The consent and community engagement process for research with Indigenous communities is rarely evaluated. Research protocols are not always collaborative, inclusive or culturally respectful. If participants do not trust or understand the research, selection bias may occur in recruitment, affecting study results potentially denying participants the opportunity to provide more knowledge and greater understanding about their community. Poorly informed consent can also harm the individual participant and the community as a whole. Invited by local Aboriginal community leaders of the Fitzroy (...) Valley, the Kimberley, Western Australia, The Picture Talk project explores the consent process for research. Focus groups of Aboriginal community members were conducted to establish preferences for methods of seeking individual consent. Transcripts were analysed through NVivo10 Qualitative software using grounded theory with inductive and deductive coding. Themes were synthesised with quotes highlighted. Focus groups with Aboriginal community members were facilitated by a Community Navigator as a cultural guide and interpreter and a researcher. Participants were recruited from all main language groups of the Fitzroy Valley – Gooniyandi, Walmajarri, Wangkatjungka, Bunuba and Nikinya. Participants were aged ≥18 years, with 5 female groups and one male group. Themes identified include: Reputation and trust is essential; The Community Navigator is key; Pictures give the words meaning – milli milli versus Pictures; Achieving consensus in circles; Signing for consent; and Research is needed in the Valley. Aboriginal communities of the Fitzroy Valley recommend that researchers collaborate with local leaders, develop trust and foster a good reputation in the community prior to research. Local Aboriginal researchers should be employed to provide cultural guidance throughout the research process and interpret local languages especially for elders. Pictures are preferred to written text to explain research information and most prefer to sign for consent. The Fitzroy Valley welcomes research when collaborative and for the benefit of the community. Future research could include exploring how to support young people, promote health screening and improve understanding of medical knowledge. (shrink)

ObjectivesDuring their lifetimes, a majority of musicians experience playing-related musculoskeletal disorders. PRMD prevalence is tied to instrument choice, yet most studies examine heterogeneous groups of musicians, leaving some high-risk groups such as oboists understudied. This paper aims to ascertain the prevalence and nature of PRMDs in oboists, determine relevant risk factors, and evaluate the efficacy of treatment methods in preventing and remedying injuries in oboe players.MethodsA 10-question online questionnaire on PRMDs and their treatments was completed by 223 oboists. PRMDs were (...) compared across gender, weekly playing hours, career level, age, and years of playing experience.ResultsOf all respondents, 74.9% reported having had at least one PRMD in their lifetime. A majority of these injuries were of moderate to extreme severity. Females reported significantly more severe injuries than males. No significant effects of career level, age, or years of playing experience were observed. We found significant non-linear relationships between weekly playing hours and PRMD prevalence and severity. Injuries were most commonly on the right side of the body, with the right thumb, wrist, hand, and forearm being most affected in frequency and severity. Of those injuries for which recovery information was provided, only 26.1% of injuries were “completely recovered.” The perceived effectiveness of a few treatments tended to be ranked more highly than others.ConclusionThe oboists in this study experienced high rates of PRMD, particularly in the right upper extremities. Females and those playing 7-9 and 16-18 h per week reported a significantly higher severity of injuries than other groups. (shrink)

Many philosophers have argued that psychological time is a fundamental, inherent quality of consciousness that provides continuity and sequence to mental events—enabling memory. And, since memory is consciousness, psychological time enables the individual intentionality of consciousness. Levinas , on the other hand, argues that an individual’s past, in the most original sense, is the past of other. The irreducible alterity of one’s past sets the stage for the other who co-determines the meaning of the past. This paper is about the (...) exploration cultural memory within the context of a Caucasian doctoral student entering into an African-American community during an internship, who finds that cultural memories are remarkably more complicated than the propositional description of historic events. The paper further explores how cultural memory is not a record of “what happened” but a sociolinguistic creative meaning making process. Histories can be contested. Memory, on the other hand, never adheres to the strict true or false dichotomy. Memory is like searching for the Divine, it cannot be found, only revealed in mysterious and small details. Memory, is the intruding of the infinite, creating as an effect the idea of a finite , they are not “representations” of the past nor are they a kind of mnemonic system of subjectivism to mediate all of consciousness. (shrink)

