A multidisciplinary faculty committee designed a curriculum to shape biomedical graduate students into researchers with a high commitment to professionalism and social responsibility and to provide students with tools to navigate complex, rapidly evolving academic and societal environments with a strong ethical commitment. The curriculum used problem-based learning (PBL), because it is active and learner-centred and focuses on skill and process development. Two courses were developed: Scientific Professionalism: Scientific Integrity addressed discipline-specific and broad professional norms and obligations for the ethical (...) practice of science and responsible conduct of research (RCR). Scientific Professionalism: Bioethics and Social Responsibility focused on current ethical and bioethical issues within the scientific profession, and implications of research for society. Each small-group session examined case scenarios that included: (1) learning objectives for professional norms and obligations; (2) key ethical issues and philosophies within each topic area; (3) one or more of the RCR instructional areas; and (4) at least one type of moral reflection. Cases emphasised professional standards, obligations and underlying philosophies for the ethical practice of science, competing interests of stakeholders and oversight of science (internal and external). To our knowledge, this is the first use of a longitudinal, multi-semester PBL course to teach scientific integrity and professionalism. Both faculty and students endorsed the active learning approach for these topics, in contrast to a compliance-based approach that emphasises learning rules and regulations. (shrink)

Objective We conducted a process evaluation to (a) assess the effectiveness of a new problem-based learning curriculum designed to teach professionalism and scientific integrity to biomedical graduate students and (b) modify the course to enhance its relevance and effectiveness. The content presented realistic cases and issues in the practice of science, to promote skill development and to acculturate students to professional norms of science. Method We used 5-step Likert-scaled questions, open-ended questions, and interviews of students and facilitators to assess curricular (...) effectiveness. Results Both facilitators and students perceived course objectives were achieved. For example, respondents preferred active learning over lectures; both faculty and students perceived that the curriculum increased their understanding of norms, role obligations and responsibilities of professional scientists. They also reported an increased ability to identify ethical situations and felt that they had developed skills in moral reasoning and effective group work. Conclusions These data helped to improve course implementation and instructional material. For example, to correct a negative perception that this was an ‘ethics’ course, we redesigned case debriefing activities to reinforce learning objectives and important skills. We refined cases to be more engaging and relevant for students, and gave facilitators more specific training and resources for each case. The problem-based learning small group strategy can stimulate an environment whereby participants are more aware of ethical implications of science, and increase their socialisation and open communication about professional behaviour. (shrink)

The words in children's language learning environments are strongly predictive of cognitive development and school achievement. But how do we measure language environments and do so at the scale of the many words that children hear day in, day out? The quantity and quality of words in a child's input are typically measured in terms of total amount of talk and the lexical diversity in that talk. There are disagreements in the literature whether amount or diversity is the more critical (...) measure of the input. Here we analyze the properties of a large corpus of speech to children and simulate learning environments that differ in amount of talk per unit time, lexical diversity, and the contexts of talk. The central conclusion is that what researchers need to theoretically understand, measure, and change is not the total amount of words, or the diversity of words, but the function that relates total words to the diversity of words, and how that function changes across different contexts of talk. (shrink)

Background In May 2020, England moved to an opt-out organ donation system, meaning adults are presumed to be an organ donor unless within an excluded group or have opted-out. This change aims to improve organ donation rates following brain or circulatory death. Healthcare staff in the UK are supportive of organ donation, however, both healthcare staff and the public have raised concerns and ethical issues regarding the change. The #options survey was completed by NHS organisations with the aim of understanding (...) awareness and support of the change. This paper analyses the free-text responses from the survey. Methods The #options survey was registered as a National Institute of Health Research (NIHR) portfolio trial [IRAS 275992] 14 February 2020, and was completed between July and December 2020 across NHS organisations in the North-East and North Cumbria, and North Thames. The survey contained 16 questions of which three were free-text, covering reasons against, additional information required and family discussions. The responses to these questions were thematically analysed. Results The #options survey received 5789 responses from NHS staff with 1404 individuals leaving 1657 free-text responses for analysis. The family discussion question elicited the largest number of responses (66%), followed by those against the legislation (19%), and those requiring more information (15%). Analysis revealed six main themes with 22 sub-themes. Conclusions The overall #options survey indicated NHS staff are supportive of the legislative change. Analysis of the free-text responses indicates that the views of the NHS staff who are against the change reflect the reasons, misconceptions, and misunderstandings of the public. Additional concerns included the rationale for the change, informed decision making, easy access to information and information regarding organ donation processes. Educational materials and interventions need to be developed for NHS staff to address the concepts of autonomy and consent, organ donation processes, and promote family conversations. Wider public awareness campaigns should continue to promote the positives and refute the negatives thus reducing misconceptions and misunderstandings. Trial registration National Institute of Health Research (NIHR) [IRAS 275992]. (shrink)

