Background Speaking up to safeguard patients is a crucial ethical and moral obligation for nurses, but it is also a difficult and potentially dangerous component of nursing work. Health advocacy is gaining impetus in the medical literature, despite being hampered by barriers resulting in many nurses in Ghana remaining mute when faced with advocacy-required situations. We explored situations that thwart nurses from performing their health advocacy role. Research question What would cause nurses to take no action when they witness situations (...) that require them to act as health advocates for their clients or communities? Research Design An inductive, descriptive qualitative design was used to collect and analyse data on barriers that prevent nurses from practising their health advocacy role in Ghana. Individual one-on-one in-depth interviews were conducted using a semi-structured interview guide. The data were analysed using qualitative content analysis. Participants and research context Twenty-four professional nurses and midwives registered with the Nursing and Midwifery Council were recruited from three regional hospitals in Ghana. These public hospitals were chosen from the upper, middle and coastal regions. Ethical considerations The UKZN Ethics Review Committee in South Africa and the GHS Ethics Review Committee in Ghana both gave their approval for this study. Findings Intrapersonal barriers, interpersonal barriers, and structural barriers emerged as major obstacles that nurses experience when performing their health advocacy role. Conclusions Barriers to health advocacy have undermined nurses' ability to function as health advocates and are preventing them from utilising their health advocacy position in nursing practise. Giving nursing students positive role models in the classroom and in the clinic can help them become more effective health advocates. (shrink)

The use of social media as a recruitment tool for research with humans is increasing, and likely to continue to grow. Despite this, to date there has been no specific regulatory guidance and there has been little in the bioethics literature to guide investigators and institutional review boards faced with navigating the ethical issues such use raises. We begin to fill this gap by first defending a nonexceptionalist methodology for assessing social media recruitment; second, examining respect for privacy and investigator (...) transparency as key norms governing social media recruitment; and, finally, analyzing three relatively novel aspects of social media recruitment: the ethical significance of compliance with website “terms of use”; the ethics of recruiting from the online networks of research participants; and the ethical implications of online communication from and between participants. Two checklists aimed at guiding investigators and IRBs through the ethical issues are included as appendices. (shrink)

It is not uncommon for multiple clinical trials at the same institution to recruit concurrently from the same patient population. When the relevant pool of patients is limited, as it often is, trials essentially compete for participants. There is evidence that such a competition is a predictor of low study accrual, with increased competition tied to increased recruitment shortfalls. But there is no consensus on what steps, if any, institutions should take to approach this issue. In this article, we argue (...) that an institutional policy that prioritises some trials for recruitment ahead of others is ethically permissible and indeed prima facie preferable to alternative means of addressing recruitment competition. We motivate this view by appeal to the ethical importance of minimising the number of studies that begin but do not complete, thereby exposing their participants to unnecessary risks and burdens in the process. We then argue that a policy of prioritisation can be fair to relevant stakeholders, including participants, investigators and funders. Finally, by way of encouraging and helping to frame future debate, we propose some questions that would need to be addressed when identifying substantive ethical criteria for prioritising between studies. (shrink)

Interest in science and math plays an important role in encouraging STEM motivation and career aspirations. This interest decreases for girls between late childhood and adolescence. Relatedly, positive mentoring experiences with female teachers can protect girls against losing interest. The present study examines whether visitors to informal science learning sites differ in their expressed science and math interest, as well as their science and math stereotypes following an interaction with either a male or female educator. Participants were visitors to one (...) of four ISLS in the United States and United Kingdom. Following an interaction with a male or female educator, they reported their math and science interest and responded to math and science gender stereotype measures. Female participants reported greater interest in math following an interaction with a female educator, compared to when they interacted with a male educator. In turn, female participants who interacted with a female educator were less likely to report male-biased math gender stereotypes. Self-reported science interest did not differ as a function of educator gender. Together these findings suggest that, when aiming to encourage STEM interest and challenge gender stereotypes in informal settings, we must consider the importance of the gender of educators and learners. (shrink)

Volume 20, Issue 9, September 2020, Page 23-25.

