This paper describes COMET, the first 'expert' computer system to incorporate a comprehensive set of the rules of law and medical ethics relating to consent to medical treatment.

Fifteen years ago, Peter Singer published Animal Liberation: A New Ethics for Our Treatment of Animals. In it, he proposed to end “the tyranny of humans over nonhuman animals” by “thinking through, carefully, and consistently, the question of how we ought to treat animals” (p. ix). On this anniversary of the book's publication, a critical analysis shows that the logic he presents, though popularly appealing, is philosophically flawed. Though influential in slowing and in some cases stopping biomedical research involving animals, (...) the animal rights movement in the United States has yet to offer a clear and compelling argument for the equlity of species. (shrink)

Human cooperation is held to be an evolutionary puzzle because people voluntarily engage in costly cooperation, and costly punishment of non-cooperators, even among anonymous strangers they will never meet again. The costs of such cooperation cannot be recovered through kin-selection, reciprocal altruism, indirect reciprocity, or costly signaling. A number of recent authors label this behavior ‘strong reciprocity’, and argue that it is: (a) a newly documented aspect of human nature, (b) adaptive, and (c) evolved by group selection. We argue exactly (...) the opposite; that the phenomenon is: (a) not new, (b) maladaptive, and (c) evolved by individual selection. In our perspective, the apparent puzzle disappears to reveal a biological and evolutionary logic to human cooperation. Group selection may play a role in theory, but it is neither necessary nor sufficient to explain human cooperation. Our alternative solution is simpler, makes fewer assumptions, and is more parsimonious with the empirical data. (shrink)

This second edition represents a wide-ranging critical introduction to the psychology of Carl Jung, one of the founders of psychoanalysis. Including two new essays and thorough revisions of most of the original chapters, it constitutes a radical assessment of his legacy. Andrew Samuels' introduction succinctly articulates the challenges facing the Jungian community. The fifteen essays set Jung in the context of his own time, outline the current practice and theory of Jungian psychology and show how Jungians continue to question and (...) evolve his thinking and apply it to aspects of modern culture and psychoanalysis. The volume includes a full chronology of Jung's life and work, extensively revised and up to date bibliographies, a case study and a glossary. It is an indispensable reference tool for both students and specialists, written by an international team of Jungian analysts and scholars from various disciplines. (shrink)

The European Legacy, Volume 17, Issue 4, Page 541-542, July 2012.

This paper critically examines the claim that parallel distributed processing (PDP) networks are autonomous learning systems. A PDP model of a simple distributed associative memory is considered. It is shown that the 'generic' PDP architecture cannot implement the computations required by this memory system without the aid of external control. In other words, the model is not autonomous. Two specific problems are highlighted: (i) simultaneous learning and recall are not permitted to occur as would be required of an autonomous system; (...) (ii) connections between processing units cannot simultaneously represent current and previous network activation as would be required if learning is to occur. Similar problems exist for more sophisticated networks constructed from the generic PDP architecture. We argue that this is because these models are not adequately constrained by the properties of the functional architecture assumed by PDP modelers. It is also argued that without such constraints, PDP researchers cannot claim to have developed an architecture radically different from that proposed by the Classical approach in cognitive science. (shrink)

