BackgroundClinical trials should be as inclusive as possible to facilitate equitable access to research and better reflect the population towards which any intervention is aimed. Informed by the UK’s National Institute for Health and Care Research (NIHR) Innovations in Clinical Trial Design and Delivery for the Under-served (INCLUDE) guidance, we audited oncology trials conducted by the Clinical Trials and Statistics Unit at The Institute of Cancer Research, London (ICR-CTSU) to identify whether essential documents were overtly excluding any groups and whether (...) sufficient data were collected to assess diversity of trial participants from groups suggested by INCLUDE as under-served by research in the UK.MethodsThirty cancer clinical trials managed by ICR-CTSU and approved between 2011–2021 were audited. The first ethics approved version of each trial’s protocol, patient information sheet, and patient completed questionnaire, together with the first case report forms (CRFs) version were reviewed. A range of items aligned with the INCLUDE under-served groups were assessed, including age, sex and gender, socio-economic and health factors. The scope did not cover trial processes in participating hospitals.ResultsData relating to participants’ age, ethnic group and health status were well collected and no upper age limit was specified in any trials’ eligibility criteria. 23/30 (77%) information sheets used at least one gendered term to address patients. Most CRFs did not specify whether they were collecting sex or gender and only included male or female categories. The median reading age for information sheets was 15–16 years (IQR: 14–15 – 16–17). Socio-economic factors were not routinely collected and not commonly mentioned in trial protocols.ConclusionsNo systemic issues were identified in protocols which would explicitly prevent any under-served group from participating. Areas for improvement include reducing use of gendered words and improving readability of patient information. The challenge of fully assessing adequate inclusion of under-served populations remains, as socio-economic factors are not routinely collected because they fall beyond the data generally required for protocol-specified trial endpoint assessments. This audit has highlighted the need to agree and standardise demographic data collection to permit adequate monitoring of the under-served groups identified by the NIHR. (shrink)

Results: We analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92–0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00–1.28) to report difficulty refilling medications. Only 2% of (...) CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19. (shrink)

There is remarkable variety in emotional life. Not all mental states referred to by the same word (e.g., “fear”) look alike, feel alike, or have the same neurophysiological signature. Variability has been observed within individuals over time, across individuals from the same culture, and of course across cultures. In this paper, I outline an approach to understanding the richness and diversity of emotional life. This model, called the conceptual act model, is not only well suited to explaining individual differences in (...) the frequency and quality of emotion, but it also suggests the counter-intuitive view that the variety in emotional life extends past the boundaries of events that are conventionally called “emotion” to other classes of psychological events that people call by different names, such as “cognitions”. As a result, the conceptual act model is a unifying account of the broad variety of mental states that constitute the human mind. (shrink)

We extend the literature by providing evidence that a cultural variable, intrinsic Islamic religiosity is important in understanding auditors’ judgement in the Islamic context of Pakistan. The intrinsic Islamic religiosity theoretical construct examined is Islamic Worldview which represents deeply held enduring and stable values which are likely to be dominant in influencing professionals’ judgements. Moreover, theoretical underpinning and empirical evidence in social psychology and organisational behaviour have established the critical role of intrinsic religiosity in influencing behaviour. Our first objective is (...) to examine whether IW impacts auditors’ judgements in the context of their acceptance of uncorroborated low-reliability client-provided evidence. Understanding the potential impact of cultural factors on auditors’ acceptance of client-provided information is an essential factor in improving audit quality. Our findings support the hypothesis that auditors with high IW scores are more likely to accept uncorroborated low-reliability client-provided evidence. Our second objective is to examine the relationship between IW and auditors’ preference for exercising more or less judgements. Examining this topic is important because auditing is a judgement-based process: auditors’ judgements determine audit quality and, by extension, the quality of associated financial reports. Our findings provide overall support for the hypothesis that auditors with high IW scores have a preference for exercising more judgement. Our findings have implications for global and national standard setters, regulators, practitioners, and researchers. The results are also relevant to global audit firms and their affiliates, particularly networks operating in Islamic countries, in ensuring global consistency of audits. (shrink)

Within the ethics and science literature surrounding uterus transplantation (UTx), emphasis is often placed on the extent to which UTx might improve upon, or offer additional benefits when compared to, existing ‘treatment options’ for women with absolute uterine factor infertility, such as adoption and gestational surrogacy. Within this literature UTx is often positioned as superior to surrogacy because it can deliver things that surrogacy cannot (such as the experience of gestation). Yet, in addition to claims that UTx is superior in (...) the aforementioned sense it is also often assumed (either implicitly or explicitly) that UTx is less fraught with ethical difficulties and thus should be considered a less morally problematic option. This article seeks to examine this assumption. Given that much UTx research has been performed in Sweden, a country where surrogacy is effectively although not currently explicitly forbidden, we do this through an analysis of the arguments underpinning a 2016 Swedish white paper which considered amending existing policy such that altruistic surrogacy arrangements would be permitted. By applying the white paper’s arguments for a restrictive position on altruistic surrogacy to the case of UTx using living altruistic donors we find that such arguments, if they hold in the case of surrogacy, apply similarly to UTx. We thus suggest that, for reasons of consistency, a similar stance should be taken towards the moral and legal permissibility of these two practices. (shrink)

