The current Medicare prospective payment system has many positive incentives for hospitals to control costs. Hospitals are increasing outpatient surgery, decreasing admissions, decreasing length of stay, and decreasing use of ancillary services. These are just the effects that Congress and the Health Care Financing Administration hoped for to save the Medicare trust fund. However, there has been evidence of some adverse outcomes including premature discharge, “dumping” sicker patients and patients without insurance, and adverse impact on hospitals with specialty centers. We (...) examine these issues and present a possible solution based on a new Computerized Severity Index. (shrink)

Abduction is or subsumes a process of inference. It entertains possible hypotheses and it chooses hypotheses for further scrutiny. There is a large literature on various aspects of non-symbolic, subconscious abduction. There is also a very active research community working on the symbolic (logical) characterisation of abduction, which typically treats it as a form of hypothetico-deductive reasoning. In this paper we start to bridge the gap between the symbolic and sub-symbolic approaches to abduction. We are interested in benefiting from developments (...) made by each community. In particular, we are interested in the ability of non-symbolic systems (neural networks) to learn from experience using efficient algorithms and to perform massively parallel computations of alternative abductive explanations. At the same time, we would like to benefit from the rigour and semantic clarity of symbolic logic. We present two approaches to dealing with abduction in neural networks. One of them uses Connectionist Modal Logic and a translation of Horn clauses into modal clauses to come up with a neural network ensemble that computes abductive explanations in a top-down fashion. The other combines neural-symbolic systems and abductive logic programming and proposes a neural architecture which performs a more systematic, bottom-up computation of alternative abductive explanations. Both approaches employ standard neural network architectures which are already known to be highly effective in practical learning applications. Differently from previous work in the area, our aim is to promote the integration of reasoning and learning in a way that the neural network provides the machinery for cognitive computation, inductive learning and hypothetical reasoning, while logic provides the rigour and explanation capability to the systems, facilitating the interaction with the outside world. Although it is left as future work to determine whether the structure of one of the proposed approaches is more amenable to learning than the other, we hope to have contributed to the development of the area by approaching it from the perspective of symbolic and sub-symbolic integration. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

The aim of our commentary is to strengthen Cowan's proposal for an inherent capacity limitation in STM by suggesting a neurobiological mechanism based on competitive networks and nonlinear oscillations that avoids some of the shortcomings of the scheme discussed in the target article (Lisman & Idiart 1995).

Summarya) Bell tries to formulate more explicitly a notion of “local causality”: correlations between physical events in different space‐time regions should be explicable in terms of physical events in the overlap of the backward light cones. It is shown that ordinary relativistic quantum field theory is not locally causal in this sense, and cannot be embedded in a locally causal theory.b) Clauser, Home and Shimony criticize several steps in Bell's argument that any theory of local “beables” is incompatible with quantum (...) mechanics. It is contended that the Clauser‐Horne derivation of a Bell‐type inequality circumvents his weak steps. The Clauser‐Horne derivation must assume that there are no undetected correlations between choices of controllable variables in two space‐like separated regions. Methodological considerations support this assumption.c) In response to criticism by Shimony, Home, and Clauser, Bell tries to clarify the argument of “The theory of local beables”, and to defend as permissible the hypothesis of free variables.d) Bell's reply to an earlier criticism by Shimony, Clauser, and Home is answered. The convergence of Bell's position towards theirs is noted. (shrink)

How cool is the philosophy of religion? Content Type Journal Article Category Article Pages 3-19 DOI 10.1007/s11153-011-9330-5 Authors John Churchill, Phi Beta Kappa National Office, Washington, DC, USA Ingolf Dalferth, Institute of Hermeneutics and Philosophy of Religion, University of Zurich, Kirchgasse 9, 8001 Zurich, Switzerland Patrick Horn, Claremont Graduate Center, Claremont, CA, USA Jeffery Willetts, Leland School of Ministries, Richmond, VA, USA Journal International Journal for Philosophy of Religion Online ISSN 1572-8684 Print ISSN 0020-7047 Journal Volume Volume 71 Journal (...) Issue Volume 71, Number 1. (shrink)

