The popular view of non-directive genetic counseling limits the counselor's role to providing information to clients and assisting families in making decisions in a morally neutral fashion. This view of non-directive genetic counseling is shown to be incomplete. A fuller understanding of what it means to respect autonomy shows that merely respecting client choices does not exhaust the duty. Moreover, the genetic counselor/client relationship should also be governed by the counselor's commitment to the principle of beneficience. When non-directive counseling is (...) reexamined in light of both these principles, it becomes clear that there are cases in which counselors should attempt to persuade clients to reconsider their decisions. Such attempts are consistent with non-directive counseling because, while respecting the clients' decision-making authority, they insure that clients act with full knowledge of the moral consequences of their decisions. (shrink)

The sounds that make up spoken words are heard in a series and must be mapped rapidly onto words in memory because their elements, unlike those of visual words, cannot simultaneously exist or persist in time. Although theories agree that the dynamics of spoken word recognition are important, they differ in how they treat the nature of the competitor set—precisely which words are activated as an auditory word form unfolds in real time. This study used eye tracking to measure the (...) impact over time of word frequency and 2 partially overlapping competitor set definitions: onset density and neighborhood density. Time course measures revealed early and continuous effects of frequency (facilitatory) and on set based similarity (inhibitory). Neighborhood density appears to have early facilitatory effects and late inhibitory effects. The late inhibitory effects are due to differences in the temporal distribution of similarity within neighborhoods. The early facilitatory effects are due to subphonemic cues that inform the listener about word length before the entire word is heard. The results support a new conception of lexical competition neighborhoods in which recognition occurs against a background of activated competitors that changes over time based on fine-grained goodness-of-fit and competition dynamics. (shrink)

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

Is synaesthesia cognitively useful? Individuals with time–space synaesthesia experience time units as idiosyncratic spatial forms, and report that these forms aid them in mentally organising their time. In the present study, we hypothesised that time–space synaesthesia would facilitate performance on a time-related cognitive task. Synaesthetes were not specifically recruited for participation; instead, likelihood of time–space synaesthesia was assessed on a continuous scale based on participants’ responses during a semi-structured interview. Participants performed a month-manipulation task, which involved naming every second month (...) or every third month in reverse-chronological order, beginning and ending with a target month. Using hierarchical multiple regression, we found that time–space synaesthesia corresponded with faster performance on both versions of the task. We propose that time–space synaesthesia may expedite the cognitive manipulation of time-based information. Our results also indicate that synaesthesia is far less unusual than widely believed. (shrink)

Although there has been critical analysis of how the informed consent process functions in relation to participation in research and particular ethical 'dilemmas', there has been little examination of consenting to more routine medical procedures. We report a qualitative study of 25 women who consented to surgery. Of these, nine were ambivalent or opposed to having an operation. When faced with a consent form, women's accounts suggest that they rarely do anything other than obey professionals' requests for a signature. An (...) interactionist analysis suggests that women's capacity to act is reduced by the hospital structure of tacit, socially-imposed rules of conduct. Bourdieu's concepts of habitus, capital and symbolic power/violence show how the practical logic that women apply confers a 'sense of place' relative to professionals. Women experience deficits in capital that constrain their ability to exercise choice. This work demonstrates the weakness of the consent process as a safeguard of autonomy. (shrink)

Process models are valuable conceptual tools to help in understanding the approaches to value creation in social enterprises. This teaching case illustrates the application of a process model about creating, building, and sustaining a social enterprise with a mission to provide clean water to communities in need. The social enterprise generates revenue in support of community water projects and works with community stakeholders in different locations throughout the world to provide sustainable clean water solutions. The case study uses primary data (...) from semi-structured interviews, direct observations of a community project, and archival sources to demonstrate application of the process model. The study shows how the social enterprise developed as a promising idea; was implemented through an operating model with resources to support social impact; and continues to build and evolve while guided by the social mission. The paper concludes with a discussion and teaching note on ways to use the case for educational purposes to enhance learning about the social value creation process. (shrink)

