Training of resident physicians is essential for the care of future patients. While surgical trainee involvement is necessary, its disclosure to patients can often be omitted or underplayed by surgeons. The informed consent process and the underlying ethical principles make evident that patients should be informed of trainee involvement. In this review we explore the importance of disclosure, current themes in practice, and the optimal discussion for which we should strive.

The present paper analyzes the self‐generated explanations (from talk‐aloud protocols) that “Good” and “Poor” students produce while studying worked‐out examples of mechanics problems, and their subsequent reliance on examples during problem solving. We find that “Good” students learn with understanding: They generate many explanations which refine and expand the conditions for the action parts of the example solutions, and relate these actions to principles in the text. These self‐explanations are guided by accurate monitoring of their own understanding and misunderstanding. Such (...) learning results in example‐independent knowledge and in a better understanding of the principles presented in the text. “Poor” students do not generate sufficient self‐explanations, monitor their learning inaccurately, and subsequently rely heavily on examples. We then discuss the role of self‐explanations in facilitating problem solving, as well as the adequacy of current AI models of explanation‐based learning to account for these psychological findings. (shrink)

The present paper analyzes the self‐generated explanations (from talk‐aloud protocols) that “Good” and “Poor” students produce while studying worked‐out examples of mechanics problems, and their subsequent reliance on examples during problem solving. We find that “Good” students learn with understanding: They generate many explanations which refine and expand the conditions for the action parts of the example solutions, and relate these actions to principles in the text. These self‐explanations are guided by accurate monitoring of their own understanding and misunderstanding. Such (...) learning results in example‐independent knowledge and in a better understanding of the principles presented in the text. “Poor” students do not generate sufficient self‐explanations, monitor their learning inaccurately, and subsequently rely heavily on examples. We then discuss the role of self‐explanations in facilitating problem solving, as well as the adequacy of current AI models of explanation‐based learning to account for these psychological findings. (shrink)

According to Mednick’s (1962) theory of individual differences in creativity, creative individuals appear to have a richer and more flexible associative network than less creative individuals. Thus, creative individuals are characterized by “flat” (broader associations) instead of “steep” (few, common associations) associational hierarchies. To study these differences, we implement a novel computational approach to the study of semantic networks, through the analysis of free associations. The core notion of our method is that concepts in the network are related to each (...) other by their association correlations - overlap of similar associative responses (“association clouds”). We began by collecting a large sample of participants who underwent several creativity measurements and used a decision tree approach to divide the sample into low and high creative groups. Next, each group underwent a free association generation paradigm which allowed us to construct and analyze the semantic networks of both groups. Comparison of the semantic memory networks of persons with low creative ability and persons with high creative ability revealed differences between the two networks. The semantic memory network of persons with low creative ability seems to be more rigid, compared to the network of persons with high creative ability, in the sense that it is more spread out and breaks apart into more sub-parts. We discuss how our findings are in accord and extend Mednick’s (1962) theory and the feasibility of using network science paradigms to investigate high level cognition. (shrink)

BackgroundBiobanks provide an important foundation for genomic and personalised medicine. In order to enhance their scientific power and scope, they are increasingly becoming part of national or international networks. Public trust is essential in fostering public engagement, encouraging donation to, and facilitating public funding for biobanks. Globalisation and networking of biobanking may challenge this trust.MethodsWe report the results of an Australian study examining public attitudes to the networking and globalisation of biobanks. The study used quantitative and qualitative methods in conjunction (...) with bioethical analysis in order to determine factors that may contribute to, and threaten, trust.ResultsOur results indicate a generally high level of trust in biobanks and in medical research more broadly. Key factors that can reduce perceived trustworthiness of biobanks are commercialisation and involvement in global networking.ConclusionsWe conclude that robust ethical oversight and governance standards can both promote trust in global biobanking and ensure that this trust is warranted. (shrink)

