There are questions about how ethics is best taught to undergraduate business students. There has been a proliferation in the number of stand-alone ethics courses for undergraduate students but research on the effectiveness of integrated versus stand-alone mode of delivery is inconclusive. Christensen et al. :347–368, 2007), in a comprehensive review of ethics, corporate social responsibility and sustainability education, investigated how ethics education has changed over the last 20 years, including the issue of integration of these topics into the core (...) course offerings. We use Brenner and Molander’s :57–71, 1977) situational ethics survey instrument to examine the effect of the mode of delivery of business ethics education on undergraduate student responses. We found a significant difference on mode of delivery. Studies have also found interesting results in respect of the effect of cultural differences and gender on the effectiveness of business ethics instruction. While not the primary focus of this study, we also looked at the influence of gender and culture on students’ responses. Our results indicate significant differences in respect of mode of delivery and culture. In contrast to other studies, we found that gender was not significant. We did test for any interactive effects of gender, culture and mode of delivery. However, no significant differences were found. (shrink)

This is a revised and expanded edition of a seminal work in the logic and philosophy of time, originally published in 1968. Arthur N. Prior (1914-1969) was the founding father of temporal logic, and his book offers an excellent introduction to the fundamental questions in the field. Several important papers have been added to the original selection, as well as a comprehensive bibliography of Prior's work and an illuminating interview with his widow, Mary Prior. In addition, (...) the Polish logic which made Prior's writings difficult for many readers has been replaced by standard logical notation. This new edition will secure the classic status of the book. (shrink)

This is a revised and expanded edition of a seminal work in the logic and philosophy of time, originally published in 1968. Arthur N. Prior was the founding father of temporal logic, and his book offers an excellent introduction to the fundamental questions in the field. Several important papers have been added to the original selection, as well as a comprehensive bibliography of Prior's work and an illuminating interview with his widow, Mary Prior. In addition, the (...) Polish logic which made Prior's writings difficult for many readers has been replaced by standard logical notation. This new edition will secure the classic status of the book. (shrink)

The particular argument which Prior selects is supposed to show that the Arminian hypothesis, viz. volitions are uncaused events, has consequences that are logically unacceptable or at any rate counterintuitive. Prior makes two claims: Edwards' argument depends on false metaphysical premises. When these are revised, uncaused events, e.g., volitions, may be acknowledged without embarrassment. If the scope of Edwards' argument is restricted, then it is, in Prior's phrase, "entirely cogent." I shall try to show that Prior (...) is mistaken on both points: the argument in question is not--at least not on any interpretation that I can think of--cogent at all, but it does serve to raise an interesting question of which Prior takes no account. (shrink)

This is a new edition, revised and expanded, of a seminal work in the logic and philosophy of time, originally published in 1968. Arthur N. Prior was the founding father of temporal logic. His work has attracted increased attention in the decades since his death: its influence stretches beyond philosophy and logic to computer science and formal linguistics. Prior's fundamental ideas about the logic of time are presented here along with his investigations into the formal properties of time (...) and tense. Already in 1969 Prior had been planning a new edition of Papers on Time and Tense, to incorporate his more recent work. Because of his untimely death this plan was never followed through--till now. Seven important papers have been added to the original selection, as well as a comprehensive bibliography of his work and an illuminating interview with his widow, Mary Prior, about his life and work. In addition, the Polish logic which made the original book difficult for many readers has been replaced by standard logical notation. This new edition will secure the classic status of the book. (shrink)

This paper examines different kinds of definite descriptions denoting purely contingent, necessary or impossible objects. The discourse about contingent/impossible/necessary objects can be organised in terms of rational questions to ask and answer relative to the modal profile of the entity in question. There are also limits on what it is rational to know about entities with this or that modal profile. We will also examine epistemic modalities; they are the kind of necessity and possibility that is determined by _epistemic_ constraints (...) related to knowledge or rationality. Definite descriptions denote so-called _offices_, roles, or _things to be._ We explicate these α-offices as partial functions from possible worlds to chronologies of objects of type α, where α is mostly the type of individuals. Our starting point is Prior’s distinction between a ‘weak’ and ‘strong’ definite article ‘the’. In both cases, the definite description refers to at most one object; yet, in the case of the weak ‘the’, the referred object can change over time, while in the case of the strong ‘the’, the object referred to by the definite description is the same forever, once the office has been occupied. The main result we present is the way how to obtain a Wh-knowledge about who or what plays a given role presented by a hyper-office, i.e. _procedure_ producing an office. Another no less important result concerns the epistemic necessity of the impossibility of knowing who or what occupies the impossible office presented by a hyper-office. (shrink)

The development of educational technologies is enhancing a distinctive feature of learning environments: the learner’s personalized environment. However, the current literature in e-learning seems to neglect an important discussion: will individuals and organizations face an enhancement concerning ethical dilemmas due to this evolution? To promote this discussion, this paper builds on a consideration of e-learning definition and its ethical dilemmas, and human-centred learning concept and its dimensions, to examine the implications of integrating social and cultural contexts. By examining the evolution (...) of e-learning management systems the argument progresses to a discussion of the relationships between pedagogy and ethics. By framing evidence at different scales, the authors critically reflect on the ethical dilemmas embedded in e-learning systems. The discussion concludes with advocating the adoption of an extension of “three P” mode of pedagogy to become the “P3E” model: personalization, participation, productivity, lecturer’s ethics, learner’s ethics, and organizational ethics. (shrink)

Some of the world’s best-loved films can be used as springboards for examining enduring philosophical questions. _Philosophy Through Film_ provides guidance in how to watch films with an eye for their philosophical content, helping students become familiar with key topics in all of the major areas in Western philosophy, and helping them master the techniques of philosophical argumentation. The perfect size and scope for a first course in philosophy, _Philosophy Through Film_ assumes no prior knowledge of philosophy. It is (...) an excellent teaching resource and learning tool, introducing students to key topics and figures in philosophy through thematic chapters, each of which is linked to one or more "focus films" that illustrate a philosophical problem or topic. Revised and expanded, the Second Edition features a new chapter on political philosophy, an introductory chapter explaining how to watch films philosophically, an appendix with primary readings, and the addition of five new focus films. Films examined in depth include: _The Matrix_ _Vanilla Sky_ _Hilary and Jackie_ _Memento_ _I, Robot_ _Minority Report_ _Crimes and Misdemeanors_ _Antz_ _Equilibrium_ _The Seventh Seal_ _The Rapture_ _Leaving Las Vegas_. (shrink)

