Objective: Ethical guidelines are designed to ensure benefits, protection and respect of participants in clinical research. Clinical trials must now be registered on open-access databases and provide details on ethical considerations. This systematic survey aimed to determine the extent to which recently registered clinical trials report the use of standard of care and post-trial obligations in trial registries, and whether trial characteristics vary according to setting. Methods: We selected global randomized trials registered on http://www.clinicaltrials.gov and http://www.controlled-trials.com. We searched for intervention (...) trials of HIV/AIDS, malaria, and tuberculosis from 9 October 2004, the date of the most recent version of the Helsinki Declaration, to 10 April 2007. Results: We collected data from 312 trials. Fifty-eight percent (58%, 95% CI = 53 to 64) of trial protocols report informed consent. Fifty-eight percent (58%, 95% CI = 53 to 64) of trials report active controls. Almost no trials (1%, 95% CI = 0.5 to 3) mention post-trial provisions. Most trials measure surrogate outcomes. Twenty percent (20%, 95% CI = 16 to 25) of trials measure patient-important outcomes, such as death; and the odds that these outcomes are in a low income country are five times greater than for a developed country (odds ratio (OR) 5.03, 95% CI = 2.70 to 9.35, p = < 0.001). Pharmaceutical companies are involved in 28% (CI = 23 to 33) of trials and measure surrogate outcomes more often than nonpharmaceutical companies (OR 2.45, 95% CI = 1.18 to 5.09, p = 0.31). Conclusion: We found a large discrepancy in the quality of reporting and approaches used in trials in developing settings compared to wealthier settings. (shrink)

Scientists seeking hard evidence of prayer's curative powers misunderstand the nature of prayer in the Western theistic traditions. Yet theistically consonant ways in which religious belief may influence health do not figure as they should in current professional practice.

A number of theoretical positions in psychology—including variants of case‐based reasoning, instance‐based analogy, and connectionist models—maintain that abstract rules are not involved in human reasoning, or at best play a minor role. Other views hold that the use of abstract rules is a core aspect of human reasoning. We propose eight criteria for determining whether or not people use abstract rules in reasoning, and examine evidence relevant to each criterion for several rule systems. We argue that there is substantial evidence (...) that several different inferential rules, including modus ponens, contractual rules, causal rules, and the law of large numbers, are used in solving everyday problems. We discuss the implications for various theoretical positions and consider hybrid mechanisms that combine aspects of instance and rule models. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 25.2 (2001) 364-367 [Access article in PDF] Book Review Hamlet in Purgatory Hamlet in Purgatory, by Stephen Greenblatt; xii & 322 pp. Princeton: Princeton University Press, 2001, $29.95. Hamlet in Purgatory is both more and less than literary criticism of Shakespeare's most haunting and most critically belabored play. Greenblatt has captured an evolving culture of belief which informs the play and goes far beyond source studies (...) or the history of ideas. He assays to show how the Medieval doctrine of Purgatory and the rejection of it by Protestant Reformers shaped the structure of Hamlet and the world of Hamlet's spiritual agony.Central to the argument is the notion that the rejection of Purgatory, and ritual practices associated with the doctrine, threatened to disrupt community and sever the relations between the living and the dead. Thus, the senior Hamlet's plea to "Remember me" takes precedence over his injunction to revenge; traditional preoccupations of Hamlet criticism become secondary to the concern for spiritual community which Reformation doctrine threatened. The exegesis is scholarly and the prose is engaging, yet the book suffers from the new historicist tendency to become absorbed more with context than with criticism and to assume too readily the relevance of the context to the criticism. Put another way, Greenblatt, like other new historicists, is not always rigorous in his inferences.Greenblatt warns that his book "requires a certain hermeneutical patience, a willingness to suspend direct literary analysis, in order to examine more thoroughly what has been treated as mere background for the canonical work of art" (p. 5). Although the book culminates in a description of the migration of discarded religious ritual into the theater, and a thoughtful commentary on Hamlet, Greenblatt cautions that "... for the book to work properly, the reader should understand literary analysis, and specifically the analysis of Hamlet, to be suspended in another sense as well, that is, distributed in tiny, almost invisible particles throughout my account" (p. 5). Amen. The caveats are essential for anyone who might expect an "interpretation" of Hamlet. Rather, Greenblatt has evoked the conflict of enduring beliefs and Reformist critiques which animated Shakespeare's imagination and Hamlet's suffering.Hermeneutical patience certainly is demanded of the reader, because more than half of the book presents commentaries on the doctrine of Purgatory from the late Middle Ages to the early seventeenth century. Greenblatt begins with Simon Fish's 1529 "Supplication for the Beggars," (p. 15) an anti-purgatorial (and anti-clerical) tract addressed to Henry VIII. Fish argued that the doctrine of Purgatory is at the heart of ecclesiastical corruption and is a danger to the state, because the fear that the doctrine can generate enables the clergy to extort enormous wealth in the form of "suffrages," donations for trentals, anniversary Masses, and other perpetual penitential memorials on behalf of the dead. Fish's argument is double: its theological burden is that Purgatory is a non-scriptural superstition; its rhetoric is that it is an abuse of the [End Page 364] poor and a danger to the economic solvency of the kingdom. Fish invokes both doctrinal error and political danger; this is thus an excellent tract to begin the elucidation of the complexity of Reformist objections to Purgatory in sixteenth-century England. Greenblatt adds that other Reformers saw Purgatory as a poetic creation, a fable, and therefore a vain imagining. John Donne's "Devotions upon Emergent Occasions" is cited to show that post-Catholic divines believed that purgation must be completed in this life.According to Greenblatt, an unintended consequence for the laity of the rejection of Purgatory is the creation of a radical divide between the living and the dead. If we pray for the dead, they are not as absent from us as if they had passed on to the timeless worlds of Heaven or Hell. Even if Purgatory is expensive or fabulous, its loss destroys a community with the dead that involved a reciprocal and continuing relationship, whereby the living can aid the dead towards Heaven and saved souls can eventually become intercessors in Heaven for the living... (shrink)

