Rips et al. raise important questions about the relation between infant quantification and achievement of natural number concepts. However, they may be oversimplifying the interactions that characterize actual development in real time. Though they propose a worthwhile agenda for future research, its explanatory power will be limited if it does not address developmental issues with greater sensitivity.

In this article, we review approaches to modeling a connection between spatial and mathematical thinking across development. We critically evaluate the strengths and weaknesses of factor analyses, meta-analyses, and experimental literatures. We examine those studies that set out to describe the nature and number of spatial and mathematical skills and specific connections between these abilities, especially those that included children as participants. We also find evidence of strong spatial-mathematical connections and transfer from spatial interventions to mathematical understanding. Finally, we map (...) out the kinds of studies that could enhance our understanding of the mechanisms by which spatial and mathematical processing are connected and the principles by which mathematical outcomes could be enhanced through spatial training in educational settings. (shrink)

Background: Treating medication-refractory freezing of gait in Parkinson’s disease remains challenging despite several trials reporting improvements in motor symptoms using subthalamic nucleus or globus pallidus internus deep brain stimulation. Pedunculopontine nucleus region DBS has been used for medication-refractory FoG, with mixed findings. FoG, as a paroxysmal phenomenon, provides an ideal framework for the possibility of closed-loop DBS.Methods: In this clinical trial, five subjects with medication-refractory FoG underwent bilateral GPi DBS implantation to address levodopa-responsive PD symptoms with open-loop stimulation. Additionally, PPN (...) DBS leads were implanted for CL-DBS to treat FoG. The primary outcome of the study was a 40% improvement in medication-refractory FoG in 60% of subjects at 6 months when “on” PPN CL-DBS. Secondary outcomes included device feasibility to gauge the recruitment potential of this four-lead DBS approach for a potentially larger clinical trial. Safety was judged based on adverse events and explantation rate.Findings: The feasibility of this approach was demonstrated as we recruited five subjects with both “on” and “off” medication freezing. The safety for this population of patients receiving four DBS leads was suboptimal and associated with a high explantation rate of 40%. The primary clinical outcome in three of the five subjects was achieved at 6 months. However, the group analysis of the primary clinical outcome did not reveal any benefit.Interpretation: This study of a human PPN CL-DBS trial in medication-refractory FoG showed feasibility in recruitment, suboptimal safety, and a heterogeneous clinical effect in FoG outcomes. (shrink)

This paper considers how Plato can account for the fact that pain features prominently in the intellectual pleasures of philosophers, given that in his view pleasures mixed with pain are ontologically deficient and inferior to ‘pure,’ painless pleasures. After ruling out the view that Plato does not believe intellectual pleasures are actually painful, I argue that he provides a coherent and overlooked account of pleasure in the Phaedrus, where purity does not factor into the philosopher’s judgment of pleasures at all; (...) what matters instead is the extent to which a given pleasure fosters the philosophical life. I show that to argue, as James Warren has recently done, that Plato thinks intellectual pleasures are not per se painful is less successful than the Phaedrus account at explaining philosophers’ lived experiences of pleasure, which often involve pain. (shrink)

Background Despite the bourgeoning of digital tools for bioethics research, education, and engagement, little research has empirically investigated the impact of interactive visualizations as a way to translate ethical frameworks and guidelines. To date, most frameworks take the format of text-only documents that outline and offer ethical guidance on specific contexts. This study’s goal was to determine whether an interactive-visual format supports frameworks in transferring ethical knowledge by improving learning, deliberation, and user experience.Methods An experimental comparative study was conducted with (...) a pre-, mid-, and post-test design using the online survey platform Qualtrics. Participants were university based early-stage health researchers who were randomly assigned to either the control condition (text-only document) or the experimental condition (interactive-visual). The primary outcome variables were learning, (measured using a questionnaire), deliberation (using cases studies) and user experience (measured using the SED/UD Scale). Analysis was conducted using descriptive statistics and mixed-effects linear regression.Results Of the 80 participants, 44 (55%) used the text-only document and 36 (45%) used the interactive-visual. Results of the knowledge-test scores showed a statistically significant difference between participants’ post-test scores, indicating that the interactive-visual format better supported understanding, acquisition, and application of the framework’s knowledge. Findings from the case studies showed both formats supported ethical deliberation. Results further indicated the interactive-visual provided an overall better episodic and remembered user experience compared with the text-only document.Conclusions Our findings show that ethical frameworks formatted with interactive and visual qualities provide a more pleasing user experience and are effective formats for ethics learning and deliberation. These findings have implications for practitioners developing and deploying ethical frameworks and guidelines (e.g., in educational or employee-onboarding settings), in that the knowledge generated can lead to more effective dissemination practices of normative guidelines and health data ethics concepts. (shrink)