On July 2021, the UK High Court of Justice heard the Case CO/2066/2020 on the application of Heidi Crowter who lives with Down’s syndrome, and Máire Lea-Wilson whose son Aidan has Down’s syndrome. Crowter and Lea-Wilson, with the support of the disability rights campaign, ‘Don’t Screen Us Out’, have been taking legal action against the Secretary of State for Health and Social Care (the UK Government) for a review of the 1967 Abortion Act: the removal of section 1(1)(d) making termination (...) of pregnancy lawful for ‘severe’ fetal indications detected after 24 weeks' gestation. On 23 September 2021, the High Court dismissed the claim. This action came at a time when non-invasive prenatal testing (NIPT) was introduced into the NHS England Fetal Anomaly Screening Programme for the trisomies 21, 13 and 18. The implementation of NIPT has been heavily criticised, in particular by ‘Don’t Screen Us Out’ campaigners, for increasing fetal selection and discrimination of people living with disabilities. The case of Crowter and Lea-Wilson echoes debates in other European countries such as in France and Germany, where the introduction of NIPT in the public healthcare system has provoked equally vehement public reactions and discussions. The comparison between these three countries allows contextualising the public discourses around NIPT and the ground for termination of pregnancy in relation to different socio-cultural and political contexts. We examine how each country, and particularly England, deals with the conflict between the principles of promoting the rights of people living with disabilities and preserving women’s reproductive autonomy. (shrink)

En s’appuyant sur le cours de Ricœur sur Le Concept philosophique de volonté – professé en 1967 – l’article examine la position que le philosophe français assume sur la question très controversée concernant l’histoire conceptuelle de la volonté dans la pensée occidentale et notamment dans la philosophie ancienne. En partant d’une clarification terminologique – centrée sur la distinction entre trois concepts de volonté (appétitif, décisionnel et dynamique) – l’article met en cause la thèse défendue ici par Ricœur, selon laquelle le (...) concept de volonté serait absent dans la philosophie ancienne et en particulier dans la pensée d’Aristote. Toutefois, d’accord avec Ricœur, on reconnaît chez Augustin une approche foncièrement novatrice du concept de volonté, dont on précise le sens et la portée dans la partie conclusive. (shrink)

In order to graduate, Florida's high school students by law must learn that Communism is evil, dangerous, and fallacious. All students must learn that the U.S. produces the highest standard of living and more freedom than any other economic system on earth. State universities in Florida are creating a curriculum to implement the Americanism versus Communism Act of 1961 and the Free Enterprise and Consumer Education Act of 1975. ;The Florida Department of Education says that ideology, noncritical thinking, is superior (...) to critical thinking and that the superiority of the U.S. political economy and the dignity of the individual rest in part on peoples' being able to express themselves freely. ;Florida's A.V.C. and F.E.C.E.A. proponents have a special way of convincing audiences that they will develop loyalty while at the same time imposing a set of ideas not open to question. ;This work argues that, intentionally or not, Florida's legislature and Department of Education have set up an official ideology and the mechanism to purvey it. This ideological approach defeats the aim of comparing systems objectively. While the stated aim is to promote critical thinking, the D.O.E.'s special philosophy underscoring words like "democracy" results in indoctrinating students with a questionable description of the U.S. system. (shrink)

Sous l'influence probable du néo-platonisme, Augustin a développé une philosophie des nombres, le nombre s'agrandissant sans fin étant même identifié à la deuxième personne de la Trinité. L'A. passe en revue plusieurs oeuvres d'Augustin et y montre l'importance de la différence entre nombre intelligible et nombre sensible dans la théorie de la connaissance, la théologie, l'éthique, la conception de la musique et de la Providence.