This article examines the role played by US foundations in shaping the academic field of race relations and a black social movement in Brazil. It takes issue with Pierre Bourdieu and Loïc Wacquant's assertion that US foundations use their power to impose a US model on understanding race in Brazil. Their analysis exaggerates the power of US foundations in Brazil, fails to understand how programming decisions are made within the foundations, greatly underestimates the intellectual agency of the Brazilian academy and (...) its black social movement, and reveals a rather dated understanding of the academic literature and public opinion on race in Brazil. The author relies on information gleaned from his former position as a Program Officer of the Ford Foundation in Rio de Janeiro and as a researcher of Brazilian race relations. (shrink)

In 2004 a survey was conducted in the member states of the European Union designed to gain greater insight into the views on control strategies for foot and mouth disease, classical swine fever, and avian influenza with respect to the epidemiological, economic and social-ethical consequences of each of these animal diseases. This article presents the results of the social-ethical survey. A selection of stakeholders from each member state was asked to prioritize issues for the prevention and control of these diseases. (...) A majority of stakeholders chose preventive measures as the preferred issue. An analysis was done to determine whether there were differences in views expressed by stakeholders from member states with a history of recent epidemics and ones without such a history, and whether there were regional differences. There were no differences between member states with or without a history of recent epidemics. There were indeed regional differences between the priority orders from Northern and Southern Europe on the one hand, and from Eastern Europe on the other. (shrink)

This paper examines the relationship between Savage's sure thing principle and the value of information. We present two classes of results. First, we show that, under a consequentialist axiom, the sure-thing principle is neither sufficient nor necessary for perfect information to be always desirable: specifically, under consequentialism, the sure thing principle is not implied by the condition that perfect information is always valuable; moreover, the joint imposition of the sure thing principle, consequentialism and either one of two state independence axioms (...) does not imply that perfect information is always desirable. Second, we demonstrate that, under consequentialism, the sure thing principle is necessary for a nonnegative value of possibly imperfect information (though of course the principle is still not sufficient). One implication of these results is that the sure thing principle, under consequentialism, plays a somewhat different role in ensuring dynamic consistency in decision making under uncertainty than does the independence axiom in decision making under risk. (shrink)

In two studies we investigated the association between physical cleansing and moral and immoral behavior in real-life situations. In Study 1, after a workout at the gym, participants cheated more after taking a shower than before taking one. In the second study, participants donated more money to charity before rather than after they bathed for religious purification. The results extend previous findings about moral cleansing and moral licensing and are discussed within the framework of conceptual metaphor theory.