This volume encompasses deeply critical dialogues that question how the field of psychology exists within and is shaped by the current neoliberal political context. Spanning from psychoanalysis to post-colonial theory, these far-reaching discussions consider how a greater ethical responsiveness to human experience and sociopolitical arrangements may reopen the borders of psychological discourse. With the understanding that psychology grows in the soil of neoliberal terrain and is a chief fertilizer for neoliberal expansion, the interviews in this book explore alternative possibilities for (...) this field of study might function. By offering their own unique responses regarding the current condition of their respective disciplines, these scholars critically consider the current conceptual frameworks that set the theoretical boundaries of psychology, and contemplate the ethical responsibilities currently affecting the field. This book will prove essential for scholars and students across several disciplines including psychology, philosophy, ethics, and post-colonial and socio-cultural studies, as well as practicing mental health professionals with an interest in the importance of psychological and social theory. (shrink)

Using a policy-capturing approach with a broad student sample we examine how individuals’ economic, social and environmental values influence their propensity to engage in a broad range of sustainability-related corporate actions. We employ a multi-dimensional sustainability framework of corporate actions and account for both the positive and negative impacts associated with corporate activity—termed strength and concern actions, respectively. Strong economic values were found to increase the propensity for concern actions and the willingness to work in controversial industries. Individuals with balanced (...) values were as likely as those with strong economic values to pursue positive economic outcomes, but without the same downside potential for concern actions. We also found significant gender effects, with females being less likely to engage in concern actions and more supportive of social and environmental strength actions. (shrink)

The author created a new course, called “Seminar in Public Health Law and Policy in an Interprofessional Setting” to address the need for interprofessional education to equip graduate and professional students for collaborative practice at the systemic and policy levels in the health care and public health fields. Despite important work being done at the clinical practice level, limited existing IPE models examine larger systemic issues. The course is designed specifically to enable students in social work, law, and public health (...) to recognize the reciprocal relationships between policy and interprofessional collaborative practice, including the need for understanding of the impact of team-practice work at the system and policy levels. (shrink)

The study of similarity is fundamental to biological inquiry. Many homology concepts have been formulated that function successfully to explain similarity in their native domains, but fail to provide an overarching account applicable to variably interconnected and independent areas of biological research despite the monistic standpoint from which they originate. The use of multiple, explicitly articulated homology concepts, applicable at different levels of the biological hierarchy, allows a more thorough investigation of the nature of biological similarity. Responsible epistemological pluralism as (...) advocated herein is generative of fruitful and innovative biological research, and is appropriate given the metaphysical pluralism that underpins all of biology. (shrink)

Since the emergence of computing as a mode of investigation in the sciences, computational approaches have revolutionised many fields of inquiry. Recently in philosophy, the question has begun rendering bit by bit—could computation be considered a deeper fundamental building block to all of reality? This paper proposes a continuum computing construct, predicated on a set of core computational principles: computability, discretisation, stability and optimisation. The construct is applied to the set of most fundamental physical laws, in the form of non-relativistic (...) conservation equations which underpin our governing physics. The discretisation approach divides all of space into a mesh of discrete computational cells, and evolution of data in those cells must obey pre-defined stability conditions from established continuum computing theory, namely, the Courant–Friedrichs–Lewy condition. Evolving cell-state data in a manner which logically optimises computational efficiency, combined with the defined stability condition, the construct derives a central coupling of space, time, and the fastest speed of information propagation. This coupling formed at the lowest level by the computing construct, naturally and inherently produces aspects of special relativity and general relativity at the macroscale. This paper therefore proposes a new explanation of why the nature of space and time may be fused, and explores simple emergent congruities with relativity. The theory invites us to reverse the philosophical premise of the original Simulation Argument. This argument currently leads us to consider: how might all of the observed physics of our reality be reproduced computationally in a simulation of our existence? This work asks instead: could foundations of the physics of our universe—namely spacetime coupling—emerge inherently, and necessarily, from fundamental principles of computation? (shrink)

