The Relevance View, exemplified by Alex Voorhoeve's Aggregate Relevant Claims, has considerable appeal. It accommodates our reluctance to aggregate weak claims in canonical cases like Life for Headaches, while permitting aggregation of claims in a range of other cases. But it has been the target of significant criticism. In an important recent paper, Patrick Tomlin argues that the view suffers from failures of internal logic, violating plausible consistency constraints and generating incoherent combinations of verdicts on cases. And in cases resembling (...) real-world healthcare allocation problems, Tomlin argues that the view offers no guidance at all. In response, I argue that the internal logic of the Relevance View is sound, and the view's core principles, suitably clarified, support a significant extension of the view beyond the simple cases to which it is typically applied. (shrink)

In cases where the claims of different groups of people compete, the Relevance View occupies a middle ground between aggregation and nonaggregation. It allows weaker claims to aggregate to outweigh a stronger claim just when the competing claims, compared pairwise, are sufficiently close in strength. The view has strong intuitive appeal when applied to simple binary choices, but I argue that attempts to extend it to nonbinary choices have been unsuccessful. I propose a new extension of the Relevance View to (...) nonbinary choices based on a “binary contrastive” account of the moral reasons that obtain in the cases of interest. (shrink)

Solov'ev (1853-1900) gilt als "der erste christliche Denker, der den individuellen und nicht nur den Gattungssinn der Liebe zwischen Mann und Frau anerkannte" (Berdjajev). Der bedeutendste russische Philosoph des 19. Jahrhunderts sieht in der Unbedingtheit des leidenschaftlichen Verlangens der sinnlichen Liebe ein Geschehen der unbedingten Anerkennung des geliebten Menschen - das Fundament der Ethik.

The feeling of error (FOE) is the subjective experience that something went wrong during a reasoning or calculation task. The main goal of the present study was to assess the accuracy of the FOE in the context of mental mathematical calculation. We used the number bisection task (NBT) to evoke this metacognitive feeling and assessed it by asking participants if they felt they have committed an error after solving the task. In the NBT participants have to determine whether the number (...) presented in the middle of a triplet corresponds to the arithmetic mean of the two outer numbers (e.g., 07_16_25) with a Yes/No answer. Our results show that FOE reports were strongly correlated with arithmetic errors and numerical properties of the NBT, suggesting that the FOE accurately represents the error. This finding indicates that even very fast metacognitive feelings are reliable when it comes to evaluating one’s own mental performance. Moreover, our results suggest that the occurrence of FOEs is determined by the fluency with which each triplet was solved and the post-decision evaluation processes that occurred after the NBT was solved. Additionally, we asked participants to report their confidence in the given answer for the cases where they did not report FOEs. Participants reported less confidence for the (objectively) incorrect answers than for the (objectively) correct ones, suggesting that in cases where they did not have a conscious FOE they still were able to implicitly detect their errors. Remarkably, confidence was also determined by the fluency of the NBT. (shrink)

This article is concerned with developing a philosophical approach to a number of significant changes to academic publishing, and specifically the global journal knowledge system wrought by a range of new digital technologies that herald the third age of the journal as an electronic, interactive and mixed-media form of scientific communication. The paper emerges from an Editors' Collective, a small New Zealand-based organisation comprised of editors and reviewers of academic journals mostly in the fields of education and philosophy. The paper (...) is the result of a collective writing process. (shrink)

William Burnside was one of the three most important algebraists who were involved in the transformation of group theory from its nineteenth-century origins to a deeper twentieth-century subject. Building on work of earlier mathematicians, they were able to develop sophisticated tools for solving difficult problems. His works are of enormous historical importance; they remain also a source of inspiration and information. The works of his contemporaries, such as Klein, Frobenius, Schur, have been published as also have the works of his (...) immediate successors such as Phillip Hall. All of Burnside's papers are reproduced here, organized chronologically and with a detailed bibliography. Walter Feit has contributed a foreword, and a collection of introductory essays are included to provide a commentary on Burnside's work and set it in perspective along with a modern biography that draws on archive material. This is the first reference volume of Burnside's collected papers, enhanced by a series of critical essays on his work, and is important for group theorists and historians and philosophers of mathematics and fills the gap in this area of literature. (shrink)

