BackgroundInvolvement of adolescent girls in biomedical HIV research is essential to better understand efficacy and safety of new prevention interventions in this key population at high risk of HIV infection. However, there are many ethical issues to consider prior to engaging them in pivotal biomedical research. In Uganda, 16–17-year-old adolescents can access sexual and reproductive health services including for HIV or other sexually transmitted infections, contraception, and antenatal care without parental consent. In contrast, participation in HIV prevention research involving investigational (...) new drugs requires adolescents to have parental or guardian consent. Thus, privacy and confidentiality concerns may deter adolescent participation. We describe community perspectives on ethical considerations for involving adolescent girls in the MTN 034 study in Uganda.MethodsFrom August 2017 to March 2018, we held five stakeholder engagement meetings in preparation for the MTN 034 study in Kampala, Uganda (NCT03593655): two with 140 community representatives, two with 125 adolescents, and one with 50 adolescents and parents. Discussions were moderated by the study team. Proceedings were documented by notetakers. Summary notes described community perspectives of adolescent participation in HIV research including convergent, divergent or minority views, challenges, and proposed solutions.ResultsMost community members perceived parental or guardian consent as a principal barrier to study participation due to concerns about adolescent disclosure of pre-marital sex, which is a cultural taboo. Of 125 adolescent participants, 119 (95%) feared inadvertent disclosure of sexual activity to their parents. Community stakeholders identified the following critical considerations for ethical involvement of adolescents in HIV biomedical research: (1) involving key stakeholders in recruitment, (2) ensuring confidentiality of sensitive information about adolescent sexual activity, (3) informing adolescents about information to be disclosed to parents or guardians, (4) offering youth friendly services by appropriately trained staff, and (5) partnering with community youth organizations to maximize recruitment and retention.ConclusionsStakeholder engagement with diverse community representatives prior to conducting adolescent HIV prevention research is critical to collectively shaping the research agenda, successfully recruiting and retaining adolescents in HIV clinical trials and identifying practical strategies to ensure high ethical standards during trial implementation. (shrink)

O relato de experiência a que este texto se refere provém do módulo intitulado Violência no Espaço Escolar, do Curso de Extensão em Gênero, Raça e Diversidade Sexual/ODEERE. A partir de temas que envolvem raça/etnia, gênero, e sexualidades, foram promovidos debates relacionados a preconceitos e discriminações que se manifestam no espaço escolar voltados para o racismo, sexismo e à homo-lesbo-bi-transfobia. O desenvolvimento da proposta didática pautou-se na abordagem qualitativa à luz da dialética, com o intuito de problematizar incômodos prescritos pelo (...) poder hegemônico e de pensar alternativas de mudanças para a promoção de uma convivência respeitosa primando pela valorização das diferenças. Palavras-chave: Violência. Escola. Diferenças. (shrink)

This paper analyses the role of foreign and local companies in shaping Brazilian positions on global sustainability. It deals with an empirical investigation of CSR practices of firms from the electronics, food, and personal care sectors in response to pressures of 'market' and 'non-market' stakeholders. The results demonstrate that CSR decisions by foreign and local firms are triggered by organisational considerations and anticipated economic gains. The degree of implementation of CSR activities by foreign firms is more advanced than that of (...) local firms. The survey also confirms the hypothesis that market stakeholders exert pressure on companies and positively influence CSR. Non-market stakeholders seem to have a minor effect on corporate social responsibility decisions. We conclude that the institutional environment is a critical determinant of the extent to which the dialogue between stakeholders and companies leads to the attainment of sustainable development. (shrink)

Verbal autopsy presents the opportunity to understand the disease burden in many low-income countries where vital registration systems are underdeveloped and most deaths occur in the community. Advances in technology have led to the development of software that can provide probable cause of death information in real time, and research considering the ethical implications of these advances is necessary to inform policy. Our research explores these ethical issues in rural Nepal using a public health ethics framework. We considered the burdens (...) and benefits of VA and giving cause of death information to families of the deceased through qualitative research with VA interviewers, community members, national policy stakeholders and international academics. Burdens can be experienced differently, and it is important to balance the emotional burden of VA with utilization of the data to inform planning and increased access to health services. The training, support and supervision of VA interviewers should be prioritized if VA is taken to scale. Initial and ongoing community engagement is recommended in addition to engaging ethical, legal, health and policy personnel in developing protocols and systems. Integrating rigorous research while cautiously moving forward is recommended to ensure systems and responses to concerns are relevant to contexts. (shrink)

