Using a Solomon four-group design, we investigate the effect of a case-based critical thinking intervention on students’ critical thinking skills. We randomly assign 31 sessions of business classes to four groups and collect data from three sources: in-class performance, university records, and Internet surveys. Our 2 × 2 ANOVA results showed no significant between-subjects differences. Contrary to our expectations, students improve their critical thinking skills, with or without the intervention. Female and Caucasian students improve their critical thinking skills, but males (...) and non-Caucasian do not. Positive performance goals and negative mastery goals enhance and decrease improvements of their CTA scores, respectively. ACT and age are related to pre- and post-test. Gender is related to pre-test. GPA is related to post-test. Results shed light on the Pygmalion effect, the Galatea effect, ability, motivation, and opportunity as signals for human capital, and business ethics. (shrink)

Background Pragmatic randomized controlled trials are designed to evaluate the effectiveness of interventions in real-world clinical conditions. However, these studies raise ethical issues for researchers and regulators. Our objective is to identify a list of key ethical issues in pragmatic RCTs and highlight gaps in the ethics literature. Methods We conducted a scoping review of articles addressing ethical aspects of pragmatic RCTs. After applying the search strategy and eligibility criteria, 36 articles were included and reviewed using content analysis. Results Our (...) review identified four major themes: 1) the research-practice distinction; 2) the need for consent; 3) elements that must be disclosed in the consent process; and 4) appropriate oversight by research ethics committees. 1) Most authors reject the need for a research-practice distinction in pragmatic RCTs. They argue that the distinction rests on the presumptions that research participation offers patients less benefit and greater risk than clinical practice, but neither is true in the case of pragmatic RCTs. 2) Most authors further conclude that pragmatic RCTs may proceed without informed consent or with simplified consent procedures when risks are low and consent is infeasible. 3) Authors who endorse the need for consent assert that information need only be disclosed when research participation poses incremental risks compared to clinical practice. Authors disagree as to whether randomization must be disclosed. 4) Finally, all authors view regulatory oversight as burdensome and a practical impediment to the conduct of pragmatic RCTs, and argue that oversight procedures ought to be streamlined when risks to participants are low. Conclusion The current ethical discussion is framed by the assumption that the function of research oversight is to protect participants from risk. As pragmatic RCTs commonly involve usual care interventions, the risks may be minimal. This leads many to reject the research-practice distinction and question the need for informed consent. But the function of oversight should be understood broadly as protecting the liberty and welfare interest of participants and promoting public trust in research. This understanding, we suggest, will focus discussion on questions about appropriate ethical review for pragmatic RCTs. (shrink)

Pragmatic randomized controlled trials are designed to evaluate the effectiveness of interventions in real-world clinical conditions. However, these studies raise ethical issues for researchers and regulators. Our objective is to identify a list of key ethical issues in pragmatic RCTs and highlight gaps in the ethics literature. We conducted a scoping review of articles addressing ethical aspects of pragmatic RCTs. After applying the search strategy and eligibility criteria, 36 articles were included and reviewed using content analysis. Our review identified four (...) major themes: 1) the research-practice distinction; 2) the need for consent; 3) elements that must be disclosed in the consent process; and 4) appropriate oversight by research ethics committees. 1) Most authors reject the need for a research-practice distinction in pragmatic RCTs. They argue that the distinction rests on the presumptions that research participation offers patients less benefit and greater risk than clinical practice, but neither is true in the case of pragmatic RCTs. 2) Most authors further conclude that pragmatic RCTs may proceed without informed consent or with simplified consent procedures when risks are low and consent is infeasible. 3) Authors who endorse the need for consent assert that information need only be disclosed when research participation poses incremental risks compared to clinical practice. Authors disagree as to whether randomization must be disclosed. 4) Finally, all authors view regulatory oversight as burdensome and a practical impediment to the conduct of pragmatic RCTs, and argue that oversight procedures ought to be streamlined when risks to participants are low. The current ethical discussion is framed by the assumption that the function of research oversight is to protect participants from risk. As pragmatic RCTs commonly involve usual care interventions, the risks may be minimal. This leads many to reject the research-practice distinction and question the need for informed consent. But the function of oversight should be understood broadly as protecting the liberty and welfare interest of participants and promoting public trust in research. This understanding, we suggest, will focus discussion on questions about appropriate ethical review for pragmatic RCTs. (shrink)

McCoy and colleagues (2023) offer a reflective framework for data ethics and governance with several historical bioethics principles as a foundation. Their framework is one among a plethora of othe...

