Background: The use of race as a category in medical research is the focus of an intense debate, complicated by the inconsistency of presumed independent variables, race and ethnicity, on which analysis depends. Interpretation is made difficult by inconsistent methods for determining the race or ethnicity of a participant. The failure to specify how race or ethnicity was determined is common in the published literature.Hypothesis: Criteria by which they assign a research participant to racial or ethnic categories are not reported (...) by published articles.Methods: Methods were reviewed for assigning race and ethnicity of research participants in 268 published reports reporting associations among race , health outcome and genotype.Results: Of the 268 published reports reviewed, it was found that 192 did not explain their methods for assigning race or ethnicity as an independent variable. This was despite the fact that 180 of those reports reached conclusions about associations among genetics, health outcome and race or ethnicity.Conclusions: More attention needs to be given to the definition of race and ethnicity in genetic studies, especially in those diseases where health disparities are known to exist. (shrink)

An interdisciplinary study of the fundamental normative issues underpinning immigration policy.

Open Judaism is an invitation to the spiritually seeking Jew; a clarion call for a pluralistic, inclusive Judaism; and a dynamic comparison of the remarkably wide array of thought within Judaism today.

An implicit association test (IAT) measures differential association of 2 target concepts with an attribute. The 2 concepts appear in a 2-choice task (e.g., flower vs. insect names), and the attribute in a 2nd task (e.g., pleasant vs. unpleasant words for an evaluation attribute). When instructions oblige highly associated categories (e.g., flower + pleasant) to share a response key, performance is faster than when less associated categories (e.g., insect + pleasant) share a key. This performance difference implicitly measures differential association (...) of the 2 concepts with the attribute. In 3 experiments, the IAT was sensitive to (a) near-universal evaluative differences (e.g., flower vs. insect), (b) expected individual differences in evaluative associations (Japanese + pleasant vs. Korean + pleasant for Japanese vs. Korean subjects), and (c) consciously disavowed evaluative differences (Black + pleasant vs. White + pleasant for self-described unprejudiced White subjects). (PsycINFO Database Record (c) 2016 APA, all rights reserved). (shrink)

V. 1. Structures and processes -- v. 2. Domains and categories.

It remains unclear what patient advocacy actually entails and what values it ought to embody. It will be useful to ascertain whether advocacy means supporting any decision the patient makes, or if the advocate can claim to represent the patient by asserting well-intentioned paternalistic claims on the patient's behalf. This is especially significant because the position of advocate brings with it certain privileges on the basis of of presumed insight into patient-perceived interests, namely, entitlement to take part in clinical decision (...) making and increased professional standing. Three issues related to patient advocacy will be explored: are patient advocates necessary; what does advocacy entail, and who ought to represent patients in this way—arguments for and against prospective candidates will also be covered. The paper considers whether advocates are necessary since not only can they be dangerously paternalistic, but the salutary values advocacy embodies are already part of good professional health care. (shrink)

Television pictures of starvation and depredation are not the only way that famine and political instability in the horn of Africa have affected the United States. Many people from that region of the world are seeking political or economic refuge here, and they are exposing us to a culture that is in some ways — most notably, in the practice of female circumcision – so radically different from the prevailing American cultures that we have been stunned. They are also forcing (...) hospital ethics committees to face issues that cannot be resolved by the facile application of the settled principles that have guided those institutions for the past several years. Autonomy and multiculturalism, long the foundations of most ethics committee decision making, have started to give way to a list of formally articulated rights and wrongs – perhaps to a restatement and adoption of rules said to be based in natural law. Female circumcision, argues one newspaper letter writer, “is just a sickening display of male power disguised as legitimate dogma. (shrink)

As ethics committees become involved in discussing the propriety of euthanasia and assisted suicide, and as healthcare providers begin to seriously consider whether they might ever have a role in hastening the dying process, many have looked to The Netherlands as the only real example of a nation that permits euthanasia in limited circumstances. Unfortunately, partisans in the Dutch debate have often written about the Dutch experience as advocates rather than as neutral observers. Some have argued that euthanasia, which, they (...) claim, is rarely actually practiced, is universally accepted within The Netherlands; others have reported that the Dutch social fabric has been rended irreparably by what they claim, is a practice far more widespread than is generally understood. The debate in the United States has also been colored by a misunderstanding of the legal regulation of euthanasia in The Netherlands. (shrink)

