Online medical reference websites are utilized by health care providers to enhance their education and decision making. However, these resources may not adequately reveal pharmaceutical-author interactions and their potential conflicts of interest. This investigation: evaluates the correspondence of two well-utilized CoI databases: the Centers for Medicare and Medicaid Services Open Payments and ProPublica’s Dollars for Docs and quantifies CoIs among authors of a publicly available point of care clinical support website which is used to inform evidence-based medicine decisions. Two data (...) sources were used: the hundred most common drugs and the top fifty causes of death. These topics were entered into a freely available database. The authors were then input into CMSOP and PDD and compensation and number of payments were determined for 2013–2015. The subset of highly compensated authors that also reported “Nothing to disclose” were further examined. There was a high degree of similarity between CMSOP and PDD for compensation and payment number. The amount received was 1.4% higher in CMSOP than in PDD. The articles where the authors had received the greatest compensation were in neurology, oncology, and endocrinology. Two authors reporting “Nothing to disclose” received appreciable and potentially relevant compensation. CMSOP and PDD produced almost identical results. CoIs were common among authors but self-reporting may be an inadequate reporting mechanism. Recommendations are offered for improving the CoI transparency of pharmaceutical-author interactions in point-of-care electronic resources. (shrink)

Online medical reference websites are utilized by health care providers to enhance their education and decision making. However, these resources may not adequately reveal pharmaceutical-author interactions and their potential conflicts of interest. This investigation: evaluates the correspondence of two well-utilized CoI databases: the Centers for Medicare and Medicaid Services Open Payments and ProPublica’s Dollars for Docs and quantifies CoIs among authors of a publicly available point of care clinical support website which is used to inform evidence-based medicine decisions. Two data (...) sources were used: the hundred most common drugs and the top fifty causes of death. These topics were entered into a freely available database. The authors were then input into CMSOP and PDD and compensation and number of payments were determined for 2013–2015. The subset of highly compensated authors that also reported “Nothing to disclose” were further examined. There was a high degree of similarity between CMSOP and PDD for compensation and payment number. The amount received was 1.4% higher in CMSOP than in PDD. The articles where the authors had received the greatest compensation were in neurology, oncology, and endocrinology. Two authors reporting “Nothing to disclose” received appreciable and potentially relevant compensation. CMSOP and PDD produced almost identical results. CoIs were common among authors but self-reporting may be an inadequate reporting mechanism. Recommendations are offered for improving the CoI transparency of pharmaceutical-author interactions in point-of-care electronic resources. (shrink)

Online medical reference websites are utilized by health care providers to enhance their education and decision making. However, these resources may not adequately reveal pharmaceutical-author interactions and their potential conflicts of interest. This investigation: evaluates the correspondence of two well-utilized CoI databases: the Centers for Medicare and Medicaid Services Open Payments and ProPublica’s Dollars for Docs and quantifies CoIs among authors of a publicly available point of care clinical support website which is used to inform evidence-based medicine decisions. Two data (...) sources were used: the hundred most common drugs and the top fifty causes of death. These topics were entered into a freely available database. The authors were then input into CMSOP and PDD and compensation and number of payments were determined for 2013–2015. The subset of highly compensated authors that also reported “Nothing to disclose” were further examined. There was a high degree of similarity between CMSOP and PDD for compensation and payment number. The amount received was 1.4% higher in CMSOP than in PDD. The articles where the authors had received the greatest compensation were in neurology, oncology, and endocrinology. Two authors reporting “Nothing to disclose” received appreciable and potentially relevant compensation. CMSOP and PDD produced almost identical results. CoIs were common among authors but self-reporting may be an inadequate reporting mechanism. Recommendations are offered for improving the CoI transparency of pharmaceutical-author interactions in point-of-care electronic resources. (shrink)

