BackgroundResponsive neurostimulation has been utilized as a treatment for intractable epilepsy. The RNS System delivers stimulation in response to detected abnormal activity, via leads covering the seizure foci, in response to detections of predefined epileptiform activity with the goal of decreasing seizure frequency and severity. While thalamic leads are often implanted in combination with cortical strip leads, implantation and stimulation with bilateral thalamic leads alone is less common, and the ability to detect electrographic seizures using RNS System thalamic leads is (...) uncertain.ObjectiveThe present study retrospectively evaluated fourteen patients with RNS System depth leads implanted in the thalamus, with or without concomitant implantation of cortical strip leads, to determine the ability to detect electrographic seizures in the thalamus. Detailed patient presentations and lead trajectories were reviewed alongside electroencephalographic analyses.ResultsAnterior nucleus thalamic leads, whether bilateral or unilateral and combined with a cortical strip lead, successfully detected and terminated epileptiform activity, as demonstrated by Cases 2 and 3. Similarly, bilateral centromedian thalamic leads or a combination of one centromedian thalamic alongside a cortical strip lead also demonstrated the ability to detect electrographic seizures as seen in Cases 6 and 9. Bilateral pulvinar leads likewise produced reliable seizure detection in Patient 14. Detections of electrographic seizures in thalamic nuclei did not appear to be affected by whether the patient was pediatric or adult at the time of RNS System implantation. Sole thalamic leads paralleled the combination of thalamic and cortical strip leads in terms of preventing the propagation of electrographic seizures.ConclusionThalamic nuclei present a promising target for detection and stimulation via the RNS System for seizures with multifocal or generalized onsets. These areas provide a modifiable, reversible therapeutic option for patients who are not candidates for surgical resection or ablation. (shrink)

After introducing the new field of cultural evolution, we review a growing body of empirical evidence suggesting that culture shapes what people attend to, perceive and remember as well as how they think, feel and reason. Focusing on perception, spatial navigation, mentalizing, thinking styles, reasoning (epistemic norms) and language, we discuss not only important variation in these domains, but emphasize that most researchers (including philosophers) and research participants are psychologically peculiar within a global and historical context. This rising tide of (...) evidence recommends caution in relying on one’s intuitions or even in generalizing from reliable psychological findings to the species, Homo sapiens. Our evolutionary approach suggests that humans have evolved a suite of reliably developing cognitive abilities that adapt our minds, information-processing abilities and emotions ontogenetically to the diverse culturally-constructed worlds we confront. (shrink)

This book is an educational tool to capture the lessons and fortify students in the greater world beyond The Citadel. The essays of comfort and wisdom reflect the author's thinking and writing during tumultuous economic times and of great stress on our body politic.

Using a conceptual framework and method combining ethical enquiry and phenomenology, we asked 73 senior baccalaureate nursing students to answer two questions: (1) What is nursing students’ experience of an ethical problem involving nursing practice? and (2) What is nursing students’ experience of using an ethical decision-making model? Each student described one ethical problem, from which emerged five content categories, the largest being that involving health professionals (44%). The basic nature of the ethical problems consisted of the nursing students’ experience (...) of conflict, resolution and rationale; 85% of the students stated that using an ethical decision-making model was helpful. Although additional research is needed, these findings have important implications for nursing ethics education and practice. (shrink)

In 1856, the State of Ohio began an enumeration of its population to count and identify people with disabilities. This paper examines the ethical role of the accounting profession in this project, which supported the transatlantic eugenics movement and its genocidal attempts to eliminate disabled persons from the population. We use a theoretical approach based on Levinas who argued that the self is generated through engagement with the Other, and that this engagement presupposes a responsibility to and for the Other. (...) We show that successive waves of legislation relied on State and County auditors along with Township clerks and assessors to conduct the mechanics of the enumeration of the population, which focused on the identification, categorization, and counting of the disabled people of the State. We argue that the accounting-based technologies of enumeration and reporting objectify the enumerated persons and deny the auditor’s pre-existing ethical obligation to this new Other. We show how the financial expertise and structures of the State were engaged in the execution of this mandate, which remained in place for over a century and supported a program of institutionalization. We consider the ramifications of this for our understanding of the ethical role of public sector accounting in the United States over this period, which has been under-explored. (shrink)

