There is a need to explore educational strategies that translate ethics knowledge into ethical behavior. Commonly used pedagogical approaches steeped in traditional normative ethical theory are less powerful than sensemaking in preparing clinicians to respond to ethical problems in practice. This integrative review of 15 articles explores the use of sensemaking as an instructional method for clinical ethics. Whittemore and Knafl’s :546–553, 2005) integrative review method guided a systematic appraisal of data from both qualitative and quantitative research traditions, synthesizing disparate (...) studies in analyzing literature about the use of sensemaking as a pedagogical approach in teaching ethics. Findings supported the use of Weick’s sensemaking theory to develop instructional methods that encourage ethical decision making in students as well as promote ethical response by health care providers. The review reveals important theoretical and training implications for introducing sensemaking as a means to promote ethical action in clinical practice. (shrink)

In clinical practice, evidence suggests that teaching ethics using normative ethical theory has little influence on the ethical actions of providers in practice. Thus, new training methods are needed that improve clinician response to ethical problems. A sensemaking approach to ethics training has demonstrated promise as an evidence-based pedagogical method to improve ethical reasoning and response. Project ECHO is theoretically linked to improved sensemaking. This study examines the effectiveness of ECHO and training in use of sensemaking approaches to ethical response (...) by clinicians. A quasi-experimental design study using univariate linear regression was used to examine the effect of the three types of ethics training on ethical response self-efficacy scores, while controlling for participant characteristics of years in practice, discipline and sex. We found evidence that training in sensemaking through participation in ECHO promotes improved ethical response self-efficacy of clinicians. However, results also suggest that a traditional ECHO format that does not explicitly introduce sensemaking strategies into the training does not result in the same learning outcomes as measured through an ethical response self-efficacy survey. This study found important preliminary results to support use of sensemaking approaches in clinical ethics training. (shrink)

A critical, philosophical engagement of the psychological structures that propagate the continued oppression of women. In this book, the Italian feminist thinker Lea Melandri argues that systemic violence against women has deep psychoanalytic roots. Drawing inspiration from the work of Freud and the psychiatrist and psychoanalyst Elvio Fachinelli, along with feminist practices of consciousness-raising, Melandri demonstrates how male dominance and female subservience are established by society through a binary and oppositional understanding of sex and gender. This understanding—and the oppression and (...) violence against women that results—is inscribed in the psyches of both men and women, and is replicated anew from generation to generation. Melandri analyzes women in media, politics, philosophy, and literature to show how this plays out, and calls for awareness of these deep psychic structures and expectations formed within the dynamics of society and primary family relations. Lea Melandri is one of Italy’s best-known feminist thinkers and activists. She is the author of many books and continues to write and advocate for women’s rights. In 2012, she was awarded by the city of Milan the Ambrogino d’oro, one of the city’s highest honors. Antonio Calcagno is Professor of Philosophy at King’s University College at Western University, Canada. He the editor of Contemporary Italian Political Philosophy and the coeditor (with Inna Viriasova) of Roberto Esposito: Biopolitics and Philosophy, both also published by SUNY Press. (shrink)

This Handbook covers the most urgent, controversial, and important topics in the philosophy of sex. It is both philosophically rigorous and yet accessible to specialists and non-specialists, covering ethics, political philosophy, metaphysics, the philosophy of science, and the philosophy of language, and featuring interactions with neighboring disciplines such as psychology, bioethics, sociology, and anthropology. The volume's 40 chapters, written by an international team of both respected senior researchers and essential emerging scholars, are divided into eight parts: I. What is Sex? (...) Is Sex Good? II. Sexual Orientations III. Sexual Autonomy and Consent IV. Regulating Sexual Relationships V. Pathologizing Sex and Sexuality VI. Contested Desires VII. Commercialized Sex VIII. Technology and the Future of Sex The broad scope of coverage, depth in insight and research, and accessibility in language make The Routledge Handbook of Philosophy of Sex and Sexuality a comprehensive introduction for newcomers to the subject as well as an invaluable reference work for those advanced students and researchers in the field. (shrink)