To test if dreams contain remote or never-experienced motor skills, we collected during 6 weeks dream reports from 15 paraplegics and 15 healthy subjects. In 9/10 subjects with spinal cord injury and in 5/5 with congenital paraplegia, voluntary leg movements were reported during dream, including feelings of walking , running , dancing , standing up , bicycling , and practicing sports . Paraplegia patients experienced walking dreams just as often as controls . There was no correlation between the frequency of (...) walking dreams and the duration of paraplegia. In contrast, patients were rarely paraplegic in dreams. Subjects who had never walked or stopped walking 4–64 years prior to this study still experience walking in their dreams, suggesting that a cerebral walking program, either genetic or more probably developed via mirror neurons is reactivated during sleep. (shrink)

Meaningful social interactions and regular physical activity are inversely associated with loneliness. Using a mixed-methods research design employing quantitative and qualitative research approaches, this research aimed to explore loneliness, physical activity, friendship, and experiences relating to the COVID-19 pandemic both prior to and during the pandemic. Quantitative data of n = 363 first-year university students assessed in 2018/2019 and of n = 175 individuals aged 18–29 years assessed in 2020 were gathered using independent self-administered online surveys. In addition, n (...) = 4 students were recruited for semi-structured, qualitative interviews in 2020 during the onset phase of the COVID-19 pandemic. Correlation and regression analyses as well as analyses of variance were conducted. Thematic analysis as a qualitative method was used to explore the role physical activity, friendship, and social interactions played in loneliness, particularly in times of social isolation and social distancing. Results revealed associations of varying strength between physical activity and loneliness in 2018/2019 and 2020. Analyses of qualitative data revealed three main themes: the lack of deep friendships at university, the positive perceived impact of team sports on feelings of loneliness, and the need for real connection in times of crisis. Thus, with regard to feelings of loneliness during the pandemic, being physically active seems to be a small but potentially relevant factor among young individuals. The qualitative study suggests that first-year university students might buffer the lack of deep friendships and meaningful interactions by building social bonds in team sports. In times of physical distancing, young individuals vulnerable to loneliness may therefore require special support such as doing sports with physical distance and perceiving connected with their team for instance by digital devices and emotional coping. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 14.4 (2004) 411-425 [Access article in PDF] Vulnerability, Vulnerable Populations, and Policy Mary C. Ruof "Special justification is required for inviting vulnerable individuals to serve as research subjects and, if they are selected, the means of protecting their rights and welfare must be strictly applied."Guideline 13: Research Involving Vulnerable Persons International Ethical Guidelines for Biomedical Research Involving Human Subjects Council for International Organizations (...) of Medical Sciences (CIOMS) and World Health Organization (WHO) Geneva, Switzerland, 2002 Within medical research and healthcare certain groups are afforded special protections and services because of their designation as vulnerable. The vulnerable require special justification to participate in human subject research in order to eliminate potential human rights abuses. The Nuremberg Code of 1947 was written in response to the extreme human subject abuses that occurred under the Nazi regime, and, although the intent of the 1947 Code was to protect human rights, rigid voluntary consent requirements deprived some individuals of the right to participate in clinical trials. Recent human research guidelines, such as the CIOMS/WHO guidelines referenced above and the guidelines referenced in Section V of this Scope Note, attempt to balance both protection from abuse in research and access to new, experimental treatments for the vulnerable.Although various protective guidelines stipulate special protections for vulnerable populations, the concept of vulnerability and consequently the criteria designating vulnerable populations remain vague. Precisely who are the vulnerable? The word "vulnerability" stems from the Latin vulnerare, "to wound." (Oxford Encyclopedic English Dictionary 1995). In clinical research, the term [End Page 411] vulnerable generally is applied to individuals who are unable to give informed consent or who are susceptible to coercion. The Common Rule (45 CFR 46, Subpart A) includes as vulnerable research subjects: children, prisoners, pregnant women, and persons who are handicapped, mentally disabled, economically disadvantaged, or educationally disadvantaged. Although the Common Rule specifies certain vulnerable categories, the guidelines were not intended to be exclusive, leaving open the interpretation of vulnerability.In medical research and health policy, vulnerability is an abstract concept that has concrete effects both for those labeled vulnerable and for those not. Clinical researchers, healthcare workers, ethical reviewers, and policymakers must be able to identify vulnerable subjects to establish how healthcare resources will be allocated and who will qualify for special protections and socialized benefits. Attempts to quantify vulnerability in clear, measurable ways have met little if any consensus. As Alexander Morawa (II, 2003, p. 150) states, "There is no single approach to definition of vulnerability. In fact, there is no purposeful categorisation at all."Difficulties in defining vulnerability have prompted discourse surrounding its utility as a qualifying factor in the allocation of health resources and its appropriateness as a guiding principle in bioethics. Some of the authors cited in this Scope Note argue against the labeling and categorization of vulnerable individuals and populations. "Labeling individuals as 'vulnerable' risks viewing vulnerable individuals as 'others' worthy of pity, a view rarely appreciated" (III, Danis and Patrick 2002, p. 320). The categories of vulnerable groups listed under the Common Rule have been the source of controversy, "for example, many find the suggestion that pregnant women are vulnerable to be quite sexist" (IV, DeBruin 2001, p. 7). Instead of creating categories of vulnerable populations, would it not be better to derive an account of just treatment from a just social policy at large that encompasses human vulnerabilities (II, Brock 2002, p. 283).For some of the authors listed here, the concept of vulnerability is essential to bioethics. Robert Goodin (I, 1985, p. 107) writes that the vulnerability of other human beings is the source of our special responsibilities to them. In contrast to the four American principles of biomedical ethics—autonomy, nonmaleficence, beneficence, and justice—the four principles of European bioethics and biolaw include vulnerability along with autonomy, dignity, and integrity. According to, Jacob Dahl Rendtorff and Peter Kemp (I, 2000, p. 274) "the principle of vulnerability is ontologically prior to the other [European] principles, it expresses better than all of the other ethical principles... the finitude of the human condition."Some of the... (shrink)

Hempel's qualitative criteria of converse consequence and special consequence for confirmation are examined, and the resulting paradoxes traced to the general intransitivity of confirmation. Adopting a probabilistic measure of confirmation, a limiting form of transitivity of confirmation from evidence to predictions is derived, and it is shown to what extent its application depends on prior probability judgments. In arguments involving this kind of transitivity therefore there is no necessary "convergence of opinion" in the sense claimed by some personalists. The (...) conditions of application of the limiting transitivity theorem are most perspicuously described in terms of De Finetti's notion of exchangeability, which leads to a suggested revaluation of the function of theories in relation to confirmation and explanation. (shrink)