When the cost-effectiveness of newly approved cancer treatments is insufficient or unclear, they may not (immediately) be eligible for reimbursement through basic health insurance in publicly funded healthcare systems. Patients may seek access to non-reimbursed treatment through other channels, including individual funding requests made to hospitals, health insurers, or pharmaceutical companies. Alternatively, they may try to pay out of pocket for non-reimbursed treatments. While currently little is known of these practices, they run counter to a deeply held egalitarian ethos that (...) is prevalent in many publicly funded healthcare systems. In this article, we investigate to what extent this ethos can be grounded in theories of justice, notably egalitarianism and prioritarianism. We argue that allowing out-of-pocket payments by patients themselves, in principle, is not unjust from the perspective of either of these theories, provided that it does not raise in-practice justice-based concerns, for instance by displacing more cost-effective care, to the detriment of other patients, or by failing to treat patients equally. In contrast, we conclude that the practice of making exceptions for individual patients by health insurers or healthcare providers does run counter to the justice-based requirements of equal treatment. (shrink)

Public healthcare systems are increasingly refusing (temporarily) to reimburse newly approved medical treatments of insufficient or uncertain cost-effectiveness. As both patient demand for these treatments and their list prices increase, a market might arise for voluntary additional health insurance (VHI) that covers effective but (very) expensive medical treatments. In this paper, we evaluate such potential future practices of VHI in public healthcare systems from a justice perspective. We find that direct (telic) egalitarian objections to unequal access to expensive treatments based (...) on different ability to afford VHI do not stand up to scrutiny. However, such unequal access might lead to loss of self-respect among individuals, or loss of fraternity within society, rendering it more difficult for citizens to interact on equal moral footing. This would be problematic from a relational egalitarian perspective. Moreover, the introduction of VHI might turn out to have negative consequences for the comprehensiveness and/or the quality of the public healthcare services that are offered to all patients equally through basic health insurance. These consequences must be weighed against potential health gains and the value of liberty. We conclude that governments should be careful when considering the introduction of VHI in public healthcare systems. (shrink)

