The increasing use of cluster randomised trials in low-resource settings raises unique ethical issues. The Ottawa Statement on the Ethical Design and Conduct of Cluster Randomised Trials is the first international ethical guidance document specific to cluster trials, but it is unknown if it adequately addresses issues in low-resource settings. In this paper, we seek to identify any gaps in the Ottawa Statement relevant to cluster trials conducted in low-resource settings. Our method is to analyse a prototypical cluster trial conducted (...) in a low-resource setting with the Ottawa Statement; to identify ethical issues in the design or conduct of the trial not captured adequately and to make recommendations for issues needing attention in forthcoming revisions to the Ottawa Statement. Our analysis identified six ethical aspects of cluster randomised trials in low-resource settings that require further guidance. The forthcoming revision of the Ottawa Statement should provide additional guidance on these issues: streamlining research ethics committee review for collaborating investigators who are affiliated with other institutions; the classification of lay health workers who deliver study interventions as health providers or research participants; the dilemma experienced by investigators when national standards seem to prohibit waivers of consent; the timing of gatekeeper engagement, particularly when researchers face funding constraints; providing ancillary care in health services or implementation trials when a routine care control arm is known to fall below national standards and defining vulnerable participants needing protection in low-resource settings. (shrink)

This study investigated the social factors associated with body-shape preferences for females and males as perceived by Arab women living in Qatar, and correlated the current weight status of women studied with these preferences. The subjects were 535 non-pregnant Arab women aged 20–67 years, who attended heath centres in Doha City, the capital of the State of Qatar. Illustrations of male and female body shapes ranging from very thin to very obese using the 9-figure Silhouettes scale were shown to women, (...) and they were asked to select their preferred figure. Body mass index (BMI) was used to determine the weight status of women studied. Age, educational level and employment status were found to be significantly associated with ideal body-shape preference for both males and females, whereas marital status and current weight status had no significant association. In general, the Arab women studied selected a more mid-range of body fatness for males than for females. It is concluded that attention should be given to sociocultural factors, such as body-shape preferences, in any programmes to promote ideal body weight for the public. (shrink)

Este texto recupera dos posiciones en torno al concepto de destino: la de Diego de Saavedra Fajardo y la de Plutarco. Ambos, a diferencia de algunos estoicos, sostienen que, independientemente de aquellas circunstancias que escapan a la voluntad humana, el hombre posee la capacidad para ser libre y tomar decisiones respecto de sus actos, sin que esto signifique dejar atrás el ideal del sabio. Para ellos, enfrentarse con el destino implica conocer las pasiones que se hallan inmersas en la naturaleza (...) humana, así que no las toman en un sentido negativo. Por esta razón, ambos filósofos insisten en reorientar las pasiones a través de la educación, la moral o la religión y, con ello, en dejar atrás la idea de que el hombre está determinado o bien por su propia naturaleza humana o por las circunstancias que se le presentan. De esta manera, brindan un reconocimiento esencial al ejercicio de la libertad humana. (shrink)

Martin E. Rosenberg -/- The Gift of Silence: Towards an Anthropology of Jazz Improvisation as Neuro-Resistance. -/- ABSTRACT: -/- This essay addresses how the complex processes that occur during jazz improvisation enact behaviors that resemble the logic of gift exchange first described by Marcel Mauss. It is possible to bring to bear structural, sociological, political economical, deconstructive or even ethical approaches to what constitutes gift exchange during the performance of jazz. Yet, I would like to shift from focusing this (...) analysis of jazz improvisation with reference to the language of music as symbolic action (which all of these approaches require), to grounding improvisation in embodied and distributed cognition, the performance of which begins with a ritual gift of silence. By silence, I refer to the embodied, yet shared pure duration as felt synchrony within an individual performer, that extends to the members of an ensemble. Thus, I refer to both aesthetic and micro-political implications of embodied, yet also distributed musical cognition in real time. -/- For jazz musicians, embodied silence becomes the initial condition for processes of cognitive bifurcation. For it is bifurcation that attracts us to jazz in the first place. Here I expand my previous work establishing similarities in the behavior of bifurcating systems in physical and cognitive sciences to the unfolding of ambiguity in real time during improvisation with respect to polyphony, polytonality and polyrhythms in the history of jazz from Charlie Parker to Ornette Coleman. We can therefore re-conceptualize jazz improvisation as a subversive antidote for processes of determination identified in a sub-discipline of cultural studies called “cognitive capitalism.” By examining silence from this anthropological perspective, we can conceive of jazz performance as a ritualized resistance to top-down cognitive control immanent with social and digital networks. The ritual enactment that is jazz improvisation points towards an aesthetics of bifurcation that is simultaneously a micro-politics of neuro-resistance. In other words, I argue that freedom of thought requires freedom from thought as an initial condition. -/- Yet, I emphasize the empirical rather than mystical grounds to this gift of silence. The valorization of silence by jazz musicians is not simply etiquette, an ethics of reciprocity for performers exchanging “riffs,” but an initial condition that jazz performers (and, I would argue, listeners) experience in their bodies, thus linking embodied cognition to a collective field of cultural production that emerges from each embodied individual, and yet also pervades the ensemble in ways reminiscent of feedback loops in complex systems. The recent and remarkable research on music and the brain has demonstrated that it is now possible to describe jazz improvisation as possessing both embodied and distributed cognitive properties. The emergent neuronal ensemble behavior within the individual that is visible in jazz improvisors, discovered by the neuroscientists at Johns Hopkins led by Charles Limb, bears striking resemblance to the interactive behaviors of the jazz ensemble itself. Thus, it is by recourse to recent research by myself and others into the cognitive neuroscience of music generally, and jazz improvisation specifically, that the empirical grounds for an anthropology of neuro-resistance become visible. (shrink)

