Objective: Ethical guidelines are designed to ensure benefits, protection and respect of participants in clinical research. Clinical trials must now be registered on open-access databases and provide details on ethical considerations. This systematic survey aimed to determine the extent to which recently registered clinical trials report the use of standard of care and post-trial obligations in trial registries, and whether trial characteristics vary according to setting. Methods: We selected global randomized trials registered on http://www.clinicaltrials.gov and http://www.controlled-trials.com. We searched for intervention (...) trials of HIV/AIDS, malaria, and tuberculosis from 9 October 2004, the date of the most recent version of the Helsinki Declaration, to 10 April 2007. Results: We collected data from 312 trials. Fifty-eight percent (58%, 95% CI = 53 to 64) of trial protocols report informed consent. Fifty-eight percent (58%, 95% CI = 53 to 64) of trials report active controls. Almost no trials (1%, 95% CI = 0.5 to 3) mention post-trial provisions. Most trials measure surrogate outcomes. Twenty percent (20%, 95% CI = 16 to 25) of trials measure patient-important outcomes, such as death; and the odds that these outcomes are in a low income country are five times greater than for a developed country (odds ratio (OR) 5.03, 95% CI = 2.70 to 9.35, p = < 0.001). Pharmaceutical companies are involved in 28% (CI = 23 to 33) of trials and measure surrogate outcomes more often than nonpharmaceutical companies (OR 2.45, 95% CI = 1.18 to 5.09, p = 0.31). Conclusion: We found a large discrepancy in the quality of reporting and approaches used in trials in developing settings compared to wealthier settings. (shrink)
The following text is taken from the publisher's website: "Romanticism is, and always has been, one of the most hotly contested terms in literary and cultural history. Many of the writers now described as Romantic refused to be defined by the word: 'it would be such bad taste', said Byron in 1820. Lovejoy spoke of a plurality of ‘romanticisms’, born of distinct thought complexes, whilst René Wellek argued that literatures labelled Romantic indicated common conceptions. Comparably, in the post-World War II (...) period, political commentators have seen Romanticism as either profoundly radical or deeply reactionary. This significant collection gathers key critical discussions that explore the complex and many-sided nature of the 'Romantic'. A new introduction by the editors, a full index and chronological table of contents guide the reader through the wealth of material dedicated to a term that is both extremely unstable and remarkably persistent.". (shrink)
In Praise of Philosophy and Other Essays explores Lavelle, Bergson, and Socrates and provides themes from Merleau-Ponty lectures at the Collége de France including “The Problem of Speech” and “Nature and Logos: The Human Body.”.
<P>Experimental philosophy is one of the most active and exciting areas in philosophy today. In <EM>Current Controversies in Experimental Philosophy</EM>, Elizabeth O’Neill and Edouard Machery have brought together twelve leading philosophers to debate four topics central to recent research in experimental philosophy. The result is an important and enticing contribution to contemporary philosophy which thoroughly reframes traditional philosophical questions in light of experimental philosophers’ use of empirical research methods, and brings to light the lively debates within experimental philosophers’ intellectual community. (...) Two papers are dedicated to the following four topics:</P> <P></P> <UL> <LI>Language (Edouard Machery & Genoveva Martí)</LI> <LI>Consciousness (Brian Fala, Adam Arico, and Shaun Nicols & Justin Sytsma)</LI> <LI>Free Will and Responsibility (Joshua Knobe & Eddy Nahmias and Morgan Thompson)</LI> <LI>Epistemology and the Reliability of Intuitions (Kenneth Boyd and Jennifer Nagel & Joshua Alexander and Jonathan Weinberg).</LI></UL> <P></P> <P>Preliminary descriptions of each chapter, annotated bibliographies for each controversy, and a supplemental guide to further controversies in experimental philosophy (with bibliographies) help provide clearer and richer views of these live controversies for all readers.</P> <P></P> <P> </P>. (shrink)
There have been calls for mandatory vaccination legislation to be introduced into the UK in order to tackle the national and international rise of vaccine-preventable disease. While some countries have had some success associated with mandatory vaccination programmes, the Royal College of Paediatrics and Child Health insist this is not a suitable option for the UK, a country which has seen historical opposition to vaccine mandates. There is a lack of comprehensive data to demonstrate a direct link between mandatory vaccination (...) legislation and increased uptake. While there are examples whereby there has been an improvement, some studies suggest that comparable results can be obtained by strongly recommending vaccinations instead. The RCPCH insist that healthcare workers are ideally placed to engage and inform parents to make every interaction a ‘vaccine opportunity’. This paper calls for a principled, rational approach to interpretations of autonomy which underpin parental informed consent. MacLean’s concept of mutual persuasion could be a vehicle to ensuring parents are suitably informed of both the material risks associated with vaccine choices and to consider the rationality of their decisions, while ultimately upholding parental autonomy. It is argued that this, alongside infrastructural improvement, could create a more sustainable, long-term improvement in childhood vaccination rates in the UK than mandatory vaccination. (shrink)