This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach due to rugged (...) natural terrain and have very limited telecommunications infrastructure. The lack of these and other basic services makes it difficult for medical personnel to settle in these areas, which leads to an acute shortage of medical personnel. We comment on this problem and how it is addressed by 'The Virtual Doctor Project', emphasizing that while the telemedicine concept is not new in sub-Saharan Africa, the combination of mobility and connectivity to service a number of villages 'on the go' is an important variation in the shift back to the 1978 Alma Ata principles of the United Nations World Health Organization [WHO].This overview of the Virtual Doctor Project in Zambia provides insight into both the potential for ICT, and the problems and limitations that any "real-world" articulation of this technology must confront. (shrink)

We show that if κ is a weakly compact cardinal, then $\left( \matrix \kappa ^{+} \\ \kappa\endmatrix \right)\rightarrow \left(\left( \matrix \alpha \\ \kappa \endmatrix \right)_{m}\left( \matrix \kappa ^{n} \\ \kappa \endmatrix \right)_{\mu}\right)^{1,1}$ for any ordinals α < κ⁺ and µ < κ, and any finite ordinals m and n. This polarized partition relation represents the statement that for any partition $\kappa \times \kappa ^{+}=\underset i<m\to{\bigcup }K_{i}\cup \underset j<\mu \to{\bigcup }L_{j}$ of κ × κ⁺ into m + µ pieces either there (...) are A ∈ [κ]κ, B ∈ [κ⁺]α, and i < m with A × B ⊆ Ki or there are C ∈ [κ]κ, D ∈ [κ⁺]α, and j < μ with C × D ⊆ Lj. Related results for measurable and almost measurable κ are also investigated. Our proofs of these relations involve the use of elementary substructures of set models of large fragments of ZFC. (shrink)

The aim of this exploratory study was to examine client demographics and expectations, reasons for use, sensations during treatment, and perceived outcomes of Pranic Healing, an energy healing system lacking in scientific documentation but whose use in the general population is becoming more widespread internationally. This study consisted of a cross-sectional survey of adults (18+ years of age) receiving care from 12 Pranic Healing practices in four different states in the U.S. (N = 179) completing online questionnaires. Closed-ended response sets (...) were analyzed descriptively, while qualitative data were analyzed using content analysis. Reasons to use the therapy included physical, mental/emotional, and metaphysical issues, dissatisfaction with conventional care, and overall well-being. Expectations of care included enhanced abilities, cure or relief, or unsure. Respondents were more likely to cite a specific problem from which they needed alleviation than to cite overall health or wellness as their goal. Sensations experienced were reported to be of a relaxing nature and not, as was hypothesized, of an energizing nature. Results show that those who use Pranic Healing fit the sociodemographic profile of CAM (complementary and alternative medicine) users in the United States, that their reasons for use are not homogeneous, and that preliminary descriptive data from a selective subsample of respondents indicated that some respondents are experiencing positive outcomes attributed to this modality. (shrink)

Academic incivility can create divisiveness and affect learners’ sustainability towards degree attainment. Therefore, there is a need to empirically assess learner views on what constitutes academic incivility in higher education. To fill this gap, we developed the Incivility Indicators Instrument (i3), a multifaceted scale that measures the extent to which students view cumulative behaviors and dynamics as instances of academic incivility. To examine the reliability and factor structure of the i3, we conducted a two-part study with two samples of adults (...) in the United States who were enrolled in higher education programs. In study 1 (N = 342), we conducted an exploratory factor analysis (EFA) and found the initial three-factor structure. In study 2, we administered the instrument to a validating sample (N = 510) and examined the stability of the three-factor model and scores through confirmatory factor analysis (CFA). In this study, we describe the results of the study, provide implications, and discuss future directions. (shrink)

Upshot: We seek to address several questions and statements made in the commentaries by elaborating on the four main aspects of the M-N-L framework. Before doing so, we discuss the issue of constructivist teaching in the context of schools. We conclude by hypothesizing on what would be lost in the M-N-L framework by taking constructivism out of the picture.

