BackgroundClinical trials should be as inclusive as possible to facilitate equitable access to research and better reflect the population towards which any intervention is aimed. Informed by the UK’s National Institute for Health and Care Research (NIHR) Innovations in Clinical Trial Design and Delivery for the Under-served (INCLUDE) guidance, we audited oncology trials conducted by the Clinical Trials and Statistics Unit at The Institute of Cancer Research, London (ICR-CTSU) to identify whether essential documents were overtly excluding any groups and whether (...) sufficient data were collected to assess diversity of trial participants from groups suggested by INCLUDE as under-served by research in the UK.MethodsThirty cancer clinical trials managed by ICR-CTSU and approved between 2011–2021 were audited. The first ethics approved version of each trial’s protocol, patient information sheet, and patient completed questionnaire, together with the first case report forms (CRFs) version were reviewed. A range of items aligned with the INCLUDE under-served groups were assessed, including age, sex and gender, socio-economic and health factors. The scope did not cover trial processes in participating hospitals.ResultsData relating to participants’ age, ethnic group and health status were well collected and no upper age limit was specified in any trials’ eligibility criteria. 23/30 (77%) information sheets used at least one gendered term to address patients. Most CRFs did not specify whether they were collecting sex or gender and only included male or female categories. The median reading age for information sheets was 15–16 years (IQR: 14–15 – 16–17). Socio-economic factors were not routinely collected and not commonly mentioned in trial protocols.ConclusionsNo systemic issues were identified in protocols which would explicitly prevent any under-served group from participating. Areas for improvement include reducing use of gendered words and improving readability of patient information. The challenge of fully assessing adequate inclusion of under-served populations remains, as socio-economic factors are not routinely collected because they fall beyond the data generally required for protocol-specified trial endpoint assessments. This audit has highlighted the need to agree and standardise demographic data collection to permit adequate monitoring of the under-served groups identified by the NIHR. (shrink)

This is a paper based on research with the LGBTIQ+ community in South Australia, the likes of which has not been conducted previously in the state. The paper, which utilized both quantitative and qualitative research methods identifies the key issues that the LGBTIQ+ community face with respect to sporting involvement. There were a range of themes that emerged in relation to a variety of topics including homophobia, sexism and gender discrimination, gender roles and gender stereotypes. This paper provides data and (...) discussion around this important part of the research, which has implications pertaining to sporting organizations and the LGBTIQ+ community. (shrink)

In Belief, Inference, and the Self-Conscious Mind (BISCM), Eric Marcus analyses and responds to a core set of puzzles concerning belief and inference. Most centrally on offer are: an explanation of non-evidential/non-observational doxastic self-knowledge, an explanation of the unintelligibility of Moore-Paradoxical statements, an account of inference (built on an interpretation of the ‘Taking Condition’) fit to solve the Lewis Carroll regress, and an account of what constitutes the unity of the rational mind. Marcus’ answers depend on viewing beliefs as (...) essentially self-known and expressible (through asserting their contents (“P”), or avowing them in a self-ascription (“I believe that P”)). Beliefs are also held to (metaphysically) necessarily exclude their contradictories, and (metaphysically) necessitate their implications. Or at least they do in their paradigm form; when they are ‘in mind’ (an important theoretical concept Marcus makes much use of throughout the book. In this paradigmatic form, Marcus terms them judgments. A significant achievement of BISCM is in how, despite the strength of these and other core commitments (theses variously acknowledged to be “very strong”, “wildly unpopular”, and “singularly anachronistic”, Marcus remains utterly clear-eyed about the need to pass the plausibility test. Nowhere, for example, does he lose sight of the fact that we are “distinctively liable to irrationality”, including to self-deception (which is analysed in terms of both belief and the doxastic self-knowledge which essentially accompanies it on Marcus’ view, being ‘out of mind’). A second, and related strength is in the connections Marcus traces between both expressive and rational mental capacities. This is relatively rare in many of the literatures Marcus is engaging with, especially in the first half of the book. Marcus (building on earlier work) shows how such a synthesis can bear serious fruit, not least in his excellent analysis of Moore-Paradoxical unintelligibility. There is a lot one could say about what is exciting and valuable about each element of Marcus’ discussion. And inevitably for a book so bold and full of riches, there is also a lot one might question about these elements. But as Marcus emphasises, what is on offer is “… not a collection of discrete solutions to putatively separate problems [but] a unified conception of the mind in its theoretical orientation”. And what I want to press him on is a big-picture question: what are the boundaries, and what is the internal structure, of the mind's ‘theoretical’ orientation? For, for all the important and detailed work throughout the book, in which a general conception of believing is suggested, tested, refined, and applied, I don't yet have a stable sense of Marcus’ answers to these questions. (shrink)