À suivre une vision assez simplifiée, Nietzsche haïssait Platon et le rejetait d’une manière tant fondamentale que radicale. Mais à y regarder de plus près, nous devons distinguer, d’un côté, les motifs principaux du rejet de Platon par Nietzsche, d’un autre côté, un certain nombre de perspectives sous lesquelles il appréciait Platon et même le louait. Alors qu’il est très critique envers la plus grande part de l’éthique de Platon, son attitude envers sa pensée politique est beaucoup plus amicale. Il (...) est important de dégager les arrières-plans philosophiques, y compris celui du jeune Nietzsche philologue classique durant la période de Bâle, tel que nous le trouvons dans ses notes de cours et dans quelques uns de ses fragments édités par Colli et Montinari. Dans le volume II/4 de l’édition critique notamment, nous disposons de presque 190 pages de matériel sur Platon que Nietzsche a utilisé pour ses leçons à l’université. (shrink)

In the modern age, the political secret has acquired a bad reputation. With modern democracy’s ideal of transparency, political secrecy is identified with political crime or corruption. The article argues that this repression of secrecy in modern democracies falls short of a substantial understanding of the structure and workings of political secrecy. By outlining a genealogy of political secrecy, it elucidates the logic as well as the blind spots of a current culture of secrecy. It focuses on two fundamental logics (...) of secrecy, deduced from the Latin terms ‘ arcanum’ and ‘ secretum’. Whereas the logic of arcanum regards secrecy as a legitimate dimension of government, a modern logic of secretum is marked by an inextricable dialectics between the withdrawal and communication of knowledge, between secrecy and publicity. Here, the secret is not so much a piece of withheld knowledge as a ‘secrecy effect’ that binds the realm of secrecy to the public sphere by a dialectics of permanent suspicion and scandal. Instead of falling into the trap of this ‘secrecy effect’ it is worth taking a closer look at the tradition of thought on the arcana imperii, from Tacitus to early modern doctrines of raison d’état to Carl Schmitt. What this tradition deals with is the functionality of secrecy and its complicated relation to the law. The arcana tradition elaborates the crucial point of secrecy: its potential, but also its profound ambivalence. Secrecy opens up a discretionary space of action exempt from the rule of law, and, according to Carl Schmitt, ignores the law so as to allow it to become effective. Secrecy serves to protect and stabilize the state, but at the same time it opens a space of exception from the rule of law that breeds violence, corruption and oppression. Instead of seeing secrecy as the opposite of a political culture of transparency, it is more productive to regard secrecy as transparency's complement – a counterpart, however, that is marked by the profound paradox of being both a consolidation of and a threat to democracy. (shrink)

Before he became infamous for character assassination disguised as literary executorship, Rufus W. Griswold established his reputation in America as a critic and early literary anthologist. In 1842, Griswold released the first edition of his massive Poets and Poetry of America with prominent Philadelphia publisher Carey and Hart. At nearly five hundred royal octavo pages—complete with elaborate frontispiece; ornamental title page with an etching by George Hewitt Cushman after Thomas Creswick; twelve-page, double-columned “historical introduction”; authorial headnotes; and selections of verse (...) from more than one hundred poets active in the roughly seventy years since American independence—Griswold’s volume was... (shrink)

It is customary to think that Objective List (“OL), Desire-Satisfaction (“D-S”) and Hedonistic (“HED”) theories of prudential value pretty much cover the waterfront, and that those of the three that are “subjective” are naturalistic (in the sense attacked by Moore, Ross and Ewing), while those that are “objective” must be Platonic, Aristotelian or commit the naturalist fallacy. I here argue for a theory that is both naturalistic (because voluntaristic) and objective but neither Platonic, Aristotelian, nor (I hope) fallacious. In addition, (...) this proposal, called “CHOICE,” is an example of neither an OL, D-S, nor HED theory. It is a theory according to which uncoerced choosings create objective values that we (even everyone) may be wrong about, because valuations are conative rather than epistemic activities. On this view, intrinsic prudential goods necessarily involve likely (pursuant to lawlike regularities) net increases in successful free choosings . (shrink)

