Alternatives to convenience sampling (CS) are needed for HIV/STI surveillance of most-at-risk populations in Latin America. We compared CS, time space sampling (TSS), and respondent driven sampling (RDS) for recruitment of men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. During concurrent 60-day periods from June-August, 2011, we recruited MSM/TW for epidemiologic surveillance using CS, TSS, and RDS. A total of 748 participants were recruited through CS, 233 through TSS, and 127 through RDS. The TSS (...) sample included the largest proportion of TW (30.7 %) and the lowest percentage of subjects who had previously participated in HIV/STI research (14.9 %). The prevalence of newly diagnosed HIV infection, according to participants' self-reported previous HIV diagnosis, was highest among TSS recruits (17.9 %) compared with RDS (12.6 %) and CS (10.2 %). TSS identified diverse populations of MSM/TW with higher prevalences of HIV/STIs not accessed by other methods. (shrink)

The pandemic outbreak in March 2020 and its associated sanitary regulations and restrictions triggered an abrupt and significant change for society in general and for families’ organization in particular. In Chile, the Santiago Metropolitan District was under a strict lockdown that involved the closure of the entire educational system. From a systemic-family stress perspective, the impact of these changes might have consequences not only for each individual family member, but for the parental dynamic and, consequently, for children’s well-being. This paper (...) presents the results of a follow-up study showing changes in self-reported parental depression and the perceived home organization of mothers and fathers assessed at three different moments: before the pandemic, at the initial outbreak, and after 1 month of strict lockdown. Relevant moderators were explored using linear mixed models to understand the within-subject changes in mothers’ and fathers’ self-reports across the different assessment times. Financial strain, personality traits of self-criticism and dependency, previous parent–child quality interaction, recent major stressful events, and number of children are highlighted as relevant factors that moderate changes in home chaos and parental mental health perception. Significant risks and protective factors are described for fathers and mothers. The use of pre-pandemic measures as baseline levels enabled the identification of personal and family characteristics that were related to better outcomes. The results help increase our understanding of the sanitary regulations’ impacts on the family system and identify vulnerability indicators that should be considered. (shrink)

Background: Doctor–patient sexual relationship is considered to be unfair because the first party would be abusing the second party’s vulnerability. The prohibition of this relationship is noted in the Hippocratic oath. Currently, a reprise of the use of oaths in medical schools can be observed.Aim: To determine whether the prohibition has been maintained and how its expression has varied in the oaths during different periods.Methods: 50 oaths were studied: 13 ancient–medieval and 37 modern–contemporary. Of the 50 texts, 19 were versions (...) of the original oaths. The oaths that pointed out the prohibited doctor–patient relationship referred to any sexual aspect or included paragraphs that began as the Hippocratic oath does were noted.Results: Of the 24 texts that expressed the prohibition, 8 were ancient–medieval and 16 were modern–contemporary. Some expressly call it Hippocratic oath, many use general terminology and others describe it in association with other commitments .Conclusions: The clause on the prohibition of the doctor–patient sexual relationship in Hippocratic oath was included to be for legal, economic and social reasons at the time. That the clause is found mostly in the ancient–medieval oaths can be attributed to the influence of the original. This commitment is generalised and associated with others by contemporary formulas. Currently, sexual relationships are the subject of legal and ethical analysis and their inclusion in the oaths is being debated. (shrink)

8 March, now known as International Women’s Day, is a day for feminist claims where demonstrations are organized in over 150 countries, with the participation of millions of women all around the world. These demonstrations can be viewed as collective rituals and thus focus attention on the processes that facilitate different psychosocial effects. This work aims to explore the mechanisms involved in participation in the demonstrations of 8 March 2020, collective and ritualized feminist actions, and their correlates associated with personal (...) well-being and collective well-being, collective efficacy and collective growth, and behavioral intention to support the fight for women’s rights. To this end, a cross-cultural study was conducted with the participation of 2,854 people from countries in Latin America and Europe, with a retrospective correlational cross-sectional design and a convenience sample. Participants were divided between demonstration participants and non-demonstrators or followers who monitored participants through the media and social networks. Compared with non-demonstrators and with males, female and non-binary gender respondents had greater scores in mechanisms and criterion variables. Further random-effects model meta-analyses revealed that the perceived emotional synchrony was consistently associated with more proximal mechanisms, as well as with criterion variables. Finally, sequential moderation analyses showed that proposed mechanisms successfully mediated the effects of participation on every criterion variable. These results indicate that participation in 8M marches and demonstrations can be analyzed through the literature on collective rituals. As such, collective participation implies positive outcomes both individually and collectively, which are further reinforced through key psychological mechanisms, in line with a Durkheimian approach to collective rituals. (shrink)

