Antimicrobial resistance (AMR) is one of the defining global health threats of our time, but no international legal instrument currently offers the framework and mechanisms needed to address it. Fortunately, the actions needed to address AMR have considerable overlap with the actions needed to confront other pandemic threats.

Ensuring that life-saving antimicrobials remain available as effective treatment options in the face of rapidly rising levels of antimicrobial resistance will require a massive and coordinated global effort. Setting a collective direction for progress is the first step towards aligning global efforts on AMR. This process would be greatly accelerated by adopting a unifying global target — a well-defined global target that unites all countries and sectors. The proposed pandemic instrument — with its focus on prevention, preparedness and response — (...) represents an ideal opportunity to develop and adopt a unifying global target that catalyzes global action on AMR. We propose three key characteristics of a unifying global target for AMR that — if embedded within the pandemic preparedness instrument — could rally public support, funding, and political commitment commensurate with the scale of the AMR challenge. (shrink)

BackgroundThe COVID-19 pandemic has had a significant impact on the health system worldwide. The organ and tissue donation and transplantation (OTDT) system is no exception and has had to face ethical challenges related to the pandemic, such as risks of infection and resource allocation. In this setting, many Canadian transplant programs halted their activities during the first wave of the pandemic.MethodTo inform future ethical guidelines related to the COVID-19 pandemic or other public health emergencies of international concern, we conducted a (...) literature review to summarize the ethical issues.ResultsThis literature review identified three categories of ethical challenges. The first one describes the general ethical issues and challenges reported by OTDT organizations and transplantation programs, such as risks of COVID-19 transmission and infection to transplant recipients and healthcare professionals during the transplant process, risk of patient waitlist mortality or further resource strain where transplant procedures have been delayed or halted, and resource allocation. The second category describes ethical challenges related to informed consent in the context of uncertainty and virtual consent. Finally, the third category describes ethical issues related to organ allocation, such as social considerations in selecting transplant candidates.ConclusionThis literature review highlights the salient ethical issues related to OTDT during the current COVID-19 pandemic. As medical and scientific knowledge about COVID-19 increases, the uncertainties related to this disease will decrease and the associated ethical issues will continue to evolve. (shrink)

