Introduction While quizzing during informed consent for research to ensure understanding has become commonplace, it is unclear whether the quizzing itself is problematic for potential participants. In this study, we address this issue in a multinational HIV prevention research trial enrolling injection drug users in China and Thailand. Methods Enrolment procedures included an informed consent comprehension quiz. An informed consent survey followed. Results 525 participants completed the informed consent survey (Heng County, China=255, Xinjiang, China=229, Chiang Mai, Thailand=41). Mean age was (...) 33 and mean educational level was 8 yrs. While quizzing was felt to be a good way to determine if a person understands the nature of clinical trial participation (97%) and participants did not generally find the quiz to be problematic, minorities of respondents felt pressured (6%); anxious (5%); bored (5%); minded (5%); and did not find the questions easy (13%). In multivariate analysis, lower educational level was associated with not minding the quizzing (6–10 yrs vs 0–5 yrs: OR=0.27, p=0.03; more than 11 yrs vs 0–5 yrs: OR=0.18, p=0.03). There were also site differences (Heng County vs Xinjiang) in feeling anxious (OR=0.07; p=<0.01), not minding (OR=0.26; p=0.03), being bored (OR=0.25; p=0.01) and not finding the questions easy (OR=0.10; p=<0.01). Conclusions Quizzing during the informed consent process can be problematic for a minority of participants. These problems may be associated with the setting in which research takes place and educational level. Further research is needed to develop, test and implement alternative methods of ensuring comprehension of informed consent. Trial Registration clinicaltrials.gov number NCT00270257. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

James questions the validity of the very tentative statement made in the final sentence of our paper. Our claim concerned the proportion of twins in Britain in the 1990s that might have arisen through subfertility treatment and was linked to the suggestion that the natural twinning rate might still be in decline. If this were true, we, like James, would regard that prospect with concern.

As contribution to a recent debate (James, 1998; Murphy etal., 1997, 1998) the proportion of twins following ovulation induction (OI) or assisted conception (AC) in 1994 in Oxfordshire and West Berkshire was estimated, and by extrapolation the natural twinning rate in England and Wales was judged to have maintained a plateau phase since the 1970s. Similar figures for 1995 and 1996 from the same study, and hence a more stable local estimate, are now provided. The proportions, as before, were estimated (...) from women's responses to a questionnaire within a case[hyphen]control study, with ascertainment from general practitioners' records or hospital case[hyphen]notes for non[hyphen]responders or for those excluded from the study originally. In 1994, 1995 and 1996 the proportion of twins following OI/AC was overall 27% (24%, 30% and 27% respectively). Restriction to the 87% locally resident made no difference. The national crude twinning rate for those years was overall 13·3 per 1000 maternities (12·8, 13·6 and 13·4 respectively). (shrink)

This volume brings together 14 classic papers by interpersonal pioneers. Collectively, these papers not only demonstrate the coherence and explanatory richness of interpersonal psychoanalysis; they anticipate the emphasis on relational patterns and analyst-analysand interaction that typifies much recent theorizing. Each paper receives a substantial introduction from a leading contemporary interpersonalist. The pioneers of interpersonal psychoanalysis are: H. Sullivan, F. Fromm-Reichmann, J. Rioch, C. Thompson, R. Crowley, E. Schachtel, E. Tauber, E. Fromm, H. Bone, E. Singer, D. Schecter, J. Barnett, S. (...) Arieti, and J.Schimel. (shrink)

Contemporary developments in American epistemology, by R. M. Chisholm.--Contemporary metaphysics in the United States, by D. F. Gustafson.--Philosophy of physics, by H. Putnam--The influence of continental philosophy on the contemporary American scene: a summons to autonomy, by G. A. Scharader, Jr.--The influence of the later Wittgenstein on American philosophy, by J. O. Nelson.--Philosophy of mind, by F. H. Donnell, Jr.--Some remarks on the philosophy of language, by J. A. Fodor.--Ethics in the United States today, by D. Kading.--Social philosophy; philosophy (...) of social science, by P. Diesing. (shrink)

Depue & Morrone-Strupinsky (D&M-S) present a thorough case for the role of “reward” brain circuits in affiliative bonding. Integration of information in the nucleus accumbens shell (NA), the role of dopamine in this processing, and opioid (primarily via mu receptors) control of these circuits are the primary elements of the model. Although the overall picture is quite compelling, the description leans excessively in the view of dopamine systems as “reward” circuits.