We place agency front-and-centre in the aesthetics of science via an analysis of experimental design and performance. This first involves developing an account of scientific agency relevant to experiment. We do this via an analogy between experiments and games (as understood by Suits and Nguyen): both involve artificial practical environments designed to enable participants to exercise particular forms of agency. Second, we consider how this account of agency might underwrite an aesthetics of experiment. Experiments are well-designed not only when they (...) generate clear, elegant results, but also when they actively confront the experimenter with experimental phenomena, afford the exercise of agency throughout experimental runs and in iterative design and tweaking, and underlie stable, intersubjective experiences across agents. We apply the account to Newton’s optical work, and contrast this with contemporary experimental practices, where significantly more ‘experimental distance’ holds between the experimenter and the result. Taking the agency of experimental practice seriously enables a richer account of the role of aesthetic values, sensibilities, and judgments in science. (shrink)

The 2023 doctors’ strikes in the UK have elicited a familiar moral outcry that such strikes are morally wrong. We consider five arguments that might be thought to show doctors’ strikes are morally impermissible but show that they all fail. The most we can conclude from such arguments is that doctors’ strikes are morally permissible in a narrower range of circumstances than strikes in other sectors.We then outline two independent but compatible justifications for doctors’ strikes, one that appeals to doctors’ (...) interests in fair pay and working conditions and one that appeals to doctors’ duty to protect public health. We also suggest that doctors’ strikes can be supererogatory when they aim to correct a government failing in its own duty to protect public health. Finally, we assess the 2023 UK doctors’ strikes. We conclude that they are justified and there is a case for considering them supererogatory. (shrink)

In their target article, Conley et al. (2023) appropriately highlight the ongoing conceptual and practical opacity of public engagement (PE) in the translation of human gene editing (HGE) (Conley e...

Video ethics in educational research involving children is a recent topic that has arisen since the increase in the use of visual mediums in research especially with the development of new and ubiquitous internet technologies and social media. This paper emerged as an expressed concerned by a group of scholars associated with the new Video Journal of Education and Pedagogy that was established in 2016. The paper is the result of a collective writing process over a period of a few (...) months that discusses visual studies in education and visual ethics in relation to qualitative research in education, and as it applies to children. The article also uses the newly established convention of open review, publishing the results with the paper. (shrink)

Rodger et al have interestingly argued that xenotransplantation should, if possible, entail the use of genetic pain disenhancement to prevent otherwise unavoidable pain in ‘donor’ animals.1 Their argument relies on the empirical assumption that xenotransplantation offers a realistic solution to organ shortage, and that, due to the recent clinical developments and the lack of human donors, it will thus continue for the foreseeable future. We argue below that other options should be prioritised over xenotransplantation, and that so-called ‘non-sentientist’ harms are (...) undervalued in discussions on disenhancement. We do not challenge the empirical claim made by the authors. That is, xenotransplantation research might continue for the foreseeable future since organ demand is increasing. However, we disagree with the priority given to xenotransplantation over other solutions that are more morally desirable. We argue that, if we comply with the 3R principles (Replacement, Reduction, and Refinement of the use of animals in research) and follow a minimal welfarist reasoning (to which the authors seem to adhere), then (1) the principle of replacement demands the use of non-animal alternatives if possible and (2) there are alternative solutions that lead to morally better consequences. Schematically, there are …. (shrink)

As members of the fetal surgery advisory board at a large tertiary care center, we read with great interest Hendriks’ et al. target article proposing a new ethical framework for fetal therap...