We present a one per cent measurement of the cosmic distance scale from the detections of the baryon acoustic oscillations in the clustering of galaxies from the Baryon Oscillation Spectroscopic Survey, which is part of the Sloan Digital Sky Survey III. Our results come from the Data Release 11 sample, containing nearly one million galaxies and covering approximately 8500 square degrees and the redshift range 0.2 < z < 0.7. We also compare these results with those from the publicly released (...) DR9 and DR10 samples. Assuming a concordance Λ cold dark matter cosmological model, the DR11 sample covers a volume of 13 Gpc3 and is the largest region of the Universe ever surveyed at this density. We measure the correlation function and power spectrum, including density-field reconstruction of the BAO feature. The acoustic features are detected at a significance of over 7σ in both the correlation function and power spectrum. Fitting for the position of the acoustic features measures the distance relative to the sound horizon at the drag epoch, rd, which has a value of rd,fid = 149.28 Mpc in our fiducial cosmology. We find DV = at z = 0.32 and DV = at z = 0.57. At 1.0 per cent, this latter measure is the most precise distance constraint ever obtained from a galaxy survey. Separating the clustering along and transverse to the line of sight yields measurements at z = 0.57 of DA = and H =. Our measurements of the distance scale are in good agreement with previous BAO measurements and with the predictions from cosmic microwave background data for a spatially flat CDM model with a cosmological constant. © 2014 The Author Published by Oxford University Press on behalf of the Royal Astronomical Society. (shrink)

There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors that are crucial for the reproductive success of animals living in groups. The Perception-Action Model, (...) together with an understanding of how representations change with experience, can explain the major empirical effects in the literature. It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations. Key Words: altruism; cognitive empathy ; comparative; emotion; emotional contagion; empathy ; evolution; human; perception-action; perspective taking. (shrink)

A surfeit of research confirms that people activate personal, affective, and conceptual representations when perceiving the states of others. However, researchers continue to debate the role of self–other overlap in empathy due to a failure to dissociate neural overlap, subjective resonance, and personal distress. A perception–action view posits that neural-level overlap is necessary during early processing for all social understanding, but need not be conscious or aversive. This neural overlap can subsequently produce a variety of states depending on the context (...) and degree of common experience and emotionality. We outline a framework for understanding the interrelationship between neural and subjective overlap, and among empathic states, through a dynamic-systems view of how information is processed in the brain and body. (shrink)

Only a broad theory that looks across levels of analysis can encompass the many perspectives on the phenomenon of empathy. We address the major points of our commentators by emphasizing that the basic perception-action process, while automatic, is subject to control and modulation, and is greatly affected by experience and context because of the role of representations. The model can explain why empathy seems phenomenologically more effortful than reflexive, and why there are different levels of empathy across individuals, ages, and (...) species. (shrink)

Perception–action approaches are sometimes criticized because empathy takes cognitive forms and people do not overtly imitate or feel all observed states. These complaints reflect a misunderstanding of the framework, which we tried to clarify through a review that bridged social and neuroscientific views. Far from “simple fixes,” these misunderstandings appear to reflect deeply rooted differences in the way that each discipline conceptualizes science and the mind. We address the important points made by the commentators and reiterate the need to incorporate (...) rich, phenomenological descriptions into academic works so that we may prevent such conceptual cross-talk in the future. The open exchange of ideas across fields is often difficult, but essential to an integrated, scientific view of empathy. (shrink)

The shared circuits model (SCM) relies on well-regarded theories of perception-action, mirror neurons, and forward models, but the functional/informational level of the model limits its ability to explain complex behavior such as true imitation. Data from our lab and others confirm the more general details of the model, accepted by most, but specify the neural mechanisms involved in perception-action processes.

