Institutional review boards are almost universally considered to be overworked and understaffed. They also require substantial commitments of time and resources from their members. Although some surveys report average IRB memberships of 15 people or more, federal regulations require only five. We present data on IRB meetings at eight of the top 25 academic medical centers in the United States funded by the National Institutes of Health. These data indicate substantial contributions from primary reviewers and chairs during protocol discussions but (...) little from other members, which implies that it may be possible for smaller IRBs to accomplish the same tasks with no reduction in the quality of review. (shrink)

A good deal of attention has been recently focused on the presumed advertising excesses of the healthcare industry in its promotion techniques to healthcare professionals, whether through offering gratuities such as gifts, honoraria, or travel support2-6 or through deception. Two basic concerns have been expressed: Does the acceptance of gratuities bias the recipient, tainting his or her responsibilities as the patient's agent? Does acceptance of the gratuity by the healthcare professional contribute to the high cost of healthcare products? The California (...) Society of Hospital Pharmacists was recently asked by its members to formulate a policy for an appropriate relationship between the Society and the healthcare industry, addressing these concerns. In formulating its policy, it became clear that the Society depended on healthcare industry support, gathered through journal advertising, fees for booths at its various educational events, and grants for speakers. (shrink)

Volume 20, Issue 7, July 2020, Page 147-150.

In _Hidden Questions, Clinical Musings_, M. Robert Gardner chronicles an odyssey of self-discovery that has taken him beneath and beyond the categoies and conventions of traditional psychoanalysis. His essays offer a vision of psychoanalytic inquiry that blends art and science, a vision in which the subtly intertwining not-quite-conscious questions of analysand and analyst, gradually discerned, open to ever-widening vistas of shared meaning. Gardner is wonderfully illuminating in exploring the associations, images, and dreams that have fueled his own analytic (...) inquiries, but he is no less compelling in writing about the different perceptual modalities and endlessly variegated strategies that can be summoned to bring hidden questions to light. This masterfully assembled collection exemplifies the lived experience of psychoanalysis of one of its most gifted and reflective practitioners. In his vivid depictions of analysis oscillating between the poles of art and science, word and image, inquiry and self-inquiry, Gardner offers precious insights into tensions that are basic to the analytic endeavor. Evincing rare virtuosity of form and content, these essays are evocative clinical gems, radiating the humility, gentle skepticism, and abiding wonder of this lifelong self-inquirer. Gardner's most uncommon musings are a gift to the reader. (shrink)

In _Hidden Questions, Clinical Musings_, M. Robert Gardner chronicles an odyssey of self-discovery that has taken him beneath and beyond the categoies and conventions of traditional psychoanalysis. His essays offer a vision of psychoanalytic inquiry that blends art and science, a vision in which the subtly intertwining not-quite-conscious questions of analysand and analyst, gradually discerned, open to ever-widening vistas of shared meaning. Gardner is wonderfully illuminating in exploring the associations, images, and dreams that have fueled his own analytic (...) inquiries, but he is no less compelling in writing about the different perceptual modalities and endlessly variegated strategies that can be summoned to bring hidden questions to light. This masterfully assembled collection exemplifies the lived experience of psychoanalysis of one of its most gifted and reflective practitioners. In his vivid depictions of analysis oscillating between the poles of art and science, word and image, inquiry and self-inquiry, Gardner offers precious insights into tensions that are basic to the analytic endeavor. Evincing rare virtuosity of form and content, these essays are evocative clinical gems, radiating the humility, gentle skepticism, and abiding wonder of this lifelong self-inquirer. Gardner's most uncommon musings are a gift to the reader. (shrink)

Since early in this century, a number of cultural anthropologists and archaeologists have been theorizing that some of the very culture traits Boehm regards as ‘primitive’ are, in fact, partial products of the difficult circumstances of the last few thousand years. For instance, the mobility and egalitarianism of some foragers may have been amplified by their culture contact experiences. Boehm must consider these theories if he hopes to identify foragers whose cultures may be representative of the past.

This rich and varied collection of essays addresses some of the most fundamental human questions through the lenses of philosophy, literature, religion, politics, and theology. Peter Augustine Lawler and Dale McConkey have fashioned an interdisciplinary consideration of such perennial and enduring issues as the relationship between nature and history, nature and grace, reason and revelation, classical philosophy and Christianity, modernity and postmodernity, repentance and self-limitation, and philosophy and politics.

Legislation enabling pharmacists to prescribe is being drafted and passed in Canada and internationally. But is it a good idea for pharmacists to be prescribing psychotropic medications? In this discussion, the term “pharmacist prescribing” is dei ned, the issues of the potential conl ict of interest of pharmacists discussed, and the education and training of pharmacists reviewed. Finally, an experienced psychiatrist weighs in on the discussion with a personal rel ection on this important discussion, concluding that “we should move forward (...) cautiously but in a spirit of collaboration, mutual respect and above all in the best interests of the patient. (shrink)

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

In this paper I outline various different objects of investigation that may be picked out by word “law” (or its cognates). All of these objects must be investigated in an integrated way before one can provide a complete philosophical explanation of the nature of law. I begin with the distinction between laws (artefacts) and law (the genre to which the artefacts belong). This leads me to the distinction between the law (of a particular legal system) and law (the genre of (...) artefacts). Then I discuss the contrast between law (the genre of artefacts) and law (the practice). Finally I comment on legality as the name of an ideal for laws and legal systems to live up to. I commend H. L. A. Hart's explanation of the nature of law for investigating these various objects in an integraed way, while nevertheless respecting the distinctions among them. I also criticise some of R. M. Dworkin's work for failing to respect the same distinctions. (shrink)

The AIR Modelsm of Reflective Ethical Inquiry (Cohen et al. 2005) is a practical framework that leads toward more caring, compassionate and appreciative ethical actions in administration, teaching, research and student life. In this article, we consider a corollary of the model: AIR practitioners are prepared to effectively meet anticipated and unanticipated ethical challenges. By being present to, curious about and responsive to ethical concerns as they arise in everyday situations, AIR practitioners emerge as both ‘direct ethical leaders’ (Gardner (...) 1995) who embody an ethical tone and set an ethical direction, as well as an ‘indirect leaders’ (ibid.) who exert an impact through personal and collective works. The underlying AIR process is the foundation for individual and shared ethical leadership and leadership training, both of which reduce costly mistakes and enhance productivity. (shrink)