In many countries the debate over the role that physicians may play in ending life has been limited to the judiciary and other law making institutions, professional medical organizations; and academics. Because of their multidisciplinary and diverse membership, ethics committees may be a particularly appropriate venue through which these discussions can be expanded to include a much larger community. In addition, ethics committees generally act in only advisory capacities because they do not actually make decisions, so they may provide a (...) forum for open discussions in ways that the court and the medical boards cannot. (shrink)

Over the past year the debate over physician-assisted death has been waged in several courts and legislatures, and before at least one electorate as well. Measure 16, the Oregon Death With Dignity initiative that would permit physician-assisted suicide in some circumstances, was approved by the electorate; but it remains on hold while a permanent injunction issued against it by a Federal judge is reviewed by the United States Court of Appeals. Another Federal court judge's decision that the Washington statute criminalizing (...) physician-assisted suicide was unconstitutional when applied to the case of a competent terminally ill patient in intractable pain, was reversed by a three judge panel of that same United States Court of Appeals. (shrink)

A productive way to think about imagistic mental models of physical systems is as though they were sources of quasi‐empirical evidence. People depict or imagine events at those points in time when they would experiment with the world if possible. Moreover, just as they would do when observing the world, people induce patterns of behavior from the results depicted in their imaginations. These resulting patterns of behavior can then be cast into symbolic rules to simplify thinking about future problems and (...) to reveal higher order relationships. Using simple gear problems, three experiments explored the occasions of use for, and the inductive transitions between, depictive models and number‐based rules. The first two experiments used the convergent evidence of problem‐solving latencies, hand motions, referential language and error data to document the initial use of a model, the induction of rules from the modeling results, and the fallback to a model when a rule fails. The third experiment explored the intermediate representations that facilitate the induction of rules from depictive models. The strengths and weaknesses of depictive modeling and more analytic systems of reasoning are delineated to motivate the reasons for these transitions. (shrink)

This article explores the accounts of Canadian-trained health professionals working in humanitarian and development organizations who considered not treating a patient or group of patients because of resource limitations. In the narratives, not treating the patient(s) was sometimes understood as the right thing to do, and sometimes as wrong. In analyzing participants’ narratives we draw attention to how medications and equipment are represented. In one type of narrative, medications and equipment are represented primarily as scarce resources; in another, they are (...) represented as patient care. In the contexts respondents were working, medications and equipment were often both patient care interventions and scarce resources. The analytic point is that health professionals tend to emphasize one conceptualization over the other in coming to assert that not treating is right, or wrong. Rendering tacit ethical frameworks more explicit makes them available for reflection and debate. (shrink)

College students from small, medium, and large institutions with either a modified or no honor code were presented with cheating scenarios and asked to rate how dishonest they perceived the behavior to be and the likelihood that they would report it. No main effects were found for institution size or type of honor code. Student–faculty ratio was not correlated with responses to the cheating scenarios. Students from modified honor code schools perceived more severe punishments for cheating and understood the reporting (...) process better than students from non–honor code schools. Implications for modified honor code systems are discussed. (shrink)

Smith et al. demonstrate the viability of animal metacognition research. We commend their effort and suggest three avenues of research. The first concerns whether animals are explicitly aware of their metacognitive processes. The second asks whether animals have metaknowledge of their own uncertain responses. The third issue concerns the monitoring/control distinction. We suggest some ways in which these issues elucidate metacognitive processes in nonhuman animals.

Thinkers in related fields such as philosophy, psychology, and education define metacognition in a variety of different ways. Based on an emerging standard definition in psychology, we present evidence for metacognition in animals, and argue that mindreading and metacognition are largely orthogonal.