MMA fighting in a competition is not necessarily wrong and is often, as far as we can tell, permissible. Our argument has two premises. First, if an act does not infringe on anyone’s moral right or violate another side-constraint, then it is morally permissible. Second, MMA-violence does not infringe on anyone’s moral right or violate another side-constraint. The first premise rested on two assumptions. First, if a person does a wrong act, then he wrongs someone. Second, if one person wrongs (...) a second, then the first infringes on the second’s right. We then looked at Nicholas Dixon’s powerful Kantian argument that MMA fighting is wrong. (shrink)

Nurses die by suicide at a higher rate than the general population. Previous studies have observed mental health problems, including substance use, as a prominent antecedent before death. The purpose of this study was to explore the characteristics of nurses who died by suicide documented in the death investigation narratives from the National Violent Death Reporting System from 2003 to 2017 using thematic analysis and natural language processing. One thousand three hundred and fifty‐eight subjects met these inclusion criteria. Narratives from (...) 601 subjects were thematically analyzed and 2544 individual narratives were analyzed using natural language processing. The analyses revealed five themes: “mental health treatment,” “poor general health and chronic pain,” “substance use,” “worsening mental health after bereavement,” and “repeating a family member's suicide.” Mental health/substance use, chronic illness, and chronic pain were seen to coexist in a complex, interdependent manner that appeared to be entangled in the nurses' narratives before death. These findings echo the need for reducing the stigmatization of mental health problems in nursing and removing barriers to help‐seeking behaviors as early preventative interventions. Future research is needed to determine if a comprehensive healthcare integration approach to address these entangled problems would reduce suicide vulnerability in nurses and improve their quality of life. (shrink)

Handwashing is important in preventing infectious diseases like COVID-19. The current public health emergency has required rapid implementation of increased handwashing in the general public; however, rapidly changing health behavior, especially on this scale, is difficult. This study considers attitudes and affective responses to handwashing as possible factors predicting COVID-19 related changes to handwashing behavior, future intentions, and readiness to change during the early stages of the pandemic in the United States. Income was explored as a potential moderator to these (...) relationships. To explore these issues, data from 344 community participants were analyzed. Results indicate that stronger affective responses toward handwashing relate to increases in handwashing since the outbreak of COVID-19, and both attitudes and affect uniquely predict handwashing intentions. Income significantly moderated the relationship between affect and readiness to change. Those with low income were more influenced by both affective responses and attitudes. These results suggest messages targeting both cognitions and affective responses are needed to increase the handwashing behavior during a global pandemic and these variables are critical in increasing readiness to change in low-income individuals. (shrink)

A novel photon-based proton model is developed. A proton’s ground state is assumed to be coherent to the degree that all of its mass-energy precipitates into a single uncharged spherical structure. A quantum vortex, initiated by the strong force, but sustained in the proton’s ground state by the circular Unruh effect and a spherical Rindler horizon, is proposed to confine the proton’s mass-energy in its ground state. A direct connection between the circular Unruh effect, the zitterbewegung effect, spin, and general (...) relativity is proposed. Such a structure acts as an uncharged zitterbewegung fermion, and may explain neutrino mass. A ground-state proton’s central zitterbewegung fermion is assumed to be surrounded by a halo of charge shells of both signs. Virtual photon standing waves are assumed to synchronize the inner shell with the central zitterbewegung fermion. The charge shells are proposed to be associated with isospin and proton g-factor. There are only two model inputs—proton mass and quantized electronic charge—and just one adjustable parameter. The adjustable parameter, reduced only by about 0.4% from an initial estimate, provides the proton’s experimentally determined magnetic moment to arbitrary precision. The resulting modeled proton charge radius agrees very well with the 2018 CODATA value. Magnetic moment and charge radius are calculated algebraically in a manner easily understood by undergraduate physics students. This proposed ground-state proton model could be considered a low-energy approximation to a full quantum chromodynamical proton model. (shrink)

