Background In earlier work, we found important selection biases when we tried to obtain consent for participation in a national stroke registry. Recognizing that not all registries will be exempt from requiring consent for participation, we examine here in greater depth the reasons for the poor accrual of patients from a systems perspective with a view to obtaining as representative sample as possible. Methods We determined the percent of eligible patients who were approached to participate and, among those approached, the (...) percent who actually consented to participate. In addition we examined the reasons why people were not approached or did not consent and the variation across sites in the percent of patients approached and consented. We also considered site variation in restrictions on the accrual and data collection process imposed by either the local research ethics board or the hospital. Results Seventy percent of stroke patients were approached, with wide variations in approach rates across sites (from: 41% to 86%), and considerable inter-site variation in hospital policies governing patient accrual. Chief reasons for not approaching were discharge or death before being approached for consent. Seventeen percent of those approached refused to participate (range: 5% to 75%). Finally, 11% of those approached did not participate due to language or communication difficulties. Conclusion We found wide variation in approach and agree rates across sites that were accounted for, in part, by different approaches to accrual and idiosyncratic policies of the hospitals. This wide variation in approach and agree rates raises important challenges for research ethics boards and data protection authorities in determining when to waive consent requirements, when to press for increased quality control, when to permit local adaptation of the consent process, and when to permit alternatives to individual express consent. We offer several suggestions for those registries that require consent for participation. (shrink)

It describes and explains the patient-centered model examining and evaluating qualitative and quantitative research. It comprehensively covers the evolution and the six interactive components of the patient-centered clinical method, taking the reader through the relationships between the patient and doctor and the patient and clinician. All the editors are professors in the Department of Family Medicine at the University of Western Ontario, London, Canada.

Moira Howes and Catherine Hundleby ABSTRACT: While anger can derail argumentation, it can also help arguers and audiences to reason together in argumentation. Anger can provide information about premises, biases, goals, discussants, and depth of disagreement that people might otherwise fail to recognize or prematurely dismiss. Anger can also enhance the salience of certain premises...

It has typically been assumed that affective and social components of disagreement, such as trust and fair treatment, can be handled separately from substantive components, such as beliefs and logical principles. This has freed us to count as “deep” disagreements only those which persist even between people who have no animosity towards each other, feel equal to one another, and are willing to argue indefinitely in search of truth. A reliance on such ideal participants diverts us from the question of (...) whether we have swept away the opportunity for some real arguers to have their voices heard, and for those voices to determine the real substance of the disagreement. If affective and social issues need to be assessed side by side with belief differences and reasoning paradigms, investigating trust may assist us to understand and make progress on the affective and social components that are involved in disagreement. (shrink)

Moira Gatens investigates the ways in which differently sexed bodies can occupy the same social or political space. Representations of sexual difference have unacknowledged philosophical roots which cannot be dismissed as a superficial bias on the part of the philosopher, nor removed without destroying the coherence of the philosophical system concerned. The deep structural bias against women extends beyond metaphysics and its effects are felt in epistemology, moral, social and political theory. The idea of sexual difference is contextualised in (...) _Imaginary Bodies_ and traced through the history of philosophy. Using her work on Spinoza, Gatens develops alternative conceptions of power, new ways of conceiving women's embodiment and their legal, political and ethical status. (shrink)

Why would the work of the 17th century philosopher Benedict de Spinoza concern us today? How can Spinoza shed any light on contemporary thought? In this intriguing book, Moira Gatens and Genevieve Lloyd show us that in spite of or rather because of Spinoza's apparent strangeness, his philosophy can be a rich resource for cultural self-understanding in the present. _Collective Imaginings_ draws on recent re-assessments of the philosophy of Spinoza to develop new ways of conceptualising issues of freedom and (...) difference. This ground-breaking study will be invaluable reading to anyone wishing to gain a fresh perspective on Spinoza's thought. (shrink)

Parental burnout is a specific syndrome resulting from enduring exposure to chronic parenting stress. But why do some parents burn out while others, facing the same stressors, do not? The main aim of this paper was to propose a theory of parental burnout capable of predicting who is at risk of burnout, explaining why a particular parent burned out and why at that specific point in time, and providing directions for intervention. The secondary goal was to operationalize this theory in (...) a tool that would be easy to use for both researchers and clinicians. The results of this two-wave longitudinal study conducted on 923 parents suggest that the Balance between Risks and Resources (BR 2 ) theory proposed here is a relevant framework to predict and explain parental burnout. More specifically, the results show that (1) the BR 2 instrument reliably measures parents' balance between risks (parental stress-enhancing factors) and resources (parental stress-alleviating factors), (2) there is a strong linear relationship between BR 2 score and parental burnout, (3) parental burnout results from a chronic imbalance of risks over resources, (4) BR 2 predicts parental burnout better than job burnout and (5) among the risk and resource factors measured in BR 2, risks and resources non-specific to parenting (e.g., low stress-management abilities, perfectionism) equally predict parental and job burnout, while risks and resources specific to parenting (e.g., childrearing practices, coparenting) uniquely predict parental burnout. (shrink)

Clarke, Moira On the East coast of America, every 13 or 17 years, billions of red-eyed magicicadas emerge from underground. For the next few weeks every tree resounds with a near-deafening symphony, a courting ritual that has been measured at 94 decibels. Finally, the resulting offspring burrow back into the earth, there to remain inactive for the exact same duration, 13 or 17 years.