There have been many efforts to infer causation from association byusing statistical models. Algorithms for automating this processare a more recent innovation. In Humphreys and Freedman[(1996) British Journal for the Philosophy of Science 47, 113–123] we showed that one such approach, by Spirtes et al., was fatally flawed. Here we put our arguments in a broader context and reply to Korb and Wallace [(1997) British Journal for thePhilosophy of Science 48, 543–553] and to Spirtes et al.[(1997) British Journal for (...) the Philosophy of Science 48, 555–568]. Their arguments leave our position unchanged: claims to have developed a rigorous engine for inferring causation from association are premature at best, the theorems have no implications for samples of any realistic size, and the examples used to illustrate the algorithms are indicative of failure rather than success. The gap between association and causation has yet to be bridged. (shrink)

Os discursos da Biblioteconomia brasileira são objeto de estudo desta pesquisa, que se concentrou nos artigos publicados durante a década de 1980 na Revista de Biblioteconomia de Brasília. Essa revista, cujo primeiro número foi publicado em 1973, encerrou suas atividades em 2001 e teve como foco as áreas de Biblioteconomia, Ciência da Informação, Arquivologia e afins. Com a intenção de discutir sobre dois conceitos centrais da Biblioteconomia - o de biblioteca e o de bibliotecário - analisamos as produções que versavam (...) sobre tais categorias de análise. A pesquisa é, então, considerada exploratória, de cunho bibliográfico, cujo método empregado foi o da análise de conteúdo. Essa década foi marcada pela importância da informação e da tecnologia como fatores responsáveis pelo desenvolvimento social e econômico do país. A biblioteca, nesse contexto de uma sociedade da informação, é marcada pela discussão da automação de seus serviços e produtos. O bibliotecário, visto como um profissional da informação, também tem um importante papel a desempenhar na sociedade, inclusive, o de estar ao lado dos mais vulneráveis. (shrink)

Mindfulness-based interventions have proved effective in reducing various clinical symptoms and in improving general mental health and well-being. The investigation of the mechanisms of therapeutic change needs methods for assessment of mindfulness. Existing self-report measures have, however, been strongly criticized on various grounds, including distortion of the original concept, response bias, and other. We propose a psychophysiological method for the assessment of the mindfulness learned through time-limited mindfulness-based therapy by people who undergo meditation training for the first time. We use (...) the individual pre-post-therapy changes (dERPi) in the event-related brain potentials (ERPs) recorded in a passive meditation task as a measure of increased mindfulness. dERPi is computed through multivariate assessment of individual participant's ERPs. We tested the proposed method in a group of about 70 recurrently depressed participants, randomly assigned in 1.7:1 ratio to mindfulness-based cognitive therapy (MBCT) or cognitive therapy (CT). The therapy outcome was measured by the long-term change (dDS) relative to baseline in the depression symptoms (DS) assessed weekly, for 60 weeks, by an online self-report questionnaire. We found a strong, highly significant, negative correlation (r = -0.55) between dERPi (mean = 0.4) and dDS (mean = -0.7) in the MBCT group. Compared to this result, the relationship between dDS and the other (self-report) measures of mindfulness we used was substantially weaker and not significant. So was also the relationship between dERPi and dDS in the CT group. The interpretation of dERPi as a measure of increased mindfulness was further supported by positive correlations between dERPi and the other measures of mindfulness. In this study, we also replicated a previous result, namely, the increase (dLCNV) of the late contingent negative variation (LCNV) of the ERP in the MBCT group, but not in the control group (in this case, CT). We interpreted dLCNV as a measure of increased meditative concentration. The relationship between dLCNV and dDS was, however, very week, which suggests that concentration might be relatively unimportant for the therapeutic effect of mindfulness. The proposed psychophysiological method could become an important component of a "mindfulness test battery" together with self-report questionnaires and other newly developed instruments. (shrink)

The intention of the present paper is to resettle the importance of the Comte’s thought to the philosophy of science. To do so, we discard certain prejudices about positivism and reassess certain comtean’s concepts, such as the three states law, the science’s classification and the role of hypotheses in order to restore its relevance in the background of the history of the philosophy.

