BackgroundRadiotherapy is an essential component of cancer treatment, yet many countries do not have adequate capacity to serve all patients who would benefit from it. Allocation systems are needed to guide patient prioritization for radiotherapy in resource-limited contexts. These systems should be informed by allocation principles deemed relevant to stakeholders. This study explores the ethical dilemmas and views of decision-makers engaged in real-world prioritization of scarce radiotherapy resources at a cancer center in Rwanda in order to identify relevant principles.MethodsSemi-structured interviews (...) were conducted with a purposive sample of 22 oncology clinicians, program leaders, and clinical advisors. Interviews explored the factors considered by decision-makers when prioritizing patients for radiotherapy. The framework method of thematic analysis was used to characterize these factors. Bioethical analysis was then applied to determine their underlying normative principles.ResultsParticipants considered both clinical and non-clinical factors relevant to patient prioritization for radiotherapy. They widely agreed that disease curability should be the primary overarching driver of prioritization, with the goal of saving the most lives. However, they described tension between curability and competing factors including age, palliative benefit, and waiting time. They were divided about the role that non-clinical factors such as social value should play, and agreed that poverty should not be a barrier.ConclusionsMultiple competing principles create tension with the agreed upon overarching goal of maximizing lives saved, including another utilitarian approach of maximizing life-years saved as well as non-utilitarian principles, such as egalitarianism, prioritarianism, and deontology. Clinical guidelines for patient prioritization for radiotherapy can combine multiple principles into a single allocation system to a significant extent. However, conflicting views about the role that social factors should play, and the dynamic nature of resource availability, highlight the need for ongoing work to evaluate and refine priority setting systems based on stakeholder views. (shrink)

In this paper, we explore challenges in conveying the culturally constructed meanings of local Indigenous musics and the worldviews they manifest to students in K-12 school music classes, when foundational aspects of the English language, historical and current discourse, and English language habits function to thwart the transmission of those meanings. We recount how, in settler colonial societies in North America, speakers of the dominant English language have historically misrepresented, discredited, and obscured cultural meanings that inhere in local Indigenous musics. (...) First, we examine three ways in which the use of English has distorted the cultural meanings of those musics. Next, we explain how historical discourses in English have intentionally undervalued or discredited the values intrinsic to those musics, also describing how some current music education discourse in English might work against the embedding of Indigenous meanings in school music education settings. We then consider additional factors distinguishing Indigenous languages from European languages (especially English) to show how a people’s “language habits” influence their perception of and thus their relationship with their natural environment. We conclude by considering the role of music education in revitalizing local Indigenous languages and musics and advancing the cultural values of their originating communities. (shrink)

A sense of agency over wilful actions is thought to be dependent on the level of choice and the nature of the outcome. In a preregistered study, we manipulated choice and valence of outcome to assess the relationship between SoA across the depression and psychosis continuum. Participants completed a Libet Clock task, in which they had either a free or forced choice to press one of two buttons and received either a rewarding or punishing outcome. Participants also completed questionnaires on (...) depressive and psychosis-like traits. Rewarding outcomes increased intentional binding. The evidence favoured no effect of choice on average, but this was influenced by inter-individual differences. Individuals reporting more depressive traits had less of a difference in intentional binding between free and forced choice conditions. We show that implicit SoA is sensitive to outcome valence and the effect of choice differs across the depression continuum. (shrink)

Background Psychological practitioners often seek to directly change the form or frequency of clients' maladaptive perfectionist thoughts, because such thoughts predict future depression. Indirect strategies, such as self-compassion interventions, that seek to change clients' relationships to difficult thoughts, rather than trying to change the thoughts directly could be just as effective. This study aimed to investigate whether self-compassion moderated, or weakened, the relationship between high perfectionism and high depression symptoms in both adolescence and adulthood. Methods The present study utilised anonymous (...) self-report questionnaires to assess maladaptive perfectionism, depression, and self-compassion across two samples covering much of the life-span. Questionnaires were administered in a high school setting for the adolescent sample, and advertised through university and widely online to attract a convenience sample of adults. Results Moderation analyses revealed that self-compassion reduced the strength of relationship between maladaptive perfectionism and depression in our adolescent Study 1 and our adult study 2. Limitations Cross-sectional self-reported data restricts the application of causal conclusions and also relies on accurate self-awareness and willingness to respond to questionnaire openly. Conclusions The replication of this finding in two samples and across different age-appropriate measures suggests that self-compassion does moderate the link between perfectionism and depression. Self-compassion interventions may be a useful way to undermine the effects of maladaptive perfectionism, but future experimental or intervention research is needed to fully assess this important possibility. (shrink)

