The ethical recruitment of participants with neurological disorders in clinical research requires obtaining initial and ongoing informed consent. The purpose of this study is to characterize barriers faced by research personnel in obtaining informed consent from research participants with neurological disorders and to identify strategies applied by researchers to overcome those barriers. This study was designed as a web-based survey of US researchers with an optional follow-up interview. A subset of participants who completed the survey were selected using a stratified (...) purposeful sampling strategy and invited to participate in an in-depth qualitative interview by phone or video conference. Data were analyzed using a mixed methods approach, including content analysis of survey responses and thematic analysis of interview responses. Over 1 year, 113 survey responses were received from US research personnel directly involved in obtaining informed consent from participants in neurological research. Frequently identified barriers to informed consent included: cognitive and communication impairments (e.g. aphasia), unrealistic expectations of research participants, mistrust of medical research, time constraints, literacy barriers, lack of available social support, and practical or resource-related constraints. Strategies to enhance informed consent included: involving close others to support participant understanding of study-related information, collaborating with more experienced research personnel to facilitate training in obtaining informed consent, encouraging participants to review consent forms in advance of consent discussions, and using printed materials and visual references. Beyond conveying study-related information, researchers included in this study endorsed ethical responsibilities to support deliberation necessary to informed consent in the context of misconceptions about research, unrealistic expectations, limited understanding, mistrust, and/or pressure from close others. Findings highlight the importance of training researchers involved in obtaining informed consent in neurological research to address disease-specific challenges and to support the decision-making processes of potential research participants and their close others. (shrink)

© 2014 Taylor Francis. The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus testing of every client presenting for services in venues where HIV prevalence is high. Because older adults have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent and ever HIV testing in a probability sample of at-risk (...) adults seeking services in needle exchange sites, sexually transmitted disease clinics, and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months or ever. Aging-related disparities in HIV testing exist among clients of these high HIV prevalence venues and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis. (shrink)

Sensory deficits are a feature of autism and schizophrenia, as well as the upper end of their non-clinical spectra. The mismatch negativity (MMN), an index of pre-attentive auditory processing, is particularly sensitive in detecting such deficits; however, little is known about the relationship between the visual MMN (vMMN) to facial emotions and autism and schizophrenia spectrum symptom domains. We probed the vMMN to happy, sad, and neutral faces in 61 healthy adults (18–40 years, 32 female), and evaluated their degree of (...) autism and schizophrenia spectrum traits using the Autism Spectrum Quotient (AQ) and Schizotypal Personality Questionnaire (SPQ). The vMMN to happy faces was significantly larger than the vMMNs to sad and neutral faces. The vMMN to happy faces was associated with interpersonal difficulties as indexed by AQ Communication and Attention to Detail subscales, and SPQ associated with more interpersonal difficulties. These data suggest that pre-attentive processing of positive affect might be more specific to the interpersonal features associated with autism and schizophrenia. These findings add valuable insights into the growing body of literature investigating symptom-specific neurobiological markers of autism and schizophrenia spectrum conditions. (shrink)

This book is a collection of secondary essays on America's most important philosophic thinkers—statesmen, judges, writers, educators, and activists—from the colonial period to the present. Each essay is a comprehensive introduction to the thought of a noted American on the fundamental meaning of the American regime.

The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these. Experience of gaining research ethics approval for a UK study (SharpTalk), involving internet-based discussion groups with young people who self-harm and health professionals is described. During ethical review, unsurprisingly, concerns were raised about the vulnerability of (...) potential participants. These were dominated by the issue of anonymity, which also affected participant safety and consent. These ethical problems are discussed, and our solutions, which included: participant usernames specific to the study, a closed website, private messaging facilities, a direct contact email to researchers, information about forum rules displayed on the website, a ‘report’ button for participants, links to online support, and a discussion room for forum moderators. This experience with SharpTalk suggests that an approach to ethics, which recognises the relational aspects of research with vulnerable people, is particularly useful for internet-based health research. The solutions presented here can act as guidance for researchers developing proposals and for ethics committees reviewing them. (shrink)

