Aim: Streamlining consent for low-risk comparative effectiveness research (CER) could facilitate research, while safeguarding patients' rights. Materials & methods: 2618 adults were randomized to one of seven consent approaches (six streamlined and one traditional) for a hypothetical, low-risk CER study. A survey measured understanding, voluntariness, and feelings of respect. Results: Participants in all arms had a high understanding of the trial and positive attitudes toward the consent interaction. Highest satisfaction was with a streamlined approach showing a video before the medical (...) appointment. Participants in streamlined were more likely to mistakenly think a signature was required. Conclusion: Streamlined consent was no less acceptable than traditional, signed consent. Streamlined and traditional approaches achieved similar levels of understanding, voluntariness and a feeling that the doctor–patient interaction was respectful. (shrink)

BackgroundNeuroethics describes several interdisciplinary topics exploring the application and implications of engaging neuroscience in societal contexts. To explore this topic, we present Part 3 of a four-part bibliography of neuroethics’ literature focusing on the “ethics of neuroscience.”MethodsTo complete a systematic survey of the neuroethics literature, 19 databases and 4 individual open-access journals were employed. Searches were conducted using the indexing language of the U.S. National Library of Medicine. A Python code was used to eliminate duplications in the final bibliography.ResultsThis bibliography (...) consists of 1137 papers, 56 books, and 134 book chapters published from 2002 through 2014, covering ethical issues in neuroimaging, neurogenetics, neurobiomarkers, neuro-psychopharmacology, brain stimulation, neural stem cells, neural tissue transplants, pediatric-specific issues, dual-use, and general neuroscience research issues. These works contain explanations of recent research regarding neurotechnology, while exploring ethical issues in future discoveries and use. (shrink)

We propose a ‘Moral Imagination’ methodology to facilitate a culture of responsible innovation for engineering and product teams in technology companies. Our approach has been operationalized over the past two years at Google, where we have conducted over 50 workshops with teams from across the organization. We argue that our approach is a crucial complement to existing formal and informal initiatives for fostering a culture of ethical awareness, deliberation, and decision-making in technology design such as company principles, ethics and privacy (...) review procedures, and compliance controls. We characterize some distinctive benefits of our methodology for the technology sector in particular. (shrink)

Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...) of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences. (shrink)

This paper introduces a new, expanded range of relevant cognitive psychological research on collaborative recall and social memory to the philosophical debate on extended and distributed cognition. We start by examining the case for extended cognition based on the complementarity of inner and outer resources, by which neural, bodily, social, and environmental resources with disparate but complementary properties are integrated into hybrid cognitive systems, transforming or augmenting the nature of remembering or decision-making. Adams and Aizawa, noting this distinctive complementarity argument, (...) say that they agree with it completely: but they describe it as “a non-revolutionary approach” which leaves “the cognitive psychology of memory as the study of processes that take place, essentially without exception, within nervous systems.” In response, we carve out, on distinct conceptual and empirical grounds, a rich middle ground between internalist forms of cognitivism and radical anti-cognitivism. Drawing both on extended cognition literature and on Sterelny’s account of the “scaffolded mind” (this issue), we develop a multidimensional framework for understanding varying relations between agents and external resources, both technological and social. On this basis we argue that, independent of any more “revolutionary” metaphysical claims about the partial constitution of cognitive processes by external resources, a thesis of scaffolded or distributed cognition can substantially influence or transform explanatory practice in cognitive science. Critics also cite various empirical results as evidence against the idea that remembering can extend beyond skull and skin. We respond with a more principled, representative survey of the scientific psychology of memory, focussing in particular on robust recent empirical traditions for the study of collaborative recall and transactive social memory. We describe our own empirical research on socially distributed remembering, aimed at identifying conditions for mnemonic emergence in collaborative groups. Philosophical debates about extended, embedded, and distributed cognition can thus make richer, mutually beneficial contact with independently motivated research programs in the cognitive psychology of memory. (shrink)

Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...) of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences. (shrink)

Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...) of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences. (shrink)