We present a method for rejecting competing models from noisy time-course data that does not rely on parameter inference. First we characterize ordinary differential equation models in only measurable variables using differential-algebra elimination. This procedure gives input-output equations, which serve as invariants for time series data. We develop a model comparison test using linear algebra and statistics to reject incorrect models from their invariants. This algorithm exploits the dynamic properties that are encoded in the structure of the model equations without (...) recourse to parameter values, and, in this sense, the approach is parameter-free. We demonstrate this method by discriminating between different models from mathematical biology. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The 12–Minute JourneyHeather A. CarlsonI met Jack for the first time when he was in the intensive care unit as he was just waking up from his emergent tracheostomy surgery. As I walked into his room he opened his eyes in panic and he struggled to take in a deep breath, fighting the ventilator that was trying to deliver slow steady breaths for him. His face was flooded with (...) fear and the ventilator alarms were blaring. He was surrounded by nurses and respiratory technicians all trying to calm him down, while adjusting the settings on the machine. “Just try and breathe slowly,” they instructed him, though this seemed to be impossible for him as he continued to try and suck in as much air as possible through the new hole in his throat. As his arm flailed out I grabbed his hand and while holding it in mine I just tried to emulate tranquility for him. I thought to myself this is exactly how I would react if I woke up in this condition and could imagine the fear that he was now feeling. While nurses rushed around with suction equipment and the respiratory technicians made adjustments and monitored the results I stood there holding his hand silently praying that he become calm. With all of our support he did eventually relax and find the ability to sync his breathing with the ventilator settings.I am a palliative care nurse practitioner and had been asked to see Jack to help with symptom management and establishing his goals of care as he had recently been diagnosed with head and neck cancer. He had presented to the hospital with complaints of difficulty breathing and it didn’t take long for the emergency room physician to determine that his airway was almost completely occluded by tumor. Jack had actually been diagnosed with this cancer the month before, and had met with a radiation oncologist who planned to start radiation as soon as possible to avoid tumor growth that could impair his breathing. Unfortunately Jack was so anxious and scared about this treatment plan that he never went back to the cancer center. Instead, he stayed in his room in the boarding house that he lived in, smoking cigarettes to calm his nerves. Jack was a recovering alcoholic who had previously been homeless and out on the streets for many years before becoming sober and finding shelter at the boarding house where he now lived. He was a heavy smoker and found that it was one thing that helped to ease his anxiety. The thought of being strapped down to a table with a tight mask over his head while radiation zapped the cancer in his neck had terrified him. His anxiety and claustrophobia had prevented him from following through with his cancer treatment.My initial visits with Jack were spent trying to treat his anxiety as well as the pain he experienced in his neck and head.Because he had undergone a tracheostomy and was now on a ventilator he was unable to speak. To communicate he pointed to a picture board that had common sayings on it, like “I have pain” and “I have to go to the bathroom”. He also used a clipboard with paper and pen and could write what he wanted to say, but this was a time consuming endeavor. Despite this, he was a very animated gentleman who had a lot to say and he wasn’t going to let the loss of his voice impair him. I found myself enjoying my visits with him each day, as he would tell me more about himself. I quickly discovered that he was a very spiritual man and his faith was his inspiration. He wrote on his clipboard “this cancer is actually a gift” and went on to explain that he had been on a fast track toward self destruction, but now feels as though he has been given another chance at life. He spent his time in the hospital reflecting on his life’s journey and how he would be able to help others in similar circumstances. He wrote on his [End Page 192] clipboard multiple... (shrink)