Process models are valuable conceptual tools to help in understanding the approaches to value creation in social enterprises. This teaching case illustrates the application of a process model about creating, building, and sustaining a social enterprise with a mission to provide clean water to communities in need. The social enterprise generates revenue in support of community water projects and works with community stakeholders in different locations throughout the world to provide sustainable clean water solutions. The case study uses primary data (...) from semi-structured interviews, direct observations of a community project, and archival sources to demonstrate application of the process model. The study shows how the social enterprise developed as a promising idea; was implemented through an operating model with resources to support social impact; and continues to build and evolve while guided by the social mission. The paper concludes with a discussion and teaching note on ways to use the case for educational purposes to enhance learning about the social value creation process. (shrink)

There has been longstanding interest in the consistency of decisions made by research ethics committees in the UK, but most of the evidence has come from single studies submitted to multiple committees. A systematic comparison was carried out of the decisions made on 18 purposively selected applications, each of which was reviewed independently by three different RECs in a single strategic health authority. Decisions on 11 applications were consistent, but disparities were found among RECs on decisions on seven applications. An (...) analysis of the agreement between decisions of RECs yielded an overall measure of agreement of κ = 0.286 , indicating a level of agreement that, although probably better than chance, may be described as “slight”. The small sample size limits the robustness of these findings. Further research on reasons for inconsistencies in decision making between RECs, and on the importance of such inconsistencies for a range of arguments, is needed. (shrink)

Using two decades worth of experimental philosophy (aka x-phi), Edouard Machery argues in Philosophy within its Proper Bounds (OUP, 2017) that philosophers’ use of the “method of cases” is unreliable because it has a strong tendency to elicit different intuitive responses from non-philosophers. And because, as Machery argues, appealing to such cases is usually the only way for philosophers to acquire the kind of knowledge they seek, an extensive philosophical skepticism follows. I argue that Machery’s “Unreliability” argument fails because, once (...) its premises are percisified, they are either self-defeating or without justification. This is a significant result because Machery’s arguments are the most widely cited and discussed x-phi arguments for philosophical skepticism and many hold that Machery provides the most empirically informed, convincing, and thus best case for this kind of skepticism. So, if my arguments are sound, then the best x-phi argument for philosophical skepticism fails. I further argue that this result provides strong reason to believe the more general conclusion that “negative” x-phi is likely doomed: x-phi likely can never support a substantive philosophical skepticism. Ultimately, I argue for the broad conclusion that all empirically minded arguments for philosophical skepticism are likely to fail for the same reasons that Machery’s does, i.e. they are (likely) self-defeating. (shrink)

The spatial organization of the genome is intimately linked to its biological function, yet our understanding of higher order genomic structure is coarse, fragmented and incomplete. In the nucleus of eukaryotic cells, interphase chromosomes occupy distinct.

People spontaneously discover new representations during problem solving. Discovery of a mathematical representation is of special interest, because it shows that the underlying structure of the problem has been extracted. In the current study, participants solved gear‐system problems as part of a game. Although none of the participants initially used a mathematical representation, many discovered a parity‐based, mathematical strategy during problem solving. Two accounts of the spontaneous discovery of mathematical strategies were tested. According to the automatic schema abstraction hypothesis, experience (...) with multiple, unique problem exemplars facilitates extraction of the parity relation. According to the comparison‐based abstraction hypothesis, explicitly comparing gear pathways that have different number, but the same parity, should result in extraction of parity. An event history analysis showed that accumulation of experiences with different‐number, same‐parity comparisons predicted discovery of parity; accumulation of unique exemplars did not. Results suggest that comparison‐based abstraction processes can lead to the discovery of a mathematical relation. (shrink)

