Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. -/- Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary and (...) anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. -/- Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/ energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). -/- Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality. (shrink)

Recruiting research participants based on genetic information generated about them in a prior study is a potentially powerful way to study the functional significance of human genetic variation, but it also presents ethical challenges. To inform policy development on this issue, we conducted a survey of U.S. institutional review board chairs concerning the acceptability of recontacting genetic research participants about additional research and their views on the disclosure of individual genetic results as part of recruitment. Our findings suggest there is (...) unlikely to be a “one-size-fits-all” solution, but rather several ethically acceptable approaches to genotype-driven recruitment, depending on context. Disclosures made during the consent process for the original study and the clinical validity of the results are key considerations. Researchers must be prepared to communicate and answer questions in clear lay language about what is known and not known regarding the role of genetics in their proposed area of research. (shrink)

This report describes the rationale, approaches, organization, and resource development leading to a large-scale deletion bin map of the hexaploid wheat genome. Accompanying reports in this issue detail results from chromosome bin-mapping of expressed sequence tags representing genes onto the seven homoeologous chromosome groups and a global analysis of the entire mapped wheat EST data set. Among the resources developed were the first extensive public wheat EST collection. Described are protocols for sequencing, sequence processing, EST nomenclature, and the assembly of (...) ESTs into contigs. These contigs plus singletons were used for selection of distinct sequence motif unigenes. Selected ESTs were rearrayed, validated by 5′ and 3′ sequencing, and amplified for probing a series of wheat aneuploid and deletion stocks. Images and data for all Southern hybridizations were deposited in databases and were used by the coordinators for each of the seven homoeologous chromosome groups to validate the mapping results. Results from this project have established the foundation for future developments in wheat genomics. (shrink)

In psychologists' attempts to explain the nature of language and thought, all pretense of building an axiomatic system was laid aside. The severely limited success of formal axiomatic systems in psychology eliminated most of the desire to even attempt such a project shortly after Hull's work was completed. Whatever axiomatic qualities psychological theories possess, they are rarely expressed as such. We have seen that Dollard and Miller translated some Freudian principles into those of Hull, and although they demonstrated the (...) similarities that existed between the two theories, this never induced Freudians to change their vocabulary or their theoretical concepts to those of Hull. Freudian theory was so extensively interpretative and so restructured in a formal, or even semi-formal, axiomatic manner. However, as we have seen, since Skinner developed a system that lent itself to axiomatic arrangement, a successful attempt to account for the functional aspects of language and thought through the principles of behavior analysis would constitute a major advance in psychological theory. (shrink)

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

Since publication of the 1986 Carnegie Commission report, A Nation Prepared: Teachers for the 21st Century, the professional teaching standards movement has gained noticeable momentum. The professional standards movement in teaching has been fueled by national organizations such as the National Council for Accreditation of Teacher Education, the Interstate New Teachers Assessment and Support Consortium, the National Board for Professional Teaching Standards, the National Commission on Teaching and America's Future, and by close collaboration among these four entities. Further, nearly all (...) of the fifty states are embracing the professional standards movement through formal participation in the work of one or more of these organizations. Although the professional standards movement in teaching is strong and growing stronger, its implications are not clear for instructional programs in social foundations of education, either at the teacher preparation or the advanced graduate levels. In response to the standards movement, social foundations educators have a number of options before them, three of which are to (1) largely ignore these developments, as "this too shall pass"; (2) critically interpret and resist these developments through scholarship and collective professional action, as social foundations scholars did with Competency Based Teacher Education in the 1970s; and (3) critically interpret these developments while working to strengthen the potential of the professional teaching standards movement to achieve its stated goal of providing caring and qualified teachers for every classroom in the nation. Of these three options, the last is most advisable, but it presents a considerable challenge to social foundations educators. Although the absence of social foundations skills, perspectives, and understanding should make it very difficult for teacher candidates and teachers to perform well on standards-based teaching assessments, there is no guarantee that these assessments will hold candidates accountable for social foundations learning. Implications for social foundations educators and activists are significant. (shrink)

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

From computerized medical records to databases of pharmacological interactions and automated provisional EKG readings, the emergence of information technology has significantly altered the practice of medicine. Information technology has been widely used to enhance diagnosis and treatment and to improve communication between providers. The advent of the Internet also brings far-reaching implications for patient–physician communication, challenging physicians, patients, and policymakers to consider its impact on the delivery of medical care and the therapeutic relationship. A new set of practices by patients (...) and physicians is unfolding in cyberspace, ranging from the use of e-mail to communicate between physicians and patients in an existing relationship to one-to-one consultations with an anonymous physician and ongoing online treatment, such as psychotherapy. These practices are emerging in both the for-profit and not-for-profit spheres. (shrink)

We argue that the propositional and link-based approaches to human contingency learning represent different levels of analysis because propositional reasoning requires a basis, which is plausibly provided by a link-based architecture. Moreover, in their attempt to compare two general classes of models (link-based and propositional), Mitchell et al. refer to only two generic models and ignore the large variety of different models within each class.