Somatic muscle formation is an unusual process as it requires the cells involved, the myoblasts, to relinquish their individual state and fuse with one another to form a syncitial muscle fiber. The potential use of myoblast fusion therapies to rebuild damaged muscles has generated continuing interest in elucidating the molecular basis of the fusion process. Yet, until recently, few of the molecular players involved in this process had been identified. Now, however, it has been possible to couple a detailed understanding (...) of the cellular basis of the fusion process with powerful classical and molecular genetic strategies in the Drosophila embryo. We review the cellular studies, and the recent genetic and biochemical analyses that uncovered interacting extracellular molecules present on fusing myoblasts and the intracellular effectors that facilitate fusion. With the conservation of proteins and protein functions across species, it is likely that these findings in Drosophila will benefit understanding of the myoblast fusion process in higher organisms. BioEssays 24:591–601, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

A striking trend is emerging in the Canadian and American literary landscape, and memoirs with the following narrative trajectory are now widely read: a stranger abducts a young woman, and holds her captive for years. She endures sexual, physical, and emotional abuse, eventually escapes, and returns to her former life. The sole scholarly discussion about these memoirs frames them as empowering for the authors, but the social and economic factors that inform these texts remain unaddressed. Drawing from Michel Foucault's discussion (...) of the confession, this article complicates and extends this analysis. First, it situates memoirs by Elizabeth Smart, Amanda Berry and Gena DeJesus, Jaycee Dugard, Michelle Knight, and Josefina Rivera as examples of the Foucauldian sexual confession. It then maps the ways memoirs enable the authors to voice their understanding of the social and economic factors that both gave rise to their plight and inform media discussions that blame them for their suffering. I will ultimately argue that memoirs function as a public venue to resist or reject dominant interpretive frames that shape a survivor's experiences, while simultaneously reaffirming the ubiquity of these lines of thinking. (shrink)

"Permanent Things reminds us that some of the century's most imaginative minds - G. K. Chesterton, T. S. Eliot, C. S. Lewis, Dorothy Sayers, and Evelyn Waugh - were profoundly at odds with the secularist spirit of the age, seeing progressive enlightenment as ushering in, not a millennium of perfect freedom, but a Waste Land whose inhabitants - Waugh's "vile bodies," Eliot's "hollow men," Lewis's "men without chests" - can find refuge from their boredom and anomie only in the ceaseless (...) acquisition of things or in the consoling illusions of pseudo religions - "distracted from distraction by distraction," as Eliot memorably put it." "How does one explain the desolation of a world which, though richly endowed with material comforts, is mentally and spiritually impoverished? The essayists here are united, as were their subjects, by a need to try to answer this question. Modern man's poverty of spirit, visible alike in so much of his art and architecture, his literature and philosophy and political science, reflects his loss of any good reasons for living - his loss of the Permanent Things." "The Christian writers whose work is eloquently interpreted in this book repay our attention for at least two reasons. First is their ability to sharpen our awareness of what, by any previous civilized standards, must be called the abnormal condition of modern man. For all the writers treated in this book, it was never enough to simply capture the spiritual aridity of modern life. It was also necessary to speak of a moral order that may yet be restored by the expressive power and beauty of the written word."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved. (shrink)

Neuropalliative care developed to address the needs of patients living with life‐limiting neurologic disease. One critical consideration is that disease‐related changes to cognition, communication, and function challenge illness experiences and care practices. We conducted an ethnography to understand neuropalliative care as a phenomenon; how it was experienced, provided, conceptualized. Personhood served as our conceptual framework; with its long philosophical history and important place in nursing theory, we examined the extent to which it captured neuropalliative experiences and concerns. Personhood contextualized complex (...) losses, aligning the impact of functional and relational changes. Cognition, communication, and functional alterations stretched conceptions of personhood, insinuating it can be relational, fluid, adaptive. Although normative conceptions of personhood guided research and decision‐making, ethical considerations suggested personhood could be transformed, remade. We consider the implications of our findings through three themes. First, we examine how literature on illness experience fails to integrate the realities of people living with and dying from neurologic disease; we counter this by interrogating the concept of experience. Second, we turn to Ricoeur's work on recognition to illuminate relational conceptions of personhood to inform care practices. Finally, we reflect on how personhood can bridge the gap left by functional changes, enhance relational engagement, and promote dignity at the end of life. (shrink)