Jean Ayres invented Sensory Integration for children experiencing learning and social difficulties because, according to Ayres, they could not adequately integrate information from multiple sensory modalities. She established a scientific basis for her identification of children with sensory integrative difficulties, using statistical techniques to identify symptoms and neuroscience to determine a cause. She was an unusually reflective practitioner who catalyzed a community of practice around SI without becoming a guru—indeed, she encouraged her students to come up with their own ideas (...) and test them empirically. She felt isolated from the growing field of Occupational Therapy yet is viewed as one of its greatest pioneers. After her death in 1988, the SI community gradually began to argue about fundamental issues like what should constitute an appropriate diagnosis and set of tests for SI. At present, the network is fragmented to the point where some of the opposing positions may be incommensurable with each other, which would require a trading zone. (shrink)

‘The problem with simulations is that they are doomed to succeed.’ So runs a common criticism of simulations—that they can be used to ‘prove’ anything and are thus of little or no scientific value. While this particular objection represents a minority view, especially among those who work with simulations in a scientific context, it raises a difficult question: what standards should we use to differentiate a simulation that fails from one that succeeds? In this paper we build on a structural (...) analysis of simulation developed in previous work to provide an evaluative account of the variety of ways in which simulations do fail. We expand the structural analysis in terms of the relationship between a simulation and its real-world target emphasizing the important role of aspects intended to correspond and also those specifically intended not to correspond to reality. The result is an outline both of the ways in which simulations can fail and the scientific importance of those various forms of failure. (shrink)

The patient-physician relationship, as formulated in the traditional biomedical model of medicine, is inherently flawed. In entering this relationship, most patients seek simply to be delivered from illness back to normal psychosocial functioning. The physician, however, almost invariably responds with a purely biologic approach to diagnosis and treatment that often does not effectively address the patient's needs. This precludes the opportunity for a consensus between them, and may in fact lead to the physician manipulating the patient's decisions about the course (...) of therapy. The relationship should be reshaped within a new scientific model of patient care that combines the biomedical analysis of disease with an empathic understanding of the patient's illness experience. Truly informed consent is viewed as a natural outcome of the application of this more comprehensive framework. (shrink)

Their general theme might be taken as, "What is the way which man ought to choose for himself?" The debate they encourage by these stimulating and frank contributions will be welcomed by those of all faiths and traditions interested in the quality of our society.

O livro em questão, O Pecado: do descrédito ao aprofundamento, é uma bela obra para pesquisa, estudo e ensino. O autor, além de denunciar o pecado, mostra caminhos de conversão e aponta valores que possam remir do pecado qualquer ser humano, independente de raça, crença, posição social ou religiosa.

Identity politics and citizenship are often envisaged in dichotomous terms, but cosmopolitan theorists believe commitments to “thin” universal values can be generated from divergent “thick” positions. Yet, they often gloss over the ways in which the nexus of thick and thin is negotiated in practice—a weak link in the cosmopolitan argument. To understand this nexus better, we turn to women’s rights organizations (WROs) in polarized Turkey to show that women affiliated with rival camps (e.g., pro-religious/pro-secular, Turkish/Kurdish, liberal/leftist) can mobilize over (...) issues like empowerment, violence against women, and education. However, thick readings of these issues inflect upon collaboration. This has spurred pro-religious and Kurdish women to develop strategies that flag their specific concerns. As such, mutual recognition along cosmopolitan lines appears possible—and is reinforced through iterative encounters—but is not necessarily negotiated between equally empowered agents and entails complex processes of contestation and concession-making. (shrink)