“Off and on, of late years, I have studied the history and development of all religions with immense interest as being for me, at least, the most illuminating ‘case histories’ of the inner life of man.”—Eugene O’Neill writing to M. C. Sparrow, 1929 While it is commonly accepted that Eugene O’Neill studied Oriental mystical religions and that this study may be detected in some of his less successful experimental plays there has not been an effort to consider systematically his “immense (...) interest” and the influence it had on O’Neill’s thought and writing. Robinson explores the tension between Occidental and Oriental elements in the playwright’s art, examining both the sources of the conflict and its manifestation in selected plays written between 1916 and 1942. Through an examination of O’Neill’s correspondence, research library, and manuscript materials Robinson is able to reveal the origins of O’Neill’s Orientalism. An easy familiarity with the complex interrelationships of Eastern and Western religions and the Oriental thought that underlies the ideas of many Western philosophers, allows Robinson to address the intricate problem of Oriental influences on O’Neill’s favorite Western sources, including Nietzsche, Schopenhauer, Jung, Strindberg, and Emerson. Finally in a play-by-play exegesis, Robinson traces the course of O’Neill’s mysticism from its apparent repudiation in the deeply flawed Dynamo to its synthesis in The Iceman Cometh, Long Day’s Journey Into Night, and Hughie, where Eastern ideas of maya, dynamic polarity, and the emptiness of the universe are again evident. (shrink)
The relationship between corporate social responsiveness and profitability is investigated in a sample of corporate directors. The findings show there is no relationship between the level of director social responsiveness and corporate profitability. The implications of these results are discussed, especially as they relate to concerns about corporate governance.
Most studies of corporate social responsiveness (CSR) focus on the relationship between CSR and profit. Here, we use three perspectives (institutional theory, economic theory and agency theory) to explain CSR. Industry norms, market share and indicators of management reputation predict variance in CSR. The combined perspectives improve understanding of both CSR and the CSR-profit relationship in two ways. First, they suggest that CSR levels and their relationship with profit will vary by industry. Second, they suggest that stock market measures and (...) accounting measures will respond differently to CSR measures. Stock market measures lead, while accounting measures lag, CSR. (shrink)
The paper addresses O'Neill's view that her version of Kant's Categorical Imperative, namely, the requirement of followability (RF), marks the supreme principle of reason; it takes issue with her claim that RF commits us to Kantian constructivism in practical philosophy. The paper distinguishes between two readings of RF: on a weak reading, RF ranges over all (practical) reasoning but does not commit to constructivism, and on a strong version RF commits to constructivism but fails to meet its own test, (...) and so is self-defeating. The paper argues that RF, if understood strongly, depends for its reasonableness on reasons that cannot coherently be required to meet RF, so that RF cannot be the supreme principle of reason. The paper considers several responses to this problem in order to suggest that RF depends for its reasonableness on perfectionist considerations. (shrink)
Using NORC annual survey data, the authors selected 21 questions describing respondent attitudes toward job, life in general, and financial status. Respondents were catigorized as management, white collar, blue collar, and those not affiliated with business organizations. Attitudes were compared across the four occupational groups. Little dissatisfaction was found in any but the blue collar group. Management as a group, and men as well as women managers showed high levels of satisfaction, with few significant differences found in responses by men (...) and women. This study does not support the earlier finding of widespread alienation in business firms. (shrink)
Next SectionFollowing the influential Gifford and Reith lectures by Onora O’Neill, this paper explores further the paradigm of individual autonomy which has been so dominant in bioethics until recently and concurs that it is an aberrant application and that conceptions of individual autonomy cannot provide a sufficient and convincing starting point for ethics within medical practice. We suggest that revision of the operational definition of patient autonomy is required for the twenty first century. We follow O’Neill in recommending a principled (...) version of patient autonomy, which for us involves the provision of sufficient and understandable information and space for patients, who have the capacity to make a settled choice about medical interventions on themselves, to do so responsibly in a manner considerate to others. We test it against the patient–doctor relationship in which each fully respects the autonomy of the other based on an unspoken covenant and bilateral trust between the doctor and patient. Indeed we consider that the dominance of the individual autonomy paradigm harmed that relationship. Although it seems to eliminate any residue of medical paternalism we suggest that it has tended to replace it with an equally (or possibly even more) unacceptable bioethical paternalism. In addition it may, for example, lead some doctors to consider mistakenly that unthinking acquiescence to a requested intervention against their clinical judgement is honouring “patient autonomy” when it is, in fact, abrogation of their duty as doctors. (shrink)