Glastonbury Abbey was the wealthiest and most influential monastery in later Anglo-Saxon England. It was a noted centre of scholarship, and claimed ancient origins which were later extravagantly embellished to link the house with such luminaries as St Patrick, St David and King Arthur. The historiographical evidence for Glastonbury is particularly challenging, because the accounts of the monastery's early history were revised and interpolated over centuries, as the legends grew. There are also complications in the study of its archive: the (...) manuscripts are mostly late and corrupt, and the whole is overshadowed by the contents list of a lost cartulary, which included many more early charters than now survive. The present volume is the first critical edition of the sixty-one surviving charters from the abbey's pre-Conquest archive, which date from the later seventh century to the reign of Cnut. The texts are edited to a high standard, with comprehensive commentaries that include translation and elucidation of the Old English boundary clauses, and authoritative assessments of authenticity. There is a long introduction with analysis and synthesis of the documentary evidence for Glastonbury's history in the Anglo-Saxon period and for the accumulation of its endowment, including a section on William of Malmesbury's works on Glastonbury. The volume concludes with a series of appendixes which present all the evidence for the lost charters in the Liber Terrarum and in other sources. (shrink)

Immanuel Kant’s position on special revelation is a matter of debate. Here I discuss Kant’s position in detail and compare it to that of Richard Swinburne. I examine both philosophers’ views on the assertability of special revelation, its contingency, whether it is necessary, the possibility of error, and appropriate methods of interpretation. I argue that, like Swinburne, Kant finds belief in special revelation to be acceptable, even beneficial, under certain circumstances.

Governments and other food system actors from the private sector, civil society, research and education institutions are being called upon to work together to enhance the sustainability, resilience and inclusiveness of food systems. The analysis presented in this study provides an insight into the process and direction of food system transformation, and the key capabilities required. It portrays the interplay of different internal and external dynamics combined with the capacity of food system actors to connect, forge alliances and commit to (...) specific actions that has enabled countries to move towards a more sustainable food system. (shrink)

Ethical guidance for genomic research is increasingly sought and perceived to be necessary. Although there are pressing ethical issues in genomic research – concerning for example the recruitment of patients/participants; the process of taking consent; data sharing; and returning results to patients/participants – there is still limited useful guidance available for researchers/clinicians or for the research ethics committees who review such projects. This report outlines the ethical principles and guidance for genomic research co-produced with stakeholders during two workshops which took (...) place in the UK between November 2016 and May 2017. The stakeholders involved in these workshops included: healthcare professionals, genomic research teams, academics, patients, biobank managers, and representatives from the Health Research Authority, NHS Research Ethics Committees, patient support groups, pharmaceutical industry, and health policy think tanks. The co-produced principles and guidance are specifical... (shrink)

The dominant, individualistic understanding of autonomy that features in clinical practice and research is underpinned by the idea that people are, in their ideal form, independent, self-interested and rational gain-maximising decision-makers. In recent decades, this paradigm has been challenged from various disciplinary and intellectual directions. Proponents of ‘relational autonomy’ in particular have argued that people’s identities, needs, interests – and indeed autonomy – are always also shaped by their relations to others. Yet, despite the pronounced and nuanced critique directed at (...) an individualistic understanding of autonomy, this critique has had very little effect on ethical and legal instruments in clinical practice and research so far. In this article, we use four case studies to explore to what extent, if at all, relational autonomy can provide solutions to ethical and practical problems in clinical practice and research. We conclude that certain forms of relational autonomy can have a tangibl... (shrink)

