ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

A new technique for proving realisability results is presented, and is illustrated in detail for the simple case of arithmetic minus induction. CL is a Gentzen formulation of classical logic. CPQ is CL minus the Cut Rule. The basic proof theory and model theory of CPQ and CL is developed. For the semantics presented CPQ is a paraconsistent logic, i.e. there are non-trivial CPQ models in which some sentences are both true and false. Two systems of arithmetic minus induction are (...) introduced, CL-A and CPQ-A based on CL and CPQ, respectively. The realisability theorem for CPQ-A is proved: It is shown constructively that to each theorem A of CPQ-A there is a formula A *, a so-called “realised disjunctive form of A ”, such that variables bound by essentially existential quantifiers in A * can be written as recursive functions of free variables and variables bound by essentially universal quantifiers. Realisability is then applied to prove the consistency of CL-A, making use of certain finite non-trivial inconsistent models of CPQ-A. (shrink)

Boarding school is a major educational option for many students (e.g., students living in remote areas, or whose parents are working interstate or overseas, etc.). This study explored the motivation, engagement, and achievement of boarding and day students who are educated in the same classrooms and receive the same syllabus and instruction from the same teachers (thus a powerful research design to enable unique comparisons). Among 2,803 students (boardingn= 481; dayn= 2,322) from 6 Australian high schools and controlling for background (...) attributes and personality, we found predominant parity between boarding and day students in their motivation, engagement, and achievement. We also found that classroom-average motivation, engagement, and achievement was not significantly affected by the number of boarders (relative to day students) in the classroom. In addition, the effects of boarding were generally not moderated by students’ background or personality attributes. We conclude that boarders have academic opportunities and outcomes that are comparable to their day student counterparts. Implications for students, teachers, and parents are discussed. (shrink)

We address the following issues raised by the commentators of our target article and book: the problem of multiple perspectives; how to define group selection; distinguishing between the concepts of altruism and organism; genetic versus cultural group selection; the dark side of group selection; the relationship between psychological and evolutionary altruism; the question of whether the psychological questions can be answered; psychological experiments. We thank the contributors for their commentaries, which provide a diverse agenda for future study of evolution and (...) morality. Our response will follow the organization of our book, distinguishing between evolutionary issues that concern fitness effects and psychological issues that concern motives. (shrink)

At the close of the recent Boston Symposium, a panel discussion was held on the general theme of the conference. The following are the remarks of Professor J. N. Findlay of Yale, recorded and transcribed here with his permission.

In response to rapidly rising health care costs in the United States, federal and state governments and private industry are instituting numerous and diverse cost-containment plans. As devices for coping with a scarcity of resources, such plans present serious challenges to physicians' traditional single-minded devotion to patient welfare. Those which contain costs by directly limiting medical options or by controlling physicians' daily clinical decisions can threaten the quality of medical care by allowing economic authorities to make essentially medical judgments. In (...) contrast, other plans coax compliance by arranging incentives, e.g., offering financial rewards for successful cost containment. While they allow for clinical freedom, these plans create conflicts between physicians' fiduciary obligations to their patients and the competing interests of the payers. Such conflicts arise as physicians try to work within governmental or corporate cost containment policies, and also as they attempt to streamline clinical efficiency. Throughout, issues of justice emerge as physicians seek to reconcile their own patients' claims upon limited common resources with others' equally legitimate claims. (shrink)

Revisitation of the much debated issue of the mind-body relation in Origen, with new insights, discussion of evidence, and of scholarship.

In this paper, I first of all define various kinds of ontological dependence, motivating these definitions by appeal to examples. My contention is that whenever we need, in metaphysics, to appeal to some notion of existential or identity-dependence, one or other of these definitions will serve our needs adequately, which one depending on the case in hand. Then I respond to some objections to one of these proposed definitions in particular, namely, my definition of (what I call) essential identity-dependence. Finally, (...) I show how a similar approach can be applied in the theory of truthmaking, by offering an account of the truthmaking relation which defines it in terms of a type of essential dependence. I also say why I think that this approach is preferable to one which treats the truthmaking relation as primitive. More generally, my view is that accounts of dependence or ‘grounding’ which treat these notions as primitive are less satisfactory than my own position, which is that in all cases a suitable definition is forthcoming if we look hard enough. (shrink)

This book is a clear, comprehensive guide to the philosophic and religious concepts of the world's outstanding philosophers. Here are the great thoughts and ideas of the Western mind, selected and explained with magnificent precision by an eminent scholar. It is an illuminating portrait of man's intellectual and moral struggle to understand the world and the meaning of human life and destiny. Plato Aristotle Augustine Aquinas Luther Descartes Kant Rousseau Marx Nietzsche.

What is silence? Is it a loss, an omission? Is it a stopping of the mouth, of the voice? An empty place where no meaning has come forward…or perhaps at times quite the opposite, an absence-as-presence Deleuze, 1990; Derrida, 1976)? Might silence evoke much more about what we assume is our monological, unitary reality, indexing possibilities yet unseen? This paper outlines the ways in which silence is typically understood according to scholarly orthodoxy: as omission in human communication or a silencing (...) of minoritized individuals or communities by those in power. It then moves to critique the preeminence of whitestream Western-centric academic authority, which self-perpetuates via the exclusion of outsider ways of doing, being and knowing such as those brought forward by silence, constituting a loss of meaning and knowledge from the social imaginary. This paper suggests that the pursuit of an articulate unknowing regarding silence as a creative, disruptive force beyond the control of rationality is a means of engaging with radical possibilities for a different, juster world. It proposes a socio-diologic politics of the real that welcomes silence as an unsettling of our current thinking about what is and will be possible, as well as who does and does not matter. It concludes by illustrating the ingenious force of silence in examples of subversive art that expose the hegemonizing, rational version of reality sold by academics and powerholders, bringing forward into the imagination what prospects for change, justice, and social transformation yet await. (shrink)

Universalism from Christian beginnings to Julian of Norwich.