Group-orientated supervision is provided continually to student nurses during their education. In the supervision process it is necessary to create a relationship between the supervisor and the supervisee that is based on an ethical, trusting relationship. The aim of the study was to investigate supervisors’ (n = 18) experiences of the ethical dimensions of ongoing group-orientated supervision. An additional aim was to describe the supervisors’ values by which they are guided in supervision. Data were collected by (...) means of an open-ended questionnaire and analysed using the hermeneutic transformative process. The findings revealed the following themes: respect and responsibility; carefulness and sensitivity; reflection and confirmation; and genuineness and fairness. The values guiding the supervisors were dignity, normative ethics, privacy and confidentiality. (shrink)

We propose that doping be legalized under medical supervision. First, we discuss two motivations for allowing medically supervised doping. We reject the ‘compromised choice/harm minimization’ motivation as unlikely to win the support of athletes. We agree that it could lead to an arms race. Instead, we favor full acceptance of doping under medical supervision and answer Reid’s spirit of sport objection to medical manipulation. After presenting a set of guiding principles, we use them to answer the arms race (...) objection and rebut one of the most prominent objections in the literature about the safety of medically supervised doping, the game-theoretic objection. (shrink)

This guide offers practical templates and tools for supervisors hoping to refine the problem-solving, decision-making, and instruction of teachers under their supervision.

The supervision of teachers is essential for ensuring effective teaching methods, ongoing professional growth, and student success. This study explored the experiences of program heads in supervising teachers. It was conducted in a local college in Tangub City, Misamis Occidental. The phenomenological design was used in the study. Eleven program heads served as the participants selected through the purposive sampling technique. The Interview Guide was used as the research instrument. Moustakas' transcendental phenomenology of data analysis was utilized to (...) analyze the data gathered. Results revealed the following main themes: the critical role of supervision in advancing teacher development and educational excellence, mutual learning and growth, the role of program heads in teacher supervision, overcoming challenges in teacher supervision, and effective communication strategies. Supervision improves teaching and learning quality, which supports professional development. The complex nature of supervisory roles requires adaptive strategies and strong support networks. It is recommended for program heads and teachers to establish open communication to help address the challenges encountered during supervision. (shrink)

The increasing need for innovative research driven by rapid global changes gives doctoral supervisors of early-stage researchers a significant role in facilitating the ethical conduct of qualitative research. In the context of European Commission funding, the demands of research ethics and integrity place a tremendous responsibility on the supervisors of early-stage researchers involved in cross-national projects. This document study seeks to illuminate the role of the supervisors in facilitating research ethics in these projects. Specifically, we describe and discuss the supervisor (...) role associated with five approaches to doctoral supervision of qualitative research, namely those described as ‘Functional’, ‘Enculturation’, ‘Critical thinking’, ‘Emancipation’ and ‘Developing a quality relationship’. The main challenges for supervisors of cross-national research projects are the cultural and linguistic mobilisation of ethical principles in qualitative research processes and the management of the future use of open data. The results from this study have implications for planning and conducting cross-national studies within research involving human participants. These results can guide supervisors in the codification and mobilisation of ethical qualitative research in practice. (shrink)

Thomas Kretschmar and Andreas Hamburger provide an important overview of psychodynamic work in companies, presenting different viewpoints and explaining key psychoanalytic terms and techniques for coaching and supervision. Written in the form of a dialog between Kretschmar, an entrepreneur, and Hamburger, a psychoanalyst, the book provides unique insight into psychodynamic coaching and supervision. Psychodynamic Coaching and Supervision for Executives begins with an overview of coaching, psychodynamic approaches, the unconscious and relevant psychoanalytic theory. Kretschmar and Hamburger then consider (...) Operationalized Psychodynamic Diagnosis (OPD) in business, assess current research into coaching and supervision and present a selection of key case studies. At the end of each chapter, the authors compare their positions, giving important contextual information, exploring objections, complications and improvements, and providing a precise summary of the topic. This book will be an illuminating guide for therapists and professionals who wish to learn how psychoanalytic theory and practice can be used for coaching, counseling, and supervision in an organizational context. (shrink)

Mental disorders such as depression and anxiety are increasingly common. Yet there are too few specialists to offer help to everyone, and negative attitudes to psychological problems and their treatment discourage people from seeking it. As a result, many people never receive help for these problems. The Oxford Guide to Low Intensity CBT Interventions marks a turning point in the delivery of psychological treatments for people with depression and anxiety. Until recently, the only form of psychological intervention available for (...) patients with depression and anxiety was traditional one-to-one 60 minute session therapy - usually with private practitioners for those patients who could afford it. Now Low Intensity CBT Interventions are starting to revolutionize mental health care by providing cost effective psychological therapies which can reach the vast numbers of people with depression and anxiety who did not previously have access to effective psychological treatment. The Oxford Guide to Low Intensity CBT Interventions is the first book to provide a comprehensive guide to Low Intensity CBT interventions. It brings together researchers and clinicians from around the world who have led the way in developing evidence-based low intensity CBT treatments. It charts the plethora of new ways that evidence-based low intensity CBT can be delivered: for instance, guided self-help, groups, advice clinics, brief GP interventions, internet-based or book-based treatment and prevention programs, with supported provided by phone, email, internet, sms or face-to-face. These new treatments require new forms of service delivery, new ways of communicating, new forms of training and supervision, and the development of new workforces. They involve changing systems and routine practice, and adapting interventions to particular community contexts. The Oxford Guide to Low Intensity CBT Interventions is a state-of-the-art handbook, providing low intensity practitioners, supervisors, managers commissioners of services and politicians with a practical, easy-to-read guide - indispensible reading for those who wish to understand and anticipate future directions in health service provision and to broaden access to cost-effective evidence-based psychological therapies. (shrink)

The comprehensive guide to ethics "An excellent blend of case law, research evidence, down-to-earth principles, and practical examples from two authors with outstanding expertise. Promotes valuable understanding through case illustrations, self-directed exercises, and thoughtful discussion of such issues as cultural diversity."--Dick Suinn, president-elect 1998, American Psychological Association "The scenarios and accompanying questions will prove especially helpful to those who offer courses and workshops concerned with ethics in psychology."--Charles D. Spielberger, former president, American Psychological Association; distinguished research professor of psychology, (...) University of South Florida The authors draw on their professional experience, empirical studies, and case examples to examine the ethical responsibilities that confront psychotherapists and counselors in their day-to-day practice. They offer insights into contending with the sometimes competing demands of clients' needs, formal ethical principles, personal values, and evolving legal standards in a range of areas--including fees, informed consent, sexual concerns, confidentiality, documentation, and supervision. (shrink)

