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Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

IntroductionBrain tumours frequently cause language impairments and are also likely to co-occur with localised abnormal slow-wave brain activity. However, it is unclear whether this applies specifically to low-grade brain tumours. We investigate slow-wave activity in resting-state electroencephalography in low-grade glioma and meningioma patients, and its relation to pre- and postoperative language functioning.MethodPatients with a glioma infiltrating the language-dominant hemisphere and patients with a meningioma with mass effect on this hemisphere underwent extensive language testing before and 1 year after surgery. EEG (...) was registered preoperatively, postoperatively, and once in healthy individuals. Slow-wave activity in delta- and theta- frequency bands was evaluated visually and quantitatively by spectral power at three levels over the scalp: the whole brain, the affected hemisphere, and the affected region.ResultsGlioma patients had increased delta activity and increased theta activity before and after surgery. In these patients, increased preoperative theta activity was related to the presence of language impairment, especially to poor word retrieval and grammatical performance. Preoperative slow-wave activity was also related to postoperative language outcomes. Meningioma patients showed no significant increase in EEG slow-wave activity compared to healthy individuals, but they presented with word retrieval, grammatical, and writing problems preoperatively, as well as with writing impairments postoperatively.DiscussionAlthough the brain-tumour pathology in low-grade gliomas and meningiomas has a different effect on resting-state brain activity, patients with low-grade gliomas and meningiomas both suffer from language impairments. Increased theta activity in glioma patients can be considered as a language-impairment marker, with prognostic value for language outcome after surgery. (shrink)

Under poor circumstances, co-residence of a grandmother is generally considered to be beneficial for children. Empirical evidence does not unequivocally support this expectation and suggests that the grandmother’s importance depends on the family’s circumstances. We study the relationship between grandmother’s co-residence and children’s schooling in sub-Saharan Africa under a broad range of circumstances. Results make clear that the effect of a co-residing grandmother varies but is almost always positive. Grandmothers over age 60 are most effective in helping their children. They (...) are particularly important for girls, and when the mother is deceased or not living in the household. Grandmothers are less effective in situations with few opportunities, as in very poor regions or in communities with few schooling opportunities. Our findings indicate that providing support to grandmothers should not be overlooked when designing policies aimed at strengthening the position of women and children in the sub-Saharan African context. (shrink)

This latest work from one of the world's leading political philosophers will appeal to audiences from a variety of fields, including philosophy, political science, women's studies, ethnic studies, sociology, and communications studies.

This is the text of The Lindley Lecture for 2003, given by Iris Marion Young, an American philosopher.

The "Protagoras," like several of the Dialogues of Plato, is put into the mouth of Socrates, who describes a conversation which had taken place between himself and the great Sophist at the house of Callias-'the man who had spent more upon the Sophists than all the rest of the world'-and in which the learned Hippias and the grammarian Prodicus had also shared, as well as Alcibiades and Critias, both of whom said a few words-in the presence of a distinguished company (...) consisting of disciples of Protagoras and of leading Athenians belonging to the Socratic circle. The dialogue commences with a request on the part of Hippocrates that Socrates would introduce him to the celebrated teacher. He has come before the dawn had risen-so fervid is his zeal. Socrates moderates his excitement and advises him to find out 'what Protagoras will make of him, ' before he becomes his pupil. Presented here is the classic introduction and translation of Benjamin Jowett. (shrink)

In this essay I follow one argument strand from Linda Singer's Erotic Welfare. How can we have a forward-looking and affirmative ideal of sexual freedom when the AIDS panic has altered the sexual landscape and instigated new justifications for oppressive sexual disciplines? How can we be sexual subjects when processes of commodification and disciplinary practices have constrained sexual expression while proliferating sexual fetishes? These are some of the questions this book formulates, without answering.

Critics of a politics of difference have misidentified these social movements as asserting an identity politics of recognition. Most of these movements are better understood as resisting unjust structural inequalities. Inclusive democratic process involves paying specific attention to group differences in order to transform preferences and maximize social knowledge.