A general algorithm is given for determining whether or not a given set of pair distributions allows for the construction of all the members of a specified set of higher-order distributions which return the given pair distributions as marginals. This mathematical question underlies studies of quantum correlation experiments such as those of Bell or of Clauser and Horne, or their higher-spin generalizations. The algorithm permits the analysis of rather intricate versions of such problems, in a form readily adaptable to the (...) computer. The general procedure is illustrated by simple derivations of the results of Mermin and Schwarz for the symmetric spin-1 and spin-3/2 Einstein-Podolsky-Rosen problems. It is also used to extend those results to the spin-2 and spin-5/2 cases, providing further evidence that the range of strange quantum theoretic correlations does not diminish with increasing s. The algorithm is also illustrated by giving an alternative derivation of some recent results on the necessity and sufficiency of the Clauser-Horne conditions. The mathematical formulation of the algorithm is given in general terms without specific reference to the quantum theoretic applications. (shrink)

Decoupling a modestly construed Narrative Self Shaping Hypothesis from Strong Narrativism this paper attempts to motivate devoting our intellectual energies to the former. Section one briefly introduces the notions of self-shaping and rehearses reasons for thinking that self-shaping, in a suitably tame form, is, at least to some extent, simply unavoidable for reflective beings. It is against this background that the basic commitments of a modest Narrative Self-Shaping Hypothesis are articulated. Section two identifies a foundational commitment—the central tenet—of all Strong (...) Narrativist proposals, those that posit a necessary link between narrative self-shaping and narrative self-experience. As will be shown, in the hands of Strong Narrativists the latter notion is unpacked in stronger or weaker ways by appeal to the notion of implicit Narrativizing. Section three reminds the reader of Strawson’s challenge to Strong Narrativism. It is revealed that Strawson’s objections are most effective if they target Strong Narrativism’s central tenet construed as a phenomenological revelation about what is necessary for self-experience and not merely the psychological Narrativity thesis, construed as an empirical hypothesis about typical Narrativizing proclivities. Having set the stage, section four critically examines two different strategies, pursued by Rudd and Schechtman respectively, for escaping the horns Strawson’s dilemma poses for Strong Narrativism. In the end both strategies invoke the notion of implicit Narrativizing at a crucial juncture. Section five reveals that a substantive proposal about what implicit Narrativizing might be is lacking, hence we have no reason to believe that it actually occurs. It is concluded that, as things stand, Strong Narrativism has no way of avoiding the horns of Strawson’s dilemma. Brief concluding remarks in the final section are a reminder why, despite their modesty, softer versions of the NSSH—when coupled with a developmental proposal about the narrative basis of our folk psychological competence—are non-trivial and worthy of further development and investigation. (shrink)

A method is given to determine whether or not the distribution functions describing the two spin measurements in the spin-s Einstein-Podolsky-Rosen experiment are compatible with the existence of distributions describing three spin measurements (not all of which can actually be performed). When applied to the spin-1/2 case the method gives the results of Wigner, or of Clauser, Holt, Horne, and Shimony, depending on whether or not the two-spin distributions are assumed to have the forms given by the quantum theory. Generalizations (...) of the conditions of Wigner or of Clauser et al. to the spin-1 case are explicitly calculated. The spin-3/2 case is examined in some simple geometries to show that an apparently monotonic trend toward local realism as s increases from1/2 to1 is, in fact, violated when s increases from1 to3/2. The analysis is based on a novel representation of the modulus squared of a rotation matrix element. The structure of that matrix element responsible for the restoration of local realism in the classical (large s) limit is identified, but a rigorous treatment of the classical limit is not attempted. The higher-spin results are significantly stronger than those given by Mermin's spin-s Bell inequality. (shrink)