For at least the past 15 years, food safety stakeholders across all levels of government have recognized the critical role that state and local agencies play in our nation's food safety system. State and local agencies are the first responders to foodborne outbreaks and have primary responsibility for keeping their residents safe from foodborne disease through effective surveillance and rapid response to outbreaks. They also conduct the vast majority of food safety inspections across the nation's restaurants, grocery stores, and other (...) food service and food retail establishments.Recent efforts among industry and government officials alike have focused on creating a more integrated, prevention-oriented food safety system. The Food Safety Modernization Act, the first major overhaul of the nation's food safety laws since the 1930s, now mandates that most sectors of the food industry put preventive controls in place, changing the emphasis of what the FDA does from response to prevention. (shrink)

This article demonstrates how researchers from both the sciences and the humanities can learn from Charles Darwin’s mixed methodology. We identify two basic challenges that face emotion research in the sciences, namely a mismatch between experiment design and the complexity of life that we aim to explain, and problematic efforts to bridge the gap, including invalid inferences from constrained study designs, and equivocal use of terms like “sympathy” and “empathy” that poorly reflect such methodological constraints. We argue that Darwin’s mixed (...) methodology is a model for addressing these challenges even in laboratory work on emotion, because it shows how close observation of emotional phenomena makes sense only within broader historical contexts. The article concludes with 5 practical research recommendations. (shrink)

Chater & Loewenstein argue for a shift in focus from individual- to structural-level approaches to societal ills. This is valid and important but overlooks the barriers inherent in the current US partisan context. Psychology can be applied to help people of mixed allyship join together, to effectively and quickly force institutions and corporations to accept structural change.

This paper deals mainly with generalizations of results in finitary combinatorics to infinite ordinals. It is well-known that for finite ordinals ∑bT<αβ is the number of 2-element subsets of an α-element set. It is shown here that for any well-ordered set of arbitrary infinite order type α, ∑bT<αβ is the ordinal of the set M of 2-element subsets, where M is ordered in some natural way. The result is then extended to evaluating the ordinal of the set of all n-element (...) subsets for each natural number n ≥ 2. Moreover, series ∑β<αf are investigated and evaluated, where α is a limit ordinal and the function f belongs to a certain class of functions containing polynomials with natural number coefficients. The tools developed for this result can be extended to cover all infinite α, but the case of finite α appears to be quite problematic. (shrink)

Objectives The use of empathy during clinical practice is paramount to delivering quality patient care and is important for understanding patient concerns at both the cognitive and affective levels. This study sought to determine how and when physicians self-report the use of empathy when interacting with their patients. Methods A cross-sectional survey of 76 physicians working in a large urban hospital was conducted in August of 2017. Physicians were asked a series of questions with Likert scale responses as well as (...) asked to respond to open-ended questions. Results All physicians self-report that they always (69%) or usually (29.3%) use empathic statements when engaging with patients. 93.1% of physicians believe that their colleagues always (20.7%) or usually (69%) use empathic statements when communicating with patients. Nearly one-third of physicians (33%) indicated that using the words “I understand” denotes an empathic statement. Although 36% of physicians reported that they would like to receive more training or assistance about how and when to use empathy during clinical practice. Significance of Results Despite the self-reported prevalent use of empathic statements, one-third of physicians indicate a desire for more training in what empathy means and when it should be used in a clinical setting. Additionally, nearly one-third of physicians in this study reported using responses that patients may not perceive as being empathic, even when intended to be empathic. This suggests that many physicians feel uncertain about a clinical skill they believe should be used in most, if not all, encounters. (shrink)

This article asks under what circumstances controversial technologies would be considered seriously for remediation instead of being rejected out of hand. To address this question, the authors developed a conceptual framework called public acceptability of controversial technologies. PACT considers site-specific, decision-oriented dialogues among the individuals and groups involved in selecting or recommending hazardous waste remediation technologies. It distinguishes technology acceptability, that is, a willingness to consider seriously, from technology acceptance, the decision to deploy. The framework integrates four dimensions: an acceptability (...) continuum that underlies decision-oriented dialogues among individuals and constituency groups, the attributes of these individuals and groups, the attributes of the technology at issue, and the community context—social, institutional, and physical. This article describes and explores PACT as a tool for understanding and better predicting the acceptability of controversial technologies. (shrink)