Repetitive thinking predicts and maintains depression and anxiety, yet the role of RT in the perinatal context has been under-researched. Further, the content and themes that emerge during RT in the perinatal period have been minimally investigated. We recruited an online community sample of women who had their first baby within the past 12 months. Participants completed a battery of self-report questionnaires which included four open-ended questions about the content of their RT. Responses to the latter were analyzed using an (...) inductive thematic analysis approach. Participants reported RT about a range of unexpected emotional responses to becoming a new mother, impact on their sleep and cognitive functioning, as well as the impact on their identity, sense of self, lifestyle, achievements, and ability to function. RT was commonly experienced in first-time mothers, and the themes that emerged conveyed an overall sense of discrepancy between expectations and reality, as well as adjustment to profound change. By providing insight into the content of RT in new mothers, the findings of our study have scope to inform the content of interventions that seek to prevent and treat postnatal mental health problems, particularly those which target key psychological processes such as RT. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 61.2 (2000) 263-283 [Access article in PDF] Contesting Metaphors and the Discourse of Consciousness in William James Jill M. Kress Ah, not to be cut off,not by such slight partitionto be excluded from the stars' measure.What is inwardness?What if not sky intensified,flung through with birds and deepwith winds of homecoming? --Rainer Maria Rilke William James's lifelong attention to questions about human mental (...) experience elucidates the development of the concept of consciousness through its realization in fields as disparate as natural science, radical empiricism, and religious mysticism. 1 Over the course of a career that both establishes and traverses disciplinary boundaries, James's work embodies tensions between scientific explanations for mental phenomena and the inescapability of metaphysical arguments. Jamesian psychology thus alternates between materialist and spiritualist assumptions of scientists and philosophers at the turn of the century, joining their compulsive investigations into the nature of consciousness. 2 Most readers [End Page 263] of James puzzle over the theoretical contradictions within his work, debating central philosophical dilemmas concerning the status of the conscious self. Perhaps the most paradoxical aspect of James's theories, his response to dualism, emerges as he attempts to negotiate ethereal explanations for consciousness with bodily processes. 3 The mind-body problem disrupts James's more delicately balanced theories, a disruption registered explicitly through the metaphors in his texts.Reading The Principles of Psychology (1890) alongside "Does 'Consciousness' Exist" (1904), this essay demonstrates how figurative language directs James's study of consciousness. I argue that metaphor does more than describe consciousness; metaphor constructs James's arguments, governs his conflicting theories of mind through a series of rhetorical configurations and provokes the continual reconstruction of his ideas of human subjectivity. Furthermore, while it is impossible for James to explain and to study consciousness without metaphor, he experiences great anxiety about using language, figurative or otherwise, to represent his object of study. The language becomes more powerful than his intentions or designs and, indeed, raises implications that James cannot control. James possesses a heightened awareness of what he crafts with words; he also, perhaps more penetratingly, acknowledges the inadequacy of any linguistic system to realize concepts thoroughly. 4 Struggling over appropriate "names" and "terms" for consciousness, James presupposes some clearly delineated concept around which we might wrap a verbal expression; yet he also seems painfully aware that every new metaphor launches an entirely new theory. Fluid and unpredictable, consciousness becomes like language itself, yielding its power precisely because it can be so many things at once. The ultimate principle of Jamesian consciousness seems to be its creative capacity; still, once James admits that the problem of consciousness is a problem of language, his carefully constructed designs begin to unravel. Though consciousness will be translated into James's notion of "pure experience" by the time he writes the radical empiricism [End Page 264] essays, James remains simultaneously committed to his figures (especially of the "stream of consciousness") and ambivalent about the account of consciousness that they provide. James helps create the modern self with its enhanced individuality, though his metaphors at once direct us inward to a centered, private self and propel us outward to find consciousness materializing in the fluxional cycle of the natural world.In presenting his initial theory of the stream of our thoughts, James argues for its coherence. His most famous metaphor of the "stream" of consciousness appears to saturate the varied material of the mind, its water washing over and through any distinctions or separations which the mind might present: Consciousness, then, does not appear to itself chopped up in bits. Such words as "chain" or "train" do not describe it fitly as it presents itself in the first instance. It is nothing jointed; it flows. A "river" or a "stream" are the metaphors by which it is most naturally described. In talking of it hereafter, let us call it the stream of thought, of consciousness, or of subjective life. 5James's desire to find words that are more "natural... (shrink)

As demand for locally grown food increases there have been calls to ‘scale-up’ local food production to regionally distribute food and to sell into more mainstream grocery and retail venues where consumers are already shopping. Growing research and practice focusing on how to improve, expand and conceptualize regional distribution systems includes strategies such as value chain development using the Agriculture of the Middle framework. When the Ohio Food Policy Advisory Council asked how they could scale-up the distribution of Ohio fresh (...) fruits and vegetables to Ohioans, we decided to use this practical opportunity to not only provide recommendations to this council, but to simultaneously contribute to the literature on AOTM, value-based and spatially–proximate relationships, and conceptualizations of food system hybridity. We do this while examining an entire sub-sector of the Ohio agricultural economy, namely fruit and vegetables and applying the AOTM framework beyond the farm, namely to distributors and retailers. Through interviews with Ohio retailers and a survey of all fresh fruit and vegetable distributors Ohio we: Describe current distribution systems within the state; Identify firms interested in scaling-up distribution, and; Inform state-level policy efforts by identifying opportunities to better target any state-level policy and program efforts. We demonstrate support for the concept of AOTM applied beyond the farm, for value chain development strategies that can transmit ‘quality’ via spatially proximate supply chains, and support for considering hybrid solutions, such as piggybacking for scaling-up local food systems. This work highlights the role a statewide food policy council can have in facilitating market development and their unique position to provide public sector and institutional support to facilitate meaningful connections in the food system. (shrink)

This volume examines the distinctive and important role played by humanism in the development of early modern philosophy. Focusing on individual authors as well as intellectual trends, this collection of essays aims to portray the humanist movement as an essential part of the philosophy of the 15th, 16th and 17th centuries.