Background It is widely acknowledged that there is a global divide on health care and health research known as the 10/90 divide. Methods A retrospective survey of articles published in the BMJ, Lancet, NEJM, Annals of Internal Medicine & JAMA in a calendar year to examine the contribution of the developing world to medical literature. We categorized countries into four regions: UK, USA, Other Euro-American countries (OEAC) and (RoW). OEAC were European countries other than the UK but including Australia, New (...) Zealand and Canada. RoW comprised all other countries. Results The average contribution of the RoW to the research literature in the five journals was 6.5%. In the two British journals 7.6% of the articles were from the RoW; in the three American journals 4.8% of articles were from RoW. The highest proportion of papers from the RoW was in the Lancet (12%). An analysis of the authorship of 151 articles from RoW showed that 104 (68.9%) involved authorship with developed countries in Europe or North America. There were 15 original papers in these journals with data from RoW but without any authors from RoW. Conclusions There is a marked under-representation of countries in high-impact general medical journals. The ethical implications of this inequity and ways of reducing it are discussed. (shrink)

Police officers around the world must often select between equally unappealing, uncertain courses of action in an attempt to achieve the best outcome. Despite the immense importance of such decisions, there remains a lack of understanding in the study of individual differences in police decision-making. Here, using a sample of senior police officers recruited from decision-making training events across the United Kingdom (n = 96), we used the Least-worst Uncertain Choice Inventory For Emergency Responses (LUCIFER) to measure the effect of (...) maximization on both domain-specific (police) and domain-general (military) decisions. In line with a wealth of research on traditional “consumer” decisions, we found that police officers who were “maximizers” found decisions more difficult. Gender and previous military experience also influenced the process of decision-making. Specifically, police officers with military experience took more time to assess the situation but were faster to choose a course of action and commit to it. Female police officers also were slower to assess the situation. As recent events show, the outcomes of police decisions have significant consequences for the public, the officers involved, the police force as a whole, and the wider population, yet psychological research has yet to fully explore the role of individual differences in how such decisions are made. While this study does not seek to identify factors associated with “good” or “better” decision-makers, it provides strong support for the need to factor in perspectives of the individual when creating theory, or applied tools, in support of police decision-making. (shrink)

Analysing ten interviews with women diagnosed with and treated for congenital absence of the vagina, this article theorises the notion of ideal (hetero)relational normality. It explores how women in my case study negotiate, relate to and challenge this notion and examines the normative and bodily work for which it calls. The article specifically underscores the corporeal dimension of (hetero)relational normality. I argue that this notion of normality shapes the bodies of the women through medical interventions, while concurrently being reinforced through (...) the corporeal shapings that the women undergo. These corporeal shapings consolidate enacted norms concerning heterosexuality and form understandings of female and male bodies. The analysis also reveals how these women nevertheless find ways to re-negotiate and question the notion of ideal (hetero)relational normality and its intertwinement with medical practice. The article contributes both to the critical examination of genital surgery and to feminist discussions of how to critically examine heterosexuality without rejecting it. Furthermore, it provides a deeper understanding of how medical interventions designed to create a vagina, or dilate a vagina considered ‘too small’, are made meaningful by the women affected. (shrink)

In 2014, the first child in the world was born after live uterus transplantation and IVF (UTx-IVF). Before and after this event, ethical aspects of UTx-IVF have been discussed in the medical and bioethical debate as well as, with varying intensity, in Swedish media and political fora. This article examines what comes to be identified as important ethical problems and solutions in the media debate of UTx-IVF in Sweden, showing specifically how problems, target groups, goals, benefits, risks and stakes are (...) delineated and positioned. It also demonstrates how specific assumptions, norms and values are expressed and used to underpin specific positions within this debate, and how certain subjects, desires and risks become shrouded or simply omitted from it. This approach—which we label the Ethics of the Societal Entrenchment-approach, inspired by Koch and Stemerding (1994)—allows us to discuss how the identification of something as the problem helps to shape what gets to be described as a solution, and how specific solutions provide frameworks within which problems can be stated and emphasised. We also offer a critical discussion of whether some of these articulations and formations should be seen as ethically troubling, and if so, why. (shrink)

