As clinical trials end, little is understood about how participants exiting from clinical trials approach decisions related to the removal or post-trial use of investigational brain implants, such as deep brain stimulation (DBS) devices. This empirical bioethics study examines how research participants experience the process of exit from research at the end of clinical trials of implanted neural devices. Using a modified grounded theory study design, we conducted semi-structured, in-depth interviews with 16 former research participants from clinical trials of DBS (...) and responsive neurostimulation (RNS). Open-ended questions elicited motivations for joining the trial, understanding of study procedures at the time of initial informed consent, the process of exiting from research, and decisions about device removal or post-trial device use. Thematic analysis identified categories related to: limited preparedness for the end of research participation, straightforwardness of decisions to explant or keep the device, reconciling with the end of research participation, reconciling post-trial expectations, and achieving a sense of closure after exit from research. A preliminary theoretical model describes contextual factors influencing the process and experience of exit from research. Experiences of clinical trial participants should guide research practices to enhance the ethical design and conduct of clinical trials in DBS and other brain devices. (shrink)

The new National Institutes of Health (NIH) Policy on the Use of a Single Institutional Review Board (sIRB) for Multi-Site Research was adopted primarily to simplify and speed the review of complex multisite clinical trials. However, speeding review requires overcoming a number of obstacles. Perhaps the most substantial obstacle is the time and effort needed to develop reliance agreements among the participating sites. We conducted 102 semistructured interviews with sIRB personnel, including directors, chairs, reviewers, and staff, from 20 IRBs that (...) acted as sIRBs for multisite research, including 6 commercial/independent sIRBs, and 10 university-based academic and 4 federal sIRBs. Almost without exception, the interviewees agreed that reliance agreements were complex, difficult to develop, and time-consuming. A major problem for relying sites was that different agreements specified different responsibilities for the relying sites. Attitudes differed about whether these problems will be resolved as IRB staff and managers become more experienced with sIRBs. However it is clear that the process of developing reliance agreements must be simplified. Federal assistance in standardizing at least some sections of reliance agreements might reduce the difficulties involved. (shrink)

PurposePrevious studies examining the relationship between health-related quality of life and speech perception ability in cochlear implant users have yielded variable results, due to a range of factors, such as a variety of different HRQoL questionnaires and CI speech testing materials in addition to CI configuration. In order to decrease inherent variability and better understand the relationship between these measures in CI users, we administered a commonly used clinical CI speech testing battery as well as two popular HRQoL questionnaires in (...) bimodal and bilateral CI users.MethodsThe Glasgow Benefit Inventory, a modified five-factor version of the GBI, and the Nijmegen Cochlear Implant Questionnaire were administered to 25 CI users. Speech perception abilities were measured with the AzBio sentence test in several conditions.ResultsHigher performance scores on the GBI general subscore were related to greater binaural speech perception ability in noise. There were no other relationships between the GBI or NCIQ and speech perception ability under any condition. Scores on many of the GBI-5F factors were substantially skewed and asymmetrical; therefore, correlational analyses could not be applied. Across all participants, binaural speech perception scores were greater than first-ear CI only scores.ConclusionThe GBI general subscore was related to binaural speech perception, which is considered the everyday listening condition of bimodal and bilateral CI users, in noise; while the more CI-specific NCIQ did not relate to speech perception ability in any listening condition. Future research exploring the relationships between the GBI, GBI-5F, and NCIQ considering bimodal and bilateral CI configurations separately is warranted. (shrink)