Background Design thinking is a tool for generating and exploring ideas from multiple stakeholders. We used DT principles to introduce students to the ethical implications of organ transplantation. Students applied DT principles to propose solutions to maximise social justice in liver transplant allocation. Methods A 150 min interactive workshop was integrated into the longitudinal ethics curriculum. Following a group didactic on challenges of organ donation in the USA supplemented by patient stories, teams of students considered alternative solutions to optimise fairness (...) of organ distribution and ethical implications of changing the current model. Facilitators led students through DT steps of empathy, defining the team’s point of view, ideating on potential solutions, prototyping a specific idea and testing the idea through oral presentation, with questions and answers by peers and faculty. The curriculum was evaluated with presurveys and postsurveys including quantitative and open-ended items. Results 100 first year medical students participated. Before the session, 75.3% of students had no practical experience with DT. Following participation, students reported an increased understanding of the current liver transplant allocation system and an increased appreciation of shortcomings of the current organ allocation system. After the session, 73.8% of students felt that DT could be used to approach complex health system problems. Discussion Students participating in a DT workshop displayed improved knowledge and attitudes toward organ transplantation and DT. In this pilot study, DT showed promise as a student-led approach emphasising collaboration and creativity in ethics curricula in medical education. (shrink)

Transactive memory theory describes the processes by which benefits for memory can occur when remembering is shared in dyads or groups. In contrast, cognitive psychology experiments demonstrate that social influences on memory disrupt and inhibit individual recall. However, most research in cognitive psychology has focused on groups of strangers recalling relatively meaningless stimuli. In the current study, we examined social influences on memory in groups with a shared history, who were recalling a range of stimuli, from word lists to personal, (...) shared memories. We focused in detail on the products and processes of remembering during in-depth interviews with 12 older married couples. These interviews consisted of three recall tasks: (1) word list recall; (2) personal list recall, where stimuli were relevant to the couples’ shared past; and (3) an open-ended autobiographical interview. We conducted these tasks individually and then collaboratively two weeks later. Across each of the tasks, although some couples demonstrated collaborative inhibition, others demonstrated collaborative facilitation. We identified a number of factors that predicted collaborative success, in particular, group-level strategy use. Our results show that collaboration may help or hinder memory, and certain interactions are more likely to produce collaborative benefits. (shrink)

A relatively small segment of business, known as social entrepreneurship (SE), is increasingly being acknowledged as an effective source of solutions for a variety of social problems. Because society tends to view "new" solutions as "the" solution, we are concerned that SE will soon be expected to provide answers to our most pressing social ills. In this paper we call into question the ability of SE, by itself, to provide solutions on a scope necessary to address large-scale social issues. SE (...) cannot reasonably be expected to solve social problems on a large scale for a variety of reasons. The first we label the orga nizational legitimacy argument. This argument leads to our second argument, the isomorphism argument. We also advance three other claims, the moral y political and structural arguments. After making our arguments, we explore ways in which SE, in concert with other social institutions, can effectively address social ills. We also present two examples of successful ventures in which SEs partnered with governments and other institutions. (shrink)

It was, until recently, accepted that the two classes of acetylcholine (ACh) receptors are distinct in an important sense: muscarinic ACh receptors signal via heterotrimeric GTP binding proteins (G proteins), whereas nicotinic ACh receptors (nAChRs) open to allow flux of Na+, Ca2+, and K+ ions into the cell after activation. Here we present evidence of direct coupling between G proteins and nAChRs in neurons. Based on proteomic, biophysical, and functional evidence, we hypothesize that binding to G proteins modulates the activity (...) and signaling of nAChRs in cells. It is important to note that while this hypothesis is new for the nAChR, it is consistent with known interactions between G proteins and structurally related ligand‐gated ion channels. Therefore, it underscores an evolutionarily conserved metabotropic mechanism of G protein signaling via nAChR channels.Also watch the Video Abstract. (shrink)

Highlights: -/- • -/- Proposes forward-looking approach to studying climate collapse risks. • -/- Suggests diminishing returns on climate adaptation as a collapse mechanism. • -/- Suggests strategies for sustainable adaptation pathways in face of climate change. • -/- Illustrates analysis with examples of small island states and global food security. -/- Abstract: -/- This article proposes a forward-looking approach to studying societal collapse risks related to climate change. Such an approach should indicate how to study emerging collapse risks and (...) suggest strategies for adapting to them. Our approach is based on three postulates that facilitate a forward-looking approach: (1) collapse, if it occurred, would be a lengthy process rather than an abrupt event; (2) significant collapse risks already exist in some places; and (3) diminishing returns on adaptation to intensifying climate impacts are a key driver of collapse risks. The first two postulates suggests that collapse risks can be studied in process, while the third points to strategies for adaptation pathways that avoid unsustainable diminishing returns. Applying diminishing returns to climate change adaptation, rather than sociopolitical complexity or resource extraction, is also a novel theoretical contribution to collapse literature. [Open access]. (shrink)