Without the active participation of enterprises and front-line workers, it is difficult for the government to perform effective supervision to ensure behavioral safety among front-line workers. To overcome inadequate government supervision and information attenuation caused by vertical management mode and limited resources, and to change passive supervision into active control with the proactive participation of enterprises and workers, this paper combines the entity responsibility mechanism and the third-party participation mechanism based on government supervision to analyze the (...) decision-making process of government and enterprises on safety behavior supervision. An evolutionary game model was established to describe the decision-making interactions between the government and construction enterprises under the two mechanisms, and a simulation was performed to illustrate the factors influencing the implementation of the mechanisms. The results show that both mechanisms have a positive effect on government supervision, and the third-party participation mechanism was found to be working better. The implementation of the two mechanisms is influenced by punishment, subsidy, and cost, and it has different sensitivities to the three influencing factors. This study provides a theoretical framework for enhancing the government supervision mechanism, and the decision-making between the government and construction enterprises enhances the management form and guides their actual supervision practices. (shrink)

ABSTRACT Most of the ethical decision making literature that guides mental health practice comes from the Western hemisphere. The well-meaning application of Western values in supervision can result in the intrusion of ethical standards that may not match the context and lacks sensitivity. In this qualitative study, researchers explored the supervisory experiences of 25 mental health professionals of 14 different nationalities, navigating complex ethical challenges in supervision practice in 17 countries. Using thematic analysis, several well-supported themes emerged. Recommendations (...) for practice include the importance of supervisors taking primary responsibility for initiating cultural discussions and fostering a collaborative approach to navigating complex cultural dilemmas. (shrink)

This article outlines the potential for Research Higher Degree supervisors at universities and similar institutions to use ethical review as a constructive, dynamic tool in guiding RHD students in the timely completion of effective, innovative research projects. Ethical review involves a bureaucratized process for checking that researchers apply risk management strategies when dealing with human participants. Ethical review can also be a powerful instrument for RHD supervisors in the creative arts if they use it to lead students through processes of (...) imagining, articulating, and improving their methodologies and relationships with research participants. Proposed strategies involve adaptation of theories of visualization and imagination from several disciplines—imagined interaction from the social sciences and psychology, dramatic rehearsal from political science, and creative visualization from the health professions, sports coaching and many other personal–professional development contexts. By using creativity and imagination, supervisors can use ethical review to help students to ‘walk through’ the potential, progressive phases of proposed research in order to refine or redesign both ‘big picture’ strategies and specific steps taken to reach research goals. This can stimulate students to unearth possibilities that improve the quality and quantity of knowledge that their research generates and to avoid or manage problems that might disrupt their research. (shrink)

Conducting phenomenological research for dissertations can be an involved and challenging process, and writing it up is often the most challenging part. How to Write a Phenomenological Dissertation gives students practical, applied advice on how to structure and develop each chapter of the dissertation specifically for phenomenological research. Phenomenology is about personal experience and personal experience varies from researcher to researcher. However, this variation is a big source of confusion for new researchers in the social, behavioral, or health sciences. This (...) brief text is written in a simple, step-by-step fashion to account for this flexibility and variation while also providing structure necessary for a successful dissertation. Broken up into chapters that follow each chapter of the dissertation, this text logically addresses the various parts of phenomenological research, starting with ensuring phenomenology is the right method for your research, writing the literature review, going through methods and results sections to analysis and discussion. The author, using experience gleaned from supervising phenomenological dissertations for many years, gives time-tested advice on how structure the dissertation to fit into more common frameworks, using checklists and tables throughout. Each chapter includes a list of helpful resources for students to use alongside this book with specific information on methods and research. Unique to this text is a chapter on creating your own phenomenological method which allows students to expand their viewpoints and experiment in future studies after the dissertation. (shrink)

In this article, we will consider how the regulation of populations is not just a feature of prisons, but of all institutions and organisations that control members though hierarchies, divisions and norms. While nurses and other allied health professionals are considered to be predominantly self‐regulatory, practice is guided by a code of conduct and codes of ethics that act as rules that serve to uphold the safety of the patient, whether they are a sick person in a hospital bed or (...) an inmate in a prison. The codes of conduct espouse a number of rules that to a certain extent govern the behaviour of individual and groups of practitioners through reciprocal rewards and punishments. Supervision is one method of monitoring the effectiveness of the codes of conduct and ethics while regulating both the minimum standard of individual practice and of training organisations. It is posited that one of the possible effects of clinical supervision is to make the person effectively self‐regulatory as, an autonomous practitioner. We take the view that professional autonomy is a highly problematic concept requiring closer examination. (shrink)

BackgroundPsychiatric staff members have the power to decide the options that frame encounters with patients. Intentional as well as unintentional framing can have a crucial impact on patients’ opportunities to be heard and participate in the process. We identified three dominant ethical perspectives in the normative medical ethics literature concerning how doctors and other staff members should frame interactions in relation to patients; paternalism, autonomy and reciprocity. The aim of this study was to describe and analyse statements describing real work (...) situations and ethical reflections made by staff members in relation to three central perspectives in medical ethics; paternalism, autonomy and reciprocity.MethodsAll staff members involved with patients in seven adult psychiatric and six child and adolescent psychiatric clinics were given the opportunity to freely describe ethical considerations in their work by keeping an ethical diary over the course of one week and 173 persons handed in their diaries. Qualitative theory-guided content analysis was used to provide a description of staff encounters with patients and in what way these encounters were consistent with, or contrary to, the three perspectives.ResultsThe majority of the statements could be attributed to the perspective of paternalism and several to autonomy. Only a few statements could be attributed to reciprocity, most of which concerned staff members acting contrary to the perspective. The result is presented as three perspectives containing eight values.•Paternalism; 1) promoting and restoring the health of the patient, 2) providing good care and 3) assuming responsibility.•Autonomy; 1) respecting the patient’s right to self-determination and information, 2) respecting the patient’s integrity and 3) protecting human rights.•Reciprocity; 1) involving patients in the planning and implementation of their care and 2) building trust between staff and patients.ConclusionsPaternalism clearly appeared to be the dominant perspective among the participants, but there was also awareness of patients’ right to autonomy. Despite a normative trend towards reciprocity in psychiatry throughout the Western world, identifying it proved difficult in this study. This should be borne in mind by clinics when considering the need for ethical education, training and supervision. (shrink)