As customer return rates increase, retailer bottom lines suffer from customers’ misuse of the policies and to the ethics of such practice. The purpose of this study is to explore customers’ orientation toward return behaviors, and to develop a return orientation assessing these dimensions. This research identified three dimensions relevant to consumer return behavior: the planned/unethical returner; the eager returner; and the reluctant/educated returner. A retest with another sample confirmed these three dimensions. Each dimension was analyzed for its relationship with (...) consumer ethical beliefs as measured by the Muncy–Vitell Consumer Ethics Scale, ethical philosophies and shopping behaviors. These relationships supported the ethical and unethical aspects of returner orientation. Results of this research imply that the core aspect of returner orientation is relevant to ethical behavior and misuse of retail return policies. The three return orientations identified partially support the Rosenbaum & Bitner-Olson research. (shrink)

Lists of species underpin many fields of human endeavour, but there are currently no universally accepted principles for deciding which biological species should be accepted when there are alternative taxonomic treatments (and, by extension, which scientific names should be applied to those species). As improvements in information technology make it easier to communicate, access, and aggregate biodiversity information, there is a need for a framework that helps taxonomists and the users of taxonomy decide which taxa and names should be used (...) by society whilst continuing to encourage taxonomic research that leads to new species discoveries, new knowledge of species relationships, and the refinement of existing species concepts. Here, we present 10 principles that can underpin such a governance framework, namely (i) the species list must be based on science and free from nontaxonomic considerations and interference, (ii) governance of the species list must aim for community support and use, (iii) all decisions about list composition must be transparent, (iv) the governance of validated lists of species is separate from the governance of the names of taxa, (v) governance of lists of accepted species must not constrain academic freedom, (vi) the set of criteria considered sufficient to recognise species boundaries may appropriately vary between different taxonomic groups but should be consistent when possible, (vii) a global list must balance conflicting needs for currency and stability by having archived versions, (viii) contributors need appropriate recognition, (ix) list content should be traceable, and (x) a global listing process needs both to encompass global diversity and to accommodate local knowledge of that diversity. We conclude by outlining issues that must be resolved if such a system of taxonomic list governance and a unified list of accepted scientific names generated are to be universally adopted. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

In this essay we attempt to accomplish two things related to the work of G.K. Chesterton. The first is to use one of his favorite ploys to articulate the nature of play. We discuss several paradoxical characteristics of play and attempt to show how seemingly contradictory features actually help us to understand play’s allure and other values. We introduce the second topic of theological analyses of work and play with a review of the Christian literature on these subjects. We then (...) employ Chesterton’s paradoxical theology to see how these two aspects of living might come to life and how people of faith should experience them. (shrink)

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

methods that have shown promise for improving extreme risk analysis, particularly for assessing the risks of invasive pests and pathogens associated with international trade. We describe the legally inspired regulatory regime for banks, where these methods have been brought to bear on extreme ‘operational risks’. We argue that an ‘advocacy model’ similar to that used in the Basel II compliance regime for bank operational risks and to a lesser extent in biosecurity import risk analyses is ideal for permitting the diversity (...) of relevant evidence about invasive species to be presented and soundly evaluated. We recommend that the process be enhanced in ways that enable invasion ecology to make more explicit use of the methods found successful.. (shrink)