Increasingly, the Internet is proving to be an important research tool. Today, cyberspace affords researchers easy access to traditionally difficult to reach populations, a host of virtual communities, and a wealth of data created through computer-mediated-communication. This newfound research frontier brings with it, however, a multiplicity of ethical concerns, including: (1) whether the Internet constitutes a private or public space; (2) whether the human subject paradigm is appropriate when considering the ethics of Internet research; and (3) whether cyber participants/‘speakers-as-writers’ and (...) communities should be guaranteed confidentiality and anonymity when researchers contain or consider them in research. This paper examines these specific ethical concerns as they relate to Canada's Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans, which, as yet, does not explicitly address ethics involved in Internet research. I propose that in large part the Internet is by definition a public site of activity, and as such, many posters cannot expect their texts to remain confidential, nor their names anonymous, and that the human subject paradigm is highly problematic in terms of regulating ethics involved in some research generated through new information technologies. This is most expressly the case with computer-mediated-communication, which, in light of the Tri-Council Policy Statement, can be viewed as theoretically akin to public entertainment and performance. (shrink)

Most documented extinctions of vertebrates in the last 400 years have been island endemics. In this paper, we focus on the need to develop a historical framework to establish conservation priorities for insular faunas and, in particular, to test the validity of nominal endemics. We use the example of the islands of the North Pacific Coast of North America, a region that includes approximately one-half of all mammals endemic to North American islands north of Mexico. Few of these endemics have (...) been re-evaluated since their original descriptions, although many of these islands have been heavily impacted by habitat conversion, species introductions, over-exploitation, and secondary ripple effects. Evidence from molecular genetics and paleontology suggests that many taxa arrived in the region since the last glacial advance. Some of these nominal endemics show minimal differentiation, while others comprise multiple evolutionary lineages. The NPC may also have played an important role in the in situ diversification of some taxa during the Pleistocene. Evidence, such as new fossil discoveries and numerous described endemics, lends support for refugia hypotheses. However, these ideas cannot be tested until a better understanding of geographic variation and the evolutionary relationships of the fauna and flora of the North Pacific Coast is developed. This framework would provide significant insight into the dynamic biogeographic history of the region and help prioritize conservation efforts. (shrink)

It may seem that there is no need to review such a well-known book. This is the second edition of Peter Singer's text, Practical Ethics. The first edition has been widely used and influential; indeed for many it defines the field of applied ethics. The field is lucky; rarely is such popular work so carefully argued, so factually well informed and so well written. In addition, it is unusual for the author of a basic text to be so daring. Peter (...) Singer deserves credit for placing the interests of animals and famine victims on the agenda of applied ethics, and for making that agenda so prominent in public fora. But it behooves us to scrutinize carefully the power of definitive works as well. What sets the agenda is, for that very reason, more difficult to assess critically. (shrink)

It has been theorized that the contagion of behaviors may be related to social cognitive abilities, but empirical findings are inconsistent. We recorded young adults’ behavioral expression of contagious yawning and contagious smiling to video stimuli and employed a multi-method assessment of sociocognitive abilities including self-reported internal experience of emotional contagion, self-reported trait empathy, accuracy on a theory of mind task, and observed helping behavior. Results revealed that contagious yawners reported increases in tiredness from pre- to post-video stimuli exposure, providing (...) support for the internal experience of emotional contagion, and were more likely to provide help to the experimenter relative to non-contagious yawners. Contagious smilers showed stably high levels of self-reported happiness from pre- to post-video exposure, were more likely to provide help to the experimenter, and had increased accuracy on a theory of mind task relative to non-contagious smilers. There were no differences in self-reported trait empathy for contagious versus non-contagious yawners or smilers. Contagious yawning may be related to some basic (i.e., emotional contagion) and advanced (i.e., helping behavior) sociocognitive processes, whereas contagious smiling is related to some advanced sociocognitive processes (i.e., theory of mind and helping behavior). (shrink)