Recent data breaches underscore the importance of organizational cybersecurity. However, the high costs of such security can force chief financial officers (CFOs) to make difficult financial and ethical trade-offs that have both business and societal implications. We employ a 2 × 2 randomized experiment that varies both an observed scenario CFO’s investment decision (invest/not invest in security) and organizational outcomes (positive/negative) to investigate these trade-offs. Participant managers assess the observed CFO’s investment behavior and indicate their own intentions to invest. Results (...) indicate that when the observed scenario CFO invests in security, managers primarily follow their peers when making investment decisions. However, when the observed CFO does not invest in security, managers make their own decisions by engaging in more in-depth reasoning that includes assessment of the seriousness of consequences, as well as the ethical and societal considerations. Moderated mediation findings further deconstruct and corroborate these relationships. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Wonder, Imagination, and the Matter of Theatre in The TempestMary MooreAriel occurs. Recounting his performance of "the tempest" in Act I, scene 1 of The Tempest, he presents himself as being and action, fracturing grammar, spatial and temporal logic in ways that amaze and confound:I boarded the King's ship; now on the beak, Now in the waist, the deck, in every cabin, I flamed amazement. Sometime I'd divide, And (...) burn in many places; on the topmast, The yards, and bowsprit would I flame distinctly, Then meet and join...(1.2.195–201) 1"I flamed" means that Ariel emits or is flames, which in the normal order of things would consume him. His very narration, however, proves his survival, evoking wonder through the utterance itself. Forceful and compacted syntax, a recognized source of wonder in Classical and Renaissance accounts of style (Biester, pp. 14; 35–40), magnifies this effect. 2 Shakespeare's transitive use of the usually intransitive verb flame reflects a not uncommon practice, as E. A. Abbott shows; 3 but this syntactic device also reflects The Tempest's own logic. Ariel crosses boundaries between [End Page 496] deed and being, verb and noun, subject and object, matter and spirit: he both is and does flames. What could be more jarring to syntax and semantics than a singular subject whose utterance claims that he can flame, divide, meet and join? Just as "a" fire consists of many flames yet functions grammatically as a singular substance in English, just as the Christian Trinity is both singular and multiple, Ariel burns in many places at once. Meanwhile, this extraordinary language seems belied by the actor's very embodiment. Ariel cannot have done what he claims; yet the prior scene has represented the very storm in which Ariel flamed. In that sense, the actor's embodiment represents what we imagine to be matter's intractability, while Ariel's claims, coupled with the storm we have just witnessed, reveal matter's fluidity and permeability to imagination. Fluidity and intractability co-exist, another source of wonder. Sound mimics these paradoxes: the assonance and consonance in flame and amazement create a near rhyme that echoes the near identity of fire and human amazement. If, as Gurr and Ichikawa observe, a Renaissance audience expected to hear more than see a play, this echo calls attention to Ariel's marvelous powers. 4 Lest the noises and pleasures of the Renaissance theatre, which recent scholarship deems to be considerable, distract audience members from this bit of language, similar moments reinforce Ariel's play in and with language and matter throughout the play. Marvelous poetic language is of a piece with a "fever" that is of "the mind," with music that "creeps," actors who vanish, new found goddesses who speak the discoverers' own language.Amazement provides our cue: it and its cognates name the appropriate response to Ariel, his language, and to The Tempest itself. Attention to Ariel's poetic language reveals that it, like the plot, conforms to the marvels of the play and to the period's well documented love for marvels in several ways. Wonder, an aesthetic "'object of desire'" in itself, and a response to the inexplicable in classical and early modern views, may be evoked by the unexpected in style (and through other strategies that the era's handbooks taught). 5 The clause "I flamed amazement" epitomizes the unexpected in syntax as well as differing from one of the few sources found for The Tempest, William Strachey's 1610 letter, which describes just such a storm. 6 While St. Elmo's fire itself may elicit wonder, Shakespeare's syntax and diction reinforce that marvel. And no wonder: rhetoric and theatre alike depend upon audience attention, and wonders naturally evoke it. Jarring language also harmonizes with The Tempest's structural marvels—loose ends, disrupted actions, unforeseen futures—issues several critics explore. 7 [End Page 497]The wonders of The Tempest, however, also involve imagination—in early modern psychology, the human faculty that permits perception of the world and invention of images. 8 Wonder responds to how the perceived differs from the expected, how the imagined supplants the usual, how an... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Wonder, Imagination, and the Matter of Theatre in The TempestMary MooreAriel occurs. Recounting his performance of "the tempest" in Act I, scene 1 of The Tempest, he presents himself as being and action, fracturing grammar, spatial and temporal logic in ways that amaze and confound:I boarded the King's ship; now on the beak, Now in the waist, the deck, in every cabin, I flamed amazement. Sometime I'd divide, And (...) burn in many places; on the topmast, The yards, and bowsprit would I flame distinctly, Then meet and join...(1.2.195–201) 1"I flamed" means that Ariel emits or is flames, which in the normal order of things would consume him. His very narration, however, proves his survival, evoking wonder through the utterance itself. Forceful and compacted syntax, a recognized source of wonder in Classical and Renaissance accounts of style (Biester, pp. 14; 35–40), magnifies this effect. 2 Shakespeare's transitive use of the usually intransitive verb flame reflects a not uncommon practice, as E. A. Abbott shows; 3 but this syntactic device also reflects The Tempest's own logic. Ariel crosses boundaries between [End Page 496] deed and being, verb and noun, subject and object, matter and spirit: he both is and does flames. What could be more jarring to syntax and semantics than a singular subject whose utterance claims that he can flame, divide, meet and join? Just as "a" fire consists of many flames yet functions grammatically as a singular substance in English, just as the Christian Trinity is both singular and multiple, Ariel burns in many places at once. Meanwhile, this extraordinary language seems belied by the actor's very embodiment. Ariel cannot have done what he claims; yet the prior scene has represented the very storm in which Ariel flamed. In that sense, the actor's embodiment represents what we imagine to be matter's intractability, while Ariel's claims, coupled with the storm we have just witnessed, reveal matter's fluidity and permeability to imagination. Fluidity and intractability co-exist, another source of wonder. Sound mimics these paradoxes: the assonance and consonance in flame and amazement create a near rhyme that echoes the near identity of fire and human amazement. If, as Gurr and Ichikawa observe, a Renaissance audience expected to hear more than see a play, this echo calls attention to Ariel's marvelous powers. 4 Lest the noises and pleasures of the Renaissance theatre, which recent scholarship deems to be considerable, distract audience members from this bit of language, similar moments reinforce Ariel's play in and with language and matter throughout the play. Marvelous poetic language is of a piece with a "fever" that is of "the mind," with music that "creeps," actors who vanish, new found goddesses who speak the discoverers' own language.Amazement provides our cue: it and its cognates name the appropriate response to Ariel, his language, and to The Tempest itself. Attention to Ariel's poetic language reveals that it, like the plot, conforms to the marvels of the play and to the period's well documented love for marvels in several ways. Wonder, an aesthetic "'object of desire'" in itself, and a response to the inexplicable in classical and early modern views, may be evoked by the unexpected in style (and through other strategies that the era's handbooks taught). 5 The clause "I flamed amazement" epitomizes the unexpected in syntax as well as differing from one of the few sources found for The Tempest, William Strachey's 1610 letter, which describes just such a storm. 6 While St. Elmo's fire itself may elicit wonder, Shakespeare's syntax and diction reinforce that marvel. And no wonder: rhetoric and theatre alike depend upon audience attention, and wonders naturally evoke it. Jarring language also harmonizes with The Tempest's structural marvels—loose ends, disrupted actions, unforeseen futures—issues several critics explore. 7 [End Page 497]The wonders of The Tempest, however, also involve imagination—in early modern psychology, the human faculty that permits perception of the world and invention of images. 8 Wonder responds to how the perceived differs from the expected, how the imagined supplants the usual, how an... (shrink)

