Multimodal integration is the formation of a coherent percept from different sensory inputs such as vision, audition, and somatosensation. Most research on multimodal integration in speech perception has focused on audio-visual integration. In recent years, audio-tactile integration has also been investigated, and it has been established that puffs of air applied to the skin and timed with listening tasks shift the perception of voicing by naive listeners. The current study has replicated and extended these findings by testing the effect of (...) air puffs on gradations of voice onset time along a continuum rather than the voiced and voiceless endpoints of the original work. Three continua were tested: bilabial (“pa/ba”), velar (“ka/ga”), and a vowel continuum (“head/hid”) used as a control. The presence of air puffs was found to significantly increase the likelihood of choosing voiceless responses for the two VOT continua but had no effect on choices for the vowel continuum. Analysis of response times revealed that the presence of air puffs lengthened responses for intermediate (ambiguous) stimuli and shortened them for endpoint (non-ambiguous) stimuli. The slowest response times were observed for the intermediate steps for all three continua, but for the bilabial continuum this effect interacted with the presence of air puffs: responses were slower in the presence of air puffs, and faster in their absence. This suggests that during integration auditory and aero-tactile inputs are weighted differently by the perceptual system, with the latter exerting greater influence in those cases where the auditory cues for voicing are ambiguous. (shrink)

OBJECTIVES: To compare the practices of local research ethics committees and the time they take to obtain ethical approval for a multi-centre study. DESIGN: A retrospective analysis of outcome of applications for a multi-centre study to local research ethics committees. SETTING: Thirty-six local research ethics committees covering 38 district health authorities in England. MAIN MEASURES: Response of chairmen and women, the time required to obtain approval, and questions asked in application forms. RESULTS: We received replies from all 36 chairmen contacted: (...) four (11%) granted their approval, and 32 (89%) required our proposal to be considered by their local research ethics committee. Three committees asked us to attend their meetings. The application was approved by all 36 local research ethics committees but the time to obtain ethical approval varied between six to 208 days. One third of the committees did not approve the project within three months, and three took longer than six months. There was considerable variation in the issues raised by local research ethics committees and none conformed exactly to the Royal College of Physicians' guidelines. CONCLUSION: Obtaining ethical approval for a multi-centre study is time-consuming. There is much diversity in the practice of local research ethics committees. Our data support the recommendation for a central or regional review body of multi-centre studies which will be acceptable to all local research ethics committees. (shrink)

BackgroundThe COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19.MethodsAn extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19. ResultsThree (...) hundred forty-five nurses (70.7%), 40 intensivists (8.2%), and 103 supporting staff (21.1%) completed the survey. Moral distress levels were higher for nurses than supporting staff. Moral distress levels in intensivists did not differ significantly from those of nurses and supporting staff. “Inadequate emotional support for patients and their families” was the highest-ranked cause of moral distress for all groups of professionals. Of all factors, all professions rated the ethical climate most positively regarding the culture of mutual respect, ethical awareness and support. “Culture of not avoiding end-of-life-decisions” and “Self-reflective and empowering leadership” received the lowest mean scores. Moral distress scores during COVID-19 were significantly lower for ICU nurses (p < 0.001) and intensivists (p < 0.05) compared to one year prior.ConclusionLevels and causes of moral distress vary between ICU professionals and differ from the historical control group. Targeted interventions that address moral distress during a crisis are desirable to improve the mental health and retention of ICU professionals and the quality of patient care. (shrink)

There are a number of problematic features within the current treatment of time in physical theories, including the “timelessness” of the Universe as encapsulated by the Wheeler–DeWitt equation. This paper considers one particular investigation into resolving this issue; a conditional probability interpretation that was first proposed by Page and Wooters. Those authors addressed the apparent timelessness by subdividing a faux Universe into two entangled parts, “the clock” and “the remainder of the Universe”, and then synchronizing the effective dynamics of the (...) two subsystems by way of conditional probabilities. The current treatment focuses on the possibility of using a realistic clock system; namely, a coherent-state description of a damped harmonic oscillator. This clock proves to be consistent with the conditional probability interpretation; in particular, a standard evolution operator is identified with the position of the clock playing the role of time for the rest of the Universe. Restrictions on the damping factor are determined and, perhaps contrary to expectations, the optimal choice of clock is not necessarily one of minimal damping. (shrink)

The essays in this Journal issue offer examples of how textual analysis, literary theory, and the reading and writing of literature can contribute to an understanding of ethical issues in medicine. The editors' purpose in such an issue is to stimulate discussion between philosopher-ethicists and literary scholars whose work concerns this topic. With the concluding essays by editors Clouser and Hawkins, this discussion begins.