The COVID-19 pandemic represents the most significant global challenge in a generation. Based on extant data from previous pandemics, demographic, occupational, and psychological factors have been linked to distress and for some vulnerable members of society. COVID-19 has added to the layers of grief and distress of existing trauma. Evidence-based frameworks exist to guide our individual and collective response to reduce the trauma associated with the experience of a pandemic. Pandemic and post-pandemic measures to ameliorate impacts require a multi-disciplined approach, (...) central to which is community connectedness, resilience, and access to support. We advocate for the acceptance and broader application of Dadirri, a healing practice held by the Ngan'gikurunggurr and Ngen'giwumirri Aboriginal people of the Daly River region in the Northern Territory, Australia. This modality engages therapeutic phases that are comparable with other practiced trauma therapies. The demonstrated therapeutic outcomes from Dadirri can be attained through an individualistic or in a relational engagement context. This practice is accessible to all ages, is non-specific to gender and is suitable for people constrained in their mobility or limited by resources, pertinent in pandemic affected settings. (shrink)

The sense of touch informs us of the physical properties of our surroundings and is a critical aspect of communication. Before touches are perceived, mechanical signals are transmitted quickly and reliably from the skin's surface to mechano‐electrical transduction channels embedded within specialized sensory neurons. We are just beginning to understand how soft tissues participate in force transmission and how they are deformed. Here, we review empirical and theoretical studies of single molecules and molecular ensembles thought to be involved in mechanotransmission (...) and apply the concepts emerging from this work to the sense of touch. We focus on the nematode Caenorhabditis elegans as a well‐studied model for touch sensation in which mechanics can be studied on the molecular, cellular, and systems level. Finally, we conclude that force transmission is an emergent property of macromolecular cellular structures that mutually stabilize one another. (shrink)

The present study examined whether a dissociation among formats for rational numbers can be obtained in tasks that require comparing a number to a non-symbolic quantity. In Experiment 1, college students saw a discrete or else continuous image followed by a rational number, and had to decide which was numerically larger. In Experiment 2, participants saw the same displays but had to make a judgment about the type of ratio represented by the number. The magnitude task was performed more quickly (...) using decimals, whereas the relation task was performed more accurately with fractions. The pattern observed for percentages was very similar to that for decimals. A dissociation between magnitude comparison and relational processing with rational numbers can be obtained when a symbolic number must be compared to a non-symbolic display. (shrink)

This paper examines a range of issues concerned with the process of choosing schools in the private and state sectors at the primary/pre‐preparatory stage and at the time of transfer to secondary/senior school. The findings indicate that choices about schools are made at different times and in different ways by parents who use the state and private sectors. One of the key findings is that the process of choosing a school begins earlier in the private than in the state sector; (...) another is that quality of education is cited more frequently as one of the ‘top three’ essential factors by parents of children in the private sector. At both the primary and transfer to secondary stages, very high percentages of parents consider it essential that their child should be happy. A discussion of the different notions that private school and the state school parents may have of ‘happiness’ is offered. (shrink)

Background Record linkage is a useful tool for health research. Potential benefits aside, its use raises discussions on privacy issues, such as whether a written informed consent for access to health records and linkage should be obtained. The authors aim to systematically review studies that assess consent proportions to record linkage. Methods 8 databases were searched up to June 2011 to find articles which presented consent proportions to record linkage. The screening, eligibility and inclusion of articles were conducted by two (...) independent reviewers. The authors carried out meta-regression, subgroup and sensitivity analyses to assess heterogeneity. Results Of the 141 studies identified, only 11 presented empirical consent proportions and were included in the systematic review. The consent proportion varied widely from 39% to 97%. Seven studies presented consent proportions of 88% or higher, one of 72%, and only three presented consented proportion equal to or lower than 53%. None of the studies' characteristics evaluated explained heterogeneity. Conclusion The results of this review show that, in general, individuals tend to consent to the use of their data for record linkage, with exceptions in specific populations or minorities. The authors believe that this, as well as the cited literature, lends support to policies that, while keeping relevant ethical controls in place, do not require individual informed consent for each and every study that relies on secondary data. (shrink)

