Patients have received experimental pharmaceuticals outside of clinical trials for decades. There are no industry-wide best practices, and many companies that have granted compassionate use, or ‘preapproval’, access to their investigational products have done so without fanfare and without divulging the process or grounds on which decisions were made. The number of compassionate use requests has increased over time. Driving the demand are new treatments for serious unmet medical needs; patient advocacy groups pressing for access to emerging treatments; internet platforms (...) enabling broad awareness of compelling cases or novel drugs and a lack of trust among some that the pharmaceutical industry and/or the FDA have patients’ best interests in mind. High-profile cases in the media have highlighted the gap between patient expectations for compassionate use and company utilisation of fair processes to adjudicate requests. With many pharmaceutical manufacturers, patient groups, healthcare providers and policy analysts unhappy with the inequities of the status quo, fairer and more ethical management of compassionate use requests was needed. This paper reports on a novel collaboration between a pharmaceutical company and an academic medical ethics department that led to the formation of the Compassionate Use Advisory Committee. Comprising medical experts, bioethicists and patient representatives, CompAC established an ethical framework for the allocation of a scarce investigational oncology agent to single patients requesting non-trial access. This is the first account of how the committee was formed and how it built an ethical framework and put it into practice. (shrink)

On March 11, 2020 the World Health Organization classified COVID‐19, caused by Sars‐CoV‐2, as a pandemic. Although not much was known about the new virus, the first outbreaks in China and Italy showed that potentially a large number of people worldwide could fall critically ill in a short period of time. A shortage of ventilators and intensive care resources was expected in many countries, leading to concerns about restrictions of medical care and preventable deaths. In order to be prepared for (...) this challenging situation, national triage guidance has been developed or adapted from former influenza pandemic guidelines in an increasing number of countries over the past few months. In this article, we provide a comparative analysis of triage recommendations from selected national and international professional societies, including Australia/New Zealand, Belgium, Canada, Germany, Great Britain, Italy, Pakistan, South Africa, Switzerland, the United States, and the International Society of Critical Care Medicine. We describe areas of consensus, including the importance of prognosis, patient will, transparency of the decision‐making process, and psychosocial support for staff, as well as the role of justice and benefit maximization as core principles. We then probe areas of disagreement, such as the role of survival versus outcome, long‐term versus short‐term prognosis, the use of age and comorbidities as triage criteria, priority groups and potential tiebreakers such as ‘lottery’ or ‘first come, first served’. Having explored a number of tensions in current guidance, we conclude with a suggestion for framework conditions that are clear, consistent and implementable. This analysis is intended to advance the ongoing debate regarding the fair allocation of limited resources and may be relevant for future policy‐making. (shrink)

This book addresses the effects of corruption in Nigeria and provides a concise overview for a lasting solution. Offering insight from the authors' original thinking and experiences, the book traces corruption from colonial rule through nearly fifty years of successive civilian and military government, counter coupes, and ethical reform programs.

In Spoils of War, a diverse group of distinguished contributors suggest that acts of aggression resulting from the racism and sexism inherent in social institutions can be viewed as a sort of "war," experienced daily by women of color.

We investigated the definition, prevalence, perceived prevalence and severity of, as well as justifications for and expected responses to, academic dishonesty at the graduate level in a sample of 246 graduate students, 49 faculty, and 20 administrators. Between 2.5% and 55.1% of students self-reported engaging in academically dishonest behaviors, depending on the nature of the behavior. Students and faculty rated 40 examples of academically dishonest behaviors similarly in terms of severity, but faculty tended to underestimate the prevalence of academic dishonesty. (...) Students and faculty also reported how they would idealistically and realistically expect themselves to respond to cheating situations. Students rated 21 behaviors in terms of their likeliness to increase or decrease academically dishonest behavior. Suggestions are given for developing a climate or culture of academic integrity to address academic dishonesty. (shrink)

The lack of gender parity in philosophy has garnered serious attention recently. Previous empirical work that aims to quantify what has come to be called “the gender gap” in philosophy focuses mainly on the absence of women in philosophy faculty and graduate programs. Our study looks at gender representation in philosophy among undergraduate students, undergraduate majors, graduate students, and faculty. Our findings are consistent with what other studies have found about women faculty in philosophy, but we were able to add (...) two pieces of new information. First, the biggest drop in the proportion of women in philosophy occurs between students enrolled in introductory philosophy classes and philosophy majors. Second, this drop is mitigated by the presence of more women philosophy faculty. (shrink)