Access to a deep pool of talent is essential to the success of every professional services firm. The supply of that talent is contingent upon the available rewards for the exercise of that talent, and both the existence of the potential rewards and the beliefs that individuals hold about the existence of the rewards affect the decision to remain in the field. One structural factor that may affect the judgment about whether to remain in a profession concerns promotions based on (...) the gender of the employee. In this study, we examine the “glass ceiling” within the context of the accounting profession. While advances have been made within the accounting profession to address the glass ceiling, the continued existence—and perceptions about the continued existence—of the issue exert adverse effects upon the available talent pool and may create long-term problems for the profession. In this study, we investigate glass ceiling perceptions among a large sample of female accounting professionals employed in accounting; the sample includes both public accountants, and those employed in industry accounting. Our study yields the finding of beliefs in bias-driven effects, structural effects, and cultural effects among these accounting professionals. Glass ceiling perceptions are also influenced by several demographic factors. Furthermore, accounting professionals employed by industry are more likely to report a glass ceiling within their firms than accounting professionals employed by public accounting firms. The findings are of interest to researchers who explore gender-related issues in professional service firms such as the field of accounting, and to senior members of practice who are tasked with ensuring the integrity and quality of the talent pool and the equitable distribution of rewards to employees. (shrink)

As social media becomes increasingly popular, human subjects researchers are able to use these platforms to locate, track, and communicate with study participants, thereby increasing participant retention and the generalizability and validity of research. The use of social media; however, raises novel ethical and regulatory issues that have received limited attention in the literature and federal regulations. We review research ethics and regulations and outline the implications for maintaining participant privacy, respecting participant autonomy, and promoting researcher transparency when using social (...) media to locate and track participants. We offer a rubric that can be used in future studies to determine ethical and regulation-consistent use of social media platforms and illustrate the rubric using our study team’s experience with Facebook. We also offer recommendations for both researchers and institutional review boards that emphasize the importance of well-described procedures for social media use as... (shrink)

Scholars have critiqued mainstream economic approaches to environmental valuation for decades. These critiques have intensified with the increased prominence of environmental valuation in decision-making. This paper has three goals. First, we summarise prominent critiques of monetary valuation, drawing mostly on the work of Clive Spash, who worked extensively on cost–benefit analysis early in his career and then became one of monetary valuation's most thorough and ardent critics. Second, we, as a group of scholars who study relational values, describe how relational (...) values research engages with and addresses many of the critiques of monetary valuation. Third, we offer suggestions for relational values research that continues and deepens its ability to respond to critiques of monetary valuation and contributes to transformative change towards sustainability. (shrink)

The European Medical Information Framework project, funded through the IMI programme, has designed and implemented a federated platform to connect health data from a variety of sources across Europe, to facilitate large scale clinical and life sciences research. It enables approved users to analyse securely multiple, diverse, data via a single portal, thereby mediating research opportunities across a large quantity of research data. EMIF developed a code of practice to ensure the privacy protection of data subjects, protect the interests of (...) data sharing parties, comply with legislation and various organisational policies on data protection, uphold best practices in the protection of personal privacy and information governance, and eventually promote these best practices more widely. EMIF convened an Ethics Advisory Board, to provide feedback on its approach, platform, and the EcoP. The most important challenges the ECoP team faced were: how to define, control and monitor the purposes for which federated health data are used; the kinds of organisation that should be permitted to conduct permitted research; and how to monitor this. This manuscript explores those issues, offering the combined insights of the EAB and EMIF core ECoP team. For some issues, a consensus on how to approach them is proposed. For other issues, a singular approach may be premature but the challenges are summarised to help the community to debate the topic further. Arguably, the issues and their analyses have application beyond EMIF, to many research infrastructures connected to health data sources. (shrink)

