BackgroundThe aim of this survey was to determine the level of awareness and understanding of peer review and peer review models amongst junior hospital doctors and whether this influences clinical decision-making.MethodsA 30-question online anonymous survey was developed aimed at determining awareness of peer review models and the purpose of peer review, perceived trustworthiness of different peer review models and the role of peer review in clinical decision-making. It was sent to 800 trainee doctors in medical specialties on the University College (...) London Partners trainee database.ResultsThe response rate was (178/800) 22%. Most respondents were specialist registrars. Checking that research is conducted correctly (152/178, 85%) and the data interpreted correctly (148/178, 83%) were viewed as the most important purposes of peer review. Most respondents were aware of open (133/178, 75%), double-blind (125/178, 70%) and single-blind peer review (121/178, 68%). 101/178 (57%) had heard of collaborative, 87/178 (49%) of post publication and 29/178 (16%) of decoupled peer review. Of those who were aware of double-blind, single-blind open and collaborative peer review, 85 (68%), 82 (68%), 74 (56%) and 24 (24%), respectively, understood how they worked. The NEJM, Lancet and The BMJ were deemed to have most trustworthy peer review, 137/178 (77%), 129/178 (72%) and 115/178 (65%), respectively. That peer review had taken place was important for a journal content to be used for clinical decision-making 152/178 (85%), but the ability to see peer review reports was not as important 22/178 (12%). Most felt there was a need for peer review training and that this should be at the specialist registrar stage of training.ConclusionsJunior hospital doctors view peer review to be important as a means of quality control, but do not value the ability to scrutinize peer review themselves. The unquestioning acceptance of peer review as final validation in the field of medicine emphasises not only the responsibility held by medical journals to ensure peer review is done well but also the need to raise awareness amongst the medical community of the limitations of the current peer review process. (shrink)

R. M. Hare has argued 1 that there are conceivable circumstances in which it would be right not to abolish the institution of slavery: in the imaginary land of Juba established slave-plantations are managed by a benevolent elite for the good of all, no ‘cruel or unusual ’ punishments are in use, and citizens of the neighbouring island of Camaica, ‘free ’but impoverished, regularly seek to become slaves. Hare adds that it is unlikely, given human nature, that ‘masters ’would treat (...) ‘slaves ’humanely, and avoid a gradual corruption of their moral consciousness which would cancel out any possible advantages of the system. Slavery is wrong, he argues, not because it violates ‘fundamental human rights’, but I because it would in practice generally increase misery. (shrink)

Musicians, like athletes, daily face the stark reality of physical and psychological health issues that can negatively affect or end their careers. Research shows compelling reasons for making changes to the value systems and in the educational process under which musicians are trained to help alleviate these problems. Changes would include teaching from a person-centered approach, including a broader understanding of music and adding wellness training into the music curriculum. This article outlines the evidence from the literature, overviews the resources (...) available to assist with these changes, and discusses the important role that music educators can play in creating this healthy paradigm shift within the profession. (shrink)

Many religious people are alarmed about features of the current age - violence in the media, a pervasive hedonism, a marginalization of religion, and widespread abortion. These concerns influence politics, but just as there should be a separation between church and state, so should there be a balance between religious commitments and secular arguments calling for social reforms. Robert Audi offers a principle of secular rationale, which does not exclude religious grounds for action but which rules out restricting freedom except (...) on grounds that any rational citizen would accept. The book describes the essential commitments of free democracy, explains how religious and secular moral considerations can be integrated to facilitate co-operation in a world of religious pluralism, and proposes ideals of civic virtue that express the mutual respect on which democracy depends. Audi offers a balanced and sophisticated treatment of the relations between religion and politics in a modern, secular society. (shrink)

A response to Michael Moxter's account of the need for 'religious feeling' for social order, suggesting that togetherness is currently promoted in overtly non-religious ways, and that true piety may often be at odds with social - and especially with state - order.

1. Believing Enough to Think The Scottish system of university education requires most aspirants to an Ordinary Degree to study some philosophy. Philosophers in Scottish Universities must therefore contend with enormous first-year classes, stocked with youngsters who have little real desire to be philosophers, or even to philosophize. Some years ago, at Glasgow, a question in the final exam was as follows: ‘“Philosophy is of no use, and so should not be studied.” Discuss’. A couple of hundred students answered, more (...) or less fluently, that one should not assume that what was of no use should not be studied, since some things were worth studying in their own right, but that in any case the study of philosophy was useful since it helped one to question what authoritative figures said. No essayist, apparently, saw any paradox in this reply, which was, of course, taken word for word from the professor's lectures. (shrink)