BackgroundThe ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines are widely endorsed but compliance is limited. We sought to determine whether journal-requested completion of an ARRIVE checklist improves full compliance with the guidelines.MethodsIn a randomised controlled trial, manuscripts reporting in vivo animal research submitted to PLOS ONE (March–June 2015) were randomly allocated to either requested completion of an ARRIVE checklist or current standard practice. Authors, academic editors, and peer reviewers were blinded to group allocation. Trained reviewers performed outcome adjudication (...) in duplicate by assessing manuscripts against an operationalised version of the ARRIVE guidelines that consists 108 items. Our primary outcome was the between-group differences in the proportion of manuscripts meeting all ARRIVE guideline checklist subitems.ResultsWe randomised 1689 manuscripts (control: n = 844, intervention: n = 845), of which 1269 were sent for peer review and 762 (control: n = 340; intervention: n = 332) accepted for publication. No manuscript in either group achieved full compliance with the ARRIVE checklist. Details of animal husbandry (ARRIVE subitem 9b) was the only subitem to show improvements in reporting, with the proportion of compliant manuscripts rising from 52.1 to 74.1% (X2 = 34.0, df = 1, p = 2.1 × 10−7) in the control and intervention groups, respectively.ConclusionsThese results suggest that altering the editorial process to include requests for a completed ARRIVE checklist is not enough to improve compliance with the ARRIVE guidelines. Other approaches, such as more stringent editorial policies or a targeted approach on key quality items, may promote improvements in reporting. (shrink)

Context: Constructivist teachers who find themselves working within an educational system that adopts a realist epistemology, may find themselves at odds with their own beliefs when they catch themselves paying closer attention to the knowledge authorities intend them to teach rather than the knowledge being constructed by their learners. Method: In the preliminary analysis of the mathematical learning of six low-performing Year 7 boys in a Maltese secondary school, whom one of us taught during the scholastic year 2014-15, we constructed (...) a conceptual framework which would help us analyze the extent to which he managed to be sensitive to constructivism in a typical classroom setting. We describe the development of the framework M-N-L as a viable analytical tool to search for significant moments in the lessons in which the teacher appeared to engage in what we define as “constructivist teaching” during mathematics lessons. The development of M-N-L is part of a research program investigating the way low-performing students make mathematical sense of new notation with the help of the software Grid Algebra. Results: M-N-L was found to be an effective instrument which helped to determine the extent to which the teacher was sensitive to his own constructivist beliefs while trying to negotiate a balance between the mathematical concepts he was expected to teach and the conceptual constructions of his students. Implications: One major implication is that it is indeed possible for mathematics teachers to be sensitive to the individual constructions of their learners without losing sight of the concepts that society, represented by curriculum planners, deems necessary for students to learn. The other is that researchers in the field of education may find M-N-L a helpful tool to analyze CT during typical didactical situations established in classroom settings. (shrink)

Si la discussion présente — comme la poésie — quelque au-delà d'ordre ontologique, il nous ferait plaisir de reprendre les points posés par M. Brault dans son post-scriptum à un récent article* …D'abord il était question d'éviter les « à peu près» quant aux bases de discussion valable sur toute poésie; or, le but de notre exposé ne visait certes pas à polir une définition originale; il allait de soi que nous faisions nôtres les acceptions généralement admises, à commencer par (...) celles de M. Brault. La poésie est rythme, chant, véhicule d'images — et de pensées — susceptibles d'émouvoir; témoignage de notre soif de certitude, prière … II n'en est pas moins vrai que, pendant des siècles, le concept a maintenu gaillardement ses droits dans l'expression poétique à côté du frisson causé par des impondérables et sans toujours, immanquablement, lui nuire. La poésie de Racine est tout de meme conceptuelle; et celle de Vigny — et celle de Chateaubriand si, comme on nous le fait justement remarquer, la poésie dépasse le cadre d'une prosodie plus ou moins traditionnelle. (shrink)