We apply Benacerraf’s distinction between mathematical ontology and mathematical practice to examine contrasting interpretations of infinitesimal mathematics of the seventeenth and eighteenth century, in the work of Bos, Ferraro, Laugwitz, and others. We detect Weierstrass’s ghost behind some of the received historiography on Euler’s infinitesimal mathematics, as when Ferraro proposes to understand Euler in terms of a Weierstrassian notion of limit and Fraser declares classical analysis to be a “primary point of reference for understanding the eighteenth-century theories.” Meanwhile, scholars like (...) Bos and Laugwitz seek to explore Eulerian methodology, practice, and procedures in a way more faithful to Euler’s own. Euler’s use of infinite integers and the associated infinite products are analyzed in the context of his infinite product decomposition for the sine function. Euler’s principle of cancellation is compared to the Leibnizian transcendental law of homogeneity. The Leibnizian law of continuity similarly finds echoes in Euler. We argue that Ferraro’s assumption that Euler worked with a classical notion of quantity is symptomatic of a post-Weierstrassian placement of Euler in the Archimedean track for the development of analysis, as well as a blurring of the distinction between the dual tracks noted by Bos. Interpreting Euler in an Archimedean conceptual framework obscures important aspects of Euler’s work. Such a framework is profitably replaced by a syntactically more versatile modern infinitesimal framework that provides better proxies for his inferential moves. (shrink)

BackgroundIn Parkinson's disease, the side of motor symptoms onset may influence disease progression, with a faster motor symptom progression in patients with left side lateralization. Moreover, worse neuropsychological outcomes after subthalamic nucleus deep brain stimulation have been described in patients with predominantly left-sided motor symptoms. The objective of this study was to evaluate if the body side of motor symptoms onset may predict motor outcome of bilateral STN-DBS.MethodsThis retrospective study included all consecutive PD patients treated with bilateral STN-DBS at Grenoble (...) University Hospital from 1993 to 2015. Demographic, clinical and neuroimaging data were collected before and 1 year after surgery. The predictive factors of motor outcome at one-year follow-up, measured by the percentage change in the MDS-UPDRS-III score, were evaluated through univariate and multivariate linear regression analysis.ResultsA total of 233 patients were included with one-year follow-up after surgery [143 males ; 121 right body onset; 112 left body onset; mean age at surgery, 55.31 ± 8.44 years; mean disease duration, 11.61 ± 3.87]. Multivariate linear regression analysis showed that the left side of motor symptoms onset did not predict motor outcome.ConclusionsIn this retrospective study, the body side of motor symptoms onset did not significantly influence the one-year motor outcome in a large cohort of PD patients treated with bilateral STN-DBS. (shrink)

A criticism of some research involving Aboriginal people is that it is not equitable in its design or application, further disadvantaging the poor and marginalized. In Australia, much research has been done on Aboriginal people, but Aboriginal people themselves have benefited little, adding to distrust between Aboriginal and non-Aboriginal people over many years. Is it possible to take “scientific” research practices and transform them into research that can be done with a community rather than on a community? How can research (...) findings benefit Aboriginal people? This chapter shares our study of Aboriginal people’s stories of diabetes care. It is a collaborative story told by four Aboriginal Health Workers and two non-Aboriginal researchers which focuses on methodology rather than findings. We share aspects of our research which we propose values Aboriginal people and invites participation and reciprocity at design, data collection, and research translation stages. We discuss tensions which occur between the “scientific way” and the “culturally appropriate way” and describe how we resolved this. Imposing research designs and practices on Aboriginal people and communities without consideration that each community is unique has the potential to cause further harm and disempowerment. Valuing an Aboriginal way of knowing influenced all aspects of our study design and procedures. We would like to inspire others to challenge methodological norms to develop research methods with their community to allow the unique voice of their community to be heard and for this to facilitate pragmatic change leading to meaningful improvements in health. (shrink)

