Background More than one in 10 of all prisoners in England and Wales are Foreign Nationals. This article discusses whether the research applications to one London prison are aimed at understanding a prisoner population characterised by significant multinational and multilingual complexity. Methods We studied all accessible documents relating to research undertaken at a women's prison between 2005 and 2009 to assess the involvement of Foreign National prisoners and women with limited English. The source of information was prison research applications and (...) protocols. We also looked at available final research reports and journal articles. Results Two key findings emerged from this study. First, studies at this prison frequently excluded Foreign National prisoners and women with limited English. Second, Foreign National prisoners were often clustered as a homogeneous category in the research reports reviewed. This is despite their diverse cultural backgrounds, their variable immigration status and their differing competence in English, all of which affect their lives. Conclusions The failure to include and/or identify social subgroups of the population can undermine the value of research, including, in the case of the study prison, funded health research. This can compromise associated needs assessments and service delivery, particularly important in already disadvantaged populations; this may encourage and/or perpetuate a range of health inequalities. There is a pressing need to examine cultural exclusion in other health and criminal justice settings, to assess the ways in which—and the extent to which—such exclusion may compromise the merit of proposed and completed health and social research. (shrink)

Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

Beş sanattan şiir felsefe tarihi boyunca kendini sürekli gündemde tutmayı başarmıştır. Platon şiire daha çok politik/dini kaygı çerçevesinde yaklaşarak onun dönüştürücü gücünü ideal devleti bağlamında kontrol altına almaya çalışırken Aristoteles şiir sanatına büyük önem vermiş ve bu bağlamda Poetika adlı müstakil eserini kaleme almıştır. Daha sonraki süreçte bu eser öğrencileri tarafından Organon (alet) isimli mantık külliyatının içine dâhil edilmiştir. Platon’un muhteva kritiği diyebileceğimiz yaklaşımından farklı olarak şiiri daha çok form bağlamında ele alan Aristoteles’in söz konusu politik kaygıyı gütmediği anlaşılmaktadır. Ancak (...) şiir, tüm bu geleneklerden beslenen Fârâbî’ye kadar mantık ile doğrudan ilgisi kurulan bir sanat olarak ortaya çıkmaz. Fârâbî’nin özgünlüğü şiiri edebi bir tür olmanın yanında mantıksal ilgisi bağlamında ele almış olmasıdır. Bu makalede şiir ile mantık ilişkisinin Fârâbî’de biri şiirin felsefe öğreniminde ve kıyas türleri bağlamında işlevselliğine diğeri ise mantığın şiirin beş sanat içerisinde tanınmasını ve ayrıştırılmasını sağlayan yönüne işaret eden iki veçheli bir şekilde tasarlandığı savunulacaktır. (shrink)

Değer felsefesindeki önemli ayrımlardan birisi özsel değer ve araçsal değer ayrımıdır. Bu ayrıma göre bazı şeyler dışsal ilişkilerinden bağımsız şekilde, kendi doğası itibariyle, özsel şekilde değerli iken bazı şeyler, böyle olmayıp ancak özsel şekilde değerli olan başka bir şeye araç olması itibariyle değerlidir. Bu ayrım üzerinden ilerlediğimiz zaman önümüze çıkan temel sorulardan birisi hangi şeylerin özsel şekilde değerli olduğu sorusudur. Hedonizm bu soruya sadece hazzın özsel şekilde değerli olduğu ve haz dışındaki her şeyin sadece hazza götürmesi veya haz vermesi sayesinde, (...) araçsal olarak değerli olduğu cevabını verir. Fakat hedonizmin bu temel iddiası yeteri kadar temellendirilmiş midir? Bu temel tez lehinde yeteri kadar sağlam veya güçlü argümanlar var mıdır? Yine bu temel tez aleyhinde sağlam veya güçlü argümanlar var mıdır? Bu çalışmada bu sorulara cevap bulmaya çalıştık. Daha spesifik olarak da çalışmamızda, hedonizmin lehinde sunulan yaygın argümanların yeteri kadar güçlü olmadığını, genelde, yaygın olarak başvurulan argümanların öncüllerinin doğruluğunun yeteri kadar açık veya temellendirilmiş olmamasından hareketle göstermeye çalıştık. Diğer yandan hedonizmin aleyhindeki, onun tutarsızlığına veya temel tezinin makul olmadığına işaret eden karşı argümanları sunduk. Böylece hedonizmin lehindeki argümanların yetersiz olduğu ve onun aleyhinde çok sayıda ikna edici argümanın bulunduğu gerekçelerinden hareketle hedonizmin felsefi açıdan temellendirilmiş, sağlam bir yaklaşım olmadığını savunmaya çalıştık. (shrink)

