Anselm: I agreed that Pegasus is a flying horse according to the stories people tell, the paintings painters paint and so on . That is, Pegasus is a flying horse in the understanding of storytellers, their readers and the artists who depict Pegasus. You asked whether flying is not an unmediated causal power . Well, it could be an unmediated causal power if you or I had it, but not if a being with only mediated powers had it. And so (...) poor Pegasus, a being whose powers are only those given him by storytellers and artists, has only the mediated power of flying that they have given him. He flies in the thoughts and depictions of beings with unmediated powers. Still, Pegasus has not only the mediated power to fly but also the mediated power to entertain us, and perhaps even inspire us. Fool: But people could tell stories about you, too, about how you sprouted wings and flew onto the roof of Canterbury Cathedral. Anselm: Alas, if it were only in stories that I could do that, then flying would not be an unmediated causal power of mine. I would still have unmediated causal powers all right, and so would be greater than Pegasus. But flying is not one of my unmediated causal powers. However, something than which nothing greater can be conceived would, and does, as I have proved in my Proslogion, have unmediated causal powers – indeed, much greater unmediated causal powers than any poor mortals like you and me.1 •↵1 For …. (shrink)

On August 29, 1995, the United States District Court for the Northern District of Ohio ruled that certain practices of Blue Cross and Blue Shield of Ohio relating to the calculation of copayments on insurance claims violated provisions of ERISA, and thus BCBSO could be liable for unpaid benefits and breach of fiduciary duty ). According to BCBSO's Explanation of Benefits and Schedule of Benefits, beneficiaries were responsible for a 20 percent copayment for hospital charges, and the remaining 80 percent (...) of the Provider's Reasonable Charges would be paid by BCBSO. BCBSO negotiated with the hospitals to create discount agreements whereby the actual charge to BCBSO was less than 80 percent of the total amount of the hospital's charges. By this arrangement, BCBSO paid less than 80 percent of what patients were billed; concurrently, patients paid more than 20 percent of the amount ultimately paid to hospitals for their services. (shrink)

Background. Africa has seen an increase in the number of health research projects being conducted on the continent, particularly clinical trials. Ideally, this should be accompanied by a commensurate improvement in research ethics review capacity to competently provide the much-required research ethics oversight. Unfortunately, this is not the case in many African countries, which are still grappling with weak research ethics oversight capacity, not only at national level but also at institutional level. Objectives. To describe the proposal by Kenya’s national (...) research ethics regulatory authority, the National Commission for Science Technology and Innovation (NACOSTI), to build the capacity of its National Scientific and Ethics Committee (NSEC), tasked with providing the required research ethics oversight in the country. Methods. This is the proposal submitted by NACOSTI to the European and Developing Countries Clinical Trials Partnership for funding of a project entitled ‘Strengthening Research Ethics and Oversight in Kenya’ (STReK). It describes the activities involved to strengthen the NSEC to provide the required research ethics in the country, and to build the research ethics capacity of research ethics committees (RECs) it has accredited, through training and mentorship programmes, to enable them to efficiently review research proposals. Results. Proposed activities of the project are presented. Implementation of the activities described is ongoing. Conclusion. Lessons learnt in this regard may be of benefit to other research ethics regulatory authorities in resource-constrained countries aiming to strengthen their research ethics oversight capacity. (shrink)