The number of women living with HIV/AIDS is increasing worldwide, and there is an urgent public health need to develop new user-initiated HIV prevention methods, including microbicides. Although funding for microbicide development has increased since 2000, financial support is provided predominantly by governmental agencies and private foundations. Many donors, including the US Agency for International Development (USAID) and the US National Institutes of Health (NIH), have policies that restrict how research funds may be used. Among these are the now-rescinded Mexico (...) City Policy, elements of the US Foreign Assistance Act, and restrictions on non-study-related care. The effect of these restrictions on the design and conduct of clinical research is poorly understood. As part of a recent mapping exercise conducted by the Global Campaign for Microbicides, we reviewed the impact of donor restrictions on seven HIV prevention trials. We found considerable confusion within the HIV prevention field as to whether and how Mexico City and other policies affect the use of research funds. We also found that these donor-imposed policies limited the level of care provided to trial participants and the types of capacity building projects undertaken. (shrink)

What is the value of having medical students engage in creative production as part of their learning? Creating something new requires medical students to take risks and even to fail--something they tend to be neither accustomed to nor comfortable with doing. “Making stuff” can help students prepare for such failures in a controlled environment that doesn’t threaten their professional identities. Furthermore, doing so can facilitate students becoming resilient and creative problem-solvers who strive to find new ways to address vexing questions. (...) Though creating something new can be fun, this is not the main outcome of interest. Rather, the principle reason we recommend devoting precious curricular time to creative endeavors is because it helps medical students become better doctors. (shrink)

Next SectionIntensification of poverty and degradation of health infrastructure over recent decades in countries most affected by HIV/AIDS present formidable challenges to clinical research. This paper addresses the overall standard of health care (SOC) that should be provided to research participants in developing countries, rather than the narrow definition of SOC that has characterised the international debate on standards of health care. It argues that contributing to sustainable improvements in health by progressively ratcheting the standard of care upwards for research (...) participants and their communities is an ethical obligation of those in resource-rich countries who sponsor and implement research in poorer ones. (shrink)

Recent data indicate that under a specific posthypnotic suggestion to circumvent reading, highly suggestible subjects successfully eliminated the Stroop interference effect. The present study examined whether an optical explanation could account for this finding. Using cyclopentolate hydrochloride eye drops to pharmacologically prevent visual accommodation in all subjects, behavioral Stroop data were collected from six highly hypnotizables and six less suggestibles using an optical setup that guaranteed either sharply focused or blurred vision. The highly suggestibles performed the Stroop task when naturally (...) vigilant, under posthypnotic suggestion not to read, and while visually blurred; the less suggestibles ran naturally vigilant, while looking away, and while visually blurred. Although visual accommodation was precluded for all subjects, posthypnotic suggestion effectively eliminated Stroop interference and was comparable to looking away in controls. These data strengthen the view that Stroop interference is neither robust nor inevitable and support the hypothesis that posthypnotic suggestion may exert a top-down influence on neural processing. (shrink)

The number of children with chronic critical illness (CCI) is a growing population in the United States. A defining characteristic of this population is a prolonged hospital stay. Our study assessed the proportion of pediatric patients with chronic critical illness in U.S. hospitals at a specific point in time, and identified a subset of children whose hospital stay lasted for months to years. The potential harms of a prolonged hospitalization for children with CCI, which include over treatment, infection, disruption of (...) family life, and the intensive utilization of resources—combined with the moral distress experienced by the clinicians who care for the children, suggest the need for ethical analysis of this growing issue to identify actions that could be taken at the clinical and health systems levels to reduce the harms associated with prolonged hospital stay.In this article we present three real cases from our study that involved a very long hospital stay. We applied a framework developed by Mackenzie, Rogers, and Dodds to analyze inherent, situational, and pathogenic vulnerabilities to examine the ways that interventions intended to remedy one source of harm for the children in our cohort inadvertently created other harms. We examined the complex ways that children with protracted hospitalization are vulnerable to the choices made by their family and clinicians, as well as by healthcare systems and communities. Finally, we used this analysis to summarize actions and ethical responses to this growing patient population. Such an understanding is essential to making clinical and ethical decisions that arise for children who are at risk for a very long stay in the hospital. (shrink)

