Employers must determine the types of health care plans to offer and also set employee premiums for each plan provided. Depending on the structure of the employee share of premiums across different health insurance plans, the incentives to choose one plan over another are altered. If employees know premiums do not fully reflect the risk differences among workers, such pricing can give rise to a so-called “death spiral” due to adverse selection. This paper uses longitudinal information from a natural experiment (...) in the management of health benefits for a large employer to explore the impact of moving from a fixed-dollar contribution policy to a partially risk-adjusted employer contribution policy. Our results show that implementing a significant risk adjustment had no discernable effect on adverse selection against the most generous indemnity insurance policy. This stands in stark contrast to previous studies, which have tended to estimate large impacts attributed to selection when employers move to a fixed-dollar policy from one with some risk adjustment. Further analysis suggests that previous studies, which appeared to detect plans in the throes of a death spiral, may instead have been reflecting an inexorable movement away from a non-preferred product, one that would have been inefficient for nearly all workers even in the absence of adverse selection. (shrink)

A large proportion of hospital inpatients are affected by cognitive impairment, posing challenges in the provision of their care in busy, fast-paced acute wards. Signs and symbols, known as visual identifiers, are employed in many U.K. hospitals with the intention of helping healthcare professionals identify and respond to the needs of these patients. Although widely considered useful, these tools are used inconsistently, have not been subject to full evaluation, and attract criticism for acting as a shorthand for a routinized response. (...) In order for visual identifiers to be used effectively in acute care settings, thorough consideration must be given to the ethical and legal issues that are engaged in this context, and their potential benefits and harms must be weighed and balanced. This paper proposes a set of legal and ethical principles that can be used to guide the implementation of visual identifiers. Together, these principles provide a framework applicable in the design and implementation phases to systematically identify relevant considerations arising from the use of these tools. We outline some tensions that arise between principles and conclude that selecting a preferred moral framework could help to guide decision-making, as does clarity around the purpose and objectives of the identifier. (shrink)

BackgroundThere is increasing need for peer reviewers as the scientific literature grows. Formal education in biostatistics and research methodology during residency training is lacking. In this pilot study, we addressed these issues by evaluating a novel method of teaching residents about biostatistics and research methodology using peer review of standardized manuscripts. We hypothesized that mentored peer review would improve resident knowledge and perception of these concepts more than non-mentored peer review, while improving review quality.MethodsA partially blinded, randomized, controlled multi-center study (...) was performed. Seventy-eight neurology residents from nine US neurology programs were randomized to receive mentoring from a local faculty member or not. Within a year, residents reviewed a baseline manuscript and four subsequent manuscripts, all with introduced errors designed to teach fundamental review concepts. In the mentored group, mentors discussed completed reviews with residents. Primary outcome measure was change in knowledge score between pre- and post-tests, measuring epidemiology and biostatistics knowledge. Secondary outcome measures included level of confidence in the use and interpretation of statistical concepts before and after intervention, and RQI score for baseline and final manuscripts.ResultsSixty-four residents (82%) completed initial review with gradual decline in completion on subsequent reviews. Change in primary outcome, the difference between pre- and post-test knowledge scores, did not differ between mentored (−8.5%) and non-mentored (−13.9%) residents (p = 0.48). Significant differences in secondary outcomes (using 5-point Likert scale, 5 = strongly agree) included mentored residents reporting enhanced understanding of research methodology (3.69 vs 2.61; p = 0.001), understanding of manuscripts (3.73 vs 2.87; p = 0.006), and application of study results to clinical practice (3.65 vs 2.78; p = 0.005) compared to non-mentored residents. There was no difference between groups in level of interest in peer review (3.00 vs 3.09; p = 0.72) or the quality of manuscript review assessed by the Review Quality Instrument (RQI) (3.25 vs 3.06; p = 0.50).ConclusionsWe used mentored peer review of standardized manuscripts to teach biostatistics and research methodology and introduce the peer review process to residents. Though knowledge level did not change, mentored residents had enhanced perception in their abilities to understand research methodology and manuscripts and apply study results to clinical practice. (shrink)