Moral or ethical questions are vital because they affect our daily lives: what is the best choice we can make, the best action to take in a given situation, and ultimately, the best way to live our lives? Health ethics has contributed to moving ethics toward a more experience-based and user-oriented theoretical and methodological stance but remains in our practice an incomplete lever for human development and flourishing. This context led us to envision and develop the stance of a “living (...) ethics”, described in this inaugural collective and programmatic paper as an effort to consolidate creative collaboration between a wide array of stakeholders. We engaged in a participatory discussion and collective writing process known as instrumentalist concept analysis. This process included initial local consultations, an exploratory literature review, the constitution of a working group of 21 co-authors, and 8 workshops supporting a collaborative thinking and writing process. First, a living ethics designates a stance attentive to human experience and the role played by morality in human existence. Second, a living ethics represents an ongoing effort to interrogate and scrutinize our moral experiences to facilitate adaptation of people and contexts. It promotes the active and inclusive engagement of both individuals and communities in envisioning and enacting scenarios which correspond to their flourishing as authentic ethical agents. Living ethics encourages meaningful participation of stakeholders because moral questions touch deeply upon who we are and who we want to be. We explain various aspects of a living ethics stance, including its theoretical, methodological, and practical implications as well as some barriers to its enactment based on the reflections resulting from the collaborative thinking and writing process. (shrink)

Cet article interroge l’originalité ludique du dispositif sociotechnique conçu par les réseaux socionumériques autour du profil pour organiser les différentes activités en ligne. Alors que les jeux constituent une des activités les plus prisées par les membres du réseau à laquelle ils consacrent un temps important, peu de recherches se sont focalisées sur l’analyse des activités ludiques sur les réseaux socionumériques. Par l’application de cadres conceptuels éprouvés pour analyser les jeux et activités ludiques, il est possible d’interroger la spécificité des (...) modalités de jeux qui sont proposées sur les réseaux socionumériques. Une analyse centrée sur les fonctionnalités offertes par Facebook conduit à interroger de façon critique la nature même de l’activité ludique menée dans le contexte particulier des réseaux socionumériques.This article looks into the distinctively “playful” nature of the socio-technical system that social networking sites construct around user profiles in order to organize different online activities. Although games some of the most popular activities among network members, to which they devote a considerable amount of time, there have been few analyses to date of game-playing on social networking sites. A number of proven conceptual frameworks can be used to analyze online games and game-playing and to examine the particular patterns found on the social networking sites. Based on an analysis of Facebook features, we offer an in-depth discussion of the nature of the game-playing that takes place in the particular context of social networking sites. (shrink)

_Changing the Subject_ is a classic critique of traditional psychology in which the foundations of critical and feminist psychology are laid down. Pioneering and foundational, it is still _the _groundbreaking text crucial to furthering the new psychology in both teaching and research. Now reissued with a new foreword describing the changes which have taken place over the last few years, _Changing the Subject _will continue to have a significant impact on thinking about psychology and social theory.

Cette contribution s’intéresse au statut de l’aidant dans l’accompagnement non professionnel de patients atteints de la maladie d’Alzheimer. Nous envisageons le rôle de la maladie et la fonction du proche impliqué dans une relation d’aide ainsi que leur construction sociale, politique et sanitaire à partir des sciences du langage. Il s’agit de contribuer complémentairement aux professionnels de santé, à la compréhension d’une problématique urgente, l’accompagnement de la fin de vie, par l’une de ses manifestations dans différents espaces discursifs. Nous définissons (...) d’abord la problématique de l’aidance pour étudier à l’interface d’une analyse sémantique de mots (Sémantique des possibles argumentatifs) et d’une analyse linguistique des discours comment les discours (dictionnairiques, juridiques et médiatiques) disent et construisent l’activité d’accompagnement du malade. Il s’agit de mieux comprendre comment les aidants vivent cette expérience dans leur relation au malade, aux instances impliquées dans l’aide et dans l’espace social proche ou éloigné. En questionnant ainsi ce que font les mots dans le vécu des acteurs, depuis le choix des dénominations imposées par les discours juridiques jusqu’aux stratégies pour parler de l’aidant dans les discours médiatiques, nous interrogeons également leur adéquation à la reconnaissance d’un rôle social désormais incontournable. (shrink)

