The translational research community, in general, and the Clinical and Translational Science Awards (CTSA) community, in particular, share the vision of repurposing EHRs for research that will improve the quality of clinical practice. Many members of these communities are also aware that electronic health records (EHRs) suffer limitations of data becoming poorly structured, biased, and unusable out of original context. This creates obstacles to the continuity of care, utility, quality improvement, and translational research. Analogous limitations to sharing objective data in (...) other areas of the natural sciences have been successfully overcome by developing and using common ontologies. This White Paper presents the authors’ rationale for the use of ontologies with computable semantics for the improvement of clinical data quality and EHR usability formulated for researchers with a stake in clinical and translational science and who are advocates for the use of information technology in medicine but at the same time are concerned by current major shortfalls. This White Paper outlines pitfalls, opportunities, and solutions and recommends increased investment in research and development of ontologies with computable semantics for a new generation of EHRs. (shrink)

Here we present what we believe is a novel account of what languages are, along with an axiomatically rich representation of languages and language-related data that is based on this account. We propose an account of languages as aggregates of dispositions distributed across aggregates of persons, and in doing so we address linguistic competences and the processes that realize them. This paves the way for representing additional types of language-related entities. Like demographic data of other sorts, data about languages may (...) be of use to researchers in a number of areas, including biomedical research. Data on the languages used in clinical encounters are typically included in medical records, and capture an important factor in patient-provider interactions. Like many types of patient and demographic data, data on a person’s preferred and primary languages are organized in different ways by different systems. This can be a barrier to data integration. We believe that a robust framework for representing language in general and preferred and primary language in particular – which has been lacking in ontologies thus far – can promote more successful integration of language-related data from disparate data sources. (shrink)

We introduce the Vital Sign Ontology (VSO), an extension of the Ontology for General Medical Science (OGMS) that covers the consensus human vital signs: blood pressure, body temperature, respiratory rate, and pulse rate. VSO provides a controlled structured vocabulary for describing vital sign measurement data, the processes of measuring vital signs, and the anatomical entities participating in such measurements. VSO is implemented in OWL-DL and follows OBO Foundry guidelines and best practices. If properly developed and extended, we believe the VSO (...) will find applications for the EMR, clinical informatics, and medical device communities. (shrink)

In the TACITUS project for using commonsense knowledge in the understanding of texts about mechanical devices and their failures, we have been developing various commonsense theories that are needed to mediate between the way we talk about the behavior of such devices and causal models of their operation. Of central importance in this effort is the axiomatization of what might be called commonsense metaphysics. This includes a number of areas that figure in virtually every domain of discourse, such as granularity, (...) scales, time, space, material, physical objects, shape, causality, functionality, and force. Our effort has been to construct core theories of each of these areas, and then to define, or at least characterize, a large number of lexical items in terms provided by the core theories. In this paper we discuss our methodological principles and describe the key ideas in the various domains we are investigating. (shrink)

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

In late January of 1987, the State Treasurer of Pennsylvania, R. Budd Dwyer, shot himself to death in front of a dozen reporters and camera crews during a news conference in his office. Much was subsequently made in the popular press, and within the profession, about the difficult ethical decision television journalists were faced with in determining how much of the very graphic suicide tape to air. A review of the literature in this area suggests, however, that journalists have established (...) a set of relatively detailed conventions for dealing with events involving graphic depictions of death. Analysis of the Dwyer tape and interviews conducted with Pennsylvania television news directors show that eighteen of the twenty stations in the state that carry news used basically the same type and amount of footage in their evening newscasts. One decided to use no tape. One showed the moment of death. When the story broke around noon, two additional stations showed the moment of suicide, but they revised their story for the evening program. In addition, the wide majority of news directors interviewed said they had little difficulty in deciding how to edit the tape. The processing of the Dwyer story suggests that any ethical dilemmas faced by journalists during decision making were put aside for later consideration. The material was edited quickly and according to similar patterns, or conventions, around the state. The study suggests greater attention be given to the definition and interaction of personal professional values, in the ethical sense, and norms of news processing, in the sociological sense. (shrink)