First Published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

The reasons why upland farmerson the Indonesian island of Sulawesi areengaged in a cacao boom and its long termimplications are addressed in the context ofprotected area management regulations, andpolitical and economic conditions inPost-Suharto, Indonesia. In the remote casestudy village of Moa in Central Sulawesi, wefound that while few households cultivatedcacao in the early 1990s, all had planted cacaoby 2000. Furthermore, the vast majoritycultivate cacao in former food-crop focusedswidden fields under full-sun conditions.Farmers cultivate cacao to establish propertyrights in light of a (...) land shortage driven inpart by the prohibition of farming and forestproduct collecting in a nearby national park,and to secure a future source of income, aconcern that has been exacerbated byIndonesia's economic crisis. However,conversion of swidden fields to sun-grown cacaoconstrains future food productionopportunities, increases susceptibility todrought stress and potential soil nutrient andorganic matter losses, and increases householddependence on a commodity that is subject toextreme price volatility. These factors raisesignificant concerns for local food securityand agricultural sustainability. (shrink)

Factors such as subsistence turnover, warfare, or interaction between different groups can be major sources of cultural change in human populations. Global demographic shifts such as the transition to agriculture during the Neolithic and more recently the urbanization and globalization of the twentieth century have been major catalysts for cultural change. Here, we test whether cultural traits such as patri/matrilocality and postmarital migration persist in the face of social upheaval and gene flow during the past 150 years in postcolonial South (...) Africa. The recent history of South Africa has seen major demographic shifts that resulted in the displacement and forced sedentism of indigenous Khoekhoe and San populations. During the expansion of the colonial frontier, the Khoe-San admixed with European colonists and enslaved individuals from West/Central Africa, Indonesia, and South Asia, introducing novel cultural norms. We conducted demographic interviews among Nama and Cederberg communities representing nearly 3,000 individuals across three generations. Despite the history of colonial expansion, and the subsequent incorporation of Khoe-San and Khoe-San-descendant communities into a colonial society with strong patrilocal norms, patrilocality is the least common postmarital residence pattern in our study populations today. Our results suggest that more recent forces of integration into the market economy are likely the primary drivers of change in the cultural traits examined in our study. Birthplace had a strong effect on an individual’s odds of migration, distance moved, and postmarital residence form. These effects are at least partially explained by the population size of the birthplace. Our results suggest that market factors local to birthplaces are important drivers of residence decisions, although the frequency of matrilocal residence and a geographic and temporal cline in migration and residence patterns also indicate the persistence of some historic Khoe-San cultural traits in contemporary groups. (shrink)

Good listening is an essential element in the provision of quality healthcare (Attree 2001). Good listening also supports accurate diagnosis, patient adherence to medical recommendations, and stron...

In this article, I draw on my fieldwork creating protein models of hepatitis B at a biotech laboratory to think through how to approach the body and disease from ontological and phenomenological perspectives. I subsequently draw on Mariella Pandolfi’s work on how bodies can be made to suffer history and Paul Farmer’s work on global tuberculosis disparities to explore ways of analysing embodied activity as a means of identifying and clinically addressing enactments of social inequality and disease. I also introduce (...) Merleau-Ponty’s phenomenological concept of ‘flesh’ as a conceptual heuristic that allows us to understand the meaningful structuring of ontological worlds beyond our own. As I argue, bringing these perspectives together not only allows us to re-envision what an effective disease treatment should be in diverse medical contexts, but also how to better understand health disparities and the nature of disease itself. (shrink)

