In Good Citizens: Creating Enlightened Society, Thich Nhat Hanh lays out the foundation for an international solidarity movement based on a shared sense of compassion, mindful consumption, and right action. Following these principles, he believes, is the path to world peace. The book is based on our increased global interconnectedness and subsequent need for harmonious communication and a shared ethic to make our increasingly globalized world a more peaceful place. The book will be appreciated by people of all faiths and (...) cultural backgrounds. While based on the basic Buddhist teachings of the Four Noble Truths and the Eight-Fold Path, Thich Nhat Hanh boldly leaves Buddhist terms behind as he offers his contribution to the creation of a truly global and nondenominational blueprint to overcoming deep-seated divisions and a vision of a world in harmony and the preservation of the planet. Key topics include the true root causes of discrimination; the exploration of the various forms of violence; economic, social, and sexual violence. He encourages the reader to practice nonviolence in all daily interactions, elaborates on the practice of generosity, and teaches the art of deep listening and loving speech to help reach a compromise and reestablish communication after misunderstandings have escalated into conflicts. Good Citizens also contains a new wording of the Five Mindfulness Trainings (traditionally called "precepts") for lay practitioners, bringing them in line with modern-day needs and realities. In their new form they are concrete and practical guidelines of ethical conduct that can be accepted by all traditions. Good Citizens also includes the complete text of the UN Manifesto 2000, a declaration of transforming violence and creating a culture of peace for the benefit of the children of the world. It was drafted by numerous Peace Nobel Prize recipients and signed by over 100 million people worldwide. Coinciding with a US presidential election year, Good Citizens reaches across all political backgrounds and faith traditions. It shows that dualistic thinking--Republican/Democrat, Christian/Muslim--creates tension and a false sense of separateness. When we realize that we share a common ethic and moral code, we can create a community that can change the world. (shrink)

Zen Master Thích Nhá̂t Hạnh's commentary on Nāgārjuna's Treatise on the Middle Way, one of the most famous Buddhist texts in existence. Nāgārjuna is a giant in the Buddhist canon, thought to be the greatest Buddhist philosopher after the Buddha. He lived in southern India in the 2nd century CE. Cracking the Walnut contains the text of Nāgārjuna's Treatise on the Middle Way (Mulamadhyamakakarika), defending the essential premise that all things have the nature of emptiness, they have no self-nature, but (...) are in a constant process of change and interrelationship with one another. Weaving Nāgārjuna's text with commentary by Thích Nhá̂t Hạnh', taken from talks given at two 3-month-long retreats, helps us bring these teachings into our daily life. They are strong teachings, designed to break through all metaphysical speculation. To a greater or lesser extent, we all have notions and ideas about life. Sometimes our ideas can contribute to the advancement of humanity, but the problem comes when we are caught in our ideas and believe them to be the absolute truth. When people believe that something is the absolute truth, they may be ready to fight, kill, or die for it. This brings about polarization, deep division, and suffering in ourselves, our society, community, and family. This is not the way ahead for humanity. This book helps us let go of our ideas and go in the direction of understanding and compassion. (shrink)

Making adaptive choices between solution strategies is a central element of contemporary mathematics education. However, previous studies signal that students make suboptimal choices between mental and written strategies to solve division problems. In particular, some students of a lower math ability level appear inclined to use mental strategies that lead to lower performance. The current study uses a pretest-training-posttest design to investigate the extent to which these students’ choices for written strategies and performance may be increased. Sixth graders (...) of below-average mathematics level (N = 147) participated in one of two training conditions: an explicit-scaffolding training designed to promote writing down calculations or a practice-only training where strategy use was not explicitly targeted. Written strategy choices and performance increased considerably from pretest to posttest for students in both training conditions, but not in different amounts. Exploratory results suggest that students’ strategy choices may also be affected by their attitudes and beliefs and the sociocultural context regarding strategy use. (shrink)

The U.K.'s National Health Service (NHS) is critically reliant on staff from overseas, which means that a sizeable number of U.K. healthcare professionals have received their training at the cost of other states, whose populations are urgently in need of healthcare professionals. At the same time, while healthcare is widely seen as a primary good, many migrants are unable to access the NHS without charge, and anti‐immigration political trends are likely to further reduce that access. Both of these topics (...) have received close attention in the global health ethics literature. In this article, I make the novel move of suggesting that these two seemingly disparate issues should be folded into the same moral narrative. The ‘brain drain’ upon which the NHS and its users depend derives from the same gradient of wealth, security, and opportunity that produces migrants who require the NHS. I endorse moral cosmopolitanism as a lens for understanding patients' right to healthcare regardless of nationality or immigration status. I argue that the NHS in its current formulation effectively enacts a partial cosmopolitanism in its reliance on medical workers from abroad, but could more meaningfully instantiate that cosmopolitanism were it to offer the same healthcare to migrants as it does to citizens. (shrink)

Since the publication of Kitcher’s influential paper The Division of Cognitive Labor, some philosophers wondered about these two related issues: (1) which is the optimal distribution of cognitive efforts among rival methods within a scientific community?, and (2) whether and how can a community achieve such an optimal distribution? Though not committing to any specific answer to question (1), I claim that issue (2) does not depend exclusively on an invisible hand like mechanism, since both intra-scientific and extra-scientific institutions (...) may play a major role. Finally, I examine some practical difficulties of reallocating scientists from a method to another, which leads to stress the importance of well-planned training and recruitment. (shrink)

In The Main Enterprise of the World, Philip Kitcher identifies an over-specialized and over-loaded curriculum as a particular affliction of education in our time. Kitcher criticizes a narrow view of education on which it is conceived as being no more than job training and proposes a more humane set of educational goals to be pursued in school. For Kitcher, the problem of the narrowness of the economic aims of education and the problem of the over-loaded curriculum are connected and, (...) in Chapter 2 of the book, he presents a thoroughgoing critique of educational specialization as a distinguishing feature of education today. He holds that the economic value of education cannot capture education's full value and that true education should build children and young people's capacities for meaningful life and work. In this paper, I discuss Kitcher's critique of educational specialization. I note that Kitcher draws most of his inspiration from considerations about what makes a human life go well and therefore situates his thinking about education in the realm of ethics, rather than in his home discipline of the philosophy of science. Defending educational specialization, I turn to some of Kitcher's earlier work in the philosophy of science to show that the epistemic division of labour calls for a considerable degree of specialization in educational curricula on epistemic, rather than on economic, grounds. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Clear Division of Labor Within Environmental Philosophy?William M. Throop (bio)In discussions about the future of environmental philosophy, I have found myself supporting two positions that are in tension with one another. The first, which has been well explored in the last decade, is that environmental philosophy should have a more dramatic impact outside of academic circles. It should affect policy and guide the behavior of non-philosophers, which (...) usually requires that it deeply engage the empirical details of problems it addresses. The second is that environmental philosophy needs to improve its status within the larger philosophical community, which requires its practitioners to use methods that dominate mainstream philosophy and to be conversant with contemporary work in ethical theory, epistemology, metaphysics, and continental philosophy. Some have argued that this tension places a double burden on those training to be environmental philosophers; they must demonstrate both theoretical and practical excellence. I fear that such a standard will limit [End Page 147] the growth of environmental philosophy. It will be daunting to new environmental philosophers and achieved by only a few.With respect to this tension, I suggest that environmental philosophy should support a robust division of labor. Many new environmental philosophers should be recruited from cohorts trained primarily in core areas of philosophy. Most of these thinkers will probably focus on highly theoretical issues—issues that anyone in the field would recognize as philosophical.Their knowledge of environmental problems may be superficial and their audience likely will consist primarily of other philosophers. Their impact beyond philosophy may be quite limited (except for their students). I come from this tradition, and I am still delighted by the purely intellectual puzzles that our field generates. Work of this sort should be honored, but our field will be sterile if it is dominated by this kind of thought.I hope that many other new environmental philosophers will be trained in interdisciplinary environmental graduate programs or "applied" philosophy Ph.D. programs where they will acquire the interdisciplinary expertise necessary to address practical problems and to effectively engage non-philosophical audiences. This group of "practical" environmental philosophers should also include a host of practitioners in other fields who contribute to philosophical dialogue. I suspect that much work in this area will be case-based, empirically sophisticated and, where it addresses non-philosophical audiences, more reliant on compelling metaphors than on tight arguments. I doubt that it is fruitful to view this group as applying the work of the former group. The aims, the sources of insight and the standards of quality for the two groups are categorically different. For practical philosophers, the political feasibility of a proposal matters, and the arguments must have the capacity to move relevant stakeholders. The results of this work may appear to be philosophy-lite to those in the first group, but only if judged by standards that are inappropriate if we accept a division of labor in the field.This division of labor cannot be an apartheid. Many promising innovations in environmental philosophy will come from the interface between these groups. And unfortunately, a good bit of questionable work done in each group may result from a failure to understand progress that has been made by the other group. For example, philosophers focused only on theory may draw implications for action that fail to accord with current empirical information. Practical philosophers may [End Page 148] critique simplified metaethical positions that have long been abandoned in favor of more sophisticated versions. A healthy dialogue and a mutual respect should diminish these dangers. Such a division of labor has significant implications for graduate education, hiring and evaluation of faculty, and allocation of prestige within the field. The health and growth of environmental philosophy will depend on part on how we address these implications.William M. Throop Bill Throop is provost and professor of philosophy at Green Mountain College, an environmental liberal arts college in Poultney, VT. His background is in epistemology and philosophy of science, but in the last decade his work has focused on conceptual and ethical issues in ecological restoration and wilderness preservation. E-mail: [email protected] © 2007 Indiana University Press... (shrink)