Although older persons (aged 65 years and older) experience stressful ethical problems involving their health, research is lacking about this phenomenon. The purpose of this study was to describe and examine the content and basic nature of older persons’ ethical problems concerning their health. The conceptual framework and method combined ethical enquiry and phenomenology. The participants were 18 older persons and 12 of their children or grandchildren (for contextual understanding). The 19 women and 11 men, 73% of whom were Caucasian, (...) described 184 ethical problems, from which emerged 10 content categories. The basic nature of the ethical problems consisted of conflict, resolution and rationale. The results could assist health professionals to promote older persons’ ethical decision making, quality of life, and good death. (shrink)

A. F. Norman has recently suggested that a hitherto overlooked passage in Suidas is a fragment from the history of Eunapius of Sardis. He is clearly correct in referring the passage to an incident at the siege of Maiozamalcha during the Persian campaign of the emperor Julian, but I am not so sure that he is right in ascribing it to Eunapius, or in the conclusions he draws from this ascription. I give in parallel columns the accounts of Ammianus Marcellinus, (...) Zosimus, and the passage from Suidas, together with a further version of the incident, unfortunately without names, from the pen of Libanius. (shrink)

A. F. Norman has recently suggested that a hitherto overlooked passage in Suidas is a fragment from the history of Eunapius of Sardis. He is clearly correct in referring the passage to an incident at the siege of Maiozamalcha during the Persian campaign of the emperor Julian, but I am not so sure that he is right in ascribing it to Eunapius, or in the conclusions he draws from this ascription. I give in parallel columns the accounts of Ammianus Marcellinus, (...) Zosimus, and the passage from Suidas, together with a further version of the incident, unfortunately without names, from the pen of Libanius. (shrink)

This Korean study replicated a previously published American study. The conceptual framework and method combined ethical enquiry and phenomenology. The research questions were: (1) What is nursing students’ experience of ethical problems involving nursing practice? and, (2) What is nursing students’ experience of using an ethical decision-making model? The participants were 97 senior baccalaureate nursing students, each of whom described one ethical problem and chose to use one of five ethical decision-making models. From 97 ethical problems, five content categories emerged, (...) the largest being health professionals (69%). The basic nature of the ethical problems was the students’ experience of conflict, resolution and rationale. Using an ethical decision-making model helped 94% of the students. A comparison of the Korean and American results yields important implications for nursing ethics education, practice and research. (shrink)

Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the Science, Health and (...) Policy-relevant Ethics in Singapore Initiative. It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts. It also describes a set of substantive and procedural values that can be weighed up in addressing these concerns, and a step-by-step process for identifying, considering, and resolving the ethical issues arising from big data uses in health and research. This Framework is subsequently applied in the papers published in this Special Issue. These papers each address one of six domains where big data is currently employed: openness in big data and data repositories, precision medicine and big data, real-world data to generate evidence about healthcare interventions, AI-assisted decision-making in healthcare, public-private partnerships in healthcare and research, and cross-sectoral big data. (shrink)

Background There has been considerable investment and strategic planning to introduce genomic testing into Australia’s public health system. As more patients’ genomic data is being held by the public health system, there will be increased requests from researchers to access this data. It is important that public policy reflects public expectations for how genomic data that is generated from clinical tests is used. To inform public policy and discussions around genomic data sharing, we sought public opinions on using genomic data (...) contained in medical records for research purposes in the Australian state of Queensland. Methods A total of 1494 participants completed an online questionnaire between February and May 2019. Participants were adults living in Australia. The questionnaire explored participant preferences for sharing genomic data or biological samples with researchers, and concerns about genomic data sharing. Results Most participants wanted to be given the choice to have their genomic data from medical records used in research. Their expectations on whether and how often they needed to be approached for permission on using their genomic data, depended on whether the data was identifiable or anonymous. Their willingness to sharing data for research purposes depended on the type of information being shared, what type of research would be undertaken and who would be doing the research. Participants were most concerned with genomics data sharing that could lead to discrimination, data being used for marketing, data security, or commercial use. Conclusions Most participants were willing to share their genomic data from medical records with researchers, as long as permission for use was sought. However, the existing policies related to this process in Queensland do not reflect participant expectations for how this is achieved, particularly with anonymous genomics data. This inconsistency may be addressed by process changes, such as inclusion of research in addition to clinical consent or general research data consent programs. (shrink)