After presenting the rules of Eleatic antilogic, i.e., dialectic, I argue that Zeno was a practitioner, and, on the basis of key passages from Plato’s Parmenides (127e-128e and 135d-136c), that his paradoxes of divisibility and movement were notreductio ad absurdum, but simple derivation of impossibilities (adunaton) meant to ridicule Parmenides’ adversaries. Thus, Zeno did not try to prove that there is no motion, but simply derived this consequence from premises held by his opponents. I argue further that these paradoxes were (...) devised, in accordance with Eleatic antilogic, following a scheme that included hypotheses and their contradictories, within which the subject is to be treated both “in relation to itself,” and “in relation to other things”. (shrink)

Imperfect efficiency in healthcare delivery is sometimes given as a justification for refusing to ration or even discuss how to pursue fair rationing. This paper aims to clarify the relationship between inefficiency and rationing, and the conditions under which bedside rationing can be justified despite coexisting inefficiency. This paper first clarifies several assumptions that underlie the classification of a clinical practice as being inefficient. We then suggest that rationing is difficult to justify in circumstances where the rationing agent is or (...) should be aware of and contributes to clinical inefficiency. We further explain the different ethical implications of this suggestion for rationing decisions made by clinicians. We argue that rationing is more legitimate when sufficient efforts are undertaken to decrease inefficiency in parallel with efforts to pursue unavoidable but fair rationing. While the qualifier ‘sufficient’ is crucial here, we explain why ‘sufficient efforts’ should be translated into ‘benchmarks of efficiency’ that address specific healthcare activities where clinical inefficiency can be decreased. Referring to recent consensus papers, we consider some examples of specific clinical situations where improving clinical inefficiency has been recommended and consider how benchmarks for efficiency might apply. These benchmarks should state explicitly how much inefficiency shall be reduced in a reasonable time range and why these efforts are ‘sufficient’. Possible strategies for adherence to benchmarks are offered to address the possibility of non-compliance. (shrink)

Le doute cartésien – théorique, généralisé, hyperbolique et volontaire – reprend et renforce tout d’abord les raisons sceptiques traditionnelles de douter, afin de mettre pour la première fois en doute tout le sensible, mais aussi de montrer que ces raisons buttent sur les naturae simplicissimae et la certitude de la mathesis universalis. Descartes forge alors un nouvel argument sceptique : le « Dieu qui peut tout », qui permet de penser que, lorsque je me rends à l’évidence des natures simples, (...) je peux me tromper du point de vue d’une autre rationalité et d’une évidence supérieure à la mienne. Mais le doute n’est pas seulement chez Descartes un moment et un moyen provisoires qu’il s’agirait de vaincre, et qui serait effectivement vaincu par la certitude du cogito. Puisqu’il ne dévoile aucune chose, n’énonce aucune proposition et n’engage pas la moindre prédication, le doute laisse en effet la parole ne dire qu’elle-même et se manifester ce qui y parle, c’est-à-dire celui qui parle, ego. On peut donc soutenir que c’est directement du doute, véritable premier principe cartésien, que provient l’existence. (shrink)

What an honor to have political and educational theorists of such caliber take up ideas from my work! What a daunting task to try to respond! My remarks will touch on the following questions: What are some key issues of distributive justice in education today? Why does defining justice in terms of oppression and domination imply that issues of justice cannot be reduced to distribution? How does normalization constitute a major process enacting oppression, and what does this imply for education? (...) What does it mean to include marginalized groups in economic opportunity and democratic process, and how can educational institutions foster such inclusion? Why do issues of religion and other forms of cultural expression belong to a distinct category of justice? Are values of freedom of expression and tolerance in tension with the project of democratic inclusion? How shall we consider transnational issues of educational justice? (shrink)

These days, the radicalization of young people is above all viewed as a security risk. Almost all research into this phenomenon has been carried out from a legal, criminological or socio-psychological perspective with a focus on detecting and containing the risks posed by radicalization. In the light of the political developments since September 11, 2001, this is entirely understandable but perhaps not altogether wise. Research and theory development from a pedagogical perspective can also make a significant contribution towards a better (...) understanding of radicalization processes and possibly offer new points of departure for intervention strategies. On the basis of five typical cases, the authors examine the role of educators, social workers and teachers, and the problems they face when dealing with young people with extreme ideals. This article attempts to provide insight into the pedagogical conditions for the development of extreme ideals and suggests starting points for developing effective countermeasures. (shrink)

Being is evil not because it is finite but because it is without limits. This extraordinary declaration no doubt marks the rather hidden center of a work that is seminal, in any case essential, because it constitutes, in the same way as the brilliant 1951 article “Is Ontology Fundamental?” one of the irrevocable decisions that helped Levinas to become what he was: the greatest French philosopher since Bergson and also the first phenomenologist who seriously attempted to free himself from his (...) provenance, which is to say, from Heidegger. (shrink)