Emérita Quito was the first woman from the Philippines to complete a Ph.D. in Philosophy. Her early Scholastic training as an undergraduate was at the University of Santo Tomas expanded to include phenomenology and existentialism during her graduate studies at major European universities. Upon returning home she began to focus on the idea of developing a methodology for investigating indigenous Filipino philosophy. How does one reveal the concepts and principles underlying the belief systems within a country that has suffered a (...) thousand years of occupation by foreign forces, that speaks with hundreds of different dialects across more than seven thousand islands spread across more than one hundred thousand square miles? This amazing philosopher published extensively not only in western philosophy, but on that indigenous to this island nation, prior to the incursions of western nations and the introduction to the Philippines of western philosophical views. (shrink)

This article examines the temporal politics of the 2017 California Gender Recognition Act (CGRA). The author first offers a brief history of the dominant temporal requirements for “gender recognition” in prior legislation around sex/gender markers on identity documents in the United States and United Kingdom, focusing on how this legislation places temporal boundaries around legitimate gender identity. Then, turning directly to the CGRA, the author asks to what extent the act's emphasis on self-identification revises or intervenes in these (...) class='Hi'>prior conceptualizations of time and identity by the state administration of sex/gender systems. The article closes with an exploration of the temporality of identity documentation itself, speculating about how this legislation might be placed more directly into conversation with the role of time in colonial and racial state building. (shrink)

Prior studies have shown a general preference among citizens for juries over judges. Researchers, however, have not considered whether race and ethnicity modify this preference. We hypothesized that minorities (African-Americans, Hispanics), who generally express less trust in the legal system, may also express less trust in juries than non-Hispanic whites. We asked a representative sample of 1,465 residents of Texas to state whether they would prefer a jury or a judge to be the decision maker in four hypothetical circumstances. (...) Consistent with expectations, non-Hispanic whites favored juries over judges, particularly if they imagined themselves as a defendant in a criminal trial. By comparison, although African-Americans and some Hispanics generally favored juries, they showed a much weaker set of jury preferences. African Americans had markedly lower support for the civil jury, but support was higher among minorities with prior jury service. Among Hispanics, respondents who took the survey in Spanish typically preferred a judge to make legal decisions. We consider the implications of our findings for trust in the jury system and trust in community members as decision makers. (shrink)

I aim to clarify the argument for space that Newton presents in De Gravitatione (composed prior to 1687) by putting Newton's remarks into conversation with the account of geometrical knowledge found in Proclus's Commentary on the First Book of Euclid's Elements (ca. 450). What I highlight is that both Newton and Proclus adopt an epistemic progression (or “order of knowing”) according to which geometrical knowledge necessarily precedes our knowledge of metaphysical truths concerning the ontological state of affairs. As I (...) argue, Newton's commitment to this order of knowing clarifies the interplay of the imagination and understanding in geometrical inquiry and illuminates how geometrical knowledge of space can lead to knowledge that space depends on and is related to God. In general, appreciating the Proclean elements of Newton's argument brings added light to the significance of geometrical inquiry for his general natural philosophical program and grants us insight into the philosophical grounding for the notion of absolute space that is presented in the Principia mathematica (1687). (shrink)

Metaphysics Θ treats potentiality (δύναμις) and actuality (ἐνέργεια), and many scholars think that Aristotle broaches these topics once he has answered his main questions in Ζ and Η. In Ζ he asked, what is primary being? After arguing in Ζ.1 that substance (οὐσία) is primary being—a being existentially, logically, and epistemologically prior to quantities and qualities and other categorial beings—he devotes the rest of the book to οὐσία itself, investigating what it is, to decide what entities count as primary (...) substances. I differ from the leading interpretative consensus that ΖΗ adequately answer the questions about primary substance, and contend instead that Metaphysics Θ continues the same investigation as ΖΗ and, using δύναμις and ἐνέργεια as tools, arrives at a striking new conception of hylomorphism, different from that in ΖΗ, which enables Aristotle to defend the substantial primacy of living organisms consisting of matter and form. (shrink)

Although children learn more when teachers gesture, it is not clear how gesture supports learning. Here, we sought to investigate the nature of the memory processes that underlie the observed benefits of gesture on lasting learning. We hypothesized that instruction with gesture might create memory representations that are particularly resistant to interference. We investigated this possibility in a classroom study with 402 second‐ and third‐grade children. Participants received classroom‐level instruction in mathematical equivalence using videos with or without accompanying gesture. After (...) instruction, children solved problems that were either visually similar to the problems that were taught, and consistent with an operational interpretation of the equal sign (interference), or visually distinct from equivalence problems and without an equal sign (control) in order to assess the role of gesture in resisting interference after learning. Gesture facilitated learning, but the effects of gesture and interference varied depending on type of problem being solved and the strategies that children used to solve problems prior to instruction. Some children benefitted from gesture, while others did not. These findings have implications for understanding the mechanisms underlying the beneficial effect of gesture on mathematical learning, revealing that gesture does not work via a general mechanism like enhancing attention or engagement that would apply to children with all forms of prior knowledge. (shrink)