In The Norm of Belief, John Gibbons claims that there is a “natural reaction” to the general idea that one can be normatively required to Ø when that requirement is in some sense outside of one’s first person perspective or inaccessible to one. The reaction amounts to the claim that this is not possible. Whether this is a natural or intuitive idea or not, it is difficult to articulate exactly why we might think it is correct. To do so, we (...) need a view about the relationship between agents’ capacities to accord with normative requirements and the conditions under which those normative requirements obtain. I offer an account of the epistemic dimension of this relationship. The goal is to provide enough of a story about the natural reaction to make accounting for it look like an important desideratum for any theory of the nature of normative requirements—whether these are moral or epistemic. To focus the discussion, I use Timothy Williamson’s knowledge-first view of evidence as an example of a view in epistemology that generates the natural reaction. One upshot of the discussion, then, is a detailed account of what is troubling about Williamson’s influential but controversial view of evidence. (shrink)

We offer an overview of what we take to be the main themes in Annalisa Coliva’s book, Moore and Wittgenstein: Scepticism, Certainty and Common Sense. In particular, we focus on the ‘framework reading’ that she offers of Wittgenstein’s On Certainty and its anti-sceptical implications. While broadly agreeing with the proposal that Coliva puts forward on this score, we do suggest one important supplementation to the view—viz., that this way of dealing with radical scepticism needs to be augmented with an account (...) of the meta-sceptical problem which this proposal generates, which we call epistemic vertigo. (shrink)

Limited research has been done among pregnant people participating in investigational drug trials. To enhance the ethical understanding of pregnant people’s perspectives on research participation, we sought to describe motives and risk perceptions of participants in a phase 1 trial of ledipasvir/sofosbuvir treatment for chronic Hepatitis C virus during pregnancy. Pregnant people with chronic HCV infection enrolled in an open-label, phase 1 study of LDV/SOF participated in semi-structured, in-depth interviews to explore their reasons for participation and experiences within the study. (...) Pregnant people took 12 weeks of LDV/SOF and were interviewed at enrollment and at the end of study. We recorded the interviews, transcribed them verbatim, coded them using NVivo software, and performed inductive thematic analysis. Nine women completed the study yielding 18 interview transcripts. We identified two themes regarding motives and one regarding risk perception. Motives— Women conceptualized study participation as part of the caregiving role they associate with motherhood; participating was viewed as an act of caregiving for their infants, their families, themselves, and other pregnant women with chronic HCV. Women also noted that they faced multiple barriers to treatment prior to pregnancy that created a desire to receive therapy through trial participation. Risk perception— Women acknowledged personal and fetal risk associated with participation. Acceptance of risk was influenced by women’s concepts of motherhood, preexisting knowledge of HCV and medical research, family members, intimate partners, or by the study design. Women enrolled in a phase 1 trial for chronic HCV therapy during pregnancy acknowledged risks of participation and were motivated by hopes for fetal and personal benefit and by lack of prenatal access to treatment. Ethical inclusion of pregnant people in research should acknowledge structural factors that contribute to vulnerability and data deficiencies for treatment in pregnancy. (shrink)

Research Ethics, Volume 18, Issue 2, Page 132-150, April 2022. Limited research has been done among pregnant people participating in investigational drug trials. To enhance the ethical understanding of pregnant people’s perspectives on research participation, we sought to describe motives and risk perceptions of participants in a phase 1 trial of ledipasvir/sofosbuvir treatment for chronic Hepatitis C virus during pregnancy. Pregnant people with chronic HCV infection enrolled in an open-label, phase 1 study of LDV/SOF participated in semi-structured, in-depth interviews to (...) explore their reasons for participation and experiences within the study. Pregnant people took 12 weeks of LDV/SOF and were interviewed at enrollment and at the end of study. We recorded the interviews, transcribed them verbatim, coded them using NVivo software, and performed inductive thematic analysis. Nine women completed the study yielding 18 interview transcripts. We identified two themes regarding motives and one regarding risk perception. Motives— Women conceptualized study participation as part of the caregiving role they associate with motherhood; participating was viewed as an act of caregiving for their infants, their families, themselves, and other pregnant women with chronic HCV. Women also noted that they faced multiple barriers to treatment prior to pregnancy that created a desire to receive therapy through trial participation. Risk perception— Women acknowledged personal and fetal risk associated with participation. Acceptance of risk was influenced by women’s concepts of motherhood, preexisting knowledge of HCV and medical research, family members, intimate partners, or by the study design. Women enrolled in a phase 1 trial for chronic HCV therapy during pregnancy acknowledged risks of participation and were motivated by hopes for fetal and personal benefit and by lack of prenatal access to treatment. Ethical inclusion of pregnant people in research should acknowledge structural factors that contribute to vulnerability and data deficiencies for treatment in pregnancy. (shrink)

