There has been much philosophical interest regarding the ‘hierarchy of evidence’ used to determine which study designs are of most value for reporting on questions of effectiveness, prognosis, and so on. There has been much less philosophical interest in the choice of outcome measures with which the results of, say, an RCT or a cohort study are presented. In this paper, we examine the FDA’s recently published guidelines for assessing the psychometric adequacy of patient-reported outcome measures. We focus on their (...) recommendations for demonstrating content validity and also for how researchers should weigh up the sum of psychometric evidence when choosing these measures. We argue that questions regarding judgment and understanding meaning of these measures should play a more central role in determining their adequacy. (shrink)

Since the 1970’s epidemiological measures focusing on “health-related quality of life” or simply “quality of life” have figured increasingly as endpoints in clinical trials. Before the 1970’s these measures were known, generically, as performance measures or health status measures. Relabeled as “quality of life measures” they were first used in cancer trials. In the early 2000’s they were relabeled again as “patient-reported outcome measures” or PROMs, in their service to the FDA to support drug labeling claims. To the limited degree (...) that the philosophical literature addresses these measures, it tends to associate them with two major theories of well-being: subjective well-being and the capabilities approach. In this paper, I argue that philosophers ought to treat quality of life measures/proms as a distinct from these theories. I argue that quality of life/proms serve healthcare as vehicles for patient-centered care and this has important consequences for how we theorize these measures. To this end, two requirements set them apart from measures of subjective well-being and the capabilities approach: quality of life/proms need to be patient-directed and inclusive. (shrink)

In this paper I discuss how we should distinguish legitimate from illegitimate questions. I will argue that we should not make such distinctions prior to asking our questions; that questioning is more of an art than a science and that this art is part of the art of conversation in general. Nonetheless, the desire to limit in advance the questions that we can legitimately ask is not infrequent. In the philosophy of science this ambition manifests in response to concerns regarding (...) the corruption of scientific knowledge and inquiry. Similarly in the quantitative social sciences researchers develop measures by isolating in advance just those questions that they believe will best illuminate the construct under investigation. In order to preserve the integrity of their data much is done to avoid and adjust for errant respondent understandings of these questions. I argue, however, that limiting our questions in these ways does not secure knowledge and inquiry from bias, but rather unduly limits what we might come to know. Drawing on Gadamer’s work in Truth and Method I argue that we can distinguish legitimate from illegitimate questions, but that we can only do so by first asking them. (shrink)

A sense of agency over wilful actions is thought to be dependent on the level of choice and the nature of the outcome. In a preregistered study, we manipulated choice and valence of outcome to assess the relationship between SoA across the depression and psychosis continuum. Participants completed a Libet Clock task, in which they had either a free or forced choice to press one of two buttons and received either a rewarding or punishing outcome. Participants also completed questionnaires on (...) depressive and psychosis-like traits. Rewarding outcomes increased intentional binding. The evidence favoured no effect of choice on average, but this was influenced by inter-individual differences. Individuals reporting more depressive traits had less of a difference in intentional binding between free and forced choice conditions. We show that implicit SoA is sensitive to outcome valence and the effect of choice differs across the depression continuum. (shrink)

Background: This article describes the overall attitudes of children, their parents, and attending physicians toward including or excluding pediatric patients in medical communication and health care decision-making processes. Methods: Fifty-two interviews were carried out with pediatric patients (n = 17), their parents (n = 19), and attending oncologists (n = 16) in eight Swiss pediatric oncology centers. The interviews were analyzed using thematic coding. Results: Parenting styles, the child's personality, and maturity are factors that have a great impact upon the (...) inclusion of children in their health care processes. Children reported the desire to be heard and involved, but they did not want to dominate the decision-making process. Ensuring trust in the parent–child and physician–patient relationships and respecting the child as the affected person were important values determining children's involvement. These two considerations were closely connected with the concern that fantasies are often worse than reality. Seeking children's compliance with treatment was a practical but critical reason for informing them about their health care. The urge to protect them from upsetting news sometimes resulted in their (partial) exclusion. Conclusions: The ethical imperative for inclusion of children in their health care choices was not so much determined by the right for self-determination, but by the need to include them. If children are excluded, they imagine things, become more isolated, and are left alone with their fears. Nevertheless, the urge to protect children is innate, as adults often underestimate children's coping capacities. (shrink)