This study provides a formal framework for considering the so-called "Universalizability Principle" in morality and its relation to such metaphysical theses as "Leibnizianism". That these claims are thought to be ethical and metaphysical in import provides the point of the subtitle. In spite of this, however, Rabinowicz's study is less an examination of the arguments which may be given for or against these claims or the uses which may be made of them in morals or metaphysics, than an attempt on (...) a possible worlds model to frame them clearly and to explore their logical mesh. In the introductory chapter Rabinowicz is concerned first to make clear to us what principle it is which he wishes to designate as the Universalizability Principle and to distinguish it from certain others, e.g., the Golden Rule, Kant's Categorical Imperative, Singer's Generalization Principle, Hare's "thesis of universalizability," and principles of impartiality and fairness, with which it may be confused. Specifically, UP represents a claim that the moral properties of things are essentially independent of what might be called their "individual aspects." In terms of his framework, where w, v, u, and z are possible worlds, E represents an equivalence relation of some unspecified manner of sufficient similarity in non-individual aspects, and D is read as "is a deontic alternative to," UP has the following form: if wEv and wDu, then there is a z such that vDz and uEz. On this formulation we are enabled to see where the main problem with UP lies: E must be specified in such a way as to provide significance for UP, i.e., so as to provide us with a clear, non-trivial, non-vacuous formulation of UP which yet conforms to the intuitions of those ethicists who are "universalists." It is this problem and its proposed solution which constitutes the real theme of this book. For suppose that E is specified in terms of either of the two most intuitively obvious and appealing candidates, namely, "exact similarity" and "morally relevant similarity." Then, on Leibnizianism, the exact-similarity variant becomes trivial, whereas the relevant-similarity variant is, by virtue of the systematic unclarity of the notion of "relevance," confusing and useless. Because he accepts the possibility that Leibnizianism may be true, Rabinowicz conceives of his task as one of inquiring whether some third variant of UP can be framed which slips between the horns of this dilemma. (shrink)

It has been 35 years since the publicationMelzack and Wall's Gate Control Theory whichhypothesized that nociceptive information wassubject to dynamic regulation by mechanismslocated in the spinal cord dorsal horn thatcould ultimately lead to hyperalgesic orhypoalgesic states. This paper examines GateControl Theory in light of our currentunderstanding of the neuroanatomical,neurophysiological and neurochemical substratesof nociception and antinociception. Despiteits initial controversies, no one has proposeda more comprehensive overall theory of painmodulation or has successfully refuted most ofthe basic tenets of this theory.