This paper explores gender barriers to the formation of the female mentor – male protégé relationship. The authors consider both physiological as well as social gender as a way to help understand the scarcity of these relationships. A number of gender-related factors are considered, including organizational demographics, relational demography, sexual liaisons, gender stereotypes, gender behaviors, and power dynamics. The paper concludes with directions for future research that will help provide further insights into the development and success of the female mentor (...) – male protégé relationship. (shrink)
This qualitative study describes the lived experience of physicians who work in communities that have experienced a public mass shooting. Semi-structured interviews were conducted with seventeen physicians involved in eight separate mass casualty shooting incidents in the United States. Four major themes emerged from constant comparative analysis: The psychological toll on physicians: “I wonder if I'm broken”; the importance of and need for mass casualty shooting preparedness: “[We need to] recognize this as a public health concern and train physicians to (...) manage it”; massive media attention: “The media onslaught was unbelievable”; and commitment to advocacy for a public health approach to firearm violence: “I want to do whatever I can to prevent some of these terrible events.”. (shrink)
BackgroundThe ARRIVE guidelines are widely endorsed but compliance is limited. We sought to determine whether journal-requested completion of an ARRIVE checklist improves full compliance with the guidelines.MethodsIn a randomised controlled trial, manuscripts reporting in vivo animal research submitted to PLOS ONE were randomly allocated to either requested completion of an ARRIVE checklist or current standard practice. Authors, academic editors, and peer reviewers were blinded to group allocation. Trained reviewers performed outcome adjudication in duplicate by assessing manuscripts against an operationalised version (...) of the ARRIVE guidelines that consists 108 items. Our primary outcome was the between-group differences in the proportion of manuscripts meeting all ARRIVE guideline checklist subitems.ResultsWe randomised 1689 manuscripts, of which 1269 were sent for peer review and 762 accepted for publication. No manuscript in either group achieved full compliance with the ARRIVE checklist. Details of animal husbandry was the only subitem to show improvements in reporting, with the proportion of compliant manuscripts rising from 52.1 to 74.1% in the control and intervention groups, respectively.ConclusionsThese results suggest that altering the editorial process to include requests for a completed ARRIVE checklist is not enough to improve compliance with the ARRIVE guidelines. Other approaches, such as more stringent editorial policies or a targeted approach on key quality items, may promote improvements in reporting. (shrink)
Kantian constructivists accord a constitutive, justificatory role to the issue of scope: they typically claim that first-order practical thought depends for its authority on being suitably acceptable within the right scope, or by all relevant others, and some Kantian constructivists, notably Onora O'Neill, hold that our views of the nature and criteria of practical reasoning also depend for their authority on being suitably acceptable within the right scope. The paper considers whether O'Neill-type Kantian constructivism can coherently accord this (...) key role to the issue of scope while adhering to the universalist, ‘cosmopolitan’ commitments at its core. The paper argues that this is not so. On the one hand, it shows that O'Neill's attempt to ‘fix’ the scope of practical reasoning supposes, rather than establishes, a view of ethical standing and the scope of practical reasoning. On the other hand, the paper argues that Kantian constructivism should endorse a non-constructivist, perfectionist view of the good to determine that scope. The paper thereby supports the perfectionist conjecture that Kantian constructivism, in order to defend its universalist commitments, should take refuge in non-constructivist, perfectionist considerations, and that Kantian constructivism should therefore construe perfectionism as a partial, though uneasy, ally. (shrink)
By recognizing symbols of research culture in postgraduate medical education, educators and trainees can gain a deeper understanding of the existing culture and mechanisms for its transformation. First, I identify symbolic manifestations of the research culture through a case narrative of a single anesthesia residency program, and I offer a visual conceptualization of the research culture. In the second part, I theorize the application of Senge’s (1994) disciplines of a learning organization and discuss leverage for enhancing research culture. This narrative (...) account is offered to inform the work of enhancing the broader research culture in postgraduate medical education. (shrink)