We explore whether a Rawlsian approach might provide a guiding philosophy for the development of a healthcare system, in particular with regard to resolving tensions between different groups within it. We argue that an approach developed from some of Rawls’ principles – using his ‘veil of ignorance’ and both the ‘difference’ and ‘just savings’ principles which it generates – provides a compelling basis for policy making around certain areas of conflict. We ask what policies might be made if those making (...) them did not know if one was patient, doctor, nurse or manager – in this generation or the next. We first offer a brief summary of Rawls’ approach and how we intend to extrapolate from it. We examine how this adapted Rawlsian framework could be applied to specific examples of conflict within healthcare; we demonstrate how this framework can be used to develop a healthcare service which is both sustainable (in its training and treatment of staff, and in encouraging research and innovation) and open (to protect the powers and opportunities of those using the health service). We conclude that while Rawls’ approach has previously been rejected as a means to address specific healthcare decisions, an adapted veil of ignorance can be a useful tool for the consideration of how a just health service should be constructed and sustained. Turning the theoretical into the practical (and combining Rawls’ thought experiment with Scanlonian contractarianism), managers, doctors, patients, carers and nurses could come together and debate conflicting issues behind a hypothetical veil. (shrink)

There are many passages in Plato which look as if they alluded to well-worn practices, discussions, or lessons in the Academy. As is natural with allusions, they are often marked by a puzzling brevity or oddity of expression. One need not assume that they are always conscious allusions; for every writer has moments of obscurity which are due not so much to his conclusions as to his reaching them along lines that have long been familiar to Mm. To appreciate his (...) whole meaning the reader has then to infer as best he can the writer's train of thought. I wish to suggest that the language in which Dialectic is described in the later Dialogues presupposes a particular and probably familiar method of illustrating it. This was a geometrical illustration of the rules of Division by means of a divided line. By failing to notice it readers have not been led into any important misunderstanding of the Academy's rules. But I hope it will appear that the recognition of it makes Plato's manner of describing Division intelligible to an extent that is otherwise difficult. It is only a tentative suggestion, and would perhaps not have been worth making but for the possibility that some points of interest might at the same time emerge for those who were unconvinced by it. (shrink)

There are many passages in Plato which look as if they alluded to well-worn practices, discussions, or lessons in the Academy. As is natural with allusions, they are often marked by a puzzling brevity or oddity of expression. One need not assume that they are always conscious allusions; for every writer has moments of obscurity which are due not so much to his conclusions as to his reaching them along lines that have long been familiar to Mm. To appreciate his (...) whole meaning the reader has then to infer as best he can the writer's train of thought. I wish to suggest that the language in which Dialectic is described in the later Dialogues presupposes a particular and probably familiar method of illustrating it. This was a geometrical illustration of the rules of Division by means of a divided line. By failing to notice it readers have not been led into any important misunderstanding of the Academy's rules. But I hope it will appear that the recognition of it makes Plato's manner of describing Division intelligible to an extent that is otherwise difficult. It is only a tentative suggestion, and would perhaps not have been worth making but for the possibility that some points of interest might at the same time emerge for those who were unconvinced by it. (shrink)

While cochlear implantation has benefitted many patients with single-sided deafness (SSD), there is great variability in cochlear implant (CI) outcomes and binaural performance remains poorer than that of normal-hearing (NH) listeners. Differences in sound quality across ears – temporal fine structure (TFS) information with acoustic hearing versus coarse spectro-temporal envelope information with electric hearing – may limit integration of acoustic and electric patterns. Binaural performance may also be limited by inter-aural mismatch between the acoustic input frequency and the place of (...) stimulation in the cochlea. SSD CI patients must learn to accommodate these differences between acoustic and electric stimulation to maximize binaural performance. It is possible that training may increase and/or accelerate accommodation and further improve binaural performance. In this study, we evaluated lateralization training in NH subjects listening to broad simulations of SSD CI signal processing. A 16-channel vocoder was used to simulate the coarse spectro-temporal cues available with electric hearing; the degree of inter-aural mismatch was varied by adjusting the simulated insertion depth (SID) to be 25 mm (SID25), 22 mm (SID22), and 19 mm (SID19) from the base of the cochlea. Lateralization was measured using headphones and head-related transfer functions (HRTFs). Baseline lateralization was measured for unprocessed speech (UN) delivered to the left ear to simulate SSD and for binaural performance with the acoustic ear combined with the 16-channel vocoders (UN+SID25, UN+SID22, and UN+SID19). After completing baseline measurements, subjects completed 6 lateralization training exercises with the UN+SID22 condition, after which performance was re-measured for all baseline conditions. Post-training performance was significantly better than baseline for all conditions (p<0.05 in all cases), with no significant difference in training benefits among conditions. Given that there was no significant difference between the SSD and the SSD CI conditions before or after training, the results suggest that NH listeners were unable to integrate TFS and coarse spectro-temporal cues across ears for lateralization, and that inter-aural mismatch played a secondary role at best. While lateralization training may benefit SSD CI patients, the training may largely improve spectral analysis with the acoustic ear alone, rather than improve integration of acoustic and electric hearing. (shrink)

In their article, Sahan and colleagues have presented ethical dilemmas faced by clinical scientists working in genomics.1 This is a welcome development since thus far little has been published on the ethical issues faced by clinical scientists in general. In their article, the authors present the three themes which emerged from discussions with clinical scientists in respect to three case studies: ‘(1) the redistribution of labour and responsibilities resulting from the practice of genomic medicine; (2) the interpretation and certainty of (...) results and (3) the proposal that better standardisation and consistency of ethical approaches (for example, more guidelines and policy) could resolve some of the challenges arising’.1 One theme which appeared not to emerge is that of ethics education received by clinical scientists during their training, and this is the theme on which this commentary will focus. As noted elsewhere, ‘Clinical Scientists receive some lectures on clinical and research ethics as part of their training, but it amounts to only to a couple of hours of lectures (references omitted)’.2 The usual route to becoming a clinical scientist involves undertaking the 3-year postgraduate Scientist Training Programme (STP), though the ‘equivalence’ route is quite commonly taken by clinical scientists working in …. (shrink)

This paper focuses on two methodological questions that arise from Plato’s account of collection and division. First, what place does the method of collection and division occupy in Plato’s account of philosophical inquiry? Second, do collection and division in fact constitute a formal “method” (as most scholars assume) or are they simply informal techniques that the philosopher has in her toolkit for accomplishing different philosophical tasks? I argue that Plato sees collection and division as useful tools (...) for achieving two distinct goals – generating real definitions and discovering the basic natural kinds of a given domain of knowledge – both of which occupy a preliminary stage in his account of philosophical inquiry. As to the second question, I claim that the evidence for seeing collection and division as a formal method is weak. Although Plato calls the procedure a technê and a methodos, he makes no real attempt to formalize it in any way. For Plato, collection and division do not constitute an algorithmic process that can be learned from a rule book. Instead the ability to collect and divide properly are skills that good dialecticians must acquire through the kind of hands-on training illustrated by the Sophist and Statesman. Whereas Aristotle insists on formal rules for making proper divisions, Plato seems to emphasize the need to recognize where the natural joints of the world are. In this sense, Plato’s Sophist and Statesman and Aristotle’s Topics and Analytics present two very different pictures of collection and division. (shrink)

Silvia Castellazzi shows how companies can implement their corporate responsibility and support employability and access to training in an incentive-compatible manner. The study provides insights into unrealized cooperation and disincentives which prevent companies from investing in a shared pool of employable and skilled people. The research draws on the theoretical framework of the economic ethics and on in-depth interviews with key stakeholders in two European countries. Findings show that incentives for investments in training are selective and might reinforce (...) path-dependencies and exclusion, while not supporting cooperation and productive competition. The study also shows the value of conceptualizing employability as a social rather than a psychological contract to facilitate investments and the implementation of corporate responsibility. Contents Trends and Conflicts in Employability and Provision of Training Incentives Structures and Stakeholders' Strategies A Social Contract for Employability Target Groups Researchers in business ethics, employee relations, further education and training HR and training managers; CSR managers The Author Silvia Castellazzi works as account manager in the corporate education division of MIP Graduate School of Business (Politecnico di Milano). Her research interests and activities are focused on professional and executive education, corporate responsibility and decision-making, the future of work and new forms of work organization. (shrink)

We read with great interest the commentaries submitted in response to our paper about clinical scientists and the role of ethical preparedness1. The responses raised some important themes that intersect with those discussed in our paper, and we are grateful for the opportunity to expand on them. Pruski2 highlights the importance of ethics education for clinical scientists, noting insufficient provision of such teaching within the clinical science profession. This gap means that scientists completing higher specialist training, who now encounter (...) more complex ethical challenges, are not benefitting from equivalent ethics education standards enjoyed by their counterparts in medical professions. We agree that clinical scientists deserve access to quality education in ethics in order to develop their skills in this area. Alongside a formal element to education, we see ethical preparedness (EP) as advocating for more informal education opportunities. This can be facilitated through the encouragement and creation of space (both physical and metaphorical) to discuss ethical issues as they arise in practice and explore potential scenarios in a supportive and judgement-free environment. Cultivating such an environment plays is crucial to develop professional skills in navigating ethical challenges, promoting a greater sense of collective responsibility and capability to do justice to ethical issues encountered. Van Steijvoort et al 3 draw …. (shrink)

Explains how Nietzsche's late-period elitism emerges out of the cultural division of labor envisioned in _Human, All-too-Human_ between a scientifically-trained (but essentially philosophical) avant-garde whose work opens up new paths for cultural development, thus avoiding cultural stagnancy.

