The Medication Event Monitoring System (MEMS) is a relatively new device designed to overcome some of the disadvantages of traditional adherence-measuring techniques. MEMS has also been found useful in tracking adherence behaviour without the need to visit patients frequently. In this study each patient was given a pre-filled, labelled MEMS bottle and cap. Patients were monitored for 24 weeks. For patients specifically studied, there were periods when drug levels may have been low and some exhibited erratic medication-taking behaviour. It is (...) concluded that MEMS can measure adherence behaviour objectively, and so might be used to improve prescribing decisions, identify drug wastage and improve carer support. Further research is needed before the routine use of electronic medication monitoring can be recommended. (shrink)

The balance between births and deaths in an age-structured population is strongly influenced by the spatial distribution of sub-populations. Our aim was to describe the demographic process of a fish population in an hierarchical dendritic river network, by taking into account the possible movements of individuals. We tried also to quantify the effect of river network changes (damming or channelling) on the global fish population dynamics. The Salmo trutta life pattern was taken as an example for.We proposed a model which (...) includes the demographic and the migration processes, considering migration fast compared to demography. The population was divided into three age-classes and subdivided into fifteen spatial patches, thus having 45 state variables. Both processes were described by means of constant transfer coefficients, so we were dealing with a linear system of difference equations. The discrete case of the variable aggregation method allowed the study of the system through the dominant elements of a much simpler linear system with only three global variables: the total number of individuals in each age-class. (shrink)

Background: The factors influencing parents’ willingness to enroll their children in biobanks are poorly understood. This study sought to assess parents’ willingness to enroll their children, and their perceived benefits, concerns, and information needs under different consent and data-sharing scenarios, and to identify factors associated with willingness. Methods: This large, experimental survey of patients at the 11 eMERGE Network sites used a disproportionate stratified sampling scheme to enrich the sample with historically underrepresented groups. Participants were randomized to receive one of (...) three consent and data-sharing scenarios. Results: In total, 90,000 surveys were mailed and 13,000 individuals responded (15.8% response rate). 5737 respondents were parents of minor children. Overall, 55% (95% confidence interval 50–59%) of parents were willing to enroll their youngest minor child in a hypothetical biobank; willingness did not differ between consent and data-sharing scenarios. Lower educational attainment, higher religiosity, lower trust, worries about privacy, and attitudes about benefits, concerns, and information needs were independently associated with less willingness to allow their child to participate. Of parents who were willing to participate themselves, 25% were not willing to allow their child to participate. Being willing to participate but not willing to allow one’s child to participate was independently associated with multiple factors, including race, lower educational attainment, lower annual household income, public health care insurance, and higher religiosity. Conclusions: Fifty-five percent of parents were willing to allow their youngest minor child to participate in a hypothetical biobank. Building trust, protecting privacy, and addressing attitudes may increase enrollment and diversity in pediatric biobanks. (shrink)

The introduction of novel diagnostic techniques in clinical domains such as genomics and radiology has led to a rich ethical debate on how to handle unsolicited findings that result from these innovations. Yet while unsolicited findings arise in both genomics and radiology, most of the relevant literature to date has tended to focus on only one of these domains. In this article, we synthesize and critically assess similarities and differences between “scanning the body” and “sequencing the genome” from an ethical (...) perspective. After briefly describing the novel diagnostic contexts leading to unsolicited findings, we synthesize and reflect on six core ethical issues that relate to both specialties: terminology; benefits and risks; autonomy; disclosure of unsolicited findings to children; uncertainty; and filters and routine screening. We identify ethical rationales that pertain to both fields and may contribute to more ethically sound policies. Considerations of preserving public trust and ensuring that people perceive healthcare policies as fair also support the need for a combined debate. (shrink)

A scholarly edition of a work by David Hume. The edition presents an authoritative text, together with an introduction, commentary notes, and scholarly apparatus.