In this paper, I argue that the objectivity of persons is best understood in terms of intellectual virtue, the telos of which is an enduring commitment to salient and accurate information about reality. On this view, an objective reasoner is one we can trust to manage her perspectives, beliefs, emotions, biases, and responses to evidence in an intellectually virtuous manner. We can be confident that she will exercise intellectual carefulness, openmindedness, fairmindedness, curiosity, and other intellectual virtues in her reasoning. I (...) argue further that the cultivation and exercise of such virtues is a social phenomenon and thus challenge highly individualistic notions of intellectual character, epistemic autonomy, and personal objectivity. An advantage of this account of objectivity is that it better enables us to address bias in scientific research, science policy, and public debates about science. (shrink)

What language devises, it might divide. By exploring the relations among the core geometries of the physical world, the abstract geometry of Euclid, and language, I give new insight into both the persistence of core knowledge into adulthood and our access to it through language. My extension of Spelke's language argument has implications for pedagogy, philosophy, and artificial intelligence.

Sets out Catholic teaching on hotly debated issues such as stem cell research, reproductive technologies, euthanasia and much more.

This article focuses on documentary narration in literary prose, which is analyzed with regard to its function and poetics using the example of selected texts of GDR protocol literature and German documentary literature of the post-reunification years. The question of what constitutes the peculiarity of documentary literature and what caused its popularity in the pre- and post-reunification period will be explored. Furthermore, selected examples will be used to illustrate how the levels of the factual and the fictional intermingle and complement (...) each other in the individual texts. The texts discussed in this article are narratives that remain close to factual events, but at the same time fictionalize them and therefore cannot be considered completely and unambiguously in either the category of literary fiction or documentary. (shrink)

When people argue, they are vulnerable to unwanted and costly changes in their beliefs. This vulnerability motivates the position that belief involuntarism makes argument inherently adversarial, as well as the development of alternatives to adversarial argumentation such as “invitational rhetoric”. The emphasis on involuntary belief change in such accounts, in our perspective, neglects three dimensions of arguing: the diversity of arguer intentions, audience agency, and the benefits of belief change. The complex impact of arguments on both audiences and arguers involves (...) vulnerabilities related to various forces of argument, not just the intellectual force of premise-conclusion complexes. Shifting emphasis from adversariality to vulnerability, we propose a more holistic understanding of argument, in which vulnerability reveals various sources of strength and opportunity in addition to risk. (shrink)

This extremely accessible textbook provides a wide-ranging analysis of the relations between philosophy and feminist thought. Examining not only feminist critiques of philosophical ideas, Gatens also looks at the ways in which feminist theory can be informed by philosophical analysis and debates. Gatens adopts an historical approach, beginning with an analysis of Mary Wollstonecraft's critique of Rousseau. She then examines attempts by Harriet Taylor and J. S. Mill to extend liberal principles to women's situation. Other chapters discuss the work of (...) more recent philosophers, including Simone de Beauvoir, Luce Irigaray, Mary Daly and Dale Spender. Gatens concludes with a discussion of current debates in the politics of sexual difference. (shrink)

Aristotle's Conception of Freedom MOIRA M. WALSH That human being is free, we say, who exists for his own sake and not for another's. ' 1. INTRODUCTION THERE IS NO PLACE in the Nicomachean Ethics, or the Politics, where Aristotle provides us with an explicit definition of freedom. Nevertheless, it is possible to glean Aristotle's notion of freedom from a series of passages in the Politics, in which Aristotle discusses such matters as the existence of the natural slave, and (...) the understanding of freedom underlying certain forms of democracy. This effort is useful insofar as it not only helps us to understand Aristotle, but also presents us with a conception of freedom interestingly different from many contemporary versions and perhaps worth our consideration. ~ The reader will notice that I deliberately retain, for the most part, the generic use of 'man' and of masculine pronouns in translating and commenting on Aristotle, a practice which cannot go without explanation in this day and age. Such terms in English convey just the same ambiguity as Aristode's Greek does when, for instance, he uses the masculine adjectives eleutheros or agathos as generic terms -- that is, they leave the reader uncertain as to whether women are considered capable of freedom or goodness in the same way that men are, with the suspicion that they are not. I do not share the opinion, apparently held by Aristotle, that members of my gender are.. (shrink)