The loss of friendship can be a frequent occurrence for children as they explore their social worlds and navigate their way through the demands of particular relationships. Given that friendship is a relationship of special regard, and associated with a particular partiality to our friends, the ending of friendship and the subsequent interactions between former friends, can be difficult areas for schools to deal with. Whilst there has been considerable research on the formation and maintenance of friendship, a consideration of (...) what happens after friendship has had surprisingly limited attention. Much of our current understanding of issues on moral behaviour fails to fully address the positioning of former friends in our moral thinking particularly as regards matters arising from the priority of attachment. Recent empirical research seems to indicate that the memory of prior encounters has a far greater influence on future reciprocal exchanges than previously accepted. This paper considers suggests that this view of memory can be played out in two contrasting ways. First, a prudential view suggests that as our former friends were previously given access to our intimate secrets and confidences, self-interest would seem to indicate that we treat them well. Secondly, a residual duties view suggests that some obligations remain after the friendship has ended based on the history of the relationship. Finally, I then draw out some of the implications this may have for schools and the education of children. (shrink)

The loss of friendship can be a frequent occurrence for children as they explore their social worlds and navigate their way through the demands of particular relationships. Given that friendship is a relationship of special regard, and associated with a particular partiality to our friends, the ending of friendship and the subsequent interactions between former friends, can be difficult areas for schools to deal with. Whilst there has been considerable research on the formation and maintenance of friendship, a consideration of (...) what happens after friendship has had surprisingly limited attention. Much of our current understanding of issues on moral behaviour fails to fully address the positioning of former friends in our moral thinking particularly as regards matters arising from the priority of attachment. Recent empirical research seems to indicate that the memory of prior encounters has a far greater influence on future reciprocal exchanges than previously accepted. This paper considers suggests that this view of memory can be played out in two contrasting ways. First, a prudential view suggests that as our former friends were previously given access to our intimate secrets and confidences, self-interest would seem to indicate that we treat them well. Secondly, a residual duties view suggests that some obligations remain after the friendship has ended based on the history of the relationship. Finally, I then draw out some of the implications this may have for schools and the education of children. (shrink)

Recent AI progress led to a boost in beneficial applications from multiple research areas including VR. Simultaneously, in this newly unfolding deepfake era, ethically and security-relevant disagreements arose in the scientific community regarding the epistemic capabilities of present-day AI. However, given what is at stake, one can postulate that for a responsible approach, prior to engaging in a rigorous epistemic assessment of AI, humans may profit from a self-questioning strategy, an examination and calibration of the experience of their own (...) epistemic agency – especially to counteract both intentional misdirection by unethical actors and unintentional epistemic self-sabotage. In this paper, we expound on a new avenue of utilizing AIVR tools to advance an AI-related misdirection awareness of humans in the deepfake era. Firstly, we harness scientific knowledge from the psychology and neuroscience of magic where the study of misdirection techniques is center stage. Secondly, we connect the latter to creativity research linking human creative potential to inspiration from the seemingly impossible. Overall, AIVR could become an empowering experiential testbed for human epistemic agency enabling a better rational evaluation of AI capabilities. However, a misuse of the same type of tools could yield AIVR safety risks if not counteracted preemptively. (shrink)

This article examines whether a training program in ethical decision making can change young athletes’ doping attitudes. Fifty-two young elite athletes were randomly assigned to either an ethical decision-making training group or a standard-knowledge-based educational program group. Another 17 young elite athletes were recruited for no-treatment control purposes. The ethical decision-making training comprised six 30-min online sessions in which the participants had to work through 18 ethical dilemmas related to doping. The standard-knowledge-based educational program was also conducted in six online (...) sessions of comparable length to that of the ethical training. A short version of the Performance Enhancement Attitude Scale was administered to measure the effects of the trainings on doping attitude. Prior to as well as after the intervention, the mean doping attitude scores of the young athletes were low to very low, indicating vehement rejections of doping. The results of our experiment showed that the ethical training led to an attenuation of these rejections. No intervention effect was found in the standard education group. The observed slight increase in the doping attitude score could be an indication that the ethical decision-making training was successful in breaking up the athletes’ stereotypical style of reasoning about doping. (shrink)

Although very young children have unprecedented access to touchscreen devices, there is limited research on how successfully they operate these devices for play and learning. For infants and toddlers, whose cognitive, fine motor, and executive functions are immature, several basic questions are significant: Can they operate a tablet purposefully to achieve a goal? Can they acquire operating skills and learn new information from commercially available apps? Do individual differences in executive functioning predict success in using and learning from the apps? (...) Accordingly, 31 2-year-olds were compared with 29 3-year-olds using two commercially available apps with different task and skill requirements: a shape matching app performed across 3 days, and a storybook app with performance compared to that on a matched paper storybook. Children also completed the Minnesota Executive Functioning Scale. An adult provided minimal scaffolding throughout. The results showed: toddlers could provide simple goal-directed touch gestures and the manual interactions needed to operate the tablet after controlling for prior experience with shape matching, toddlers’ increased success and efficiency, made fewer errors, decreased completion times, and required less scaffolding across trials, they recognized more story content from the e-book and were less distracted than from the paper book, executive functioning contributed unique variance to the outcome measures on both apps, and 3-year-olds outperformed 2-year-olds on all measures. The results are discussed in terms of the potential of interactive devices to support toddlers’ learning. (shrink)

The formalism of operational statistics, a generalized approach to probability and statistics, provides a setting within which inference strategies can be studied with great clarity. This paper is concerned with the asymptotic behavior of the Bayesian inference strategy in this setting. We consider a sequence of posterior distributions, obtained from a prior as a result of successive conditionings by the events of an admissible sequence. We identify certain statistical hypotheses whose limiting posterior probabilities converge to one. We describe these (...) hypotheses, and show that when the prior is vague, they contain those probability models which represent the long-run relative frequencies of occurrence for the events in the sequence. (shrink)