BackgroundThere is increasing need for peer reviewers as the scientific literature grows. Formal education in biostatistics and research methodology during residency training is lacking. In this pilot study, we addressed these issues by evaluating a novel method of teaching residents about biostatistics and research methodology using peer review of standardized manuscripts. We hypothesized that mentored peer review would improve resident knowledge and perception of these concepts more than non-mentored peer review, while improving review quality.MethodsA partially blinded, randomized, controlled multi-center study (...) was performed. Seventy-eight neurology residents from nine US neurology programs were randomized to receive mentoring from a local faculty member or not. Within a year, residents reviewed a baseline manuscript and four subsequent manuscripts, all with introduced errors designed to teach fundamental review concepts. In the mentored group, mentors discussed completed reviews with residents. Primary outcome measure was change in knowledge score between pre- and post-tests, measuring epidemiology and biostatistics knowledge. Secondary outcome measures included level of confidence in the use and interpretation of statistical concepts before and after intervention, and RQI score for baseline and final manuscripts.ResultsSixty-four residents (82%) completed initial review with gradual decline in completion on subsequent reviews. Change in primary outcome, the difference between pre- and post-test knowledge scores, did not differ between mentored (−8.5%) and non-mentored (−13.9%) residents (p = 0.48). Significant differences in secondary outcomes (using 5-point Likert scale, 5 = strongly agree) included mentored residents reporting enhanced understanding of research methodology (3.69 vs 2.61; p = 0.001), understanding of manuscripts (3.73 vs 2.87; p = 0.006), and application of study results to clinical practice (3.65 vs 2.78; p = 0.005) compared to non-mentored residents. There was no difference between groups in level of interest in peer review (3.00 vs 3.09; p = 0.72) or the quality of manuscript review assessed by the Review Quality Instrument (RQI) (3.25 vs 3.06; p = 0.50).ConclusionsWe used mentored peer review of standardized manuscripts to teach biostatistics and research methodology and introduce the peer review process to residents. Though knowledge level did not change, mentored residents had enhanced perception in their abilities to understand research methodology and manuscripts and apply study results to clinical practice. (shrink)

In The Ethics of Food, Gregory E. Pence brings together a collection of voices who share the view that the ethics of genetically modified food is among the most pressing societal questions of our time. This comprehensive collection addresses a broad range of subjects, including the meaning of food, moral analyses of vegetarianism and starvation, the safety and environmental risks of genetically modified food, issues of global food politics and the food industry, and the relationships among food, evolution, and human (...) history. (shrink)