Why do humans make music? Theories of the evolution of musicality have focused mainly on the value of music for specific adaptive contexts such as mate selection, parental care, coalition signaling, and group cohesion. Synthesizing and extending previous proposals, we argue that social bonding is an overarching function that unifies all of these theories, and that musicality enabled social bonding at larger scales than grooming and other bonding mechanisms available in ancestral primate societies. We combine cross-disciplinary evidence from archeology, anthropology, (...) biology, musicology, psychology, and neuroscience into a unified framework that accounts for the biological and cultural evolution of music. We argue that the evolution of musicality involves gene–culture coevolution, through which proto-musical behaviors that initially arose and spread as cultural inventions had feedback effects on biological evolution because of their impact on social bonding. We emphasize the deep links between production, perception, prediction, and social reward arising from repetition, synchronization, and harmonization of rhythms and pitches, and summarize empirical evidence for these links at the levels of brain networks, physiological mechanisms, and behaviors across cultures and across species. Finally, we address potential criticisms and make testable predictions for future research, including neurobiological bases of musicality and relationships between human music, language, animal song, and other domains. The music and social bonding hypothesis provides the most comprehensive theory to date of the biological and cultural evolution of music. (shrink)

Exceptionally preserved fossils are the product of complex interplays of biological and geological processes including burial, autolysis and microbial decay, authigenic mineralization, diagenesis, metamorphism, and finally weathering and exhumation. Determining which tissues are preserved and how biases affect their preservation pathways is important for interpreting fossils in phylogenetic, ecological, and evolutionary frameworks. Although laboratory decay experiments reveal important aspects of fossilization, applying the results directly to the interpretation of exceptionally preserved fossils may overlook the impact of other key processes that (...) remove or preserve morphological information. Investigations of fossils preserving non-biomineralized tissues suggest that certain structures that are decay resistant are rarely preserved, and decay-prone structures can fossilize, albeit rarely. As we review here, decay resistance is an imperfect indicator of fossilization potential, and a suite of biological and geological processes account for the features preserved in exceptional fossils. Organisms decayed experimentally in seawater have been used as direct analogs for soft-bodied fossil taxa, with fossils representing a snapshot of a particular stage of decay. We argue that numerous geological and biological processes account for fossilization and that all of these should be considered when reconstructing extinct organisms. (shrink)

Exceptionally preserved fossils are the product of complex interplays of biological and geological processes including burial, autolysis and microbial decay, authigenic mineralization, diagenesis, metamorphism, and finally weathering and exhumation. Determining which tissues are preserved and how biases affect their preservation pathways is important for interpreting fossils in phylogenetic, ecological, and evolutionary frameworks. Although laboratory decay experiments reveal important aspects of fossilization, applying the results directly to the interpretation of exceptionally preserved fossils may overlook the impact of other key processes that (...) remove or preserve morphological information. Investigations of fossils preserving non-biomineralized tissues suggest that certain structures that are decay resistant are rarely preserved, and decay-prone structures can fossilize, albeit rarely. As we review here, decay resistance is an imperfect indicator of fossilization potential, and a suite of biological and geological processes account for the features preserved in exceptional fossils. Organisms decayed experimentally in seawater have been used as direct analogs for soft-bodied fossil taxa, with fossils representing a snapshot of a particular stage of decay. We argue that numerous geological and biological processes account for fossilization and that all of these should be considered when reconstructing extinct organisms. (shrink)