This study identifies and explores evolving concepts of trust and privacy in the context of user-generated health data. We define “user-generated health data” as data captured through devices or software and used outside of traditional clinical settings for tracking personal health data. The investigators conducted qualitative research through semistructured interviews with researchers, health technology start-up companies, and members of the general public to inquire why and how they interact with and understand the value of user-generated health data. We found significant (...) results concerning new attitudes toward trust, privacy, and sharing of health data outside of clinical settings that conflict with regulations governing health data within clinical settings. Members of the general public expressed little concern about sharing health data with the companies that sold the devices or apps they used, and indicated that they rarely read the “terms and conditions” detailing how their data may be exploited by the company or third-party affiliates before consenting to them. In contrast, interviews with researchers revealed significant resistance among potential research participants to sharing their user-generated health data for purposes of scientific study. The widespread rhetoric of personalization and social sharing in “user-generated culture” appears to facilitate an understanding of user-generated health data that deemphasizes the risk of exploitation in favor of loosely defined benefits to individual and social well-being. We recommend clarification and greater transparency of regulations governing data sharing related to health. (shrink)

Depression experienced by older adults is proving an increasing global health burden, with rates generally 7% and as high as 27% in the USA. This is likely to significantly increase in coming years as the number and proportion of older adults in the population rises all around the world. Therefore, it is imperative that the effectiveness of approaches to the prevention and treatment of depression are understood. Creative arts interventions, including art, dance movement, drama and music modalities, are utilised internationally (...) to target depression and depressive symptoms in older adults. This includes interventions led by trained arts therapists as well as other health and arts professionals. However, to date there has not been a systematic review that reports effects and examines the processes (why) and mechanisms (how) of creative arts interventions are used to address depression in this older age group. This systematic review of studies on creative arts interventions for older adults experiencing depression examined: outcomes of four creative arts modalities (art, dance movement, drama, and music); with particular attention paid to processes documented as contributing to change in each modality; and mechanisms considered to result from these processes. Our analysis of 75 articles (17 art, 13 dance, 4 drama and 41 music) indicates mostly significant quantitative or positive qualitative findings, particularly for interventions led by creative arts therapists. Mechanisms of change gleaned from the studies that were common across modalities include physical (e.g. increased muscle strength; neurochemical effects, such as endorphin release), intra-personal (e.g. enhanced self-concept, strengthened agency and mastery; processing and communication of emotions), cultural (e.g. creative expression, aesthetic pleasure), cognitive (e.g. stimulation of memory) and social (e.g. increased social skills and connection), that were all considered to contribute to reduced depression and symptoms. Recommendations for future research include a stronger focus on testing of processes and mechanisms. (shrink)

We present a compositional semantics for first-order logic with imperfect information that is equivalent to Sevenster and Sandu’s equilibrium semantics (under which the truth value of a sentence in a finite model is equal to the minimax value of its semantic game). Our semantics is a generalization of an earlier semantics developed by the first author that was based on behavioral strategies, rather than mixed strategies.

In this paper we explore the rise of ‘the breast cancer gene’ as a field of medical, cultural and personal knowledge. We address its significance in the Norwegian public health care system in relation to so-called biological citizenship in this particular national context. One of our main findings is that, despite its claims as a measure for health and disease prevention, gaining access to medical knowledge of BRCA 1/2 breast cancer gene mutations can also produce severe instability in the individuals (...) and families affected. That is, although gene testing provides modern subjects with an opportunity to foresee their biological destiny and thereby become patients in waiting, it undoubtedly also comes with difficult existential dilemmas and choices, with implications that resonate beyond the individual and into different family and love relations. By elaborating on this finding we address the question of whether the empowerment slogan, which continues to be advocated through various health, BRCA and breast cancer discourses, reinforces a naïve or an idealized notion of the actively responsible patient: resourceful enough to seek out medical expertise and gain sufficient knowledge, on which to base informed decisions, thereby reducing the future risk of developing disease. In contrast to this ideal, our Norwegian informants tell a different story, in which there is no apparent heroic mastery of genetic fates, but rather a pragmatic attitude to dealing with a dire situation over which they have little control, despite having complied with medical advice through national guidelines and follow-up procedures for BRCA 1/2 carriers. In conclusion we claim that the sense of safety that gene testing and its associated medical solutions allegedly promise to provide proved illusory. Although BRCA-testing offers the potential for protection from adverse DNA-heritage, administered through possibilities for self-monitoring and self-management of the body, the feeling of ‘being in good health’ has hardly been reinforced by the emergence of gene technology. (shrink)