Political Theologies of Justice: Meritocratic Values from a Global Perspective Michael Puett In fourth century BCE China, a religious revolutionary named Mozi emerged. In opposition to much of the religious practices and assumptions of the time, Mozi announced that Heaven, the highest god, was a just and non-capricious deity who had created the world for humanity. As a just deity, Heaven rewarded good humans and punished bad ones. And Heaven charged humans with creating a political order that did the same: (...) Moreover, there are ways that I (Mozi) know Heaven loves the people deeply. It shaped and made the sun, moon, stars, and constellations so as to illuminate and guide [the people]. It formed and made the four seasons, spring, autumn, winter, and summer, so as to weave them into order. It sent down thunder, snow, frost, rain, and dew so as to make the five grains, hemp, and silk grow and prosper, and sent the people to obtain materials and benefit from them. It arranged and made mountains, streams, gorges, and valleys, and distributed and bestowed the hundred affairs so as to oversee and supervise the goodness and badness of the people. It made kings, dukes, and lords and charged them with, first, rewarding the worthy and punishing the wicked, and, second, plundering the metals, wood, birds, and beasts and working the five grains, hemp, and silk so as to make the materials for people's clothing and food. (shrink)

Accompanying _The_ _Routledge Doctoral Student’s Companion_ this book examines what it means to be a doctoral student in education and the social sciences, providing a guide for those supervising students. Exploring the key role and pedagogical challenges that face supervisors in students’ personal development, the contributors outline the research capabilities which are essential for confidence, quality and success in doctorate level research. Providing guidance about helpful resources and methodological support, the chapters: frame important questions within the history of debates (...) act as a road map through international literatures make suggestions for good practice raise important questions and provide answers to key pedagogical issues provide advice on enabling students’ scholarly careers and identities. While there is no one solution to ideal supervision, this wide-ranging text offers resources that will help supervisors develop their own personal approach to supervision. Ideal for all supervisors whether assisting part-time of full-time students, it is also highly suitable for helping academics to support international students who confront Western doctoral traditions and academic cultures, helping both supervisor and student to understand why things are as they are. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Rethinking Variations of Musical MeaningfulnessAnneli ArhoAs a curious mind, I am able to focus on new kinds of topics, to research unknown practices; I am able to explore different cultures, interesting customs of making music, or I may trace various ways of musical thinking. It is wonderful to be able to enrich and transform my understanding of the musical world. [End Page 55]As a lived body,1 I have grown (...) up in the Western music tradition.2 This is my culture. This is the tradition I know as a composer, as a player of an instrument, as a teacher, as a researcher. Living in this culture has given me an embodied understanding of music. This understanding provides me with a meaningful background whenever I sense (hear, see, feel with my body's movements, read, fancy, and speak, write, or read about) music. I know this music in myself.As a musician, I have often been puzzled—even annoyed—that the tradition of writing about music favors descriptions and contemplations which I, as a musician, often find misleading and distorted. It has taken me a long time to realize two things: (1) the professional writers within various discourses create their own kinds of musical meaningfulness that are often interesting in themselves, and (2) in order to really share that kind of meaningfulness, I would have had to grow up within the discourse through which that meaningfulness evolved or was constructed.As a researcher, therefore, I have chosen to ground my research in my lived body, in the musicianship constituted through my experiences in making music. I am interested in phenomena of the lived world—as they are lived through and understood when making music.3 I am interested in different practices and divergent ways of regulating and guiding the making of music. I am interested in habitual ways of speaking about music, common ways of manual and mental training and rehearsing, and in different ways of teaching, supervising, and coaching. For me, all these reveal the phenomenon of music in our culture.My Living with Music—A Field of Musical MeaningfulnessAs a composer, I sometimes work with children and young people, and with their instrumental teachers. I have just started a three-year project in a music school, working each year with a new group of players. In 2004, I conducted a pilot project with recorder players. This year it will be the violin players; next year I may work with the piano players. There are many possibilities for the third year: the head of the school will have a hard job choosing a group from among the several enthusiastic candidates.I have enjoyed the open-mindedness of the children and of the volunteer teachers, too. Learning to play with music—learning to handle, vary, and transform, to compose, decompose, and recompose musical fragments, pieces, or sequences—may be as natural as any playing. Intertwining play, variation, and imitation seems to be an essential part of living and learning.But, I have also had to confront entrenched mythical conceptions of what it means to compose music, and curricula based on those conceptions.4 In my mind, composing cannot be regarded as a phenomenon that could simply be included in a curriculum. In practice, composing may refer to a variety of ways [End Page 56] of making music that are not always easy to tell apart from other culturally named phenomena, like playing, singing, improvising, or writing music.5 For me, composing simply refers to certain ways I live with music: several different ways of dealing with music, different kinds of activities, makings and doings, special states of mind, and special ways of using my embodied knowledge of music. Thus, composing refers to an individual and invisible6 background, an embodied perspective, a way of being, which shows me a certain variety of musical phenomena and their qualities, and conceals some others. Composing, like all arts of making and doing, generates its own practical and existential questions, which often are not an issue for those who do not compose. An outsider never really grasps the situation of a practitioner.Culturally bound ways of making music are being redefined... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Empire of the Tetrarchs: Imperial Pronouncements and Government a.d. 284–324T. D. BarnesSimon Corcoran. The Empire of the Tetrarchs: Imperial Pronouncements and Government a.d. 284–324. Oxford: Clarendon Press, 1996. xv 1 406 pp. Cloth, $85. (Oxford Classical Monographs)The four decades between the accession of Diocletian on 20 November 284 and the abdication of Licinius on 19 September 324 witnessed profound changes in the government and administrative structure of (...) the Roman world. These changes are naturally reflected in the legislation of the period, which survives in relative abundance—indeed, a larger proportion of the emperors’ legal decisions and enactments probably survives from these four decades than from any previous period of forty years in the history of the Roman Empire. The high rate of survival is due in part to the activity of the commissioners who compiled the Theodosian Code in the 430s and the Codex Justinianus in the sixth century: the former set out to collect general laws and edicts of the Christian Roman Empire since the conversion of Constantine, while the latter included in their compilation a large part of two Diocletianic collections of imperial rescripts, the Codex Gregorianus and the Codex Hermogenianus. But the legislation of Diocletian and his imperial colleagues and successors is also known from a wide variety of other sources—papyri, inscriptions, nonofficial collections of laws, Lactantius’ account of the decade of Christian persecution from 303 to 313 in his On the Deaths of the Persecutors, and Eusebius’ Ecclesiastical History. Moreover, Eusebius’ Life of Constantine quotes important documents from the last months of 324.Simon Corcoran includes all this varied and historically significant material in his purview, and he provides a reliable guide to it. His monograph is a revised version of an Oxford doctoral thesis which he began in 1987 under the supervision of Fergus Millar and completed in 1992 under that of John Matthews, and he has also taken advice from Tony Honoré. His work is technically proficient. I have not noticed any careless errors of any consequence, and Corcoran has used my work on the period of Diocletian and Constantine in the spirit in [End Page 145] which I intended it to be used: he has understood the underlying principles upon which it rests, then applied them critically, sometimes to reach conclusions which not only differ from my own but are superior to them.Corcoran begins with two introductory chapters which succinctly survey the subject and the evidence available. On interpolation in legal texts, he is cautious and sensible. He proceeds on the assumption that though “the transmitted texts are seldom identical with what the imperial chancery originally issued,” they have seldom undergone drastic alteration: “abbreviation is the most common fate of constitutions in the legal sources” (19). Yet he provides a salutary reminder and example of what can happen (16–18): whereas a rescript in the Fragmenta Vaticana denies that the temporary gift of estates subject to tax is valid (Frag. Vat. 283, si stipendariorum proprietatem dono de-disti,... donatio inrita est), the same rescript in the Codex Justinianus directly contradicts and asserts that such a gift is valid (CJ 8.54.2, si praediorum proprietatem dono dedisti,... donatio valet). On a priori grounds alone, it seems highly probable that something similar has happened to some texts which are known only through the Codex Justinianus—and where the alteration may not be at all obvious.What of the date and contents of the two Diocletianic codes? Corcoran confronts the problems of dating and attribution squarely and honestly. Most of his conclusions may not be new, but his discussion has been able to proceed from the fact that an Aurelius Hermogenianus, who can hardly be anyone other than the jurist, is now securely attested as praetorian prefect between 293 and 305 with Julius Asclepiodotus as his colleague (AE 1987, 456). Corcoran argues that Gregorius published the Codex Gregorianus in 291/2 or ca. 292, after serving as magister libellorum with Diocletian from 285 to 290: he accounts for the ascription of some later constitutions to this code by postulating a second edition compiled ca. 306, possibly at the court of Maximinus or... (shrink)