Dürziler, gerek itikadi açıdan gerekse de hukuki prensipleri bağlamında Osmanlı-Hanefi ideolojisi dışında kalan bir cemaatti. Bununla birlikte Dürzi liderler 19. Yüzyılın başlarına kadar devletin Cebel-i Lübnan’daki idari tem-silcileri olarak siyasi otoriteyi ellerinde tutmayı başardılar. Bunun yanı sıra geleneksel hukuklarını da koruyan Dürziler, Osmanlı Devleti’nin sosyal yapısını oluşturan Millet Sistemi içinde farklı bir pozisyonda kimlik edindiler. Tanzimat reformlarının Cebel-i Lübnan’da uygulanmaya başlaması ise Dürzilerin kimlik tanımlarında siyasi paradigmaların dışına çıkmalarına sebep olmuş, Osmanlı kimliğini İslami terminolojiyle tamamlamak adına hareket eden cemaat, hukuki (...) statülerini bir meşruiyet aracı olarak kullanmaya başlamış ve devletin değişen reformist duruşu karşısında farklı bir hukuki yer edinmeye çalışmışlardı. Bu çalışma, Cebel-i Lübnanlı Dürzilerin Osmanlı Devleti’nin son zamanlarında ortaya çıkan kimlik problemine bakışlarını ele almakta, cemaatin meşruiyet kaygılarına karşı aldığı tedbir ve devletin hukuk politikasını incelemektedir. Araştırmada kendi kaynaklarında ve Osmanlı arşivinde yer alan bazı Dürzi davalarından örnekler verilerek cemaatin iç hukukuna değinilmiş, ayrıca devletin mezhep siyasetinde izlediği yöntemin Dürziler üzerindeki etkisi analiz edilmiştir. (shrink)

Individuals, Institutions, and Markets offers a theory of how the institutional framework of a society emerges and how markets within institutions work. The book shows that both social institutions, defined as the rules of the game, and exchange processes can be analyzed along a common theoretical structure. Mantzavinos' proposal is that a problem solving model of individual behavior inspired by the cognitive sciences provides such a unifying theoretical structure. Integrating the latest scholarship in economics, sociology, political science, law, and anthropology, (...) Mantzavinos offers a genuine political economy showing how social institutions affect economic outcomes. (shrink)

We have examined only a few of the basic questions about causal inference that result from Reichenbach's two principles. We have not considered what happens when the probability distribution is a mixture of distributions from different causal structures, or how unmeasured common causes can be detected, or what inferences can reliably be drawn about causal relations among unmeasured variables, or the exact advantages that experimental control offers. A good deal is known about these questions, and there is a good deal (...) more to find out. (shrink)

Introduction: conceptual analysis of teaching, by B. P. Komisar and T. W. Nelson.--A concept of teaching, by B. O. Smith.--The concept of teaching, by I. Sheffler.--A topology of the teaching concept, by T. F. Green.--Teaching: act and enterprise, by B. P. Komisar.--Must an education have an aim? By R. S. Peters.--Curriculum as a field of study, by D. Heubner.--Can and should means-ends reasoning be used in teaching? By C. J. B. Macmillan and J. E. McClellan.

In this interview, C. P. Goodman invites British Polanyi scholar Richard T. Allen to reflect on his interest in Polanyi’s philosophical ideas and share what he believes is valuable in his thought.

Rawlsians argue for principles of justice that apply exclusively to the basic structure of society, but it can seem strange that those who accept these principles should not also regulate their choices by them. Valid moral principles should seemingly identify ideals for both institutions and individuals. What justifies this nonintuitive distinction between institutional and individual principles is not a moral division of labor but Rawls’s dual commitments to conventionalism and constructivism. Conventionalism distinguishes the relevant ideals for evaluating institutions from those (...) for evaluating actions, while constructivism explains why this distinction is morally fundamental. (shrink)

This paper sets out to assess the internal coherence of Roy Bhaskar's transcendental realist account of science. Whilst fully supporting his transcendental derivation of a stratified ontology of structures and generative mechanisms from the scientific practice of experimentation, I argue that Bhaskar's adoption of the stance of epistemic relativism results in his inability to defend the generalizability of this ontology. My argument against his epistemic stance turns on the fact that it rests on a false dichotomy between epistemic relativism and (...) epistemic absolutism, and, moreover, that it is quite unnecessary for his efforts to avoid the excesses of epistemological foundationalism. The net result of this stance, in my view, is an inability to sustain the normative force of the concepts of truth and scientific explanation precisely at a time when postmodern authors are denying their privileged status. (shrink)

Patients with 'persistent vegetative state' (PVS) are often cited in the discussions of ethicists as examples of human beings who are unconscious and do not experience life, and a number of theoretical and practical recommendations have been made on that basis. This article examines the evidence and the theoretical rationale for the belief that people with PVS are unconscious and finds them wanting. This conclusion is related to the practice of the discipline of ethics.