Current theory-of-mind research faces the challenge of reconciling two sets of seemingly incompatible findings: Whereas children come to solve explicit verbal false belief tasks from around 4years of age, recent studies with various less explicit measures such as looking time, anticipatory looking, and spontaneous behavior suggest that even infants can succeed on some FB tasks. In response to this tension, two-systems theories propose to distinguish between an early-developing system, tracking simple forms of mental states, and a later-developing system, based on (...) fully developed concepts of belief and other propositional attitudes. One prediction of such theories is that the early-developing system has signature limits concerning aspectuality. We tested this prediction in two experiments. The first experiment showed that 2- and 3-year-olds take into account a protagonist's true or false belief about the location of an object in their active helping behavior. In contrast, toddlers' helping behavior did not differentiate between true and false belief conditions when the protagonist's belief essentially involved aspectuality. Experiment 2 replicated these findings with a more stringent method designed to rule out more parsimonious explanations. Taken together, the current findings are compatible with the possibility that early theory-of-mind reasoning is subject to signature limits as predicted by the two-systems account. (shrink)

The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

According to certain models of the musical work-performance relationship, musical works persist through time. Dodd and Thomasson argue that perdurantist accounts of musical persistence—according to which musical works persist by having temporal parts at every time they exist—are untenable, and Tillman argues that musical endurantism—according to which persisting works are wholly present at each time they exist—avoids Dodd’s worries. In this paper, I argue that both Dodd’s and Thomasson’s arguments—and Tillman’s response—rely on assumptions linking theories of persistence to common-sense views (...) about musical works and, moreover, that these assumptions are unwarranted. As a result, only an attitude of neutrality towards questions about the nature of musical persistence is warranted. (shrink)

The ease with which genotyping technologies generate tremendous amounts of data on research participants has been well chronicled, a feat that continues to become both faster and cheaper to perform. In parallel to these advances come additional ethical considerations and debates, one of which centers on providing individual research results and incidental findings back to research participants taking part in genetic research efforts. In 2006 the Industry Pharmacogenomics Working Group offered some ‘Points-to-Consider’ on this topic within the context of the (...) drug development process from those who are affiliated to pharmaceutical companies. Today many of these points remain applicable to the discussion but will be expanded upon in this updated viewpoint from the I-PWG. The exploratory nature of pharmacogenomic work in the pharmaceutical industry is discussed to provide context for why these results typically are not best suited for return. Operational challenges unique to this industry which cause barriers to returning this information are also explained. (shrink)

After reviewing the literature on current knowledge about consciousness in humans, we present a state-of-the art discussion on consciousness and related key concepts in animals. Obviously much fewer publications are available on non-human species than on humans, most of them relating to laboratory or wild animal species, and only few to livestock species. Human consciousness is by definition subjective and private. Animal consciousness is usually assessed through behavioural performance. Behaviour involves a wide array of cognitive processes that have to be (...) assessed separately using specific experimental protocols. Accordingly, several processes indicative of the presence of consciousness are discussed: perception and cognition, awareness of the bodily-self, self-related knowledge of the environment (including social environment). When available, specific examples are given in livestock species. Next, we review the existing evidence regarding neuronal correlates of consciousness, and emphasize the difficulty of linking aspects of consciousness to specific neural structures across the phyla because high-level cognitive abilities may have evolved independently along evolution. Several mammalian brain structures (cortex and midbrain) are involved in the manifestations of consciousness, while the equivalent functional structures for birds and fishes would likely be the pallium/tectum and midbrain. Caution is required before excluding consciousness in species not having the same brain structures as the mammalian ones as different neural architectures may mediate comparable processes. Finally, specific neurophysiological mechanisms appear to be strongly linked to the emergence of consciousness, namely neural synchrony and neural feedback. Considering the limited amount of data available and the few animal species studied so far, we conclude that different manifestations of consciousness can be observed in animals but that further refinement is still needed to characterize their level and content in each species. Further research is required to clarify these issues, especially in livestock species. (shrink)

Guy Rohrbaugh (2003) and Allan Hazlett (2012) have argued against the identification of musical works with sound-pattern types by arguing that musical works are.