This issue of Itinera aims to address the connections between architecture and the performing arts in its various aspects and from multiple points of view. The growing emphasis on the performative character of artistic practices, namely, their ability to involve spectators directly and pervasively (Dixon 2007), imbues the relationship between architecture, the performing arts, and the spectator’s experience. The sharing of the scenic space by spectators and performers is essential for the co-production of a common energy which operates as a (...) “transforming force” and thereby opens up the shared experience of discovering oneself and the other as a union of the body and the mind (Fischer-Lichte 2004). (shrink)

ObjectivesTo measure general psychopathology in dermatologic outpatients using the Symptom-Checklist-K-9 ; to investigate whether the SCL-K-9 is able to categorize patients with and without significant non-psychotic disorders; and to perform a single-item analysis of the SCL-K-9, with a focus on gender differences.MethodsCross-sectional study on consecutive dermatological patients. We used two self-administered questionnaires to assess general psychopathology symptoms: General Health Questionnaire-12 and SCL-K-9. Sociodemographic information was collected with standardized forms. The performance of the SCL-K-9 in classifying patients according to their current (...) emotional distress severity was assessed using a ROC procedure. Finally, we measured differences in scores obtained among women and men in SCL-K-9 single items.ResultsA total of 292 patients were studied. We observed statistically significant differences in SCL-K-9 total mean scores and in most single items among genders. We found that it would be more appropriate to use gender-specific cut-offs when using SCL-K-9 to screen dermatological patients for general psychopathology.ConclusionThe SCL-K-9, with its compact format could provide, in a short time, a wide range of information related to critical areas that challenge the mental health of patients with skin diseases. (shrink)

Placebo-controlled trials are held by many, including regulators at agencies like the United States Food and Drug Administration, to be the gold standard in the assessment of new medical interventions. Yet the use of placebo controls in clinical trials has been the focus of considerable controversy. In this two-part article, we challenge a number of common beliefs concerning the value of placebo controls. Part I critiques statistical and other scientific justifications for the use of placebo controls in clinical research. The (...) continued use of placebo controls in clinical trials on diseases for which accepted treatment exists raises equally important ethical, legal, and regulatory issues for which various justifications have been given. Defense of this practice relies on normative as well as empirical myths.In their attack on the prevailing use of placebo controls, Kenneth Rothman and Karin Michels emphasize that this practice stands in violation of the World Medical Association's guidelines on the ethics of human experimentation, most commonly known as the Helsinki Declaration. (shrink)

In summary, the usual elements of a typical health care ethics consultation note might reasonably accommodate the needs and expectations of relevant parties, and would therefore include: 1. identification of the relevant ethical issues, questions, or dilemmas; 2. reference to any relevant facts--medical, nursing, social, psychological, spiritual, legal, political, etc.; 3. a prioritized list of recommendations to improve coordinated care; 4. a clear and concise articulation of relevant arguments, wtih specific reference to the list of recommendations as well as to (...) the institution's overall ethos; 5. a contextual statement, identifying the perceived degree of consensus or support for the recommendations and conclusions, as well as any inherent agendas. (shrink)

This essay explores the epistemological significance of the kinds of beliefs that grow out of traumatic experiences, such as the rape survivor's belief that she is never safe. On current theories of justification, beliefs like this one are generally dismissed due to either insufficient evidence or insufficient propositional content. Here, Freedman distinguishes two discrete sides of the aftermath of psychic trauma, the shattered self and the shattered worldview. This move enables us to see these beliefs as beliefs; in other (...) words, as having cognitive content. Freedman argues that what we then need is a theory of justification that allows us to handpick reliable sources of information on sexual violence, and give credibility where deemed appropriate. She advances a mix of reliabilism and coherentism that privileges feminism. On this account, the evidence for the class of beliefs in question will depend on an act of sexual violence (or testimony, or statistics) to the extent that the act is a reliable indication of the prevalence of sexual violence against women. (shrink)

Over the past two decades the growth of the organic sector has been accompanied by a shift away from first party, or peer review, systems of certification and towards third party certification, in which a disinterested party is responsible for the development of organic standards and the verification of producer compliance. This paper explores some of the limitations of the third party certification model and presents the case of Mexico as an example of how an alternative form of participatory certification (...) has emerged. The paper suggests that participatory guarantee systems (PGS) are reflective of the growing “beyond organic” movement, which focuses on reconstructing the local and re-embedding food systems into their socio-ecological contexts. It argues that PGS offers a number of benefits for producers and consumers, particularly in the South, but that it faces a number of challenges as well, such as a lack of formal recognition, social conflicts and dependence on donated resources. (shrink)

Prologue -- Paris, August 1, 1990 -- What happened next -- Live in it -- Africa, 2008 -- Paris, revisited.