How did the events of the early modern period affect the way gender and the self were represented? This collection of essays attempts to respond to this question by analysing a wide spectrum of cultural concerns - humanism, technology, science, law, anatomy, literacy, domesticity, colonialism, erotic practices, and the theatre - in order to delineate the history of subjectivity and its relationship with the postmodern fragmented subject. The scope of this analysis expands the terrain explored by feminist theory, while its (...) feminist focus reveals that the subject is always gendered - although the terms in which gender is conceived and represented change across history. Feminist Readings of Early Modern Culture not only explores the representation of gendered subjects, but in its commitment to balancing the productive tensions of methodological diversity, also speaks to contemporary challenges facing feminism. (shrink)

Religion is often understood to play a positive role in shaping moral attitudes among believers. We assessed the relationship between church members’ levels of felt connectedness to their respective congregations and perceived similarity in personal and congregational moral values, and whether there was a relationship between these and the amount of time spent in synchronous movement or singing during worship. The similarity between personal and perceived congregational moral importance was correlated with feelings of closeness to one’s congregation but not by (...) the amount of time spent in synchronous movement or singing. Differences in moral foundations scores and in moral importance of specific issues were found between different theological traditions. These findings demonstrate that, for churchgoers, there is a relationship between the use of music or synchronous movement in a church service and feelings of social bonding and there is also a relationship between the degree to which churchgoers identify with their church community and the degree to which they believe their priorities match those of their church. Furthermore, differences in theological tradition appear to be reflected in differences in moral values. (shrink)

Many contemporary thinkers of the Anthropocene, who attempt to articulate a non-modern and relational ontology, all too readily dismiss critical theory inherited from the Frankfurt School for being anthropocentric, failing to acknowledge certain basic similarities. Instead, this article argues that the scaffolding of Anthropocene thinking—the recognition of the origins of the contemporary condition of ‘loss of world’ and the hope of ‘living on in the ruins’—share much with earlier critical theorists’ recognition that the Holocaust necessitated a fundamental break with the (...) past. In reading these two sets of literatures together, we suggest we can get a better grasp of the stakes involved in the contemporary crisis of critique, and in the speculative framings enabling alternative futures to come into being. (shrink)

While positive information in the context of clinical care can lead to placebo effects, negatively framed information can have negative or nocebo effects. Extant literature documents how doctor–patient encounters are fertile ground for suboptimal interactions leading to negative experiences for ethnoracial minority patients. In their _JME_ paper, Blease presents a critical perspective on the potential for patients’ access to their doctors’ clinical notes, ‘open notes’, to engender nocebo effects. 1 In this commentary, we affirm the central claim that nocebo effects (...) could emerge ‘via negative wording or framing of health information expressed by clinicians in documentation’. The advent of electronic health records (EHR) allowed patients the unprecedented opportunity to access personal clinical documentation, giving them a window into decision making around their health. This shift is undoubtedly complex, and thus warrants a more fulsome rendering of the unique challenges faced by ethnoracial minority patients. Herein, we highlight three... (shrink)

While there is a significant amount of research investigating managerial ethical judgments, a limited amount examines consumer judgments of unethical corporate behavior and its impact on the marketplace. This study examines how consumers' commitment to a company impacts not only their ethical judgment of corporate behavior but also the outcomes of that judgment. The authors test hypotheses with data from 334 consumers and find that consumers' level of commitment attenuates the level of perceived fairness. More specifically, highly committed consumers may (...) forgive companies for behaviors when perceived harm is low, but become progressively dissatisfied as the level of perceived harm increases. Results of the study point to the importance of considering ethical behavior from a consumer perspective. If corporate actions are perceived as unethical, the company stands to lose favor with their most committed customers. Considering that more time, effort and investment is required to gain a new customer as to retain an old, this study shows that engaging in behavior perceived as unethical by consumers risks alienating the most committed customers. (shrink)

The Toolbox dialogue method enables members of heterogeneous groups to identify, share, and compare their perspectives on topics of common interest, such as research questions or complex problems (Hubbs et al. 2020). These interactions occur in dialogue, typically in relatively brief (eg, two-to four-hour) workshop settings, where participants jointly consider their responses to abstract and often philosophical statements that express positions on the topics. By expressing positions on topics that matter to the group, these statements structure a dialogue that enhances (...) mutual understanding in valuable ways. The method is valuable for heterogeneous groups because it enhances both self-understanding and mutual understanding. It does this by transforming dialogue participants into teachers and learners: teachers of their own perspective to others and learners of the perspectives of others and, to some extent... (shrink)