Large language models (LLMs) reflect societal norms and biases, especially about gender. While societal biases and stereotypes have been extensively researched in various NLP applications, there is a surprising gap for emotion analysis. However, emotion and gender are closely linked in societal discourse. E.g., women are often thought of as more empathetic, while men's anger is more socially accepted. To fill this gap, we present the first comprehensive study of gendered emotion attribution in five state-of-the-art LLMs (open- and closed-source). We (...) investigate whether emotions are gendered, and whether these variations are based on societal stereotypes. We prompt the models to adopt a gendered persona and attribute emotions to an event like 'When I had a serious argument with a dear person'. We then analyze the emotions generated by the models in relation to the gender-event pairs. We find that all models consistently exhibit gendered emotions, influenced by gender stereotypes. These findings are in line with established research in psychology and gender studies. Our study sheds light on the complex societal interplay between language, gender, and emotion. The reproduction of emotion stereotypes in LLMs allows us to use those models to study the topic in detail, but raises questions about the predictive use of those same LLMs for emotion applications. (shrink)

Emotions are a central aspect of communication. Consequently, emotion analysis (EA) is a rapidly growing field in natural language processing (NLP). However, there is no consensus on scope, direction, or methods. In this paper, we conduct a thorough review of 154 relevant NLP publications from the last decade. Based on this review, we address four different questions: (1) How are EA tasks defined in NLP? (2) What are the most prominent emotion frameworks and which emotions are modeled? (3) Is the (...) subjectivity of emotions considered in terms of demographics and cultural factors? and (4) What are the primary NLP applications for EA? We take stock of trends in EA and tasks, emotion frameworks used, existing datasets, methods, and applications. We then discuss four lacunae: (1) the absence of demographic and cultural aspects does not account for the variation in how emotions are perceived, but instead assumes they are universally experienced in the same manner; (2) the poor fit of emotion categories from the two main emotion theories to the task; (3) the lack of standardized EA terminology hinders gap identification, comparison, and future goals; and (4) the absence of interdisciplinary research isolates EA from insights in other fields. Our work will enable more focused research into EA and a more holistic approach to modeling emotions in NLP. (shrink)

The basis of science is the hypothetico-deductive method and the recording of experiments in sufficient detail to enable reproducibility. We report the development of Robot Scientist "Adam," which advances the automation of both. Adam has autonomously generated functional genomics hypotheses about the yeast Saccharomyces cerevisiae and experimentally tested these hypotheses by using laboratory automation. We have confirmed Adam's conclusions through manual experiments. To describe Adam's research, we have developed an ontology and logical language. The resulting formalization involves over 10,000 different (...) research units in a nested treelike structure, 10 levels deep, that relates the 6.6 million biomass measurements to their logical description. This formalization describes how a machine contributed to scientific knowledge. (shrink)

This handbook presents a comprehensive introduction to the core areas of philosophy of education combined with an up-to-date selection of the central themes. It includes 95 newly commissioned articles that focus on and advance key arguments; each essay incorporates essential background material serving to clarify the history and logic of the relevant topic, examining the status quo of the discipline with respect to the topic, and discussing the possible futures of the field. The book provides a state-of-the-art overview of philosophy (...) of education, covering a range of topics: Voices from the present and the past deals with 36 major figures that philosophers of education rely on; Schools of thought addresses 14 stances including Eastern, Indigenous, and African philosophies of education as well as religiously inspired philosophies of education such as Jewish and Islamic; Revisiting enduring educational debates scrutinizes 25 issues heavily debated in the past and the present, for example care and justice, democracy, and the curriculum; New areas and developments addresses 17 emerging issues that have garnered considerable attention like neuroscience, videogames, and radicalization. The collection is relevant for lecturers teaching undergraduate and graduate courses in philosophy of education as well as for colleagues in teacher training. Moreover, it helps junior researchers in philosophy of education to situate the problems they are addressing within the wider field of philosophy of education and offers a valuable update for experienced scholars dealing with issues in the sub-discipline. Combined with different conceptions of the purpose of philosophy, it discusses various aspects, using diverse perspectives to do so. Contributing Editors: Section 1: Voices from the Present and the Past: Nuraan Davids Section 2: Schools of Thought: Christiane Thompson and Joris Vlieghe Section 3: Revisiting Enduring Debates: Ann Chinnery, Naomi Hodgson, and Viktor Johansson Section 4: New Areas and Developments: Kai Horsthemke, Dirk Willem Postma, and Claudia Ruitenberg. (shrink)