Treatise 2.3.6, “Of the influence of the imagination on the passions,” provides a magnified view into the relationship between motivation, morality, and politics in Hume’s philosophy. Here, Hume analyzes a “noted passage” from the history of antiquity in which the citizens of fifth-century Athens deliberated over whether to burn the ships of their neighboring Grecians after winning a decisive naval victory against the Persians. Hume finds the passage notable precisely because of a failure of the imagination to exert an influence (...) on the Athenians’ passions during their deliberations, leading them to abstain from further military action. This paper discusses how Hume’s analysis of this event reveals new connections between his passional, moral, and political theories in the Treatise. (shrink)

G. W. F. Hegel’s Elements of Philosophy of Right analogizes the unfolding of a people’s political self-consciousness to the unfolding of an education. Yet Hegel is somewhat unsystematic in accounting for how the process of political education unfolds in its differentiated moments. This paper pieces together a more systematic account of political education from Hegel’s scattered remarks on the subject in Philosophy of Right. I argue that, once we understand how political education fits into the holistic picture of Hegel’s Rechtsphilosophie, (...) we see that it exercises both a fortifying and a threatening influence on the state: fortifying the state insofar as it habituates individuality to universality in the form of ethical dispositions such as patriotism, threatening the state insofar as it represents a destabilizing tendency toward democratic judgment in the emergence of public opinion. I conclude by raising the possibility that political education poses an entropic, “democratic” threat to the modern state. (shrink)

G. W. F. Hegel’s Elements of Philosophy of Right analogizes the unfolding of a people’s political self-consciousness to the unfolding of an education. Yet Hegel is somewhat unsystematic in accounting for how the process of political education unfolds in its differentiated moments. This paper pieces together a more systematic account of political education from Hegel’s scattered remarks on the subject in Philosophy of Right. I argue that, once we understand how political education fits into the holistic picture of Hegel’s Rechtsphilosophie, (...) we see that it exercises both a fortifying and a threatening influence on the state: fortifying the state insofar as it habituates individuality to universality in the form of ethical dispositions such as patriotism, threatening the state insofar as it represents a destabilizing tendency toward democratic judgment in the emergence of public opinion. I conclude by raising the possibility that political education poses an entropic, “democratic” threat to the modern state. (shrink)

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Many drugs used in paediatric medicine are off-label. There is a rising call for the use of adaptive clinical trial designs in responding to the need for safe and effective drugs given their potential to offer efficiency and cost-effective benefits compared with traditional clinical trials. ADs have a strong appeal in paediatric clinical trials given the small number of available participants, limited understanding of age-related variability and the desire to limit exposure to futile or unsafe interventions. Although the ethical value (...) of adaptive trials has increasingly come under scrutiny, there is a paucity of literature on the ethical dilemmas that may be associated with paediatric adaptive designs. This paper highlights some of these ethical concerns around safety, scientific/social value and caregiver/guardian comprehension of the trial design. Against this background, the paper develops a non-static conceptual lens for understanding PADs. It shows that ADs are epistemically open and reduce some of the knowledge-associated uncertainties inherent in clinical trials as well as fast-track the time to draw conclusions about the value of evaluated drugs/treatments. On this note, the authors argue that PADs are ethically justifiable given they have multiple layers of safety, exposing enrolled children to lesser potential risks, create social/scientific value generally and for paediatric populations in particular, specifically foster the flourishing of paediatric populations and can significantly improve paediatric trial efficiency when properly designed and implemented. However, because PADs are relatively new and their regulatory, ethical and logistical characteristics are yet to be clarified in some jurisdictions, the cooperation of various public and private stakeholders is required to ensure that the interests of children, their caregivers and parents/guardians are best served while exposing paediatric research subjects to the most minimal of risks when they are enrolled in paediatric trials that use ADs. Data sharing not applicable as no datasets generated and/or analysed for this study. Not applicable. (shrink)

Considers the social and political significance of Kristeva’s oeuvre.

