During the set-up phase of an international study of genetic influences on outcomes from sepsis, we aimed to characterise potential differences in ethics approval processes and outcomes in participating European countries. Between 2005 and 2007 of the FP6-funded international Genetics Of Sepsis and Septic Shock project, we asked national coordinators to complete a structured survey of research ethic committee approval structures and processes in their countries, and linked these data to outcomes. Survey findings were reconfirmed or modified in 2017. Eighteen (...) countries participated in the study, recruiting 2257 patients from 160 ICUs. National practices differed widely in terms of composition of RECs, procedures and duration of the ethics approval process. Eight countries used a single centralised process for approval, seven required approval by an ethics committee in each participating hospital, and three required both. Outcomes of the application process differed widely between countries because of differences in national legislation, and differed within countries because of interpretation of the ethics of conducting research in patients lacking capacity. The RECs in four countries had no lay representation. The median time from submission to final decision was 1.5 months; in nine approval was received within 1 month; six took over 6 months, and in one 24 months; had all countries been able to match the most efficient approvals processes, an additional 74 months of country or institution-level recruitment would have been available. In three countries, rejection of the application by some local RECs resulted in loss of centres; and one country rejected the application outright. The potential benefits of the single application portal offered by the European Clinical Trials Regulation will not be realised without harmonisation of research ethics committee practices as well as national legislation. (shrink)

The phenomena referred to by the term attention were not discovered by scientific psychology. They were discovered and described within philosophy and gently handed over to the emerging academic psychology of the nineteenth century. The main contributors and contributions to the delineation and construction of attention as an empirical phenomenon and a topic for theorizing were Aristotle, who noticed that not all that reaches the senses is clearly perceived; Augustine, who interpreted attention as an effort of the soul; Descartes, who (...) distinguished active attention from passive attention; and Leibniz, who discussed the relation between attention, perception, and consciousness. (For further information on attention's philosophical past the reader is referred to Neumann's (in press) brief history of this philosophical past that is badly in need of an English translation.). (shrink)

Beschouwing vanuit een orthodox-christelijk perspectief.

The authors discuss some of the conceptual issues that must be considered in using and understanding psychiatric classification. DSM-IV is a practical and common sense nosology of psychiatric disorders that is intended to improve communication in clinical practice and in research studies. DSM-IV has no philosophic pretensions but does raise many philosphical questions. This paper describes the development of DSM-IV and the way in which it addresses a number of philosophic issues: nominalism vs. realism, epistemology in science, the mind/body dichotomy, (...) the definition of mental disorders, and dimensional vs. categorical classification. (shrink)

The reputation Theologoumena Arithmeticae has acquired is largely that of being an odd, and frequently opaque, compilation of arithmological lore. As a sourcebook for this aspect of the Pythagorean tradition it is, of course, invaluable. However, its poor reputation is increased, and its historical value lessened, by the depredations time has wrought on the text. ThA was never great prose: it is a compilation, largely from the lost Theologoumena Arithmeticae of Nicomachus of Gerasa and from Anatolius' Peri Dekados; and the (...) text which cannot be safely or conjecturally assigned to these two sources often reads like little more than the written-up notes of some student. However, the treatise contains passages of considerable lucidity, within the context of its peculiar framework. (shrink)

Objective: To review the principles and practice of the use of conscious sedation for IVF.Design: The pertinent literature was reviewed and recommendations are provided.Result(s): Conscious sedation appears to be the most commonly used method of pain relief for transvaginal retrieval of oocytes. Conscious sedation does not require the presence of an anesthesiologist and can be done in freestanding clinics. Agents commonly used include opioids in combination with benzodiazepines. This combination minimizes pain, decreases anxiety, and provides sedation and some amnesia Adjuvants (...) such as promethazine and hydroxyzine can also be used but often are not needed. Conscious sedation is well tolerated by patients and does not require highly specialized equipment. However, there are specific safeguards that should be followed. Only a few toxicity studies have been performed, but they are reassuring because they have not found significant effects on fertilization or cleavage.Conclusion(s): Conscious sedation appears to be a safe and cost-effective method of providing analgesia and anesthesia for transvaginal retrieval of oocytes. (shrink)

The explanatory gap refers to the lack of concepts for understanding “how it is that . . . a state of consciousness comes about as a result of irritating nervous tissue.” By assuming that there are colours in the outside world, Block needlessly widens this gap and Lycan and Kitcher simply fail to see the gap. When such assumptions are abandoned, an unnecessary and incomprehensible constraint disappears. It then becomes clear that the brain can use its own neural language for (...) representing aspects of the outside world. While this may not close the gap, it becomes clearer where we need new concepts. (shrink)

Everybody knows the phenomena summarized with the term attention: concentration, focalization, limitation, selection, and intensification . The explanation of these phenomena is, however, a different matter. Problems easily arise with regard towhathas to be explained and with regard to thestyleof explanation. A problem of the first kind is the “methodology of ‘bad focus’”: the explanation starts with and is fixated on an intuitively striking but nonessential behavioral feature or cognitive achievement. A problem of the second kind is a “virtus dormitiva” (...) explanation: the explanation starts with emphasizing one aspect of the observed phenomena, the emphasized aspect receives an interesting and suggestive name, and that name with its connotations is used as a concept in the explanation. At the start of contemporary, behavior-based, information processing psychology, avirtus dormitivaexplanation infiltrated the functional accounts of the phenomena of attention; the empirical observation that people show performance limitations was translated into the theoretical concept of a communication channel with a limited capacity. That limited capacity notion became the core concept in what can be called the standard theory of attention. This standard theory of attention faced severe difficulties in explaining the guidance of attention by the information processor's goals and intentions. Subsequent modifications, concerned with removing these difficulties, revealed that selection, guided by goals and intentions, is the essential behavioral feature and that the observed performance limitations are a result of this selection. So, the limited capacity theorizing was not only plagued by avirtus dormitivaexplanation, it also suffered from the methodology of bad focus. (shrink)

The author, a cardiac surgeon specialising in heart transplantation, argues that excellence in medicine must always be pursued and confronts the problems of specialties and super-specialties with widely varying costs and benefit in which the pursuit of excellence results. He advocates that decisions on resource allocation should be the responsibility of the Department of Health and Social Security, acting on the advice of the public's elected representatives on the one hand and the medical profession on the other. The profession has (...) an ever-increasing responsibility to ensure that its advice is soundly based on rigorous self-audit, which should include considering the costs and benefit of its work. His commentator, Lady McCarthy, until recently chairman of an area health authority, responds by arguing that the tripartite system for resource allocation does not work. Doctors resent the imposition of any priorities other than their own. Their two-dimensional medical ethics, concerning doctors' obligations to individual patients, must be supplemented by concern for society as a whole. Both papers are based on contributions to the 1982 annual conference of the London Medical Group on Appropriate Medicine. (shrink)