Berger and Miller raise important considerations regarding the ongoing relevance and use of cultural competency in medical education. In particular, the authors critique the United States’ L...

Vaccination complacency occurs when perceived risks of vaccine-preventable diseases are sufficiently low so that vaccination is no longer perceived as a necessary precaution. Disease outbreaks can once again increase perceptions of risk, thereby decrease vaccine complacency, and in turn decrease vaccine hesitancy. It is not well understood, however, how change in perceived risk translates into change in vaccine hesitancy. -/- We advance the concept of vaccine propensity, which relates a change in willingness to vaccinate with a change in perceived risk (...) of infection—holding fixed other considerations such as vaccine confidence and convenience. (shrink)

Soil is fragile and nonrenewable but the most basic of natural resources. It has a capacity to tolerate continuous use but only with proper management. Improper soil management and indiscriminate use of chemicals have contributed to some severe global environmental issues, e.g., volatilization losses and contamination of natural waters by sediments and agricultural fertilizers and pesticides. The increasing substitution of energy for labor and other cultural inputs in agriculture is another issue. Fertilizers and chemicals account for about 25% of the (...) production energy investment in agriculture. An additional 60% is accounted for by machinery, gasoline, electricity, and power-related inputs. Fertilizer additions to cropland are not utilized fully and significant amounts, depending on conditions, are either lost in surface runoff or leached into the ground water. The annual discharge of dissolved solids from agricultural lands to the waterways in the USA is substantial. The increasing use of herbicides in agriculture is a threat to the quality of surface and ground water, although this threat is dependent upon both the chemistry of the compound and the ecosystem in which it is used. Especially within the Third World, development of an environmental ethic and environmental laws have not kept pace with the increase in pesticide use. Above all is the severe and global problem of soil degradation currently occurring at the rate of five to seven million hectares per year. The policy and moral aspects of these issues are discussed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Rhetoric of RHETORIC: The Quest for Effective CommunicationCarolyn R. MillerThe Rhetoric of RHETORIC: The Quest for Effective Communication. Wayne C. BoothMalden, Mass: Blackwell, 2004. Pp. xvi + 206. $20.95, paperback.By using the traditional word rhetoric I want to suggest a whole philosophy of how men succeed or fail in discovering together, in discourse, new levels of truth (or at least agreement) that neither side suspected before.—Wayne C. (...) Booth, 1974Listening-Rhetoric is what I most long to celebrate and practice—the kind that is sadly rare.... Here both sides join in a trusting dispute, determined to listen to the opponent's arguments, while persuading the opponent to listen in exchange.... Both sides are pursuing not just victory but a new reality, a new agreement about what is real.—Wayne C. Booth, 2004By the evidence of these two quotations, the late Wayne Booth sustained a passionate interest in a constructivist, cooperative rhetoric for at least thirty years. His 1974 Modern Dogma and the Rhetoric of Assent first sounds many of the themes that are rearticulated in his 2004 The Rhetoric of RHETORIC, a volume in the Blackwell Manifestos series. Both books were motivated by evident failures of public discourse, the earlier one by those emanating from the Vietnam War, including student protests at the University of Chicago, and the recent one by multiple rhetorical sins of the Bush administration and the national media, especially those concerning the war in Iraq. Indeed, Booth confesses here that his distress dates at least to 1963, when he lamented that "the debate about the [Kennedy] assassination [may be] a greater national disgrace than the assassination itself" (109).What animates Booth in both books is the conviction not that only we can do better in conducting our discursive relationships as a nation, as institutions, as families, but that we must do so. We must do so because our ability to live and progress together depends on our talking rather than resorting to force and on our talking in a way that engenders trust and enables continued debate, rather than provoking mistrust and disrespect. The two enemies he has always in sight are violence and deception. These are two forms of rhetorical failure, but the two become entangled when "violence and the threat of violence corrupt rhetoric," particularly during times of war (118), and when corrupt rhetoric itself becomes a kind of violence (48). [End Page 261]As a "manifesto" addressed to a non-specialist audience, The Rhetoric of RHETORIC is relatively brief, engagingly written, and passionately argued. It includes chapters on definitions of rhetoric (good and bad), the history of rhetorical studies, the difficulties of judging rhetoric (i.e., the disjunction between instrumental and ethical effectiveness), the dispersal of rhetoric to multiple disciplines and forums, the condition of rhetorical education today, the dangers of bad rhetoric in politics and in the media, and a demonstration of how our many intractable debates might be improved with "listening-rhetoric," using as a case example the "warfare" between science and religion. Throughout, Booth dramatizes his ideal of listening-rhetoric by engaging in frequent proleptic questioning and refutation as well as reflexive commentary.Anyone who heard Booth talk at a conference within the past decade or more has first-hand knowledge of his predilection for neologism, and he indulged himself in this book (though he resisted in 1974; see Modern Dogma, 11n5). His term for bad rhetoric, the rhetoric that exacerbates misunderstanding or seeks victory through deception, is "rhetrickery"; his term for the best rhetoric, a kind of critical consciousness that seeks to find common ground and to remove misunderstanding, is "rhetorology." We are also introduced to LR (listening-rhetoric), WR (win-rhetoric), BR (bargain-rhetoric), Rhet-Ed (rhetorical education), P-Rhet (political rhetoric), and MR (media rhetoric).Rhetorology, or listening-rhetoric, is Booth's solution to our rhetorical woes, a solution that admittedly has both philosophical and practical limitations. Rhetorology opposes rhetrickery and some versions of win-rhetoric. He is at some pains to explain and sequester these damaging capabilities so that the unsavory aspects of rhetoric's reputation do not obscure its positive potential. Readers familiar with recent rhetorical theorizing... (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