The study of similarity is fundamental to biological inquiry. Many homology concepts have been formulated that function successfully to explain similarity in their native domains, but fail to provide an overarching account applicable to variably interconnected and independent areas of biological research despite the monistic standpoint from which they originate. The use of multiple, explicitly articulated homology concepts, applicable at different levels of the biological hierarchy, allows a more thorough investigation of the nature of biological similarity. Responsible epistemological pluralism as (...) advocated herein is generative of fruitful and innovative biological research, and is appropriate given the metaphysical pluralism that underpins all of biology. (shrink)

Multiple states are at risk of becoming uninhabitable due to climate change, forcing their populations to flee. While the 1951 Refugee Convention provides the gold standard of international protection, it is only applied to a limited subset of people fleeing their countries, those who suffer persecution, which most people fleeing climate change cannot establish. While many journalists and non-lawyers freely use the term “climate refugees,” governments, and courts, as well as UNHCR and many refugee experts, have excluded most climate refugees (...) from the Convention as a matter of legal interpretation. In our 2015 paper, “Unable to Return in the 1951 Refugee Convention: Stateless Refugees and Climate Change”, we sought to reopen the debate on “climate refugees” by arguing that some climate refugees qualify under the 1951 Convention as it is currently written (even if they are not persecuted): those who are stateless and are unable to return to their country of origin because climate change has rendered it uninhabitable. Our interpretation, however, has been rejected by Goodwin-Gill and McAdam (2021) and by Foster and Lambert (2019), which explicitly responds to our paper. Here, we address and respond to their arguments, and develop a new supplementary one, drawing on the principle of systemic integration, as enshrined in Article 31(3)(c) of the Vienna Convention on the Law of Treaties. (shrink)

Aim To ascertain the quantity and nature of gifts and items provided by the pharmaceutical industry in Australia to medical specialists and to consider whether these are appropriate in terms of justifiable ethical standards, empirical research and views expressed in the literature.

Cognitive control is easy to identify in its effects, but difficult to grasp conceptually. This creates somewhat of a puzzle: Is cognitive control a bona fide process or an epiphenomenon that merely exists in the mind of the observer? The topiCS special edition on cognitive control presents a broad set of perspectives on this issue and helps to clarify central conceptual and empirical challenges confronting the field. Our commentary provides a summary of and critical response to each of the papers.

Recent studies of Reinhold Niebuhr's life and work demonstrate his continued importance in theology, ethics, and political thought. Historical studies by Heather Warren, Mark Kleinman, and Normunds Kamergrauzis provide new assessments of Niebuhr's role as a political and religious leader in his own time and trace the consequences of the movements in which he participated. They also show us more clearly how his work was connected to the ideas and programs of his contemporaries. Colm McKeogh offers a more systematic (...) treatment of Niebuhr's political realism in relation to just war theory. Niebuhr's intellectual legacy remains disputed, with Stanley Hauerwas and Langdon Gilkey offering radically different assessments of his theology. Hauerwas sees in Niebuhr a close connection to the religious liberalism of William James that precludes any authentic Christian witness. Niebuhr's empiricism reduces God to a necessary feature of human consciousness. Gilkey notes Niebuhr's early use of James' psychology, but discerns a theology of history that is central to Niebuhr's mature work. In that theology, the ground of hope necessarily lies beyond human consciousness, and indeed beyond history itself. (shrink)