Aberrant consumer behaviour costs firms millions of pounds a year, and the Internet has provided young techno-literate consumers with a new medium to exploit businesses. This paper addresses Internet related ethics and describes the ways in which young consumers misdemean on the Internet and their attitudes towards these. Using a sample of 219 generation Y consumers, the study identified 24 aberrant behaviours which grouped into five factors; illegal, questionable activities, hacking related, human Internet trade and downloading. Those perceived as least (...) wrong were; "Downloading movie and music files from the Internet for free". The consequences of these behaviours have implications for educators, consumer policy and marketers. (shrink)

This study investigates the performance of psychopathic individuals on tasks believed to be sensitive to dorsolateral prefrontal and orbitofrontal cortex (OFC) functioning. Psychopathic and non-psychopathic individuals, as defined by the Hare psychopathy checklist revised (PCL-R) [Hare, The Hare psychopathy checklist revised, Toronto, Ontario: Multi-Health Systems, 1991] completed a gambling task [Cognition 50 (1994) 7] and the intradimensional/extradimensional (ID/ED) shift task [Nature 380 (1996) 69]. On the gambling task, psychopathic participants showed a global tendency to choose disadvantageously. Specifically, they showed an (...) impaired ability to show learning over the course of the task. On the ID/ED task, the performance of psychopathic individuals was not significantly different from incarcerated controls on attentional set-shifting, but significant impairments were found on response reversal. These results are interpreted with reference to an OFC and amygdala dysfunction explanation of psychopathy. (shrink)

Previous studies have found Forsyth’s Ethical Position Questionnaire (EPQ) to vary between countries, but none has made a systematic evaluation of its psychometric properties across consumers from many countries. Using confirmatory factor analysis and multi-group LISREL analysis, this paper explores the factor structure of the EPQ and the measurement equivalence in five societies: Austria, Britain, Brunei, Hong Kong and USA. The results suggest that the modified scale, measuring idealism and relativism, was applicable in all five societies. Equivalence was found across (...) Britain, Brunei and USA, but the original scale cannot be used validly. (shrink)

This study investigates the ability of individuals with psychopathy to perform passive avoidance learning and whether this ability is modulated by level of reinforcement/punishment. Nineteen psychopathic and 21 comparison individuals, as defined by the Hare Psychopathy Checklist Revised (Hare, 1991), were given a passive avoidance task with a graded reinforcement schedule. Response to each rewarding number gained a point reward specific to that number (i.e., 1, 700, 1400 or 2000 points). Response to each punishing number lost a point punishment specific (...) to that number (i.e., the loss of 1, 700, 1400 or 2000 points). In line with predictions, individuals with psychopathy made more passive avoidance errors than the comparison individuals. In addition, while the performance of both groups was modulated by level of reward, only the performance of the comparison population was modulated by level of punishment. The results are interpreted with reference to a computational account of the emotional learning impairment in individuals with psychopathy. (shrink)

This article addresses five research questions: What specific behaviors are described in the literature as ethical or unethical? What percentage of business people are believed to be guilty of unethical behavior? What specific unethical behaviors have been observed by bank employees? How serious are the behaviors? Are experiences and attitudes affected by demographics? Conclusions suggest: There are seventeen categories of behavior, and that they are heavily skewed toward internal behaviors. Younger employees have a higher level of ethical consciousness than older (...) employees. The longer one works for a company, the more one may look to job security as a priority; this can lead to rationalizing or overlooking apparently unethical behaviors. More emphasis is needed on internal behaviors with particular attention on the impact that external behaviors have on internal behaviors. (shrink)