In his contribution to the first issue of Memory Studies, Jeffrey Olick notes that despite “the mutual affirmations of psychologists who want more emphasis on the social and sociologists who want more emphasis on the cognitive”, in fact “actual crossdisciplinary research … has been much rarer than affirmations about its necessity and desirability” (2008: 27). The peculiar, contingent disciplinary divisions which structure our academic institutions create and enable many powerful intellectual cultures: but memory researchers are unusually aware that uneasy faultlines (...) and glaring gulfs lie in the uncertain zones between them. The processes of memory are simultaneously natural and cultural. But our difficulties in imagining even fragments of a genuinely integrated framework for understanding diverse memory-related phenomena do not arise from a simple ‘two-cultures’ problem: it’s not as if there are substantially unified visions of memory within either ‘the sciences’ or ‘the humanities’. (shrink)

The goal of the 2010 Ontology Summit was to address the current shortage of persons with ontology expertise by developing a strategy for the education of ontologists. To achieve this goal we studied how ontologists are currently trained, the requirements identified by organizations that hire ontologists, and developments that might impact the training of ontologists in the future. We developed recommendations for the body of knowledge that should be taught and the skills that should be developed by future ontologists; these (...) recommendations are intended as guidelines for institutions and organizations that may consider establishing a program for training ontologists. Further, we recommend a number of specific actions for the community to pursue. (shrink)

ObjectiveCo-morbid insomnia and sleep apnea is a common and debilitating condition that is more difficult to treat compared to insomnia or sleep apnea-alone. Emerging evidence suggests that cognitive behavioral therapy for insomnia is effective in patients with COMISA, however, those with more severe sleep apnea and evidence of greater objective sleep disturbance may be less responsive to CBTi. Polysomnographic sleep study data has been used to predict treatment response to CBTi in patients with insomnia-alone, but not in patients with COMISA. (...) We used randomized controlled trial data to investigate polysomnographic predictors of insomnia improvement following CBTi, versus control in participants with COMISA.MethodsOne hundred and forty five participants with insomnia and sleep apnea [apnea-hypopnea index ≥ 15] were randomized to CBTi or no-treatment control. Mixed models were used to investigate the effect of pre-treatment AHI, sleep duration, and other traditional, and novel [quantitative electroencephalography ] polysomnographic predictors of between-group changes in Insomnia Severity Index scores from pre-treatment to post-treatment.ResultsCompared to control, CBTi was associated with greater ISI improvement among participants with; higher AHI, less wake after sleep onset, and less N3 sleep. No quantitative electroencephalographic, or other traditional polysomnographic variables predicted between-group ISI change.DiscussionAmong participants with COMISA, higher OSA severity predicted a greater treatment-response to CBTi, versus control. People with COMISA should be treated with CBTi, which is effective even in the presence of severe OSA and objective sleep disturbance. (shrink)

Psychedelics have been recognized as model interventions for studying altered states of consciousness. However, few empirical studies of the shamanic state of consciousness, which is anecdotally similar to the psychedelic state, exist. We investigated the neural correlates of shamanic trance using high-density electroencephalography (EEG) in 24 shamanic practitioners and 24 healthy controls during rest, shamanic drumming, and classical music listening, followed by an assessment of altered states of consciousness. EEG data were used to assess changes in absolute power, connectivity, signal (...) diversity, and criticality, which were correlated with assessment measures. We also compared assessment scores to those of individuals in a previous study under the influence of psychedelics. Shamanic practitioners were significantly different from controls in several domains of altered states of consciousness, with scores comparable to or exceeding that of healthy volunteers under the influence of psychedelics. Practitioners also displayed increased gamma power during drumming that positively correlated with elementary visual alterations. Furthermore, shamanic practitioners had decreased low alpha and increased low beta connectivity during drumming and classical music and decreased neural signal diversity in the gamma band during drumming that inversely correlated with insightfulness. Finally, criticality in practitioners was increased during drumming in the low and high beta and gamma bands, with increases in the low beta band correlating with complex imagery and elementary visual alterations. These findings suggest that psychedelic drug-induced and non-pharmacologic alterations in consciousness have overlapping phenomenal traits but are distinct states of consciousness, as reflected by the unique brain-related changes during shamanic trance compared to previous literature investigating the psychedelic state. (shrink)