Existing social disparities in the United States are inconsistent with the promise of democracy; therefore, there was a need for critical conceptualization of the first principles that undergird American democracy and the genesis of democratic social change in America. This constructivist grounded theory study aimed to construct a grounded theory that provides an understanding of the process of American democratic social change as it emerged from the nation’s founding documents. A post hoc polytheoretical framework including Foucault’s, Bourdieu’s, and Marx and (...) Engels’s theories of power was used to understand power dynamics. The research question focused on understanding the process of democratic social change in America. The sample comprised the Articles of Confederation, the U.S. Declaration of Independence, The Federalist Papers, and the U.S. Constitution. The documents were retrieved from the National Archives and Library of Congress. The data analysis plan incorporated successive comparison, situational and dramaturgical analysis, deconstruction, and perspective taking as strategies. The result was the construction of a democratic social change process theory preceded by five grounded theories: (a) first principles of democracy, (b) first principles of democracy conceptual framework, (c) socio-ethical principles of democracy, (d) demoralizing process, and (e) either-or approach to democracy. Positive social change implications include applying a democratic social change process to future social change endeavors across domains and levels of analysis, a normative framework for a republican form of government, and a tool to analyze and minimize the latent consequences of social justice policies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Controversy Between Schelling and Jacobi LEWIS S. FORD SCHELLING, ALONGWITH FICHTE, has suffered the fate of being labelled one of tIegel's predecessors. Richard Kroner provides the classic expression of this viewpoint in his monumental study, Von Kant bis Hegel, which examines Schelling's thought primarily for its contribution to Hegel's final synthesis.I In English we have Josiah Royce's sympathetic and lively account of Schelling's early romantic exuberance, regarded (...) as a transitional stage in the development of German idealism. 2 But this emphasis on the early ScheUing has led to an unfortunate neglect of his work subsequent to the break with Hegel in 1807. Schelling's romanticism, so ably documented by E. D. Hirsch, Jr., 3 can only be regarded as one phase in the total sweep of his thought, for, after the break with Hegel, Schelling produced at least three major works: the essay •ber das Wesen der menschlichen Freiheit,4 wrestling with the problem of evil and human freedom, the fragmentary Weltalter, 5 which in scope and dialectical intricacy should be compared with Hegel's Logic, and the Philosophie der Mythologie und Offenbarung, 6 furnishing a fundamental critique of the whole dialectical enterprise. Save for the essay on human freedom, however, none of these works were published during his lifetinm, as Schelling withdrew from the public eye after his controversies with Hegel and Jacobi. Thus the publishing histories of Schelling and Hegel are exactly reverse. Schelling rushed into print his early speculative gropings, while Hegel suppressed his/making the Ph~nomenologic des Geistes his first major publication. Then while Hegel's Logic and Encyclopedia were being publicly acclaimed, Schelling remained silent. This accident of history is largely responsible for the illusion that Schelling is the older of the two x (Tiibingen: J. C. B. Mohr, 1921-24),2 vols. 2The Spirit of Modern Philosophy (Boston: Houghton Mifflin, 1892), Lecture VI, 164-189. Wordsworth and ScheUing, A Typological Study of Romanticism (New Haven: Yale University Press, 1960),Yale Studies in English, Vol. CXLV. 4Friedrich Wilhelm Joseph yon Sehelling, Philosophische Untersuchungen i~berdas Wesen der menschlichen Freyheit und die damit zusaramenhdngenden Gegenstdnde, 1809. Reprinted in the Sdmmtliche Werke, Erste Abtheilung, VII. Band (Stuttgart und Augsburg: J. G. Cotta, 1856), 331-416. English translation by James Gutmann: Of Human Freedom (Chicago: Open Court, 1936). 5Three fragmentary versions of the Weltalter have been published. The Urfassungen of 1811 and 1813were edited by Manfrcd SehrSter and published as a separate Naehlassband to the M~nchener Jubildumsausgabe of the collected works: Die Weltalter, Fragmente (Munich: Biederstein, Leibniz, 1946). A later version is published in S.W. I: 8, pp. 195-344,which has been translated by Frederick de Wolfe Bolman, Jr. : The Ages of the World (NewYork: Columbia University Press, 1942). 6Philosophie der Mythologie is published in S.W. II: 1-2; Philosophie der Offenbarung in S.W. II: 3-4. These essays were first collected and published by Herman Nohl in Hegels theologische Jugendschriften (Tiibingen: 1907).T. M. Knox translated them into English, with an introduction by Richard Kroner: GeorgWilhelm Friedrich Hegel, Early Theological Writings (Chicago: University of Chicago Press, 1948). [75] 76 HISTORY OF PHILOSOPHY thinkers (actually he was five years Hegel's junior), who retired from the philosophical scene after making his contribution to the Hegelian synthesis. Paul Tillich's doctoral dissertations s and Ernst Cassirer's studies in post-Kantian thought 9 made serious inroads on this conception, yet the iIInsion persisted. Their insistence on the importance of the later Schelling has been brilliantly sustained by two recent studies: Horst Fuhrmans's Schellings Philosophie der Weltalter1~and Walter Schulz's Die Vollendung des deutschen Idealismus in der Spdtphilosophie Schellings, ~ and we may hope that the conventional estimate of Schelling will be drastically revised. Fuhrmans has demonstrated that the split between the early and the later Schelling must be placed in the year 1806 when he came in contact with Franz yon Bander in Munich, who encouraged him to delve deeper into the theological and cosmological ramifications of Jacob Boehme's thought. TM The reorientation this caused is apparent in the essay on human freedom, published in 1809, but it was not fully exploited until the... (shrink)

Jōkei 貞慶, posthumously known as GEDATSU Shōnin 解脱上人, was a prominent scholar-monk of the Hossō 法相 school who lived during Japan’s momentous transition to a medieval society. Hossō 法相 is the East Asian transmission of the Indian Yogācāra system of thought. Jōkei is perhaps best known for his critique of Hōnen’s 法然 exclusive nenbutsu teachings, memorialized in a petition to the Court in 1205 C.E. to censure Hōnen and his followers. He is also noteworthy for promoting devotion to an eclectic (...) array of divine beings ranging from various Buddhas and bodhisattvas to popular kami. This essay will focus on Jōkei’s doctrinal reform efforts for which he has only recently been recognized. (shrink)