The use of statistics in medical research has been compared to a religion: it has its high priests, supplicants, and orthodoxy. Although the comparison may be more unfair to religion than to research, a useful lesson can nonetheless be drawn: the practice of clinical research may benefit—as does the spirit—from critical self-examination. Arguably, no aspect of the conduct of clinical trials is currently more controversial—and thus in as dire need of critical examination—than the use of placebo controls. The ethical and (...) scientific controversies associated with placebo-controlled trials, never far below the surface, have once again seized public attention. Clearly, concern about these issues within the professional community runs deep and wide, as evidenced by the volume of response generated by Kenneth Rothman and Karin Michels's recent Critique. Criticisms of the use of placebo controls in clinical research are scattered through the literatureo; our objective is to present the case against placebos in a compendious form that takes account of scientific and statistical as well as normative issues. (shrink)

Duty and Healing positions ethical issues commonly encountered in clinical situations within Jewish law. The concept of duty is significant in exploring bioethical issues, and this book presents an authentic and non-parochial Jewish approach to bioethics, while it includes critiques of both current secular and Jewish literatures. Among the issues the book explores are the role of family in medical decision-making, the question of informed consent as a personal religious duty, and the responsibilities of caretakers. The exploration of contemporary ethical (...) problems in healthcare through the lens of traditional sources in Jewish law is an indispensable guide of moral knowledge. (shrink)

Motivated ignorance is an incentivized absence of knowledge that arises in circumstances of unequal power relations, a self-protective non-knowing which frees individuals from having to reflect on the privileges they have in virtue of membership in a dominant social group. In philosophical discussions, the term “motivated ignorance” gets used interchangeably with “willful ignorance.” In the first half of this paper, using Charles Mills’ (2007) white ignorance as the defining case, I argue that this is a mistake. A significant swath of (...) cases of motivated ignorance are non-willful, or deep, following Rik Peels (2010). But in all cases, benefits accrued to some in virtue of their social position are gained and maintained at the expense of harms to others. In the second half of this paper, I argue that these harms are what ground attributions of culpability in cases of motivated ignorance and drive the normative requirement that the subject know better, so long as the facts in question are ordinarily and easily knowable (in a sense to be specified). Willfulness is not a necessary condition for culpability, even if it is a sufficient one. (shrink)

Advances in neuroscience research have changed the ways in which the relationship between brain and behavior are studied and conceptualized. These advances are important and suggest the possibility of new approaches to helping people with neurological and psychiatric illnesses, but they also bring with them the risk of applying supposed breakthroughs without acknowledgment of the limits and assumptions which underlie the research. As neuroscience is increasingly used to, or proposed as, a means of controlling behavior, through criminal and civil legal (...) systems, researchers have an obligation to articulate the assumptions, limits, and ecological validity of their findings. Yet, neuroscience researchers rarely describe the assumptions underlying the studies, the generalizability of the findings and most importantly, the limits of its applicability to real world behavior. (shrink)

Monogenesis of language is widely accepted, but the conventional argument seems to be mistaken; a simple probabilistic model shows that polygenesis is likely. Other prehistoric inventions are discussed, as are problems in tracing linguistic lineages. Language is a system of representations; within such a system, words can evoke complex and systematic responses. Along with its social functions, language is important to humans as a mental instrument. Indeed, the invention of language,that is the accumulation of symbols to represent emotions, objects, and (...) acts may be the most important event in human evolution, because so many developments follow from it. For example, Edward Sapir speculated that some embryonic form of language must have been available to early man to help him fashion tools from stone (Sapir,1921). Sophisticated biface stone tools date to early Homo erectus some 1.5 million years ago, suggesting a similar age for language. This paper considers whether the invention of language occurred at only one pre-historic site or at several sites. In other words, did language emerge by monogenesis or polygenesis? Early thinkers believed in monogenesis, against a background of divine creation. Perhaps the best known account is the biblical story of Adam giving names to plants and animals in the Garden of Eden. Similar legends are found among many peoples. Modern linguists too assume monogenesis, but on probabilistic grounds (see, for instance, Southworth and Daswani, 1974, p.314). The argument seems to be that the invention of language is an extremely unlikely event, because symbolization involves abstraction and requires synchronized insight by several individuals; therefore, the probability of occurrence at more than one site must be vanishingly small. We have found no explicit quantitative treatment of this question in the literature, but the underlying logic has to be the multiplication of probabilities. If p is small at one site,then p.p for two sites is smaller still, and so on. This reasoning is false, as we show here. The fallacy lies in the focus on two particular sites rather than consideration of all pairs of sites. (shrink)