A volume in Contemporary Human Resource Management: Issues, Challenges, and Opportunities Series Editor Ronald R. Sims, College of William and Mary The primary purpose of this book is to stimulate dialogue and discussion about the most effective ways of teaching ethics. Contributors to the book focus on approaches and methodologies and lessons learned that are having an impact in leading students to confront with accountability and understanding the bases of their ethical thinking, the responsibilities they have to an enlarged (...) base of stakeholders (whose needs and interests often are conflicting), and their stewardship to use their talents responsibility not only in fulfilling an enterprise's economic goals but also to recognize the impact of their actions on both individuals and larger society. The primary audiences for the book are those individuals responsible for teaching management, especially those with responsibilities for teaching business ethics. But the book is also designed for practicing managers, for these managers have among their most important responsibilities the development of people in their organizations who have the integrity, values, and competences to be effective managers of economic resources while at the same time to recognize the roles of their enterprise in shaping society. (shrink)

Research on the nature of science and science education enjoys a longhistory, with its origins in Ernst Mach's work in the late nineteenthcentury and John Dewey's at the beginning of the twentieth century.As early as 1909 the Central Association for Science and MathematicsTeachers published an article – ‘A Consideration of the Principles thatShould Determine the Courses in Biology in Secondary Schools’ – inSchool Science and Mathematics that reflected foundational concernsabout science and how school curricula should be informed by them. Sincethen (...) a large body of literature has developed related to the teaching andlearning about nature of science – see, for example, the Lederman and Meichtry reviews cited below. As well there has been intensephilosophical, historical and philosophical debate about the nature of scienceitself, culminating in the much-publicised ‘Science Wars’ of recent time. Thereferences listed here primarily focus on the empirical research related to thenature of science as an educational goal; along with a few influential philosophicalworks by such authors as Kuhn, Popper, Laudan, Lakatos, and others. Whilenot exhaustive, the list should prove useful to educators, and scholars in otherfields, interested in the nature of science and how its understanding can berealised as a goal of science instruction. The authors welcome correspondenceregarding omissions from the list, and on-going additions that can be made to it. (shrink)

Infants have been described as 'statistical learners' capable of extracting structure (such as words) from patterned input (such as language). Here, we investigated whether prior knowledge influences how infants track transitional probabilities in word segmentation tasks. Are infants biased by prior experience when engaging in sequential statistical learning? In a laboratory simulation of learning across time, we exposed 9- and 10-month-old infants to a list of either disyllabic or trisyllabic nonsense words, followed by a pause-free speech stream composed of a (...) different set of disyllabic or trisyllabic nonsense words. Listening times revealed successful segmentation of words from fluent speech only when words were uniformly disyllabic or trisyllabic throughout both phases of the experiment. Hearing trisyllabic words during the pre-exposure phase derailed infants' abilities to segment speech into disyllabic words, and vice versa. We conclude that prior knowledge about word length equips infants with perceptual expectations that facilitate efficient processing of subsequent language input. (shrink)

This study investigates professional tax practitioners' ethical judgments and behavioral intentions in cases involving client pressure to adopt aggressive reporting positions, an issue that has been identified as the most difficult ethical/moral problem facing public accounting practitioners. The multidimensional ethics scale (MES) was used to measure the extent to which a hypothetical behavior was consistent with five ethical philosophies (moral equity, contractualism, utilitarianism, relativism, and egoism). Responses from a sample of 67 tax professionals supported the existence of all dimensions of (...) the MES other than egoism. Regressions of ethical judgments and behavioral intentions on the MES dimensions indicate that ethical decision making is most heavily influenced by the moral equity dimension, followed by the contractualism dimension. In contrast, the utilitarianism and relativism dimensions were only related to ethical judgments and behavioral intentions in isolated instances. (shrink)

There has been much recent debate about Presentism among those who believe the doctrine to be nontrivial and true, those who believe it to be nontrivial and false, and those who believe it to be trivial — either trivially true or trivially false. Formulating Presentism precisely is problematic, which accounts for some of the controversy.