Lucy O'Brien argues that a satisfactory account of first-person reference and self-knowledge needs to concentrate on our nature as agents. Clearly written, with rigorous discussion of rival views, this book will be of interest to anyone working in the philosophy of mind and action.

The purpose of the study was to develop an understanding of how nursing students gained perspective on nursing care of diverse populations through watching documentaries in a cultural diversity course. The basis of this paper is our analyses of students’ written responses and reactions to documentaries viewed in class. The guiding theoretical frameworks for the course content and the study included postcolonial feminism, Foucauldian thought, and cultural safety. Krathwohl's Taxonomy of the Affective Domain was used to identify themes and determine (...) how undergraduate nursing students were progressing in achieving learning outcomes. Our findings suggest that while the use of documentaries serves as a tool for deepening students’ understanding of the realities of various populations, this activity, in the absence of critical reflection, may inadvertently promote stereotypes and further marginalize different people groups. Even though nursing students reflected on the importance of cultural safety in nursing, our findings indicate that their actions may not reflect this, especially since these students are in the early stages of the nursing program. Students need to be provided with a space where they can explore implicit biases evoked by exposure to new information about different people groups as a way of enhancing culturally safe care. (shrink)

At the time of writing there appear to have been no electronic submissions to the Journal of Medical Ethics. It seems appropriate, therefore, to begin electronic correspondence with a consideration of some of the ethical implications of this new form of ethical dialogue.I have posted this response to Kenneth Boyd’s editorial on Mrs Pretty and Ms B1 as this article may provoke debate far beyond the medical and ethical establishment. This issue may be of tremendous concern to patients or their (...) carers who are presently suffering in circumstances similar to those described.The electronic response forum of the BMJ has been in operation for over four years.2 An editorial in the BMJ on physician assisted suicide3 has attracted 125 responses at the time of writing. An important feature of electronic responses, particularly on items that generate a lot of debate, is that the …. (shrink)

In his new book, Lewis D. Sargentich shows how two different kinds of legal argument - rule-based reasoning and reasoning based on principles and policies - share a surprising kinship and serve the same aspiration. He starts with the study of the rule of law in life, a condition of law that serves liberty - here called liberal legality. In pursuit of liberal legality, courts work to uphold people's legal entitlements and to confer evenhanded legal justice. Judges try to (...) achieve the control of reason in law, which is manifest in law's coherence, and to avoid forms of arbitrariness, such as personal moral judgment. Sargentich offers a unified theory of the diverse ways of doing law, and shows that they all arise from the same root, which is a commitment to liberal legality. (shrink)

Reprint of the ed. published by Viking Press, New York.