Home-based service jobs have developed considerably across Western societies. In fact, chances are high that a working-class woman in France today will, at some point in her life, be a house cleaner, home-based child care provider, or home aide for the elderly. Going against political, scholarly, and everyday discourses that, saturated with the double prejudices of gender and class, treat all these home service occupations, which require little prior training, the same, this article illuminates the variability of the forms (...) of subordination experienced by women practicing these occupations in France. Comparing these jobs with the ensemble of low-skill jobs and with each other exposes what is specific to the particular form of subordination each job type entails, in terms of the extent of job supervision and the nature of the home where it is practiced, the presence or absence of relations with coworkers and/or a “public,” and the nature of this “public.” It mobilizes nationwide statistical data in a new way to shift attention to these numerous ordinary work situations, which are much less studied than those of the domestic workers of the wealthiest cities of the Western world. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"To make a difference...":Narrative Desire in Global MedicineByron J. Good and Mary-Jo DelVecchio GoodIf, as Arthur Frank (2002) writes, "moral life, for better and worse, takes place in storytelling," this collection of narratives written by physicians working in field settings in global medicine gives us a glimpse of some aspects of moral experience, practice, and dilemmas in settings of poverty and low health care resources. These essays are (...) written from the midst of practice, in diverse settings in Africa, South Asia, Latin America, the Caribbean, and the United States. The majority of the writers are practitioners of contemporary 'global medicine'—physicians from North America or Europe who spend part of their lives flying into settings of poverty or special need to practice medicine and work with on-going collaborative clinical and public health systems—while a smaller number are working in the societies in which they were born. Although a few work for classic humanitarian organizations or have developed their own local NGO's, the great majority are engaged in the 'hybrid life' described by Robert Riviello and noted by Renée Fox, moving between academic medical centers and distant health care systems that are supported by local governments, major international organizations and funding agencies, and international NGO's like Partners in Health. These diverse forms of practice have become a common model for contemporary clinicians engaged in what has emerged as a new discipline of global health or global medicine, and these narratives give us a glimpse of some of the enduring, as well as newly emerging, forms of moral practice and ethical dilemmas characteristic of today's global medicine.Many of these stories are filled with the tension and pathos that makes clinical narratives powerful to read. Physicians are forced to make unfathomable decisions about whether to resuscitate and keep a baby alive, using all means available, or to let the infant die, whether to carry out a procedure that will save an infant in birth but would put the mother at risk, about how to deal with a cancer found in a very advanced state. However, virtually all of the stories transcend these classical stories of the decisions physicians are forced to make by being placed in settings of great scarcity of resources, which stand in particular contrast to the academic medical settings in North America or Europe where many of these global medicine specialists have trained and many continue to practice. The unspeakable inequality of resources emerges throughout these narratives as a kind of master theme, as the underlying moral, as opposed to plot, which gives meaning and sense to the stories. For those who practice medicine in such settings, global inequalities and scarcity of medical resources are deeply felt. They produce the rage that Jeffrey Deal describes. ("I learned to despise American churches during that time, a time when my world encompassed a dying newborn in Sudan, as well as the air conditioned padded seats [End Page 121] of our affluent suburban church.") They produce the distinctive experiences of helplessness and pain felt by clinicians who cannot separate how they would be able to treat such a patient at home from how they have to practice in these settings. For those clinicians working in their own societies, scarcity of resources often produces deep anger at the corrupt governments that fail to support basic human services for the great majority of their population. ("We were temporary actors performing in the cynical play of scarcity on permanent display in Port-au-Prince," writes Haitian physician Paul Pierre about his experience prior to joining Partners in Health.)But for those who regularly travel back and forth across the divide between rich and poor, whether across national boundaries or within their own society, the challenge to live a moral life is unendingly complicated. While becoming a part of a struggle for global justice with colleagues and advocates from both sides of the divide, few of the narrators can avoid personal feelings of ambivalence and guilt at being able to easily move from one side of that divide to the other back home. Many fantasize about giving up their lives in the north to devote themselves... (shrink)

Two experiments investigated whether moral evaluations of organ transplantation influence judgments of death and causation. Participants’ beliefs about whether an unconscious organ donor was dead and whether organ removal caused death in a hypothetical vignette varied depending on the moral valence of the vignette. Those who were randomly assigned to the good condition were more likely to believe that the donor was dead prior to organ removal and that organ removal did not cause death. Furthermore, attitudes toward euthanasia and (...) organ donation independently predicted judgments of death and causation, regardless of experimental condition. The results are discussed in light of the framework of motivated reasoning, in which motivation influences the selection of cognitive processes and representations applied to a given domain, as well as Knobe’s person-as-moralist model, in which many basic concepts are appropriately imbued with moral features. On either explanatory framework, these data cast doubt on the psychological legitimacy of the mainstream justification for vital organ procurement from heart-beating donors, which holds that neurological criteria for death are scientifically justified, independently of concerns about organ transplantation. These data suggest that, rather than concluding that organ removal is permissible because the donor is dead, people may believe that the donor is dead because they believe organ removal to be permissible. (shrink)

Research in cognitive neuroscience now considers the state of the brain prior to the task an important aspect of performance. Hypnosis seems to alter the brain state in a way which allows external input to dominate over internal goals. We examine how normal development may illuminate the hypnotic state.

‘Gender’, understood as the social construction of sex, is a key concept for feminists working at the interface of theory and policy. This article examines challenges to the concept which emerged from different groups at the UN Fourth World Conference on Women in Beijing, September 1995, an important arena for struggles over feminist public policies. The first half of the article explores contradictory uses of the concept in the field of gender and development. Viewpoints from some southern activist women at (...) the NGO Forum of the Beijing Conference are presented, Some of them argued that the way ‘gender’ has been deployed in development institutions has led to a depoliticization of the term, where feminist policy ambitions are sacrificed to the imperative of ease of institutionalization. ‘Gender’ becomes a synonym for ‘women’, rather than a form of shorthand for gender difference and conflict and the project of transformation in gender relations. ‘Gender sensitivity’ can be interpreted by non-feminists as encouragement to use gender-disaggregated statistics for development planning, but without consideration of relational aspects of gender, of power and ideology, and of how patterns of subordination are reproduced. A completely different attack on ‘gender’ came from right-wing groups and was battled out over the text of the Platform for Action agreed at the official conference. Six months prior to the conference, conservative groups had tried to bracket for possible removal the term ‘gender’ in this document, out of opposition to the notion of socially constructed, and hence mutable, gender identity. Conservative views on gender as the ‘deconstruction of woman’ are discussed here. The article points out certain contradictions and inconsistencies in feminist thinking on gender which are raised by the conservative backlash attack on feminism and the term ‘gender’. (shrink)

This paper explores how embryos have been representedin law. It argues that two main models haveunderpinned legal discourse concerning the embryo. Onediscourse, which has become increasingly prevalent,views embryos as legal subjects or persons. Suchrepresentations are facilitated by technologicaldevelopments such as ultrasound imaging. In additionto influencing Parliamentary debate prior to thepassage of the Human Fertilisation and Embryology Act1990, images of embryos as persons featureprominently in popular culture, including advertisingand films, and this discourse came to the fore in the`orphaned embryo' debate (...) in 1996. The main opposingdiscourse dismisses embryos as commodifiable objects,which fits with a trend towards legal recognition thatreproductive materials such as sperm may be classifiedas property which may be donated or sold. In thecase of cryo-preserved embryos these competingperspectives have resulted in litigation over thestatus of frozen embryos. In this paper I argue thatit might be productive to shift the debate from thispolarised dispute over whether embryos matter or not,whether they are pre-persons or commodities. Instead,I suggest that we should attempt to locate them in abiotechnological milieu, where cyborg metaphors may beutilised, and questions of how we should treat embryoswould be contextualised alongside our response toother cyborgs. (shrink)