In The Phenomenology of Religious Belief, the renowned philosopher Michael J. Shapiro investigates how art - and in particular literature and film - can impact upon both traditional interpretations and critical studies of religious beliefs and experiences. In doing so, he examines the work of prolific and award-winning writers such as Toni Morrison, Philip K. Dick and Robert Coover. By placing their work in conjunction with critical analyses of media by the likes of Ingmar Bergman and Pier Paolo Pasolini (...) and combining it with the work of groundbreaking thinkers such as George Canguilhem, Giorgio Agamben and Slavoj Žižek, Shapiro takes a truly interdisciplinary approach to the question of how life should be lived. His assessment of phenomenological subjectivity also leads him to question the nature of political theology and extend the criticism of Pauline theology. (shrink)

It has been debated what implications multiple realizability has for reductionism. I claim that more explicit attention needs to be paid to the distinction between multiple realizations of kinds and diverse implementations of laws. In this paper, I distinguish two different theses on the relations between multiple realization and diverse implementation: one thesis states that multiple realizations imply diverse implementations and the other states the converse. I claim that although antireductionism might turn out to be false if the first thesis (...) is accepted, this "realization-based" antireductionism is not the only option for antireductionism. For the antireductionists who accept the second thesis, multiple realizations only provide evidence for diverse implementations. I defend this "implementation-based" antireductionism again Shapiro's dilemma. I argue that one horn of the dilemma does not pose any problem and that the other horn simply begs the question. (shrink)

The authors developed this textbook in response to an increasing interest in ethics, and a growing number of courses on this topic that are now being offered in educational leadership programs. It is designed to fill a gap in instructional materials for teaching the ethics component of the knowledge base that has been established for the profession. The text has several purposes: First, it demonstrates the application of different ethical paradigms (the ethics of justice, care, critique, and the profession) through (...) discussion and analysis of real-life moral dilemmas that educational leaders face in their schools and communities. Second, it addresses some of the practical, pedagogical, and curricular issues related to the teaching of ethics for educational leaders. Third, it emphasizes the importance of ethics instruction from a variety of theoretical approaches. Finally, it provides a process that instructors might follow to develop their own ethics unit or course. * Part I provides an overview of why ethics is so important, especially for today's educational leaders, and describes a multiparadigm approach essential to practitioners as they grapple with ethical dilemmas. * Part II deals with the dilemmas themselves. Ethical dilemmas written by the authors' graduate students bring readers face-to-face with the kinds of dilemmas faced by practicing administrators in urban, suburban, and rural settings in an era full of complexities and contradictions. * Part III focuses on pedagogy and provides teaching notes for the instructor. The authors discuss the importance of self-reflection on the part of both instructors and students, and model how they thought through their own personal and professional ethical codes as well as reflected upon the critical incidents in their lives that shaped their teaching and frequently determined what they privileged in class. (shrink)

Stewart Shapiro's ambition in Vagueness in Context is to develop a comprehensive account of the meaning, function, and logic of vague terms in an idealized version of a natural language like English. It is a commonplace that the extensions of vague terms vary according to their context: a person can be tall with respect to male accountants and not tall (even short) with respect to professional basketball players. The key feature of Shapiro's account is that the extensions of (...) vague terms also vary in the course of conversations and that, in some cases, a competent speaker can go either way without sinning against the meaning of the words or the non-linguistic facts. As Shapiro sees it, vagueness is a linguistic phenomenon, due to the kinds of languages that humans speak; but vagueness is also due to the world we find ourselves in, as we try to communicate features of it to each other. (shrink)

Moving beyond both realist and anti-realist accounts of mathematics, Shapiro articulates a "structuralist" approach, arguing that the subject matter of a mathematical theory is not a fixed domain of numbers that exist independent of each other, but rather is the natural structure, the pattern common to any system of objects that has an initial object and successor relation satisfying the induction principle.

We examine George Boolos's proposed abstraction principle for extensions based on the limitation-of-size conception, New V, from several perspectives. Crispin Wright once suggested that New V could serve as part of a neo-logicist development of real analysis. We show that it fails both of the conservativeness criteria for abstraction principles that Wright proposes. Thus, we support Boolos against Wright. We also show that, when combined with the axioms for Boolos's iterative notion of set, New V yields a system equivalent to (...) full Zermelo-Fraenkel set theory with a principle of global choice. This advances Boolos's longstanding interest in the foundations of set theory. (shrink)