TOT states may be viewed as a temporary and reversible microamnesia. We investigated the effects of lorazepam on TOT states in response to general knowledge questions. The lorazepam participants produced more commission errors and more TOTs following commission errors than the placebo participants . The resolution of the TOTs was unimpaired by the drug. Neither feeling-of-knowing accuracy nor recognition were affected by lorazepam. The higher level of incorrect recalls produced by lorazepam participants may be due to the fact that they (...) were more frequently temporarily unable to access a known item. For some of these items, the awareness of the retrieval failure resulted in a commission TOT . The resolution of the TOT conflict is discussed in the light of the anxiolytic and anticonflict effects of lorazepam. The data are discussed in terms of contemporary theories of TOTs and the effects that benzodiazepines have on semantic memory. (shrink)

Health care professionals who travel from their home countries to participate in humanitarian assistance or development work experience distinctive ethical challenges in providing care and services to populations affected by war, disaster or deprivation. Limited information is available about organizational practices related to preparation and support for health professionals working with non-governmental organizations. In this article, we present one component of the results of a qualitative study conducted with 20 Canadian health care professionals who participated in international aid work. The (...) findings reported here relate to expatriate clinicians’ experiences and perceptions of ethics preparation, training and support. The strategies examined include pre-departure training and preparation, in-field supports and retrospective debriefing of ethical issues. Participants experienced a range of training and supports as beneficial for addressing ethical challenges in humanitarian assistance and development work. Participants also expressed ambivalence or scepticism about the benefits offered by specific modalities. This analysis can contribute to informing discussions of how organizations and individual practitioners can best develop, implement and utilize ethics training and support for international aid work. (shrink)

Humanitarian health care practitioners working outside familiar settings, and without familiar supports, encounter ethical challenges both familiar and distinct. The ethical guidance they rely upon ought to reflect this. Using data from empirical studies, we explore the strengths and weaknesses of two ethical models that could serve as resources for understanding ethical challenges in humanitarian health care: clinical ethics and public health ethics. The qualitative interviews demonstrate the degree to which traditional teaching and values of clinical health ethics seem insufficient (...) for addressing all the realities of health care practice during humanitarian missions. They equally suggest that greater good orientations of public health ethics can thwart the best intentions of health care professionals wanting to attend to the interests of individual patients. Even though neither is complete on its own for helping guide health professionals on field missions, taken together these models have much to offer. At the same time, the narratives of the humanitarian health care workers illustrate how some of the crucial differences between public health ethics and clinical ethics generate tensions in humanitarian health practice. We offer an analysis of some of the complexities this creates for humanitarian health care ethics, and consider ways of adjudicating between the two models. (shrink)

Most of us find the surgeon's surprise at this patient' request understandable, and it is hard to imagine any surgeon acceding to this patient's demand. On the other hand, the patient is right—the surgeon is denying his technical skill because his values are different from those of the patient, whose values the surgeon does not respect. The autonomy of the patient is being limited by the values of the doctor whose own interests, other than his interest in practicing medicine according (...) to his own ethical values, would remain unaffected by his decision to provide the service. (shrink)

Under shift, caused for example by eye movement, or by relative movement of the subject or object of perception, the cortical representation undergoes very large changes in “size” and “shape.” Space-variance of cortical representation rules out models that fundamentally require linear interpolation between shifted patterns (e.g., Edelman's model) or rigid shift of an invariant retinal stimulus corresponding to shift at the cortex (e.g., the shifter theory of van Essen). Recently, a computational solution of “quasi-shift” invariance for space-variant mappings has been (...) constructed (Bonmassar & Schwartz 1997a; 1997b). (shrink)