Some of the world’s best-loved films can be used as springboards for examining enduring philosophical questions. Philosophy Through Film provides guidance on how to watch films with an eye for their philosophical content, helping students become familiar with key topics in all of the major areas in Western philosophy, and helping them to master the techniques of philosophical argumentation. -/- The perfect size and scope for a first course in philosophy, Philosophy Through Film assumes no prior knowledge of philosophy. (...) It is an excellent teaching resource and learning tool, introducing students to key topics and figures in philosophy through thematic chapters, each of which is linked to one or more “focus films” that illustrate a philosophical problem or topic. -/- This new edition features a new chapter on the mind-body problem. In addition, one new primary reading and nine new focus films have been added. Films examined in depth include: Arrival The Matrix Inception Memento Moon Live, Die, Repeat: Edge of Tomorrow Her Ex Machina Minority Report Beautiful Boy Crimes and Misdemeanors Gone Baby Gone Equilibrium Divergent A Serious Man Silence Ad Astra . (shrink)

BackgroundMedical aid in dying was introduced in Quebec in 2015. Quebec clinical guidelines recommend that MAiD be approached as a last resort when other care options are insufficient; however, the law sets no such requirement. To date, little is known about when and how requests for MAiD are situated in the broader context of decision-making in end-of-life care; the timing of MAiD raises potential ethical issues.MethodsA retrospective chart review of all MAiD requests between December 2015 and June 2017 at two (...) Quebec hospitals and one long-term care centre was conducted to explore the relationship between routine end-of-life care practices and the timing of MAiD requests.ResultsOf 80 patients requesting MAiD, 54% received the intervention. The median number of days between the request for MAiD and the patient’s death was 6 days. The majority of palliative care consults came less than 7 days prior to the MAiD request and in another 25% of cases occurred the day of or after MAiD was requested. 35% of patients had no level of intervention form, or it was documented as 1 or 2 at the time of the MAiD request and 19% were receiving life-prolonging interventions.InterpretationWe highlight ethical considerations relating to the timing of MAiD requests within the broader context of end-of-life care. Whether or not MAiD is conceptualised as morally distinct from other end-of-life options is likely to influence clinicians’ approach to requests for MAiD as well as the ethical importance of our findings. We suggest that in the wake of the 2015 legislation, requests for MAiD have not always appeared to come after an exploration of other options as professional practice guidelines recommend. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Future Directions for Oversight of Stem Cell Research in the United States: An UpdateMary A. Majumder (bio) and Cynthia B. Cohen (bio)On 9 March 2009, President Barack Obama (2009a) signed an executive order revoking the statement issued by President George W. Bush during a televised speech in August 2001, in which the latter had sharply restricted the scope of federally funded human embryonic stem cell (hESC) research to cell (...) lines derived (without federal funding) prior to 9:00 P.M. EDT on 9 August 2001. Action by President Obama to remove the cut-off date had been expected. It came as a surprise, however, that he gave authority to determine the scope of eligible research to the Director of the National Institutes of Health (NIH), referencing only general concerns of responsibility, scientific worth, and legality.1 This contrasted not only with the approach of former President Bush, but also with that of former President Clinton, who had expressed personal opposition to the creation of embryos for research and had a distinction between hESCs derived from embryos created for research and those derived from spare embryos enshrined in NIH policy.President Obama’s remarks upon signing the executive order give some insight into the thinking behind his approach. Implicit in them are the views that earlystage human embryos outside the womb do not have full moral status and that the destruction of human embryos in the effort to care for and ease the suffering of human beings who do have full moral status does not devalue human life. The President also stressed that the decision to pursue hESC research reflected not only his opinion, but also a broad social consensus. He concluded with strong ethical commitments on two fronts:We will develop strict guidelines, which we will rigorously enforce, because we cannot ever tolerate misuse or abuse. And we will ensure that our government never opens the door to the use of cloning for human reproduction. It is dangerous, profoundly wrong, and has no place in our society, or any society.(Obama 2009b)The specific guarantee that President Obama gave against government support for the development of cloning techniques for human reproductive purposes made his silence on the use of cloning for research seem significant. Comments he had made in the course of the campaign (Obama 2008) suggested that he would affirm [End Page 195] the Clinton-era policy of limiting federal funding to hESCs derived from spare embryos. Did this silence mean that President Obama was opening the door to federal funding of research cloning when and if scientists might manage that feat?2009 NIH GuidelinesThe answer to this question and several others came on 17 April, when Raynard Kington, the acting director of NIH, released Draft NIH Guidelines for Human Stem Cell Research (NIH 2009), developed by an NIH Stem Cell Task Force, along with a request for public comment within 30 days of their publication in the Federal Register.2 The 2009 Draft Guidelines exclude from federal funding the derivation of hESCs, a restriction mandated by the reenactment of the Dickey-Wicker Amendment as part of the 2009 Omnibus Appropriations Act (Public Law 111-8, Division F, Title V, § 509). The 2009 Draft Guidelines also exclude the use of hESCs derived from embryos created for research purposes, and so represent a refusal to open the funding door as broadly as the NIH interpretation of the Dickey-Wicker Amendment might allow, at least for the time being.It appears that the drafters used as their starting point the 2000 NIH Guidelines for Research Using Human Pluripotent Stem Cells (NIH 2000) dating from the Clinton Administration, rather than more recent guidelines from the National Academy of Sciences (National Research Council 2005; 2007; 2008) and other private bodies. Both the format and content of the 2000 and 2009 NIH efforts are similar, making the departures in the latter stand out in high relief. We highlight departures related to informed consent to embryo donation, creation of human-nonhuman chimeras, and the role of an NIH task force, updating our original comment (Cohen and Majumder 2009).Informed Consent to Embryo DonationThe 2009 NIH Draft Guidelines require that certain statements... (shrink)

