BackgroundInformed consent as stipulated in regulatory human research guidelines requires volunteers to be well-informed about what will happen to them in a trial. However, researchers may be faced with the challenge of how to ensure that a volunteer agreeing to take part in a clinical trial is truly informed. This study aimed to find out volunteers’ comprehension of informed consent and voluntary participation in Human Immunodeficiency Virus (HIV) clinical trials during the registration cohort.MethodsWe conducted a qualitative study among volunteers who (...) were enrolled in the registration cohort of HIV clinical trials in Dar es Salaam, Tanzania. A purposive sampling strategy was used to obtain twenty study participants. The data were collected between June and September 2020 using a semi-structured interview guide. In-depth interviews were used to collect the data to obtain deep insights of the individual study participants on the comprehension of informed consent and participation in the clinical trial. A thematic analysis approach was used to analyze the data. Themes and subthemes were supported by the quotes from the participants.ResultsVolunteers described comprehension of informed consent from different perspectives. They reported that various components of the informed consent such as study procedure, confidentiality, risk and benefits were grasped during engagement meetings. Furthermore, the volunteers’ decision to participate in the registration cohort was voluntary. However, trial aspects such as health insurance, free condoms, and medical checkups could have indirectly influenced their reluctance to withdraw from the study.ConclusionEngagement meetings may increase the comprehension of informed consent among potential participants for HIV clinical trials. However, trial incentives may influence participation, and thus future research should focus on the challenges of giving incentives in the study. This will ensure comprehension and voluntary participation in the context of HIV clinical trials. (shrink)

David Furley's work on the cosmologies of classical antiquity is structured around what he calls "two pictures of the world." The first picture, defended by both Plato and Aristotle, portrays the universe, or all that there is (to pan), as identical with our particular ordered world-system. Thus, the adherents of this view claim that the universe is finite and unique. The second system, defended by Leucippus and Democritus, portrays an infinite universe within which our particular kosmos is only one of (...) countless kosmoi. Aristotle's argument in De caelo I.9 that the world is necessarily unique is an important contribution to this debate. This argument holds interest because it shows Aristotle wrestling with an apparent inconsistency in his own philosophy, as deeply-held convictions within his cosmology collide with an equally deeply-held conviction within his metaphysics. The following three principles, each of which Aristotle appears committed to, are inconsistent: -/- The cosmic uniqueness principle. The world is necessarily unique. The cosmic form principle. The world is an ordered, structured unity. As such, the world has a form. The possibility of multiple instantiation principle. For all F, if F is a form, it is possible that there exist multiple Fs. In De caelo I.9, Aristotle argues that we can establish the uniqueness of the universe, reject the multiple instantiation principle, yet still retain the distinction between 'this world' and 'world in general,' if the following is true (as it is): the world takes up all the matter that exists. Aristotle illustrates this argument with one of the stranger analogies in his corpus: imagine an aquiline nose that takes up all the flesh in the universe. If this were so, then there could not exist any other aquiline objects whatsoever. (For this reason, we dub the De caelo I.9 argument the 'Cosmic Nose argument.') This paper is an interpretation of how this argument is supposed to proceed and an assessment of its success. The first section states the problem Aristotle is confronted with, sorts through Aristotle's various statements of the Cosmic Nose argument, which exhibit some sloppiness, and reconstructs charitably a single argument. We also spend some time examining the significance of Aristotle's example of a gigantic aquiline nose. We argue that, even charitably reconstructed, the argument appears to commit a serious modal fallacy. The remainder of the paper explores whether this modal fallacy can be overcome. We conclude that, although not a cogent argument for the uniqueness of the world (as this would require a significant revision of our current astronomy), the Cosmic Nose argument does succeed on its own terms. However, it should not be regarded as a free-standing argument for the uniqueness of the world. Instead, it depends crucially on the earlier argument in De caelo I.8 for the universe's uniqueness; De caelo I.9 should be viewed as an attempt to extend the conclusion of De caelo I.8 and to show how this conclusion can be made consistent with Aristotle's metaphysical principles about the nature of form. (shrink)

With good reason, most critics associate the Papacy with reaction. The lingering image is one of a Renaissance holy prince lying in state beneath twisted Bernini columns, his aquiline Medici profile turned toward heaven. Popes have historically been of, and hence often for, the well-born. Their writings have been typified by a noblesse oblige attitude toward the poor who, after all, will “always be with us.” Indeed, on the one occasion when the forces of rebellion embraced a Pope — (...) Pius IX, in the 1840s — they watched the “prince” of the Church turn back into just that. With even greater certainty ever after, the view on the Left has been that Popes will be Popes. (shrink)