Experiences of having caused a certain outcome may arise from motor predictions based on action–outcome probabilities and causal inferences based on pre-activated outcome representations. However, when and how both indicators combine to affect such self-agency experiences is still unclear. Based on previous research on prediction and inference effects on self-agency, we propose that their contribution crucially depends on whether people have knowledge about the causal relation between actions and outcomes that is relevant to subsequent self-agency experiences. Therefore, we manipulated causal (...) knowledge that was either relevant or irrelevant by varying the probability of co-occurrence of specific actions and outcomes. Afterwards, we measured self-agency experiences in an action–outcome task where outcomes were primed or not. Results showed that motor prediction only affected self-agency when relevant actions and outcomes were learned to be causally related. Interestingly, however, inference effects also occurred when no relevant causal knowledge was acquired. (shrink)

Arguably the most influential models of human decision-making today are based on the assumption that two separable systems – intuition and deliberation – underlie the judgments that people make. Our recent work is among the first to present neural evidence contrary to the predictions of these dual-systems accounts. We measured brain activations using functional magnetic resonance imaging (fMRI) while participants were specifically instructed to either intuitively or deliberately judge the authenticity of emotional facial expressions. Results from three different analyses revealed (...) both common brain networks of activation across decision mode and differential activations as a function of strategy adherence. We take our results to contradict popular dual-systems accounts that propose a clear-cut dichotomy of the processing systems, and to support rather a unified model. According to this, intuitive and deliberate judgment processes rely on the same rules, though only the former are thought to be characterized by non-conscious processing. (shrink)

The American Journal of Bioethics, Volume 11, Issue 7, Page 57-59, July 2011.

Escalation of commitment causes people to continue a failing course of action. We study the role of construal level in such escalation of commitment. Consistent with the widely held view of construal level as a primed effect, we employed a commonly used prime for manipulating this construct in a laboratory experiment. Our findings revealed that the prime failed to produce statistically significant differences in construal level, which was measured using the Behavior Identification Form. Furthermore, there was no effect of the (...) prime on escalation of commitment, or on constructs that have previously been linked to construal level such as the perceived importance of feasibility considerations relative to desirability considerations, and the number of pros and cons that subjects can think of.Interestingly, however, subjects’ actual construal level scores on the BIF were found to significantly affect escalation. Specifically, our findings show that people with a low construal level are less willing to continue a failing project. This relation is mediated by the perceived importance of the feasibility of the project relative to its desirability. For people with a low construal level, the perceived importance of feasibility relative to desirability is higher, which in turn makes escalation of commitment less likely.Our findings are consistent with prior research suggesting that priming construal level may not always be effective. Thus, while construal level has typically been regarded as a state-like variable that can be primed, in this study, we show that construal level may also be considered as a trait. (shrink)

Ethnic minority patients have been discussed and problematised in Western health literature. Drawing on an interpretation of central parts of the French philosopher Michel Foucault's authorship, we analysed a broad selection of materials to identify mechanisms through which the truth about ethnic minority patients is constructed. We identified a single, yet consistent discursive strategy that we termed ‘figure of inconvenience’ in which ethnic minority patients were classified and assigned a specific subjection illustrating them as ‘inconvenient’ to the nurse's practice. Concurrently, (...) their relatives were afforded the position of substitutes. The discourse exemplifies how the behaviour or appearances of ethnic minority patients cannot be reconciled with the traits of ethnic Danish patients. Finally, we discussed implications that such a strategy may have for the provision of healthcare services for ethnic minority patients in Denmark. (shrink)