Institutional review boards, tasked with facilitating ethical research, are often pulled in competing directions. In what we call the protection-inclusion dilemma, we acknowledge the tensions IRBs face in aiming to both protect potential research participants from harm and include under-represented populations in research. In this manuscript, we examine the history of protectionism that has dominated research ethics oversight in the United States, as well as two responses to such protectionism: inclusion initiatives and critiques of the term vulnerability. We look at (...) what we know about IRB decision-making in relation to protecting and including “vulnerable” groups in research and examine the lack of regulatory guidance related to this dilemma, which encourages protection over inclusion within IRB practice. Finally, we offer recommendations related to how IRBs might strike a better balance between inclusion and protection in research ethics oversight. (shrink)

Folie à deux is the transference of delusional ideas from one 'primary' individual to one or more 'secondary' individuals (Lasègue & Falret, 1877). However, it is difficult to investigate experimentally because often only one patient is identified as delusional. We investigated whether hypnosis could model the experiences of the secondary in this delusion. Our primary was a confederate, who displayed two delusional beliefs and attempted to transmit them to hypnotised subjects. We manipulated the status of the confederate so that they (...) were portrayed as either "credible" or merely "interesting". Many high hypnotisable individuals adopted the confederate's beliefs and confabulated evidence in support of them. Also, subjects who interacted with a credible confederate extended their delusions beyond those displayed by the confederate. We discuss the strengths and limitations of this approach and suggest ways to improve the validity of this model. (shrink)

The injunction to “analyze the way you randomize” is well known to statisticians since Fisher advocated for randomization as the basis of inference. Yet even those convinced by the merits of randomization-based inference seldom follow this injunction to the letter. Bernoulli randomized experiments are often analyzed as completely randomized experiments, and completely randomized experiments are analyzed as if they had been stratified; more generally, it is not uncommon to analyze an experiment as if it had been randomized differently. This article (...) examines the theoretical foundation behind this practice within a randomization-based framework. Specifically, we ask when is it legitimate to analyze an experiment randomized according to one design as if it had been randomized according to some other design. We show that a sufficient condition for this type of analysis to be valid is that the design used for analysis should be derived from the original design by an appropriate form of conditioning. We use our theory to justify certain existing methods, question others, and finally suggest new methodological insights such as conditioning on approximate covariate balance. (shrink)

Volume 19, Issue 6, June 2019, Page 62-64.

We compare and contrast the 60 commentaries by 109 authors on the pair of target articles by Mehr et al. and ourselves. The commentators largely reject Mehr et al.'s fundamental definition of music and their attempts to refute (1) our social bonding hypothesis, (2) byproduct hypotheses, and (3) sexual selection hypotheses for the evolution of musicality. Instead, the commentators generally support our more inclusive proposal that social bonding and credible signaling mechanisms complement one another in explaining cooperation within and competition (...) between groups in a coevolutionary framework (albeit with some confusion regarding terminologies such as “byproduct” and “exaptation”). We discuss the proposed criticisms and extensions, with a focus on moving beyond adaptation/byproduct dichotomies and toward testing of cross-species, cross-cultural, and other empirical predictions. (shrink)

We are grateful to everyone who took the time to offer such insightful comments with regard to the protection–inclusion dilemma in research oversight. Nearly all respondents agreed that this dilemm...

Recent experimental evidence indicates that intuitions about inherence and system justification are distinct psychological processes, and that the inherence heuristic supplies important explanatory frameworks that are accepted or rejected based on their consistency with one's motivation to justify the system.

Compared to our understanding of positive prediction error signals occurring due to unexpected reward outcomes, less is known about the neural circuitry in humans that drives negative prediction errors during omission of expected rewards. While classical learning theories such as Rescorla–Wagner or temporal difference learning suggest that both types of prediction errors result from a simple subtraction, there has been recent evidence suggesting that different brain regions provide input to dopamine neurons which contributes to specific components of this prediction error (...) computation. Here, we focus on the brain regions responding to negative prediction error signals, which has been well-established in animal studies to involve a distinct pathway through the lateral habenula. We examine the activity of this pathway in humans, using a conditioned inhibition paradigm with high-resolution functional MRI. First, participants learned to associate a sensory stimulus with reward delivery. Then, reward delivery was omitted whenever this stimulus was presented simultaneously with a different sensory stimulus, the conditioned inhibitor. Both reward presentation and the reward-predictive cue activated midbrain dopamine regions, insula and orbitofrontal cortex. While we found significant activity at an uncorrected threshold for the CI in the habenula, consistent with our predictions, it did not survive correction for multiple comparisons and awaits further replication. Additionally, the pallidum and putamen regions of the basal ganglia showed modulations of activity for the inhibitor that did not survive the corrected threshold. (shrink)