_BMC Medical Ethics_ is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies. _BMC __Medical Ethics _is part of the _BMC_ series which publishes subject-specific journals focused on the needs of individual research communities across all areas of biology and medicine. We do not make editorial decisions on the basis of the interest of a study or (...) its likely impact. Studies must be scientifically valid; for research articles this includes a scientifically sound research question, the use of suitable methods and analysis, and following community-agreed standards relevant to the research field. Specific criteria for other article types can be found in the submission guidelines. _BMC series - open, inclusive and trusted_. (shrink)

This study investigated the performance of boys with psychopathic tendencies and comparison boys, aged 9 to 17 years, on two tasks believed to be sensitive to amygdala and orbitofrontal cortex func- tioning. Fifty-one boys were divided into two groups according to the Psychopathy Screening Device (PSD, P. J. Frick & R. D. Hare, in press) and presented with two tasks. The tasks were the gambling task (A. Bechara, A. R. Damasio, H. Damasio, & S. W. Anderson, 1994) and the Intradimensional/ (...) Extradimensional (ID/ED) shift task (R. Dias, T. W. Robbins, & A. C. Roberts, 1996). The boys with psychopathic tendencies showed impaired performance on the gambling task. However, there were no group differences on the ID/ED task either for response reversal or extradimensional set shifting. The implications of these results for models of psychopathy are discussed. (shrink)

Though emotional faces preferentially reach awareness, the present study utilised both objective and subjective indices of awareness to determine whether they enhance subjective awareness and “blindsight”. Under continuous flash suppression, participants localised a disgusted, fearful or neutral face (objective index), and rated their confidence (subjective index). Psychopathic traits were also measured to investigate their influence on emotion perception. As predicted, fear increased localisation accuracy, subjective awareness and “blindsight” of upright faces. Coldhearted traits were inversely related to subjective awareness, but not (...) “blindsight”, of upright fearful faces. In a follow-up experiment using inverted faces, increased localisation accuracy and awareness, but not “blindsight”, were observed for fear. Surprisingly, awareness of inverted fearful faces was positively correlated with coldheartedness. These results suggest that emotion enhances both pre-conscious processing and the qualitative experience of awareness, but that pre-conscious and conscious processing of emotional faces rely on at least partially dissociable cognitive mechanisms. (shrink)

In its comprehensive overview of Alain Locke's pragmatist philosophy this book captures the radical implications of Locke's approach within pragmatism, the critical temper embedded in Locke's works, the central role of power and empowerment of the oppressed and the concept of broad democracy Locke employed.

Working in ZF + DC with no additional use of the axiom of choice, we show how to iterate the extended ultrapower construction of Spector . This generalizes the technique of iterated ultrapowers to choiceless set theory. As an application, we prove the following theorem: Assume V = LU[κ] + “κ is λ-supercompact with normal ultrafilter U” + DC. Then for every sufficiently large regular cardinal ρ, there exists a set-generic extension V[G] of the universe in which there exists for (...) some σ a set S ρ for which one can define an elementary embedding j mapping V to LD[S], where D is the filter in V[G] generated by the closed unbounded filter on ρ. Moreover, we have j = ρ, j = σ, j) = S according to LD[S]), and j = D ∩ LD[S] i s a normal ultrafilter in LD[S] on ρ. (shrink)

For over forty years John Finnis has pioneered the development of a new classical theory of natural law, a systematic philosophical explanation of human life that offers an integrated account of personal identity, practical reason, morality, political community, and law. The core of Finnis' theory, articulated in his seminal work Natural Law and Natural Rights, has profoundly influenced later work in the philosophy of law and practical reason, while his contributions to the ethical debates surrounding nuclear deterrence, abortion, and sexual (...) morality have been a powerful, and controversial exposition of the practical implications of his theory of natural law. The Collected Essays of John Finnis brings together 122 papers. Thematically arranged, the five volumes provide ready access to his contributions across central areas of modern practical philosophy - the philosophy of practical reason; the philosophy of personal identity and intention; political philosophy; the philosophy of law; and the philosophy of revelation and the role of religion in public life. Fully cross-referenced, cross-indexed, and introduced by the author, the Collected Essays reveal the connections and coherence of the different branches of Finnis' work, showing the full picture of his philosophical contribution for the first time. Covering topics from the nature of divine revelation, the morality of abortion, to the adoption of Bills of Rights, the work in these volumes offer a unique insight into the intellectual currents and political debates that have transformed major areas of public morality and law over the last half century. Together with the new edition of Natural Law and Natural Rights, they will be an essential resource for all those engaged with the philosophy of law and broader questions in practical philosophy. (shrink)