ABSTRACTMemory bias is a risk factor for depression. In two independent studies, the efficacy of one CBM-Memory session on negative memory bias and depressive symptoms was tested in vulnerable samples. We compared positive to neutral CBM-Memory trainings in highly-ruminating individuals and individuals with elevated depressive symptoms. In both studies, participants studied positive, neutral, and negative Swahili words paired with their translations. In five study–test blocks, they were then prompted to retrieve either only the positive or neutral translations. Immediately following the (...) training and one week later, we tested cued recall of all translations and autobiographical memory bias; and also measured mood, depressive symptoms, and rumination. Retrieval practice resulted in training-congruent recall both immediately after and one week after the training. Overall, there was no differential decrease in symptoms or difference in autobiographical memory bias between the tra... (shrink)

What an honor to have political and educational theorists of such caliber take up ideas from my work! What a daunting task to try to respond! My remarks will touch on the following questions: What are some key issues of distributive justice in education today? Why does defining justice in terms of oppression and domination imply that issues of justice cannot be reduced to distribution? How does normalization constitute a major process enacting oppression, and what does this imply for education? (...) What does it mean to include marginalized groups in economic opportunity and democratic process, and how can educational institutions foster such inclusion? Why do issues of religion and other forms of cultural expression belong to a distinct category of justice? Are values of freedom of expression and tolerance in tension with the project of democratic inclusion? How shall we consider transnational issues of educational justice? (shrink)

Pourquoi les philosophes, et plus précisément les philosophes européens (mais justement en quel sens y en a-t-il qui ne le soient pas, d’une manière ou d’une autre, européens? – voilà un problème européen par excellence) écrivent-ils tant sur l’Europe? Sans doute parce que l’Europe elle-même apparaît comme une question prioritaire de la pensée et même prioritairement à penser, donc une question prioritaire pour la philosophie. Mais en quel sen...

The attitude of biologists to the history of their discipline varies. For some, a hazy knowledge of the recent past is all that is necessary to provide an explanatory basis for their work. They take it for granted that everything of value from the less recent past has been appropriately incorporated into present-day thinking. Other biologists see history as an integral part of their research: the historical roots of accepted facts and theories help in the evaluation of present positions. These (...) biologists bring to history their specialized knowledge, which can be an advantage, but often they also bring an agenda that biases what they investigate and how they present it. We illustrate this by describing our own foray into history, which was motivated by findings in cell biology that suggested that some accepted views about heredity and evolution were wrong. (shrink)

Emerging parallel to long-standing, academic and policy inquiries on personal responsibility for health is the empirical assessment of lay persons’ views. Yet, previous studies rarely explored personal responsibility for health among lay persons as dynamic societal values. We sought to explore lay persons’ views on personal responsibility for health using the Fairness Dialogues, a method for lay persons to deliberate equity issues in health and health care through a small group dialogue using a hypothetical scenario. We conducted two 2-h Fairness (...) Dialogues sessions (n = 15 in total) in Nova Scotia, Canada. We analyzed data using thematic analysis. Our analysis showed that personal choice played an important role in participants’ thinking about health. Underlying the concept of personal choice was considerations of freedom and societal debt. In participants’ minds, personal and social responsibilities co-existed and they were unwilling to determine health care priority based on personal responsibility. The Fairness Dialogues is a promising deliberative method to explore lay persons’ views as dynamic values to be developed through group dialogues as opposed to static, already-formed values waiting to be elicited. (shrink)

: The essay theorizes the logic of masculinist protection as an apparently benign form of male domination. It then argues that authoritarian government is often justified through a logic of masculinist protection, and that this is the form of justification for the security regime that has emerged in the United States since September 11, 2001. I argue that those who live under a security regime live within an oppressive protection racket. The paper ends by cautioning feminists not ourselves to adopt (...) a stance of protector toward women in so-called less developed societies. (shrink)

This paper provides a case study of an unique initiative in corporate (SME) social responsibility which is too often overlooked in the academic study of “socialresponsibility of business in society” This case focuses on three specific points, 1) the role of an SME in social responsibility, 2) the role of a non-business trained entrepreneur and 3) the adaptation of social responsibility to a new and different socio-economic culture. This case presents the hypothesis that “a good socially responsible initiative provides an (...) excellent insurance policy for the health of a business venture in a new culture internationally. (shrink)