We give a short, critical review of the issue of decoherence. We estab- lish the most general framework in which decoherence can be discussed, how it can be quantified and how it can be measured. We focus on environment induced decoher- ence and its degree of usefulness for the interpretation of quantum theory. We finally discuss the emergence of a classical world. An overall emphasis is given in pointing at common fallacies and misconceptions.

An appropriate combination of Quine’s ontology and Frege’s semantics is useful to emphasize the empirical entities “ethnic group” and “nation” expressed through an axiomatic system. If “cultural diversity” is taken as a primitive because it is good ethically and it is beautiful esthetically, then “internationalist nationalism” is the correct order of human society from a political point of view.

Despite the prominence of healthcare-relatedconcerns in public debate, the ground remainsinfertile for the idea of conscripting citizensinto medical research. Reluctance to entertainthe thought of a system where nearly everyonecould be selected for service might reflectuncertainty about what the project wouldinvolve. There might also be a fear that themore crucial issue is how to protect researchsubjects within current, voluntary systems. Nodoubt reluctance to explore a system ofuniversal service results from the common hopethat each of us might avoid research in anycapacity besides (...) researcher. A system of fullcivic participation might, however, avoid manyof the usual objections. Ethics regulations,including informed-consent guidelines, couldfor the most part remain in force. Though thesystem would compel people to serve, it couldremain responsive to principles of autonomy andjustice if it centered on broad publiceducation, community representation, and alottery-type selection process. The systemcould draw from the largest possiblecross-section of society, and offer conscriptsthe widest possible range of service. In thisway, a compulsory system might reconcile theexpectations about healthcare with researchneeds. (shrink)

It is now widely accepted that a patient's ability to engage in autonomous decision-making can be seriously threatened when she denies significant aspects of her medical condition. In this paper I use a true case to reveal the harmful effects of physician denial upon patient autonomy and well-being. I suggest further that such physician denial may be more common than is generally acknowledged, since aspects of the contemporary medical ethos likely serve to reinforce rather than to undercut such denial.

Thinking aloud is the concurrent verbalization of thoughts while performing a task. The study of thinking-aloud protocols has a long tradition in cognitive psychology, the field of education, and the industrial-organizational context. It has been used rarely in cultural and cross-cultural psychology. This paper will describe thinking aloud as a useful method in cultural and cross-cultural psychology referring to a few studies in general and one study in particular to show the wide applications of this method. Thinking-aloud protocols can be (...) applied for a) improving the validity of cross-cultural surveys, b) process analysis of thoughts and the analysis of changes over time, c) theory development across cultures, d) the study of cultural meaning systems, and e) individual as well as group level analyses allowing hypothesis testing cross-culturally. Limitations of the thinking-aloud method are also discussed. (shrink)

Routledge is now re-issuing this prestigious series of 204 volumes originally published between 1910 and 1965.

Disabling pain or symptoms can occur at any age from many different causes. Pain and palliative specialists are able to relieve most pain and symptoms, although repeated adjustments to modalities, medications and doses may be needed. Because pain and palliative specialists comprise only a small percentage of physicians, many patients find it difficult to access them or obtain pain relief. Globally, there are too few such specialists to meet existing needs. Most are affiliated with hospice and palliative units, so their (...) accessibility to patients without terminal conditions is negligible. Doctors outside pain and palliative specialties are often unfamiliar with pain guidelines and sceptical about patient reports of unrelieved pain. They are therefore likely to undertreat it. Undertreating pain, however, violates respect for persons and beneficence. This paper reviews literature supporting these claims and offers a narrative description of the author’s attempts to find relief from shingles and postherpetic neuralgia. It argues that physicians in most specialties are not, but should be, familiar with palliative evidence and guidelines so that they are equipped to relieve pain and symptoms quickly and effectively. Such information should be routinely introduced in medical curricula to encourage the mastery of knowledge, attitudes and skills necessary to upholding ethical principles and to ensure that more doctors in any discipline are willing to believe and be compassionate to patients whose pain is unresponsive to initial treatments. Routinely exposing students to such information would better prepare them to fulfil their professional duties to patients and society. (shrink)