The recent proposal by Douglas and Savulescu for an ethics of knowledge provokes a renewed consideration of an enduring issue. Yet, the concept raises significant challenges for procedural and substantive justice. Indeed, the operationalisation of ‘an ethics of knowledge’ could be as alarming as what it seeks to prevent. While we can acknowledge that there is, and surely always will be, potential for misuse of beneficial science and technology, a contemplated conception of what we ought to not know, devise or (...) disseminate sets before us an enormously complex task. This essay challenges an ethics of knowledge to respond to concerns of procedural and substantive justice. While the concept has a certain appeal, it does not appear to adequately address certain fundamental issues as it is currently presented. Here, the author invites consideration of two primary points: (1) who should decide, based on whose interests? and (2) could such an exercise actually be effective in achieving its goal? (shrink)

A collection of papers, revised for the volume, on likely and unlikely futures for humanity.

The Treatment Escalation Plan (TEP) was introduced into our trust in an attempt to improve patient involvement and experience of their treatment in hospital and to embrace and clarify a wider remit of treatment options than the Do Not Resuscitate (DNR) order currently offers. Our experience suggests that the patient and family are rarely engaged in DNR discussions. This is acutely relevant considering that the Mental Capacity Act (MCA) now obliges these discussions to take place. The TEP is a form (...) that the doctor completes, ideally with the competent patient or close relative, documenting what treatment options would be appropriate if that patient were to become acutely unwell. Ventilation of the lungs, cardiac resuscitation, renal replacement therapy, intravenous fluids and antibiotics are all discussed. The study evaluated patient and relative experiences with the TEP. 55 patients or their relatives were interviewed regarding their experience of the TEP and thoughts regarding the process. 96% of patients and relatives evaluated thought that the TEP was a good idea. Free text comments were all positive and only 34% of patients claimed to feel anxious when completing the form. Following this study, the TEP has been expanded hospital wide and into the community within our trust. Discussions are currently taking place in hospitals within our region to introduce the TEP form into other local trusts. (shrink)

The American Journal of Bioethics, Volume 12, Issue 8, Page 17-18, August 2012.

Cette étude de l’histoire des femmes européennes qui ont eu une vie professionnelle du milieu du XIXe siècle à nos jours est une précieuse synthèse et une belle introduction à l’historiographie récente. Sylvie Schweitzer s’intéresse surtout aux femmes françaises, mais elle apporte de nombreux éléments qui permettent de les comparer à leurs collègues d’autres pays en Europe occidentale, voire de quelques pays de l’Europe de l’Est. Un thème central du livre est l’histoire de la résistance à l’é...

I consider reasons for questioning ‘the laws of logic’, and suggest that these laws do not accord with everyday reality. Either they are rhetorical tools rather than absolute truths, or else Plato and his successors were right to think that they identify a reality distinct from the ordinary world of experience, and also from the ultimate source of reality.