Aim Facebook is an increasingly popular online social networking site. The purpose of this study was to describe the Facebook activity of residents and fellows and their opinions regarding the impact of Facebook on the doctor–patient relationship. Methods An anonymous questionnaire was emailed to 405 residents and fellows at the Rouen University Hospital, France, in October 2009. Results Of the 202 participants who returned the questionnaire (50%), 147 (73%) had a Facebook profile. Among responders, 138 (99%) displayed their real name (...) on their profile, 136 (97%) their birthdates, 128 (91%) a personal photograph, 83 (59%) their current university and 76 (55%) their current position. Default privacy settings were changed by 61% of users, more frequently if they were registered for >1 year (p=0.02). If a patient requested them as a ‘friend’, 152 (85%) participants would automatically decline the request, 26 (15%) would decide on an individual basis and none would automatically accept the request. Eighty-eight participants (48%) believed that the doctor–patient relationship would be altered if patients discovered that their doctor had a Facebook account, but 139 (76%) considered that it would change only if the patient had open access to their doctor's profile, independent of its content. Conclusions Residents and fellows frequently use Facebook and display personal information on their profiles. Insufficient privacy protection might have an impact the doctor–patient relationship. (shrink)

We prove an effective version of the Lopez-Escobar theorem for continuous domains. Let $Mod(\tau )$ be the set of countable structures with universe $\omega $ in vocabulary $\tau $ topologized by the Scott topology. We show that an invariant set $X\subseteq Mod(\tau )$ is $\Pi ^0_\alpha $ in the Borel hierarchy of this topology if and only if it is definable by a $\Pi ^p_\alpha $ -formula, a positive $\Pi ^0_\alpha $ formula in the infinitary logic $L_{\omega _1\omega }$. As (...) a corollary of this result we obtain a new pullback theorem for positive computable embeddings: Let $\mathcal {K}$ be positively computably embeddable in $\mathcal {K}'$ by $\Phi $, then for every $\Pi ^p_\alpha $ formula $\xi $ in the vocabulary of $\mathcal {K}'$ there is a $\Pi ^p_\alpha $ formula $\xi ^{*}$ in the vocabulary of $\mathcal {K}$ such that for all $\mathcal {A}\in \mathcal {K}$, $\mathcal {A}\models \xi ^{*}$ if and only if $\Phi (\mathcal {A})\models \xi $. We use this to obtain new results on the possibility of positive computable embeddings into the class of linear orderings. (shrink)

L’épreuve projective intitulée « spatiographie projective familiale » a pour objectif de comprendre l’image inconsciente du corps familial à travers l’analyse du dessin groupal de la « maison de rêve ». Par cette méthodologie, les auteurs peuvent établir un diagnostic de la structure des liens inconscients de la famille et en faire un objet médiateur pour la prise en charge psychothérapique et une épreuve projective groupale familiale pour le diagnostic. Le dessin de la « maison de rêve » est un (...) outil original qui investigue les dimensions diachronique et synchronique permettant une approche complète de la structuration de l’image du corps familial. (shrink)

Recently, two apparently quite different duality-based approaches to automata minimisation have appeared. One is based on ideas that originated from the controllability-observability duality from systems theory, and the other is based on ideas derived from Stone-type dualities specifically linking coalgebras with algebraic structures derived from modal logics. In the present paper, we develop a more abstract view and unify the two approaches. We show that dualities, or more generally dual adjunctions, between categories can be lifted to dual adjunctions between categories (...) of coalgebras and algebras, and from there to automata with initial as well as final states. As in the Stone-duality approach, algebras are essentially logics for reasoning about the automata. By exploiting the ability to pass between these categories, we show that one can minimize the corresponding automata. We give an abstract minimisation algorithm that has several instances, including the celebrated Brzozowski minimisation algorithm. We further develop three examples that have been treated in previous works: deterministic Kripke frames based on a Stone-type duality, weighted automata based on the self-duality of semimodules, and topological automata based on Gelfand duality. As a new example, we develop alternating automata based on the discrete duality between sets and complete atomic Boolean algebras. (shrink)

Recent arguments claim that behavioral science has focused – to its detriment – on the individual over the system when construing behavioral interventions. In this commentary, we argue that tackling economic inequality using both framings in tandem is invaluable. By studying individuals who have overcome inequality, “positive deviants,” and the system limitations they navigate, we offer potentially greater policy solutions.