Background: There is evidence that household point-of-use water treatment products can reduce the enormous burden of water-borne illness. Nevertheless, adoption among the global poor is very low, and little evidence exists on why. Methods: We gave 600 households in poor communities in Dhaka, Bangladesh randomly-ordered two-month free trials of four water treatment products: dilute liquid chlorine, sodium dichloroisocyanurate tablets, a combined flocculant-disinfectant powdered mixture, and a silver-coated ceramic siphon filter. Consumers also received education on the dangers of untreated drinking water. (...) We measured which products consumers used with self-reports, observation, and chlorine tests. We also measured drinking water's contamination with E. coli. Findings: Households reported highest usage of the filter, although no product had even 30% usage. E. coli concentrations in stored drinking water were generally lowest when households had Water Guard. Households that self-reported product usage had large reductions in E. coli concentrations with any product as compared to controls. Conclusion: Traditional arguments for the low adoption of POU products focus on affordability, consumers' lack of information about germs and the dangers of unsafe water, and specific products not meshing with a household's preferences. In this study we provided free trials, repeated informational messages explaining the dangers of untreated water, and a variety of product designs. The low usage of all products despite such efforts makes clear that important barriers exist beyond cost, information, and variation among these four product designs. Without a better understanding of the choices and aspirations of the target end-users, household-based water treatment is unlikely to reduce morbidity and mortality substantially in urban Bangladesh and similar populations. © 2011 Luoto et al. (shrink)

A survey of the work of the Majorcan lay theologian and philosopher Ramon Llull (1232-1316), along with examples of its wide influence in late medieval, Renaissance, and early modern Europe and in colonial Spanish America.

Alan Westin’s work Privacy and Freedom remains foundational to the field of privacy, and Westin is frequently cited for his definition of privacy as control over personal information. However, Westin’s full definition of privacy is much more complex than this statement, describing four states of privacy (solitude, intimacy, anonymity, and reserve) that one achieves through physical or psychological means. The “claim” of privacy involves negotiating a balance between a desire for disclosure and social participation and a desire for withdrawal into (...) one of the “states” of privacy. Influencing this adjustment process are social norms (and surveillance to enforce social norms), environmental conditions, and the curiosity of others. In this Article, I draw upon this complexity in order to reread Westin’s definition of privacy as a claim of control over personal information and use this rereading to understand how the law should protect and promote privacy in the twenty-first century. I argue that the law should focus on securing meaningful privacy choices rather than on individual control over personal information. Meaningful choice requires that our informational infrastructure, and the social practices that it enables, make states of privacy available for choice along with the means of attaining them. To enable such meaningful individual choice, we need to shift our attention from a focus on individuals to a more systemic focus on our public norms and built infrastructure. Otherwise we risk protecting a narrow understanding of individual control, while ignoring a more general and systematic erosion of privacy. (shrink)

The literature on affective determinants of physical activity is growing rapidly. The present paper aims to provide greater clarity regarding the definition and distinctions among the various affect-related constructs that have been examined in relation to PA. Affective constructs are organized according to the Affect and Health Behavior Framework, including: affective response to PA; incidental affect; affect processing; and affectively charged motivational states. After defining each category of affective construct, we provide examples of relevant research showing how each construct may (...) relate to PA behavior. We conclude each section with a discussion of future directions for research. (shrink)

Background Investigative genetic genealogy (IGG) is a technique that involves uploading genotypes developed from perpetrator DNA left at a crime scene, or DNA from unidentified remains, to public genetic genealogy databases to identify genetic relatives and, through the creation of a family tree, the individual who was the source of the DNA. As policymakers demonstrate interest in regulating IGG, it is important to understand public perspectives on IGG to determine whether proposed policies are aligned with public attitudes.Methods We conducted eight (...) focus groups with members of the public (N = 72), sampled from four geographically diverse US regions, to explore general attitudes and perspectives regarding aspects of IGG practices, applications, and policies. Five major topics were explored in each focus group: when IGG should be used; who should perform IGG; how to approach consent for genetic database users; what systems of oversight should govern IGG practitioners; and whether to notify database users if their data are involved in law enforcement (LE) matching.Results Participants were supportive of IGG in most scenarios, especially for cold and violent cases. The favorable attitudes toward IGG were, however, tempered by distrust of law enforcement among some participants. All participants agreed that databases must inform users if IGG is allowed, but they did not agree on how individual database users should be allowed to opt out or whether to notify them if their data are involved in specific investigations. All participants agreed that IGG should be subject to some prescriptive guidelines, regulations, or accountability mechanisms.Conclusions These findings suggest broad public support for IGG, and interest in developing systems of accountability for its practice. Our study provides useful insight for policy makers, genomic database stewards, law enforcement, and other stakeholders in IGG’s practice, and suggests multiple directions for future research. (shrink)

The word ‘tyrant’ was not originally Greek, but borrowed from some eastern language, perhaps in western Asia Minor. On the other hand, tyranny as it developed in the Greek cities in the archaic age would seem to have been initially an indigenous growth, independent of any intervention by foreign powers. It then became a constantly recurring phenomenon of Greek political and social life, so long as the Greeks enjoyed an independent history.