The impact of neoliberal reforms of education systems on the work of teachers and school leaders, particularly in relation to high-stakes accountability frameworks, has been extensively studied in recent decades. One significant aspect of neoliberal schooling is the emergence of quasi-autonomous public schools (such as Academies in England, Charter Schools in the USA and Independent Public Schools in Australia), characterised by heterarchical governance models, the promotion of entrepreneurial leadership cultures, and the promotion of a discourse of pursuing educational equity by (...) means of ‘achievement for all’. This paper explores the emergence of a mode of teacher professionalism characteristic of these quasi-autonomous schools, and conceptualises this as being ‘neo-performative’. The neo-performative profession is shaped by the shift in the focus of the regulation and management of schools from ‘governing to governance’, and the consequential rise of the ‘responsibilised profession’, and marked by the emergence of an entrepreneurial model of school leadership. The paper argues that this new conceptualisation of teacher professionalism requires further, more focused, empirical study in order to explore how neoperformative teachers and school leaders articulate their vision of educational equity and social justice, and how they enact this vision in an increasingly intensified high-stakes accountability culture. (shrink)

This publication features the stories and experiences of pharmacy professionals who identify as members of historically underrepresented groups. This collection of personal essays presents significant events in the lives of those in the pharmacy community whose experiences have been shaped by their race, ethnicity, gender or gender presentation, sexual orientation, ability, language, mental health, or other factors. The perspectives from the narratives highlight the importance of diversity, equity, and inclusion in the healthcare sector. The authors of the narratives also reflect (...) on their experience to consider what they wish would have happened in the experience, to offer advice for others that may be faced with similar situations. Access to these stories will deepen the collective understanding among pharmacy colleagues, patients, and society of the experiences that individuals from historically underrepresented groups within pharmacy have experienced. (shrink)

This article describes the spiritual formation training program for counseling students at Richmont Graduate University, an evangelical institution providing Master’s-level instruction for counselors and ministers. This model of spiritual formation has a dual foundation which includes the centrality of love to the Christian life and the importance of attachment to the development of persons. The training is intentionally designed to invite students to pursue a more secure attachment to God, healthier relationships with others, and a more grace-based self-awareness. Integrative and (...) clinical instruction, and experiences that foster establishment of secure attachment are described. Co-curricular efforts in research and student advisement focus on grace and wellness, as well as opportunities for service, and these serve to further contribute to a supportive environment for spiritual formation. (shrink)

Experimental memory research has traditionally focused on the individual, and viewed social influence as a source of error or inhibition. However, in everyday life, remembering is often a social activity, and theories from philosophy and psychology predict benefits of shared remembering. In a series of studies, both experimental and more qualitative, we attempted to bridge this gap by examining the effects of collaboration on memory in a variety of situations and in a variety of groups. We discuss our results in (...) terms of a functional view of collaborative remembering, and consider when and in what ways remembering with others might help or hinder memory. (shrink)

We have a striking ability to alter our psychological access to past experiences. Consider the following case. Andrew “Nicky” Barr, OBE, MC, DFC, (1915 – 2006) was one of Australia’s most decorated World War II fighter pilots. He was the top ace of the Western Desert’s 3 Squadron, the pre-eminent fighter squadron in the Middle East, flying P-40 Kittyhawks over Africa. From October 1941, when Nicky Barr’s war began, he flew 22 missions and shot down eight enemy planes in his (...) first 35 operational hours. He was shot down three times, once 25 miles behind enemy lines while trying to rescue a downed pilot. He escaped from prisoner of war camps four times, once jumping out of a train as it travelled from Italy into Austria. His wife Dot, who he married only weeks before the war, waited for him at home. She was told on at least three occasions that he was missing in action or dead. For 50 years, Nicky Barr never spoke publicly, and rarely privately, of his war-time experiences. He was very much a forgotten and forgetting hero (for further details, see Dornan, 2002). In his first public interview in 2002 on the Australian documentary program “Australian Story”, Nicky explained his 50 year silence by saying. (shrink)