Reconnaissant que la foi en Dieu Créateur est un mystère qui transcende notre pouvoir de compréhension humaine et de mise en concepts, l'auteur met en oeuvre divers modèles théologiques pour jeter quelque lumière sur la richesse de cette croyance. En ce qui concerne le modèle ontologique, il a recours à la théologie de Karl Rahner pour explorer le sens de l'être-créature. De par sa constitution ontologique l'être humain est à la fois différent et dépendant de Dieu en tout acte. Le (...) modèle «fiduciaire» favorisé par les Réformateurs, insiste sur le fait que la foi en Dieu Créateur est réellement un acte de confiance en l'attention que Dieu nous porte. Le modèle eschatologique, proposé par des penseurs tels Moltmann et Pannenberg, met l'accent sur Dieu comme notre futur absolu et l'objet de nos plus profonds désirs. L'article examine également certains modèles écologiques courants ainsi que l'«ecoféminisme» qui soulignent le besoin d'une intendance de la création plutôt que d'une domination. Un modèle de domination conduit à la violation de la terre comme à l'exploitation de la femme. L'article se préoccupe principalement de montrer que la foi en Dieu Créateur dans le Nouveau Testament est toujours liée au Christ comme Nouvelle Création. L'intention divine en créant était de conduire les créatures à partager la filiation du Christ. Les créatures deviennent imago Dei en vivant la relation filiale du Christ vis-à-vis du Père. Ignace de. (shrink)

L'article commence une analyse de la vertu théologique de l'espérance par une phénoménologie de l'espérance. En plus d'un regard donné aux considérations philosophiques sur l'espérance chez des auteurs tels Gabriel Marcel et Ernst Bloch, il étudie les oeuvres dramatiques de Marcel ainsi qu'un certain nombre d'auteurs utopistes tels Thomas More, Henry David Thoreau et Charles Péguy. Des métaphores de la situation humaine, tels l'emprisonnement et l'exil, sont examinées ainsi que la lumière que les auteurs concernés trouvent dans des expériences d'obscurité. (...) La crise de l'histoire est aussi examinée particulièrement dans les écrits de l'auteur italien, Sergio Quinzio: comment pouvons-nous continuer à espérer deux mille ans après la mort du Christ tandis que l'histoire de la souffrance humaine continue, apparemment sans solution ? Après avoir posé la question de l'espérance, la réponse chrétienne est examinée surtout à travers les oeuvres de Jürgen Moltmann qui base sa théologie sur le Dieu qui vient à nous comme futur, le Dieu qui renouvelle toutes choses, le Dieu créateur qui fait être a partir de rien et ressuscite les morts. Tandis que l'optimisme se base sur les resources humaines et la croyance que les choses iront inévitablement mieux, l'espérance s'enracine en ce que Dieu peut faire dans une situation de souffrance, de mort et de destruction. Une telle espérance ne nous conduit cependant pas à fuir le monde. Au contraire, notre espé. (shrink)

At the heart of the current surge of interest in religion among contemporary Continental philosophers stands Augustine’s Confessions. With Derrida’s Circumfession constantly in the background, this volume takes up the provocative readings of Augustine by Heidegger, Lyotard, Arendt, and Ricoeur. Derrida himself presides over and comments on essays by major Continental philosophers and internationally recognized Augustine scholars. While studies on and about Augustine as a philosopher abound, none approach his work from such a uniquely postmodern point of view, showing both (...) the continuing relevance of Augustine and the religious resonances within postmodernism. Posed at the intersection of philosophy, theology, and religious studies, this book will be of interest to scholars and students of Augustine as well as those interested in the invigorating discussion between philosophy, religion, and postmodernism. Contributors include Geoffrey Bennington, Philippe Capelle, John D. Caputo, Elizabeth A. Clark, Hent de Vries, Jacques Derrida, Jean Bethke Elshtain, Richard Kearney, Catherine Malabou, James O’Donnell, Michael J. Scanlon, and Mark Vessey. Indiana Series in the Philosophy of Religion—Merold Westphal, general editor. (shrink)

In this exemplary study of Cassiodorus, O'Donnell offers us a biography of the man, an analysis of his writings, and a reevaluation of Cassiodorus' contributions to western culture. The search for the man and for the motivation of the writings are entirely interdependent so that the image of the man emerges from the meticulous and often brilliant study of the literature.

This chapter begins with conversations in a prison on Samuel Beckett and pedagogy, conversations that emerged from the authors classes in philosophy. There are two interwoven strands in the chapter. One questions the emphasis on competition and achievement in contemporary education and its implications for the author's relationship to failure. The second, strongly influenced by Beckett, explores ways of reimagining the relationship to failure in such a way that allows them to reflect on what matters in life. Rather than seeking (...) to eliminate failure, it is more interesting to think about how the concept of failure could be reimagined if, as Beckett suggests, failure is not accompanied by disappointment but became simply what we do, rather than being something we are. (shrink)