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Este artigo propõe-se a discutir a possibilidade de utilizar as tecnologias digitais online e as redes sociais como espaço de aprendizagem digital de uma maneira que favoreça a aprendizagem cooperativa entre os estudantes, alicerçado na Epistemologia Genética de Jean Piaget. Este estudo foi baseado em uma pesquisa-ação, nas aulas de Matemática, realizada com estudantes do ensino médio integrado em informática do IFRS – Campus Osório (RS), em 2011 e 2012-1. Os estudantes demonstraram apropriação deste espaço de aprendizagem digital, como o (...) Facebook, e apontaram que este potencializa a aprendizagem cooperativa no que tange à disciplina de Matemática, por ações colaborativas com a professora. (shrink)

Traditionally, hospital emergency readiness plans primarily addressed natural disasters, but because of preparations for year 2000, the arrival of terrorism in the United States, and the potential for mass casualties, hospitals were prompted to bring together new partners and create new emergency readiness plans. These new plans, however, give rise to a number of important issues hospitals must consider. First, hospitals must consider legal liability that might arise during an emergency. For example, what liability might arise when decision are made (...) regarding the provision of individual treatment versus mass triage? Second, hospitals must be cognizant of relevant privacy rules, such as the Health Insurance Portability and Accountability Act, as they apply to public health emergencies activities. Third, hospitals must be aware of the Emergency Medical Treatment and Active Labor Act which requires Medicarefunded hospitals to screen patients for emergency medical conditions and prohibits their transfer until they are stabilized. (shrink)

It has been said that all philosophy begins with a set of concerns and a set of intuitions. With this idea in mind, we ask: Would it be helpful to understand Mexican-American philosophy as a kind of philosophy that begins with the concerns and intuitions of the Mexican-American community? On this view, what distinguishes Mexican-American philosophy is the orientation from which the philosophical investigation proceeds. Such an orientation is shaped by the experiences and relationships that are characteristic of those who (...) identify as Mexican-American. We offer a list of concerns and intuitions that we suggest are widely held by the Mexican-American community. Focusing on questions surrounding linguistic assimilation in the U.S., we illustrate how beginning from these particular starting points might alter the way we think about philosophical issues. (shrink)

Academic incivility has contributed to (a) disruptions in learning, (b) poor mental health, (c) diminished academic achievement, and (d) increased financial costs. Understanding and characterizing human roles in academic incivility is foundational to developing plans and policies to mitigate the damaging effects of academic incivility. The purpose of this exploratory study is to characterize the roles of those involved in academic incivility in higher education. In this quantitative study of (N = 459) of higher education learners from 44 of 50 (...) states in the United States, a survey was deployed to investigate the role of self-esteem and advocacy beliefs in relationship to academic incivility roles (i.e., victim, perpetrator, bystander, and upstander). Statistical analysis included regression and correlations. Findings include that upstanders have higher self-esteem and perceptions of options to self-advocate than bystanders, victims, perpetrators, and victim/perpetrator. Likewise, respondents identified being involved in a plurality of incivility roles. Other findings included bystanders preferred faculty intervention in academic incivility incidences over self-advocacy. Those who endorsed being an incivility victim or victim/perpetrator were predictive of acknowledging having low self-esteem. (shrink)

Everett (2005) has argued that fictional realism runs into insuperable difficulties when faced with fictional stories in which there are indeterminate identities. By appeal to a principle linking the individuation of characters within stories and without, Everett argues that such stories entail that there are indeterminate identities outside of fiction on the fictional realist picture. And although indeterminate identities are perfectly acceptable within fiction, they are intolerable in the (nonfictional) world itself. In this paper, I develop the “extended-game” model of (...) fiction according to which fictional characters are props—and, hence, potential objects of reference—in authorized games of make-believe for fictional works in which they appear but do not originate but are neither props nor potential objects of reference in authorized games for works in which they do originate. And I argue that this entails that Everett’s linking principle, on which his argument depends, simply fails to apply. (shrink)