Variations in levels of apolipoprotein E have been tied to the risk and progression of Alzheimer's disease . Our group has previously compared and contrasted the promoters of the mouse and human ApoE gene promoter sequences and found notable similarities and significant differences that suggest the importance of the APOE promoter's role in the human disease. We examine here three specific single-nucleotide polymorphisms within the human APOE promoter region, specifically at -491 , -427 , and at -219 upstream from the (...) +1 transcription start site. The -219 and -491 polymorphic variations have significant association with instance of AD, and -491AA has significant risk even when stratified for the APOEepsilon4 allele. We also show significant effects on reporter gene expression in neuronal cell cultures, and, notably, these effects are modified by species origin of the cells. The -491 and -219 polymorphisms may have an interactive effect in addition to any independent activity. DNA-protein interactions differ between each polymorphic state. We propose SP1 and GATA as candidates for regulatory control of the -491 and -219 polymorphic sites. This work's significance lies in drawing connection among APOE promoter polymorphisms' associations with AD to functional promoter activity differences and specific changes in DNA-protein interactions in cell culture-based assays. Taken together, these results suggest that APOE expression levels are a risk factor for AD irrespective of APOEepsilon4 allele status. (shrink)

According to the thought experiment most commonly used to argue against reliabilism, Mr. Truetemp is given an unusual but reliable cognitive faculty. Since he is unaware of the existence of this faculty, its deliverances strike him as rather odd. Many think that Truetemp would not have justified beliefs. Since he satisfies the reliabilist conditions for justified belief, reliabilism appears to be mistaken. I argue that the Truetemp case is underdescribed and that this leads readers to make erroneous assumptions about Truetemp's (...) epistemic situation. After examining empirical studies of actual subjects who, like Truetemp, have received new perceptual faculties, I show that Truetemp must have been endowed with all of the reorganized neural circuitry and cognitive skills that subjects with new perceptual faculties normally acquire during a long and difficult process of adaptation and development. When readers realize how much more the designers of Truetemp's new faculty had to do than simply slip an artificial device under Truetemp's scalp, I find that they no longer think his beliefs would be unjustified. Because the thought experiment fails to support anti-reliabilist intuitions when further details of the case are made explicit, the Truetemp thought experiment does not constitute a clear and decisive counterexample to reliabilism. (shrink)

Equality is the great political issue of our time. Liberty is forgotten: Fraternity never did engage our passions: the maintenance of Law and Order is at a discount: Natural Rights and Natural Justice are outmoded shibboleths. But Equality—there men have something to die for, kill for, agitate about, be miserable about. The demand for Equality obsesses all our political thought. We are not sure what it is—indeed, as I shall show later, we are necessarily not sure what it is—but we (...) are sure that whatever it is, we want it: and while we are prepared to look on frustration, injustice or violence with tolerance, as part of the natural order of things, we will work ourselves up into paroxysms of righteous indignation at the bare mention of Inequality. (shrink)

From the 5th edition of Beauchamp and Childress' Principles of Biomedical Ethics, the problem of common morality has been given a more prominent role and emphasis. With the publication of the 6th and latest edition, the authors not only attempt to ground their theory in common morality, but there is also an increased tendency to identify the former with the latter. While this stratagem may give the impression of a more robust, and hence stable, foundation for their theoretical construct, we (...) fear that it comes with a cost, namely the need to keep any theory in medical ethics open to, and thereby aware of, the challenges arising from biomedical research and clinical practice, as well as healthcare systems. By too readily identifying the moral life of common morality with rule-following behaviour, Beauchamp and Childress may even be wrong about the nature of common morality as such, thereby founding their, by now, classic theory on quicksand instead of solid rock. (shrink)

The purpose of this essay is to stimulate academic discussion about the ethical justification of using human primordial stem cells for tissue transplantation, cell replacement, and gene therapy. There are intriguing alternatives to using embryos obtained from elective abortions and in vitro fertilisation to reconstitute damaged or dysfunctional human organs. These include the expansion and transplantation of latent adult progenitor cells.