South Africa has the highest rate of foetal alcohol syndrome (FAS) in the world. The problem of alcohol abuse in pregnancy has very deep historical roots that are intertwined with the injustices of both apartheid and pre-apartheid colonialism. Much of the research that is being done in these communities is focused on identifying the epidemiological variables associated with these patterns of alcohol abuse. The underlying reasons as to why these patterns continue seem to remain largely obscured from view. In this (...) article, I apply the theory proposed by Powers and Faden of social justice as a ‘moral foundation for public health and health policy’ to the problem of FAS in South Africa. The objective of this application is two-fold: first, to critically explore the additional insights and alternative perspectives to the problem of FAS that this approach may provide and second, to assess the utility of the theory when applied directly to a specific public health problem. I conclude by noting that although this approach could result in the kind of ‘public health scope creep’ that has been criticized by various authors, it does provide fresh insights to the problem of FAS in South Africa. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Dr. Ambedkar and Untouchability: Fighting the Indian Caste SystemChristopher S. QueenDr. Ambedkar and Untouchability: Fighting the Indian Caste System. By Christophe Jaffrelot. New York: Columbia University Press, 2005. xiii + 205 pp.Outside of India, Bhimrao Ramji Ambedkar remains virtually unknown. Everyone knows that Mahatma Gandhi led the fight for Indian independence and that his nonviolent marches inspired Dr. King and the American civil rights movement. Most educated men (...) and women have heard of Nehru and some of the political and literary figures that India has produced in modern times. But few know of the first Untouchable to attend college, who went on to earn advanced degrees in the social sciences and law at Columbia University, the London School of Economics, and Grays Inn, who returned to India in the 1920s to launch a civil rights movement for Untouchables, [End Page 168] who drafted the constitution for the Republic of India as its first law minister, and who led a mass conversion to Buddhism weeks before this death.Dr. B. R. Ambedkar (1891–1956) is venerated by millions of Buddhist and low-caste followers in India today, and at the same time feared by politicians determined to preserve the Hindu caste system he vowed to destroy. Admirers call him Babasaheb Ambedkar or simply Baba, using a traditional term of respect for a guiding elder, and many use the greeting Jai Bhim (“Victory to Bhimrao”) within the Untouchable communities. Ambedkar is portrayed on ubiquitous wall calendars, public statues, and home altars alongside that of the Buddha, wearing a Western suit and tie, with the horn-rimmed glasses and pocket pens of a scholar and diplomat. Although widely regarded as a bodhisattva or Buddhist saint, he is never pictured in the robes of a holy man or entreated in prayer by his devotees. And while most of his campaigns for Untouchable human rights were driven back by the Hindu nationalists, many of the provisions of his path-breaking legislation were eventually adopted after his death. In the intervening decades, amid deepening polarization over his legacy, the state government of Maharashtra has published eighteen volumes of Ambedkar’s collected works and the government of India has bestowed on him its highest civilian honor, the Bharat Ratna.Given the dearth of Western scholarship on Ambedkar’s place in the history of modern India and the emergence of socially engaged Buddhism, I welcome Chris-tophe Jaffrelot’s Dr. Ambedkar and Untouchability: Fighting the Indian Caste System. As a social scientist and director of the Centre d’Études et de Recherches Internatio-nales (CERI) who has published more than a dozen books on South Asian politics, Jaffrelot is well qualified to assess Ambedkar’s life and thought. Drawing on a wide range of materials on the social reform movements of the nineteenth and twentieth centuries and Ambedkar’s contributions to sociology and politics, the author aims to redress Ambedkar’s neglect by Indian scholars before the 1990s, when the low-caste movement began finally to gain traction. However, he does not address the anomaly of Ambedkar’s neglect by all but a small circle of Western authors.1The strength of Dr. Ambedkar and Untouchability is its concise analysis of the geographical, political, and social context of Ambedkar’s career. Jaffrelot shows how British recruitment of the Mahars, members of Ambedkar’s lowly but numerous caste, for service in the colonial army resulted in disproportionate levels of literacy. Ambedkar was the fourteenth child in such a military family, whose father held the rank of major and served as a school master for the barracks. Both parents and all of Bhimrao’s uncles could read and write, compared to less than one percent of Mahars in village life. Moreover, in spite of his brilliance and determination, Ambedkar could not have continued his education without the financial support of Maratha maharajahs who opposed the Brahmins’ monopoly in education. “Ambedkar was the heir to a regional tradition; his struggle harked back to the anti-Brahmin movements which emerged in western Maharashtra from the mid-nineteenth century onward, a precocity that only the Dravidian South—the other key area of anti-Brahmin mobilization—could match.”Jaffrelot presents... (shrink)

Cognitive science has converged in many ways with cognitive psychology, but while also maintaining a distinctive interdisciplinary nature. Here we further characterize this existing state of the field before proposing how it might be reconceptualized toward a broader and more distinct, and thus more stable, position in the realm of sciences.