Members of the Clinical Ethics Consultation Affairs Standing Committee of the American Society for Bioethics and Humanities present a collection of insights and recommendations developed from their collective experience, intended for those engaged in the work of healthcare ethics consultation.

Recent data indicate that under a specific posthypnotic suggestion to circumvent reading, highly suggestible subjects successfully eliminated the Stroop interference effect. The present study examined whether an optical explanation could account for this finding. Using cyclopentolate hydrochloride eye drops to pharmacologically prevent visual accommodation in all subjects, behavioral Stroop data were collected from six highly hypnotizables and six less suggestibles using an optical setup that guaranteed either sharply focused or blurred vision. The highly suggestibles performed the Stroop task when naturally (...) vigilant, under posthypnotic suggestion not to read, and while visually blurred; the less suggestibles ran naturally vigilant, while looking away, and while visually blurred. Although visual accommodation was precluded for all subjects, posthypnotic suggestion effectively eliminated Stroop interference and was comparable to looking away in controls. These data strengthen the view that Stroop interference is neither robust nor inevitable and support the hypothesis that posthypnotic suggestion may exert a top-down influence on neural processing. (shrink)

The volume presents essays on the philosophical explanation of the relationship between body and soul in antiquity from the Presocratics to Galen. The title of the volume alludes to a phrase found in Plato, Aristotle and Plotinus, referring to aspects of living behaviour involving both body and soul, and is a commonplace in ancient philosophy, dealt with in very different ways by different authors.

The German philosopher Rickert substituted for Hegel's formulation of the dialectic a "Heterological Principle of Thought" where identity and otherness become moments within the pure logical object of thought. The logical object of thought takes precedence over dialectical movement, and otherness takes precedence over negation. Flach expounds and defends Rickert's position against its critics. The discussion is specialized but contains some valuable insights into Hegel. --R. H. K.

This is the first of a number of volumes designed to review the philosophical work which has been done in various areas of philosophy between the years 1956 and 1966. It succeeds an earlier three volume publication entitled Philosophy in the Mid-Century which covered the period from 1949 to 1955. This first volume in the series covers the fields of logic, philosophical logic, foundations and philosophy of mathematics. For anyone interested in these fields, the book is an indispensable guide. The (...) procedure is that an expert in a given area writes a summary of the work done in the area in the last ten years and adds a bibliography covering the same period. In all there are thirty-two such essays, most written in English, but a few in French and German. Some representative essays and their authors are the following: On the logical side, Modal Logic, Many Valued Logics, Logic of Practical Discourse, Semantics, Model Theory, Pragmatics, Chronological or Tense Logic, The Logic of Questions, Combinatory Logic and others. There are two general essays on recent developments in philosophical logic and a number of essays on the development of logic in various Eastern and Western European countries and Japan. On the mathematical side are three essays on foundations of set theory and mathematics, essays on Intuitionism in mathematics, and general essays by A. Church, H. Freudenthal and others. The essays are generally of high caliber and the bibliographies in most cases very comprehensive. Occasionally the essays contain not only summary of work done but original suggestions and development of ideas. It would be hard to find a more useful guide for the philosopher overwhelmed by the many developments in these fields in recent years.--R. H. K. (shrink)

In this phenomenological approach to meaning, the author defines his task as one of taking account of the kinds of relations the logical order can have to the preconceptual order. This preconceptual order is represented by a pre-logical activity which is called "experiencing." There is experiencing of meaning as well as of things. This "experienced or felt meaning" is said to be as important a dimension of meaning as the traditional modes distinguished by philosophers, e.g., denotation, connotation. Apparent throughout is (...) the author's concern as a psychotherapist to find theoretical foundations for clinical methods.--R. H. K. (shrink)