Background Ethical and scientific principles require that clinical trials address an important question and have the resources needed to complete the study. However, there are no clear standards for review that would ensure that these principles are upheld.Methods We conducted semi-structured interviews with a convenience sample of nineteen experts in clinical trial design, conduct, and/or oversight to elucidate current practice and identify areas of need with respect to ensuring the scientific value and feasibility of clinical trials prior to initiation and (...) while ongoing. We used a priori and grounded theory to analyze the data and constant comparative method to induce higher order themes.Results Interviewees perceived determination of scientific value as the responsibility of the investigator and, secondarily, other parties who review or oversee research. Interviewees reported that ongoing trials are rarely reevaluated due to emerging evidence from external sources, evaluation is complex, and there would be value in the development of standards for monitoring and evaluating evidence systematically. Investigators, IRBs, and/or data monitoring committees (DMCs) could undertake these responsibilities. Feasibility assessments are performed but are typically inadequate; potential solutions are unclear.Conclusions There are three domains where current approaches are suboptimal and in which further guidance is needed. First, who has the responsibility for conducting scientific review, whether it be the investigator, IRB, and/or DMC is often unclear. Second, the standards for scientific review (e.g., appropriate search terms, data sources, and analytic plan) should be defined. Third, guidance is needed on the evaluation of ongoing studies in light of potentially new and evolving evidence, with particular reference to evidence from outside the trial itself. (shrink)

Appropriate concerns about cost and unequal access to healthcare have resulted in the creation of powerful managed networks seeking to share the risks of high healthcare costs among plans, providers, and patients. Much to their credit, these managed networks have slowed the rise in healthcare spending by as much as 44% in markets with high HMO penetration. However, whether these savings will materially improve access and quality remains to be seen.

This chapter takes the form of a discussion between the editors of this volume and Steven Lukes, one the most eminent critics of methodological individualism. The focus is on Lukes’ interpretation of methodological individualism in terms of linguistic exclusivism (i.e., naive reductionism), the multiple-realization problem, Boudon’s and Elster’s micro-foundationalist approach, ontological individualism, and the rationality of human action.

Background Institutional review board (IRB) expertise is necessarily limited by maintaining a manageable board size. IRBs are therefore permitted by regulation to rely on outside experts for review. However, little is known about whether, when, why, and how IRBs use outside experts.Methods We conducted a national survey of U.S. IRBs to characterize utilization of outside experts. Our study uses a descriptive, cross-sectional design to understand how IRBs engage with such experts and to identify areas where outside expertise is most frequently (...) requested.Results The survey response rate was 18.4%, with 55.4% of respondents reporting their institution’s IRB uses outside experts. Nearly all respondents who reported using outside experts indicated they do so less than once a month, but occasionally each year (95%). The most common method of identifying an outside expert was securing a previously known subject matter expert (83.3%). Most frequently, respondents sought consultation for scientific expertise not held by current members (69.6%). Almost all respondents whose IRBs had used outside experts reported an overall positive impact on the IRB review process (91.5%).Conclusions Just over half of the IRBs in our sample report use of outside experts; among them, outside experts were described as helpful, but their use was infrequent overall. Many IRBs report not relying on outside experts at all. This raises important questions about what type of engagement with outside experts should be viewed as optimal to promote the highest quality review. For example, few respondents sought assistance from a Community Advisory Board, which could address expertise gaps in community perspectives. Further exploration is needed to understand how to optimize IRB use of outside experts, including how to recognize when expertise is lacking, what barriers IRBs face in using outside experts, and perspectives on how outside expert review impacts IRB decision-making and review quality. (shrink)

Hastings Center Report, Volume 52, Issue 1, Page 51-58, January/February 2022.