Over the last decades, changes within higher education have created increased pressure and uncertainty for academics, increasing their risk for cognitive, behavioral, physical, as well as psychological issues due to high job demands. Specifically, for new academics in teaching roles, their lack of knowledge and skills can contribute to a negative effect of these job demands on their well-being. This study therefore explored how teaching-related professional development programs can enhance new university teachers’ well-being, through semi-structured interviews with 10 university teachers (...) participating in such a program at a mid-sized Dutch university. We pay special attention to the relationship between specific learning activities integrated in the program and various dimensions of the psychological model of well-being by Ryff and Keyes. Using co-occurrence analysis and content analysis, we found that different learning activities had distinct relationships with different well-being facets. For example, formal workshops were mainly related to environmental mastery, a purpose in life and personal growth, while reflecting seemed to be especially connected to teachers’ self-acceptance, and participating in a learning community was mainly related to positive relations with others and personal growth. Our findings have implications for research on teacher well-being as well as for the design of professional development programs for higher education teaching staff. (shrink)

Primary headaches are highly prevalent and represent a major cause of disability in young adults. Neurofeedback is increasingly used in the treatment of chronic pain; however, there are few studies investigating its efficacy in patients with headaches. We report the results of a cross-over sham-controlled study on the efficacy of neurofeedback in the prophylactic treatment of tension-type headache. Participants received ten sessions of infra-low frequency electroencephalographic neurofeedback and ten sessions of sham-neurofeedback, with the order of treatments being randomized. The study (...) also included a basic psychotherapeutic intervention — a psychoeducational session performed before the main study phases and emotional support provided throughout the study period. The headache probability was modeled as a function of the neurofeedback and sham-neurofeedback sessions performed to date. As a result, we revealed a strong beneficial effect of neurofeedback and no influence of the sham sessions. The study supports the prophylactic use of infra-low frequency neurofeedback in patients with TTH. From a methodological point of view, we advocate for the explicit inclusion of psychotherapeutic components in neurofeedback study protocols. (shrink)

Cet article propose la première publication complète d’un monument consacré par les Thespiens aux Muses dans leur sanctuaire au pied de l’Hélicon, dont les éléments constitutifs sont connus depuis le xixe s., et notamment depuis les fouilles de P. Jamot au Val des Muses. Les statues en bronze de petite taille des neuf Muses se dressaient sur une base en arc de cercle d’une ampleur de ca 10 m, placée dans un écrin architectural largement ouvert sur l’extérieur. Un nouveau lustre (...) est donné à ce groupe statuaire hellénistique exceptionnel à l’époque d’Auguste par la gravure, sous chacune des figures, d’une épigramme descriptive et érudite signée par le poète corinthien Honestos. Est ainsi conservé l’un des rares exemples archéologiques de recueil de poèmes décrivant des œuvres d’art figuré. L’analyse des épigrammes et l’observation détaillée des mortaises de fixation visibles à la face supérieure des blocs de la base permettent d’émettre des hypothèses sur les types utilisés pour la représentation des Muses, mais aussi d’assurer, au‑delà de tout doute, que les statues prenaient place au milieu d’ornements végétaux en bronze qui évoquaient le paysage du Val des Muses. La représentation de la nature comme élément non plus secondaire, mais essentiel d’un groupe sculpté correspond aux recherches nouvelles de la basse époque hellénistique. Faute de fouilles exhaustives du sanctuaire des Muses, l’emplacement du monument ne peut être déterminé avec certitude. Des lettres de remontage nous apprennent en revanche qu’il a été déplacé, peut‑être à l’époque où furent gravés les poèmes d’Honestos. (shrink)

This study examined the extent to which concussion management plans at National Collegiate Athletic Association member schools were in line with NCAA Concussion Policy and best practice recommendations in absence of any process to ensure compliance. Most schools' concussion management plans were in compliance with 3 or 4 of the NCAA's 4 required components. Annual athlete education and acknowledgement was the requirement least often included, representing an area for improvement. Further, schools tended to more often include best practices that were (...) more medically-oriented, compared to best practices that were less medical in nature. (shrink)