Though explicit references to music are infrequent in Barthes's Collège de France lectures, Barthes's use of music in other work from the 1970s makes it clear that music can act as a fruitful analogy in consideration of the text. This article uses the serialist or atonal analogy, as set up by Barthes in ‘From Work to Text’ and elsewhere, to examine the structuring of Comment vivre ensemble and The Neutral. In viewing these courses as serial or open works we can, (...) it is hoped, arrive at a fuller understanding of their methodology and the role they ascribe to the listener or reader. The atonal analogy, however, is left behind in 1978, as Barthes's major projects employ more conventional, developmental structuring. It is here, then, that the analogy with tonality, again suggested by Barthes, can be usefully employed. (shrink)

The ‘new normality’ of food crises requires nuanced understandings of emergent responses. Through an exploratory analysis of public-facing reports from major food governance actors, this study empirically outlines mainstream solution frames for addressing the contemporary food crisis and the ways in which these differ from the 2008 food crisis. Using food regime theory as the theoretical underpinning, four con­sistently used solution frames are identified that provide insight into the organizing principles of the third food regime: promoting trade liberalization, emphasizing agricultural (...) productivism, mobilizing private finance, and leveraging data. The latter two involve recent shifts in governance responses that shape global food governance and impact global food insecurity in novel ways. (shrink)

Time in romantic philosophies of music.- Romanticism, as an intellectual movement, presupposes a new vision, one which we are still living off. This paper makes a critique of time in the music of the period, and in musical thought of the period (taking for granted that the music and the thought are eseentially related). In this context, the question is raised, what conception of time is to be found in the philosophers of the nineteenth and twentieth centuries? This leads on (...) to a study of time in music and in musical theory, especially in those of the nineteenth centuries. (shrink)

Studies of education and careers in science, technology, engineering, and math commonly use a pipeline metaphor to conceptualize forward movement and persistence. However, the “STEM pipeline” carries implicit assumptions regarding length, contents, and perceived purpose. Using the National Survey of College Graduates, we empirically measure each of these dimensions. First, we show that a majority of STEM workers report skills training throughout their careers, suggesting no clear demarcation between education and work. Second, we show that using on-the-job expertise requirements paints (...) a very different portrait of the STEM workforce—and persistence in it. Third, we show that STEM-educated workers are well-prepared for but dissatisfied with non-STEM jobs, complicating our understanding of leaving. Collectively, these results recommend expanded conceptions of STEM education and careers and contribute to studies of science and engineering workforce transitions and diversity. (shrink)

La préface des Principes oppose les quatre premiers degrés d'une sagesse empirique, fondée sur les notions communes, l'expérience sensible et la fréquentation d'autrui dans la conversation ou la lecture (IX, B, 5), à la morale la plus achevée qu'il situe ainsi au sommet du système : " Toute la philosophie est comme un arbre, dont les racines sont la métaphysique, le tronc est la physique et les branches qui sortent de ce tronc sont toutes les autres sciences, qui se réduisent (...) à trois principales, à savoir la médecine, la mécanique et la morale ; j'entends la plus haute et la plus parfaite morale, qui présupposant une entière connaissance des autres sciences, est le dernier degré de la sagesse. ". (shrink)

The most accessible, practical, and affordable introduction to ethical theory and moral reasoning.

Following Kenya’s independence in 1963, scientists converged on an ecologically sensitive area in southern Kenya on the northern slope of Mt. Kilimanjaro called Amboseli. This region is the homeland of the Ilkisongo Maasai who grazed this ecosystem along with the wildlife of interest to the scientists. Biologists saw opportunities to study this complex community, an environment rich in biological diversity. The Amboseli landscape proved to be fertile ground for testing new methods and lines of inquiry in the biological sciences that (...) were generalizable and important for shaping natural resource management policies in Kenya. However, the local community was in the midst of its own transformation from a primarily transhumant lifestyle to a largely sedentary one, a complex political situation between local and national authorities, and the introduction of a newly educated generation. This article examines the intersection of African history and field science through the post-colonial Africanization of Kenyan politics, the broadening of scientific practices in Amboseli in previously Western-occupied spaces to include Kenyan participants, and an increasing awareness of the role of local African contexts in the results, methods, and implications of biological research. “Africanization” as an idea in the history of science is multifaceted encompassing not just Africans in the scientific process, but it needs an examination of the larger political and social context on both a local and national level. (shrink)