For individuals pursuing medically assisted gender transition, gender-affirming surgical treatments, such as oophorectomy (removal of the ovaries) and orchiectomy (removal of the testicles), cause sterility, and gender-affirming hormone treatment with medications (i.e., testosterone and estrogen) may negatively impact infertility. The major United States (US) medical associations already endorse fertility preservation (FP) through cryopreservation (i.e., “freezing” egg and sperm) for transgender individuals. Despite these endorsements from the relevant medical societies, medical insurance coverage for FP remains very limited in the US. Given (...) the high out-of-pocket costs for FP services, fertility preservation remains financially out of reach for many transgender individuals who may desire it. We present an ethical justification for universal FP coverage for all transgender and gender diverse (TGD) individuals who request this option during medically assisted gender transition. First, we argue that gender-affirming medical care is analogous to other medical interventions and treatment regimens that compromise fertility, such as cancer care, and that both types of interventions need to be afforded the same medical benefits and assistance in pursuing fertility goals. Second, we argue that the lack of FP for transgender individuals contributes to the ongoing and profound transphobia and anti-trans bias that has been exacerbated in the past several years across the healthcare landscape in the United States. We argue that the provision of FP coverage for transgender individuals is necessary for clinicians and third-party payers to state their unequivocal support for TGD patients and their healthcare needs. (shrink)

Feminist critiques of science show that systematic biases strongly influence what scientific communities find salient. Features of reality relevant to women, for instance, may be under-appreciated or disregarded because of bias. Many feminist analyses of values in science identify problems with salience and suggest better epistemologies. But overlooked in such analyses are important discussions about intellectual virtues and the role they play in determining salience. Intellectual virtues influence what we should find salient. They do this in part by managing the (...) emotions, which are cognitively involved in what we actually do find salient. One reason intellectual virtues do not factor more strongly in feminist epistemology is the mistaken assumption that they could not serve as explicit epistemic community standards for scientific inquiry. There are good reasons, however, to think in terms of community intellectual virtue and consequently, to advance explicit public standards of intellectual virtue for scientific research. To show how explicit public standards for intellectual virtue might improve reasoning in biased conditions, I analyze a striking oversight in several evolutionary immunological hypotheses concerning women's reproduction and sexuality. I conclude that feminist epistemology would benefit from greater consideration of intellectual virtues, particularly in connection with social epistemological insights. (shrink)

With rapidly expanding technological capacity, research has outpaced the existing infrastructure of ethical and regulatory guidance. In the area of incidental findings, this is particularly true.The regulations under which most Institutional Review Boards operate were established over 25 years ago and have not been substantially altered in the intervening years. The technology available today that creates the opportunity for IFs was not conceived of, or considered, in the crafting of those regulations. Therefore, little guidance can be derived directly from these (...) regulations. Rather, aspects of existing ethical guidance and regulations can be adapted to assist IRBs and researchers in dealing with issues surrounding IFs. (shrink)

The global education crisis is a complex problem that requires change from teachers, school managers, civil society, implementers, planners, governments and donors. Addressing the issues that lie beneath this crisis requires new ways of working. Systems thinking is a suite of approaches to grappling with complex problems that is beginning to gain traction in international education. This innovative book brings together new research in the nascent field of systems thinking in international education to exemplify how systems thinking offers the tools, (...) frameworks and concepts to improve outcomes in education systems. (shrink)

Spinoza took it to be an important psychological fact that belief cannot be compelled. At the same time, he was well aware of the compelling power that religious and political fictions can have on the formation of our beliefs. I argue that Spinoza allows that there are ‘good’ and ‘bad’ fictions. His complex account of the imagination and fiction, and their disabling or enabling roles in gaining knowledge of Nature, is a site of disagreement among commentators. The novels of George (...) Eliot (who translated Spinoza's works) represent a significant development for those who aim to resolve such disagreement in favour of the epistemic value of the imagination and fiction. Although Eliot agreed with Spinoza that belief cannot be compelled, she nevertheless affirmed the potential of certain kinds of fiction to be not only compelling but also edifying. The parallel reading of Eliot and Spinoza offered here raises the question of whether his philosophy can accommodate a theory of art in which the artist is seen to be capable of attaining and imparting dependable knowledge. (shrink)

Summarizes author’s contextual empiricism and uses it to analyze the difference between neuro-endocrinological accounts of presumed behavioral sex differences and neuro-selectionist accounts. Contextual empiricism is a philosophical approach that both shows how feminist critique works in the sciences and makes a contribution to general philosophy of science.