§ 1. Introduction. Perhaps the most surprising recent development in complexity theory is the discovery that the class NP can be characterized using a form of randomized proof checker that only examines a constant number of bits of the “proof” that a string is in a language [6, 5, 31, 3, 4]. More specifically, writing ∣x∣ for the length of a string x, a language L in the class NP of languages recognizable in Nondeterministic polynomial time is traditionally given by (...) a polynomial p and a polynomial-time predicate P such that a string x is in L iff there is some string y satisfying P, where ∣y∣ ≤ p. Intuitively, we can think of a string y as a possible proof that x ϵ L, with the predicate P some kind of proof checker that distinguishes good proofs from bad ones. A string x is therefore in a language L ϵ NP if there is a short proof that x ϵ L, and not in L otherwise. The surprising discovery is that the deterministic proof checker that reads the entire input and proof can be replaced by a probabilistic verifier that on input x and possible proof y, where y is presented in a certain way, flips at most O coins and reads at most a constant number of bits of x and y. Obviously, a probabilistic verifier that does not read the whole proof will sometimes make mistakes. However, the surprising and essentially non-intuitive mathematical fact is that for each language L in NP, it is possible to find a polynomial q and verifier V flipping a logarithmic number of coins and reading a constant number of bits such that, for any x ϵ L, there exists y with ∣y∣ ≤ q and with V accepting with probability 1 and, for x ∉ L, there is no y with ∣y∣ ≤ q and with V accepting with probability ≥ 1/4. This idea canalsobeextended to PSPACE [10, 9], using a game that alternates between two players instead of a proof presented by a “single player.”. (shrink)

_ Source: _Volume 46, Issue 1, pp 70 - 97 In 1946 Heidegger suffered a mental breakdown and received treatment by Dr. Viktor Emil Freiherr von Gebsattel. I explore the themes of health and help in Heidegger’s work before and after his treatment. I begin with Heidegger’s views on health while Rector in 1933–34 and his abandonment of these views by war’s end. A short while later, Heidegger’s breakdown occurs and the treatment under Gebsattel begins. Soon after his treatment, Heidegger (...) lauds what he terms a “broken-down” thinking, and I examine his contribution to a 1958 _Festschrift_ for Gebsattel to better articulate such a thinking. Lastly, I take up Heidegger’s remarks on the role of the medical profession in a technological age from a 1962 speech. In presenting this material, I hope to shed new light on a little known aspect of Heidegger’s career and biography and to situate philosophically his relationship with Dr. Gebsattel. (shrink)

We construct, assuming that there is no inner model with a Woodin cardinal but without any large cardinal assumption, a model Kc which is iterable for set length iterations, which is universal with respect to all weasels with which it can be compared, and is universal with respect to set sized premice.