Recent clinical trials show that psychedelics such as LSD and psilocybin can be given safely in controlled conditions, and can cause lasting psychological benefits with one or two administrations. Supervised psychedelic sessions can reduce symptoms of anxiety, depression, and addiction, and improve well-being in healthy volunteers, for months or even years. But these benefits seem to be mediated by "mystical" experiences of cosmic consciousness, which prompts a philosophical concern: do psychedelics cause psychological benefits by inducing false or implausible beliefs about (...) the metaphysical nature of reality? This book is the first scholarly monograph in English devoted to the philosophical analysis of psychedelic drugs. Its central focus is the apparent conflict between the growing use of psychedelics in psychiatry and the philosophical worldview of naturalism. Within the book, Letheby integrates empirical evidence and philosophical considerations in the service of a simple conclusion: this "Comforting Delusion Objection" to psychedelic therapy fails. While exotic metaphysical ideas do sometimes come up, they are not, on closer inspection, the central driver of change in psychedelic therapy. Psychedelics lead to lasting benefits by altering the sense of self, and changing how people relate to their own minds and lives-not by changing their beliefs about the ultimate nature of reality. The upshot is that a traditional conception of psychedelics as agents of insight and spirituality can be reconciled with naturalism (the philosophical position that the natural world is all there is). Controlled psychedelic use can lead to genuine forms of knowledge gain and spiritual growth-even if no Cosmic Consciousness or transcendent divine Reality exists. Philosophy of Psychedelics is an indispensable guide to the literature for researchers already engaged in the field of psychedelic psychiatry, and for researchers-especially philosophers-who want to become acquainted with this increasingly topical field. (shrink)

Background: Attending surgeons must maintain balance between promoting education and assuring safe, transparent patient care. This investigation aimed to define ethics that guide surgical training. We hypothesized that resident autonomy in the operating room is influenced by attending approach to patients, specifically patients considered to be vulnerable. Materials and Methods: After IRB approval, surgeons from three institutions were invited to participate in a pilot, survey, exploring how principles of patient autonomy, physician beneficence, nonmaleficence, and justice apply to participant opinions. (...) Responses were transcribed and coded for quantitative and qualitative analysis. Results: 51 attendings and 55 residents completed the survey. We identified that patient autonomy is upheld through transparent consent practices. Intraoperative supervision is a key practice that maintains the principles of physician beneficence and nonmaleficence and mitigates the risk of resident participation. Vulnerable patients were defined by respondents as those unable to participate in their own consent and those limited by social determinants of health and barriers to medical literacy. In contrast, resident participation is not limited in the care of vulnerable patients but is restricted in cases of higher complexity and those procedures deemed to have lower error margins. Conclusions: Although residents measure the success of their training based on their level of intraoperative independence, autonomy afforded to the resident does not only depend on objective skill. There are ethical considerations that the attending must navigate as they decide on effective teaching and safe surgical management, which is especially relevant in the care of complex cases. (shrink)

A major challenge for semantic video segmentation is how to exploit the spatiotemporal information and produce consistent results for a video sequence. Many previous works utilize the precomputed optical flow to warp the feature maps across adjacent frames. However, the imprecise optical flow and the warping operation without any learnable parameters may not achieve accurate feature warping and only bring a slight improvement. In this paper, we propose a novel framework named Dynamic Warping Network to adaptively warp the interframe features (...) for improving the accuracy of warping-based models. Firstly, we design a flow refinement module to optimize the precomputed optical flow. Then, we propose a flow-guided convolution to achieve the adaptive feature warping based on the refined optical flow. Furthermore, we introduce the temporal consistency loss including the feature consistency loss and prediction consistency loss to explicitly supervise the warped features instead of simple feature propagation and fusion, which guarantees the temporal consistency of video segmentation. Note that our DWNet adopts extra constraints to improve the temporal consistency in the training phase, while no additional calculation and postprocessing are required during inference. Extensive experiments show that our DWNet can achieve consistent improvement over various strong baselines and achieves state-of-the-art accuracy on the Cityscapes and CamVid benchmark datasets. (shrink)