The academic standing of the staff working in vocational higher education must be judged as unsatisfactory according to two possible criteria: the traditional criteria, which are derived from the universities operating within the previous unitary higher education system; and the criteria outlined by the bill of the Law of Higher Education Institutions. The latter derive from the same historical institutional pattern.There are many reasons to conclude that, academically, in most fields of study, the new institutions do not reach the level (...) of the old ones. However, the mission of the new sector—the second-rank academic institutions in the eyes of the traditional academic community—is at least debatable, if not mistaken. The public university sector appears to be in deep crisis, with academics so attached to the Humboldtian university that they ignore the claims for social relevance in education.8 This is further complicated by deepening financial hardship.Using traditional criteria, it is possible that Estonia will be left with two socially irrelevant higher education sectors, instead of one functioning sector. It is also possible that the second sector, which does not fit these criteria, will be eliminated. However, the fault does not lie wholly with the dominance of traditional university attitudes. It also lies in a lack of vision on the part of the new institutions. As children of the proletariat society, they fail to recognise their vocational orientation as a benefit, and instead try to hide it. They are developing theoretically overloaded four- to five-year study programmes. None of these institutions has solved the problem of balancing the requirement of employing 50 per cent faculty full time and maintaining a satisfactory academic level. The need to demonstrate that part-time employees may actually benefit the vocational sector has not yet been understood.9As long as the sector continues to accept the rules forced upon it by the old universities, it probably has no useful role in Estonia. Its institutions, especially the public institutions, cannot compete with the traditional universities in academic fields. The universities, on the other hand, are beginning to understand that the policy they proclaimed some years ago, which was based on the clear distinction between two sectors on the German pattern, does not work in a small country with very limited resources, and an inheritance from the previous regime of a large university sector with an enrolment rate of more than 20 per cent of the age group. The universities have agreed to offer their own non-degree courses at diploma level, and now seriously threaten the small new institutions. From the financial point of view, the universities' expressed desire to swallow the small vocational institutions is beneficial since the small institutions have no clearly distinct role of their own.The private vocational higher education institutions do not conceal the fact that, according to their own vision, they have little place in the vocational sector. Some of them would like an official status equal to that of the universities, the right to offer graduate and postgraduate courses as well as diploma courses, and the registration of their diplomas and certificates on an equal basis with the public universities in the Register of Diplomas and Certificates at the Ministry of Culture and Education. In other words, they are interested in becoming fully accredited universities. This increases competition for students and—given the Estonian mechanism of public financing of higher education based on the number of students admitted provided by the Ministry of Culture and Education10—there will be less money for public universities. Here lies the origin of the principle that the universities are established by parliament and the vocational higher education institutions by executive action by the government.The existence of the new sector is seriously threatened. The current pattern of postgraduate studies has blocked the preparation of a sufficient number of research-degree holders, even at master's level.11 The new institutions cannot train their own faculty. The recent experience of Concordia International University—which depends greatly on staff with bachelor's and master's degrees from the United States, who form some 80 per cent of the faculty—demonstrates that the participation of first- or even second-rank Western academics in Estonian higher education can never be very high. If the system cannot accept experienced local staff for legal appointments in the vocational sector, unless they have a research degree, these institutions will not survive for long. Society will be back to the position where there are a large number of underpaid or unemployed academics, but a shortage of qualified individuals who could be self-employed and capable of running small and medium-size enterprises. (shrink)

NHS Blood and Transplant is responsible for the procurement and allocation of human organs in the United Kingdom. Its main role is to “ensure that organs donated for transplant are matched and allocated to patients in a fair and unbiased way.” NHSBT’s liver allocation policies are underpinned by the National Liver Transplant Standards, a document published by the Department of Health in 2005 to oversee patient care, patient assessment, liver allocation and transplantation, education and training, and research and development. (...) NHSBT has developed its own liver allocation protocols under the powers assigned to it by the Department of Health, which include a “super-urgent” liver allocation policy, a Liver Allocation Sequence, and pediatric candidate liver allocation protocols. (shrink)

The National Health Service (NHS) has, for over four decades, been beset with numerous ‘scandals’ relating to poor patient care across several diverse clinical contexts. Ensuing inquiries proceed as though each scandal is unique, with recommendations highlighting the need for more staff training, a change of culture within the NHS based upon a ‘duty of candour’, and proposed criminal sanctions for employees believed to breach good patient care. However, mistakes reoccur and failings in patient safety continue. While inquiries describe (...) _what_ went awry in each case, questions of _how_ and _why_ such failures came to be remain unanswered. Psychology has a role in answering these questions. Applying psychological theory can guide an understanding of the _causes_ that lead to catastrophic failures in healthcare settings. Indeed, what is often neglected in inquiries is the role of human behaviour in contributing to these failures. Drawing upon behavioural, social and cognitive theories, a psychological analysis of key factors, typically present in clinical contexts where serious failures of care occur, is presented. Applying theory and models from the field of psychology can guide further understanding of the precipitants to poor care. (shrink)

Training programme on “Research Methodology” -/- Planning, Monitoring & Research Division of DGHS with technical support of Bangladesh Bioethics Society (BBS) and American University of Sovereign Nation (AUSN, USA) organized a three days Training programme on “Research Methodology” on 3-5 December, 2017 at Conference Room, DGHS (1st floor, Old Building). -/- Graduation Ceremony: Following Members of BBS have been graduated from AUSN, USA in 2017 and honored by BBS through a programme. -/- PhD (Bioethics, Sustainability and Global (...) Public Health) Prof Shamima Parvin Lasker, Professor & Head of Anatomy, MH Samorita Medical College, Dhaka – She is the 2nd PhD holder and 1st Female PhD from AUSN. -/- Master of Bioethics and Global Public Health Dr Tonmoy Biswas Tanya Ahmed Tamjida Ahmed . (shrink)

The ethics of citation has attracted increased attention in recent discussions of research and publication ethics, fraud and plagiarism. Little attempt has been made, however, to situate specific citation misbehaviors in terms of broader ethical practices and principles. To investigate researchers’ perceptions of citation norms, we surveyed active US researchers receiving federal funding from the National Institutes of Health (NIH), the National Science Foundation (NSF), and the National Endowment for the Humanities (NEH). Participants (_n_ = 257) were asked about citation (...) norms they endorse (norm reports), the behaviors they perceive others to engage in (peer reports), and their own citation behaviors (self-reports). Our analyses showed that while considerable discrepancies exist between norm reports, peer reports and self-reports, respondents’ discipline has no significant effect on these. Participants indicated that their own practices and that of their peers falls short of the norms they endorse, but that their own behavior is much less ethically deficient than that of their peers. An exploratory factor analysis revealed that ethically questionable citation behaviors could be grouped usefully into three categories: strategic citations, neglectful citations, and blind citations. Contrary to our hypothesis, the survey showed that greater experience does not always result in better citation practices. A particularly divisive issue pertained to intentionally citing authors from underrepresented demographic groups for reasons of social justice, but broad support for this practice is lacking, although arts and humanities scholars are slightly more supportive. Most researchers view questionable citation practices as negatively affecting their disciplines. Our findings suggest the need for clearer articulations of the citation norms and improved guidance and training about citations. (shrink)