Tissue plasminogen activator (tPA) is administered to patients with suspected ischemic stroke to improve blood flow to the brain In rare cases, patients present with complaints of stroke symptoms that appear to be non-organic due to malingering, factitious disorder, or conversion disorder (psychogenic stroke mimics). Deciding whether or not to administer tPA to these patients can be challenging. The risk of hemorrhage after administration of tPA is low, but not zero. The ethical principles of beneficence and nonmaleficence need to be (...) weighed carefully in these situations. We present two cases of patients with suspected psychogenic stroke mimics to illustrate the ethical challenges faced in identifying and managing psychogenic stroke mimics. Further research is needed to demonstrate effective treatment strategies for patients with acute stroke symptoms of psychogenic etiology. (shrink)

This article presents the results of the research “Philosophical Attitude and Childhood: Teachers’ Formation and Transformation”, developed at the Universidad Pedagógica y Tecnológica de Colombia UPTC Kindergarten, by using the Community of Inquiry as a strategy to foster a philosophical attitude. It is divided in three descriptive moments, the first one, previous considerations, contains: philosophy as a tool to think, philosophical attitude as a life style, philosophy for kids as a theoretical and methodological perspective; the second one includes methodological perspectives; (...) and the third one, the experience as a transformation, covers: the Community of Inquiry and ludic, the Community of Inquiry with kids, teacher’s formation and transformation, childhood’s discovery, critical, creative and ethic thinking in childhood, and from the Community of Inquiry to a life style. (shrink)

Aristotle's endeavor, at least insofar as we can judge from the way it has been transmitted to us and from the titles of the lost works, is often presented as the first work of an encyclopedic nature, as it seems to embrace and order all of the elements of knowledge. Does Aristotle not advance a classification of sciences, in Metaphysics, E, 1, as well as a systematic outline of the “sciences of nature” in his Meteorologica, I, 1? And again, although (...) logic is often presented as not belonging to the system of sciences since it is not counted as a science in Metaphysics, E, 1, is Aristotle not generally considered the inventor of this discipline? The impression is all the stronger in that Andronicus of Rhodes, in the first century b.c., edited Aristotle's works by roughly adopting the threefold division of philosophy into Logic-Physics-Ethics, a division that had become common during the Hellenistic period though more particularly proper to the Stoic system. Since then, all the editions of Aristotle, in every language, have been made to serve the order in which Aristotle's treatises were thus edited. (shrink)

Background The first COVID-19 wave started in February 2020 in France. The influx of patients requiring emergency care and high-level technicity led healthcare professionals to fear saturation of available care. In that context, the multidisciplinary Ethics- Support Cell (EST) was created to help medical teams consider the decisions that could potentially be sources of ethical dilemmas. Objectives The primary objective was to prospectively collect information on requests for EST assistance from 23 March to 9 May 2020. The secondary aim was (...) to describe the Cell’s functions during that period. Research design This observational, real-time study of requests for Cell consultations concerned ethical dilemmas arising during a public health crisis. The EST created a grid to collect relevant information (clinical, patient’s/designated representative’s preferences and ethical principles strained by the situation), thereby assuring that each EST asked the same questions, in the same order. Participants and research context Only our university hospital’s clinicians could request EST intervention. Ethical considerations The hospital Research Ethics Committee approved this study (no. CER-2020-107). The patient, his/her family, or designated representative was informed of this ethics consultation and most met with EST members, which enabled them to express their preferences and/or opposition. Findings/results 33 requests (patients’ mean age: 80.8 years; 29 had COVID-19: 24 with dyspnea, 30 with comorbidities). 17 Emergency Department solicitations concerned ICU admission, without reference to resource constraints; others addressed therapeutic proportionality dilemmas. Discussion Intervention-request motives concerned limited resources and treatment intensity. Management revolved around three axes: the treatment option most appropriate for the patient, the feasibility of implementation, and dignified care for the patient. Conclusions COVID-19 crisis forced hospitals to envisage prioritization of ICU access. Established decision-making criteria and protocols do not enable healthcare professionals to escape ethical dilemmas. That acknowledgement highlights ethical risks, enhances the added-value of nursing and encourages all players to be vigilant to pursue collective deliberations to achieve clear and transparent decisions. (shrink)