Developments in neuroscience have raised the possibility that pharmaceuticals may be used to enhance memory, mood, and attention in people who do not have an illness or disorder, a practice known as “cognitive enhancement.” We describe historical experiences with two medicinal drugs for which similar enhancement claims were made, cocaine in the late 19th and early 20th centuries, and amphetamines in the mid 20th century. These drugs were initially introduced as medicinal agents in Europe and North America before becoming more (...) widely used for a variety of purposes, including what would nowadays be considered cognitive enhancement. Their trajectory of use conformed to the typical use cycle of psychotropic drugs. There was an initial steep rise in prescribing for medical use, followed by expanded nonmedical use that was fueled by enthusiasm for the drugs’ effects. As the number of regular users increased, problems related to use (such as addiction) became apparent, societal concern increased, and laws were passed banning nonmedical use and eventually, medical use. This historical experience draws attention to the adverse side effects of enhancement use that only become apparent with regular, wide-scale use of a drug. We highlight the similarities between the enthusiasms for cocaine and amphetamines and the current enthusiasms for using prescription stimulants for cognitive enhancement. We argue bioethicists should not encourage the cognitive enhancement use of drugs such as methylphenidate in the absence of evidence on the efficacy and safety of their use for cognitive enhancement purposes. (shrink)

Reintroduction programs in which captive-bred or reared animals are released into natural habitats are considered a key approach for conservation; however, success rates have generally been low. Accounting for factors that enable individual animals to have a greater chance of survival can not only improve overall conservation outcomes but can also impact the welfare of the individual animals involved. One such factor may be individual personality, and personality research is a growing field. This type of research presents animal welfare scientists (...) with the opportunity to develop behavior profiles that may predict how particular individuals cope with challenges. This has direct implications for both in situ and ex situ populations and can bridge the gap between animal welfare and conservation. We designed a project to ascertain the presence of personality traits in Blanding’s turtles (Emydoidea blandingii), a species of special concern in the state of Michigan, and assess potential links between traits and post-release success. As hypothesized, the Blanding’s turtles in this study displayed behavioral responses to modified open field tests indicative of distinct personality traits: exploration, boldness and aggression. Additionally, the personality traits were correlated differently with survival and behavior patterns when the turtles were released into the Shiawassee National Wildlife Refuge. More exploratory turtles had higher survival rates, while neither boldness nor aggression were related to survival. Exploratory turtles were also more likely to travel longer distances after release. The use of muskrat dens was related to increased survival, and both bolder and more exploratory turtles made higher use of this feature. Exploratory and aggressive turtles were found basking outside of water more often, while bold turtles were more likely to be found at the water surface. Both of these basking behaviors may increase the risk of predation and may be reflective of a trade-off between risk and behaviors related to physiological health. Understanding how personality affects behavior and survival post-release can be a critical tool for improving reintroduction success. Zoo animal welfare scientists and practitioners can implement approaches that improve the welfare of individuals within the context of conservation initiatives. (shrink)

ObjectivesThe purpose of the current study was to examine whether a self-report measure identifies prenatal substance use and predicts resulting adverse birth outcomes in a large cohort using electronic medical records.MethodsPregnant patients who were admitted between 2014 and 2015 at Christiana Care Health System and delivered singleton birth were included in the analyses. Participant demographic information, pregnancy comorbidities, self-reported substance use, and birth outcomes were retrieved from electronic medical records. Detailed descriptive analyses of prenatal substance use were conducted, and logistic (...) models were evaluated for the associations between substance use and each birth outcome.ResultsThe average maternal age was 30 years, 37% receiving Medicaid. Over 58% were White, 26% were Black, and 13% were Hispanic. Cigarette smoking only showed the highest prevalence among substance u... (shrink)