What does it mean to get hooked by a work, whether a bestseller or a classic, a TV series or a painting in a museum? What is this aesthetic experience that makes us feel captivated? What do works of art do, and how, in particular, do they bind us to them? In "Hooked," Rita Felski builds an aesthetics premised on our attachments rather than our free agency and challenges the ethos of critical aloofness that is so much a part (...) of modern intellectuals' self-image. The result is sure to be as widely read, and as controversial, as Felski's 2015 book, "The Limits of Critique." Felski looks at several "attachment devices." One of these is "attunement"--those affinities and stirrings that often fall below the threshold of consciousness. Why, for example, are we drawn to a painting or piece of music in ways we struggle to explain, while being left cold by others whose merits we duly acknowledge? Another attachment device is "identification"--a widespread response to fiction that is often invoked by critics but usually treated as synonymous with either identity or empathy. But Felski shows that identifying has no neat fit with identity categories, and it can trigger ethical, political, or intellectual affinities that have little to do with co-feeling. What people most commonly identify with, Felski argues, are characters who are alluring, arresting, or alive, not in spite of their aesthetic qualities but because of them. This kind of identification is not limited to naïve readers or over-invested viewers, but is also a defining aspect of what scholars in the humanities do. Relatedly, academic "interpretation" emerges here as another circuit of connection: critics forge ties to the works they explicate, the methods they use, the disciplinary identities they inhabit. "Hooked" returns us to the fundamentals of aesthetic experience, showing that the social meanings of artworks do not lie encrypted in their depths, within reach only of expert critics, but are generated within the embrace of captivated audiences. (shrink)

In their well-known paper, John Gardner and Stephen Shute (2000) propose a pure case of rape, in which a woman is raped while unconscious and the rape, for a variety of stipulated reasons, never comes to light. This makes the pure case a harmless case of rape, or so they argue. In this paper I show that their argument hinges on an outdated conception of trauma, one which conflates evaluative responses that arise in the aftermath of rape with the non-deliberative (...) somatic responses of a central nervous system to a threatening event. In the first part of this paper, I elaborate this objection by drawing on the neurobiological model of trauma. This gives me an opportunity to illustrate the different ways that rape harms its victims, including the central way, what I call ‘threat-circuitry harm.’ This discussion of trauma invites us to rethink the wrong of rape, and sets the groundwork for my argument, in the second part of the paper, that the wrong of rape consists in its central harm. (shrink)

The purpose of this study was to illuminate the ethically difficult situations experienced by care providers working in a nursing home. Individual interviews using a narrative approach were conducted. A phenomenological-hermeneutic method developed for researching life experience was applied in the analysis. The findings showed that care providers experience ethical challenges in their everyday work. The informants in this study found the balance between the ideal, autonomy and dignity to be a daily problem. They defined the culture they work in (...) as not supportive. They also thought they were not being seen and heard in situations where they disagree with the basic values of the organization. The results are discussed in terms of Habermas’s understanding of modern society. Care settings for elderly people obviously present ethical challenges, particularly in the case of those suffering from dementia. The care provider participants in this study expressed frustration and feelings of powerlessness. It is possible to understand their experiences in terms of Habermas’s theory of modern society and the concept of the system’s colonization of the life world. (shrink)

"This edited collection is the result of a workshop organised in March 2014 at the University of Birmingham's Institute for Advanced Studies, entitled: Hybridity: Exploring Power, Social Structures, and Institutions Beyond the Liberal West.--ECIP introduction.

(1984). Lawyer‐client confidences under the A.B.A. model rules: Ethical rules without ethical reason. Criminal Justice Ethics: Vol. 3, No. 2, pp. 3-8.

Rita Carter ponders the nature, origins, and purpose of consciousness in this fascinating inquiry into the toughest problem facing modern science and philosophy. Building on the foundation of her bestselling book _Mapping the Mind, _she considers whether consciousness is merely an illusion, a by-product of our brain's workings, some as yet inexplicable feature or property of the material universe or—as the latest physics may suggest—the very fundament of reality. Little, she discovers, is as it first seems. Carter draws from (...) a solid body of knowledge—empirical findings and theoretical hypotheses--about consciousness, much of it derived from recent discoveries about the brain. Her lively, accessible narrative ranges widely over new ways of thinking about the subject and what direction new research is taking. Leading scholars from a range of perspectives provide topical essays that complement Carter's account. The book also discusses how traditional approaches—philosophical, scientific, and experiential—might be brought together to create a more complete understanding of consciousness. (shrink)