This new volume on logic follows a recognizable format that deals in turn with the topics of mathematical logic, moving from concepts, via definitions and inferences, to theories and axioms. However, this fresh work offers a key innovation in its ‘pyramidal’ graph system for the logical formalization of all these items. The author has developed this new methodology on the basis of original research, traditional logical instruments such as Porphyrian trees, and modern concepts of classification, in which pyramids are the (...) central organizing concept. The pyramidal schema enables both the content of concepts and the relations between the concept positions in the pyramid to be read off from the graph. Logical connectors are analyzed in terms of the direction in which they connect within the pyramid. Additionally, the author shows that logical connectors are of fundamentally different types: only one sort generates propositions with truth values, while the other yields conceptual expressions or complex concepts. On this basis, strong arguments are developed against adopting the non-discriminating connector definitions implicit in Wittgensteinian truth-value tables. Special consideration is given to mathematical connectors so as to illuminate the formation of concepts in the natural sciences. To show what the pyramidal method can contribute to science, a pyramid of the number concepts prevalent in mathematics is constructed. The book also counters the logical dogma of ‘false’ contradictory propositions and sheds new light on the logical characteristics of probable propositions, as well as on syllogistic and other inferences. (shrink)

If distributed cognition is to become a general analytic frame, it needs to handle more aspects of cognition than just highly efficient problem solving. It should also handle learning. We identify four classes of distributed learning: induction, repurposing, symbiotic tuning, and mutual adaptation. The four classes of distributed learning fit into a two-dimensional space defined by the stability and adaptability of individuals and their environments. In all four classes of learning, people and their environments are highly interdependent during initial learning. (...) At the same time, we present evidence indicating that certain types of interdependence in early learning, most notably mutual adaptation, can help prepare people to be less dependent on their immediate environment and more adaptive when they confront new environments. We also describe and test examples of learning technologies that implement mutual adaptation. (shrink)

If distributed cognition is to become a general analytic frame, it needs to handle more aspects of cognition than just highly efficient problem solving. It should also handle learning. We identify four classes of distributed learning: induction, repurposing, symbiotic tuning, and mutual adaptation. The four classes of distributed learning fit into a two-dimensional space defined by the stability and adaptability of individuals and their environments. In all four classes of learning, people and their environments are highly interdependent during initial learning. (...) At the same time, we present evidence indicating that certain types of interdependence in early learning, most notably mutual adaptation, can help prepare people to be less dependent on their immediate environment and more adaptive when they confront new environments. We also describe and test examples of learning technologies that implement mutual adaptation. (shrink)

For observers of pharmaceutical regulation and the Food and Drug Administration, these are uncertain times. Events in late 2016 raised concerns that the FDA's evidentiary standards were being weakened, compromising the agency's ability to adequately perform its regulatory and public health responsibilities. Two developments most directly contributed to these fears—the approval of eteplirsen, a treatment for Duchenne muscular dystrophy, against the recommendations of both FDA staff and an advisory committee and the December 2016 signing of the 21st Century Cures Act, (...) which encouraged greater use by the FDA of “real-world” evidence not obtained through randomized controlled trials. The arrival of the Trump administration—with its deregulatory, industry-friendly approach—has only amplified concerns over the future of the FDA. It is too early to know whether the recent developments are truly harbingers of an FDA less likely to prevent unsafe or ineffective products from reaching the market. But elements in the two events—the role of patient narratives in deliberations regarding eteplirsen and the enthusiasm for real-world evidence in the 21st Century Cures Act—raise critical issues for the future of evidence in the FDA's work. The rigorous, inclusive approach under way to consider issues related to real-world evidence provides a model for a similarly needed inquiry regarding public participation in FDA decision-making. (shrink)

'Leading economists presenting fundamentally important issues in economic theory' is the theme of the Nancy Schwartz lectures series held annually at the J. L. Kellogg Graduate School of Management of Northwestern University. Reporting on lectures delivered in the years 1983 through 1997, this collection of essays discusses economic behavior at the individual and group level and the implications to the performance of economic systems. Using non-technical language, the speakers present theoretical, experimental, and empirical analysis of decision making under uncertainty (...) and under full and bounded rationality, the influence of economic incentives and habits, and the effects of learning and evolution on dynamic choice. Perfect competition, economic development, social insurance and social mobility, and negotiation and economic survival, are major economic subjects analyzed through our understanding of economic behavior. (shrink)