This dissertation abstract and the reflection commentary present the work done by Dr. Lea Stadtler. Comprising four articles, the dissertation explores the challenge of designing successful public–private partnerships for development and contributes to the discourse on partnerships and business engagement in society. Article I adopts the company perspective and develops a conceptual framework for interest alignment in PPPs for development. Based on a theoretical analysis, Article II examines the role that different structures play in handling common design challenges. Articles III (...) and IV are empirical: The former analyzes how partners cope with tensions occurring on the PPP’s boundaries, while Article IV explores the roles of broker organizations, which increasingly facilitate the partnering process of PPPs for development. This extended dissertation abstract introduces the dissertation’s research focus and summarizes each article’s research question, methods, and main findings. The reflection commentary in the appendix discusses the author’s views of her dissertation journey as a junior scholar and the research process. (shrink)

In this paper, I develop a novel account of musical works according which they are situated heir lines, consisting of actual and possible work-versions that are situated in specific musical-historical contexts. And I argue that this account offers a better explanation of three core phonenomena - musical multiplicity, musical flexibility, and musical audibility - than its competitors. Finally, I introduce the broader category of musical lineages - sequences of work-versions each of which has evolved in certain ways from its predecessors (...) - and argue that musical works can be viewed as lineages that are initiated by the requisite sorts of compositional intentions and whose constituent work-versions must satisfy standards of similarity from their original contexts of composition. (shrink)

Digital Earth applications provide a common ground for visualizing, simulating, and modeling real-world situations. The potential of Digital Earth applications has increased significantly with the evolution of artificial intelligence systems and the capacity to collect and process complex amounts of geospatial data. Yet, the widespread techno-optimism at the root of Digital Earth must now confront concerns over high-risk artificial intelligence systems and power asymmetries of a datafied society. In this commentary, we claim that not only can current debates about data (...) governance and ethical artificial intelligence inform development in the field of Digital Earth, but that the specificities of geospatial data, together with the expectations surrounding Digital Earth applications, offer a fruitful lens through which to examine current debates on data governance and artificial intelligence ethics. In particular, we argue that for the implementation of ethical artificial intelligence and inclusive approaches to data governance, Digital Earth initiatives need to involve stakeholders and communities at the local level and be sensitive to social, legal, cultural, and institutional contexts, including conflicts that might arise within those contexts. (shrink)

Résumé Je défends une solution référentielle anti-réaliste au problème de l'identité intentionnelle. Je développe la solution réaliste référentielle de Nathan Salmon — selon laquelle les objets mythiques existent et que nous pouvons y faire référence en utilisant des noms d'objets mythiques — et je considère les objections de David Braun à son égard. Je soutiens que la solution de Salmon donne l'identité réelle des objets des pensées de plusieurs sujets, plutôt que leur identité intentionnelle. Je développe enfin une variante référentielle (...) anti-réaliste du point de vue de Salmon qui évite cette inquiétude — selon laquelle les objets mythiques n'existent pas et ne sont pas réels par ailleurs, bien que nous puissions néanmoins nous y référer. (shrink)

The modernization of agriculture in Northern countries has led to a loss of crop diversity, as well as a loss of knowledge, know-how and rights of farmers regarding on-farm seed breeding. In France, the _Réseau Semences Paysannes_ (RSP) brings together collectives of actors (farmers, bakers, citizens, gardeners) mobilized in a quest to reclaim these aspects. Within the framework of the decentralized participatory breeding program conducted in collaboration with INRAE, farmers have co-constructed knowledge in terms of dynamic management of heterogeneous wheat (...) populations. Yet, as the RSP network grows, these actors face new types of challenges regarding collective action. To address them, we proposed to consider peasant seeds as « common unknowns » rather than « common goods » and we adapted and applied an innovative design approach drawing upon the KCP (Knowledge-Concept-Proposals) method. This approach consisted in implementing, from 2019 to 2021, five decentralized design workshops with local seed breeding collectives. The replication of design workshops in different contexts provided a framework for interaction among RSP members, allowed the sharing of both scientific and experiential knowledge. Noteworthily, it fostered the generation of many proposals for enhancing collective action, and led to the development of operational proposals with a view to implement them in the future. This methodology-oriented paper mainly describes the decentralized design approach implemented, its outputs and outcomes, as well as its interests and limits in the context of crop diversity management. It also analyses how the workshop outputs enriches previous works in the field; in particular how such a participatory design approach leads to produce original operational solutions to respond to challenges identified in the literature. (shrink)