Bangladesh Bioethics Society in cooperation with National Institute of Neuro Science (NINS), Agargoan, Dhaka is going to organized 60 hours (Two weeks) Training Course on Applied Research Methodology and SPSS on February, 2021 for the Post graduate Medical Students of NINS. The course is designed to familiarize the participants with modern tools, techniques and methodologies of research to develop professional knowledge and skills in the field of Health care system. After completion of the course, participants will be expected to (...) undertake research projects independently and to be able to evaluate the research progress at each stage of the process. This programme is funded by SSRC, Planning Division, Ministry of Planning, Government of the People’s Republic of Bangladesh. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Tyranny of the BureaucratsSimon Wilson (bio) and Gwen Adshead (bio)Keywordsviolence, mental health, bureaucracyWe are grateful for the opportunity to respond to the two kind and thoughtful commentaries on our paper. Sadler suggests irrationality may be the key to distinguishing psychiatric from nonpsychiatric violence. We are not so sure that this is necessarily as helpful as it might at first seem. Who gets to decide what is rational? Much (...) “normal” violence, committed in the heat of the moment, impulsively, and drunkenly, may not appear that rational, even to the perpetrator, in the cold light of day. We are not sure one would wish to bring this sort of violence within the province of psychiatric explanations. Likewise, a point we made in our paper: Even delusionally driven violence often has its own internal coherence and rationality within an irrational framework.We found much to agree with in McCallum’s commentary, and perhaps his alternative approach is more helpful. He proposes a more sociological model of understanding what is going on in these complex cases, one that starts with societal dividing practices. Our present times have been described as the tyranny of the bureaucrats. Professional approaches are devalued. Diagnosis is only relevant in terms of its bureaucratic utility in moving people from one category to another. Since the writing of our paper, the criminal law has changed further in England and Wales. The Criminal Justice Act 2003 brought with it new sentences of indeterminate detention for public protection for those offenders categorized as “dangerous.” The presence or absence of psychiatric disorder being largely irrelevant for these purposes. This would seem to fit nicely with McCallum’s analysis, and in principle rather takes the wind out of our sails when we argued about the discrimination against psychiatric violence—now a diagnosis is not necessary for the state to intervene in a probabilistic fashion to prevent future violence. Deciding between what sort of violence counts as psychiatric and what does not, does not have quite the same drastic differential effect on the individual as perhaps it did. Its importance is now, as predicted by McCallum’s model, more to do with bureaucracy: Which government department will be paying for the individual’s preventive detention (Department of Health or Ministry of Justice)? [End Page 75]Related ArticlesFeature Article: When Violence Becomes a Psychiatric SymptomCommentary: The Contingent Object of PsychiatryCommentary: Reasons CountResponse: The Tyranny of the BureaucratsSimon Wilson Simon Wilson is a Consultant Forensic Psychiatrist at the Maudsley Hospital and an Honorary Senior Lecturer at the Institute of Psychiatry, London, UK. He qualified at Leeds University and trained in psychiatry at the Maudsley Hospital. He was previously Consultant Forensic Psychiatrist at HM Prison, Brixton, UK. He has particular interests in prisons, philosophical, and ethico-legal issues in psychiatry. He can be contacted via e-mail at:[email protected] Adshead Gwen Adshead is a Forensic Psychiatrist and Psychotherapist. She works as a psychotherapist in a high-security hospital. She is a group analyst and researcher in attachment theory as it relates to offenders. She has a Master’s degree in Medical Law and Ethics, and is a founder member of the Philosophy Special Interest Group of the Royal College of Psychiatrists. She can be contacted via e-mail at:[email protected] © 2009 The Johns Hopkins University Press... (shrink)

NICE must not say people are not worth treatingThe National Institute for Health and Clinical Excellence has proposed that drugs for the treatment of dementia be banned to National Health Service patients on the grounds that their cost is too high and “outside the range of cost effectiveness that might be considered appropriate for the NHS”i.1This is despite NICE’s admission that these drugs are effective in the treatment of Alzheimer’s disease and despite NICE having approved even more expensive treatments. The (...) effect is that thousands of Alzheimer’s patients will be denied the only treatment available. It is difficult to think of this as anything but wickedness or folly or more likely both. At the same time, and with no apparent sense of irony, NICE has launched a public consultation document3 on its guidelines on social value judgments. As we shall see these guidelines are ethically illiterate as well as socially divisive.Assuming permanently scarce resources it is clearly crucial that such healthcare resources as are available are not wasted. This point is often made in terms of cost effectiveness and it is argued, not implausibly, that to talk of cost effectiveness implies that we are able to measure just how cost effective each treatment is. To do so of course we need a standard of measurement. NICE has adopted the ubiquitous, but justly infamous QALY, the Quality Adjusted Life Year.The QALY combines life expectancy after treatment with measures of the expected quality of that life. There are two ways in which QALYS can be used. They might be used to determine which of rival therapies to give to a particular patient or which procedure to use to treat a particular condition, in short which of two different treatments is the more …. (shrink)

This paper explores how horses are represented in the discourses of "natural horsemanship" , an approach to training and handling horses that advocates see as better than traditional methods. In speaking about their horses, NH enthusiasts move between two registers: On one hand, they use a quasi-scientific narrative, relying on terms and ideas drawn from ethology, to explain the instinctive behavior of horses. Within this mode of narrative, the horse is "other" and must be understood through the human learning (...) to communicate and through appropriate training. On the other hand, NH enthusiasts—like many horse owners—seek to emphasize partnership. In this type of discourse, people portray their horses as almost human. The tensions between these two ways of talking about horses reflect contradictory ideas about control versus freedom in relating to horses, especially as related to emotions expressed by caregivers about their relationships with horses. (shrink)

Originally published in 1970 this title commemorates the men and ideas that started, inspired and established a pioneer institution in British psychiatry. Based on the impetus of Freudian and related innovations after the First World War, the Tavistock Clinic offered treatment, training and research facilities in the field of neurosis, child guidance and later on group relations. Dr Dicks, who had been associated for nearly forty years with the work and personalities that helped to develop the Tavistock venture, describes (...) the struggles and capacity for survival of the clinic. He shows how, belonging neither to the older classical psychiatry nor to orthodox psychoanalysis, and suspect to both, the Clinic nevertheless became increasingly used by the rest of the profession as a psychotherapeutic resource. Dr Dicks describes the influence of the Tavistock on the medical, psychological and social work scene both before and after the Second World War, and assesses its achievements as a centre of psycho- and socio-dynamic thinking. The Tavistock is shown as a pioneer _sui generis_, launching psychosomatic research and initiating the exciting ventures in social psychiatry associated with the Army in the Second World War. As the Tavistock was the outcome of work with shell-shock victims in the first war, so its offspring, the Institute of Human Relations, was the natural continuation of the military effort in man-management, morale and group dynamic studies. The book includes an account of the inter-relationship between the Clinic, now part of the National Health Service, and the Institute, a private corporation. Still going strong as part of the Tavistock and Portman NHS Foundation Trust today this is an opportunity to revisit its early history. (shrink)

This book explores two public sector scandals in the UK, drawing on Max Weber's thought on 'the iron cage' to understand how these cases of patient-neglect in NHS hospitals and failures by police and social workers to address the organised sexual exploitation of young girls occurred. Through examination of the management failures and institutional vulnerabilities, and with attention to the trends of bureaucratisation and rationalisation that characterised both scandals, it reveals the explanatory power of Weber's thought, developing a theoretical model (...) that updates and extends Weber's work in light of the cases discussed. Showing that ordinary people as well as ordinary people, including professionals, are still trapped in the 'iron cage', it will appeal to scholars of sociology and social theory, as well as those providing training and working within the caring and service professions of policing, social work and nursing. (shrink)

This paper examines the rise of what is popularly called "natural horsemanship" , as a definitive cultural change within the horse industry. Practitioners are often evangelical about their methods, portraying NH as a radical departure from traditional methods. In doing so, they create a clear demarcation from the practices and beliefs of the conventional horse-world. Only NH, advocates argue, properly understands the horse. Dissenters, however, contest the benefits to horses as well as the reliance in NH on disputed concepts of (...) the natural. Advocates, furthermore, sought to rename technologies associated with riding while simultaneously condemning technologies used in conventional training . These contested differences create boundaries and enact social inclusion and exclusion, which the paper explores. For horses, the impact of NH is ambiguous: Depending on practitioners, effects could be good or bad. However, for the people involved, NH presents a radical change—which they see as offering markedly better ways of relating to horses and a more inclusive social milieu. (shrink)

How nursing as a profession is valued may be changing and needs to be explored and understood in a global context. We draw on data from two empirical studies to illustrate our argument. The first study explored the value of nursing globally, the second investigated the experiences of overseas trained nurses recruited to work in a migrant capacity in the UK health care workforce. The indications are that nurses perceive themselves as devalued socially, and that other health care professionals do (...) not give nursing the same status as other, socially more prestigious professions, such as medicine. Organizational and management structures within the NHS and the independent care home sector devalue overseas nurses and the contribution they make to health care. Our conclusions lead us to question the accepted sociocultural value of the global nursing workforce and its perceived contribution to global health care, and to consider two ethical frameworks from which these issues could be discussed further. (shrink)

In this article it is argued that there are barriers to effective and non-discriminatory practice when mentoring overseas nurses within the National Health Service (NHS) and the care home sector. These include a lack of awareness about how cultural differences affect mentoring and learning for overseas nurses during their period of supervised practice prior to registration with the UK Nursing and Midwifery Council. These barriers may demonstrate a lack of effective teaching of ethical practice in the context of cultural diversity (...) in health care. This argument is supported by empirical data from a national study. Interviews were undertaken with 93 overseas nurses and 24 national and 13 local managers and mentors from six research sites involving UK health care employers in the NHS and independent sectors in different regions of the UK. The data collected showed that overseas nurses are discriminated against in their learning by poor mentoring practices; equally, from these data, it appears that mentors are ill-equipped by existing mentor preparation programmes to mentor overseas-trained nurses from culturally diverse backgrounds. Recommendations are made for improving mentoring programmes to address mentors’ ability to facilitate learning in a culturally diverse workplace and thereby improve overseas nurses’ experiences of their supervised practice. (shrink)