The explanatory gap refers to the lack of concepts for understanding “how it is that . . . a state of consciousness comes about as a result of irritating nervous tissue.” By assuming that there are colours in the outside world, Block needlessly widens this gap and Lycan and Kitcher simply fail to see the gap. When such assumptions are abandoned, an unnecessary and incomprehensible constraint disappears. It then becomes clear that the brain can use its own neural language for (...) representing aspects of the outside world. While this may not close the gap, it becomes clearer where we need new concepts. (shrink)

This paper is about the similarity between the appreciation of a piece of art, such as a cherished music album, and the loving appreciation of a person whom one knows well. In philosophical discussion about the rationality of love, the Qualities View (QV) says that love can be justified by reference to the qualities of the beloved. I argue that the oft-rehearsed trading-up objection fails to undermine the QV. The problems typically identified by the objection arise from the idea that (...) love-worthy qualities could be coarse-grained, when in fact they must be fine-grained. The analogy with appreciation of aesthetic qualities helps to draw out this point. Once the fine-grained nature of love-worthy qualities is properly understood, it is clear that critics of the QV cannot rely on the trading-up objection to motivate its rejection. Moreover, the paper’s core argument helps to illuminate the persistently aesthetic nature of interpersonal affections. (shrink)

There are important synergies for the next generation of ethical leaders based on the alignment of modified or adjusted mental models. This entails a synergistic application of moral imagination through collaborative input and critique, rather than "me too" obedience. In this article, we will analyze the Milgram results using frameworks relating to mental models (Werhane et al., Profitable partnerships for poverty alleviation, 2009), as well as work by Moberg on "ethics blind spots'' (Organizational Studies 27(3): 413-428, 2006), and by Bazerman (...) and Chugh on "bounded awareness" (Harvard Business Review, 2006; Mind & Society 6: 1-18, 2007) Using these constructs to examine the Milgram experiment, we will argue that the ways in which the experiments are framed, the presence of an authority figure, the appeal to the authority of science, and the situation in which the naïve participant finds herself or himself, all create a bounded awareness, a narrow blind spot that encourages a climate for obedience, brackets out the opportunity to ask the moral question: "Am I hurting another fellow human being?" and may preclude the subject from utilizing moral imagination to opt out of the experiment. We will conclude that these forms of almost blind obedience to authority are correctable, but with difficulty. We will argue that linking the modification of mental models to an unbinding of awareness represents an important synergistic relationship and one that can build effectively on the lessons learned from our experience with moral imagination. (shrink)

Standard defences of preservationism, and of the intrinsic value of nature more generally, are vulnerable to at least three objections. The first of these comes from social constructivism, the second from the claim that it is incoherent to argue that nature is both 'other' and something with which we can feel unity, whilst the third links defences of nature to authoritarian objectivism and dangerously misanthropic normative dichotomies which set pure nature against impure humanity. I argue that all these objections may (...) be answered by recasting the relationship between man and nature into a tripartite spectrum of ontological form between nature and artifact, with the key question being the extent to which nature has been humanised in accordance with certain modes of strongly instrumental rationality, these in turn being defined by reference to the split between abstract reason and natural feeling which was exacerbated by specific elements in the Enlightenment period. This new model may grant normative force by linking external nature to a broader conception of human psychological wellbeing than that offered by the quantitatively orientated models of human rationality and agency. (shrink)

Originally published in 1962. A clear and simple account of the growth and structure of Mathematical Logic, no earlier knowledge of logic being required. After outlining the four lines of thought that have been its roots - the logic of Aristotle, the idea of all the parts of mathematics as systems to be designed on the same sort of plan as that used by Euclid and his Elements, and the discoveries in algebra and geometry in 1800-1860 - the book goes (...) on to give some of the main ideas and theories of the chief writers on Mathematical Logic: De Morgan, Boole, Jevons, Pierce, Frege, Peano, Whitehead, Russell, Post, Hilbert and Goebel. Written to assist readers who require a general picture of current logic, it will also be a guide for those who will later be going more deeply into the expert details of this field. (shrink)

The author asks to what extent a knowledge of the concepts of yoga may prepare the way to a better understanding of Indian archaeology. The yoga at the basis of this study is that which forms the core of the Tantras. In the first chapter the author surveys the system of Tantrik yoga. He then continues with a discussion of the various forms of yantras, that is all the means employed by yogis in their meditational exercises as aids to the (...) concentration of thought. The author provides in-depth studies of ritual objects of the Lamaistic cult in Tibet and Nepal, the sacred cemeteries of Nepal, and pantheons in Java and Bali. (shrink)