While the UK Home Office’s proposals to preventively detain people with what it has called dangerous severe personality disorder have been subjected to debate and criticism the deeply troubling jurisprudential issues in these proposals have not yet entered into public debate in a way that their seriousness deserves.1 It is good that a commentator as well known as Professor Szasz is speaking out on this issue.Professor Szasz focuses upon a crucial question by calling into question the medicalisation of terms like (...) dangerousness and mental illness.2 There is a great temptation for legislators and the public to treat these terms as if they are purely scientific terms and to think of risk assessment as a precise science. I don’t share Professor’s Szasz’s worry about how psychiatry is using these terms but I think there are some important questions about how these concepts function in the public sphere.This issue is important enough to justify the use of some rhetorical claims because such claims can serve to bring out what are neglected and important issues. In raising the following objections I am not attempting to refute the message that is in Szasz’s article or to say that he is not making an important point but rather to attempt to sharpen the issues and to suggest ways that we can respond to Professor Szasz’s challenge.Psychiatry has progressed in a number of ways since Professor Szasz wrote The Myth of Mental Illness.3 The science is much better, we have much better medications, and psychiatrists are acutely aware of the tension between treating their patient and their obligations to the public interest.So when Professor Szasz says: “Psychiatrists offer to relieve the disturbed person of the burden of coping …. (shrink)

Justice has always been regarded as one of the fundamental political virtues. No association of human individuals could subsist, says Hume, “were no regard paid to the laws of equity and justice”, and nearly every thinker who has turned to consider human society, has reached the same conclusion. Yet we are not at all clear what justice is, nor why it is so important. There are many other ideals which a society may cherish, and often reformers have felt impatient of (...) having to compromise their aims merely for the sake of justice, and have not seen why the claims of justice should in any way override other political goods. I shall try to show why justice is, along with liberty, a peculiarly fundamental ideal, which is not merely co-ordinate with other ideals a society may value; but also that this notwithstanding, considerations of justice are not all-sufficient, and do not, and should not, always override all other political ideals. (shrink)

NICE, the draft fertility guideline and dodging the big question: should fertility treatment be provided by the NHS?In August of this year the National Institute for Clinical Excellence made its draft guideline on fertility treatment available for consultation.1 As has been widely reported in the media the draft guideline recommends that the National Health Service should provide publicly funded fertility treatment in a consistent way across England and Wales. The guideline recommends that three cycles of IVF should be available when (...) “The woman is within the optimal range for in vitro fertilisation and there is an appropriately diagnosed cause of infertility of any duration, or unexplained infertility of at least three years’ duration .Those who need fertility treatment will celebrate the guideline, as will many fertility clinics. The guideline does not, however, address key questions that will be obvious to many. Is fertility treatment the kind of thing that ought to be available on the NHS? Will the inevitable increase in demand mean that resources are directed away from other services? Is fertility treatment really the same kind of intervention as heart or hip replacement surgery?My view is that there are good reasons for doing what we can to help people access fertility services. Most of us will start a family and for those of us who do it is probably the most important of all of our life projects. Given that social status and wealth can be significant obstacles to many of the things that people would like to do with their lives, the fact that most of us are able to pursue this important life project is good from an egalitarian …. (shrink)

Professor Braithwaite’s inaugural lecture, here published in book form,1 is a trial run at a Platonic definition of the concept of dianemetic justice; or, as he himself would put it, a rational reconstruction of the concept “sensible-prudent-and-fair”. Aristotle left it that dianemetic justice was an equality and a matter of ratios. A just distribution of őoα µεριστ? τoς κoινωνoσι τς πoλιτείαѕ2 was one in which each had an equitable share, no one having either more or less than he should. Professor (...) Braithwaite goes further and replaces Aristotle’s ordered scale of the-more-and-the-less in which only imprecise and unhelpful answers could be given, by a numerical scale in which he can frame the question “Exactly how much is a fair share?” and propound his s own solution. (shrink)