The species comprising the fungal endophyte genus “Epichloë ”are symbionts of cool season grasses. About half the species in this genus are strictly vertically transmitted, and evolutionary theory suggests that these species must be mutualists. Nevertheless, Faeth and Sullivan (e.g., 2003) have argued that such vertically transmitted endophytes are ’usually parasitic,’ and Müller and Krauss (2005) have argued that such vertically transmitted endophytes fall along a mutualism-parasitism continuum. These papers (and others) have caused confusion in the field. We used a (...) systematic review to show that close to half of the published papers in this field incorrectly categorize the interaction. Here, we develop the argument that advantages and disadvantages are not the same things as mutualism and parasitism and that experimental evidence must be interpreted in the context of theory. We argue that, “contra ”Faeth and Sullivan, it is highly unlikely that such strictly vertically transmitted endophytes can be parasites, and that, “contra ”Müller and Krauss, it is inappropriate to apply the continuum concept to strictly vertically transmitted endophytes. We develop a mathematical model to support and illustrate our arguments. We use the model to clarify that parasitism “requires ”some degree of horizontal transmission, and that while it is appropriate to use the continuum concept when referring to the genus as a whole, or to species that possess horizontal transmission, we argue that it is inappropriate to use the concept when referring to species that are strictly vertically transmitted. (shrink)

__Cultural Studies and Education_ is a timely introduction to cultural studies and the ways in which it can enrich both education scholarship and practice._ An extensive field that in the last few decades has transformed many academic disciplines, cultural studies has yet to be fully considered by educators and education scholars. Cultural Studies and Education redresses this great shortcoming, bringing cultural studies and its implications for education to the fore. The book aims to serve three main purposes. First, it is (...) an introduction for educators and education researchers to some of the most important theoretical debates and analytic frameworks that have shaped the field of cultural studies. Second, it offers an introduction to and examples of three important areas of inquiry in which education and cultural studies overlap: gender and queer studies; postcolonial and ethnic studies; and popular culture and youth studies. Third, it illustrates how education scholars have dealt with the conceptual challenges of cultural studies and how education offers unique perspectives and contributions to the broader debates in the field.". (shrink)

While pharmaceutical industry involvement in producing, interpreting, and regulating medical knowledge and practice is widely accepted and believed to promote medical innovation, industry-favouring biases may result in prioritizing corporate profit above public health. Using diabetes as our example, we review successive changes over forty years in screening, diagnosis, and treatment guidelines for type 2 diabetes and prediabetes, which have dramatically expanded the population prescribed diabetes drugs, generating a billion-dollar market. We argue that these guideline recommendations have emerged under pervasive industry (...) influence and persisted, despite weak evidence for their health benefits and indications of serious adverse effects associated with many of the drugs they recommend. We consider pharmaceutical industry conflicts of interest in some of the research and publications supporting these revisions, and in related standard-setting committees and oversight panels. We raise concern over the long-term impact of these multifaceted involvements. Rather than accept industry conflicts of interest as normal, needing only to be monitored and managed, we suggest challenging that normalcy, and ask: what are the real costs of tolerating such industry participation? We urge the development of a broader focus to fully understand and curtail the systemic nature of industry’s influence over medical knowledge and practice. (shrink)