The behavior analytic research community emphasizes within-subject research methodologies to study relations between individual behavior and the environment. This is unique as behavior analytic practitioners can then replicate directly the research they read when determining whether a research finding applies to the clients with whom they work. Research Ethics in Behavior Analysis: From Laboratory to Clinic and Classroom is a reference guide for behavior analysts who conduct, supervise, or consume research specific to behavior analysis. This book is sequenced to (...) follow the natural research process, beginning with an introduction to the history of research ethics that led to modern principles and values of scientific research ethics. The reader is taken through sequential steps from obtaining resources to support a research project through participant recruitment, conducting the study, communicating results, and supporting replication. Each chapter incorporates critical and under-discussed topics unique to research ethics in behavior analysis such as diversity, equity, and inclusion in the research process; balancing methodological rigor with clinical outcomes; aligning research and clinical goals; assessing generalization of research findings; the gray lines of assent and consent for intervention versus research; identifying and obtaining resources to support research; conflicts of interest; using technology and social media; and ethically handling data. Incorporates critical and under-discussed topics unique to research ethics in behavior analysis Reviews how to use technology and social media within your research Explains various approaches to communicating both negative and positive results Explores the gray lines of assent and consent for intervention versus research Written specifically for behavior analysts who conduct, supervise, or consume research specific to behavior analysis. (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

The fate of eukaryotic proteins, from their synthesis to destruction, is supervised by the ubiquitin–proteasome system (UPS). The UPS is the primary pathway responsible for selective proteolysis of intracellular proteins, which is guided by covalent attachment of ubiquitin to target proteins by E1 (activating), E2 (conjugating), and E3 (ligating) enzymes in a process known as ubiquitylation. The UPS can also regulate protein synthesis by influencing multiple steps of RNA (ribonucleic acid) metabolism. Here, recent publications concerning the interplay between the UPS (...) and different types of RNA are reviewed. This interplay mainly involves specific RNA‐binding E3 ligases that link RNA‐dependent processes with protein ubiquitylation. The emerging understanding of their modes of RNA binding, their RNA targets, and their molecular and cellular functions are primarily focused on. It is discussed how the UPS adapted to interact with different types of RNA and how RNA molecules influence the ubiquitin signaling components. (shrink)

As vehicles become more autonomous, the task of designing guiding systems that make morally acceptable decisions is getting more urgent. It is sometimes assumed that one solution will be acceptable across various cultures. In this paper we argue for the importance of intercultural perspectives; in particular, we explore possible insights derived from Buddhist philosophy, taking avail of the virtue of compassion (karuṇā). We suggest that autonomous vehicles should first learn in supervised situations so that they reach a level of decision-making (...) ability that human experts within a given culture deem morally good. How will they be evaluated? In some debates it is assumed that there is a one-fit-all answer to be found based on an agreed-upon moral theory. Apart from problems of ethical pluralism within a given culture, there are also problems due to different moral preferences and driving styles across cultures. One way the problem might be addressed is to introduce a machine-learning training curriculum that would provide autonomous vehicles with a process comparable to a novice human driver learning to drive and passing her own driving license test. (shrink)

Background: Clinical ethics committees have been broadly implemented in university hospitals, general hospitals and nursing homes. To ensure the quality of ethics consultations, evaluation should be mandatory. Research question/aim: The aim of this article is to evaluate the perspectives of all people involved and the process of implementation on the wards. Research design and participants: The data were collected in two steps: by means of non-participating observation of four ethics case consultations and by open-guided interviews with 28 participants. Data analysis (...) was performed according to grounded theory. Ethical considerations: The study received approval from the local Ethics Commission (registration no.: 32/11/10). Findings: ‘Communication problems’ and ‘hierarchical team conflicts’ proved to be the main aspects that led to ethics consultation, involving two factors: unresolvable differences arise in the context of team conflicts on the ward and unresolvable differences prevent a solution being found. Hierarchical asymmetries, which are common in the medical field, support this vicious circle. Based on this, minor or major disagreements regarding clinical decisions might be seen as ethical conflicts. The expectation on the clinical ethics committee is to solve this (communication) problem, but the participants experienced that hierarchy is maintained by the clinical ethics committee members. Discussion: The asymmetrical structures of the clinical ethics committee reflect the institutional hierarchical nature. They endure, despite the fact that the clinical ethics committee should be able to detect and overcome them. Disagreements among care givers are described as one of the most difficult ethically relevant situations and should be recognised by the clinical ethics committee. On the contrary, discussion of team conflicts and clinical ethical issues should not be combined, since the first is a mandate for team supervision. Conclusion: To avoid dominance by physicians and an excessively factual character of the presentation, the case or conflict could be presented by both physicians and nurses, a strategy that strengthens the interpersonal and emotional aspects and also integrates both professional perspectives. (shrink)

Being a friend makes our lives better, but it seems this consideration cannot guide our pursuit of friendship, lest this mean we are not true friends and that our lives are not made better. The aim of this paper is to show how, appearances notwithstanding, being a true friend is consistent with having one's own happiness as one's ultimate end. Aristotle's idea that friends are other selves, and recent accounts of practical reason, show how (i) one's acting as a (...) friend could be motivated and justified by one's being a friend (and not directly by one's own happiness), and yet (ii) one's being a friend (and not one's friendly actions) is in turn supervised and justified by one's own happiness. The paper ends by considering whether such a person's pursuit of another's good is still too circumscribed by that of their own for them to count as a true friend. (shrink)

Deprescribing is the term used to describe the process of withdrawal of an inappropriate medication supervised by a clinician. This article presents a discussion of how the Four Principles of biomedical ethics that may guide medical practitioners’ prescribing practices apply to deprescribing medications in older adults. The view of deprescribing as an act creates stronger moral duties than if viewed as an omission. This may explain the fear of negative outcomes which has been reported by prescribers as a barrier (...) to deprescribing. Respecting the autonomy of older adults is complex as they may not wish to be active in the decision-making process; they may also have reduced cognitive function and family members may therefore have to step in as surrogate decision-makers. Informed consent is intended as a process of information giving and reflection, where consent can be withdrawn at any time. However, people are rarely updated on the altered risks and benefits of their long-term medications as they age. Cessation of inappropriate medication use has a large financial benefit to the individual and the community. However, the principle of justice also dictates equal rights to treatment regardless of age. (shrink)