The sounds that make up spoken words are heard in a series and must be mapped rapidly onto words in memory because their elements, unlike those of visual words, cannot simultaneously exist or persist in time. Although theories agree that the dynamics of spoken word recognition are important, they differ in how they treat the nature of the competitor set—precisely which words are activated as an auditory word form unfolds in real time. This study used eye tracking to measure the (...) impact over time of word frequency and 2 partially overlapping competitor set definitions: onset density and neighborhood density. Time course measures revealed early and continuous effects of frequency (facilitatory) and on set based similarity (inhibitory). Neighborhood density appears to have early facilitatory effects and late inhibitory effects. The late inhibitory effects are due to differences in the temporal distribution of similarity within neighborhoods. The early facilitatory effects are due to subphonemic cues that inform the listener about word length before the entire word is heard. The results support a new conception of lexical competition neighborhoods in which recognition occurs against a background of activated competitors that changes over time based on fine-grained goodness-of-fit and competition dynamics. (shrink)

The aim of this study was to uncover and critically examine hidden assumptions that underpin the findings of nurses’ unethical conduct arising from inquiries conducted by the Nurses Tribunal in New South Wales. This was a qualitative study located within a post-structural theoretical framework. Transcripts of five inquiries conducted between 1998 and 2003 were analysed using critical discourse analysis. The findings revealed two dominant discourses that were drawn upon in the inquiries to construct nurses’ conduct as unethical. These were discourses (...) of trust and accountability. The way the nurses were spoken about during the inquiries was shaped by normalising judgements that were used to discursively position the nurse through narrative. (shrink)

The complex-systems approach to cognitive science seeks to move beyond the formalism of information exchange and to situate cognition within the broader formalism of energy flow. Changes in cognitive performance exhibit a fractal (i.e., power-law) relationship between size and time scale. These fractal fluctuations reflect the flow of energy at all scales governing cognition. Information transfer, as traditionally understood in the cognitive sciences, may be a subset of this multiscale energy flow. The cognitive system exhibits not just a single power-law (...) relationship between fluctuation size and time scale but actually exhibits many power-law relationships, whether over time or space. This change in fractal scaling, that is, multifractality, provides new insights into changes in energy flow through the cognitive system. We survey recent findings demonstrating the role of multifractality in (a) understanding atypical developmental outcomes, and (b) predicting cognitive change. We propose that multifractality provides insights into energy flows driving the emergence of cognitive structure. (shrink)

The sounds that make up spoken words are heard in a series and must be mapped rapidly onto words in memory because their elements, unlike those of visual words, cannot simultaneously exist or persist in time. Although theories agree that the dynamics of spoken word recognition are important, they differ in how they treat the nature of the competitor set—precisely which words are activated as an auditory word form unfolds in real time. This study used eye tracking to measure the (...) impact over time of word frequency and 2 partially overlapping competitor set definitions: onset density and neighborhood density. Time course measures revealed early and continuous effects of frequency (facilitatory) and on set based similarity (inhibitory). Neighborhood density appears to have early facilitatory effects and late inhibitory effects. The late inhibitory effects are due to differences in the temporal distribution of similarity within neighborhoods. The early facilitatory effects are due to subphonemic cues that inform the listener about word length before the entire word is heard. The results support a new conception of lexical competition neighborhoods in which recognition occurs against a background of activated competitors that changes over time based on fine‐grained goodness‐of‐fit and competition dynamics. (shrink)

Ethical perception involves seeing what is ethically salient about the particular details of the world. This kind of seeing is like informed judgment. It can be shaped by what we know and what we come to learn about, and by the development of moral virtue. I argue here that we can learn to see food justice, and I describe some ways to do so using three narrative case studies. The mechanism for acquiring this kind of vision is a “food justice (...) narrative” that is particular and concrete. These kinds of stories are counter narratives to a popular and dominant “script” about food that disguises the identity of people who eat, and obscures how constraints on free choice are created by particular lived circumstances. Food justice narratives specify the social and political location of individual people who are trying to nourish themselves. Once this contextual surround is included we are in a position to ask why this person, in this set of circumstances, is impeded in their access to nutritious food. This is not a question we are likely to consider if we leave out the identity of food consumers. Food justice narratives are forward looking as well because they bring into clearer focus what actions and kinds of social activism are appropriate responses to constraints on free choice. (shrink)