© 2015 Elsevier Inc.Toxoplasma gondii is a protozoan pathogen in the phylum Apicomplexa that resides within an intracellular parasitophorous vacuole that is selectively permeable to small molecules through unidentified mechanisms. We have identified GRA17 as a Toxoplasma-secreted protein that localizes to the parasitophorous vacuole membrane and mediates passive transport of small molecules across the PVM. GRA17 is related to the putative Plasmodium translocon protein EXP2 and conserved across PV-residing Apicomplexa. The PVs of GRA17-deficient parasites have aberrant morphology, reduced permeability to (...) small molecules, and structural instability. GRA17-deficient parasites proliferate slowly and are avirulent in mice. These GRA17-deficient phenotypes are rescued by complementation with Plasmodium EXP2. GRA17 functions synergistically with a related protein, GRA23. Exogenous expression of GRA17 or GRA23 alters the membrane conductance properties of Xenopus oocytes in a manner consistent with a large non-selective pore. Thus, GRA17 and GRA23 provide a molecular basis for PVM permeability and nutrient access. (shrink)

This volume explores the role of some of the most prominent twentieth-century philosophers and political thinkers as teachers. It examines what obstacles they confronted as teachers and how they overcame them in conveying truth to their students in an age dominated by ideological thinking.

Research has shown high levels of housing precarity among government-assisted refugees connected to difficult housing markets, limited social benefits, and other social and structural barriers to positive settlement. The COVID-19 pandemic has likely exacerbated this precarity. Research to date demonstrates the negative consequences of the COVID-19 pandemic for refugees and low-income households, including both health-related issues and economic challenges, that may exacerbate their ability to obtain affordable, suitable housing. In this context, we examined Syrian government-assisted refugees’ experiences during the pandemic, (...) asking: how the COVID-19 pandemic has impacted Syrian refugees’ experiences of housing stability. To examine this issue, we interviewed 38 families in Calgary, London, and Fredericton. Using a qualitative descriptive methodology for analysis and interpretation, we found the liminality of settling as a GAR has been compounded by isolation, further economic loss, and new anxieties during the pandemic. Ultimately, for many participants, the pandemic has thwarted their housing stability goals and decreased their likelihood of improving their housing conditions. Based on our findings, we discuss potential policy and practice relevant solutions to the challenges faced by refugees in Canada during the pandemic and likely beyond. (shrink)

The emergence of the “4th Industrial Revolution,” i.e. the convergence of artificial intelligence, the Internet of Things, advanced materials, and bioengineering technologies, could accelerate socioeconomic insecurities and anxieties or provide beneficial alternatives to the status quo. In the post-Covid-19 era, the entities that are best positioned to capitalize on these innovations are large firms, which use digital platforms and big data to orchestrate vast ecosystems of users and extract market share across industry sectors. Nonetheless, these technologies also have the potential (...) to democratize ownership, broaden political-economic participation, and reduce environmental harms. We articulate the potential sociotechnical pathways in this high-stakes crossroads by analyzing cellular agriculture, an exemplary 4th Industrial Revolution technology that synergizes computer science, biopharma, tissue engineering, and food science to grow cultured meat, dairy, and egg products from cultured cells and/or genetically modified yeast. Our exploration of this space involved multi-sited ethnographic research in both the cellular agriculture community and alternative economic organizations devoted to open source licensing, member-owned cooperatives, social financing, and platform business models. Upon discussing how these latter approaches could potentially facilitate alternative sociotechnical pathways in cellular agriculture, we reflect upon the broader implications of this work with respect to the 4th Industrial Revolution and the enduring need for public policy reform. (shrink)

Throughout Jewish history, revolutionary events and subversive ideas have burst onto the scene, transforming everything in their path. Re-forming Judaism seeks to explore these ideas-and the individuals behind them-by delving into historical disruptions that led to lasting change in Jewish thought.