Honorable Mention, Joseph Levenson Prize, Association for Asian Studies By the middle of the third century B.C.E. in China there were individuals who sought to become transcendents deathless, godlike beings endowed with supernormal powers. This quest for transcendence became a major form of religious expression and helped lay the foundation on which the first Daoist religion was built. Both xian and those who aspired to this exalted status in the centuries leading up to 350 C.E. have traditionally been portrayed as (...) secretive and hermit-like figures. This groundbreaking study offers a very different view of xian-seekers in late classical and early medieval China. It suggests that transcendence did not involve a withdrawal from society but rather should be seen as a religious role situated among other social roles and conceived in contrast to them. Robert Campany argues that the much-discussed secrecy surrounding ascetic disciplines was actually one important way in which practitioners presented themselves to others. He contends, moreover, that many adepts were not socially isolated at all but were much sought after for their power to heal the sick, divine the future, and narrate their exotic experiences. The book moves from a description of the roles of xian and xian-seekers to an account of how individuals filled these roles, whether by their own agency or by others or, often, by both. Campany summarizes the repertoire of features that constituted xian roles and presents a detailed example of what analyses of those cultural repertoires look like. He charts the functions of a basic dialectic in the self-presentations of adepts and examines their narratives and relations with others, including family members and officials. Finally, he looks at hagiographies as attempts to persuade readers as to the identities and reputations of past individuals. His interpretation of these stories allows us to see how reputations were shaped and even co-opted sometimes quite surprisingly into the ranks of xian. Making Transcendents provides a nuanced discussion that draws on a sophisticated grasp of diverse theoretical sources while being thoroughly grounded in traditional Chinese hagiographical, historiographical, and scriptural texts. The picture it presents of the quest for transcendence as a social phenomenon in early medieval China is original and provocative, as is the paradigm it offers for understanding the roles of holy persons in other societies. (shrink)

Because spaying/neutering animals involves the harming of some animals in order to prevent harm to others, some ethicists, like David Boonin, argue that the philosophy of animal rights is committed to the view that spaying/neutering animals violates the respect principle and that Trap Neuter Release programs are thus impermissible. In response, I demonstrate that the philosophy of animal rights holds that, under certain conditions, it is justified, and sometimes even obligatory, to cause harm to some animals in order to prevent (...) greater harm to others. As I will argue, causing lesser harm to some animals in order to prevent greater harm to others, as TNR programs do, is compatible with the recognition of the inherent value of the ones who are harmed. Indeed, we can, and do, spay/neuter cats while acknowledging that they have value in their own right. (shrink)

It is common for conservationists to refer to non-native species that have undesirable impacts on humans as “invasive”. We argue that the classification of any species as “invasive” constitutes wrongful discrimination. Moreover, we argue that its being wrong to categorize a species as invasive is perfectly compatible with it being morally permissible to kill animals—assuming that conservationists “kill equally”. It simply is not compatible with the double standard that conservationists tend to employ in their decisions about who lives and who (...) dies. (shrink)

The philosophy of animal rights is often characterized as an exclusively justice oriented approach to animal liberation that is unconcerned with, and moreover suspicious of, moral emotions, like sympathy, empathy, and compassion. I argue that the philosophy of animal rights can, and should, acknowledge that compassion plays an integral role in animal liberation discourse and theory. Because compassion motivates moral actors to relieve the serious injustices that other animals face, or, at the very least, compassion moves actors not to participate (...) in or cause these injustices, the philosophy of animal rights can and should recognize both a duty to cultivate compassion and a duty to promote compassion. Contra to feminist critiques of Regan’s justice-approach to ethics, the philosophy of animal rights is not committed to eschewing the moral emotions. (shrink)

The December 2008 White Paper (WP) on “Brain Death” published by the President’s Council on Bioethics (PCBE) reaffirmed its support for the traditional neurological criteria for human death. It spends considerable time explaining and critiquing what it takes to be the most challenging recent argument opposing the neurological criteria formulated by D. Alan Shewmon, a leading critic of the “whole brain death” standard. The purpose of this essay is to evaluate and critique the PCBE’s argument. The essay begins with a (...) brief background on the history of the neurological criteria in the United States and on the preparation of the 2008 WP. After introducing the WP’s contents, the essay sets forth Shewmon’s challenge to the traditional neurological criteria and the PCBE’s reply to Shewmon. The essay concludes by critiquing the WP’s novel justification for reaffirming the traditional conclusion, a justification the essay finds wanting. (shrink)