Originally published in 1970 this title commemorates the men and ideas that started, inspired and established a pioneer institution in British psychiatry. Based on the impetus of Freudian and related innovations after the First World War, the Tavistock Clinic offered treatment, training and research facilities in the field of neurosis, child guidance and later on group relations. Dr Dicks, who had been associated for nearly forty years with the work and personalities that helped to develop the Tavistock venture, describes (...) the struggles and capacity for survival of the clinic. He shows how, belonging neither to the older classical psychiatry nor to orthodox psychoanalysis, and suspect to both, the Clinic nevertheless became increasingly used by the rest of the profession as a psychotherapeutic resource. Dr Dicks describes the influence of the Tavistock on the medical, psychological and social work scene both before and after the Second World War, and assesses its achievements as a centre of psycho- and socio-dynamic thinking. The Tavistock is shown as a pioneer _sui generis_, launching psychosomatic research and initiating the exciting ventures in social psychiatry associated with the Army in the Second World War. As the Tavistock was the outcome of work with shell-shock victims in the first war, so its offspring, the Institute of Human Relations, was the natural continuation of the military effort in man-management, morale and group dynamic studies. The book includes an account of the inter-relationship between the Clinic, now part of the National Health Service, and the Institute, a private corporation. Still going strong as part of the Tavistock and Portman NHS Foundation Trust today this is an opportunity to revisit its early history. (shrink)

Many western industrialized countries are currently suffering from a crisis in health human resources, one that involves a debate over the recruitment and licensing of foreign-trained doctors and nurses. The intense public policy interest in foreign-trained medical personnel, however, is not new. During the 1960s, western countries revised their immigration policies to focus on highly-trained professionals. During the following decade, hundreds of thousands of health care practitioners migrated from poorer jurisdictions to western industrialized countries to solve what were then deemed (...) to be national doctor and nursing 'shortages' in the developed world. Migration plummeted in the 1980s and 1990s only to re-emerge in the last decade as an important debate in global health care policy and ethics. This paper will examine the historical antecedents to this ethical debate. It will trace the early articulation of the idea of a 'brain drain', one that emerged from the loss of NHS doctors to other western jurisdictions in the 1950s and 1960s. Only over time did the discussion turn to the 'manpower' losses of 'third world countries', but the inability to track physician migration, amongst other variables, muted any concerted ethical debate. By contrast, the last decade's literature has witnessed a dramatically different ethical framework, informed by globalization, the rise of South Africa as a source donor country, and the ongoing catastrophe of the AIDS epidemic. Unlike the literature of the early 1970s, recent scholarship has focussed on a new framework of global ethics. (shrink)

When the state buys and then provides to the citizens goods and services, the state may certainly choose to audit, independently and comprehensively, the quality of the goods and services so provided, particularly when citizens are reporting back that the goods or services are causing unwanted, deleterious effects. This principle applies to intellectual property -- information -- education -- as well as to other goods and services. In particular, it applies to the theory of evolution as taught by the state (...) in its schools, colleges, and universities. A substantial public has long expressed concern; and the state may properly respond to that concern. Naturally, the state would never allow the vendor of goods and services to dictate that only its employees, or others whom it effectively controls, may be allowed to conduct audits. Indeed, persons substantially subject to the control of the vendor are the last possible choices to serve as independent auditors. The conflict-of-interest is well-recognized regarding information and opinion services: a huge problem arose with the big national auditing firms when they also established management consulting divisions -- the auditors tended to report favorably about companies and projects on which their own management consultants were involved. Yet the science community quite bluntly and openly proclaims that only its members -- persons it controls -- may function as auditors of the quality of scientific statements and propositions. They do this by asserting that only scientists may declare what is, or is not, scientific. Now it may be true that within any company, only employees of that company may properly develop the products that the company sells, and only they may deliver the company's statements regarding the quality of its own products. But when a company sells its products outside of itself, to others, such as the government, it may not impose as a condition of sale that only its employees may continue to render opinions about the quality of the product. When the science community actively urges the government to take-up and re-distribute its product, it necessarily surrenders any claim to a monopoly over auditing the product. A difficulty of conducting truly independent audits of science product vended to the government for delivery to the people lies in the fact that to-date, there is no systematic program of developing and training people to serve as such independent auditors. The closest group of people to rely on for this would be lawyers who, in litigation, have developed the ability to cross-examine expert witnesses in cases such as patent cases, or product-liability cases, or other litigations that involve expert testimony in advanced academic fields. This paper outlines a program by which states can conduct appropriate independent audits of evolution as vended to the state by the science community. (shrink)

Background: Black, Asian and minority ethnic groups have a high need for organ transplantation but deceased donation is low. This restricts the availability of well-matched organs and results in relatively long waiting times for transplantation, with increased mortality risks. Objective: To identify barriers to organ donor registration and family consent among the BAME population, and to develop and evaluate a training intervention to enhance communication with ethnic minority families and identify impacts on family consent. Methods: Three-phase programme comprising community-based (...) research involving two systematic reviews examining attitudes and barriers to organ donation and effective interventions followed by 22 focus groups with minority ethnic groups; hospital-based research examining staff practices and influences on family consent through ethics discussion groups with staff, a study on intensive care units and interviews with bereaved ethnic minority families; and development and evaluation of a training package to enhance cultural competence among ICU staff. Setting: Community focus group study in eight London boroughs with high prevalence of ethnic minority populations. Hospital studies at five NHS hospital trusts. Participants: Community studies: 228 focus group participants; hospital studies: 35 nurses, 28 clinicians, 19 hospital chaplains, 25 members of local Organ Donation Committees, 17 bereaved family members; and evaluation: 66 health professionals. Data sources: Focus groups with community residents, systematic reviews, qualitative interviews and observation in ICUs, EDGs with ICU staff, bereaved family interviews and questionnaires for trial evaluation. Review methods: Systematic review and narrative synthesis. Results: Community studies: Organ Donor Register – different ethnic/faith and age groups were at varying points on the ‘pathway’ to organ donor registration, with large numbers lacking knowledge and remaining at a pre-contemplation stage. Key attitudinal barriers were uncertainties regarding religious permissibility, bodily concerns, lack of trust in health professionals and little priority given to registration, with the varying significance of these factors varying by ethnicity/faith and age. National campaigns focusing on ethnic minorities have had limited impact, whereas characteristics of effective educational interventions are being conducted in a familiar environment; addressing the groups’ particular concerns; delivery by trained members of the lay community; and providing immediate access to registration. Interventions are also required to target those at specific stages of the donation pathway. Hospital studies: family consent to donation – many ICU staff, especially junior nurses, described a lack of confidence in communication and supporting ethnic minority families, often reflecting differences in emotional expression, faith and cultural beliefs, and language difficulties. The continuing high proportion of family donation discussions that take place without the collaboration of a specialist nurse for organ donation reflected consultants’ views of their own role in family consent to donation, a lack of trust in SNODs and uncertainties surrounding controlled donations after circulatory death. Hospital chaplains differed in their involvement in ICUs, reflecting their availability/employment status, personal interests and the practices of ICU staff. Evaluation: professional development package – a digital versatile disk-based training package was developed to promote confidence and skills in cross-cultural communication. Initial evaluation produced positive feedback and significant affirmative attitudinal change but no significant difference in consent rate over the short follow-up period with requirements for longer-term evaluation. Limitations: Participants in the focus group study were mainly first-generation migrants of manual socioeconomic groups. It was not permitted to identify non-consenting families for interview with data regarding the consent process were therefore limited to consenting families. Conclusions: The research presents guidance for the effective targeting of donation campaigns focusing on minority ethnic groups and provides the first training package in cultural competence in the NHS. Future work: Greater evaluation is required of community interventions in the UK to enhance knowledge of effective practice and analysis of the experiences of non-consenting ethnic minority families. Funding: The National Institute for Health Research Programme Grants for Applied Research programme. (shrink)