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

The field of clinical ethics consultation has matured into a multidisciplinary profession, with clinical ethics consultants (CECs) being trained in bioethics, philosophy, theology, law, medicine, n...

What does it mean to be a good thinker? Which virtues work together in someone who possesses good intellectual character? Although recent research on virtues has highlighted the benefits of individual intellectual virtues, being an excellent thinker is likely a function of possessing multiple intellectual virtues. Specifically, a good thinker would both recognize one’s intellectual shortcomings and possess an eagerness to learn driven by virtues such as love of knowledge, curiosity, and open-mindedness. Good intellectual character may only successfully manifest when (...) individuals possess not just one or a few intellectual virtues, but a larger set of such virtues to different degrees. However, little is currently known about what combination of virtues are necessary for good thinking. We argue that it is important to identify and clarify the nature of the good thinker and outline a profile methodology for achieving this goal. This approach characterizes the good thinker in terms of a profile of multiple intellectual virtues. Understanding this profile can allow greater insight into the extent to which people possess such a profile, and the potential for societal benefits of educating for these qualities. (shrink)

It was customary in traditional approaches to the sociology of knowledge to bracket either questions about the possibility of the social determination of natural scientific ideas or questions about the ability of the sociology of knowledge to evaluate other types of knowledge claims. The current strong program in the sociology of knowledge, a typical representative of the new approach to the sociology of science, wants to study the production of natural scientific knowledge scientifically and simultaneously bracket normative considerations. We criticize (...) this neglect of the normative dimension in the strong program on the basis of the role that Marx envisioned for his sociology of knowledge. For example, the sociology of knowledge should be understood as a critique of power that does not merely accept the status quo as a datum. In addition, we attempt to extend Marx's discussion of the social bases of such a critique. (shrink)

The preceding five years have brought remarkable advances in our understanding of the primary structure of drug receptors. The roles of certain amino acid residues in binding drugs and effecting receptor function have been proposed. As even more detailed structures become available, the goal of rational design of drug molecules based on predicted fits between the drug and its receptor will be near at hand. Although none of the classical receptors has yet yielded to X‐ray crystallographic analysis, the methods of (...) molecular biology facilitate the production of the large amounts of these rare proteins necessary for crystallization. Receptor proteins share one fundamental characteristic with allosterically regulated enzymes. Both have the structural flexibility that allows information to be transmitted to distant parts of the molecule. We will discuss recent observations about receptor structure and the dynamic nature of drug receptors, and pose questions about the significance of receptor dynamics for drug design. (shrink)

Information can be public among a group. Whether or not information is public matters, for example, for accounts of interdependent rational choice, of communication, and of joint intention. A standard analysis of public information identifies it with (some variant of) common belief. The latter notion is stipulatively defined as an infinite conjunction: for p to be commonly believed is for it to believed by all members of a group, for all members to believe that all members believe it, and so (...) forth. This analysis is often presupposed without much argument in philosophy. Theoretical entrenchment or intuitions about cases might give some traction on the question, but give little insight about why the identification holds, if it does. The strategy of this paper is to characterize a practical-normative role for information being public, and show that the only things that play that role are (variants of) common belief as stipulatively characterized. In more detail: a functional role for “taking a proposition for granted” in non-isolated decision making is characterized. I then present some minimal conditions under which such an attitude is correctly held. The key assumption links this attitude to beliefs about what is public. From minimal a priori principles, we can argue that a proposition being public among a group entails common commitment to believe among that group. Later sections explore partial converses to this result, the factivity of publicity and publicity from the perspective of outsiders to the group, and objections to the aprioricity of the result deriving from a posteriori existential presuppositions. (shrink)