Backround Education in ethics and professionalism should reflect the realities medical students encounter in the hospital and clinic. Method We performed content analyses on Case Observation and Assessments (COAs) written by third-year medical students about ethical and professional issues encountered during their internal medicine and paediatrics clinical clerkships. Results A cohort of 141 third-year medical students wrote 272 COAs. Content analyses identified 35 subcategories of ethical and professional issues within 7 major domains: decisions regarding treatment (31.4%), communication (21.4%), professional duties (...) (18.4%), justice (9.8%), student-specific issues (5.4%), quality of care (3.8%), and miscellaneous (9.8%). Conclusions Students encountered a wide variety of ethical and professional issues that can be used to guide pre-clinical and clinical education. Comparison of our findings with results from similar studies suggests that the wording of an assignment (specifying “ethical” issues, “professional” issues, or both) may influence the kinds of issues students identify in their experience-based clinical narratives. (shrink)

In debates about the moral foundations of intellectual property, one very popular strand concerns the role of labor as a moral basis for intellectual property rights. This idea has a great deal of intuitive plausibility; but is there a way to make it philosophically precise? That is, does labor provide strong reasons to grant intellectual property rights to intellectual laborers? In this paper, I argue that the answer to that question is “yes”. I offer a new view, different from existing (...) labor theories of intellectual property, which I call the productive capacities view. This view gives us a way to make sense of the idea of labor as the basis for intellectual property rights, as well as a tool for critically evaluating existing intellectual property institutions. (shrink)

Macrocephaly is present in about 2–5% of the general population. It can be found as an isolated benign trait or as part of a syndromic condition. Brain overgrowth has been associated with neurodevelopmental disorders such as autism during the first year of life, however, evidence remains inconclusive. Furthermore, most of the studies have involved pathological or high-risk populations, but little is known about the effects of brain overgrowth on neurodevelopment in otherwise neurotypical infants. We investigated the impact of brain overgrowth (...) on basic perceptual learning processes during the first year of life. We recorded high density electroencephalograms in 116 full-term healthy infants aged between 3 and 11 months, 35 macrocephalic and 81 normocephalic classified according to the WHO head circumference norms. We used an adapted oddball paradigm, time-frequency analyses, and auditory event-related brain potentials to investigate differences between groups. We show that brain overgrowth has a significant impact on repetition effects and change detection response in the 10–20 Hz frequency band, and in N450 latency, suggesting that these correlates of sensorial learning processes are sensitive to brain overgrowth during the first year of life. (shrink)

IntroductionIn recent years, there has been something of an explosion of news stories about various college and university campuses across North America experiencing heightened levels of political advocacy and political unrest. Visible examples include the “canceling” of invited speakers who have been deemed offensive by select student groups1 or petitions calling for the removal of instructors who have been accused of using harmful language.2 While these examples shed light on some of the more intense political debates circulating in higher educational (...) institutions, they are also newsworthy stories precisely because they suggest strong divisiveness in worldviews in action—the contradiction between different…. (shrink)

Background The fourth section of the 1967 Abortion Act states that individuals (including health care practitioners) do not have to participate in an abortion if they have a conscientious objection. A conscientious objection is a refusal to participate in abortion on the grounds of conscience. This may be informed by religious, moral, philosophical, ethical, or personal beliefs. Currently, there is very little investigation into the impact of conscientious objection on service users in Britain. The perspectives of service users are imperative (...) in understanding the real-world consequences and potential impact of conscientious objection and should be considered when creating and reviewing policies and guidelines. This research provided a platform for women and those who can become pregnant to share their experiences and opinions at a time when these voices are largely excluded in the great tradition of Western political philosophy and law-making processes. Method Five service users were interviewed using a narrative interview approach to uncover their abortion journeys and experiences of conscientious objection. Findings The findings were presented as found poems and uncovered that doctors are not always: informing service users that they have a conscientious objection to abortion, giving service users enough information to access abortion (indirect referral), treating them non-judgmentally, and providing medically correct information. Service users did not experience burdens such as long waiting times and were still able to access legal abortion. However, service users did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred and/or were mistreated. Conclusions Findings indicate that conscientious objection could work in practice. However, it is currently failing some individuals on an emotional level, as not all doctors are adhering to guidelines. Conscientious objection in Britain needs to be addressed, to ensure service users receive fair, impartial, non-judgmental care. (shrink)