Futsal is a sport that presents alternation of high- and low-intensity moments, which lacks investigations regarding the effects of the organization of the training load on biomotor skills. In this sense, this study aims to verify the monitoring of the training load throughout the season and the behavior of biomotor skills in futsal athletes. Twelve futsal athletes from the adult category, who competed in the first division of the Paulista championship, participated in the study. Throughout the season, (...) the internal training load was calculated, through the relationship between volume and the rate of perceived exertion, monotony, and training strain. The training periods were divided into preparatory, competitive, and competitive II for a total of four moments of evaluation: M1: at the beginning of the preparatory period; M2: 50 week, at the end of the preparatory period; M3: 13th week, in the middle of the competitive period; and M4: at the start of the competitive period II. The tests used were: Power of lower limbs: countermovement jump ; Displacement speed, over the 10-meter distance, and Aerobic power by the Carminatti test. The variables analyzed were compared at different moments of evaluation using the two-way ANOVA completed by the Bonferroni test. For monotony, training strain, and ILT, the ANOVA ONE-WAY test was used between the evaluation periods completed by the Bonferroni test. The significance value adopted was p < 0.05. A significant improvement was observed in the power of lower limbs from M1 to M3, from M2 to M3, and from M1 to M4. Aerobic power showed a significant increase from M1 to M3 and from M1 to M4. The ITL showed a difference between competitive I and II in relation to the preparatory period. In conclusion, the proposed training organization was sufficient to improve the power of the lower limbs and the aerobic power. (shrink)

Complementary and alternative therapiesThere has long been debate about the degree to which conventional health professionals should work closely with complementary and alternative medicine practitioners, if patients choose treatment from both. Some doctors are trained in conventional and alternative therapies but often, liaison depends on the type of therapy, whether it is regulated by law and whether it supplements conventional methods of diagnosis and treatment or claims to provide an alternative to them. Among the therapies often used by patients to (...) supplement conventional medicine, but which do not claim to have a diagnostic purpose, are aromatherapy, massage, stress therapy, reflexology and hypnotherapy. Chinese medicine and homoeopathy are among those which are not statutorily regulated but claim to provide diagnosis and treatment. Practitioners of conventional medicine are often wary of unregulated treatments that supplant evidence-based therapy—even though not all conventional medicine has been proven by randomised controlled trials.The role of complementary and alternative therapies came under scrutiny in England in February 2010 when the Parliamentary Science and Technology Committee published a critical report on NHS funding for homoeopathy. 1 Focusing on whether government policy on homoeopathy was evidence-based, the Committee found a mismatch between the evidence and policy. Its main conclusion was that the evidence indicates that homoeopathy is not efficacious and does not produce results beyond the placebo effect. The Committee said that explanations for why homoeopathy was thought to work were implausible and that further homoeopathic clinical trials could not be justified. The amount that the NHS actually spends on homoeopathic therapies was left unclear and was subject to varying claims from the Society of Homoeopaths and the Health Minister.2 The Parliamentary report recommended that there should be a clear policy on prescribing placebos, including homoeopathic medicines, but the government has been …. (shrink)

Recently, scholars have begun to shift focus toward the effectiveness of different teaching methods for entrepreneurship education. However, the establishment of a unified and clear standard for the division of entrepreneurship educational methods remains unfulfilled, affecting the accuracy of research conclusions. In the present study, for the first time, the aim was to divide the entrepreneurship educational method into the classroom teaching method and the extracurricular activity method from the perspective of competency level training. On the basis of (...) the modified planning behavior theory, the influence of entrepreneurship education on entrepreneurial intention was explored. In the present study, 514 college students of 14 universities in China were surveyed. The results reveal that the CTM and EAM had a direct positive bearing on EI, with indirect impact exerted by attitude toward entrepreneurship and perceived behavioral control. Although the direct effects of the two teaching methods were similar, EAM could effectively improve ATE and PBC, thereby resulting in a positive effect on EI to a greater extent. Further observations were made that the participation of research University students in CTM was significantly lower than that of applied University students, leading to lower EI. Additionally, higher EI could be attributed to the more active participation in EAM of male students than female students, while no significant difference was indicated between different majors in EI. The results are of significant reference value for promoting the reform of entrepreneurship education and improving the quality of entrepreneurship education in colleges and universities. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.2 (2004) 165-173 [Access article in PDF] Professional Judgment, Critical Realism, Real People, and, Yes, Two Wrongs Can Make a Right! K.W.M. Fulford Anthony Colombo Keywords values, values-based practice, models of disorder, concept of mental illness, user-centred practice, patient-centred practice, multidisciplinary teamwork We are grateful to our four commentators for putting much-needed conceptual air and space around the models project. Published originally as an empirical (...) study of the different implicit models of disorder, held by users of services, carers, nurses, psychiatrists, and social workers (Colombo et al. 2003), our paper outlined the philosophical roots of the models project in linguistic analytic philosophy of the "Oxford school" (Fulford and Colombo 2004). Our four commentators provide extra dimensions of understanding, respectively from professional education (Williams 2004), sociology (Bendelow 2004), Heideggerian phenomenology (Heginbotham 2004), and mental health policy and practice (Williamson 2004).Since the original study, the models project has been taken forward as a key contribution to a range of philosophy-into-practice initiatives called, collectively, Values-Based Practice. In this brief response, we outline the key features of Values-Based Practice and indicate how these connect with some of the many thoughtful points about models made by our commentators. Values-Based Practice Values-Based Practice, then, is the theory and skills-base for effective health care decision making where different, and hence potentially conflicting, values are in play (Fulford 2004). Premised on the democratic meta-value of equal respect for all voices, Values-Based Practice relies, much as a political democracy relies, on good process rather than preset outcomes for its practical effectiveness. The ten pointers to good process in Values-Based Practice are summarized in Figure 1. We return to the implications of these for the work on models below.Relying on good process may be thought to be a recipe more for relativism and indecision in clinical decision making than for practical effectiveness. To the contrary, however, the 'values democracy' of Values-Based Practice, again like a political democracy, carries a number of clear and coherent implications for policy and practice in health care. [End Page 165] Click for larger viewFigure 1 10 Pointers to Good Process in VBP [End Page 166]Examples of the implications of Values-Based Practice for policy and practice are given in the Values Framework shown in Figure 2. This is a policy framework for the development of Values-Based Practice in mental health produced by a project group in the National Institute for Mental Health in England (NIMHE), the section of the UK's National Health Service (NHS) responsible for implementing government policy on mental health as embodied in the National Service Framework for Mental Health (Department of Health 1999) and subsequent policies. The framework gives three key principles of Values-Based Practice (the three Rs of recognition, raising awareness, and respect) and then summarizes some of the specific implications of the approach. Racism, for example, is incompatible with Values-Based Practice because racism is by definition intolerant of diversity. Again, we indicate some of the policy implications of Values-Based Practice for the points about models made by our commentators below.Training for mental health practitioners in Values-Based Practice will be rolled out from April 2005, through both voluntary and statutory bodies, in each of the eight regions of the National Health Service of England and Wales. This roll out will be supported by training methods developed and piloted in a unique joint venture between Warwick University's Department of Philosophy and Medical School, and an in-service training provider, the Sainsbury Centre for Mental Health (Fulford, Williamson, and Woodbridge 2002; Woodbridge and Fulford 2003). These training methods are the basis of a detailed workbook for Values-Based Practice (Woodbridge and Fulford 2004). The workbook will be launched in July 2004 at a conference in London by the Minister of State with responsibility for mental health, Rosie Winterton. Professional Training and Professional Judgment The models project has been central to the development of... (shrink)