ABSTRACTThe historical process underlying Darwin’s Origin of Species did not play a significant role in the early editions of the book, in spite of the particular inductivist scientific methodology it espoused. Darwin’s masterpiece did not adequately provide his sources or the historical perspective many contemporary critics expected. Later editions yielded the ‘Historical Sketch’ lacking in the earlier editions, but only under critical pressure. Notwithstanding the sources he provided, Darwin presented the Origin as an ‘abstract’ in order to avoid giving sources; (...) a compromise he acknowledged and undertook to set right in later editions, yet failed to provide throughout the six editions under his supervision. Darwin’s reluctance to publish the historical context of his theory and his sources, particularly sources which were also ‘precursors’, may be attributed as much to the matter of intellectual ownership as science, or even good literary practice. Of special concern to Darwin were issues of priority or originality over ‘descent with modification’ and especially over Natural Selection. Many later historians have argued that Darwin was unaware of the work of his precursors on Natural Selection. Darwin’s theory was an example of independent discovery, albeit along with such obscure precursors as Matthew or Wells, who were unknown to Darwin until after the publication of the Origin. Both Matthew and Wells had a medical education, like James Hutton or Erasmus Darwin earlier in the eighteenth century, or even Charles Darwin. Evolutionary theory, at least in Britain was a product largely of the medical evolutionists rather than the natural historians which ‘history’ has chosen to select for the focus of attention; and among the medical evolutionists the figure of John Hunter stands out as theorist, experimentalist and teacher: the medical evolutionists were predominantly the product of Hunter’s legacy or of the medical profession and particularly the Scottish Universities. Much recent Darwin scholarship has focused on the private Notebooks, to establish Darwin’s discovery of Natural Selection around 1837–1838 and demonstrate Darwin’s ignorance of his precursors; requiring an explicit acknowledgement by Darwin as the legitimate substantiation of any claim to prior influence. The precursors have been categorized as uniformly obscure or irrelevant to the science of evolution which may be defined exclusively as ‘Darwinian’. The inclination to acknowledge influences, however was not something Darwin was gratuitously given to doing, especially on matters of priority. The Notebooks are not Darwin’s private thoughts; from an early stage he considered them incipient public documents and later sought to protect them as proof of his originality. William C. Wells was not an obscure thinker, but a celebrated scientist whom Herschel, Darwin’s guide to scientific methodology, had recommended as providing a model of scientific method. Darwin discovered Wells through Herschel, and quickly acquired a copy of Wells’ recommended work, no later than 1831, and held it thereafter in his library at Down House. This book, the 1818 edition of Wells’ Two Essays contains a third essay, Wells’ account of Natural Selection. Later, in the Descent of Man Darwin acknowledged his separate discovery of the correlation of colour and disease immunity in man, also earlier recounted by Wells. (shrink)

Reflective Practice is increasingly recognised as an important topic that has the potential to help nurses to develop and learn from their practice. This practical and accessible guide uses the latest research and evidence to support the development of skills in reflective practice and provides help and advice on how to get started, how to write reflectively and how to continue to use reflective practice in everyday situations. This fourth edition of Reflective Practice in Nursing contains new material on (...) mentoring and supervision and on group reflection, and includes a new chapter on teaching reflective practice. Reflective Practice in Nursing is an indispensable guide for students and practitioners alike, who wish to learn more about reflective practice, as well as containing essential information for teachers and lecturers. (shrink)

Deprescribing is the term used to describe the process of withdrawal of an inappropriate medication supervised by a clinician. This article presents a discussion of how the Four Principles of biomedical ethics that may guide medical practitioners’ prescribing practices apply to deprescribing medications in older adults. The view of deprescribing as an act creates stronger moral duties than if viewed as an omission. This may explain the fear of negative outcomes which has been reported by prescribers as a barrier (...) to deprescribing. Respecting the autonomy of older adults is complex as they may not wish to be active in the decision-making process; they may also have reduced cognitive function and family members may therefore have to step in as surrogate decision-makers. Informed consent is intended as a process of information giving and reflection, where consent can be withdrawn at any time. However, people are rarely updated on the altered risks and benefits of their long-term medications as they age. Cessation of inappropriate medication use has a large financial benefit to the individual and the community. However, the principle of justice also dictates equal rights to treatment regardless of age. (shrink)

Rhythm is key to language acquisition. Across languages, rhythmic features highlight fundamental linguistic elements of the sound stream and structural relations among them. A sensitivity to rhythmic features, which begins in utero, is evident at birth. What is less clear is whether rhythm supports infants' earliest links between language and cognition. Prior evidence has documented that for infants as young as 3 and 4 months, listening to their native language supports the core cognitive capacity of object categorization. This precocious link (...) is initially part of a broader template: listening to a non-native language from the same rhythmic class as and to vocalizations of non-human primates provide English-acquiring infants the same cognitive advantage as does listening to their native language. Here, we implement a machine-learning approach to ask whether there are acoustic properties, available on the surface of these vocalizations, that permit infants' to identify which vocalizations are candidate links to cognition. We provided the model with a robust sample of vocalizations that, from the vantage point of English-acquiring 4-month-olds, either support object categorization or fail to do so. We assess whether supervised ML classification models can distinguish those vocalizations that support cognition from those that do not, and which class of acoustic features best support that classification. Our analysis reveals that principal components derived from rhythm-relevant acoustic features were among the most robust in supporting the classification. Classifications performed using temporal envelope components were also robust. These new findings provide in principle evidence that infants' earliest links between vocalizations and cognition may be subserved by their perceptual sensitivity to rhythmic and spectral elements available on the surface of these vocalizations, and that these may guide infants' identification of candidate links to cognition. (shrink)

Exploring reflection -- Writing self : the 1st dialogical movement -- Surfing the reflective spiral : the 2nd dialogical movement -- Framing insights -- The dance with Sophia : the 3rd dialogical movement -- Guiding reflection : the 4th dialogical movement -- Weaving narrative and performance : the 5th & 6th dialogical movements -- The reflective curriculum -- Reflections on touch and the environment -- Reflections on caring -- Life begins at 40 -- Balancing the wind or a lot of (...) hot air -- A reflective model of clinical practice -- Reflective leadership -- Teetering on the edge of chaos -- Ensuring quality (clinical standards and clinical audit) -- Clinical supervision -- Tales of clinical supervision -- Therapeutic journaling with patients -- The bully and the sheep : storyboard -- Reflective prose poems -- Through a glass darkly : the performance turn. (shrink)

Eros and Illness explores the place of desire in illness. We urgently need such an exploration because illness is no longer simply a natural feature of the human condition. Most people fall ill, but illness now falls under the supervision of biomedicine, a science-based, state-regulated system dominated by the new molecular gaze. The use of a person's distinctive genetic data to guide treatment and to forestall disease--called "personalized medicine"-- reflects how the molecular gaze can produce valuable advances in (...) biomedical healthcare. What does this indispensable super-vision, however, tend to overlook? Eros and Illness proposes that biomedicine ignores, in clinical practice and in bench science, the powerful role of desire in illness. Desire, always double-edged, requires attention because it can do both great harm and great good. Patients, caregivers, family members, and physicians, as they recognize the role of desire, gain access to a power that can make the passage through illness much less onerous and far more healing: truly "personalized. (shrink)