Scholars have long been captivated by the parallels between birdsong and human speech and language. In this book, leading scholars draw on the latest research to explore what birdsong can tell us about the biology of human speech and language and the consequences for evolutionary biology. They examine the cognitive and neural similarities between birdsong learning and speech and language acquisition, considering vocal imitation, auditory learning, an early vocalization phase, the structural properties of birdsong and human language, and the striking (...) similarities between the neural organization of learning and vocal production in birdsong and human speech. After outlining the basic issues involved in the study of both language and evolution, the contributors compare birdsong and language in terms of acquisition, recursion, and core structural properties, and then examine the neurobiology of song and speech, genomic factors, and the emergence and evolution of language. Contributors: Hermann Ackermann, Gabriël J.L. Beckers, Robert C. Berwick, Johan J. Bolhuis, Noam Chomsky, Frank Eisner, Martin Everaert, Michale S. Fee, Olga Fehér, Simon E. Fisher, W. Tecumseh Fitch, Jonathan B. Fritz, Sharon M.H. Gobes, Riny Huijbregts, Eric Jarvis, Robert Lachlan, Ann Law, Michael A. Long, Gary F. Marcus, Carolyn McGettigan, Daniel Mietchen, Richard Mooney, Sanne Moorman, Kazuo Okanoya, Christophe Pallier, Irene M. Pepperberg, Jonathan F. Prather, Franck Ramus, Eric Reuland, Constance Scharff, Sophie K. Scott, Neil Smith, Ofer Tchernichovski, Carel ten Cate, Christopher K. Thompson, Frank Wijnen, Moira Yip, Wolfram Ziegler, Willem Zuidema. (shrink)

The first main result isolates some conditions which fail for the class of graphs and hold for the class of Abelian p-groups, the class of Abelian torsion groups, and the special class of "rank-homogeneous" trees. We consider these conditions as a possible definition of what it means for a class of structures to have "Ulm type". The result says that there can be no Turing computable embedding of a class not of Ulm type into one of Ulm type. We apply (...) this result to show that there is no Turing computable embedding of the class of graphs into the class of "rank-homogeneous" trees. The second main result says that there is a Turing computable embedding of the class of rank-homogeneous trees into the class of torsion-free Abelian groups. The third main result says that there is a "rank-preserving" Turing computable embedding of the class of rank-homogeneous trees into the class of Boolean algebras. Using this result, we show that there is a computable Boolean algebra of Scott rank ${\mathrm{\omega }}_{1}^{\mathrm{C}\mathrm{K}}$. (shrink)

Biologists, historians, lawyers, art historians, and literary critics all voice arguments in the critical dialogue about what constitutes evidence in research and scholarship. They examine not only the constitution and "blurring" of disciplinary boundaries, but also the configuration of the fact-evidence distinctions made in different disciplines and historical moments the relative function of such concepts as "self-evidence," "experience," "test," "testimony," and "textuality" in varied academic discourses and the way "rules of evidence" are themselves products of historical developments. The essays and (...) rejoinders are by Terry Castle, Lorraine Daston, Carlo Ginzburg, Ian Hacking, Mark Kelman, R. C. Lewontin, Pierre Vidal-Naquet, Mary Poovey, Donald Preziosi, Simon Schaffer, Joan W. Scott, Eve Kosofsky Sedgwick, and Barbara Herrnstein Smith. The critical responses are by Lauren Berlant, James Chandler, Jean Comaroff, Arnold I. Davidson, Harry D. harootunian, Elizabeth Helsinger, Thomas C. Holt, Francoise Meltzer, Robert J. Richards, Lawrence Rothfield, Joel Snyder, Cass R. Sunstein, and William Wimsatt. (shrink)

The expanded use of genetic testing raises key ethical and policy questions about possible benefits and harms for those receiving disease‐risk information. As predictive testing for Huntington’s was initiated in a clinical setting, survey research posing hypothetical test scenarios suggested that the vast majority of at‐risk relatives wanted to know whether they carried a disease‐causing mutation. However, only a small minority ultimately availed themselves of this opportunity. Many at‐risk individuals concluded that a positive test result would be too psychologically overwhelming. (...) A substantial literature suggests that individuals are often more resilient than anticipated in coping with many different health‐related stresses. Much of my own work in the field has been through the Risk Evaluation & Education for Alzheimer’s Disease study (REVEAL), a series of randomized clinical trials assessing the impact of genetic susceptibility testing on asymptomatic individuals at risk for Alzheimer’s disease. Our experience in developing and implementing four successive, multisite trials provides some potentially useful lessons for the field. More people will be asking for their personal genetic information. Better understanding will help us decide when access is appropriate and how best to disclose results in a manner that supports adjustment to test findings and promotes use of genetic information to improve human health. (shrink)