Background At the beginning of the coronavirus (Covid-19) pandemic, many non-Covid healthcare services were suspended. In April 2020, the Department of Health in England mandated that non-Covid services should resume, alongside the continuing pandemic response. This ‘resetting’ of healthcare services created a unique context in which it became critical to consider how ethical considerations did (and should) underpin decisions about integrating infection control measures into routine healthcare practices. We draw on data collected as part of the ‘NHS Reset Ethics’ project, (...) which explored the everyday ethical challenges of resetting England’s NHS maternity and paediatrics services during the pandemic. Methods Healthcare professionals and members of the public participated in interviews and focus group discussions. The qualitative methods are reported in detail elsewhere. The focus of this article is our use of Frith’s symbiotic empirical ethics methodology to work from our empirical findings towards the normative suggestion that clinical ethics should explicitly attend to the importance of relationships in clinical practice. This methodology uses a five-step approach to refine and develop ethical theory based on a naturalist account of ethics that sees practice and theory as symbiotically related. Results The Reset project data showed that changed working practices caused ethical challenges for healthcare professionals, and that infection prevention and control measures represented harmful barriers to the experience of receiving and offering care. For healthcare professionals, offering care as part of a relational interaction was an ethically important dimension of healthcare delivery. Conclusions Our findings suggest that foregrounding the importance of relationships across a hospital community will better promote the ethically important multi-directional expression of caring between healthcare professionals, patients, and their families. We offer two suggestions for making progress towards such a relational approach. First, that there is a change of emphasis in clinical ethics practice to explicitly acknowledge the importance of the relationships (including with their healthcare team) within which the patient is held. Second, that organisational decision-making should take into account the moral significance afforded to caring relationships by healthcare professionals, and the role such relationships can play in the negotiation of ethical challenges. (shrink)

"The philosophical works of A. J. Ayer": p. [334]-341. Bibliography: p. [343]-346. Includes indexes.

A. J. Ayer was one of the foremost analytical philosophers of the twentieth century, and was known as a brilliant and engaging speaker. In essays based on his influential Dewey Lectures, Ayer addresses some of the most critical and controversial questions in epistemology and the philosophy of science, examining the nature of inductive reasoning and grappling with the issues that most concerned him as a philosopher. This edition contains revised and expanded versions of the lectures and two additional essays. Ayer (...) begins by considering Hume's formulation of the problem of induction and then explores the inferences on which we base our beliefs in factual matters. In other essays, he defines the three kinds of probability that inform inductive reasoning and examines the various criteria for verifiability and falsifiability. In his extensive introduction, Graham Macdonald discusses the arguments in _Probability and Evidence_, how they relate to Ayer's other works, and their influence in contemporary philosophy. He also provides a brief biographical sketch of Ayer, and includes a bibliography of works about and in response to _Probability and Evidence_. (shrink)

In this article, I take my own position within an ongoing debate about what place (if any) Christian theology should have within the secular university. Against both “secularists” and “sectarians,” I argue that we can and should locate the study (teaching and learning) of theology squarely within the secular university, once we cease to demand that all academic study within the secular university be framed by a narrowly defined and overly constrictive “secular perspective.” Freed from the controlling dogma of the (...) “secular perspective,” theology in the secular university can proceed unhindered in its quest for knowledge, following the classical method of “faith seeking understanding,” while still remaining remarkably inclusive of, and respectful toward, those who do not share specific theological commitments. (shrink)

If rising seas render small islands uninhabitable, will displaced islanders become stateless? The modern intellectual and legal tradition tells us that states must have defined, habitable territory. If so, small islands will cease to be states, and their inhabitants will accordingly become stateless. Against this, leading scholars have recently argued that the principle of presumption of continuity of state existence implies that island states continue to be states even after becoming uninhabitable. We argue to the contrary: the principle of presumption (...) of continuity of state existence implies no such thing. If nothing is done to prevent the loss of their territory, small islands will lose their statehood, making displaced islanders stateless. (shrink)

We explore men’s negotiation of emotional expression within larger social discourses around masculinity. Drawing on the phenomenon of men’s crying within the competitive sports context, we demonstrate that although the prevailing image of men’s emotion is one of constricted expression and experience, inexpressivity is representative neither of typical nor ideal masculinity in contemporary dominant culture. We first review the literature on prevailing cultural beliefs about normative male emotional expression, then focus on literature specific to men’s tears. Turning to a discussion (...) of masculinity and sports participation, we offer possible explanations for why counter normative emotional expressions may be particularly prevalent and public in the context of men’s competitive sports, despite wider cultural discourses that appear to discourage men’s openly expressive behavior. (shrink)