The revisionary approach to semantic paradox is commonly thought to have a somewhat uncomfortable corollary, viz. that, on pain of triviality, we cannot affirm that all valid arguments preserve truth (Beall2007, Beall2009, Field2008, Field2009). We show that the standard arguments for this conclusion all break down once (i) the structural rule of contraction is restricted and (ii) how the premises can be aggregated---so that they can be said to jointly entail a given conclusion---is appropriately understood. In addition, we briefly rehearse (...) some reasons for restricting structural contraction. (shrink)

Cells are cognitive entities possessing great computational power. DNA serves as a multivalent information storage medium for these computations at various time scales. Information is stored in sequences, epigenetic modifications, and rapidly changing nucleoprotein complexes. Because DNA must operate through complexes formed with other molecules in the cell, genome functions are inherently interactive and involve two-way communication with various cellular compartments. Both coding sequences and repetitive sequences contribute to the hierarchical systemic organization of the genome. By virtue of nucleoprotein complexes, (...) epigenetic modifications, and natural genetic engineering activities, the genome can serve as a read-write storage system. An interactive informatic conceptualization of the genome allows us to understand the functional importance of DNA that does not code for protein or RNA structure, clarifies the essential multidirectional and systemic nature of genomic information transfer, and emphasizes the need to investigate how cellular computation operates in reproduction and evolution. (shrink)

I respond to Fishkin?s critique of my book The State of Democratic Theory. I reiterate my defense of a competitive model of democracy geared to reducing domination, rather than Fishkin?s deliberative model that deploys structured discussion to enlighten mass preferences. In light of the literatures on framing effects and the value of mutually independent judgments, I question whether the procedures Fishkin recommends would produce outcomes that are better informed rather than differently informed. Recognizing that deliberation might sometimes be helpful in (...) reducing domination, I note that sometimes it will not, and I fault Fishkin for his indiscriminate embrace of exceedingly costly deliberative mechanisms that promise dubious benefits? notably his and Bruce Ackerman?s?Deliberation Day? (shrink)

Building on recent work, I present sequent systems for the non-classical logics LP, K3, and FDE with two main virtues. First, derivations closely resemble those in standard Gentzen-style systems. Second, the systems can be obtained by reformulating a classical system using nonstandard sequent structure and simply removing certain structural rules (relatives of exchange and contraction). I clarify two senses in which these logics count as “substructural.”.

Two currently much discussed views about truth, truth pluralism and truth relativism, are found in Sellars’s writings. I show that his motivations for adoping these views are interestingly different from those shared by most of their recent advocates. First, I explain how Sellars comes to embrace a version of truth pluralism. I argue that his version overcomes a difficulty confronting pluralists, albeit at a serious cost. Then I argue that Sellars’s truth pluralism isn’t motivated by his interest in domains of (...) discourse beyond the “matter-of-factual.” Rather, the key to his truth pluralism, his analysis of truth as “semantical assertibility,” is motivated by the same consideration that leads him to adopt truth relativism. This is his interest in applying semantic notions to discourse that embodies conceptual structures other than ours. Despite their common motivation, I conclude that Sellars’s relativism is independent of, and indeed stands in tension with, the analysis of truth that underlies his pluralism. (shrink)

This new anthology of early modern philosophy enriches the possibilities for teaching this period by highlighting not only metaphysics and epistemology, but also new themes such as virtue, equality and difference, education, the passions, and love. It contains the works of forty-three philosophers, including traditionally taught figures such as Descartes, Spinoza, Leibniz, Locke, Berkeley, Hume, and Kant, as well as less familiar writers such as Lord Shaftesbury, Anton Amo, Julien Offray de La Mettrie, and Denis Diderot. It also highlights the (...) contributions of women philosophers, including Margaret Cavendish, Anne Conway, Gabrielle Suchon, Sor Juana Inéz de la Cruz, and Emilie Du Châtelet. (shrink)

While Descartes’s Passions of the Soul has been taken to hold a place in the history to human physiology, until recently philosophers have neglected the work. In this research summary, I set Descartes’s last published work in context and then sketch out its philosophical significance. From it, we gain further insight into Descartes’s solution to the Mind--Body Problem -- that is, to the problem of the ontological status of the mind--body union in a human being, to the nature of body--mind (...) causation, and to the way body-caused thoughts represent the world. In addition, the work contains Descartes’s developed ethics, in his account of virtue and of the passion of générosité in particular. Through his taxonomy of the passions and the account of their regulation, we also learn more about his moral psychology. (shrink)