Es geht nicht darum, die Religion wieder auferstehen zu lassen [...]. Sondern es geht darum, die blosse Vernunft auf die Unbegrenztheit hin zu offnen, die ihre Wahrheit ausmacht. Im vielbehaupteten Trend einer Ruckkehr zur Religion erweist sich Jean-Luc Nancys Philosophie als widerstandig: Einerseits steht die Frage nach der Bedeutung von Religion und insbesondere des Christentums im Mittelpunkt seiner Uberlegungen, andererseits stellt er sich nicht in die Tradition einer neuen (De-)Legitimation von Religion. In Auseinandersetzung mit Jean-Luc Nancy, insbesondere mit seinem Projekt (...) einer Dekonstruktion des Christentums, widmen sich die Beitrage dieses Bandes der allgemeinen Verortung des Phanomens der Religion in pluralistischen Gemeinschaften aus theologischer und philosophischer Sicht. (shrink)

BackgroundAlthough the peer review process is believed to ensure scientific rigor, enhance research quality, and improve manuscript clarity, many investigators are concerned that the process is too slow, too expensive, too unreliable, and too static. In this feasibility study, we sought to survey corresponding authors of recently published clinical research studies on the speed and efficiency of the publication process.MethodsWeb-based survey of corresponding authors of a 20% random sample of clinical research studies in MEDLINE-indexed journals with Ovid MEDLINE entry dates (...) between December 1 and 15, 2016. Survey addressed perceived manuscript importance before first submission, approximate first submission and final acceptance dates, and total number of journal submissions, external peer reviews, external peer reviewers, and revisions requested, as well as whether authors would have considered publicly sharing their manuscript on an online platform instead of submitting to a peer-reviewed journal.ResultsOf 1780 surveys distributed, 27 corresponding authors opted out or requested that we stop emailing them and 149 emails failed (e.g., emails that bounced n = 64, returned with an away from office message n = 70, or were changed/incorrect n = 15), leaving 1604 respondents, of which 337 completed the survey (21.0%). Respondents and non-respondents were similar with respect to study type and publication journals’ impact factor, although non-respondent authors had more publications (p = 0.03). Among respondents, the median impact factor of the publications’ journal was 2.7 (interquartile range (IQR), 2.0–3.6) and corresponding authors’ median h-index and number of publications was 9 (IQR, 3–20) and 27 (IQR, 10–77), respectively. The median time from first submission to journal acceptance and publication was 5 months (IQR, 3–8) and 7 months (IQR, 5–12), respectively. Most respondents (62.0%, n = 209) rated the importance of their research as a 4 or 5 (5-point scale) prior to submission. Median number of journal submissions was 1 (IQR, 1–2), external peer reviews was 1 (IQR, 1–2), external peer reviewers was 3 (IQR, 2–4), and revisions requested was 1 (IQR, 1–1). Sharing manuscripts to a public online platform, instead of submitting to a peer-reviewed journal, would have been considered by 55.2% (n = 186) of respondents.ConclusionCorresponding authors have high perceptions of their research and reported requiring few manuscript submissions prior to journal acceptance, most commonly by lower impact factor journals. (shrink)

In this article we examine ethical aspects of the involvement of children in clinical research, specifically those who are incapable of giving informed consent to participate. The topic is, of course, not a new one in medical ethics but there are some tensions in current guidelines that, in our view, need to be made explicit and which need to be responded to by the relevant official bodies. In particular, we focus on tensions between the World Medical Association Declaration of Helsinki, (...) and the guidance offered by the British Medical Association, the Royal College of Paediatrics and Child Health , and the Council for International Organizations of Medical Sciences. We conclude with a call for these organisations to make their guidance explicit in relation to the World Medical Association Declaration. (shrink)