Previous research indicates that individuals with depressive disorders have aberrant resting state functional connectivity and may experience memory dysfunction. While resting state functional connectivity may be affected by experiences preceding the resting state scan, little is known about this relationship in individuals with DD. Our study examined this question in the context of object memory. 52 individuals with DD and 45 healthy controls completed clinical interviews, and a memory encoding task followed by a forced-choice recognition test. A 5-min resting state (...) fMRI scan was administered immediately after the forced-choice task. Resting state networks were identified using group Independent Component Analysis across all participants. A network modeling analysis conducted on 22 networks using FSLNets examined the interaction effect of diagnostic status and memory accuracy on the between-network connectivity. We found that this interaction significantly affected the relationship between the network comprised of the medial prefrontal cortex, posterior cingulate cortex, and hippocampal formation and the network comprised of the inferior temporal, parietal, and prefrontal cortices. A stronger positive correlation between these two networks was observed in individuals with DD who showed higher memory accuracy, while a stronger negative correlation was observed in individuals with DD who showed lower memory accuracy prior to resting state. No such effect was observed for HC. The former network cross-correlated with the default mode network, and the latter cross-correlated with the dorsal attention network. Considering that the DMN and DAN typically anticorrelate, we hypothesize that our findings indicate aberrant reactivation and consolidation processes that occur after the task is completed. Such aberrant processes may lead to continuous “replay” of previously learned, but currently irrelevant, information and underlie rumination in depression. (shrink)

Abductive reasoning assigns special status to the explanatory power of a hypothesis. But how do people make explanatory judgments? Our study clarifies this issue by asking: How does the explanatory power of a hypothesis cohere with other cognitive factors? How does probabilistic information affect explanatory judgments? In order to answer these questions, we conducted an experiment with 671 participants. Their task was to make judgments about a potentially explanatory hypothesis and its cognitive virtues. In the responses, we isolated three constructs: (...) Explanatory Value, Rational Acceptability, and Entailment. Explanatory judgments strongly cohered with judgments of causal relevance and with a sense of understanding. Furthermore, we found that Explanatory Value was sensitive to manipulations of statistical relevance relations between hypothesis and evidence, but not to explicit information about the prior probability of the hypothesis. These results indicate that probabilistic information about statistical relevance is a strong determinant of Explanatory Value. More generally, our study suggests that abductive and probabilistic reasoning are two distinct modes of inference. (shrink)

In the Spring 1997 issue of the journal, Ronald M. Green's affiliation was inaccurately listed. Although he did serve at the Office of Genome Ethics at the National Institutes of Health, in correspondence prior to pub lication of his paper “Parental Autonomy and the Obligation Not to Harm One's Child Genetically,” he requested that his affiliation only be listed at the Ethics Institute at Dartmouth College. He wanted to avoid any appearance of speaking on behalf of NIH. The editors (...) regret the confusion this oversight caused Professor Green personally and journal readers. (shrink)

In the Spring 1997 issue of the journal, Ronald M. Green's affiliation was inaccurately listed. Although he did serve at the Office of Genome Ethics at the National Institutes of Health, in correspondence prior to pub lication of his paper “Parental Autonomy and the Obligation Not to Harm One's Child Genetically,” he requested that his affiliation only be listed at the Ethics Institute at Dartmouth College. He wanted to avoid any appearance of speaking on behalf of NIH. The editors (...) regret the confusion this oversight caused Professor Green personally and journal readers. (shrink)

In the Spring 1997 issue of the journal, Ronald M. Green's affiliation was inaccurately listed. Although he did serve at the Office of Genome Ethics at the National Institutes of Health, in correspondence prior to pub lication of his paper “Parental Autonomy and the Obligation Not to Harm One's Child Genetically,” he requested that his affiliation only be listed at the Ethics Institute at Dartmouth College. He wanted to avoid any appearance of speaking on behalf of NIH. The editors (...) regret the confusion this oversight caused Professor Green personally and journal readers. (shrink)

Mastery imagery (i.e., images of being in control and coping in difficult situations) is used to regulate anxiety. The ability to image this content is associated with trait confidence and anxiety, but research examining mastery imagery ability's association with confidence and anxiety in response to a stressful event is scant. The present study examined whether trait mastery imagery ability mediated the relationship between confidence and anxiety, and the subsequent associations on performance in response to an acute psychological stress. Participants (N= (...) 130; 55% male;Mage= 19.94 years;SD= 1.07 years) completed assessments of mastery imagery ability and engaged in a standardized acute psychological stress task. Immediately prior to the task, confidence, cognitive and somatic anxiety intensity, and interpretation of anxiety symptoms regarding the task were assessed. Path analyses supported a model whereby mastery imagery ability mediated the relationship between confidence and cognitive and somatic anxiety interpretation. Greater mastery imagery ability and confidence were both directly associated with better performance on the stress task. Mastery imagery ability may help individuals experience more facilitative anxiety and perform better during stressful tasks. Improving mastery imagery ability by enhancing self-confidence may help individuals successfully cope with anxiety elicited during stressful situations. (shrink)

Background: Family members are often required to act as substitute decision-makers when health care or research participation decisions must be made for an incapacitated relative. Yet most families are unable to accurately predict older adult preferences regarding future health care and willingness to engage in research studies. Discussion and documentation of preferences could improve proxies' abilities to decide for their loved ones. This trial assesses the efficacy of an advance planning intervention in improving the accuracy of substitute decision-making and increasing (...) the frequency of documented preferences for health care and research. It also investigates the financial impact on the healthcare system of improving substitute decision-making. Methods/DesignDyads (n = 240) comprising an older adult and his/her self-selected proxy are randomly allocated to the experimental or control group, after stratification for type of designated proxy and self-report of prior documentation of healthcare preferences. At baseline, clinical and research vignettes are used to elicit older adult preferences and assess the ability of their proxy to predict those preferences. Responses are elicited under four health states, ranging from the subject's current health state to severe dementia. For each state, we estimated the public costs of the healthcare services that would typically be provided to a patient under these scenarios. Experimental dyads are visited at home, twice, by a specially trained facilitator who communicates the dyad-specific results of the concordance assessment, helps older adults convey their wishes to their proxies, and offers assistance in completing a guide entitled My Preferences that we designed specifically for that purpose. In between these meetings, experimental dyads attend a group information session about My Preferences. Control dyads attend three monthly workshops aimed at promoting healthy behaviors. Concordance assessments are repeated at the end of the intervention and 6 months later to assess improvement in predictive accuracy and cost savings, if any. Copies of completed guides are made at the time of these assessments. DiscussionThis study will determine whether the tested intervention guides proxies in making decisions that concur with those of older adults, motivates the latter to record their wishes in writing, and yields savings for the healthcare system. Trial RegistrationISRCTN89993391. (shrink)

Prior research has suggested that perceptual disfluency activates analytical processing and increases the solution rate of mathematical problems with appealing but incorrect answers (i.e., the Cogn...