ABSTRACT: A popular strategylor resolving Kim 's exclusion problem is to suggest that mental and physical property tropes are identical despite the non-identity of the mental and physical properties themselves. I argue that mental and physical tropes can be identified without losing the dispositional character of mentality only if a dual-character hypothesis regarding the intrinsic characters of tropes is endorsed. But even with this assumption, the causaI efficacy of the wrong dispositions is secured.RÉSUMÉ: On résout habituellement le problème de l'exclusion (...) de Kim en suggérant que les tropes de propriété mentale et physique sont identiques en dépit de la non-identité des propriétés mentales et physiques elles-mêmes. Je soutiens que les tropes mentaux et physiques peuvent être ramenés l'un à l'autre sans perdre le caractère dispositionnel de la pensée, à la condition d'approuver une hypothèse sur la nature double des caractères intrinsèques des tropes. Même en suivant cette proposition, l'efficacité causale des dispositions fausses est maintenue. (shrink)

The ?values of sport? is a concept that is often used to justify actions and policies by a range of agents and agencies from coaches and teachers to governing bodies and educational institutions. From a philosophical point of view, these values deserve to be analysed with great care to make sure we understand their nature and reach. The aim of this paper is to critically examine the values carried by the educational conception of sport that Pierre de Coubertin developed and (...) to see how they relate to certain values in the philosophy of Friedrich Nietzsche. To be able to understand in depth the moral construct of de Coubertin's system, it is essential to delve into the entire system he builds in order to develop athletic participants closer to his ideal of what a human should be. This in turn rests on his conception of Man, which is comprised of body, spirit and character. An understanding of his structure opens the way to a broader awareness of de Coubertin's educational system, of which sport was only part. We will then see that the values are a consequence of this pedagogical search for the ideal human. It is argued that this ideal of a human is similar to the one described by Nietzsche as the Übermensch . A philosophical case study is conducted, taking as its object the story of the first recipient of the Pierre de Coubertin medal, which rewards fair play among Olympic competitors. Judging the story through Nietzschean eyes allows for his thoughts to be put into practice. His lesser-known texts such as Homer and Competition on the emulation of creative powers shed light on today's sports. Concepts such as guilt, excellence, will to power and effectiveness help us compare these two authors and understand that competition is not necessarily about dominating others, but more about generating human excellence. (shrink)

Nathan Salmon has defended what might be called “weak modal anti-realism”—the view that possible-object names can refer to possible objects that neither exist nor are otherwise real. But rather than adopting a similar view in the fictional case, he instead defends fictional creationism—the view that fictional characters are existent but abstract entities created by authors of fiction. In this paper, I first argue that if weak modal antirealism is defensible then weak fictional antirealism is defensible as well. Second, I argue (...) that there is no reason to prefer fictional creationism over weak fictional antirealism but there is very good reason to prefer the latter over the former. And third, I defend weak fictional antirealism against the charge that it cannot provide a satisfactory account of statements that prima facie involve reference to or quantification over fictional characters. (shrink)

Functionalism cannot accommodate the possibility of mad pain—pain whose causes and effects diverge from those of the pain causal role. This is because what it is to be in pain according to functionalism is simply to be in a state that occupies the pain role. And the identity theory cannot accommodate the possibility of Martian pain—pain whose physical realization is foot-cavity inflation rather than C-fibre activation (or whatever physiological state occupies the pain-role in normal humans). After all, what it is (...) to be in pain according to the identity theory is to be in whatever state that occupies the pain role for us. (shrink)