I address an intuition commonly endorsed by metaphysicians, that there must be a fundamental layer of reality, i.e., that chains of ontological dependence must terminate: there cannot be turtles all the way down. I discuss applications of this intuition with reference to Bradley’s regress, composition, realism about the mental and the cosmological argument. I discuss some arguments for the intui- tion, but argue that they are unconvincing. I conclude by making some suggestions for how the intuition should be argued for, (...) and discussing the ramifications of giving the justification I think best. (shrink)

We present a one per cent measurement of the cosmic distance scale from the detections of the baryon acoustic oscillations in the clustering of galaxies from the Baryon Oscillation Spectroscopic Survey, which is part of the Sloan Digital Sky Survey III. Our results come from the Data Release 11 sample, containing nearly one million galaxies and covering approximately 8500 square degrees and the redshift range 0.2 < z < 0.7. We also compare these results with those from the publicly released (...) DR9 and DR10 samples. Assuming a concordance Λ cold dark matter cosmological model, the DR11 sample covers a volume of 13 Gpc3 and is the largest region of the Universe ever surveyed at this density. We measure the correlation function and power spectrum, including density-field reconstruction of the BAO feature. The acoustic features are detected at a significance of over 7σ in both the correlation function and power spectrum. Fitting for the position of the acoustic features measures the distance relative to the sound horizon at the drag epoch, rd, which has a value of rd,fid = 149.28 Mpc in our fiducial cosmology. We find DV = at z = 0.32 and DV = at z = 0.57. At 1.0 per cent, this latter measure is the most precise distance constraint ever obtained from a galaxy survey. Separating the clustering along and transverse to the line of sight yields measurements at z = 0.57 of DA = and H =. Our measurements of the distance scale are in good agreement with previous BAO measurements and with the predictions from cosmic microwave background data for a spatially flat CDM model with a cosmological constant. © 2014 The Author Published by Oxford University Press on behalf of the Royal Astronomical Society. (shrink)

Philosophers and cognitive scientists have worried that research on animal mind-reading faces a ‘logical problem’: the difficulty of experimentally determining whether animals represent mental states (e.g. seeing) or merely the observable evidence (e.g. line-of-gaze) for those mental states. The most impressive attempt to confront this problem has been mounted recently by Robert Lurz. However, Lurz' approach faces its own logical problem, revealing this challenge to be a special case of the more general problem of distal content. Moreover, participants in this (...) debate do not agree on criteria for representation. As such, future debate should either abandon the representational idiom or confront underlying semantic disagreements. (shrink)

Recent work in social psychology suggests that people harbor “implicit race biases,” biases which can be unconscious or uncontrollable. Because awareness and control have traditionally been deemed necessary for the ascription of moral responsibility, implicit biases present a unique challenge: do we pardon discrimination based on implicit biases because of its unintentional nature, or do we punish discrimination regardless of how it comes about? The present experiments investigated the impact such theories have upon moral judgments about racial discrimination. The results (...) show that different theories differ in their impact on moral judgments: when implicit biases are defined as unconscious, people hold the biased agent less morally responsible than when these biases are defined as automatic (i.e., difficult to control), or when no theory of implicit bias is provided. (shrink)

We conducted a survey of residents of Kingston, Ontario, Canada, (n = 107) to understand their attitudes to and experiences of waste management and governance. Currently, the municipality is emphasising waste diversion and exploring new waste processing systems (WPS; e.g., incineration) to reduce costs. Using Foucault's governmentality theory, our data suggest Kingston's reliance on an attitude-behaviour-context model of behaviour change successfully fosters an environmental citizenship identity based on waste diversion (e.g., recycling). However, we argue that the neoliberal governmentality upon which (...) the attitude-behaviour-context model is predicated elides the need for, and inhibits consideration of, broader societal change concerning urgent environmental issues involving consumption and waste. (shrink)