Psychopathy refers to a range of complex behaviors and personality traits, including callousness and antisocial behavior, typically studied in criminal populations. Recent studies have used self-reports to examine psychopathic traits among noncriminal samples. The goal of the current study was to examine the underlying factor structure of the Self-Report of Psychopathy Scale–Short Form (SRP-SF) across complementary samples and examine the impact of gender on factor structure. We examined the structure of the SRP-SF among 2,554 young adults from three undergraduate samples (...) and a high-risk young adult sample. Using confirmatory factor analysis, a four-correlated factor model and a four-bifactor model showed good fit to the data. Evidence of weak invariance was found for both models across gender. These findings highlight that the SRP-SF is a useful measure of low-level psychopathic traits in noncriminal samples, although the underlying factor structure may not fully translate across men and women. (shrink)

Moral principles play important roles in diverse areas of moral thought, practice, and theory. Many who think of themselves as ‘moral generalists’ believe that moral principles can play these roles—that they are capable of doing so. Moral generalism maintains that moral principles can and do play these roles because true moral principles are statements of general moral fact (i.e. statements of facts about the moral attributes of kinds of actions, kinds of states of affairs, etc.) and because general moral facts (...) explain particular moral facts (i.e. facts about the moral attributes of particulars). Moral holism maintains that what is a moral reason to φ in one case may not be one in another, and may even be a moral reason not to φ given suitable circumstances. Some ‘moral particularists’ maintain that moral holism motivates scepticism about the existence of and need for moral principles, along with scepticism about the viability of principle-based approaches to ethics and moral theory. But I argue that moral holism is itself a form of moral generalism, one that takes facts about the right- and wrong-making powers of (generic) moral factors to explain certain particular moral facts—namely, the rightness and wrongness of particular actions. I also argue that a moral-theoretic version of dispositionalism—the view that dispositions, powers, or capacities are the fundamental units of explanation—explains both why moral holism is true and why moral generalism is true. (shrink)

This paper takes up a recent challenge to mechanistic approaches to computational implementation, the view that computational implementation is best explicated within a mechanistic framework. The challenge, what has been labelled “the abstraction problem”, claims that one of MAC’s central pillars – medium independence – is deeply confused when applied to the question of computational implementation. The concern is that while it makes sense to say that computational processes are abstract (i.e. medium-independent), it makes considerably less sense to say that (...) they are also concrete processes of a mechanism. After outlining the problem and its effect on MAC, I examine a recent response from Kuokkanen and Rusanen [2018. “Making Too Many Enemies: Hutto and Myin’s Attack on Computationalism.” Philosophical Explorations 21 (2): 282–294. doi:10.1080/13869795.2018.1477980]. I argue that Kuokkanen and Rusanen’s response comes up short insofar as it makes problematic trade-offs among various desiderata we have for a theory of implementation. This leads to a general dilemma for MAC: either give up being an objective theory of implementation or concede the abstraction problem and so reintroduce triviality concerns. In response, I argue that conceiving of computations as abstracta rather than illata provides a way to avoid the proposed dilemma and articulate a notion of medium independence that addresses the abstraction problem. (shrink)

What are moral principles? In particular, what are moral principles of the sort that (if they exist) ground moral obligations or—at the very least—particular moral truths? I argue that we can fruitfully conceive of such principles as real, irreducibly dispositional properties of individual persons (agents and patients) that are responsible for and thereby explain the moral properties of (e.g.) agents and actions. Such moral dispositions (or moral powers) are apt to be the metaphysical grounds of moral obligations and of particular (...) truths about what is morally permissible, impermissible, etc. Moreover, they can do other things that moral principles are supposed to do: explain the phenomena “falling within their scope,” support counterfactuals, and ground moral necessities, “necessary connections” between obligating reasons and obligations. And they are apt to be the truthmakers for moral laws, or “lawlike” moral generalizations. (shrink)