Managing cardiac illness is not easy because it dramatically disrupts people’s daily life and both the patient and his/her spouse are at risk for experiencing distress, which, in turn, may affect the support provided by the partner as caregiver. The partner, in fact, is the main source of support, but his/her support may sometimes be inadequate. In addition, dyadic coping could likely be a moderating factor. The main aim of the present study was to examine the role that dyadic coping (...) plays in moderating the link between patient and partner cardiac illness-related distress and partner support. The study included 100 married couples faced with cardiac illness who completed a self-report questionnaire. We analyzed our data in PROCESS using multiple regressions in order to assess the moderating effects of DC responses in the relationship between the couple’s cardiac illness-related distress and partner support. With regard to patient distress, results showed that higher levels of patient anxiety and depression were linked with ineffective partner support. With regard to partner distress, higher levels of partner depression were linked with hostility; higher levels of partner depression and anxiety were associated with less partner support for patient engagement. Moreover, the association between distress and partner support was moderated by the quality of DC. In particular, low positive DC represented a risk factor for both the patient and the partner during a cardiac illness, as low positive DC exacerbated the link between patient and partner distress and less effective partner support styles. Also, higher levels of negative DC were risky for couples: The association between distress and less adequate partner supportive behaviors was stronger in the case of higher negative DC. These results imply a need for psychosocial interventions for couples in cardiac illness, especially for couples lacking relational competences, such as positive dyadic coping. (shrink)

The current issue of the American Journal of Bioethics illustrates the scope of disagreement among professionals about normothermic regional perfusion (NRP). A similar range of opinions has been de...

Speakers of English frequently associate location in space with valence, as in moving up and down the “social ladder.” If such an association also holds for the sagittal axis, an object “in front of” another object would be evaluated more positively than the one “behind.” Yet how people conceptualize relative locations depends on which frame of reference (FoR) they adopt—and hence on cross‐linguistically diverging preferences. What is conceptualized as “in front” in one variant of the relative FoR (e.g., translation) is (...) “behind” under another variant (reflection), and vice versa. Do such diverging conceptualizations of an object's location also lead to diverging evaluations? In two studies employing an implicit association test, we demonstrate, first, that speakers of German, Chinese, and Japanese indeed evaluate the object “in front of” another object more positively than the one “behind.” Second, and crucially, the reversal of which object is conceptualized as “in front” involves a corresponding reversal of valence, suggesting an impact of linguistically imparted FoR preferences on evaluative processes. (shrink)

El presente artículo se propone identificar los fundamentos de la teoría de la comunicabilidad de la Obra de Arte que se puede extraer de los escritos de Edith Stein. Tras presentar el problema de la empatía y la base antropológica que afecta a los sujetos y objetos del mundo del arte, además de los posibles problemas en la transmisión de dicho mensaje artístico, se ahonda en las implicaciones de la consideración del arte como objeto y sujeto de empatía y el (...) sistema comunicativo que se puede establecer en el mundo del arte. (shrink)

El presente artículo se propone identificar los fundamentos de la teoría de la comunicabilidad de la Obra de Arte que se puede extraer de los escritos de Edith Stein. Tras presentar el problema de la empatía y la base antropológica que afecta a los sujetos y objetos del mundo del arte, además de los posibles problemas en la transmisión de dicho mensaje artístico, se ahonda en las implicaciones de la consideración del arte como objeto y sujeto de empatía y el (...) sistema comunicativo que se puede establecer en el mundo del arte. (shrink)

In this paper, I begin by defending permissivism: the claim that, sometimes, there is more than one way to rationally respond to a given body of evidence. Then I argue that, if we accept permissivism, certain worries that arise as a result of learning that our beliefs were caused by the communities we grew up in, the schools we went to, or other irrelevant influences dissipate. The basic strategy is as follows: First, I try to pinpoint what makes irrelevant influences (...) worrying and I come up with two candidate principles. I then argue that one principle should be rejected because it is inconsistent with permissivism. The principle we should accept implies that it is sometimes rational to maintain our beliefs, even upon learning that they were caused by irrelevant influences. (shrink)

Los centros educativos pueden convertirse en entornos positivos implementando programas basados en evidencias. El objetivo de este artículo es presentar el programa “Creciendo Juntos” y analizar su eficacia en la promoción del establecimiento de relaciones positivas en estos. Se contó con una muestra de 990 alumnos (=12.96; 47.5% chicas) que respondieron la Escala sobre la percepción del alumnado acerca de sus relaciones en el centro y su nivel de participación educativa (RMSEA=.049; 90%.043-.055; CFI=.976; TLI =.967 y SRMR=.026). Mientras el grupo (...) de control empeora en sus relaciones y su participación en el centro, el grupo de intervención se mantiene. (shrink)

How is medical knowledge made? There have been radical changes in recent decades, through new methods such as consensus conferences, evidence-based medicine, translational medicine, and narrative medicine. Miriam Solomon explores their origins, aims, and epistemic strengths and weaknesses; and she offers a pluralistic approach for the future.