Publicity for (and laterly increased economic stringency which makes more likely), failures of care in the NHS engender concern for care quality while its assurance remains the subject of a fragmented and unhelpful literature. A selective attempt is made to examine some underlying principles by posing and answering three questions. What is the quality of care? What basic principles must be followed in defining `standards'? How then may quality be assured? Any definition of care must be multi-faceted and in common (...) use pervaded with the patients' pre-occupation with a search for cures. Nevertheless, it is argued that there are gains in restricting the technical use of the term `care' to those systematic processes of health services and their culture which impinge on the personal experience of patients and which fashion their response. In contemporary society care ought to be designed to restore and enhance the independence, dignity and choice of the patient. Although there is a contrary tendency to abandon problems of care to the professionals, standards for care should be judged ultimately not from the specialised professional but from the viewpoint of lay people whose behaviour in the outside world fashions those norms by which independence, dignity and choice are judged. A number of difficulties in identifying and securing improvements in care are discussed. In particular, it is argued that such is the interdependence of the style of management of an institution and the style of care it provides that enforcement of high quality care is likley to be a contradiction in terms. Only trained and sensitive staff can act intuitively and pre-emptively to prevent even incipient deterioration in care. They cannot carefully foster at all times the independence and dignity of their patients unless they are treated in a similar way as professional employees. As an initial step in improving the quality of care a simple start is urged upon implementing an inventory of checks. These are designed to establish the identification and operation of health care policies and practices which give appropriate recognition to the characteristics of care that patients and public expect, coming as they do from a lay rather than professional world. The article concludes with an appropriate inventory of questions to be put to professionals by those laymen who are increasingly imported into health care management through community representation (in CHCs) and staff participation (in joint consultation) and whose interest and concern should be harnessed appropriately. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Philosophy of Simone de Beauvoir: Gendered Phenomenologıes, Erotic Generosities by Debra B. Bergoffen, Sex and Existence: Simone de Beauvoir’s ‘The Second Sex’ by Eva Lundgren-Gothlin, Beauvoir and The Second Sex: Feminism, Race, and the Origins of Existentialism by Margaret A. Simons, Philosophy as Passion: The Thinking of Simone de Beauvoir by Karen VintgesNancy BauerDebra B. Bergoffen. The Philosophy of Simone de Beauvoir: Gendered Phenomenologıes, Erotic Generosities. Albany: (...) State University of New York Press, 1997. Pp. x + 250. Cloth, $54.50.Eva Lundgren-Gothlin. Sex and Existence: Simone de Beauvoir’s ‘The Second Sex.’ Hanover, NH: Wesleyan University Press and University Press of New England, 1996. Pp. xii + 329. Paper, $19.95.Margaret A. Simons. Beauvoir and The Second Sex: Feminism, Race, and the Origins of Existentialism. Lanham, MD: Rowman & Littlefield, 1999. Pp. xx + 263. Cloth, $25.95.Karen Vintges, Philosophy as Passion: The Thinking of Simone de Beauvoir. Bloomington: Indiana University Press, 1996. Pp. xii + 202. Paper, $19.95.Anyone who is seriously interested in Simone de Beauvoir’s place in the history of philosophy must contend sooner or later with the fact that she denied, repeatedly and vehemently throughout her lifetime, that she was a philosopher. Of course, a certain species of Beauvoir-detractor will be tempted to take these denials at face value, especially since they almost always went hand in hand with Beauvoir’s plausible-sounding [End Page 688] declarations that anything philosophical about her work could be traced to the thinking of her lifelong companion Jean-Paul Sartre, who, she underscored, was the “real” philosopher in their relationship. But the very strength and frequency of her abjurations of the title of philosopher is a sign that, like Freud, Beauvoir (who wrote several straightforwardly philosophical essays, including the monograph-length Ethics of Ambiguity and Pyrrhus et Cınéas) was motivated not so much by modesty or self-abnegation but by a desire to distance herself from what counted, at least in the middle of this century, as philosophy.For most of the past 50 years, English-speaking readers of Beauvoir have simply accepted her portrayal of her relationship to philosophy. On the ordinary view, The Second Sex, while an important historical touchstone for “feminist theory” is not, or not quite, a philosophical piece of writing, and those of her publications that merit that title are mere apologetics for Sartrean existentialism. But in the years since Beauvoir’s death in 1986 allowed for the release of her voluminous and revealing letters to Sartre, more and more feminist philosophers have been taking a second look at The Second Sex and Beauvoir’s other essays and fiction as they try to engage productively both with non-academic feminist work and with the philosophical mainstream. As a result, the difficult question of just how to assess Beauvoir’s relationship both to philosophy in general and to Sartre in particular has become pressing and is at the center of the four books under review here.The authors of these books are each committed, in their own sometimes strikingly different ways, to two theses: first, that to understand Beauvoir’s place in the history of philosophy one must study her appropriations of the work of philosophers other than just Sartre and, second, that at the heart of Beauvoir’s enterprise in all of her work is a desire to think about how to create and sustain reciprocity between an existentially committed self and an equally autonomous other.The most historically oriented and, on my view, meticulous exploration of Beauvoir’s relationship to her philosophical influences is Lundgren-Gothlin’s superb Sex and Exıstence, which chronicles Beauvoir’s indebtedness to and interest in, especially, Hegel and Marx. Lundgren-Gothlin, a philosophically trained Swedish intellectual historian, shows decisively that one cannot make philosophical sense of The Second Sex as long as one reduces its philosophical dimension to boilerplate Sartreanism. Indeed, given Sartre’s antipathy toward Marx and his ambivalence about Hegel in Beıng and Nothingness, Lundgren-Gothlin’s work raises serious questions about the extent to which Beauvoir’s considered views in The Second Sex are even compatible with those of the early... (shrink)

Objective: To determine the practice in UK hospitals regarding the level of patient involvement and consent when representatives of commercial surgical device manufacturers attend and advise during operations.Methods: An anonymous postal questionnaire was sent to the senior nurse in charge in all 236 UK gynaecology theatres in 2004. 79/236 replies were received.Results: Operating departments were visited every 2 weeks on average by a representative of the surgical device manufacturer. Actual operations were attended every 10 weeks, although there was much variation. (...) 33/79 units consistently obtained patient consent for visits, usually orally, whereas 40/79 units did not. 65/79 units had no guidelines for surgical device representative visits. 91% of nurses in charge believed that there should be guidelines to protect both patients and staff. 6/79 units were preparing local guidelines at the time of the survey.Conclusions: Currently, patient safety, confidentiality and autonomy are being protected by a minority of NHS operating theatres when surgical device representatives attend surgery. National guidelines would hopefully ensure that fully informed patient consent is obtained and that representatives are fully trained and supervised. (shrink)

Compared with the large number of studies on reading of children with hearing loss in alphabetic languages, there are only a very limited number of studies on reading of Chinese-speaking children with HL. It remains unclear how phonological, orthographic, and semantic skills contribute to reading fluency of Chinese school-age children with HL. The present study explored this issue by examining the performances of children with HL on reading fluency and three linguistic skills compared with matched controls with normal hearing. Specifically, (...) twenty-eight children with HL and 28 chronological-age-matched children with NH were tested on word/sentence reading fluency, phonological awareness which was composed of onset/vowel/lexical tone awareness, orthographic knowledge, and semantic competence which comprised animal word identification, pseudo-homophone detection, and word segmentation. Results showed that children with HL lagged behind their peers with NH in WRF/SRF and most of the phonological, orthographic, and semantic subskills except onset awareness and pseudo-homophone detection. Furthermore, the significant contributors to WRF differed between the two groups with PA being the significant contributor in the children with NH while OK being the significant contributor in the children with HL. However, the significant contributor to SRF did not differ between the two groups with SC being the only significant contributor. These results revealed not only between-group differences but also similarities in the relative contributions of PA, OK, and SC to reading fluency at both word and sentence levels, which has practical implications for developing better training programs to improve reading for children with HL. (shrink)

How can controversy promote mutual respect in analytical psychology? Analytical psychology is a broad church, and influences areas such as literature, cultural studies, and religion. However, in common with psychoanalysis, there are many different schools of thought and practice which have resulted in divisions within the field. _Controversies in Analytical Psychology_ picks up on these and explores many of the most hotly contested issues in and around analytical psychology. A group of leading international Jungian authors have contributed papers from contrasting (...) perspectives on a series of key controversies. Some of these concern clinical issues such as what helps patients get better, or how closely analysts should work with the transference. Other contributions focus on the relationship between analytical psychology and other disciplines including evolutionary theory, linguistics, politics and religion. A critical eye is cast over Jungian theories and practices, and a number of questions are raised: * are they homophobic? * do they denigrate women? * do they confuse absolute with narrative truth? * are the frequency of sessions chosen for political rather than clinical reasons? _Controversies in Analytical Psychology_ encourages critical thinking on a variety of issues, helping foster dialogue and investigation in a climate of mutual respect and understanding. It will be invaluable for Jungian analysts and psychoanalysts in training and practice and psychotherapists. (shrink)

The Arab and Islamic world is in cultural, political and ethical flux. Pressures of globalisation contend with ancient ideas and concepts that permeate cultural frameworks. Health professionals are among the many groups battling to accommodate the rapidly changing conditions. In many predominantly Muslim countries intense debates are underway among clinicians about the impact of the forces of change on their practices. To help understand these forces we conducted a study of the experiences of clinicians in the Hashemite Kingdom of Jordan, (...) a Middle Eastern nation state where the overwhelming majority of the population is Muslim. The sample contained 508 doctors and doctors-in-training, of whom 63% were male and 80% were younger than 40 years of age. It included both a quantitative survey, covering a wide range of issues, and qualitative, free-text written responses. Our results demonstrated high levels of disquiet related to the overall organisation and administration of the health care system, the specific content of ethical decisionmaking, and the impact of changing social, cultural and religious factors. Concerns included overcrowding, widespread corruption and hierarchical, non- democratic, management practices, and tensions relating to traditional and modern approaches to ethics, especially in relation to consent, organ donation, confidentiality, privacy, abortion, and the role of women. The roles of religion and religious authorities, the relative importance of the family, and community and tribal obligations were also areas of contention. The study exposes profound divisions and widely differing perspectives among Jordanian doctors and an abiding sense of uncertainty and instability within the profession. Many doctors express ambivalence in relation to both modern trends and traditional precepts. Three main axes of ethical contention were demonstrated, relating to the tensions between: "conservative" and "pragmatic" styles of decision-making; "traditional" approaches and internationalised standards of ethics; and the role of Islam and pressures to disengage ethical decision- making from religious authority. We speculate that these issues and divisions, and the deep sense of disquiet revealed by our data reflect large-scale forces to which Jordanian society is exposed and to a substantial degree may provide a way to understand the ethical predicament of many other countries in the contemporary Arab world. (shrink)