Summary Transsexuals are individuals who identify as a member of the gender opposite to that which they are born. Many transsexuals report that they have always had a feeling of a mismatch between their inner gender-based ‘‘body image’’ and that of their body’s actual physical form. Often transsexuals undergo gender reassignment surgery to convert their bodies to the sex they feel they should have been born. The vivid sensation of still having a limb although it has been amputated, a phantom (...) limb, was first described by Weir Mitchell over a century ago. The same phenomenon is also occurs after amputation of the penis or a breast. Around 60% of men who have had to have their penis amputated for cancer will experience a phantom penis. It has recently been shown that a significant factor in these phantom sensations is ‘‘cross-activation’’ between the de-afferented cortex and surrounding areas. Despite this it also known that much of our body image is innately ‘‘hard-wired’’ into our brains; congenitally limbless patients can still experience phantom sensations. We hypothesise that, perhaps due to a dissociation during embryological development, the brains of transsexuals are ‘‘hard-wired’’ in manner, which is opposite to that of their biological sex. We go on to predict that male-to-female transsexuals will be much less likely to experience a phantom penis than a ‘‘normal’’ man who has had his penis amputated for another reason. The same will be true of female-to-male transsexuals who have had breast removal surgery. We also predict that some female-to-male transsexuals will have a phantom penis even although there is not one physically there. We believe that this is an easily testable hypothesis, which, if correct, would offer insights into both the basis of transsexuality and provide farther evidence that we have a gender specific body image, with a strong innate component that is ‘‘hard-wired’’ into our brains. This would furnish us with a better understanding the mechanism by which nature and nurture interact to link the brain-based internal body image with external sexual morphology.. (shrink)

This intervention queries whether subjecting feminist jurisprudence to a methodological transfiguration toward pragrammatology (Derrida, in Smith and Kerrigan 1984) holds liberating potential for f (be it ‘woman’, ‘female’ or ‘feminine’) as both a signifier and a subject to be read with lucidity and nuance in feminist justice claims. I examine feminist jurisprudence’s methodological challenges in the settler colonial context of Alaska with respect to the murders of Della Brown (in 2000) and Mindy Schloss (in 2007). I advance my case for (...) pragrammatology as a critical methodology for feminist jurisprudence by subjecting the case(s) of Brown and Schloss to a more lucid (re)reading in two related and intersecting moves. First, I trace and deconstruct the citations of Brown and Schloss’ legal narratives to expose violence in the systemisation of f as a power and legal relation (Ahmed in Soc Legal Stud 4:55–73, 1995). I then examine the paradoxical nature of f justice claims which necessitate a pragrammatological approach. I conclude by advancing counsel on how we might move within paradox. (shrink)

Originally published in 1934, this book contains the last three books of the Latin text of Cicero's Disputations at Tusculum, the second volume of Dougan's two-volume critical edition of the text. The Latin is accompanied by a running commentary, and Dougan provides an introduction on the arguments contained in the books and the manuscript sources for the text. This book will be of value to anyone with an interest in the works of Cicero.

We show that if there is no inner model with a Woodin cardinal and the Steel core model K exists, then every Jónsson cardinal is Ramsey in K, and every δ-Jónsson cardinal is δ-Erdös in K. In the absence of the Steel core model K we prove the same conclusion for any model L[E] such that either V = L[E] is the minimal model for a Woodin cardinal, or there is no inner model with a Woodin cardinal and V is (...) a generic extension of L[E]. The proof includes one lemma of independent interest: If V = L[A], where A $\subset$ κ and κ is regular, then L κ [A] is a Jónsson algebra. The proof of this result, Lemma 2.5, is very short and entirely elementary. (shrink)

We reprove Gitik's theorem that if the GCH holds and o(κ) = κ + 1 then there is a generic extension in which κ is still measurable and there is a closed unbounded subset C of κ such that every $\nu \in C$ is inaccessible in the ground model. Unlike the forcing used by Gitik. the iterated forcing $R_{\lambda +1}$ used in this paper has the property that if λ is a cardinal less then κ then $R_{\lambda + 1}$ can (...) be factored in V as $R_{\kappa + 1} = R_{\lambda + 1} \times R_{\lambda + 1, \kappa}$ where $\mid R_{\lambda +1}\mid \leq \lambda^+$ and $R_{\lambda + 1, \kappa}$ does not add any new subsets of λ. (shrink)