Affective variables have been shown to impact working memory and cognitive control. Theoretical arguments suggest that the functional impact of emotion on cognition might be mediated through shifting action dispositions related to changes in motivational orientation. The current study examined the effects of positive and negative affect on performance via direct manipulation of motivational state in tasks with high demands on cognitive control. Experiment 1 examined the effects of monetary reward on task-switching performance, while Experiment 2 examined the effects of (...) both rewards and punishments on working memory, using primary (liquid) reinforcers. In both experiments, dissociable trial-by-trial and contextual (block-related) enhancements of cognitive control during task performance were observed in relationship to motivational incentive value. Performance enhancements were equivalent in the reward and punishment conditions, but were differentially impacted by individual difference measures of trait reward and punishment sensitivity. Together, the results suggest both common and specific mechanisms by which approach and avoidance motivational states influence cognitive control, via activation of reward and punishment processing systems. (shrink)

American Indian/Alaska Native (AI/AN) populations in the United States continue to experience overall health inequity, despite significant improvement in health status for nearly all other racial‐ethnic groups over the past 30 years. Nurses comprise the bulk of healthcare providers in the U.S. and are in an optimal position to improve AI/AN health by transforming both nursing education and practice. This potential is dependent, however, on nurses’ ability to recognize the distinct historical and political conditions through which AI/AN health inequities have (...) been produced and sustained. Nurse providers, educators, and leaders must in turn recognize how the sustained conditions of marginalization and expropriation that underpin current AI/AN health inequities continue to shape contemporary AI/AN health outcomes. This manuscript builds upon the extant literature of AI/AN historical health policy and utilizes decolonial theorizations of nursing and a cultural safety framework to propose a series of immediately actionable steps for nursing intervention into AI/AN health inequity. Ultimately, we suggest that it is crucial for nurses to collaborate with AI/AN individuals and communities across educational and clinical settings to further refine these approaches in alignment with the disciplinary obligation of promoting social justice within healthcare. (shrink)

Hierarchical Bayesian models provide an account of Bayesian inference in a hierarchically structured hypothesis space. Scientific theories are plausibly regarded as organized into hierarchies in many cases, with higher levels sometimes called ‘paradigms’ and lower levels encoding more specific or concrete hypotheses. Therefore, HBMs provide a useful model for scientific theory change, showing how higher-level theory change may be driven by the impact of evidence on lower levels. HBMs capture features described in the Kuhnian tradition, particularly the idea that higher-level (...) theories guide learning at lower levels. In addition, they help resolve certain issues for Bayesians, such as scientific preference for simplicity and the problem of new theories. (shrink)

Rumination is a maladaptive form of emotion regulation associated with psychopathology. Research with adults suggests that rumination covaries with diurnal cortisol rhythms, yet this has not been examined among adolescents. Here, we examine the day-to-day covariation between rumination and cortisol, and explore whether trait rumination is associated with alterations in diurnal cortisol rhythms among adolescent girls. Participants provided saliva samples 3 times per day over 3 days, along with daily reports of stress and rumination, questionnaires assessing trait rumination related to (...) peer stress, and diagnostic interviews assessing depression and anxiety. Greater rumination than usual during the day was associated with lower cortisol awakening responses the following morning, but this effect was not significant after accounting for wake time and an objective measure of adherence to the saliva sampling protocol. Trait rumination was associated with lower average cortisol levels at waking and flatter diurnal slopes, accounting for wake time, protocol compliance, and other factors. These patterns may help to explain why rumination is related to the development of psychopathology. (shrink)

Medical-legal partnerships connect legal advocates to healthcare providers and settings. Maintaining effectiveness of medical-legal partnerships and consistently identifying opportunities for innovation and adaptation takes intentionality and effort. In this paper, we discuss ways in which our use of data and quality improvement methods have facilitated advocacy at both patient (client) and population levels as we collectively pursue better, more equitable outcomes.