Research ethics is an integral part of research, especially that involving human subjects. However, concerns have been expressed that research ethics has come to be seen as a procedural concern focused on a few well-established ethical issues that researchers need to address to obtain ethical approval to begin their research. While such prospective review of research is important, we argue that it is not sufficient to address all aspects of research ethics. We propose retrospective review as an important complement to (...) prospective review. We offer two arguments to support our claim that prospective review is insufficient. First, as currently practiced, research ethics has become for some a ‘tick box’ exercise to get over the ‘hurdle’ of ethics approval. This fails to capture much of what is important in ethics and does not promote careful reflection on the ethical issues involved. Second, the current approach tends to be rules-based and we argue that research ethics should go beyond this to develop people’s capacity to be sensitive to the relevant moral features of their research, their ethical decision-making skills and their integrity. Retrospective review of a project’s ethical issues, and how they were addressed, could help to achieve those aims better. We believe that a broad range of stakeholders should be involved in such retrospective review, including representatives of ethics committees, participating communities and those involved in the research. All stakeholders could then learn from others’ perspectives and experiences. An open and transparent assessment of research could help to promote trust and understanding between stakeholders, as well as identifying areas of agreement and disagreement and how these can be built upon or addressed. Retrospective review also has the potential to promote critical reflection on ethics and help to develop ethical sensitivity and integrity within the research team. Demonstrating this would take empirical evidence and we suggest that any such initiatives should be accompanied by research into their effectiveness. Our article concludes with a discussion of some possible objections to our proposal, and an invitation to further debate and discussion. (shrink)

Research using mHealth apps has the potential to positively impact health care management and outcomes. However, choosing an appropriate mHealth app may be challenging for the health researcher. The author team used existing evaluation tools, checklists, and guidelines to assess selected mHealth apps to identify strengths, challenges, and potential gaps within existing evaluation tools. They identified specific evaluation tool components, questions, and items most effective in examining app content, usability, and features, including literacy demand and cultural appropriateness; technical information; practical (...) aspects of app functionality; and evolving capabilities of mobile medical apps. Challenges included the subjective nature of the results, time required to complete the evaluation, lack of emphasis on evidence‐based content, and inadequate tool flexibility. Health researchers considering the integration of mobile apps into research will benefit from evaluation tools that assess both evidence‐based content and the ability of the mobile app to securely integrate with other digital technologies involved in patient care. Next steps will include the involvement of health care providers and professionals, including nurses a wide range of expertise, to develop an mHealth evaluation tool that focuses on identifying quality, evidence‐based mobile apps into patient outcomes research. (shrink)

For nearly four centuries Peter of Spain's influential Summaries of Logic was the basis for teaching logic; few university texts were read by more people. This new translation presents the Latin and English on facing pages, and comes with an extensive introduction, chapter-by-chapter analysis, notes, and a full bibliography.

People with lived experience are individuals who have first-hand experience of the medical condition being considered. The value of including the viewpoints of people with lived experience in health policy, health care, and health care and systems research has been recognized at many levels, including by funding agencies. However, there is little guidance or established best practices on how to include non-academic reviewers in the grant review process. Here we describe our approach to the inclusion of people with lived experience (...) in every stage of the grant review process. After a budget was created for a specific call, a steering committee was created. This group included researchers, people with lived experience, and health systems administrators. This group developed and issued the call. After receiving proposals, stage one was scientific review by researchers. Grants were ranked by this score and a short list then reviewed by people with lived experience as stage two. Finally, for stage three, the Steering Committee convened and achieved consensus based on information drawn from stages one and two. Our approach to engage people with lived experience in the grant review process was positively reviewed by everyone involved, as it allowed for patient perspectives to be truly integrated. However, it does lengthen the review process. The proposed model offers further practical insight into including people with lived experience in the review process. (shrink)

People with lived experience are individuals who have first-hand experience of the medical condition being considered. The value of including the viewpoints of people with lived experience in health policy, health care, and health care and systems research has been recognized at many levels, including by funding agencies. However, there is little guidance or established best practices on how to include non-academic reviewers in the grant review process. Here we describe our approach to the inclusion of people with lived experience (...) in every stage of the grant review process. After a budget was created for a specific call, a steering committee was created. This group included researchers, people with lived experience, and health systems administrators. This group developed and issued the call. After receiving proposals, stage one was scientific review by researchers. Grants were ranked by this score and a short list then reviewed by people with lived experience as stage two. Finally, for stage three, the Steering Committee convened and achieved consensus based on information drawn from stages one and two. Our approach to engage people with lived experience in the grant review process was positively reviewed by everyone involved, as it allowed for patient perspectives to be truly integrated. However, it does lengthen the review process. The proposed model offers further practical insight into including people with lived experience in the review process. (shrink)

