Participants in clinical research sometimes view participation as therapy or exaggerate potential benefits, especially in phase I or phase II trials. We conducted this study to discover what methods might improve cancer patients’ understanding of early-phase clinical trials. We randomly assigned 130 cancer patients from three U.S. medical centers who were considering enrollment in a phase I or phase II cancer trial to receive either a multimedia intervention or a National Cancer Institute pamphlet explaining the trial and its purpose. Intervention (...) participants were 32 times more likely to believe that the trial’s purpose was to examine safety and 60 % less likely to believe they would experience long-term benefit or cure. There was no difference in enrollment decision. However, while patients’ understanding of the trial’s purpose improved and expectations of long-term benefit diminished, half the respondents still believed they would experience long-term benefit or cure from participation. Therefore, we conclude that multimedia interventions such as this one may help oncologists to explain the risks and benefits of early-phase cancer trials in a way that patients can more easily understand, helping them to make more informed decisions about participation. But further research into other factors that influence patients’ beliefs about the outcome of enrollment is needed, both to modify the interventions and to determine how malleable patient beliefs are. (shrink)

Розкрито сутність поняття «рейтинг». Доведено значущість рейтингової оцінки для суб’єктів фінансового ринку, зокрема для страхових компаній, потенційних страхувальників, інвесторів та кредиторів.

The 1988 Education Reform Act legislated for a statutory curriculum in state-funded schools in England and Wales. This study explores how, out of a common curriculum framework for both countries, there emerged a school curriculum that was adapted to the distinctiveness of the linguistic and cultural context in Wales. The roles of those most closely involved in policy development in Wales are examined as is the relationship between the 'national' and 'territorial' arenas of policy-making in the months leading up to (...) publication of the Education Reform Bill in November 1987. It is argued that a pragmatic approach to policy development in Wales during that period laid the foundations both for a reworking of the 1988 curriculum framework during the 1990s and for potentially more radical change following the 2002 Education Act. (shrink)

"Williams's masterful translation satisfies (at last!) a long-standing need. There are lots of good translations of Augustine's great work, but until now we have been forced to choose between those that strive to replicate in English something of the majesty and beauty of Augustine's Latin style and those that opt instead to convey the careful precision of his philosophical terminology and argumentation. Finally, Williams has succeeded in capturing both sides of Augustine's mind in a richly evocative, impeccably reliable, elegantly readable (...) presentation of one of the most impressive achievements in Western thought--Augustine's Confessions." --Scott MacDonald, Professor of Philosophy and Norma K. Regan Professor in Christian Studies, Cornell University. (shrink)

The disclosure of prognosis to terminally ill patients has emerged as a recent concern given greater demands for patient involvement in medical decision‐making in the United States. As part of the informed consent process, American physicians are legally and ethically obligated to provide information to such patients about the risks, benefits, and alternatives of all available treatment options including the use of experimental therapies. Although not legally required, the disclosure of a terminal prognosis is ethically justified because it upholds the (...) principle of self‐determination and enables patients to make treatment decisions consistent with their life goals. To understand oncologists’ attitudes about disclosing prognostic information to cancer patients with advanced disease, we interviewed fourteen oncologists and conducted one focus group of medical fellows. Although oncologists reported to disclose prognosis in terms of cancer not being curable, they tend to avoid using percentages to convey prognosis. Oncologists’ reported reluctance to disclosing prognosis was conveyed through the use of metaphors depicting the perceived violent impact of such information on patients. Oncologists’ reluctance to disclose prognosis and preserve patient hope are held in check by their need to ensure that patients have ‘realistic expectations’ about therapy. We discuss these data in light of the cultural, ethical, and legal dimensions of prognosis disclosure, patient hope and the doctor–patient relationship, and recommend ways to enhance the communication process. (shrink)

This book offers a critical introduction to the work of American philosopher D. G. Leahy (1937-2014). Leahy's fundamental thinking can be characterized as an absolute creativity in which all creating is 'live' -- a happening occurring now that manifests a supersaturated polyontological actuality that is essentially created by the logic that characterizes it. Leahy leaves behind the categorial presuppositions of modern thought, eclipsing both Cartesian and Hegelian subjectivities and introducing instead an essentially new form of thinking founded in a nondual (...) logic of creation. The new thinking delineates the absolute unicity of existence as a creative interactivity beyond all traditional dichotomies (such as one vs. many, unity vs. plurality, identity vs. change): a fully "digitized" actuality that is nothing but newness, which inherently implies nothing but change. Through this new form of thinking, change itself is revealed to be the very essence of reality and mind. Any reader looking for a quantum leap beyond the thrall of modern and postmodern fixations is invited to hear and apprehend this new thinking that refuses to be conditioned by paradigms, categories, species, genera, walls, bridges, boundaries, or abstractions: an essentially free thinking that embodies creative novelty itself. (shrink)

This book is not a study of Plato's philosophy, but a contribution to the literary interpretation of the dialogues, through analysis of their formal structure, ...