Previous studies have shown that misperceptions and illusory experiences can occur if sensory stimulation is withdrawn or becomes invariant even for short periods of time. Using a perceptual deprivation paradigm, we created a monotonous audiovisual environment and asked participants to verbally report any auditory, visual or body-related phenomena they experienced. The data (analysed using a variant of interpretative phenomenological analysis) revealed two main themes: (1) reported sensory phenomena have different spatial characteristics ranging from simple percepts to the feeling of immersion (...) in a complex multisensory environment and (2) the active contribution of the perceiver where participants report engaging in exploratory processes even when there is nothing to find. Detailed analysis of the qualitative data further showed that participants who reported more perceptual phenomena were more likely to report internal bodily sensations, move more during the experiment and score higher on the Revised Hallucination Scale than those reporting fewer percepts explicitly linking perceptual deprivation to somatic phenomena. The results demonstrate how the variety of sensory experiences induced by perceptual deprivation can give further insight into the factors mediating conscious awareness and may suggest ways in which the brain imposes meaning on the environment under invariant sensory conditions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Phenomenology and Modern Behavioral PsychologyLindsay B. Fletcher (bio) and Steven C. Hayes (bio)Keywordsacceptance, contextualism, defusion, relational-frame-theoryPérez-Álvarez and Sass (2008) deserve praise for examining the philosophical roots of clinical psychological science. Modern psychology has moved away from the development of philosophy and theory that is needed to ground scientific investigation within a coherent system. The result is increasingly ill-defined constructs and research programs that each operate within their own divergent (...) paradigm. B.F. Skinner is one of the few modern experimental behavioral psychologists who attempted to build a coherent science of behavior based on observable events with testable hypotheses. Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, and Wilson 1999) and its associated basic science of cognition, Relational Frame Theory (RFT; Hayes, Barnes-Holmes, and Roche 2001), build on Skinner’s work to produce a more progressive science.Psychology and philosophy are different disciplines and how they are approached is defined by the objective. The purpose of philosophy from a scientific point of view is not the same as from a philosophical point of view. It is fine to compare radical behaviorism and phenomenology, but it seems important to ask whether and how this will lead to a more progressive science of behavior.In this commentary, we discuss the philosophy and theory that underlie ACT/RFT and show how they reflect on the relevant points made by the authors regarding the shared features of phenomenology and radical behaviorism. We make two adjustments to the explanation of radical behavioral concepts presented in the current paper to create a more coherent analysis. Finally, we show here how the development of a theory based on applied goals directly informs the methods used in clinical settings.Philosophical AssumptionsThe field of behavior analysis that originated with Skinner has different strands. Some are holistic and pragmatic, whereas others are elementalistic and mechanistic (Hayes, Hayes, and Reese 1988). ACT is based on an a-ontological philosophy termed functional contextualism (Hayes 1993), which views behavior analysis from a holistic and pragmatic perspective. Functional contextualism (AKA radical behaviorism) shares some of the assumptions of phenomenology, as has long been noted (Day 1969). For example, Pérez-Álvarez and Sass (2008) identify a-dualism, or monism, as a common feature. In functional contextualism, the whole is divided into functional units for the purpose of prediction and influence. A three-term contingency (antecedent–behavior–consequence) in behavior analysis is viewed as a [End Page 255] whole event with pragmatically distinguishable aspects, not an assemblage. As the authors point out, this results in a dialectic tension between stimulus control, action, and reinforcer because none are distinct units, and each is defined with reference to the others much as the front of a coin cannot exist without the back. These are not ontological entities, but functional units that are abstracted from the whole for pragmatic purposes. What is “radical” about radical behaviorism is that the philosopher, psychologist, or researcher participates in the event they are observing, and their own acts of scientific observation are identified based on their own functional properties.Behavioral ThinkingIn the service of further developing this philosophical and theoretical foundation and considering it along side phenomenology, we need to examine two aspects of the target article. The first regards the role of the environment in shaping behavior that is central to behavioral and contextual theories. The authors object to behaviorism’s notion of environment and suggest replacing it with the concept of the world, stating that “animals have environment, but man has world.” What is missing is an account of that shift. We believe that modern behavior analysis provides that account.Similarly, the paper argues that “reinforcers are not just things that follow behavior, but also, and above all, values that guide our life.” Again what is missing is an account of the precise behavioral basis for the distinction.In an attempt to do this, the authors incorrectly analyze operant behavior as future oriented, even appealing to final causality. In the three-term contingency, the discriminative stimulus sets the occasion for reinforcement of a particular behavior. The behavior of interest has been reinforced in similar contexts in the past, which gives... (shrink)

This paper outlines the main assumptions of relevance theory and points out some new directions for research. After discussing the nature of relevance and its role in communication and cognition, it assesses two alternative ways of drawing the explicit–implicit distinction, compares relevance theory’s approach to lexical pragmatics with those of Grice and neo-Griceans, and discusses the rationale for relevance theory’s conceptual–procedural distinction, reassessing the notion of procedural meaning in the light of recent research. It ends by looking briefly at the (...) relation between the capacity to understand a communicator’s meaning, on the one hand, and the capacity to assess her reliability and the reliability of the communicated content, on the other, and considers how these two capacities might interact. (shrink)

A repository of clinically associated Staphylococcus aureus (Sa) isolates is used to semi‐automatically generate a set of application ontologies for specific subfamilies of Sa‐related disease. Each such application ontology is compatible with the Infectious Disease Ontology (IDO) and uses resources from the Open Biomedical Ontology (OBO) Foundry. The set of application ontologies forms a lattice structure beneath the IDO‐Core and IDO‐extension reference ontologies. We show how this lattice can be used to define a strategy for the construction of a new (...) taxonomy of infectious disease incorporating genetic, molecular, and clinical data. We also outline how faceted browsing and query of annotated data is supported using a lattice application ontology. (shrink)

World literature entangled in the forms, values, terms, and genres of comparative poetics makes the literatures of sites like Asia Pacific, India, and Oceania better recognized in world creativity and border-crossing archipelagic agency. World literature can become enframed not just along "borderlands" of nations and regions but also across "borderwaters" of entangled places, regions, and zones. Given the increasing recognition of this postcolonial world-literary creativity and agency—which implies taking seriously the reworlding power of these literatures—world poetics will have to revise (...) and decenter its literary and theoretical frameworks. (shrink)