Although Aristotle (Metaphysics, Book IV, Chapter 2) was perhaps the first person to consider the part-whole relationship to be a proper subject matter for philosophic inquiry, the Polish logician Stanislow Lesniewski [15] is generally given credit for the first formal treatment of the subject matter in his Mereology.1 Woodger [30] and Tarski [24] made use of a specific adaptation of Lesniewski's work as a basis for a formal theory of physical things and their parts. The term 'calculus of individuals' was (...) introduced by Leonard and Goodman [14] in their presentation of a system very similar to Tarski's adaptation of Lesniewski's Mereology. Contemporaneously with Lesniewski's development of his Mereology, Whitehead [27] and [28] was developing a theory of extensive abstraction based on the two-place predicate, 'x extends over y\ which is the converse of 'x is a part of y\ This system, according to Russell [22], was to have been the fourth volume of their Pήncipia Mathematica, the never-published volume on geometry. Both Lesniewski [15] and Tarski [25] have recognized the similarities between Whitehead's early work and Lesniewski's Mereology. Between the publication of Whitehead's early work and the publication of Process and Reality [29], Theodore de Laguna [7] published a suggestive alternative basis for Whitehead's theory. This led Whitehead, in Process and Reality, to publish a revised form of his theory based on the two-place predicate, 'x is extensionally connected with y\ It is the purpose of this paper to present a calculus of individuals based on this new Whiteheadian primitive predicate. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Multiple Personality and Moral Responsibility”Stephen R. L. Clark (bio)Theaitetos sleeping is not quite “the same” as Theaitetos waking, any more than Alcibiades drunk is Alcibiades sober. Nor am I, at fifty, quite “the same” as Stephen was when he was five. In one way, my sober fifty-year-old waking self can reasonably disclaim responsibility for what Stephen did or seemed to do when he was dreaming, drunk, or (...) five years old. Those other Stephens were not “fully responsible,” were not doing what they freely chose because they chose it—though it would be odd to deny that they were acting willingly. Nor am I now very likely to do the things that—drunk, asleep, or five years old—“I” did: in that sense I can disown those actions and never fully “owned” them anyway. Maybe now I can even disown such actions as I once really owned: once I thought them the right thing, and now I do not.On the other hand, as Stephen Braude says, even children (even, he might have added, dogs) are treated “as if” they are “responsible”: as if, that is, they know what they were doing and may be deterred from doing it again. Should Alcibiades sober be made accountable for what “he” did when drunk? Why not, if this deters him from getting drunk again? Perhaps, as Aristotle suggested, those who do wrong when they are drunk should be fined double the amount. Perhaps those who find it difficult not to drink habitually should be fined ten times the amount. What matters is the amount of money that will put them off, that will force them to “take responsibility” for their own future lives. People who know that they can’t trust themselves when they are drunk, sexually excited, or driving a fast car must put it out of their own power to be in those positions—and if they can’t do that, then others must do it for them. Free men and women “take responsibility,” take charge of their own lives, and wish to be held responsible for what they do and have done. Those who cannot “take control” must, technically, be slaves.There is no point expecting “natural slaves” to take control of their own lives; to measure what they want against what is allowed by society. Such “slaves,” at best, can be controlled by an immediate threat or prize. In a way, it is pointless to punish them, though it may be necessary to imprison, maim, or kill them. Much the same thing may be said of some who are not, strictly, slavish. Should eighty-year-olds be “held responsible” for what they did in their forgotten youth, a world away? They will not be doing it again, and may not, even now, have any greater understanding than the rest of us as to why they did it in the past. “Punishment” in such a case can only [End Page 55] be used to deter others who might follow the same path, to help them to control their lives in ways that do not injure others. Otherwise, we are not strictly speaking of “punishment” at all: perhaps more often than we like to admit, public condemnation, incarceration, or execution is a symbolic elimination of a perceived evil, whether or not we think, or have good grounds for thinking, that the victim is really guilty. The sacrificial victim carries away our anger or unhappiness.Pragmatically, in other words, we punish people for things that—even at the time of the action—they did not control, or which they have long forgotten. For punishment to deter them, they must understand what they are being punished for. For it to reform them, they must accept that the punishment inflicted is just. Those who neither understand nor accept punishment may still be treated harshly, for the sake of others—maimed, or killed, or simply (if we choose to be humane) imprisoned. There are some acts, so Aristotle said, below the level of humanity: such bestiality cannot be punished. It does not follow that the perpetrators should be “free.” Pragmatism permits us to retain the rites of sacrifice, even... (shrink)

This article considers how race and gender shape latina and Latino paths to school success in college. A purposive sample of successful high school and college students was selected. Through interviews, fieldwork, and school records, the researchers find that Latinas navigate successfully through negative stereotypes by maintaining positive definitions of themselves and by emphasizing their group membership as Latina. Young Latino men also see themselves as part of a larger cultural group but tend to have less positive racial and ethnic (...) identities than women do. Typically, they are supported by mentors, such as white athletic coaches, and tend to draw from the meritocratic ethos of sports, regarding their success in individualistic terms. While successful Latinas do not assimilate in the ways predicted by the literature, the young men in this study accept the individualistic and meritocratic ethos of the dominant culture, but with a psychological price. (shrink)

The similarities between the United States and South Africa with respect to race, power, oppression and economic inequities are striking, and a better understanding of these parallels can provide educational gains for students and educators in both countries. Through shared experiences and perspectives, this volume presents scholarly work from U.S. and South African scholars that advance educational practice in support of social justice and transformative learning. It provides a comprehensive framework for developing transformational learning experiences that facilitates leadership for social (...) justice, and a deeper understanding of the factors influencing personal, national and global identity. (shrink)