For the last forty years, two claims have been at the core of disputes about scientific change: that scientists reason rationally and that science is progressive. For most of this time discussions were polarized between philosophers, who defended traditional Enlightenment ideas about rationality and progress, and sociologists, who espoused relativism and constructivism. Recently, creative new ideas going beyond the polarized positions have come from the history of science, feminist criticism of science, psychology of science, and anthropology of science. Addressing the (...) traditional arguments as well as building on these new ideas, Miriam Solomon constructs a new epistemology of science. After discussions of the nature of empirical success and its relation to truth, Solomon offers a new, social account of scientific rationality. She shows that the pursuit of empirical success and truth can be consistent with both dissent and consensus, and that the distinction between dissent and consensus is of little epistemic significance. In building this social epistemology of science, she shows that scientific communities are not merely the locus of distributed expert knowledge and a resource for criticism but also the site of distributed decision making. Throughout, she illustrates her ideas with case studies from late-nineteenth- and twentieth-century physical and life sciences. Replacing the traditional focus on methods and heuristics to be applied by individual scientists, Solomon emphasizes science funding, administration, and policy. One of her goals is to have a positive influence on scientific decision making through practical social recommendations. (shrink)

A new, social epistemology of science that addresses practical as well as theoretical concerns.

The aim of this paper is to describe a problem for calibrationism: a view about higher order evidence according to which one's credences should be calibrated to one's expected degree of reliability. Calibrationism is attractive, in part, because it explains our intuitive judgments, and provides a strong motivation for certain theories about higher order evidence and peer disagreement. However, I will argue that calibrationism faces a dilemma: There are two versions of the view one might adopt. The first version, I (...) argue, has the implausible consequence that, in a wide range of cases, calibrationism is the only constraint on rational belief. The second version, in addition to having some puzzling consequences, is unmotivated. At the end of the paper I sketch a possible solution. (shrink)

The question of whether it is ever permissible to believe on insufficient evidence has once again become a live question. Greater attention is now being paid to practical dimensions of belief, namely issues related to epistemic virtue, doxastic responsibility, and voluntarism. In this book, McCormick argues that the standards used to evaluate beliefs are not isolated from other evaluative domains. The ultimate criteria for assessing beliefs are the same as those for assessing action because beliefs and actions are both products (...) of agency. Two important implications of this thesis, both of which deviate from the dominant view in contemporary philosophy, are 1) it can be permissible to believe for non-evidential reasons, and 2) we have a robust control over many of our beliefs, a control sufficient to ground attributions of responsibility for belief. (shrink)

A defense of imprecise credences (and other imprecise doxastic attitudes).

This paper is about the connection between rationality and accuracy. I show that one natural picture about how rationality and accuracy are connected emerges if we assume that rational agents are rationally omniscient. I then develop an alternative picture that allows us to relax this assumption, in order to accommodate certain views about higher order evidence.

In recent years, permissivism—the claim that a body of evidence can rationalize more than one response—has enjoyed somewhat of a revival. But it is once again being threatened, this time by a host of new and interesting arguments that, at their core, are challenging the permissivist to explain why rationality matters. A version of the challenge that I am especially interested in is this: if permissivism is true, why should we expect the rational credences to be more accurate than the (...) irrational ones? My aim is to turn this challenge on its head and argue that, actually, those who deny permissivism will have a harder time responding to such a challenge than those who accept it. (shrink)

The aim of this paper is to apply the accuracy based approach to epistemology to the case of higher order evidence: evidence that bears on the rationality of one's beliefs. I proceed in two stages. First, I show that the accuracy based framework that is standardly used to motivate rational requirements supports steadfastness—a position according to which higher order evidence should have no impact on one's doxastic attitudes towards first order propositions. The argument for this will require a generalization of (...) an important result by Greaves and Wallace for the claim that conditionalization maximizes expected accuracy. The generalization I provide will, among other things, allow us to apply the result to cases of self-locating evidence. In the second stage, I develop an alternative framework. Very roughly, what distinguishes the traditional approach from the alternative one is that, on the traditional picture, we're interested in evaluating the expected accuracy of conforming to an update procedure. On the alternative picture that I develop, instead of considering how good an update procedure is as a plan to conform to, we consider how good it is as a plan to make. I show how, given the use of strictly proper scoring rules, the alternative picture vindicates calibrationism: a view according to which higher order evidence should have a significant impact on our beliefs. I conclude with some thoughts about why higher order evidence poses a serious challenge for standard ways of thinking about rationality. (shrink)