This study is to investigate conflict rate and job satisfaction among staffs in the public organizations in Rafsanjan Township in the Islamic republic of Iran. In this study, staffs personality, laws and guide directions, staffs needs, communications and job satisfaction is investigated by examining the staffs’ salary, job nature, supervisor and salary of staffs’ colleagues and their promotion. This was a quantitative study. All data of this study have been collected by using questioner. All data of this study have (...) been analyzed quantitatively by using the SPSS software. Statistical society of the study was people who have worked in the public organizations in Rafsanjan Township. This study has chosen 385 staffs and has distributed two types of questionnaires namely job satisfaction and conflict questioners among them randomly. Finally, this study has concluded that 1. There is a reciprocal relationship between conflict rate and job satisfaction. 2. There is a negative relationship between conflict rate and payments. 3. There is a reciprocal relationship between conflict rate and job nature. 4. There is a negative relationship between conflict rate and supervision style. 5. There is a negative relationship between conflict rate and colleagues. 6. There is a reciprocal relationship between conflict rate and promotion opportunity. (shrink)

Playing with correct intonation is one of the major challenges for a string player. A player must learn how to physically reproduce a target pitch, but before that, the player must learn what correct intonation is. This requires audiation- the aural equivalent of visualization- of every note along with self-assessment whether the pitch played matches the target, and if not, what action should be taken to correct it. A challenge for successful learning is that much of it occurs during practice, (...) typically without outside supervision. A student who has not yet learned to hear correct intonation may repeatedly practice out of tune, blithely normalising bad habits and bad intonation. The real-time reflective nature of intonation and its consistent demand on attention make it a ripe target for technological intervention. Using a violin augmented to combine fingerboard sensors with audio analysis for real-time pitch detection, we examine the efficacy of three methods of real-time feedback for improving intonation and pitch learning. The first, aural feedback in the form of an in-tune guide pitch following the student in real-time, is inspired by the tradition of students playing along with teachers. The second is visual feedback on intonation correctness using an algorithm optimised for use throughout normal practice. The third is a combination of the two methods, simultaneously providing aural and visual feedback. Twelve beginning violinists, including children and adults, were given four in-situ 20-30 minute lessons. Each lesson used one of the intonation feedback methods, along with a control lesson using no feedback. We collected data on intonation accuracy and conducted interviews on student experience and preference. The results varied by player, with evidence of some players being helped by the feedback methods but also cases where the feedback was distracting and intonation suffered. However interviews suggested a high level of interest and potential in having such tools to help during practice, and results also suggested that it takes time to learn to use the real-time aural and visual feedback. Both methods of feedback demonstrate potential for assisting self-reflection during individual practice. (shrink)

RésuméDans cet article, l'auteur discute les principes qui ont guidé M. Gonseth dans ses recherches sur la géométrie et le problème de l'espace. M. Gonseth défend la thèse selon laquelle avant de tenter de résoudre le problème de la géométrie, on doit disposer des facultés d'intuition, de déduction et d'une connaissance expérimentale de l'espace.M. Tummers a publié trois brochures sur la géométrie: 1. De Opbouw der Meetkunde ; 2. De Meetkunde en de Ervaring ; 3. Wijsgerige Verantwoording van het Paralelenpostulaat (...) . Il défend la thèse selon laquelle une science dont toute expérience serait bannie ne pourrait pas exister. Dans la troisième de ces brochures, il montre que la proposition des parallèles n'est pas une thèse qui peut ětre déduite, mais un véritable postulat. L'auteur suppose dans sa recherche — exactement comme M. Gonseth — l'expérience ainsi que les facultés d'intuition et de déduction.L'auteur conclut que M. Gonseth, lorsqu'il montre que l'expérience et les facultés d'intuition et de déduction sont indispensables pour la construction de la géométrie, a prouvé une thèse d'une importance fondamentale. L'auteur essaye de construire une géométrie abstraite, mais dirigée par l'expérience, alors que Hilbert introduit une géométrie entièrement abstraite, excluant l'expérience comme instrument de contrǒle.In this article the author discusses the principles leading Mr. Gonseth in his search of geometry and the problem of the space. The following books of Mr. Gonseth are consulted:I. La déduction préalable. II. Les trois aspects de la Géométrie. III. L'Edification axiomatique.Mr. Gonseth argues that—before attempting to solve the problem of geometry—we must avail ourselves of the faculties of intuition and deduction, and of an experimental knowledge of the space.The author Mr. Tummers has published three brochures on geometry:1° De Opbouw der Meetkunde 1941. 2° De Meetkunde en de Ervaring 1949. 3° Wijsgerige Verantwoording van het Paralelenpostulaat 1951.The author defends the thesis that a science from which experience is excluded cannot exist.In the third brochure the author demonstrates that the proposition of the parallels is not a thesis which can be deduced, but a true postulate. The author, exactly as Mr. Gonseth, supposes in his research the experience and the faculties of intuition and deduction.The author concludes that Mr. Gonseth, when defending that experience and the faculties of intuition and deduction are indispensable for the construction of geometry, proves a thesis of great and fundamental importance.The author tries to build up an abstract geometry but directed by experience, Hilbert introduces a geometry, entirely abstract, whereas excluding the experience as instrument of supervision. (shrink)

Neste artigo, investigamos práticas de citação de literatura científica na escrita reflexiva do gênero relatório de estágio supervisionado, produzido por professores em formação, em disciplinas de estágio obrigatório em Ensino de Língua Inglesa numa Licenciatura em Letras. Analisaremos, especificamente, como esses professores se representam a partir de citações de literatura científica, e caracterizaremos algumas funções exercidas pelas citações na escrita reflexiva emergente na esfera acadêmica. Utilizamos a abordagem dialógica da linguagem dos estudos bakhtinianos como referencial teórico de base, além de (...) aportes teórico-metodológicos acerca de tipos de sequência e de discurso propostos por Adam e Bronckart. Os resultados da pesquisa mostram que a prática de citação da literatura científica é uma invocação de autoridade com função de erudição, amplificação e ornamentação do discurso produzido, podendo orientar a ação pedagógica desenvolvida pelo professor em formação no estágio supervisionado.In this paper we investigate citation practices of scientific literature in reflexive writing from the genre of supervised pre-service training report produced by pre-service teachers enrolled in the mandatory pre-service training subject of English Language Teaching, at an undergraduate language teaching course. The aim of this research is to analyze how these pre-services teacher represent themselves based on citation practices of scientific literature, and characterize some of the functions deployed by the citations in the reflexive writing emerging in the academic sphere. We use the dialogic approach to language from Bakhtinian studies as a theoretical base, as well as theoretical and methodological contributions regarding types of sequences and of discourse proposed by Adam and Bronckart. The results of this research show that the practice of citation of scientific literature is an invocation of authority as a form of erudition, amplification and ornamentation of the discourse produced. This practice can also guide pedagogical action developed by pre-service teachers in their supervised training. (shrink)