Previous research has shown that emotionally-valenced words are given higher judgements of learning (JOLs) than are neutral words. The current study examined potential explanations for this emotional salience effect on JOLs. Experiment 1 replicated the basic emotionality/JOL effect. In Experiments 2A and 2B, we used pre-study JOLs and assessed memory beliefs qualitatively, finding that, on average, participants believed that positive and negative words were more memorable than neutral words. Experiment 3 utilised a lexical decision task, resulting in lower reaction times (...) (RTs) for positive words than for neutral words, but equivalent RTs for negative and neutral words, suggesting that processing fluency may partially account for higher JOLs for positive words, but not for negative words. Finally, we conducted a series of moderation analyses in Experiment 4 which assessed the relative contributions of fluency and beliefs to JOLs by measuring both factors in the same participants, showing that RTs made no significant contribution to JOLs for either positive or negative words. Our findings suggest that although positive words may be more fluently processed than neutral words, memory beliefs are the primary factor underlying higher JOLs for both positive and negative words. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Minds, Memes, and MultiplesStephen R. L. Clark (bio)AbstractMultiple Personality Disorder is sometimes interpreted as evidence for a radically pluralistic theory of the human mind, judged to be at odds with an older, monistic theory. Older philosophy, on the contrary, suggests that the mind is both plural (in its sub-systems or personalities) and unitary (in that there is only one light over all those lesser parts). Talk of gods and (...) demons has been a way of arranging elements of human mind and motivation. The one light, or center, is something which requires mental discipline to discover rather than being immediately obvious. This indeed is what even Descartes (sometimes blamed for introducing the notion of a simple, transparent self) really intended. Discovering or uncovering the Self is a psychotherapeutic as well as a philosophical imperative.Keywordsconsciousness, gods, Multiple Personality Disorder, passivity, thought alienationMultiple Personality 1The phenomena popularly identified as evidence of “multiple personality disorder” are strangely attractive. The stories suggest that those who provide, who are, the evidence for this disorder are usually in acute distress, but those who wish to believe in it find the idea almost exhilarating. Most of us would rather wish to think that we had undeveloped possibilities, that it would be exciting to be a married academic today, a celibate bus-driver tomorrow and a teenage hooligan on Sundays. The impulse to put aside our duties, or our habits, can be a powerful one, and only the sober thought that we would not, after all, succeed in keeping our lives separate keeps us single. The notion that there are people who take the risk, that our bodies could house a multitude, is one we would wish to believe. At the same time, we wish to remember that such divisions bring their own problems, and as easily suspect that those who apparently succeed in dividing themselves up must have suffered serious trauma in the past, and be plagued by missed appointments and self-hatred in the present. Some of us believe that “multiple personality” reveals a truth about us all, that none of us is actually the simple, heroic self that we pretend: “the self” is only an occasionally concordant swarm of impulses, easily divided. Others of us suspect that it is a wish to avoid responsibility, and guilt, that causes some of us to pretend not to be the selves that actually we are (see Rycroft 1987).On earlier occasions (notably Clark 1991b), I have myself expressed some doubt about reports of Multiple Personality Disorder, and suggested that they should be seen as fictions or dramatic representations (whether by the patient or the reporter) which should not be judged as “true” or “false,” but rather as “interesting” or “pernicious.” Stephen Braude, in a recent excellent book, seems at first to side with the true believers: it is absurd, he suggests, not to believe the many reports of fugue, discordance and fully developed multiples (Braude 1991; see also Wilkes 1984, [End Page 21] Brennan 1990). Maybe a few such reports are over-credulous: it would not be surprising that the occasional clever criminal successfully pretended not to know what an alien other did with his body. But there are, he says, too many independent records to disbelieve, and not only the distant stories of Miss Beauchamp (Prince 1908) or Eve (Thigpen & Cleckley 1954, 1957). Since the 1970s the number of reported cases has been rising again. It may be that some, many, or all the cases are artifacts, in the sense that the doctor’s expectations helped to produce or develop the varied personalities: “when a client walks into the therapist’s office and sits down, the expectation framework of the therapist immediately comes into play” (Crabtree 1985, 211; see also Hawthorn 1983). But the evidence is also compatible with the thought that psychotherapeutic fashion now allows the therapist to notice, rather than invent, the phenomena. Multiples often wish to conceal their condition, it is said, and only observers alerted to the possibility will notice them. Conscious or half-conscious role-playing, which would perhaps be less philosophically interesting, cannot explain more than a few of the cruder cases.In short... (shrink)

Alternatives to convenience sampling (CS) are needed for HIV/STI surveillance of most-at-risk populations in Latin America. We compared CS, time space sampling (TSS), and respondent driven sampling (RDS) for recruitment of men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. During concurrent 60-day periods from June-August, 2011, we recruited MSM/TW for epidemiologic surveillance using CS, TSS, and RDS. A total of 748 participants were recruited through CS, 233 through TSS, and 127 through RDS. The TSS (...) sample included the largest proportion of TW (30.7 %) and the lowest percentage of subjects who had previously participated in HIV/STI research (14.9 %). The prevalence of newly diagnosed HIV infection, according to participants' self-reported previous HIV diagnosis, was highest among TSS recruits (17.9 %) compared with RDS (12.6 %) and CS (10.2 %). TSS identified diverse populations of MSM/TW with higher prevalences of HIV/STIs not accessed by other methods. (shrink)