Previous research shows that females use more exclamation marks than males, often to establish rapport. The purpose of the present studies was to test whether people associate texters’ use of exclamation marks with friendliness and femaleness. If this association is due to normative expectations, we hypothesized that females would appear less friendly if they did not use an exclamation mark in texting. In Study 1, participants rated a texter using an exclamation mark to be highly female and highly friendly. The (...) gender results disappeared when friendliness was controlled for. In Study 2, we tested whether friendliness ratings decreased if texters violated gender-associated punctuation. Participants rated a texter with a gendered name on friendliness. Regardless of gender, participants inferred greater friendliness to texters using an exclamation mark. That is, there was no evidence of a cost for violating this gender expectation. We conclude that people predict that a texter using an exclamation mark is likely to be female, but do not penalize females for not using an exclamation mark. (shrink)

Max Bense gilt als Vorreiter der Computerkunst und der Technikphilosophie und war ein engagierter Förderer von Kunst und Literatur, Promotor interdisziplinären Denkens und politischer Provokateur. Häufig ist es bei der Auseinandersetzung mit Bense jedoch bei diesen Etikettierungen geblieben. Der Sammelband nimmt daher eine konzertierte Neuaufnahme der Diskussion von Max Benses Arbeiten aus literaturwissenschaftlicher, philosophie- und wissenschaftshistorischer sowie aus medien- und ästhetiktheoretischer Perspektive vor. Er versammelt Beiträge zu Themenkomplexen wie der Semiotik, Technikphilosophie, experimentellen Poesie und Ästhetiktheorie, zu Benses lokalen und internationalen (...) Kontakten und Netzwerken sowie zu seinem publizistischen Verhalten im Nationalsozialismus und in der Nachkriegszeit. (shrink)

Résumé À travers le cas clinique d’une adolescente obèse, l’article postule que le corps « obèse » peut être l’espace d’expression de la conflictualité inter et transgénérationnelle. Le symptôme de l’obésité viendrait alors préserver l’homéostasie familiale. Cet écrit met le projecteur sur la dimension contenante de ce corps « encombrant », signifiant formel d’une enveloppe psychique porteuse de traces douloureuses appartenant au mémorial familial. Il expose ainsi une explication au phénomène de résistance à l’amaigrissement rencontré parfois dans la clinique de (...) l’obésité. (shrink)