The doctrine of simple individuals has its equal and opposite reaction in the view that an individual is simply a bundle of properties, that the identity of an individual is entirely dependent on the identity of its properties. This view also seems to me to be in some sense wrong and I shall attack it in passing. If all my remarks have seemed excessively polemical it is because I have been anxious to make it as clear as possible what the (...) motivation behind this paper is. I am mainly concerned with the problem concerning the "it" which underlies or has properties and I shall want to argue that the identity of an individual--what it is that makes an individual that individual--does not depend merely on its being that individual or having that piece of substratum, but it depends partially and in a complicated way on the identity of its properties. The analysis will have to exhibit the nature of that dependence. Most of the discussion will revolve around proper names and their function since it is through linguistic considerations, I think, that we get the clearest illumination. The result, in case any one is interested, will be Absolute Idealism, or something like it. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Criminal Law, Pain Relief, and Physician Aid in DyingFaye Girsh, Ed.D., Executive DirectorMadam:The article by Cantor and Thomas on “Pain Relief, Acceleration of Death, and Criminal Law” (KIEJ, June 1996) was a tortured attempt to develop criteria for the humane and compassionate physician who tries to serve the needs of a patient in unremitting pain. There are three areas that merit comment.The authors dealt with pain medications that might (...) have the undesirable side effect of causing death. They did not mention tolerance, which usually occurs in a patient with chronic pain and which would require exceedingly high doses to be effective. They did not mention barbiturates, which are preferable to opiates in causing death and which are used increasingly by compassionate physicians to answer the pleas of their suffering patients, but for which there is no excuse about alleviating pain. Would the criminal law just call the prescription of a lethal dose of barbiturates a reckless act and require conviction? Fortunately, juries, as the authors point out, do not balance these formulas on the head of a pin. When they see the circumstances under which these doctors do help their patients, they choose to nullify the law and would ignore the suggestions made in this article.The authors refer to the “consent” of the patient. They do not mention that these doctors are operating with more than consent; they are administering these medications because suffering patients are begging them to put them out of their pain and the indignities of the dying process. The article discusses the process as though it were the same as consent to elective surgery. These patients—with AIDS, cancer, and hopeless neurological degeneration—are not simply agreeing to a procedure; they are desperately seeking a way out. If the criminal law were to develop criteria for physician aid in dying, certainly one of them should be the active, witnessed, repeated request of such a patient for a certain, quick, painless, gentle death.The third point is that physicians do not face prosecution when administering no treatment to a patient whose life could be saved with treatment but who chooses not to receive it. This has been upheld by the U.S. Supreme Court; no criteria for suffering, alternatives, terminality, justifiability, or unbearability are required. The doctor can stand by while the patient dies what may be a protracted, difficult death, but it is within the law. What matters in this situation is the decision of the patient to refuse treatment, and that is absolute. How ironic that the patient who cannot refuse treatment must, with his or her doctor, jump through all these hoops to achieve a peaceful death.One worries that the physician who must balance the risk of “risky pain relief” against the accusation of recklessness will err in the direction of allowing [End Page 103] the patient to bear the pain rather than help with a dose of analgesics that might be considered beyond the stipulated “risk.”Why don’t we just be honest about it? Allow dying or hopelessly ill patients to make the decision about what they want by passing a carefully defined law allowing euthanasia rather than balancing the risk and trying to determine the “purpose” of the physician’s ministrations. We protect some patients from themselves while allowing others almost complete autonomy to make the choice of ending their lives. The authors were right in saying that proponents of rational laws consider this sheer hypocrisy.Faye Girsh, Executive DirectorHemlock Society U.S.A. Denver, COFaye Girsh misconceives our article’s objective as an “attempt to develop criteria” for the humane physician. Our goal in writing the paper was to analyze the current criminal law framework in the hope of sharpening debate and engendering normative critiques. We readily acknowledge tensions in the current legal framework and would support changes in that framework.Copyright © 1997 The Johns Hopkins University Press... (shrink)

Reports from antiquity — two factual and another based on myth — claim that Ptolemy I was a son of the Macedonian king Philip II. If so, Ptolemy was a half-brother of Alexander the Great. Scholars suppose that this rumour was promoted by Ptolemy I. But this cannot be confirmed. It seems rather that Arsinoë, the mother of Ptolemy I, was a concubine at the court of Philip II and that a rumour existed that Ptolemy I was illegitimately born. This (...) rumour developed in two separate ways. In Macedon, probably in the late 280's BCE, it was claimed that the father of Ptolemy was Philip II. The story may have been inspired by Ptolemy Keraunos in the course of his quest for the Macedonian throne. In Egypt, however, in spite of an apparent reluctance of Ptolemy I to link Lagos with his name, it was officially proclaimed in the reign of his son that Lagos was the father of Ptolemy I. It is possible thereby that Ptolemy II removed the stigma of bastardy from the first Ptolemaic king. (shrink)

We build on the work of Moore and Gino (2015) and of Rest (1983, 1986) to develop the Ethical Guardrails Model (EGM). The EGM shows students how personal behaviors, relationships, and habits can help them to avoid ethical mistakes in the workplace. The EGM illustrates the components of ethical business behavior, incorporates a new deliberative component, specifies five ways in which ethical behavior may become derailed, and describes practices that can help a person to avoid derailment. We also describe our (...) use of the EGM in the business ethics classroom, an experience that has changed our approach to teaching business ethics. (shrink)