EveryK-trivial set is computable from an incomplete Martin-Löf random set, i.e., a Martin-Löf random set that does not compute the halting problem.

Participation in experimental studies can be conceptualized as Goffmanian frames, i.e. a set of rules which include the fact the experimenter will be observing participant behavior through (the recording of) the experiment. This study is focused on frame breaches in 16 video- and audio-recorded dyadic conversations taking place in an experimental setting. Our main conclusion is that the experimental frame is conceptualized by participants as including constraints that go beyond non-experimental interactions, and in particular the need to mitigate frame breaches, (...) which are seen as face-threatening. Analyses revealed that participants only broke the research frame after they completed the task they were assigned by the researcher, and that breaches did not necessarily correspond to changes in key. Insights gained in relation to face and mitigation are discussed, as well as the participants’ need to determine their next steps once the research purpose has been perceived complete. (shrink)

Behavioral momentum theory has evolved within the realm of operant conditioning. The thought-provoking momentum metaphor equates the strength of an operant response with its resistance to change and preference (i.e., choice) for that response over other available responses. Whereas baseline response rate (velocity in the metaphor) is assumed to be largely influenced by the response-reinforcer contingency, resistance to change and preference are assumed to reflect an intervening variable called behavioral mass, which is determined primarily by the stimulus-reinforcer relationship. This invites (...) the question of how well the momentum metaphor applies to the stimulus-reinforcer relationships of traditional Pavlovian paradigms. Presumably, a correspondence exists between behavioral mass and the notion of associative strength in the associative learning literature. Although response rate has little meaning in the trialwise structure of classical (i.e., Pavlovian) conditioning, response probability or magnitude might be regarded metaphorically as velocity. Momentum theory suggests that resistance to change (e.g., extinction) is a better indicator of associative strength than is response probability or magnitude. Therefore, variables that strengthen Pavlovian learning should influence resistance to extinction of conditioned responding in a similar manner. Moreover, it is important to assess momentum theory outside of strictly operant paradigms, particularly because in clinical settings many common disorders (e.g., phobias) and their therapies (e.g., cue exposure) are thought to be classically conditioned. (shrink)

Bernard Williams charges that the moral psychology built into R. M. Hare’s utilitarianism is incoherent in virtue of demanding a bifurcated kind of moral thinking that is possible only for agents who fail to reflect properly on their own practical decision making. I mount a qualified defence of Hare’s view by drawing on the account of the ‘reactive attitudes’ found in P. F. Strawson’s ‘Freedom and Resentment’. Against Williams, I argue that the ‘resilience’ of the reactive attitudes ensures that our (...) taking an instrumental view of our dispositions to experience guilt and compunction, as Hare calls for us to do while engaged in ‘critical’ moral thinking, will not prevent us from experiencing these feelings as people ordinarily do while we are thinking ‘intuitively’. I also consider the implications of my argument for consequentialism more generally and (briefly) Kantianism. (shrink)

As the title indicates, This paper represents an examination of the relationships obtaining among the concepts of foresight, Intention, And responsibility. It begins with a critical analysis of the legal and quasi-Moral principle of the resumption of intentionality (i.E., An agent is presumed to have intended the "foreseeable" consequences of her intentional actions). It is shown that, While legally indispensable, It will simply not withstand philosophical scrutiny for purposes of ascribing moral responsibility. I proceed eventually to an evaluation of a (...) proposal which would make foresight itself a sufficient--Though not a necessary--Condition for the ascription of responsibility. The strengths and weaknesses of such a proposal are assessed within both legal and moral contexts. Having distinguished between what I term the "hard-Liners" vs. The "soft-Liners" to the debate, I give my reasons for aligning myself with the hard-Liners (i.E., Those who might be sympathetically inclined to my alternate proposal). (shrink)