BackgroundIn the Netherlands, Foundation De Einder offers counselling to people who wish to be able to self-determine the timing and manner of their end of life.AimThis study explores the experiences with counselling that counselees receive from counsellors facilitated by Foundation De Einder.MethodsOpen coding and inductive analysis of in-depth interviews with 17 counselees.ResultsCounselling ranged from solely receiving information about lethal medication to combining this with psychological counselling about matters of life and death, and the effects for close ones. Counselees appreciated the (...) availability of the counsellor, their careful and open attitude, feeling respected and being reminded about their own responsibility. Some counselees felt dependent on the counsellor, or questioned their competency. Most counselees collected lethal medication. This gave them peace of mind and increased their quality of life, but also led to new concerns. Few were inclined to use their self-collected medication. Counselling contributed to thinking about if, when and how counselees would like to end their life.ConclusionHaving obtained means to end their lives can offer people feelings of reassurance, which can increase their quality of life, but can also give rise to new concerns. Next to providing information on lethal medication, counsellors can play an important role by having an open non-judgemental attitude, providing trustworthy information and being available. These positively valued aspects of counselling are also relevant for physicians taking care of patients who wish to self-determine the timing and manner of their end of life. (shrink)

Narrative analysis, creative writing, and interactive reflective writing have been identified as valuable for professional identity formation and resilience among medical and premedical students alike. This study proposes that medical student blogs are novel pedagogical tools for fostering peer-to-peer learning in academic medicine and are currently underutilized as a near-peer resource for premedical students to learn about the medical profession. To evaluate the pedagogical utility of medical student blogs for introducing core themes in the medical humanities, the authors conducted qualitative (...) analysis of one hundred seventy-six reflective essays by baccalaureate premedical students written in response to medical student-authored narrative blog posts. Using an iterative thematic approach, the authors identified common patterns in the reflective essays, distilled major themes, coded the essays, and conducted narrative analysis through close reading. Qualitative analysis identified three core themes and one overarching theme. The premedical students’ essays demonstrated significant self-reflection in response to near-peer works, discussed their perceptions of medical professionalism, and expressed concerns about their future progress through the medical education system. The essays consistently attributed the impact of the medical student narratives to the authors’ status as near-peers. The authors conclude that reading and engaging in reflective writing about near-peer blog posts encourages premedical students to develop an understanding of core concepts in the medical humanities and promotes their reflection on the profession of medicine. Thus, incorporating online blogs written by medical trainees as narrative works in medical humanities classrooms is a novel pedagogical method for fostering peer-to-peer learning in academic medicine. (shrink)

Background Q-CEP (Qualificação dos Comitês de Ética em Pesquisa que compõem o Sistema CEP/Conep) is a nationwide project resulting from a partnership between the Brazilian National Research Ethics Commission (Conep), the Ministry of Health and Hospital Moinhos de Vento (HMV). It was developed to consolidate policy for ethical review of research with human beings in all members of the CEP/Conep System, Brazil’s national system of institutional review boards. The aim of this study was therefore to report on the experience and (...) results of the Q-CEP project. Methods An observational, retrospective study includes data from the Q-CEP, obtained from visits to all the institutional research ethics committees (RECs) in the country. The actions implemented by Q-CEP were part of a two-step process: (i) training visits to each REC; (ii) development of distance learning modules on strategic topics pertaining to research ethics evaluation. The data presented herein cover step one (training visits), defined by Q-CEP as the diagnostic stage of the project. For a country with social and economics inequalities such as Brazil, this is a particularly important stage; an accurate picture of reality is needed to inform planning of quality improvement strategies. Results In 2019–2021, Q-CEP visited 832 RECs and trained 11,197 people. This sample covered almost all active RECs in the country; only 4 (0.5%) were not evaluated. Of the 94 items evaluated, 62% did not reach the target of at least 80% compliance and around 1/4 (26%) were below 50% compliance. The diagnostic stage of the process revealed inadequacies on the part of the RECs in their ethical reviews. The analysis of informed consent forms showed compliance in only 131 RECs (15.74%). The description of pending issues made by RECs in their reports was compliant in 19.33% (n = 161). Administrative and operational aspects were also considered inadequate by more than half of the RECs. Conclusions Overall, Brazilian RECs showed poor compliance in several aspects of their operation, both in ethics evaluation and in other processes, which justifies additional training. The Q-CEP project is part of a quality improvement policy promoted by the Brazilian Ministry of Health. The data obtained in the diagnostic step of the project have contributed to the qualification and consolidation of one of the world’s largest research ethics evaluation systems. (shrink)