In the US, research payments are technically taxable income. This article argues that tax liability is a form of possible economic and legal risk of paid research participation. Findings are presented from empirical research on Phase I healthy volunteer trials. The article concludes by discussing the implications of these findings for the informed consent process, as well as for broader ethical issues in whether and how payments for research participation should be regulated.

In this exploratory paper, we investigate the extension of Haidt’s :814–834, 2001, The righteous mind: Why good people are divided by politics and religion, 2012) Moral foundations theory, operationalized as the MFQ30 questionnaire, from a sample of the general public across many countries to a sample of business students. MFT posits that people rely on five major concerns, or foundations, when making moral judgments. The five concerns are care/harm, fairness/cheating, loyalty/betrayal, respect/authority, and purity/degradation. In addition, Haidt suggests that intuition, rather (...) than reasoning, leads to moral judgment. We replicate Haidt’s measurement model and find that the measurement model based on our sample is consistent. This indicates support for MFT. Further, we find structural differences in the measurement model between the genders and between areas of study. Our findings suggest that all students in the sample focus substantially on the fairness foundation. Ethics education and research may seek to expand the number of moral foundations individuals consider when discerning whether something is right or wrong. (shrink)

I argue that, because God is the author of history and has a purpose for his creation, evolution has a plot and can be analyzed with tools drawn from literary criticism. This necessitates engagement with the “epic of evolution” genre of scientific literature. I survey several prominent versions of the epic and distinguish between a purely naturalistic epic of evolution and a goal‐oriented Christian epic of evolution (CEE). In dealing with CEE, I use the thought of J. R. R. Tolkien, (...) along with Kevin Vanhoozer and Dorothy Sayers, to discuss the ways in which we can theologically legitimate speaking of God as the “author” of evolutionary history. (shrink)

The rule of law is widely perceived to be a public law doctrine, concerned with the way governmental authority conforms to dictates of law. This book explores the idea that the rule of law instead concerns the conditions under which any relationship - that among citizens as well as that between citizens and the state - becomes subject to law.

The articles brought together in this double-length section of the Annual Review of Theory, Culture & Society focus on two intertwined strands of the thought of Georg Simmel, both of them neglected until recent years. A first bears on what might be called Simmel’s metaphysics of the social, or what he himself once called ‘sociological metaphysics’. A second strand centres on the renewed contemporary relevance of Simmel’s ideas about money economies and their relation to precarious individual life-situations in an age (...) of global economic turbulence. Current sensibilities in the wake of global economic crisis and the demise of some of the more euphoric sociologies of globalization of the last two decades provide a timely setting for a reappraisal of Simmel’s thinking. With the completion in 2012 of the Suhrkamp edition of Simmel’s collected works, Simmel’s themes need to be explored more deeply, including particularly his thinking about lived experience, transcendence, death, fragmentary worlds of value, and allegorical representation. This issue of the journal showcases some of the latest scholarly work and foregrounds several pivotal primary pieces unavailable in English until now. (shrink)

It is believed that the atmosphere in which employees carry out their responsibilities influences whether employees will behave ethically. An important factor contributing to the integrity of the financial reporting process is the tone set by senior management (i.e., the corporate environment). This study was conducted to describe financial accountants'' perceptions of management''s ethical standards. These perceptions are based on both management''s actions and management''s expectations of the employee. This researcher also attempted to identify demographic variables that are related to (...) these perceptions. The results are based on a survey mailed to 400 CPAs who prepare financial reports. Accountants generally perceive management''s conduct as ethical and believe that management expects them to behave ethically. Of particular interest is that respondents have more positive attitudes about management''s expectations of them than they do about management''s own actions in terms of ethical behavior. The majority of respondents reported at least some pressure to achieve short-term performance targets. Management level, industry, size of an organization, and gender were all found to be related to employee perceptions. (shrink)