The first part of this long two-part work is a history of the development of the modern theory of the atom from Dalton to the present. The second part offers philosophical reflections on this history beginning with a discussion of epistemological implications and following that with an account of ontological implications. The author deals with familiar questions about the reality of micro-particles, complementarity, indeterminism, the role of the observer and other topics. But he also discusses topics like holism, atomic order, (...) the intelligibility of matter and others which are less commonly discussed by philosophers in connection with modern physical theories. The author, who is trained in physics as well as philosophy, has a flair for metaphysical speculation as well as wide knowledge of contemporary physical theory. He stresses the novelties of the quantum conception of matter, argues against its critics like Bohm, and sees it as presenting a radically new conception of atomic order despite its commitment to indeterminism. The views of Werner Heisenberg, who encouraged the author to write the book and who read it in manuscript, have clearly influenced the author, although they do not dominate his thinking.--R. H. K. (shrink)

BackgroundThe boundaries between health-related research and practice have become blurred as initiatives traditionally considered to be practice increasingly use the same methodology as research. Further, the application of different ethical requirements based on this distinction raises concerns because many initiatives commonly labelled as “non-research” are associated with risks to patients, participants, and other stakeholders, yet may not be subject to any ethical oversight. Accordingly, we sought to develop a tool to facilitate the systematic identification of risks to human participants and (...) determination of risk level across a broad range of projects and health-related contexts. This paper describes the development of the Public Health Ontario Risk Screening Tool.MethodDevelopment of the PHO Risk Screening Tool included: preparation of a draft risk tool ; expert appraisal; internal stakeholder validation; external validation; pilot testing and evalution of the draft tool; and revision after 1 year of testing.ResultsA risk screening tool was generated consisting of 20 items organized into five risk domains: Sensitivity; Participant Selection, Recruitment and Consent; Data/Sample Collection; Identifiability and Privacy Risk; and Commercial Interests. The PHO Risk Screening Tool is an electronic tool, designed to identify potential project-associated risks to participants and communities and to determine what level of ethics review is required, if any. The tool features an easy to use checklist format that generates a risk score associated with a suggested level of ethics review once all items have been completed. The final score is based on a threshold approach to ensure that the final score represents the highest level of risk identified in any of the domains of the tool.ConclusionsThe PHO Risk Screening Tool offers a practical solution to the problem of how to maintain accountability and appropriate risk oversight that transcends the boundaries of research and practice. We hope that the PHO Risk Screening Tool will prove useful in minimizing the problems of over and under protection across a wide range of disciplines and jurisdictions. (shrink)

The controversies in Bristol, Alder Hey and elsewhere in the UK surrounding the removal and retention of human tissue and organs have led to extensive law reform in all three UK legal systems. This paper reports a short study of the reactions of a range of health professionals to these changes. Three main areas of ethical concern were noted: the balancing of individual rights and social benefit; the efficacy of the new procedures for consent; and the helpfulness for professional practice (...) of the new legislation and regulation. Recognition of these concerns may help in forging a new partnership between professionals and patients and their families. (shrink)

As Max Jammer has rightly said, contemporary discussion of the metrical properties of space have been dominated in recent years by the work of Adolf Grünbaum. One of Grünbaum's most important essays in this area, "Geometry, Chronometry and Empiricism" is reprinted in its entirety as the first chapter of this work. The third and final chapter is a lengthy reply to Hilary Putnam who published a critique of Grünbaum's original essay in 1963. Putnam's criticisms have not led Grünbaum to substantially (...) change his views but they have provided the means for some clarification and extension of those views, e.g., with respect to the notions of congruence and conventionality and in relation to Zeno's paradoxes, color attributes, and other topics. Between the original essay and the lengthy reply to Putnam there is a shorter chapter which deals with, among other things, the hypothesis that everything has doubled overnight, a related topic to which Grünbaum has given some attention in journal articles. It is safe to say that persons concerned with the problem of conventionalism and other philosophical problems about space will have to work their way through this important book.--R. H. K. (shrink)