The psychology and phenomenology of our knowledge of other minds is not well captured either by describing it simply as perception, nor by describing it simply as inference. A better description, I argue, is that our knowledge of other minds involves both through ‘perceptual co-presentation’, in which we experience objects as having aspects that are not revealed. This allows us to say that we perceive other minds, but perceive them as private, i.e. imperceptible, just as we routinely perceive aspects of (...) physical objects as unperceived. I discuss existing versions of this idea, particularly Joel Smith’s, on which it is taken to imply that our knowledge of other minds is, in these cases, perceptual and not inferential. Against this, I argue that perceptual co-presentation in general, and mind-perception in particular, yields knowledge that is simultaneously both perceptual and inferential. (shrink)

Informal science learning sites create opportunities for children to learn about science outside of the classroom. This study analyzed children’s learning behaviors in ISLS using video recordings of family visits to a zoo, children’s museum, or aquarium. Furthermore, parent behaviors, features of the exhibits and the presence of an educator were also examined in relation to children’s behaviors. Participants included 63 children and 44 parents in 31 family groups. Results showed that parents’ science questions and explanations were positively related to (...) children observing the exhibit. Parents’ science explanations were also negatively related to children’s science explanations. Furthermore, children were more likely to provide science explanations when the exhibit was not interactive. Lastly there were no differences in children’s behaviors based on whether an educator was present at the exhibit. This study provides further evidence that children’s interactions with others and their environment are important for children’s learning behaviors. (shrink)

Actual causes - e.g. Suzy's being exposed to asbestos - often bring about their effects - e.g. Suzy's suffering mesothelioma - probabilistically. I use probabilistic causal models to tackle one of the thornier difficulties for traditional accounts of probabilistic actual causation: namely probabilistic preemption.

The term “moral absolute” refers to many different ideas. In contemporary moral philosophy, it most commonly refers to the idea of a moral prohibition or rule that holds without exception. Less commonly, it refers to the idea of a moral rule or standard that applies to all moral agents, rather than only to members of a particular society or culture or only to particular individuals (e.g., those who accept it). The present topic is moral absolutes in the first of these (...) two senses (hereinafter, “moral absolutes”). Notable philosophers who have maintained that there are such absolutes include Immanuel Kant and Elizabeth Anscombe. And the debate over the existence of moral absolutes has implications not only for general moral theory, but also for many topics in applied ethics and just war theory. For example, the question of whether the prohibition on deliberately killing the innocent is absolute has important implications for abortion, euthanasia, and noncombatant immunity. (shrink)

This paper reinvents Freire’s concepts of ‘banking education’ and ‘literacy’ within the context of the exponential growth of digital instruction in the 21st century. We argue that digital learning (i.e. online or technology enhanced) undoubtedly increases access to education globally, but also can intensify some of the worst problems described in Freire’s banking model. Accordingly, we draw from postdigital theory to scrutinize the specific structures and functions of common digital Learning Management Systems (LMSs) used by schools (i.e. Blackboard and Google (...) Classroom) to reveal a type of learning that further exacerbates the teacher-student dichotomy without liberating either party in a Freirean sense. We then use a Foucauldian lens to bring an awareness to how the accelerated use of these systems at scale, in part caused by the COVID-19 pandemic, can further entrench a data-driven, dehumanized educational experience which increases corporate profitability perhaps over the needs of students. Finally, we use these insights to modernize Freire’s concept of ‘literacy’ by building on Critical Medial Literacy (CML) in order to help educators address LMSs, (mis)information facilitated by digital content, and schooling in a (post)pandemic and postdigital world. (shrink)