The problem with which I wish to deal in this paper is the problem of singular reasons in the humanities, whether they exist, or rather, whether they can exist: for it would seem that the word “reason” carried with it some idea of generality, so that the phrase “singular reason” was a contradiction in terms, a specification which could never be fulfilled. But humanists are always sensing the singularity of their studies: and the philosopher wondering about the nature of humane (...) thinking either must conclude that it is really only inadequate science, its singularity being the mark of the fact that we never really have an adequate basis for any of our generalizations, an unfortunate reminder that the whole structure is built on the shakiest of inductive foundations; or , if he is unwilling to allow that humanists are just bad, or at least amateur, scientists, he is tempted to vindicate the rationality of their reasoning by inventing a special faculty of particular ratiocination which is able to perceive particular truths—the intuition of the moralists or the insight of the Collingwoodian mode. (shrink)

David Lewis criticizes an argument I put forward against mechansim on the grounds that I fail to distinguish between OL, Lucas's ordinary potential arithmetic output, and OML, Lucas's arithmetical output when accused of being some particular machine M; and correspondingly, between OM the ordinary potential arithmetic output of the machine M, and ONM, the arithmetic output of the machine M when accused of being a particular machine N. For any given machine, M, N, O, P, Q, R,... etc., I can (...) in principle calculate a Godel sentence for that machine - indeed infinitely many, depending on the Godel numbering scheme adopted. The Godel sentence of a particular machine can, I claim, be seen to be true, if that machine is adequate for Elementary Peano Arithmetic. Hence, if I were accused of being M, I can on that supposition see that the Godel sentence of M is true, since I am capable of Elementary Peano Arithmetic and the machine M is said to be an adequate characterization of me. (shrink)

Possible distributive justice frameworks for providing health care by general practitioners are discussed. The ethical considerations before and after the recent changes to the British National Health Service are contrasted, with particular emphasis on a possible ethical divide that has been produced between fund-holding and non-fund-holding general practitioners. It is argued that general practitioners in non-fund-holding practices can continue as ethical advocates for their patients and distribute health care within an egalitarian framework. However, those in fund-holding practices may now be (...) seen as interest advocates and may have to practise utilitarian distributive justice. Patient groups may be needed to ensure that these general practitioners are seen to act justly in the distribution of the health care resources for which they are now responsible. (shrink)

Economic models are founded in the idea of taking individuals' preferences as both known and given. This article explores the evolution of personal preferences, within a context of both entrepreneurial discovery and Objectivist philosophy. It begins by formalizing Ayn Rand's theory of Objectivism applied to human values, and continues by modeling preference changes similar to Schumpeter's theory of creative destruction—a process of self-discovery. Next the role of societal factors is examined in forming shared preference sets. Finally, the article describes how (...) the strength of human preferences is used to narrow choice sets in the presence of greater consumption options. (shrink)

Though the authors of this commentary have deep felt doubts about the fruitfulness of Björkman and Hansson’s analysis of bodily rights, they do not doubt their capacity to develop both creative and provocative thoughtsIt is always welcoming to be confronted with thoughts that, even though one wholeheartedly disagrees with them, have the effect of stimulating one’s own reflections on matters, which without such confrontations, would have been less distinct, less critical—and we would gladly admit, less polemical. Thus it is thanks (...) to Barbro Björkman and Sven Ove Hansson’s article, “Bodily rights and property rights”, that we have been able to set our present course into these murky waters. The issue they want to address is by no means of a kind that lends itself easily to theoretical speculation. This has, perhaps, as much to do with the inherent intricacy of the issue itself as with the controversy it has managed to arouse. The issue is: is it possible to have ownership over one’s own body—that is, is it appropriate to treat the body and its components as property? What are the implications of conceptualising the body and its parts in terms of property? Should one, as a general rule, be able to sell and buy human biological material? If so, who should be allowed to buy and sell it? Does the sale or donation of one’s own bodily parts imply a transfer of ownership rights to the buyer or receiver, or is it rather that ownership of human bodily parts can only be acquired after the material has been, say, manipulated in a laboratory?Contrary to Björkman and Hansson, who see “the primary normative issue” to be “what combination of rights a person should have to a particular item of biological material”, we believe that their decision to construe …. (shrink)