While there is significant consensus that undergraduate medical education should include bioethics training, there is widespread debate about how to teach bioethics to medical students. Educators disagree about course methods and approaches, the topics that should be covered, and the effectiveness and metrics for UME ethics training. One issue that has received scant attention is the timing of bioethics education during medical training. The existing literature suggests that most medical ethics education occurs in the pre-clinical years. Follow-up studies indicate that (...) medical students in their clinical rotations have little recall or ability to apply ethics concepts that were learned in their pre-clinical training. Trainees also report a desire for medical ethics to be taught in the context of practical application, which would suggest that the timing of pre-clinical ethics education is flawed. However, moving bioethics training to the clinical years should not be assumed to be the solution to the problems of recall and theory application. We argue that the effectiveness of timing bioethics education will depend on when medical students witness or experience particular categories of ethical dilemmas during their training. Our overarching hypothesis is that ethics education will be most effective when the bioethics training on a particular topic correlates to experiential exposure to that ethical issue. The purpose of our current study was to describe medical students exposure to particular categories of ethical conflicts, dilemmas, or issues. Our results may help bioethics educators better strategize about the most effective timing of medical ethics training in UME. (shrink)

This paper discusses the predicament of Oscar Pistorius. He is a Paralympic gold medallist who wishes to participate in the Olympics in Beijing in 2008. Following a brief introductory section, the paper discusses the arguments that could be, and have been, deployed against his participation in the Olympics, should he make the qualifying time for his chosen event (400m). The next section discusses a more hypothetical argument based upon a specific understanding of the fair opportunity rule. According to this, there (...) may be a case for allowing Pistorius to compete even if he should fail to make the official qualifying time. The final part of the paper reviews the situation at the time of writing and offers some assessment of the strategy of the IAAF in responding to it. It is argued below that the proper focus for assessment of Pistorius's eligibility to compete should not be on whether his blades lead to his having an unfair advantage over his competitors, but instead should focus on whether what he does counts as running. (shrink)

Soon after its publication, Readings in Ancient Greek Philosophy was hailed as the favourite to become "the 'standard' text for survey courses in ancient philosophy. Over twenty years later that prediction has been borne out: Readings in Ancient Greek Philosophy still stands as the leading anthology of its kind. It is now stronger than ever: This 5th Edition features a completely revised Aristotle unit, with new translations, as well as a newly revised glossary. The Plato unit offers new translations of (...) the Meno and Republic. In the latter, indirect dialogue is cast into direct dialogue for greater readability. The Presocratics unit has been re-edited and streamlined, and the pages of every unit have been completely reset. (shrink)

Geoffrey Rose’s prevention paradox points to a tension between two prima facie plausible moral principles: that we should save the greater number and that weshould save the most at risk. This paper argues that a novel moral theory, ex-ante contractualism, captures our intuitions in many prevention paradox cases, regardless of our interpretation of probability claims. However, it goes on to show that it might be impossible to square ex-ante contractualism with all of our moral intuitions. It concludes that even if (...) ex-ante contractualism cannot furnish an entire ethics of risk, it does identify important considerations for any such theory. (shrink)

Geoffrey Rose’s prevention paradox points to a tension between two prima facie plausible moral principles: that we should save the greater number and that weshould save the most at risk. This paper argues that a novel moral theory, ex-ante contractualism, captures our intuitions in many prevention paradox cases, regardless of our interpretation of probability claims. However, it goes on to show that it might be impossible to square ex-ante contractualism with all of our moral intuitions. It concludes that even if (...) ex-ante contractualism cannot furnish an entire ethics of risk, it does identify important considerations for any such theory. (shrink)

Tom Shakespeare’s important new book includes, among other topics, a persuasive critique of the social model of disability. A key component in his case against that model consists in an argument against the impairment/disability distinction as this is understood within the social model. The present paper focuses on the case Shakespeare makes against that distinction. Three arguments mounted by Shakespeare are summarised and responded to. It is argued that the responses adequately rebut Shakespeare’s case on this specific issue. Moreover, as (...) the engagement with Shakespeare’s argument illustrates, his claim to employ a critical realist perspective appears to be in considerable tension with the case he offers against the impairment/disability distinction. (shrink)