This paper reviews the published empirical evidence concerning journal peer review consisting of 68 papers, all but three published since 1975. Peer review improves quality, but its use to screen papers has met with limited success. Current procedures to assure quality and fairness seem to discourage scientific advancement, especially important innovations, because findings that conflict with current beliefs are often judged to have defects. Editors can use procedures to encourage the publication of papers with innovative findings such as invited papers, (...) early-acceptance procedures, author nominations of reviewers, structured rating sheets, open peer review, results-blind review, and, in particular, electronic publication. Some journals are currently using these procedures. The basic principle behind the proposals is to change the decision from whether to publish a paper to how to publish it. (shrink)

Leading sociologists outline the historical development of the discipline in Britain and document its continuing influence in this essential and comprehensive reference work. Spanning the Scottish enlightenment of the 18th century to the present day this Handbook maps the discipline and the British contribution.

Bribery is a complicated, multi-dimensional issue. Upon first glance, most westerners would immediately condemn it as an underhanded, unfair means of gaining an advantage in a competitive or legal situation, and so it is in virtually every case in the westernized world. However, the issue becomes much more complicated in the international context, particularly in developing nations, where giving and accepting bribes is often normal and expected. This paper serves to inform ethical decision-making in situations where the “right choice” is (...) unclear with regards to bribery, primarily for individuals performing aid work in foreign countries with corrupt officials and police officers. In such contexts, a simple offering of food, money, or a small trinket may make the difference between a person being able to accomplish meaningful, life-changing work for the local populace or having that work significantly slowed at best and being thrown out of the country, robbed, or imprisoned in worse cases. The larger scale bribery issues in international business and the laws pertaining to them are also discussed. (shrink)

The integrated information theory is a promising theory of consciousness. However, there are several problems with IIT's axioms and postulates. Moreover, IIT entails that some twodimensional grids of identical logic gates have more consciousness than humans. Many have found this prediction to be implausible, and as will be argued here, this prediction also exacerbates the so-called 'hard problem of consciousness'. Recently, it has been argued that if we treat the phenomenological aspects of consciousness as an illusion, we can avoid the (...) hard problem altogether by replacing it with the more tractable illusion problem: the problem of explaining how introspection systematically misrepresents experiences as having phenomenology. IIT is intended to be a theory of the phenomenological aspects of consciousness. However, it is possible to reformulate the axioms and postulates of IIT consistently with illusionism. Here it is argued that the resulting theory -- illusionist integrated information theory -- removes several problems for IIT including the hard problem and the logic gate problem, and also enables meaningful progress for illusionists on solving the illusion problem. (shrink)

This paper calculates, in a precise way, the complexity of the index sets for three classes of computable structures: the class $K_{\omega _{1}^{\mathit{CK}}}$ of structures of Scott rank $\omega _{1}^{\mathit{CK}}$ , the class $K_{\omega _{1}^{\mathit{CK}}+1}$ of structures of Scott rank $\omega _{1}^{\mathit{CK}}+1$ , and the class K of all structures of non-computable Scott rank. We show that I(K) is m-complete $\Sigma _{1}^{1},\,I(K_{\omega _{1}^{\mathit{CK}}})$ is m-complete $\Pi _{2}^{0}$ relative to Kleen's O, and $I(K_{\omega _{1}^{\mathit{CK}}+1})$ is m-complete $\Sigma _{2}^{0}$ (...) relative to O. (shrink)

Integrating research on empowering leadership with the literature on power in social psychology, we examine how empowering leaders affect the propensity of followers to engage in deviance. Across a multi-source, multi-wave field study and a controlled laboratory experiment, we find that, compared to the followers of less-empowering leaders, the followers of more empowering leaders feel subjectively more powerful and engage in more deviant behaviors. Moreover, we find that the propensity of empowered followers to engage in more deviance depends on their (...) prosocial attributes. Specifically, empowered followers engage in the highest levels of deviance when they have a weak moral identity and a strong desire for dominance. We further find that empowering leadership does not increase follower deviance when followers either have a strong moral identity or a weak desire for dominance. In sum, although past research suggests that empowering leadership may facilitate productivity and employee engagement, our work demonstrates that it can also cultivate harmful effects, such as increased deviance among certain types of followers. We discuss our theoretical contributions as well as practical implications for practicing empowering leadership. (shrink)