What is the future of Philosophy of education? Or as many of scholars and thinkers in this final ‘future-focused’ collective piece from the philosophy of education in a new key Series put it, what are the futures—plural and multiple—of the intersections of ‘philosophy’ and ‘education?’ What is ‘Philosophy’; and what is ‘Education’, and what role may ‘enquiry’ play? Is the future of education and philosophy embracing—or at least taking seriously—and thinking with Indigenous ethicoontoepistemologies? And, perhaps most importantly, what is that (...) ‘Future’? These debates have been located in the work of diverse scholars: from the West, from Global South, from indigenous thinkers. In this collective piece, we purposefully juxtapose diverse takes on the future of these intersections. We have given up the urge to organise, place together, separate with subheadings or connect the paragraphs that follow. Instead, we let these philosophers of education and thinkers who use philosophical texts and ideas to sit together in one long read as potentially ‘strange and unusual bedfellows’. This text urges us to understand how these scholars and thinkers perceive our educational philosophical futures, and how the work and thinking they have done on thinking about what the future of that new key in philosophy of education may look like is embedded in a much deeper and richer literature, and personal experience. (shrink)

Public health and service delivery programmes, interventions and policies are typically developed and implemented for the primary purpose of effecting change rather than generating knowledge. Nonetheless, evaluations of these programmes may produce valuable learning that helps determine effectiveness and costs as well as informing design and implementation of future programmes. Such studies might be termed ‘opportunistic evaluations’, since they are responsive to emergent opportunities rather than being studies of interventions that are initiated or designed by researchers. However, current ethical guidance (...) and registration procedures make little allowance for scenarios where researchers have played no role in the development or implementation of a programme, but nevertheless plan to conduct a prospective evaluation. We explore the limitations of the guidance and procedures with respect to opportunistic evaluations, providing a number of examples. We propose that one key missing distinction in current guidance is moral responsibility: researchers can only be held accountable for those aspects of a study over which they have control. We argue that requiring researchers to justify an intervention, programme or policy that would occur regardless of their involvement prevents or hinders research in the public interest without providing any further protections to research participants. We recommend that trial consent and ethics procedures allow for a clear separation of responsibilities for the intervention and the evaluation. (shrink)

A number of philosophers think that grounding is, in some sense, well-founded. This thesis, however, is not always articulated precisely, nor is there a consensus in the literature as to how it should be characterized. In what follows, I consider several principles that one might have in mind when asserting that grounding is well-founded, and I argue that one of these principles, which I call ‘full foundations’, best captures the relevant claim. My argument is by the process of elimination. For (...) each of the inadequate principles, I illustrate its inadequacy by showing either that it excludes cases that should not be ruled out by a well-foundedness axiom for grounding, or that it admits cases that should be ruled out. (shrink)

Recently John Turri (2015b) has argued, contra the orthodoxy amongst epistemologists, that reliability is not a necessary condition for knowledge. From this result, Turri (2015a, 2017, 2016a, 2019) defends a new account of knowledge - called abilism - that allows for unreliable knowledge. I argue that Turri's arguments fail to establish that unreliable knowledge is possible and argue that Turri's account of knowledge is false because reliability must be a necessary condition for knowledge.