Machine generated contents note: Part I. Introduction: 1. Personal epistemology in the classroom: a welcome and guide for the reader Florian C. Feucht and Lisa D. Bendixen; Part II. Frameworks and Conceptual Issues: 2. Manifestations of an epistemological belief system in pre-k to 12 classrooms Marlene Schommer-Aikins, Mary Bird, and Linda Bakken; 3. Epistemic climates in elementary classrooms Florian C. Feucht; 4. The integrative model of personal epistemology development: theoretical underpinnings and implications for education Deanna C. Rule and Lisa (...) D. Bendixen; 5. An epistemic framework for scientific reasoning in informal contexts Fang-Ying Yang and Chin-Chung Tsai; Appendices; 6. Who knows what and who can we believe? Epistemological beliefs are beliefs about knowledge (mostly) to be attained from others Rainer Bromme, Dorothe Kienhues, and Torsten Porsch; Part III. Students' Personal Epistemology, its Development, and Relation to Learning: 7. Stalking young persons' changing beliefs about belief Michael J. Chandler and Travis Proulx; 8. Epistemological development in very young knowers Leah K. Wildenger, Barbara K. Hofer, and Jean E. Burr; 9. Beliefs about knowledge and revision of knowledge: on the importance of epistemic beliefs for intentional conceptual change in elementary and middle school students Lucia Mason; 10. The reflexive relation between students' mathematics-related beliefs and the mathematics classroom culture Erik De Corte, Peter Op 't Eynde, Fien Depaepe, and Lieven Verschaffel; 11. Examining the influence of epistemic beliefs and goal orientations on the academic performance of adolescent students enrolled in high-poverty, high-minority schools P. Karen Murphy, Michelle M. Buehl, Jill A. Zeruth, Maeghan N. Edwards, Joyce F. Long, and Shinichi Monoi; 12. Using cognitive interviewing to explore elementary and secondary school students' epistemic and ontological cognition Jeffrey A. Greene, Judith Torney-Purta, Roger Azevedo, and Jane Robertson; Part IV. Teachers' Personal Epistemology and its Impact on Classroom Teaching: 13. Epistemological resources and framing: a cognitive framework for helping teachers interpret and respond to their students' epistemologies Andrew Elby and David Hammer; 14. The effects of teachers' beliefs on elementary students' beliefs, motivation, and achievement in mathematics Krista R. Muis and Michael J. Foy; Appendices; 15. Teachers' articulation of beliefs about teaching knowledge: conceptualizing a belief framework Helenrose Fives and Michelle M. Buehl; Appendices; 16. Beyond epistemology: assessing teachers' epistemological and ontological world views Lori Olafson and Gregory Schraw; Part V. Conclusion: 17. Personal epistemology in the classroom: what does research and theory tell us and where do we need to go next? Lisa D. Bendixen and Florian C. Feucht. (shrink)

The article argues that there are different ways of justifying suspension of judgement. We suspend judgement not only privatively, that is, because we lack evidence, but also positively, that is, because there is evidence that provides reasons for suspending judgement: suspension is more than the rational fallback position in cases of insufficient evidence. The article applies the distinction to recent discussions about the role of suspension for inquiry, Turri's puzzle about withholding, and formal representations of suspension.

Multi-national corporations (MNCs) have been criticised for not behaving ethically in some situations, which could have a negative effect on their reputation. This study examines the ethics of a large MNC in its relationship with its suppliers. A brief literature review of corporate identity, business ethics and buyer–supplier relationships is undertaken. The views and perceptions of the buying staff and the suppliers to a large South African MNC are obtained and discussed. The results indicate that this MNC has a good (...) corporate reputation among both its suppliers (an important stakeholder) and its own buying department. The existence and implementation of formal codes of ethics was found to be a necessary, but not sufficient condition for good ethical practice. Candid relationships with suppliers emerged as a second and important factor. Ethical perceptions of buyers by suppliers are driven by the management of corporate identity, through the elements of ethical standards and candid relationships. We present a model of corporate identity/reputation in Buyer–Supplier Relationships. (shrink)

The aim of this paper is to propose a systematic classification of emotions which can also characterize their nature. The first challenge we address is the submission of clear criteria for a theory of emotions that determine which mental phenomena are emotions and which are not. We suggest that emotions as a subclass of mental states are determined by their functional roles. The second and main challenge is the presentation of a classification and theory of emotions that can account for (...) all existing varieties. We argue that we must classify emotions according to four developmental stages: 1. pre-emotions as unfocussed expressive emotion states, 2. basic emotions, 3. primary cognitive emotions, and 4. secondary cognitive emotions. We suggest four types of basic emotions (fear, anger, joy and sadness) which are systematically differentiated into a diversity of more complex emotions during emotional development. The classification distinguishes between basic and non-basic emotions and our multi-factorial account considers cognitive, experiential, physiological and behavioral parameters as relevant for constituting an emotion. However, each emotion type is constituted by a typical pattern according to which some features may be more significant than others. Emotions differ strongly where these patterns of features are concerned, while their essential functional roles are the same. We argue that emotions form a unified ontological category that is coherent and can be well defined by their characteristic functional roles. Our account of emotions is supported by data from developmental psychology, neurobiology, evolutionary biology and sociology. (shrink)