Plato's Euthyrphro, Apology, andCrito portray Socrates' words and deeds during his trial for disbelieving in the Gods of Athens and corrupting the Athenian youth, and constitute a defense of the man Socrates and of his way of life, the philosophic life. The twelve essays in the volume, written by leading classical philosophers, investigate various aspects of these works of Plato, including the significance of Plato's characters, Socrates's revolutionary religious ideas, and the relationship between historical events and Plato's texts.

We present a one per cent measurement of the cosmic distance scale from the detections of the baryon acoustic oscillations in the clustering of galaxies from the Baryon Oscillation Spectroscopic Survey, which is part of the Sloan Digital Sky Survey III. Our results come from the Data Release 11 sample, containing nearly one million galaxies and covering approximately 8500 square degrees and the redshift range 0.2 < z < 0.7. We also compare these results with those from the publicly released (...) DR9 and DR10 samples. Assuming a concordance Λ cold dark matter cosmological model, the DR11 sample covers a volume of 13 Gpc3 and is the largest region of the Universe ever surveyed at this density. We measure the correlation function and power spectrum, including density-field reconstruction of the BAO feature. The acoustic features are detected at a significance of over 7σ in both the correlation function and power spectrum. Fitting for the position of the acoustic features measures the distance relative to the sound horizon at the drag epoch, rd, which has a value of rd,fid = 149.28 Mpc in our fiducial cosmology. We find DV = at z = 0.32 and DV = at z = 0.57. At 1.0 per cent, this latter measure is the most precise distance constraint ever obtained from a galaxy survey. Separating the clustering along and transverse to the line of sight yields measurements at z = 0.57 of DA = and H =. Our measurements of the distance scale are in good agreement with previous BAO measurements and with the predictions from cosmic microwave background data for a spatially flat CDM model with a cosmological constant. © 2014 The Author Published by Oxford University Press on behalf of the Royal Astronomical Society. (shrink)

Hilary Putnam's Twin Earth thought experiment has come to have an enormous impact on contemporary philosophical thought. But while most of the discussion has taken place within the context of the philosophy of mind and language, Terence Horgan and Mark Timmons (H8cT) have defended the intriguing suggestion that a variation on the original thought experiment has important consequences for ethics.' In a series of papers, they' ve developed the idea of a Moral Twin Earth and have argued that its (...) significance is that it has the resources to undermine naturalistic versions of moral realism.' H8t T don't hold back in their assessment. "Moral Twin.. (shrink)

This entry traces the historical development of the Square of Opposition, a collection of logical relationships traditionally embodied in a square diagram. This body of doctrine provided a foundation for work in logic for over two millenia. For most of this history, logicians assumed that negative particular propositions ("Some S is not P") are vacuously true if their subjects are empty. This validates the logical laws embodied in the diagram, and preserves the doctrine against modern criticisms. Certain additional principles ("contraposition" (...) and "obversion") were sometimes adopted along with the Square, and they genuinely yielded inconsistency. By the nineteenth century an inconsistent set of doctrines was widely adopted. Strawson's 1952 attempt to rehabilitate the Square does not apply to the traditional doctrine; it does salvage the nineteenth century version but at the cost of yielding inferences that lead from truth to falsity when strung together. (shrink)

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

P.E. Easterling presents a brief description of the life of Sophocles according to which he was “evidently a classic from the start.” I note a concern about the description, that all classics would seem to be classics from the start.

This paper observes that P. F. Strawson’s distinction between descriptive and revisionary metaphysics is a baffling one from the perspective of traditional metaphysics. If one thinks of metaphysics as the study of the fundamental nature of reality, it is bewildering to divide up metaphysics in this way. The paper then tries to show how the distinction is no longer bewildering if we deny that such study is possible.