-/- Following the Mental Capacity Act (MCA) becoming law in 2005, and prior to its coming into force in 2007, there was a sustained effort to train support staff in the many social care settings where this new law was applicable. This training drive was necessary because, prior to the MCA, mental capacity law had evolved in the courts through consideration of a small number of cases that concerned serious medical treatments. These included the withdrawal of artificial nutrition and (...) hydration (Airedale NHS Trust v. Bland [1993]), blood transfusion (Re T [1993]), tissue donation (Re Y [1997]) and the provision of experimental medication for terminal illness (Simms v. Simms and another (2003)). In line with the Law Commission’s recommendations, the MCA extended the application of the law to ‘all acts in connection with care or treatment’ (MCA, Section 5), meaning that, overnight, social care settings and informal family care environments immediately fell within the scope of the legislation. (shrink)

The application of recycled aggregate as a sustainable material in construction projects is considered a promising approach to decrease the carbon footprint of concrete structures. Prediction of compressive strength of environmentally friendly concrete containing recycled aggregate is important for understanding sustainable structures’ concrete behaviour. In this research, the capability of the deep learning neural network approach is examined on the simulation of CS of EF concrete. The developed approach is compared to the well-known artificial intelligence approaches named multivariate adaptive regression (...) spline, extreme learning machines, and random forests. The dataset was divided into three scenarios 70%-30%, 80%-20%, and 90%-10% for training/testing to explore the impact of data division percentage on the capacity of the developed AI model. Extreme gradient boosting was integrated with the developed AI models to select the influencing variables on the CS prediction. Several statistical measures and graphical methods were generated to evaluate the efficiency of the presented models. In this regard, the results confirmed that the DLNN model attained the highest value of prediction performance with minimal root mean squared error. The study revealed that the highest prediction performance could be attained by increasing the number of variables in the prediction problem and using 90%-10% data division. The results demonstrated the robustness of the DLNN model over the other AI models in handling the complex behaviour of concrete. Due to the high accuracy of the DLNN model, the developed method can be used as a practical approach for future use of CS prediction of EF concrete. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:HUMAN NATURE AND POLITICS: A MIMETIC READING OF CRISIS AND CONFLICT IN THE WORK OF NICCOLÒ MACHIAVELLI 1 Harald Wydra Universität Regensberg Perhaps more than any other political philosopher2, Machiavelli's writings have given rise to extremely controversial and emotionally charged interpretations.3 Ifone were to pinpoint the guiding lines ofdispute in Machiavelli scholarship, one could argue that his "foes" are convinced of his amorality and the tyrannical bias, while his (...) "friends" stress the liberal and republican basis ofhis teaching. This debate between good and the evil in Machiavelli's teaching has accompanied the conflict on the tyrannical and the republican character of his work ever since.4 While the essence of his prescriptions continues to be contested, most interpreters concur on Machiavelli 's realism or political pragmatism defined in The Prince 25 as effectual 1 I am grateful to Anthony J. Parel, Arpad Szakolczai, and AdolfTrägler for comments on an earlier draft of this essay. 2Perhaps with the exception of Marx who shares with Machiavelli the heritage of an inflationary and contentious scholarship. Despite this resemblance, there are fundamental differences when it comes to declare oneself a follower of Machiavelli or follower of Marx. See Aron (256-259). 3In his extensive overview, Berlin estimates the totality of the bibliography at more than 3,000 titles. Needless to say that is has considerably increased since then. The recent wave of new translations into English (Mansfield and Tarcov, or Codevilla) and several new approaches provide for the richness of debate. This debate sometimes acquires a heated intensity, such as in the exchange on Strauss's Machiavelli between Mansfield and Pocock in Political Theory, 3:4 (1975), 372-405. 4See for a recent update the introduction to a new translation ofthe Discourses in Mansfield and Tarcov. Harald Wydra37 truth (verità ejfetuale). In this stress on factual reality as opposed to imagination many have seen the sources of Machiavelli's advocacy of technicity, rationality and reason of state. Such a viewpoint is supported by Machiavelli's pure and emotionless style ofwriting. Machiavelli's effectual truth is essentially about the mastery over conflict and contingency in politics. Yet, there are hardly systematic studies on the status and role ofpolitical conflict and its consequences for political order in Machiavelli's work.5 Most classical studies include analysis of conflict (Pocock; Lefort; Sasso), but they do so by sticking to the natural textual division ofhis major works. This article sets out to elaborate some guidelines ofa Machiavellian theory ofconflict by linking it to René Girard's theory of mimetic conflict. It aims to achieve two things: first, to analyze the nature of political conflict in Machiavelli's work. Second, to reexamine some widespread assumption on the autonomy of politics. The Affinity of Machiavelli and Girard: Crisis and Conflict Methodologically, a reading ofMachiavelli through Girard has a status different from that of orthodox comparisons oftwo thinkers.6 This can be illustrated by considering Raymond Aron's comparison between Machiavelli and Marx. On the one hand, Machiavelli's political philosophy is marked by a stress on cyclical repetition and permanent instability. His realism maintains that the more things change the more they remain the same. On the other hand, Marx's economic philosophy of history envisages long-term progress and as such reflects upon change by its confidence in Providence. Yet, essentially both works are concerned with the contingent modalities of collective conflict over time. While for Machiavelli the struggle for power unfolds between political groups such as nobles and the people, Marx suggests the social and economic roots ofconflicts in social formations. Against this background, a reading of Machiavelli through Girard diverges from conventional comparisons. Machiavelli's work emanates from his experience as a practitioner ofpolitics who aims to be the counsellor of Princes. A trained historian and literary critic, Girard analyzes fundamental 5To my knowledge, by far the most balanced and detailed treatment is given by Sasso. For a thematic treatment of civil discord, see also Bock. 60ne can mention Raymond Aron's two fine essays "La comparaison de Machiavel et Pareto" (Aron 86-109) and "Machiavel et Marx" published in Italian in the first edition of Machiavelli's Principe (1975) and again in... (shrink)

Great Britain subjugated colonists using various power strategies, including dehumanization, misinformation, fear, and other divisive strategies. The Founders described these oppressive strategies as “a long train of abuses and usurpations.” Throughout the Declaration of Independence and the U.S. Constitution, the Founding Fathers imbued the people with hope in a government for the people: one unlike that of the monarchy, which sought to protect itself at the expense of colonists. As a result, the Founders created a government more likely to lead (...) with fairness, demonstrate respect for human dignity, unite Americans as one people, empower citizens through hope, and lead the nation toward security. This socio-ethical framework was an abductive discovery nested within a grounded theory study where it had been concluded that the first principles of democracy were woven within the American founding documents. Using Charmaz’s constructivist grounded theory, the first principles of democracy—knowledge, fairness, human dignity, hope, unity, and security—were used to answer an emerging research question: Are there two democratic frameworks in the founding documents, and how do they differ? The first principles of democracy promote a culture of ethics, resilience, and freedom. Their empowering disposition makes them suitable as a normative framework for a democratic government for the people. (shrink)

The increasing demand for transparency in AI has recently come under scrutiny. The question is often posted in terms of “epistemic double standards”, and whether the standards for transparency in AI ought to be higher than, or equivalent to, our standards for ordinary human reasoners. I agree that the push for increased transparency in AI deserves closer examination, and that comparing these standards to our standards of transparency for other opaque systems is an appropriate starting point. I suggest that a (...) more fruitful exploration of this question will involve a different comparison class. We routinely treat judgments made by highly trained experts in specialized fields as fair or well-grounded even though—by the nature of expert/layperson division of epistemic labor—an expert will not be able to provide an explanation of the reasoning behind these judgments that makes sense to most other people. Regardless, laypeople are thought to be acting reasonably—and ethically—in deferring to the judgments of experts that concern their areas of specialization. I suggest that we reframe our question regarding the appropriate standards of transparency in AI as one that asks when, why, and to what degree it would be ethical to accept opacity in AI. I argue that our epistemic relation to certain opaque AI technology may be relevantly similar to the layperson’s epistemic relation to the expert in certain respects, such that the successful expert/layperson division of epistemic labor can serve as a blueprint for the ethical use of opaque AI. (shrink)

Thomas Henry Huxley and Charles Darwin discovered in 1857 that they had a fundamental disagreement about biological classification. Darwin believed that the natural system should express genealogy while Huxley insisted that classification must stand on its own basis, independent of evolution. Darwin used human races as a model for his view. This private and long-forgotten dispute exposes important divisions within Victorian biology. Huxley, trained in physiology and anatomy, was a professional biologist while Darwin was a gentleman naturalist. Huxley agreed with (...) John Stuart Mill's rejection of William Whewell's sympathy for Linnaeus. The naturalists William Sharp Macleay, Hugh Strickland, and George Waterhouse worked to distinguish two kinds of relationship, affinity and analogy. Darwin believed that his theory could explain the difference. Richard Owen introduced the distinction between homology and analogy to anatomists, but the word homology did not enter Darwin's vocabulary until 1848, when he used the morphological concept of archetype in his work on Cirripedia. Huxley dropped the word archetype when Richard Owen linked it to Plato's ideal forms, replacing it with common plan. When Darwin wrote in the Origin of Species that the word plan gives no explanation, he may have had Huxley in mind. Darwin's preposterous story in the Origin about a bear giving birth to a kangaroo, which he dropped in the second edition, was in fact aimed at Huxley. (shrink)