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies (...) show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for the worse off, and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting. (shrink)

People live and age together in social groups. Across a range of outcomes, research has identified interdependence in the cognitive and health trajectories of ageing couples. Various types of memory decline with age and people report using a range of internal and external, social, and material strategies to compensate for these declines. While memory compensation strategies have been widely studied, research so far has focused only on single individuals. We examined interdependence in the memory compensation strategies reported by spouses within (...) 58 older couples. Couples completed the Memory Compensation Questionnaire, as well as an open-ended interview about their memory compensation practices. We found that internal, intra-individual memory compensation strategies were not associated within couples, but external, extra-individual strategies showed interdependence. Individuals’ scores on material/technological compensation strategies were positively correlated with their partners’. Reported reliance on a spouse was higher for men and increased with age. Our open-ended interviews yielded rich insights into the complex and diverse resources that couples use to support memory in day-to-day life. Particularly evident was the extent of interaction and coordination between social and material compensation, such that couples jointly used external compensation resources. Our results suggest that individuals’ reports of their compensation strategies do not tell the whole story. Rather, we propose that older couples show interdependence in their memory compensation strategies, and adopt complex systems of integrated material and social memory compensation in their day-to-day lives. (shrink)

Background: In the last two decades, nursing authors have published ethical analyses of palliative sedation—an end-of-life care practice that also receives significant attention in the broader medical and bioethics literature. This nursing literature is important, because it contributes to disciplinary understandings about nursing values and responsibilities in end-of-life care. Research aim: The purpose of this project is to review existing nursing ethics literature about palliative sedation, and to analyze how nurses’ moral identities are portrayed within this literature. Research design: We (...) reviewed discussion papers, written by nurses about the ethics of palliative sedation, which were cited in MEDLINE, CINAHL, Nursing and Allied Health, or Philosopher’s Index (search date March 2018). Twenty-one papers met selection criteria. We performed a comprehensive review and analysis (using the Qualitative Analysis Guide of Leuven), of the values, responsibilities, and relationships reflected in authors’ portrayal of the nursing role. Findings: Two different tones are apparent in the extant nursing ethics literature. One is educational, while the other is critically reflective. Irrespective of tone, all authors agree on the alleviation of suffering as a fundamental nursing responsibility. However, they differ in their analysis of this responsibility in relation to other values in end-of-life care, including those that depend on consciousness. Finally, authors emphasize the importance of subjective and experience-based understandings of palliative sedation, which they argue as depending on nurses’ proximity to patients and families in end-of-life care. Discussion and conclusion: Based on our findings, we develop three recommendations for future writing by nurses about palliative sedation. These relate to the responsibility of recognizing how consciousness might matter in (some) peoples’ moral experiences of death and dying, to the importance of moral reflectiveness in nursing practice, and to the value of a relational approach in conceptualizing the nursing ethics of palliative sedation. (shrink)

The use of remember–know judgments to assess subjective experience associated with memory retrieval, or as measures of recollection and familiarity processes, has been controversial. In the current study we had participants think aloud during study and provide verbal reports at test for remember–know and confidence judgments. Results indicated that the vast majority of remember judgments for studied items were associated with recollection from study , but this correspondence was less likely for high-confidence judgments . Instead, high-confidence judgments were more likely (...) than remember judgments to be associated with incorrect recollection and a lack of recollection. Know judgments were typically associated with a lack of recollection , but still included recollection from the study context . Thus, although remember judgments provided fairly accurate assessments of retrieval including contextual details, know judgments did not provide accurate assessments of retrieval lacking contextual details. (shrink)