It is well documented that people denied good human contact and interaction do not thrive well. One way people can be protected from the ravages of loneliness is animal companionship. Early laboratory observations of people with animals encouraged a period of research to identify, document, and assess the beneficial health implications of our relationship with companion animals. All indications are that companion animals play the role of a family member, often a member with the most desired attributes. Ordinary interactions with (...) animals can reduce blood pressure and alter survival after a heart attack. Pets, for some, afford increased opportunities to meet people, whereas for others, pets permit them to be alone without being lonely. The relationship between people and companion animals explains why people prefer alternatives to animal use for medical research. (shrink)

Die Frequenzkurven, die die lebendige Substanz charakterisieren, können als eine statische Beschreibung oder als das Ergebnis einer Entwicklung betrachtet werden.Im ersten Falle akzeptiert man ohne weiteres die gegebenen Verteilungen und man versucht, ihnen durch mathematische Gleichungen, die keine unmittelbare Wirklich-keitsbedeutung haben, nahezukommen. Das kausale Denken wird hier ausgeschaltet oder man gibt sich wenigstens mit nur sehr groben Analogien zufrieden.Verschiedene Methoden über die Genese der Frequenzkurven werden besprochen; dabei wird gezeigt, dass die Mehrheit der Fälle auf Hypothesen beruht, die biologisch wenig (...) begründet sind. Eine Ausnahme davon macht die Theorie vonJ. C. Kapteyn, weil er den Vorgang des Wachstums in die Genese einbezieht. Seine Methode weiter ausbauend kann man sich vorstellen, dass die Genese einer Frequenzkurve in erblich homogenem Pflanzenmaterial durch Variation der Wachstumsgeschwindigkeit zustandekommt.Auf solche Weise kann man in einem Koordinatensystem mit Länge und Zeit als Koordinaten ein “Deviationsraster” konstruieren.In einem experimentell untersuchten Fall ergab die graphische Methode mit völlig ausreichender Genauigkeit die schon gefundene Frequenz.Les courbes de fréquence qui caractérisent la matière vivante, peuvent être considérées ou comme une description statique ou bien comme le produit d'un développement.Dans le premier cas on accepte les distributions obtenues et on essaie de s'en rapprocher par des équations mathématiques qui n'ont pas une réalité effective. On ne recherche plus la causalité ou alors on se contente le plus souvent d'analogies très grossières.Les auteurs traitent des diverses méthodes de la genèse des courbes de fréquence et démontrent que la plupart des cas reposent sur des hypothèses qui ont peu de fond biologique. La théorie deM. J. C. Kapteyn fait exception parcequ'il introduit le processus de croissance dans la genèse. En poursuivant plus loin dans sa méthode on peut se figurer que la genèse d'une courbe de fréquence de plantes homogènes par hérédité s'expliquerait par des variations de vitesse de croissance.De cette façon on peut construire une “grille de déviation” dans un système en prenant longueur et temps comme coordonnées.Dans un cas essayé expérimentalement ce graphique donnait avec une exactitude assez grande la distribution de fréquence déjà trouvée. (shrink)

The relativistic Schrödinger theory (RST) for N-fermion systems is further elaborated with respect to three fundamental problems which must emerge in any relativistic theory of quantum matter: (i) emergence/suppression of exchange forces between identical/non-identical particles, (ii) self-interactions, (iii) non-relativistic approximation. These questions are studied in detail for two- and three-particle systems but the results do apply to a general N-particle system. As a concrete demonstration, the singlet and triplet configurations of the positronium groundstate are considered within the RST framework, including (...) a discussion of the corresponding hyperfine splitting. (shrink)