A central motivation for the type-token model of music works is its ability to explain musical multiplicity—the fact that musical works are capable of having multiple performances through which they can be experienced and which cannot be individually identified with the works themselves. The type-token model explains multiplicity by identifying musical works with structural types and taking performances to be tokens of those types. In this paper, I argue that musical works are flexible in ways which permit performances which are (...) tokens of distinct structural types to be performances of the same musical work. And I argue that various attempts to reconcile the type-token model with musical flexibility are ultimately unsuccessful. (shrink)

In this paper, I argue, contra Perry, that the existence of locating beliefs does not require the abandonment of the analysis of belief as a relation between subjects and propositions. I argue that what the "problem of the essential indexical" reveals is that a complete explanation of behaviour requires both an explanation of the type of behaviour the agent engaged in and an explanation of why she engaged in it in the circumstances that she did. And I develop an account (...) of belief which encompasses both explanatory roles and which still treats belief as a two-place relation between subjects and propositions. (shrink)

Potential conflicts between the roles of physicians and researchers have been described at the theoretical level in the bioethics literature (Czoli, et al., 2011). Physicians and researchers are generally in mutually distinct roles, responsible for patients and participants respectively. With increasing emphasis on integration of research into clinical settings, however, the role divide is sometimes unclear. Consequently, physician–researchers must consider and negotiate salient ethical differences between clinical– and research–based obligations (Miller et al, 1998). This paper explores the subjective experiences and (...) perspectives of 30 physician–researchers working in three Canadian paediatric settings. Drawing on qualitative interviews, it identifies ethical challenges and strategies used by physician–researchers in managing dual roles. It considers whether competing obligations could have both positive and adverse consequences for both physician–researchers and patients. Finally, we discuss how empirical work, which explores the perspectives of those engaged in research and clinical practice, can lead the way to understanding and promoting best practice. (shrink)

In this paper, I argue that Thomson's famous attempt to reconcile the fetus's putative right to life with robust abortion rights is not tenable. Given her view, whether or not an abortion violates the fetus's right to life depends on the abortion procedure utilised. And I argue that Thomson's view implies that any late term abortion that involves feticide is impermissible. In particular, this would rule out the partial birth abortion technique which has been so controversial of late.

Plasminogen activator inhibitor‐1 (PAI‐1) is a physiological inhibitor of urokinase (uPA), a serine protease known to promote cell migration and invasion. Intuitively, increased levels of PAI‐1 should be beneficial in downregulating uPA activity, particularly in cancer. By contrast, in vivo, increased levels of PAI‐1 are associated with a poor prognosis in breast cancer. This phenomenon is termed the “PAI‐1 paradox”. Many factors are responsible for the upregulation of PAI‐1 in the tumor microenvironment. We hypothesize that there is a breast cancer (...) predisposition to a more aggressive stage when PAI‐1 is upregulated as a consequence of Metabolic Syndrome (MetS). MetS exerts a detrimental effect on the breast tumor microenvironment that supports cancer invasion. People with MetS have an increased risk of coronary heart disease, stroke, peripheral vascular disease and hyperinsulinemia. Recently, MetS has also been identified as a risk factor for breast cancer. We hypothesize the existence of the “PAI‐1 cycle”. Sustained by MetS, adipocytokines alter PAI‐1 expression to promote angiogenesis, tumor‐cell migration and procoagulant microparticle formation from endothelial cells, which generates thrombin and further propagates PAI‐1 synthesis. All of these factors culminate in a chemotherapy‐resistant breast tumor microenvironment. The PAI‐1 cycle may partly explain the PAI‐1 paradox. In this hypothesis paper, we will discuss further how MetS upregulates PAI‐1 and how an increased level of PAI‐1 can be linked to a poor prognosis. BioEssays 29:1029–1038, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Examines art and literature of the Americas through the lens of the questionnaire, a genre as central as the manifesto to the history of the avant-garde. Demonstrates how modernism and the avant-garde were debated at the very moment of their development and consolidation"--Provided by publisher.