The present study assessed business students’ responses to an innovative interactive presentation on academic integrity that employed quoted material from previous students as launching points for discussion. In total, 15 business classes ( n = 412 students) including 2nd, 3rd and 4th year level students participated in the presentations as part of the ethics component of ongoing courses. Students’ perceptions of the importance of academic integrity, self-reports of cheating behaviors, and factors contributing to misconduct were examined along with perceptions about (...) the presentation. Discussion sessions revealed that academic misconduct is a complex issue. For example, knowledge of what constitutes misconduct was not consistent across domains (e.g. exam contexts versus group work), penalties were not wholly known, and there was variation in perceived responsibility for reporting and representing academic integrity. Survey measures revealed that self-reported academic misconduct was more prevalent than expected with only 7.5% of students indicating they had never cheated in any way. Furthermore, results showed gender and year of study as predictive factors for issues related to academic misconduct. In general, students were receptive to this form of presentation. The implications of such instructional interventions for enhancing ethical behaviors in higher education classrooms are discussed. (shrink)

In this article, we posit that a cross-scale perspective is valuable for studies of organizational resilience. Existing research in our field primarily focuses on the resilience of organizations, that is, the factors that enhance or detract from an organization’s viability in the face of threat. While this organization level focus makes important contributions to theory, organizational resilience is also intrinsically dependent upon the resilience of broader social-ecological systems in which the firm is embedded. Moreover, long-term organizational resilience cannot be well (...) managed without an understanding of the feedback effects across nested systems. For instance, a narrow focus on optimizing organizational resilience from one firm’s perspective may come at the expense of social-ecological functioning and ultimately undermine managers’ efforts at long-term organizational survival. We suggest that insights from natural science may help organizational scholars to examine cross-scale resilience and conceptualize organizational actions within and across temporal and spatial dynamics. We develop propositions taking a complex adaptive systems perspective to identify issues related to focal scale, slow variables and feedback, and diversity and redundancy. We illustrate our theoretical argument using an example of Unilever and palm oil production in Borneo. (shrink)

Clinical delusions are difficult to investigate in the laboratory because they co-occur with other symptoms and with intellectual impairment. Partly for these reasons, researchers have recently begun to use hypnosis with neurologically intact people in order to model clinical delusions. In this paper we describe striking analogies between the behavior of patients with a clinical delusion of mirrored self misidentification, and the behavior of highly hypnotizable subjects who receive a hypnotic suggestion to see a stranger when they look in the (...) mirror. Based on these analogies, we argue that the use of hypnosis is a reliable method to investigate the surface features of clinical delusions. But to what extent can hypnosis successfully recreate delusions? Can it also contribute to a better understanding of delusion formation? Although clinical delusions and hypnotically induced beliefs are different in etiology, some analogies can be identified in the underlying processes that characterise them, based on the two-factor theory of delusion formation. (shrink)

As one approach to examining the way ethical decisions are made, we asked experts and novices to review a set of scenarios that depict some important ethical tensions in research. The method employed was “protocol analysis,” a talk-aloud technique pioneered by cognitive scientists for the analysis of expert performance. The participants were asked to verbalize their normally unexpressed thought processes as they responded to the scenarios, and to make recommendations for courses of action. We found that experts spent more time (...) working through the decision-making process than novices and also raised substantially more concerns than novices. Differences also exist among the three groups of experts. (shrink)

Introduction The goal of this project was to develop and validate a new tool to evaluate learners' knowledge and skills related to research ethics. Methods A core set of 50 questions from existing computer-based online teaching modules were identified, refined and supplemented to create a set of 74 multiple-choice, true/false and short answer questions. The questions were pilot-tested and item discrimination was calculated for each question. Poorly performing items were eliminated or refined. Two comparable assessment tools were created. These assessment (...) tools were administered as a pre-test and post-test to a cohort of 58 Indian junior health research investigators before and after exposure to a new course on research ethics. Half of the investigators were exposed to the course online, the other half in person. Item discrimination was calculated for each question and Cronbach's α for each assessment tool. A final version of the assessment tool that incorporated the best questions from the pre-/post-test phase was used to assess retention of research ethics knowledge and skills 3 months after course delivery. Results The final version of the REKASA includes 41 items and had a Cronbach's α of 0.837. Conclusion The results illustrate, in one sample of learners, the successful, systematic development and use of a knowledge and skills assessment tool in research ethics capable of not only measuring basic knowledge in research ethics and oversight but also assessing learners' ability to apply ethics knowledge to the analytical task of reasoning through research ethics cases, without reliance on essay or discussion-based examination. These promising preliminary findings should be confirmed with additional groups of learners. (shrink)