Background: Collaboration between physicians and nurses is key to improving patient care. We know very little about collaboration and interdisciplinary practice in African healthcare settings. Research question/aim: The purpose of this study was to explore the ethical challenges of interdisciplinary collaboration in clinical practice and education in Botswana Participants and research context: This qualitative descriptive study was conducted with 39 participants (20 physicians and 19 nurses) who participated in semi-structured interviews at public hospitals purposely selected to represent the three levels (...) of hospitals in Botswana (referral, district, and primary). Ethical considerations: Following Institutional Review Board Approval at the University of Pennsylvania and the Ministry of Health in Botswana, participants’ written informed consent was obtained. Findings: Respondents’ ages ranged from 23 to 60 years, and their duration of work experience ranged from 0.5 to 32 years. Major qualitative themes that emerged from the data centered on the nature of the work environment, values regarding nurse–doctor collaboration, the nature of such collaboration, resources available for supporting collaboration and the smooth flow of work, and participants’ views about how their work experiences could be improved. Discussion: Participants expressed concerns that their work environment compromised their ability to provide high-quality and safe care to their patients. The physician staffing structure was described as consisting of a few specialists at the top, a vacuum in the middle that should be occupied by senior doctors, and junior doctors at the bottom—and not a sufficient number of nursing staff. Conclusion: Collaboration between physicians and nurses is critical to optimizing patients’ health outcomes. This is true not only in the United States but also in developing countries, such as Botswana, where health care professionals reported that their ethical challenges arose from resource shortages, differing professional attitudes, and a stressful work environment. (shrink)

We are grateful to Friesen and colleagues for drawing attention to the tension between the protection of populations that may experience vulnerability with their inclusion in research (Friesen et a...

ABSTRACTThe ability to evaluate scientific claims and evidence is an important aspect of scientific literacy and requires various epistemic competences. Readers spontaneously validate presented information against their knowledge and beliefs but differ in their ability to strategically evaluate the soundness of informal arguments. The present research investigated how students of psychology, compared to scientists working in psychology, evaluate informal arguments. Using a think-aloud procedure, we identified the specific strategies students and scientists apply when judging the plausibility of arguments and classifying (...) common argumentation fallacies. Results indicate that students, compared to scientists, have difficulties forming these judgements and base them on intuition and opinion rather than the internal consistency of arguments. Our findings are discussed using the mental model theory framework. Although introductory students validate scientific information against their knowledge and beliefs, the.. (shrink)

This study examines urban agriculture (UA) in Sacramento, California (USA), the nation's self-branded “Farm-to-Fork Capital,” in order to highlight UA’s distinct yet entangled roots. The study is based on 24 interviews with a diverse array of UA leaders, conducted as part of a five-year transdisciplinary study of UA in Sacramento. In it, we unearth three primary “taproots” of UA projects, each with its own historical legacies, normative visions, and racial dynamics. In particular, we examine UA projects with “justice taproots,” “health (...) taproots,” and “market taproots.” We use this analysis to understand how different kinds of UA projects are embedded in racial capitalism in ways that transform relationships between people, the city, and food systems. Unearthing these entangled roots helps illuminate UA’s underlying politics, showing how these roots grow in both competitive and symbiotic ways within the soil matrix of racial capitalism. We argue that these roots interact differently with racial capitalism, creating disparities in their growth trajectories. In particular, UA projects associated with the justice taproot are historically underrepresented and undervalued. However, we argue that there are some prospects for building alliances between the UA movement’s three roots, and that these are both promising and problematic. (shrink)

A decade in the making, the _Handbook i_s the definitive contemporary exposition of interpersonal psychoanalysis. It provides an authoritative overview of development, psychopathology, and treatment as conceptualized from the interpersonal viewpoint.