Greaves and Wallace argue that conditionalization maximizes expected accuracy. In this paper I show that their result only applies to a restricted range of cases. I then show that the update procedure that maximizes expected accuracy in general is one in which, upon learning P, we conditionalize, not on P, but on the proposition that we learned P. After proving this result, I provide further generalizations and show that much of the accuracy-first epistemology program is committed to KK-like iteration principles (...) and to the existence of a class of propositions that rational agents will be certain of if and only if they are true. (shrink)

Abstract: This paper defends a constraint that any satisfactory decision theory must satisfy. I show how this constraint is violated by all of the decision theories that have been endorsed in the literature that are designed to deal with cases in which opinions or values are represented by a set of functions rather than a single one. Such a decision theory is necessary to account for the existence of what Ruth Chang has called “parity” (as well as for cases in (...) which agents have incomplete preferences or imprecise credences). The problem with the all of the decision theories that have been defended to account for parity is that they are committed to a claim I call unanimity: when all of the functions in the set agree that an agent ought to do A, then an agent ought to do A. A decision theory committed to unanimity violates the constraint I defend in this paper. Thus, if parity exists, a new approach to decision theory is necessary. (shrink)

The aim of this essay is to argue that, if a robust form of moral realism is true, then moral vagueness is ontic vagueness. The argument is by elimination: I show that neither semantic nor epistemic approaches to moral vagueness are satisfactory.

It seems like we care about at least two features of our credence function: gradational-accuracy and verisimilitude. Accuracy-first epistemology requires that we care about one feature of our credence function: gradational-accuracy. So if you want to be a verisimilitude-valuing accuracy-firster, you must be able to think of the value of verisimilitude as somehow built into the value of gradational-accuracy. Can this be done? In a recent article, Oddie has argued that it cannot, at least if we want the accuracy measure (...) to be proper. I argue that it can. 1Introduction2Some Nuts and Bolts3First Attempts4Oddie’s Constraint5The Good5.1Proximity over the disagreement metric 5.2Proximity over the magnitude metric 6The Bad and the Ugly 7Some More Good: The Role of Evenness of Distribution 8Some More Bad: Which Propositions to Privilege? 9Concluding Thoughts: Accuracy and Practical Value. (shrink)

For this Clarendon Paperback, Dr Griffin has written a new Postscript to bring the original book fully up to date. She discusses further important and controversial questions of fact or interpretation in the light of the scholarship of the intervening years and provides additional argument where necessary. The connection between Seneca's prose works and his career as a first-century Roman statesman is problematic. Although he writes in the first person, he tells us little of his external life or of the (...) people and events that formed its setting. Miriam Griffin addresses the problem by first reconstructing Seneca's career using only outside sources and his de Clementia and Apocolocyntosis, whose political purposes are undisputed. In the second part of the book she studies Seneca's treatment of subjects of political significance, including his views on slavery, provincial policy, wealth, and suicide. On the whole, the word of the philosopher is found to illuminate the work of the statesman, but notable exceptions emerge, and the links that are revealed vary from theme to theme and rarely accord with traditional autobiographical interpretations of Seneca's works. (shrink)

It has been claimed that, in response to certain kinds of evidence, agents ought to adopt imprecise credences: doxastic states that are represented by sets of credence functions rather than single ones. In this paper I argue that, given some plausible constraints on accuracy measures, accuracy-centered epistemologists must reject the requirement to adopt imprecise credences. I then show that even the claim that imprecise credences are permitted is problematic for accuracy-centered epistemology. It follows that if imprecise credal states are permitted (...) or required in the cases that their defenders appeal to, then the requirements of rationality can outstrip what would be warranted by an interest in accuracy. (shrink)