Prior research shows that reasoners' confidence is poorly calibrated (Shynkaruk & Thompson, 2006). The goal of the current experiment was to increase calibration in syllogistic reasoning by training reasoners on (a) the concept of logical necessity and (b) the idea that more than one representation of the premises may be possible. Training improved accuracy and was also effective in remedying some systematic misunderstandings about the task: those in the training condition were better at estimating their overall performance than those who (...) were untrained. However, training was less successful in helping reasoners to discriminate which items are most likely to cause them difficulties. In addition we explored other variables that may affect confidence and accuracy, such as the number of models required to represent the problem and whether or not the presented conclusion was necessitated by the premises, possible given the premises, or impossible given the premises. These variables had systematically different relationships to confidence and accuracy. Thus, we propose that confidence in reasoning judgements is analogous to confidence in memory retrievals, in that they are inferentially derived from cues that are not diagnostic in terms of accuracy. (shrink)

The significance of private standards and associated local level initiatives in agri-food value chains are increasingly recognised. However whilst issues related to compliance and impact at the smallholder or worker level have frequently been analysed, the governance implications in terms of how private standards affect national level institutions, public, private and non-governmental, have had less attention. This article applies an extended value chain framework for critical analysis of Private Standards Initiatives (PSIs) in agrifood chains, drawing on primary research on PSIs (...) operating in Kenyan horticulture (Horticulture Ethical Business Initiative and KenyaGAP). The paper explores the legislative, executive and judicial aspects of governance in these southern PSIs highlighting how different stakeholders shape debates and act with agency. It is argued that governance is exercised ‘beyond the vertical’ in that one can identify wider horizontal processes of governance, including how the scope of key debates is constructed (especially in legislative governance) but analysis of executive governance emphasises the dominant role of the lead buyers. (shrink)

Medicine is often thought of as a science of the body, but it is also a science of data. In some contexts, it can even be asserted that data drive health. This article focuses on a key piece of data technology central to contemporary practices of medicine: the medical record. By situating the medical record in the perspective of its history, we inquire into how the kinds of data that are kept at sites of clinical encounter often depend on informational (...) requirements that originate well outside of the clinic, in particular in health insurance records systems. Although this dependency of today's electronic medical records on billing requirements is widely lamented by clinical providers, its history remains little studied. Following the archaeology of medicine developed by Michel Foucault in The Birth of the Clinic and expanding his methodology in light of more recent contributions to the field of media archaeology, this article excavates some of the underexplored technological conditions that help constitute today's electronic medical record. If in some contexts, it is true that data drive health, then an archaeology of medical records helps reveal how health insurance records often impact clinical care and, by extension, health and disease. (shrink)

Memory exhibits episodic superposition, an analog of the quantum superposition of physical states: Before a cue for a presented or unpresented item is administered on a memory test, the item has the simultaneous potential to occupy all members of a mutually exclusive set of episodic states, though it occupies only one of those states after the cue is administered. This phenomenon can be modeled with a nonadditive probability model called overdistribution (OD), which implements fuzzy-trace theory's distinction between verbatim and gist (...) representations. We show that it can also be modeled based on quantum probability theory. A quantum episodic memory (QEM) model is developed, which is derived from quantum probability theory but also implements the process conceptions of global matching memory models. OD and QEM have different strengths, and the current challenge is to identify contrasting empirical predictions that can be used to pit them against each other. (shrink)

In recent years there has been an explosion of interest in Artificial Intelligence (AI) both in health care and academic philosophy. This has been due mainly to the rise of effective machine learning and deep learning algorithms, together with increases in data collection and processing power, which have made rapid progress in many areas. However, use of this technology has brought with it philosophical issues and practical problems, in particular, epistemic and ethical. In this paper the authors, with backgrounds in (...) philosophy, maternity care practice and clinical research, draw upon and extend a recent framework for shared decision-making (SDM) that identified a duty of care to the client's knowledge as a necessary condition for SDM. This duty entails the responsibility to acknowledge and overcome epistemic defeaters. This framework is applied to the use of AI in maternity care, in particular, the use of machine learning and deep learning technology to attempt to enhance electronic fetal monitoring (EFM). In doing so, various sub-kinds of epistemic defeater, namely, transparent, opaque, underdetermined, and inherited defeaters are taxonomized and discussed. The authors argue that, although effective current or future AI-enhanced EFM may impose an epistemic obligation on the part of clinicians to rely on such systems' predictions or diagnoses as input to SDM, such obligations may be overridden by inherited defeaters, caused by a form of algorithmic bias. The existence of inherited defeaters implies that the duty of care to the client's knowledge extends to any situation in which a clinician (or anyone else) is involved in producing training data for a system that will be used in SDM. Any future AI must be capable of assessing women individually, taking into account a wide range of factors including women's preferences, to provide a holistic range of evidence for clinical decision-making. (shrink)