In the last half century, oral history has emerged as a historical approach that is being considered by archivists involved with the collection and accessibility of archival collections for researchers and interested members of the public. The approach to ethics by oral historians has emerged from two major fears: the fear of failing as researchers and the fear of failing the narrators and doing harm. Archivists also need to be cognisant of these fears when collecting oral history. Confronting these fears (...) makes it possible to understand the complex questions behind oral historians’ and archivists’ preoccupations and sheds light on how oral history has evolved and expanded as a field. The research objectives of this article are to determine the three principles identified from the Belmont Report that relate and should be applied to the collection of oral histories by archivists and historians from communities and individuals residing and working in and alongside the Kruger National Park. The theoretical framework for this article is the critical race theory to address historical accounts from communities and individuals sidelined by the mainstream media in South Africa. For the purposes of this article, the study was conducted with the Makuleka and Tsonga communities to determine what ethical implications need to be respected when conducting oral history projects with communities.Contribution: This article will contribute to ethics concerning social sciences and specifically the collection of oral history. (shrink)

Anhedonia is a risk factor for suicide and poor treatment response in depressed individuals. Most evidence-based psychological therapies target symptoms of heightened negative affect instead of deficits in positive affect and typically show little benefit for anhedonia. Viewing positive scenes through virtual reality has been shown to increase positive affect and holds great promise for addressing anhedonic symptoms. In this pilot study, six participants with clinically significant depression completed 13 sessions of exposure to positive scenes in a controlled VR environment. (...) Significant decreases were found in self-reported anhedonia, depression, anxiety, and impairments in functioning from baseline to 1-month follow-up. Negative affect decreased over all 13 sessions, and positive affect increased over sessions 8–13. Results suggest that positive experiences in VR may be a novel avenue for the treatment of anhedonia in depressed individuals. (shrink)

Modes-of-being figure centrally in Heidegger's masterwork Being and Time. Testimony to this is Heidegger's characterisation of two of his most celebrated enquiries—the Existential analytic and the Zeug analysis—as investigations into the respective modes-of-being of the entities concerned. Yet despite the importance of this concept, commentators disagree widely about what a mode-of-being is. In this paper, I systematically outline and defend a novel and exegetically grounded interpretation of this concept. Strongly opposed to Kantian readings, such as those advocated by Taylor Carman (...) and Cristina Lafont, I interpret a mode-of-being as a universal that defines a district —that is, a natural class of entities that ought to be conceptualised in a special way. As such, every mode-of-being plays an important metaphysical and epistemic role: serving both to unify a natural class of a high degree of generality and as the interpretandum of an act yielding the basic-concepts pertaining to the entities therein. In explicating and arguing for this interpretation, I attribute a characteristically Aristotelian philosophical position to the early Heidegger, encompassing both metaphysical and epistemological realism and a conceptualist theory of universals. (shrink)

Prior research suggests that most people perceive themselves to be more altruistic than the average population, an observation known as the better-than-average (BTA) effect. Understanding the BTA effect carries significant public health implications, as self-perceived altruism is closely related to altruistic behaviors, which plays a significant role in individual and societal well-being. However, little is known about whether subpopulations with specific sociodemographic profiles are more likely to hold BTA altruistic self-perceptions, making it difficult to design targeted programs based on multiple (...) sociodemographic characteristics to promote altruistic behaviors. This study addresses this gap by identifying the sociodemographic profiles of populations who are more likely to exhibit BTA effects on trait altruism. Data were derived from a representative sample of Hong Kong citizens (n= 1,185) in the 2017 Hong Kong Altruism Survey. A latent class analysis was performed using four domains of sociodemographic characteristics: sex, age, religion, and socioeconomic status. Multivariate multinomial logistic regressions were conducted to examine associations between class membership, BTA effect, and altruistic behaviors. The results yielded four classes of sociodemographic profiles. Middle-aged, Christian/Catholic, highly educated, and high-income individuals (Class 4, 17.8%) were most likely to exhibit BTA effects and behave altruistically; Class 3 (14.0%) were older, male, no/other religious belief, low education, and least likely to exhibit BTA effects and behave altruistically. Findings improve the understanding of the sociodemographic profiles of people showing BTA effects and facilitate targeted policy development to effectively promote altruism. (shrink)

In Bester’s article (2018) challenging the use of the harm principle and advocating sole reliance on the use of a best interest standard (BIS) in pediatric decision-making, we believe that the auth...