Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

This is a fascinating book. It uses tuberculosis to look at the balance between individual liberty and the public good: the tensions created between personal liberty and social responsibility, a strong theme in all work in public health. The context is New York in the 1990s, but as Coker states, “This book uses the lens of tuberculosis control, and in particular the detention of non-infectious individuals, to examine America's response to its most vulnerable and marginalised citizens, and asks the question: (...) `is detention of non-infectious, non-compliant individuals right from ethical, legal, and public health perspectives'”. The book is divided into nine chapters. It …. (shrink)

Timothy Williamson, in various places, has put forward an argument that is supposed to show that denying bivalence is absurd. This paper is an examination of the logical force of this argument, which is found wanting.

Forbidden areas, i.e. areas (sites, cities, countries) that are inaccessible for topographical reasons or especially because of decisions based on political, religious, or other motivations are usually surrounded by an aura of mystery and almost necessarily arouse curiosity. The dream of generations of explorers was to reach Lhasa. An area can be closed not only to outsiders but also to “insiders:” nobody is allowed to leave for the “outside.” The isolation imposed on Japan by the Tokugawa regime was such a (...) two-way seclusion aided, of course, by geographical conditions and hence easily enforceable. It has been suggested, perhaps not quite seriously, that the famous Chinese wall was meant not only to keep out barbarian invaders, but also to prevent Chinese from leaving. That there was some kind of border control is also suggested by the leger, according to which Lao-tse, before disappearing into the west, committed his teaching, the Tao-te-kinq, to writing at the request of the “gatekeeper.” One may well wonder whether there exists another equally influential text written at the behest of a border policeman! (shrink)

The problems and the history of contacts between distant continents in bygone ages and long before the age of fast and easy travel, have always fascinated both professional scholars and the interested public. Was ancient history really nothing but the history of co-existing and isolated geographic, cultural and political “islands?” Already at school we learned too much about migrations of peoples, economic contacts, influences on art styles, conquests, and the rise, expansion and fall of empires to believe that. The (highly (...) improbable) theory that certain archaeological finds in America suggest, or even prove, Mediterranean influence (e.g., the arrival of Phoenician ships), or the alleged Viking discovery of America centuries before Columbus, or Thor Heyerdahl's adventurous journey to prove South American influence on remote Pacific islands did not fail to cause widespread interest and even excitement (although many scholars still feel that Heyerdahl's epic adventure, thrilling as it is, failed to prove what it set out to prove). The island of Madagascar is pretty close to the African continent, but its language exhibits more points of contact with Polynesian than with African tongues. And the blow-bellows used by Malagache smiths are similar to those used in Malaysia and unlike those known to African metalworkers. Clearly the Polynesians, those great ancient mariners, sailed further than originally seemed likely. Musicologists studying the cantillation of the Hebrew Bible in the liturgy of the ancient Jewish communities on the Malabar coast in India discovered to their surprise that it was similar to the cantillation not of the Babylonian but of the Yemenite Jews! This surprise was, of course, no surprise to those who knew anything about trade-winds and shipping routes between South Arabia and the Indian coast. Historians of religion, even more than general historians, studying the spread and expansion of religious ideas and movements have realised long ago that the beginning of all wisdom is a basic knowledge of economic geography. (shrink)

R J Royce; School-based Punishment, Journal of Philosophy of Education, Volume 18, Issue 1, 30 May 2006, Pages 85–95, https://doi.org/10.1111/j.1467-9752.1984.t.

R. J. Hankinson traces the history of ancient Greek thinking about causation and explanation, from its earliest beginnings through more than a thousand years to the middle of the first millennium of the Christian era. He examines ways in which the Ancient Greeks dealt with questions about how and why things happen as and when they do, about the basic constitution and structure of things, about function and purpose, laws of nature, chance, coincidence, and responsibility.

R. J. Butler; VIII*—Substance Un-Locked, Proceedings of the Aristotelian Society, Volume 74, Issue 1, 1 June 1974, Pages 131–160, https://doi.org/10.1093/aristo.