We reprove Gitik’s theorem that if the GCH holds and $o=\gk+1$ then there is a generic extension in which $\gk$ is still measurable and there is a closed unbounded subset C of $\gk$ such that every $ν\in C$ is inaccessible in the ground model. Unlike the forcing used by Gitik, the iterated forcing $\radin\gl+1$ used in this paper has the property that if $\gl$ is a cardinal less then $\gk$ then $\radin\gl+1$ can be factored in V as $\radin\gk+1=\radin\gl+1\times\radin\gl+1,\gk$ where $\card{\radin\gl+1}\le\gl+$ (...) and $\radin\gl+1,\gk$ does not add any new subsets of $\gl$. (shrink)

This article investigates whether there is an underlying morality in the ways that human beings seek to obtain economic security within our imperfect economy, which can be illuminated through evolutionary biology research. Two research questions are the focus of the analysis: (1) What is the transaction cognitive machinery that is specialized for the entrepreneurial task of exchange-based security-seeking? and, (2) What are the moral implications of the acquisition and use of such transaction cognitions?Evolutionary biology research suggests within concepts that are (...) more Darwin- v. Huxley-based, an underlying morality supportive of algorithm-governed economizing arising from the behaviors that are most worthy of long-term reproduction. Evolutionarily stable algorithm-enhanced security-seeking is argued to be a new view of entrepreneurship, but one that, somewhat ironically, is grounded in a primordially-based entrepreneurial morality that is at the core of economic security. (shrink)

Let ΩΩ be the semigroup of all mappings of a countably infinite set Ω. If U and V are subsemigroups of ΩΩ, then we write U≈V if there exists a finite subset F of ΩΩ such that the subsemigroup generated by U and F equals that generated by V and F. The relative rank of U in ΩΩ is the least cardinality of a subset A of ΩΩ such that the union of U and A generates ΩΩ. In this paper (...) we study the notions of relative rank and the equivalence ≈ for semigroups of endomorphisms of binary relations on Ω.The semigroups of endomorphisms of preorders, bipartite graphs, and tolerances on Ω are shown to lie in two equivalence classes under ≈. Moreover such semigroups have relative rank 0, 1, 2, or in ΩΩ where is the minimum cardinality of a dominating family for . We give examples of preorders, bipartite graphs, and tolerances on Ω where the relative ranks of their endomorphism semigroups in ΩΩ are 0, 1, 2, and .We show that the endomorphism semigroups of graphs, in general, fall into at least four classes under ≈ and that there exist graphs where the relative rank of the endomorphism semigroup is 20. (shrink)

We show that if there is no inner model with a Woodin cardinal and the Steel core model K exists, then every Jonsson cardinal is Ramsey in K, and every $\delta$-Jonsson cardinal is $\delta$-Erdos in K. In the absence of the Steel core model K we prove the same conclusion for any model L$[\mathscr{E}]$ such that either V = L$[\mathscr{E}]$ is the minimal model for a Woodin cardinal, or there is no inner model with a Woodin cardinal and V is (...) a generic extension of L$[\mathscr{E}]$. The proof includes one lemma of independent interest: If V = L$[\mathscr{A}]$, where A $\subset$ $\kappa$ and $\kappa$ is regular, then L$_\kappa$[A] is a Jonsson algebra. The proof of this result, Lemma 2.5, is very short and entirely elementary. (shrink)

Let equation image be the semigroup of all mappings on the natural numbers equation image, and let U and V be subsets of equation image. We write U≼V if there exists a countable subset C of equation image such that U is contained in the subsemigroup generated by V and C. We give several results about the structure of the preorder ≼. In particular, we show that a certain statement about this preorder is equivalent to the Continuum Hypothesis.The preorder ≼ (...) is analogous to one introduced by Bergman and Shelah on subgroups of the symmetric group on equation image. The results in this paper suggest that the preorder on subsemigroups of equation image is much more complicated than that on subgroups of the symmetric group. (shrink)

This book brings together an international group of scholars to discuss the ramifications of Heidegger's Black Notebooks for philosophy and the humanities. In contrast to both those who seek to exonerate Heidegger and those who simply condemn him, they urge careful reading and rereading of his work to turn Heideggerian thought against itself.