The practice of people mandated by the university to go to school in order to observe and evaluate the activity of trainees in pre-service teachers training remains poorly documented from the point of view of professional gestures (Jorro, 2016). This article focuses on the analysis of a feedback interview, which is a key moment in this practice, aiming at commenting, evaluating the performance of a trainee after the observation of their teaching. The originality of our analysis is that it was (...) carried out from several frames, in an effort to combine different perspectives on the same object. It is therefore a multifocal analysis (Altet, 2002). (shrink)

The precarious rights of senior citizens, especially those who are highly educated and who are expected to counsel and guide the younger generations, has stimulated the creation internationally of advocacy associations and opinion leader groups. The strength of these groups, however, varies from country to country. In some countries, they are supported and are the focus of intense interest; in others, they are practically ignored. For this is reason we believe that the creation of a network of all these associations (...) is essential. The proposed network would act as a support for the already-existing policies of the United Nations’ High Commission for Human Rights, of independent experts, and of the Global Alliance for the Rights of Older People. All three have long ago recommended the creation of a recognized instrument for uniting presently scattered efforts. The proposed network, therefore, will seek to promote the international exchange of relevant expertise, and it will reinforce the commitments and actions that single countries are currently taking to meet these objectives. For example, informative public events can be organised to promote particular support initiatives and to provide an opportunity for new members of the network to be presented. The network will promote health for senior citizens, disease prevention, senior mobility, safe free time for seniors, alimentary education, protection against new risks and dangers, as well as equity in the services necessary for seniors to adopt new information and communication technologies. In the case of retired academic members, the network will promote equality with respect to continuing use of digital technologies (particularly email), continuing access to research libraries, and the guaranteed ability for seniors to fund their own research programs and to deliver free seminars. (shrink)

IntroductionA symptom cluster is very common among oncological patients: cancer-related fatigue, emotional distress, sleep difficulties, pain, and cognitive difficulties. Clinical applications of interventions based on non-ordinary states of consciousness, mostly hypnosis and meditation, are starting to be investigated in oncology settings. They revealed encouraging results in terms of improvements of these symptoms. However, these studies often focused on breast cancer patients, with methodological limitations. Another non-ordinary state of consciousness may also have therapeutic applications in oncology: self-induced cognitive trance. It seems (...) to differ from hypnosis and meditation, as it involves the body more directly. Thus, investigating its clinical applications, along with hypnosis and meditation interventions, could improve available therapeutic options in oncology. This article details the study protocol of a preference-based longitudinal controlled superiority trial aiming to assess the effectiveness of 3 group interventions to improve oncological patients’ quality of life, and more specifically CRF, emotional distress, sleep, pain, and cognitive difficulties.Methods and analysisA power analysis required a total sample of 160 patients. Main inclusion criteria are: cancer diagnosis, active treatments completed for less than a year, no practice of hypnosis, meditation, or SICT, and presence of at least one of these four symptoms: fatigue, sleep difficulties, depression, or anxiety. Each participant will choose the intervention in which they want to participate. To test the effectiveness of the interventions, data will be collected by questionnaires and neurobiological measures and directly from the medical record at four time points: before inclusion in the study ; immediately after the intervention; and at 3- and 12-month follow-up. The longitudinal data in each group will then be measured.DiscussionIn addition to standard cancer therapies, there is a growing interest from patients in complementary approaches, such as hypnosis, meditation, and SICT. The results of this study will be useful to increase knowledge about short- and long-term effectiveness of 3 group interventions for CRF, emotional distress, sleep, pain, and cognitive difficulties in patients with different cancers.Clinical Trial RegistrationClinicalTrials.gov/. Retrospectively registered on the 29th of April 2021. url: https://clinicaltrials.gov/ct2/show/NCT04873661. (shrink)