Public health legal preparedness begins with effective legal authorities, and law provides a key foundation for public health practice in the United States. Laws not only create public health agencies and fund them, but also authorize and impose duties upon government to protect the public's health while preserving individual liberties. As a result, law is an essential tool in public health practice and is one element of public health infrastructure, as it defines the systems and relationships within which public health (...) practitioners operate.For purposes of this paper, law can be defined as a rule of conduct derived from federal or state constitutions, statutes, local laws, judicial opinions, administrative rules and regulations, international codes, or other pronouncements by entities authorized to prescribe conduct in a legally binding manner. Public health legal preparedness, a subset of public health preparedness, is defined as attainment of legal benchmarks within a public health system. (shrink)

Public health legal preparedness begins with effective legal authorities, and law provides a key foundation for public health practice in the United States. Laws not only create public health agencies and fund them, but also authorize and impose duties upon government to protect the public's health while preserving individual liberties. As a result, law is an essential tool in public health practice and is one element of public health infrastructure, as it defines the systems and relationships within which public health (...) practitioners operate.For purposes of this paper, law can be defined as a rule of conduct derived from federal or state constitutions, statutes, local laws, judicial opinions, administrative rules and regulations, international codes, or other pronouncements by entities authorized to prescribe conduct in a legally binding manner. Public health legal preparedness, a subset of public health preparedness, is defined as attainment of legal benchmarks within a public health system. (shrink)

Background:The belief that we can control our thoughts is not inevitably adaptive, particularly when it fuels mental control activities that have ironic unintended consequences. The conviction that the mind can and should be controlled can prompt people to suppress unwanted thoughts, and so can set the stage for the intrusive return of those very thoughts. An important question is whether or not these beliefs about the control of thoughts can be reduced experimentally. One possibility is that behavioral experiments aimed at (...) revealing the ironic return of suppressed thoughts might create a lesson that could reduce unrealistic beliefs about the control of thoughts. Aims: The present research assessed the influence of the thought suppression demonstration on beliefs about the control of thoughts in a non-clinical sample, and among individuals with obsessive-compulsive disorder (OCD). Method: In Study 1, we assessed the effect of the thought suppression demonstration on beliefs about the control of thoughts among low and high obsessive individuals in the non-clinical population (N= 62). In Study 2, we conducted a similar study with individuals with OCD (N= 29). Results: Results suggest that high obsessive individuals in the non-clinical population are able to learn the futility of suppression through.. (shrink)

Children ranging from 3 to 5 years were introduced to two anthropomorphic robots that provided them with information about unfamiliar animals. Children treated the robots as interlocutors. They supplied information to the robots and retained what the robots told them. Children also treated the robots as informants from whom they could seek information. Consistent with studies of children's early sensitivity to an interlocutor's non-verbal signals, children were especially attentive and receptive to whichever robot displayed the greater non-verbal contingency. Such selective (...) information seeking is consistent with recent findings showing that although young children learn from others, they are selective with respect to the informants that they question or endorse. (shrink)

BackgroundThe main purpose of this study was to describe the latent structure of pregnancy perception by investigating the role of risks and medical examinations in pregnancy perception across the sexes and pregnancy status.MethodsStudy 1 developed a questionnaire based on the responses of 29 young adults on their perception of pregnancy. Study 2 consisted of distributing the questionnaire among 290 participants.ResultsThe statistical clustering analysis revealed three major clusters of pregnancy perceptions: “evaluative,” “physio-medical,” and “future considerations,” each of them encompassing several meaningful (...) sub-clusters. This structure of pregnancy perceptions supports Beck and Beck-Gernsheim’s modernization approach. Negative emotions toward pregnancy were related to social cognitions, whereas thoughts about risks were included in the medical sub-cluster. After reliability analyses, comparisons of scale scores revealed that women experienced more positive emotions, thought more about physical symptoms and about future issues compared to men.ConclusionPregnant participants felt less ambivalence toward pregnancy, thought more about risks and medical examinations and less about parents’ duties than non-pregnant participants. (shrink)