Many neuroimaging studies of semantic memory have argued that knowledge of an object's perceptual properties are represented in a modality-specific manner. These studies often base their argument on finding activation in the left-hemisphere fusiform gyrus-a region assumed to be involved in perceptual processing-when the participant is verifying verbal statements about objects and properties. In this paper, we report an extension of one of these influential papers-Kan, Barsalou, Solomon, Minor, and Thompson-Schill (2003 )-and present evidence for an amodal component in the (...) representation and processing of perceptual knowledge. Participants were required to verify object-property statements (e.g., "cat-whiskers?"; "bear-wings?") while they were being scanned by functional magnetic resonance imaging (fMRI). We replicated Kan et al.'s activation in the left fusiform gyrus, but also found activation in regions of left inferior frontal gyrus (IFG) and middle-temporal gyrus, areas known to reflect amodal processes or representations. Further, only activations in the left IFG, an amodal area, were correlated with measures of behavioural performance. (shrink)

Deep brain stimulation (DBS) to different sites allows interfering with dysfunctional network function implicated in major depression. Because a prominent clinical feature of depression is anhedonia--the inability to experience pleasure from previously pleasurable activities--and because there is clear evidence of dysfunctions of the reward system in depression, DBS to the nucleus accumbens might offer a new possibility to target depressive symptomatology in otherwise treatment-resistant depression. Three patients suffering from extremely resistant forms of depression, who did not respond to pharmacotherapy, psychotherapy, (...) and electroconvulsive therapy, were implanted with bilateral DBS electrodes in the nucleus accumbens. Stimulation parameters were modified in a double-blind manner, and clinical ratings were assessed at each modification. Additionally, brain metabolism was assessed 1 week before and 1 week after stimulation onset. Clinical ratings improved in all three patients when the stimulator was on, and worsened in all three patients when the stimulator was turned off. Effects were observable immediately, and no side effects occurred in any of the patients. Using FDG-PET, significant changes in brain metabolism as a function of the stimulation in fronto-striatal networks were observed. No unwanted effects of DBS other than those directly related to the surgical procedure (eg pain at sites of implantation) were observed. Dysfunctions of the reward system--in which the nucleus accumbens is a key structure--are implicated in the neurobiology of major depression and might be responsible for impaired reward processing, as evidenced by the symptom of anhedonia. These preliminary findings suggest that DBS to the nucleus accumbens might be a hypothesis-guided approach for refractory major depression. (shrink)

There is a continuum between prototypical cases of rule use and prototypical cases of similarity use. A prototypical rule: (1) is explicitly represented, (2) can be verbalized, and (3) requires that the user selectively attend to a few features of the object, while ignoring the others. Prototypical similarity-use requires that: (1) the user should match the object to a mental representation holistically, and (2) there should be no selective attention or inhibition. Neural evidence supports prototypical rule-use. Most models of categorization (...) fall between the two prototypes. (shrink)

Three decades ago Gilbert posited that novel proteins arise by re‐shuffling genomic sequences encoding polypeptide domains. Today, with numerous genomes and countless genes sequenced, it is well established that recombination of sequences encoding polypeptide domains plays a major role in protein evolution. There is, however, less evidence to suggest how the novel polypeptide domains, themselves, arise. Recent comparisons of genomes from closely related species have revealed numerous species‐specific exons, supporting models of domain origin based on “exonization” of intron sequences. Also, (...) a mechanism for the origin of novel polypeptide domains has been proposed based on analyses of insertion‐based polymorphisms between orthologous genes across broad phylogenetic spectra and between allelic variants of genes within species. This review discusses these processes and how each might participate in the evolutionary emergence of novel polypeptide domains. BioEssays 29: 262–270, 2007. © 2007 Wiley Periodicals, Inc. (shrink)