In this powerful and wonderfully accessible meditation on psychoanalysis, hermeneutics, and social constructivism, Donnel Stern explores the relationship between two fundamental kinds of experience: explicit verbal reflection and "unformulated experience," or experience we have not yet reflected on and put into words. Stern is especially concerned with the process by which we come to formulate the unformulated. It is not an instrumental task, he holds, but one that requires openness and curiosity; the result of the process is not accuracy alone, (...) but experience that is deeply felt and fully imagined. Stern's sense of explicit verbal experience as continuously constructed and emergent leads to a central dialectic at the heart of his work: that between curiosity and imagination, on one hand, and dissociation and unthinking acceptance of the familiar on the other. The goal of psychoanalytic work, he holds, is the freedom to be curious, whereas defense signifies the denial of this freedom. We defend against our fear of what we would think, that is, if we allowed ourselves the freedom to think it. Stern also shows how the unconscious itself can be reconceptualized hermeneutically, and he goes on to explore the implications of this viewpoint on interpretation and countertransference. He is especially persuasive in showing how the interpersonal field, which is continuously in flux, limits the experience that it is possible for participants to reflect on. Thus it is that analyst and patient are together "caught in the grip of the field," often unable to see the kind of relatedness in which they are mutually involved. A brilliant demonstration of the clinical consequentiality of hermeneutic thinking, _Unformulated Experience_ bears out Stern's belief that psychoanalysis is as much about the revelation of the new in experience as it is about the discovery of the old. (shrink)

Hayek argued that the central question of economics is the coordination problem: How does the spontaneous interaction of many purposeful individuals, each having dispersed bits of subjective knowledge, generate an order in which the actors' subjective data are coordinated in a way that enables them to dovetail their plans and activities successfully? In attempting to solve this problem, Hayek outlined an approach to economic theorizing that takes seriously the limited, subjective nature of human knowledge. Despite purporting to have appropriated Hayek's (...) thought by acknowledging the information-transmitting role of prices, mainstream economists have missed Hayek's point. The predominant tool of formal economics—equilibrium analysis—begins by assuming the data held by actors to have been pre-reconciled, and so evades the problem to be solved. Even the more advanced tools for modeling knowledge in economic analysis, such as the economics of information, assume away either the subjectivism of knowledge and expectations (rendering the coordination of beliefs and plans a trivial matter) or the frictions and “imperfections” of reality (rendering the coordination problem indeterminate). (shrink)

Building on the innovative work of _Unformulated Experience,_ Donnel B. Stern continues his exploration of the creation of meaning in clinical psychoanalysis with _Partners in Thought_. The chapters in this fascinating book are undergirded by the concept that the meanings which arise from unformulated experience are catalyzed by the states of relatedness in which the meanings emerge. In hermeneutic terms, what takes place in the consulting room is a particular kind of conversation, one in which patient and analyst serve as (...) one another’s partner in thought, an emotionally responsive witness to the other’s experience. Enactment, which Stern theorizes as the interpersonalization of dissociation, interrupts this crucial kind of exchange, and the eventual breach of enactments frees analyst and patient to resume it. Later chapters compare his views to the ideas of others, considering mentalization theory and the work of the Boston Change Process Study Group. Approaching the link between dissociation and enactment via hermeneutics, metaphor, and narrative, among other perspectives, Stern weaves an experience-near theory of psychoanalytic relatedness that illuminates dilemmas clinicians find themselves in every day. Full of clinical illustrations showing how Stern works with dissociation and enactment, _Partners in Thought_ is destined to take its place beside Unformulated Experience as a major contribution to the psychoanalytic literature. (shrink)

In this important study D. M. Armstrong offers a comprehensive system of analytical metaphysics that synthesises but also develops his thinking over the last twenty years. Armstrong's analysis, which acknowledges the 'logical atomism' of Russell and Wittgenstein, makes facts the fundamental constituents of the world, examining properties, relations, numbers, classes, possibility and necessity, dispositions, causes and laws. All these, it is argued, find their place and can be understood inside a scheme of states of affairs. This is a comprehensive and (...) rigorously this-worldly account of the most general features of reality, argued from a distinctive philosophical perspective, and it will appeal to a wide readership in analytical philosophy. (shrink)

The eukaryotic helicase is an 11-subunit machine containing an Mcm2-7 motor ring that encircles DNA, Cdc45 and the GINS tetramer, referred to as CMG. CMG is “built” on DNA at origins in two steps. First, two Mcm2-7 rings are assembled around duplex DNA at origins in G1 phase, forming the Mcm2-7 “double hexamer.” In a second step, in S phase Cdc45 and GINS are assembled onto each Mcm2-7 ring, hence producing two CMGs that ultimately form two replication forks that travel (...) in opposite directions. Here, we review recent findings about CMG structure and function. The CMG unwinds the parental duplex and is also the organizing center of the replisome: it binds DNA polymerases and other factors. EM studies reveal a 20-subunit core replisome with the leading Pol ϵ and lagging Pol α-primase on opposite faces of CMG, forming a fundamentally asymmetric architecture. Structural studies of CMG at a replication fork reveal unexpected details of how CMG engages the DNA fork. The structures of CMG and the Mcm2-7 double hexamer on DNA suggest a completely unanticipated process for formation of bidirectional replication forks at origins. Here, we review the structure and function of CMG, the 11 subunit helicase for eukaryotic DNA replication. Two CMGs are assembled at origins starting from two Mcm2-7 hexamers oriented N-to-N. The orientation of CMG at a forked DNA implies that the two CMGs at an origin pass one another. (shrink)