed into a narrative of episodic events, arranged and re-arranged by various levels of agency. After describing past research conducted at the iCinema Research Centre at the University of New South Wales, this paper sets out a framework within which to build a relational theory of interactive narrative formation, outlining future research in the area.

I do four things in responding to Patrick Toner’s incisive critique of my Aquinas and the Ship of Theseus (AST). First, I further motivate Aquinas’s position that Socrates exists in the post-mortem and ante-resurrection state by noting that Socrates’ situation is at least analogous to other states of affairs that would certainly count as atypical (although not impossible). Secondly, I offer a revised Thomistic account of artefact identity through time in light of Toner’s objections to Aquinas’srestrictive view. Unlike the restrictive (...) view, this revised account is compatible with common-sense intuitions. Thirdly, I show how my defense of Aquinas’s substance metaphysic in AST is useful for the purpose of constructing defeators for certain kinds of arguments for reductionism. Fourthly, I defend Aquinas’s views on the unity of substance against Toner’s suggestion that they are implausible on the grounds that they are in conflict with certain so-called “scientifically informed”common-sense beliefs. (shrink)

The adaptationist framework is necessary and sufficient for unifying the social and natural sciences. Gintis's “beliefs, preferences, and constraints” (BPC) model compares unfavorably to this framework because it lacks criteria for determining special design, incorrectly assumes that standard evolutionary theory predicts individual rationality maximisation, does not adequately recognize the impact of psychological mechanisms on culture, and is mute on the behavioural implications of intragenomic conflict. (Published Online April 27 2007).

I do four things in responding to Patrick Toner’s incisive critique of my Aquinas and the Ship of Theseus (AST). First, I further motivate Aquinas’s position that Socrates exists in the post-mortem and ante-resurrection state by noting that Socrates’ situation is at least analogous to other states of affairs that would certainly count as atypical (although not impossible). Secondly, I offer a revised Thomistic account of artefact identity through time in light of Toner’s objections to Aquinas’srestrictive view. Unlike the restrictive (...) view, this revised account is compatible with common-sense intuitions. Thirdly, I show how my defense of Aquinas’s substance metaphysic in AST is useful for the purpose of constructing defeators for certain kinds of arguments for reductionism. Fourthly, I defend Aquinas’s views on the unity of substance against Toner’s suggestion that they are implausible on the grounds that they are in conflict with certain so-called “scientifically informed”common-sense beliefs. (shrink)

The current study examined the effects of an intervention aimed at blocking the transfer of frustration from a previous experience (i.e. recall task) to a subsequent and unrelated task (i.e. ultimatum bargaining task). Participants who went through the intervention were more likely to accept unfair offers in the ultimatum bargaining task than those who did not go through the intervention. These results show that participants who were blocked from transferring their feelings of frustration from the recall task to the subsequent (...) bargaining task (no-transfer condition) more likely accepted unfair offers than those who inadvertently transferred their feelings of frustration (transfer condition). The effect of conditions on accept-reject decisions in the ultimatum bargaining was mediated by reported feelings of frustration. (shrink)

It is claimed by the future like ours anti-abortion argument that since killing adult humans is wrong because it deprives them of a future of value and the fetus has a future of value, killing fetuses is wrong in the same way that killing adult human beings is wrong. In The morality of abortion and the deprivation of futures (this journal, April 2000) I argued that the persuasive power of this argument rests upon an equivocation on the term “future of (...) value”. If the expression means “a potential future of value” then the moral claim is implausible because people do not in general have rights to what they need to fulfill their potential; if the expression means “self-represented future of value” then the argument fails because the fetus does not represent its future. Under no interpretation is the argument sound. In Deprivations, futures and the wrongness of killing (this journal, December 2001) Donald Marquis, author of the future like ours argument, responds at length to this objection. In the present essay the focus of the debate shifts to the proper interpretation of the right not to be killed. Donald Marquis argues that this liberty right entails the welfare right to the means necessary to sustain life; I argue that the right not to be killed does not entail unlimited welfare rights. On Marquis's view, the right not to be killed confers upon the fetus the right to whatever it takes to sustain life; on the view I defend, the right not to be killed does not confer upon the fetus or anyone else the right to another person's body. On Marquis's view, abortion is almost never permissible; on my view abortion is almost always permissible. (shrink)

Continuing the dialogue: postcolonial feminist scholarship and Bourdieu — discourses of culture and points of connection Postcolonial feminist theories provide the analytic tools to address issues of structural inequities in groups that historically have been socially and economically disadvantaged. In this paper we question what value might be added to postcolonial feminist theories on culture by drawing on Bourdieu. Are there points of connection? Like postcolonial feminists, he puts forward a position that aims to unmask oppressive structures. We argue that, (...) while there are points of connection, there are also epistemologic and methodologic differences between postcolonial feminist perspectives and Bourdieu's work. Nonetheless, engagement with different theoretical perspectives carries the promise of new insights — new ways of ‘seeing’ and ‘understanding’ that might enhance a praxis‐oriented theoretical perspective in healthcare delivery. (shrink)