Taking Hobbesian logic as my starting point, I argue that Hobbesian diffidence, one of the causes of quarrel in the state of nature, does not disappear once the citizens enter civil society. Rather, diffidence is merely contained by the sovereign. Following Alice Ristroph, I argue that diffidence comes to shape what citizens demand of the state/sovereign in the criminal law. However, I show that Ristroph does not fully appreciate that the concept of diffidence is a racialized one, and as such, (...) race underlies how the citizens understand their own diffidence, what citizens demand of the sovereign, and how they demand it. Further, because diffidence itself is racialized, criminal law need not make explicit appeals to race. Once racialized diffidence becomes embedded in the criminal law, it remains there regardless of any conscious racial animus. I show that racial profiling is a prime example of how this racialized diffidence manifests. Thus, I present Hobbesian diffidence as a framework from which to understand racial oppression. This paper is primarily an application of Hobbes to contemporary issues rather than an exegesis and analysis of Hobbes’s views. (shrink)

Prior to passage of the Oregon Death with Dignity Act, opponents of assistance in dying argued that legalization would have serious harmful consequences. Specifically, they argued that the quality and availability of palliative care would decline, that the harms of legalization would affect certain vulnerable groups disproportionately, that legal assisted dying could not be confined to the competent terminally ill who voluntarily request assistance, and that the practice would result in frequent abuses. Data from Oregon's decade-long experience decisively refute the (...) first three predictions. As to abuses, the record is not quite as clear, but if an appropriate framework for analysis is utilized, the most reasonable conclusion is that the risks of abuse do not outweigh the benefits of legalization. To the extent projected harmful consequences are relevant to the debate over legalization, Oregon's experience argues in favor of legalization of assistance in dying. (shrink)

An accurate classification of bacteria is essential for the proper identification of patient infections and subsequent treatment decisions. Multi-Locus Sequence Typing (MLST) is a genetic technique for bacterial classification. MLST classifications are used to cluster bacteria into clonal complexes. Importantly, clonal complexes can serve as a biological species concept for bacteria, facilitating an otherwise difficult taxonomic classification. In this paper, we argue for the inclusion of terms relating to clonal complexes in biomedical ontologies.

Since Teuffel's Römische Literatur mentions s.v. Varius the famous entry in the Monte Cassino MS. incipit thvestes varii, but ignores its occurrence in a Benevento MS. , it may be well to give some account of the latter codex. For I read with amusement a recent article in this journal in which the writer severely censured Mr. Garrod's ignorance of the entry in Paris 7530, but revealed his own ignorance by assuming that it was the scribe of the Paris MS. (...) who had the lost tragedy of Varius before him. (shrink)

The Placidus Glossary was hailed in Ritschl's time as a new clue to Plautus' true text. And Buecheler, Ritschl's pupil, seized on its Alapari est alapas minari, etc., and foisted this verb on Plaut. True. 928. The great Latin Thesaurus quotes the line with this piece of new cloth put on an old garment: nil alapari satiust, miles, instead of the correct philippiari satiust, miles.

Cicero defines gloria as frequens de aliquo fama cum laude, ‘much talk about a person to his praise.’ When the talk is by the person himself, the word takes the signification ‘boast’.

How any editor of Plautus can become one of the slash-cut-and-carve critics I cannot understand. The fair garden-beds of Plautus are scored all over with the hoof-prints of the reckless emender. Take this line of the Poenulus for example. Hanno gets a sight of his two long-lost daughters and is surprised to find how they have grown:Haecine meae sunt filiae?Quantae e quantillis iam sunt factae!His would-be son-in-law, not a very refined youth, says with a smile:Scin quid est?Thraecae sunt: in celonem (...) sustolli solent. (shrink)

Decisions based on ethics confront nurses daily. In this account, a cardiac nurse struggles with the challenge of securing health care benefits for Justin, a patient within the American system of health care. An exercise therapy that is important for his well-being is denied. The patient’s nurse and an interested insurance agent develop a working relationship, resulting in a relational narrative based on Justin’s care. Gadow’s concept of a relational narrative and Keller’s concept of a relational autonomy guide this particular (...) case. As an ethics framework influenced by feminist ethical theory, Gadow’s, Keller’s and Tisdale’s ideas demonstrate the fluidity with which the nurse and others can work while maintaining both autonomy and engagement without being self-sacrificing. (shrink)