A complement clause is used instead of a noun phrase; for example one can say either I heard [the result] or I heard [that England beat France]. Languages differ in the grammatical properties of complement clauses, and the types of verbs which take them. Some languages lack a complement clause construction but instead employ other construction types to achieve similar ends; these are called complementation strategies. The book explores the variety of types of complementation found across the languages of the (...) world, their grammatical properties and meanings. Detailed studies of particular languages, including Akkadian, Israeli, Jarawara, and Pennsylvania German, are framed by R. M. W. Dixon's introduction, which sets out the range of issues, and his conclusion, which draws together the evidence and the arguments. This book will interest scholars of typology, language universals, syntax, information structure, and language contact in departments of linguistics and anthropology, as well as advanced and graduate students taking courses in these subjects. (shrink)

This paper identifies and examines the possible contributions that emerging fields of study, particularly feminist public health, can make to enhancing and expanding trans/feminist theory and practice. A feminist public-health approach that is rooted in a tradition of political economy, social justice and equity studies, and an anti-oppression orientation, provides one of the most comprehensive "toolboxes" of perspectives, theoretical frameworks, methods, practices, processes, and strategies for trans-oriented scholars and activists.

Dixon, Robert; Reid, Stephen Catholics are the largest religious group in Australia. According to the 2011 Australian Census, Catholics made up just over a quarter of the Australian population: there were 5,439,268 Catholics in a total Australian population of 21,507,719. In the five years between the 2006 and 2011 Censuses, the number of Catholics increased by over 312,000, or 6.1 per cent. During the same period, the total Australian population increased by 8.3 per cent. Catholics have continued to grow (...) in numbers at every census, but their percentage in the Australian population has been declining slowly since the peak of 27.3 per cent in 1991. (shrink)

Comparison of similarities between women and animals does not necessarily show that animals are oppressed, much less that they are oppressed by patriarchy. Moreover, by seeking to establish symbolic connections, ecofeminists run the risk of essentializing women as emotional and bodily and closer to nature than men. Feminists have little to gain by concentrating exclusively on how the concepts of woman and animal overlap. Likewise, there is little to be gained for animal liberation by comparing women and animals in theory (...) and practice. Feminists have obligations to liberate animals to the degree that they have obligations to liberate any oppressed population, but not because there are either theoretical, practical, or symbolic connections between women and animals. (shrink)

Comparison of similarities between women and animals does not necessarily show that animals are oppressed, much less that they are oppressed by patriarchy. Moreover, by seeking to establish symbolic connections, ecofeminists run the risk of essentializing women as emotional and bodily and closer to nature than men. Feminists have little to gain by concentrating exclusively on how the concepts of woman and animal overlap. Likewise, there is little to be gained for animal liberation by comparing women and animals in theory (...) and practice. Feminists have obligations to liberate animals to the degree that they have obligations to liberate any oppressed population, but not because there are either theoretical, practical, or symbolic connections between women and animals. (shrink)

Dixon, Robert; Reid, Stephen; Connolly, Noel Since the Australian Catholic Bishops Conference established a pastoral research capability in 1996, a great deal of research has been carried out on various aspects of the Catholic community in Australia. This research has been carried out either directly by the Bishops Conference's research staff, or in association with other bodies such as NCLS Research, the Christian Research Association, Australian Catholic University and, most recently, Catholic Religious Australia.

This paper aims to show that any account of how artworks lie must acknowledge (I) that artworks can lie at different levels of their content—what I call ‘surface’ and ‘deep’—and (II) that, for an artwork to lie at a given level, a norm of truthful communication such as Grice’s Maxim of Quality must apply to it. A corollary is that it’s harder than you might think for artworks to lie: Quality is not automatically ‘switched on’ during our engagement with art. (...) However, I show how a work’s curation and genre-membership can ‘switch on’ Quality, allowing artworks to lie at different levels. (shrink)

Partial grounding is often thought to be formally analogous to proper parthood in certain ways. Both relations are typically understood to be asymmetric and transitive, and as such, are thought to be strict partial orders. But how far does this analogy extend? Proper parthood is often said to obey the weak supplementation principle. There is reason to wonder whether partial grounding, or, more precisely, proper partial grounding, obeys a ground-theoretic version of this principle. In what follows, I argue that it (...) does not. The cases that cause problems for the supplementation principle for grounding also serve as counterexamples to another principle, minimality, defended by Paul Audi. (shrink)