In this paper, we put forward an interdisciplinary framework describing different levels of self-representations, namely non-conceptual, conceptual and propositional self-representations. We argue that these different levels of self-representation are differently affected by cultural upbringing: while propositional self-representations rely on “theoretical” concepts and are thus strongly influenced by cultural upbringing, non-conceptual self-representations are uniform across cultures and thus universal. This differentiation offers a theoretical specification of the distinction between an independent and interdependent self-construal put forward in cross-cultural psychology. Hence, this does (...) not only allow for a deeper understanding of different self-conceptions, but also for a formulation of new hypotheses regarding the cultural influence on self-representations. As one example, we will highlight the role of the proposed levels of self-representation for emotional experience and formulate some major implications of our interdisciplinary framework for future empirical research. (shrink)

Supported decision-making has been promoted at a policy level and within international human rights treaties as a way of ensuring that people with disabilities enjoy the right to legal capacity on an equal basis with others. However, little is known about the practical issues associated with implementing supported decision-making, particularly in the context of dementia. This study aimed to understand the experiences of people with dementia and their family members with respect to decision-making and their views on supported decision-making. Thirty-six (...) interviews were undertaken with fifty-seven participants across three states in Australia. Interpretative Phenomenological Analysis was used as the methodological approach, with relational autonomy as a theoretical perspective. We identified two overarching themes relating to participants’ experiences with decision-making: “the person in relationship over time” and “maintaining involvement.” Participant views on the practical issues associated with supported decision-making are addressed under the themes of “facilitating decision-making,” “supported decision-making arrangements,” “constraints on decision-making,” and “safeguarding decision-making.” While participants endorsed the principles of supported decision-making as part of their overarching strategy of “maintaining involvement” in decision-making, they recognized that progressive cognitive impairment meant that there was an inevitable transition toward greater involvement of, and reliance upon, others in decision-making. Social and contextual “constraints on decision-making” also impacted on the ability of people with dementia to maintain involvement. These themes inform our proposal for a “spectrum approach” to decision-making involvement among people living with dementia, along with recommendations for policy and practice to assist in the implementation of supported decision-making within this population. (shrink)

How many words is a bilingual 2-year-old supposed to know or say in each of her languages? Speech and language therapists or researchers lack the tools to answer this question, because several factors have an impact on bilingual language skills: gender, amount of exposure, mode of acquisition, socio-economic status and the distance between L1 and L2. Unfortunately, these factors are usually studied separately, making it difficult to evaluate their weight on a unique measure of vocabulary. The present study measures the (...) contribution of the following factors to the vocabulary scores of bilingual toddlers: i) gender; ii) sibling ranking; iii) relative amount of exposure to each language; iv) mode of exposure; v) SES; vi) linguistic distance; vii) language spoken between parents. Close to the child’s second birthday, parents of 278 UK-based bilinguals completed successively: a 100-word version of the Oxford-CDI, the CDI in the child’s Additional Language, a family questionnaire, and the Language Exposure Questionnaire. Thirty-six British-English-AL pairs were considered, with languages contrasted on a second-language-learning scale : for example, Dutch and French are close to British-English, while Polish or Cantonese are more distant. Data from the corpus were included in two mixed-effect models, one with the English scores in comprehension as the dependent variable, and the other with production scores. The seven factors listed above were included as predictors. The amount of English exposure was the strongest predictor of comprehension scores = 9.35, p <.005, β = 0.02, t = 3.08, p <.005), followed by the language that parents speak between themselves = 14.94, p <.001, β = 1.37, t = 3.76, p <.0005), linguistic distance = 6.92, p <.01, β = -0.74, t = -2.66, p <.01) and age = 4.86, p <.05, β = 0.55, t = 2.17, p <.05). In production, gender = 13.57, p <.0005, β = -0.91, t = -03.72, p <.0005), amount of exposure to English = 13.57, p <.0005, β = -0.91, t = -03.72, p <.0005), the language that parents speak between themselves = 11.85, p <.005, β = 1.09, t = 3.41, p <.001), and the mother’s occupation = 4.51, p <.05, β = 0.63, t = 2.13, p <.05) were the significant predictors. The more English parents use to address one another, the more English words the child says and understands. This surprising result could be simply explained by the fact that parents who speak English together are also more likely to speak English to their child. The main results of this study is that linguistic distance is a powerful predictor of toddlers’ vocabulary in English, with children learning two close languages growing their vocabulary faster than those learning distant languages. (shrink)