Political liberals ask citizens not to appeal to certain considerations, including religious and philosophical convictions, in political deliberation. We argue that political liberals must include a demanding requirement of intellectual modesty in their ideal of citizenship in order to motivate this deliberative restraint. The requirement calls on each citizen to believe that the best reasoners disagree about the considerations that she is barred from appealing to. Along the way, we clarify how requirements of intellectual modesty relate to moral reasons for (...) deliberative restraint. And we argue against attempts to weaken our requirement of intellectual modesty by emphasizing those moral reasons. (shrink)

Many philosophers believe that there is a causal condition on perception, and that this condition is a conceptual truth about perception. A highly influential argument for this claim is based on intuitive responses to Gricean style thought experiments. Do the folk share the intuitions of philosophers? Roberts et al. (2016) presented participants with two kinds of cases: Blocker cases (similar to Grice’s case involving a mirror and a pillar) and Non-Blocker cases (similar to Grice’s case involving a clock and brain (...) stimulation). They found that a substantial minority agreed that seeing occurs in the Non-Blocker cases, and that in the Blocker cases significantly less agreed that seeing occurs. They thus hypothesized that folk intuitions better align with a no blocker condition than with a causal condition. This paper continues this line of enquiry with two new experiments. The paper investigates the generality and robustness of Roberts et al.’s findings by expanding the sense modalities tested from only vision to audition and olfaction as well. The paper also uses Gricean style thought experiments as a case study for investigating the “reflection defense” against the negative project in experimental philosophy. Our results replicate and extend Roberts et al.’s study and support their hypothesis that folk intuitions better align with a no blocker condition. They also provide an empirical reason to doubt the reflection defense. (shrink)

Locke is the first English philosopher to be considered in this series, and that fact of itself is worthy of attention. Philosophy, of course, like science, knows no frontiers and no national boundaries. Yet it is true to say that Locke’s contribution to philosophy is typically and peculiarly English. His moderation, his emphasis upon experience, his tolerant spirit of compromise, his dislike of mystical extravagance and of metaphysical speculation, even that elusive quality of his which people call his “common sense”, (...) are English traits. His very defects, illogicality leading to inconsistency and an awkward disorderliness of thought so abhorrent to the. (shrink)

The Nature of God explores a perennial problem in the philosophy of religion.

There are important similarities between moral thought and talk and thought and talk about gender: disagreements about gender, like disagreements about morality, seem to be intractable and to outstrip descriptive agreement; and it seems coherent to reject any definition of what it is to be a woman in terms of particular social, biological, or other descriptive features, just as it seems coherent to reject any definition of what it is to be good or right in terms of any set of (...) descriptive properties. These similarities give us reason to investigate the idea that, like moral thought and talk, gender thought and talk is inherently normative. This paper proposes a normative account of gender thought and talk in terms of fitting treatment. On this fitting treatment account, to judge that A is gender G is just to judge that it is fitting to treat A as a G. This account is a descriptive or hermeneutical account of our gender thought and talk rather than an ameliorative account of our gender concepts or a metaphysical account of gender properties in social metaphysics. This paper argues that other descriptive accounts of gender thought and talk face problems that the fitting treatment account overcomes. (shrink)

This book critically examines the case for and against the belief in personal survival of bodily death. It discusses key philosophical questions. How could a discarnate individual be identified as a person who was once alive? What is the relationship between minds and their brains? Is a 'next world' conceivable? The book also examines classic arguments for the immortality of the soul, and focuses on types of prima facie evidence of survival: near-death experiences, apparitions, mediumistic communications, and ostensible reincarnation cases.

The rising demographic of older adults worldwide has led to an increase in dementia cases. In order to ensure the proper allocation of care and resources to this clinical group, it is necessary to correctly distinguish between simulated versus bona-fide cognitive deficits typical of dementia. Performance Validity Tests are specifically designed to assess a lack of effort and the possible simulation of cognitive impairment. Previous research demonstrates that PVTs may be sensitive to dementia, thus inaccurately classifying real memory impairment as (...) simulation. Here, we analyzed the sensitivity of PVTs in discriminating between dementia and simulation using receiver operating characteristic curve analyses. Further, we examined the potential need for adjusting cut-off scores for three stand-alone and one embedded PVT for Portuguese older adults with dementia. The results showed that all measures, except for the Coin in Hand— Extended version, were sensitive to one or more sociodemographic and/or cognitive variables, and it was necessary to adjust cut-off points for all measures. Additionally, the Rey-15 Item Memory Test did not demonstrate sufficient discriminating capacity for dementia. These results present important implications for clinical practice and the daily life of patients, as the use of incorrect cut-off points could impede patients from getting the resources they need. (shrink)

Purpose: Studies of reactive and proactive modes of inhibitory control tend to show age-related declines and are accompanied by abnormalities in the prefrontal cortex. We explored which mode of inhibitory control would be more amenable to change and accrue greater benefits following engagement in a 4-week theater acting intervention in older adults. These gains were evaluated by performance on the AX-CPT task. We hypothesized that an increase in proactive control would relate to an increase in AY errors and a decrease (...) in BX errors. In contrast, an increase in reactive control would be associated with a decrease in AY errors, no change in AY reaction time, and an increase in BX response time. Further, we posited that an increase in behavioral proactive control would accompany greater cue versus probe activity for previously identified regions in the prefrontal cortex. In contrast, an increase in behavioral reactive control would be accompanied by greater probe activation in these identified brain areas.Materials and Methods: The participants were 179 community-dwelling adults aged 60–89 years who were on average, college-educated. Participants were pseudo-randomly assigned to either an active-experiencing acting intervention condition or the active control condition ; participant assignment was subject to time of enrollment. Participants in both groups were trained by theater-actor researchers with expertise in acting interventions. In contrast to the active control participants who attended a course on theater acting, the acting-intervention group was required to consistently deploy proactive and reactive control mechanisms. Both groups met two times/week for 75-min for 4 weeks. Participant brain-behavioral performance on the AX-CPT task was evaluated prior to and after this four-week period.Results: No intervention effects were found in favor of proactive control. Behavioral evidence in favor of reactive control was weak. Brain-related benefits to reactive control was illustrated by greater probe-activation in Brodmann areas 6 and 8, relative to controls and pre-intervention.Conclusion: We found some evidence for improvements in reactive control via brain measures, attributed to engagement in the acting intervention. (shrink)