In these essays, we are concerned with virtue in journalism and the media but are mindful of the tension between the commercial foundations of publishing and broadcasting, on the one hand, and journalism's democratic obligations on the other. Adam outlines, first, a moral vision of journalism focusing on individualistic concepts of authorship and craft. Next, Craft attempts to bridge individual and organizational concerns by examining the obligations of organizations to the individuals working within them. Finally, Cohen discusses the importance of (...) resisting the powerful corporate logic that pervades the news media in the United States and calls on journalists to be courageous. (shrink)

The sequencing of the human genome and decreasing costs of sequencing technology have led to the notion of ‘personalized medicine’. This has been taken by some authors to indicate that personalized medicine will provide individualized treatments solely based on one’s DNA sequence. We argue this is overly optimistic and misconstrues the notion of personalization. Such interpretations fail to account for economic, policy and structural constraints on the delivery of healthcare. Furthermore, notions of individualization based on genomic data potentially take us (...) down the road of genetic reductionism obscuring the role of environmental factors in disease and ill health. We propose that one should see personalized medicine as a way of using personal genomic information to stratify individuals into subpopulations and suggest that personalized medicine be seen within a broader idea of personalized healthcare, reflecting healthcare that integrates personal genomic data into cultural, environmental and personal contexts. (shrink)

One cue that may facilitate children's word learning is iconicity, or the correspondence between a word's form and meaning. Some have even proposed that iconicity in the early lexicon may serve to help children learn how to learn words, supporting the acquisition of even noniconic, or arbitrary, word–referent associations. However, this proposal remains untested. Here, we investigate the iconicity of caregivers’ speech to young children during a naturalistic free‐play session with novel stimuli and ask whether the iconicity of caregivers’ speech (...) facilitates children's learning of the noniconic novel names of those stimuli. Thirty‐four 1.5‐2‐year‐olds (19 girls; half monolingual English learners and half bilingual English‐Spanish learners) participated in a naturalistic free‐play task with their caregivers followed by a test of word‐referent retention. We found that caregivers’ use of iconicity, particularly in utterances in which they named the novel stimuli, was associated with the likelihood that children learned that novel name. This result held even when controlling for other factors associated with word learning, such as the concreteness and frequency of words in caregiver speech. Together, the results demonstrate that iconicity not only can serve to help children identify the referent of novel words (as in previous research) but can also support their ability to retain even noniconic word‐referent mappings. (shrink)

Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially (...) in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

_Philosophy Through Science Fiction_ offers a fun, challenging, and accessible way in to the issues of philosophy through the genre of science fiction. Tackling problems such as the possibility of time travel, or what makes someone the same person over time, the authors take a four-pronged approach to each issue, providing · a clear and concise introduction to each subject · a science fiction story that exemplifies a feature of the philosophical discussion · historical and contemporary philosophical texts that investigate (...) the issue with rigor, and · glossary, plot profiles of pertinent science fiction stories and films, and questions for further reflection. _Philosophy Through Science Fiction_ includes stories from contemporary science fiction writers including Greg Egan and Mike Resnick, as well as from classic authors like Philip K. Dick and Robert Heinlein. Philosophy readings include historical pieces by René Descartes and David Hume, and contemporary pieces by John Searle and Mary Midgley. (shrink)

The 2015 Varsity Medical Ethics debate convened upon the motion: “This house believes nootropic drugs should be available under prescription”. This annual debate between students from the Universities of Oxford and Cambridge, now in its seventh year, provided the starting point for arguments on the subject. The present article brings together and extends many of the arguments put forward during the debate. We explore the current usage of nootropic drugs, their safety and whether it would be beneficial to individuals and (...) society as a whole for them to be available under prescription. The Varsity Medical Debate was first held in 2008 with the aim of allowing students to engage in discussion about ethics and policy within healthcare. The event is held annually and it is hoped that this will allow future leaders to voice a perspective on the arguments behind topics that will feature heavily in future healthcare and science policy. This year the Oxford University Medical Society at the Oxford Union hosted the debate. (shrink)

Jecker makes three major points in her article, “A Broader View of Justice” (2008). First, she argues that justice in healthcare relates to justice in the broader social conditions of society as th...