This article proposes a geostatistical solution for area-to-point spatial prediction (downscaling) taking into account boundary effects. Such effects are often poorly considered in downscaling, even though they often have significant impact on the results. The geostatistical approach proposed in this article considers two types of boundary conditions (BC), that is, a Dirichlet-type condition and a Neumann-type condition, while satisfying several critical issues in downscaling: the coherence of predictions, the explicit consideration of support differences, and the assessment of uncertainty regarding the (...) point predictions. An updating algorithm is used to reduce the computational cost of area-to-point prediction under a given BC. In a case study, area-to-point prediction under a Dirichlet-type BC and a Neumann-type BC is illustrated using simulated data, and the resulting predictions and error variances are compared with those obtained without considering such conditions. (shrink)

If mental anomalism is to be interpreted as a thesisunique to psychology, the anomalousness must begrounded in some feature unique to the mental,presumably its rational nature. While the ground forsuch arguments from normativity has been notoriouslyslippery terrain, there are two recently influentialstrategies which make the argument precise. The firstis to deny the possibility of psychophysical bridgelaws because of the different constitutive essences ofmental and physical laws, and the second is to arguethat mental anomalism follows from the uncodifiabilityof rationality. In this (...) paper I argue that bothstrategies fail – the latter because it conflates primafacie and all things considered rationality and theformer because it rests on a false premise, theprinciple of the rational character of belief. Idistinguish four different formulations of thisprinciple and argue that those formulations which areplausible cannot support the argument for mentalanomalism. (shrink)

Nevertheless, and in spite of these drawbacks, it will be clearly intimated to him that the value of philosophy is, indeed, very great, although it happens ...

Because factory-farmed meat production inflicts gratuitous suffering upon animals and wreaks havoc on the environment, there are morally compelling reasons to become vegetarian. Yet industrial plant agriculture causes the death of many field animals, and this leads some to question whether consumers ought to get some of their protein from certain kinds of non factory-farmed meat. Donald Bruckner, for instance, boldly argues that the harm principle implies an obligation to collect and consume roadkill and that strict vegetarianism is thus immoral. (...) But this argument works only if the following claims are true: all humans have access to roadkill, roadkill would go to waste if those who happen upon it don’t themselves consume it, it’s impossible to harvest vegetables without killing animals, the animals who are killed in plant production are all-things-considered harmed by crop farming, and the best arguments for vegetarianism all endorse the harm principle. As I will argue in this paper, each claim is deeply problematic. Consequently, in most cases, humans ought to strictly eat plants and save the roadkill for cats. (shrink)

Wigner time reversal implemented by antiunitary transformations on the wavefunctions is to be refined if we are to deal with systems with internal symmetry. The necessary refinements are formulated. Application to a number of physical problems is made with some unexpected revelations about some popular models.

Systematic pluralism does not purport to be a new philosophy. Rather, it is a position on positions, a discovery of something previously unrecognized in the nature of philosophical thought. Further, “since the special arts and sciences are particular embodiments of philosophic principles, a pluralism at the level of philosophy implies a similar pluralism at the level of the special arts and sciences.” Therefore, the claims of systematic pluralism are not limited to philosophy but the position has something fundamental to report (...) about all departments of human thought, resulting in the characteristic movement between levels of generality, from widest philosophical import to narrowest disciplinary application, which appears over and over again in the writings of systematic pluralists and which is well exemplified by the essays in this issue of The Monist, the first of any publication dedicated entirely to the examination of discoveries which are now over half a century old. (shrink)

An adequate theory of rights ought to forbid the harming of animals to promote trivial interests of humans, as is often done in the animal-user industries. But what should the rights view say about situations in which harming some animals is necessary to prevent intolerable injustices to other animals? I develop an account of respectful treatment on which, under certain conditions, it’s justified to intentionally harm some individuals to prevent serious harm to others. This can be compatible with recognizing the (...) inherent value of the ones who are harmed. My theory has important implications for contemporary moral issues in nonhuman animal ethics, such as the development of cultured meat and animal research. (shrink)