As the community corrections system has moved away from a focus on rehabilitation, it has been suggested that criminal offenders are no longer understood psychologically, but rather as rational actors for whom criminality is a choice. Rehabilitative efforts thus aim to guide these choices. Utilizing mixed methodology that draws on observational, interview, and case note data collected within the probation/parole system of a western U.S. state, I suggest that both officers’ conceptualizations of the criminal self and the rehabilitative strategies (...) they use are gendered. I find that officers view the male criminal self as flawed or underdeveloped and the female as permeable and amorphous, that is, lacking firm boundaries. In response to these constructions, officers aim to rehabilitate men largely by encouraging economic roles and responsibilities, while for women, rehabilitation aims to solidify boundaries: discouraging relationship formation and containing emotions. The differences identified point to ways in which gendered concepts of the criminal self contribute to gender disparities in contemporary supervision. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Editorial – A Word of ThanksDavid B. Couturier, OFM. Cap.When Prof. Jean-François Godet-Calogeras took the helm of Franciscan Studies as General Editor eighteen years ago, he brought together a new team of editors and worked out the goals they would try to meet as they ushered in a new era in this prestigious journal's history. In their first issue, they wrote the following:In the past, Franciscan Studies has served (...) a specific platform of scholars interested in the history and development of the order in the thirteenth and fourteenth centuries, with special attention to matters pertaining to Franciscan scholastic thought and spirituality. While this rich tradition will always stay with us, it appears that the moment is ripe to enhance the impact of Franciscan Studies on other aspects of Franciscan scholarship and on the wider fields of medieval ecclesiastical, cultural and intellectual history. Ideally speaking, we would like Franciscan Studies to become a thermometer for signaling interesting new trends, to such an extent that scholars from very different backgrounds will come to regard Franciscan Studies as an important instrument to keep abreast of new developments.1Thus began the prodigious expansion of Franciscan Studies at the beginning of the new century. For the past two decades our dear colleague and friend Jean-François has not only met these lofty goals, he has exceeded them. He has done so with a superb combination of editorial acuity, diplomacy and sensitivity to our distinguished authors and audiences around the world.The fact is that Jean-François knew how to read the signs of the times. With his distinctive Franciscan tenderness, he calmed the "prophets of gloom" who forecasted demise when he "opened the windows" and let in the fresh breezes of thought and insight from other generations, styles, and cultural forms of the Franciscan intellectual tradition. The skeptics are silent now, for the quality and range of the articles he has supervised over these years remain a testament to his prophetic insight that it was time for a major change of emphasis. [End Page 5]Furthermore, as General Editor he encouraged the voices of new and emerging scholars to be heard, especially those of under-represented women and minorities. The roster of today's authors testifies that the Franciscan intellectual tradition is safely, securely and wonderfully in the hands of a new generation of lay scholars. Jean-François has been a proud advocate for that transition. We thank him for steering in that direction.For all of this, it is our good fortune to thank Prof. Jean-François Godet-Calogeras for his many years of service as the General Editor of this academic journal. To Jean-François, on behalf of all the authors you have encouraged, all the editors you have guided, all the scholars and students you have taught, and all the directors and staff with whom you have worked over these many years, I offer you our gratitude, love and best wishes as you enter this next phase of your life. Thank you for your kindness, expertise and generosity. You have blessed us and we are grateful. [End Page 6]David B. Couturier, OFM. Cap.General Editor, Franciscan StudiesFootnotes1. The Editors, Franciscan Studies 62 (2004), 1.Copyright © 2022 The Franciscan Institute, St. Bonaventure University... (shrink)

The rapid development of Internet technology has facilitated the dissemination of information that can threaten national security and public health, and effectively controlling the process of public opinion communication is an important topic in contemporary social network research. This paper establishes an official information-controlled public opinion propagation model based on the delay, latency, and conversion of public opinion communication under the control of official information. According to the influence and importance of the network nodes, we theoretically derive the attitude conversion (...) probability of the nodes, making the model more in line with the actual situation. Through actual cases, we analyzed the important influence of official information on the public opinion communication process and provided a theoretical basis for the government and relevant departments to supervise and correctly guide the public opinion network, which has certain practical significance. (shrink)

After the corporate scandals at the beginning of the new millennium, corporate governance codes were drafted and implemented in national laws and regulations. Unfortunately, due to an ongoing supply of new financial scandals and societal deceptions, our society increasingly distrusts executive directors, non-executive directors and supervisory board members, as they often appeared to play a significant role in these scandals. Nonexecutive directors (NEDs) and supervisory directors (SDs) are often accused of having overlooked the important issues in their supervising role or (...) having failed to intervene in company decision making. Previous research has shown that many NEDs and SDs operate on the basis of their own unwritten rules, which may very well be different from those of their colleagues. In this article we examine whether and how a code of conduct or code of ethics might help to further clarify how NEDs/SDs should act. We also investigated the views of NEDs/SDs themselves. It appears that current corporate governance codes are not sufficient to guide directors on behavioral aspects of their supervisory role. This article shows that a code of conduct could provide this guidance to NEDs/SDs on several issues. First, a code of conduct would compel the Supervisory Board to reflect on its own values. Second, it would compel NEDs/SDs to verbalize their unwritten rules. The results may be applied internationally and could have relevance to the experience of executive directors in addition. This article may serve as a discussion document for other jurisdictions in addition. (shrink)

The origins of research projects, the duties of supervisors and research workers, the subjective elements in research and the difficulties of publication are reviewed, as a guide to the complexities of executing an honest research project. It is assumed that research carried out with maximal intellectual integrity will result in real advances.

Little is known about how ambiguity attitudes change when consequences are flipped from gains to losses, particularly in the context of natural sources. Focusing on two such sources of uncertainty - the voter participation rates in the 2019 European elections in France and the UK - we report econometric estimations that jointly capture parametric specifications of attitudes and beliefs in the gain and loss domains. For checking purposes, we also compute indexes of ambiguity attitudes proposed by Baillon et al. (2018). (...) According to our data, attitudes in the loss domain can be inferred from those in the gain domain. Our findings show no significant differences in attitudes between the two natural sources. Furthermore, we observe no differences in beliefs for both sources, regardless of the outcome sign. Our method, which focuses on matching probabilities, offers an efficient approach for investigating ambiguity attitudes and beliefs for natural sources of uncertainty across gains and losses, particularly beneficial in field studies where data collection capabilities may be limited. (shrink)