Although they produced vastly more turmoil, the uprisings in the Arab world shared many characteristics with other early 21st-century popular protests on both the left and the right, from Spain’s Indignados and Occupy Wall Street to the anti-elite votes for Brexit and Trump. The conviction that political elites and the states they rule, which were once responsible for welfare and development, now ignore and demean the interests and concerns of ordinary citizens takes many forms, but is virtually universal. The Arab (...) world was only one site of this discontent, but the story of the Arab Spring insurrections provides a cautionary illustration of the perils in abdication of political authority and accountability and provokes questions about how we understand historical moments when passions outstrip interests. (shrink)

Welche Rolle spielt Augenzeugenschaft in Kunst und visueller Kultur von ca. 1800 bis heute? Die Beiträge des Bandes untersuchen diese Frage an einem breiten Spektrum von Gegenständen: künstlerischen und nicht-künstlerischen Bildern, Aktionen und Installationen sowie Kunstinstitutionen und -literatur. Im Zentrum des Interesses steht, wie Effekte von Augenzeugenschaft hervorgerufen und Konstruktionen von Augenzeugenschaft bei der Produktion und Rezeption von Artefakten wirksam werden. Die Reihe der Beispiele ermöglicht erstmals einen vergleichenden und interdisziplinär anschlussfähigen Blick auf einen Diskurs und eine Praxis der Authentifizierung, (...) die im 18. bis 21. Jahrhundert immer wieder von Belang gewesen sind. (shrink)

Corporate sustainability can be defined as organizations’ commitment to profitability, environment, and social well-being. This study uses a transactional culture analysis of CS reporting practices to explain why some Indian organizations conform to voluntary CS reporting guidelines and others do not. The literature contains two different perspectives on culture, defined broadly as a set of values that guide people’s behavior at a given time. Most past studies typically use national culture to explain differences in CS practices across nations. This concept (...) embeds corporate cultures within the larger national culture, neglecting intranation diversity. Conversely, according to the transactional culture approach used in this study, cultures are plural and independent of geoethnic boundaries, and emerge through social transactions. TCA encourages multilevel explorations of complex social phenomena. Since CS reporting preferences are the outcome of ongoing transactions among organizational stakeholders across different levels, TCA is more appropriate for this study. Since this application requires an understanding of social accountability, the authors use Mary Douglas’s Cultural Framework, a transactional framework of social accountability. A qualitative exploration of six Indian organizations using DCF reveals different dominant forms of social accountability in these organizations: either alone or as paired hybrids. Consequently, each organization prioritizes different stakeholders and reacts differently to voluntary CS reporting guidelines. Identifying the dominant form or forms of social accountability in their organizations and understanding their underlying reasons for resisting voluntary CS guidelines enables managers to secure better collaboration for their CS initiatives. (shrink)

The notion of optimality is often invoked informally in the literature on metacognitive control. We provide a precise formulation of the optimization problem and show that optimal time allocation strategies depend critically on certain characteristics of the learning environment, such as the extent of time pressure, and the nature of the uptake function. When the learning curve is concave, optimality requires that items at lower levels of initial competence be allocated greater time. On the other hand, with logistic learning curves, (...) optimal allocations vary with time availability in complex and surprising ways. Hence there are conditions under which optimal strategies will be relatively easy to uncover, and others in which suboptimal time allocation might be expected. The model can therefore be used to address the question of whether and when learners should be able to exercise good metacognitive control in practice. (shrink)

This paper is an attempt to elaborate two concerns: those of maternal ethics, and notions of making things public. I attempt to bring these two concerns together and think them alongside one another, in hopefully productive ways. I want, in other words, to think about the ethics of what mothers ‘make public’, whether this is understood in its most rudimentary form, of enabling a child to express something, to make public an affective state, for instance, even if it is only (...) the mother who is there to witness or receive it, through to more overt and material forms of ‘publication’ glimpsed when mothers parent in spaces we call ‘public’. This paper focuses on what happens to us all when we encounter ‘mothering’ – not in the enclosed, private, secluded spaces where we imagine mothering to take place, but in what Marc Augé has termed the ‘non-places of supermodernity’, where much of the day-to-day material practices of mothering in Western late-modern urban contexts actually occurs. As is often the case, it is when experience is dislodged from the contexts in which we expect to find it that its contours are shown up in relief, and we are called on to re-configure our understandings of experiences in ways that also shift our understandings of the contexts in which they occur. In this sense, mothering, that I am claiming ‘makes things public’, as well as occurring frequently and importantly ‘in public’, not only shows up something we may overlook about the maternal, but also deforms and reforms our understandings of ‘the public’ itself. (shrink)

An understanding of autonomy has important significance in North American health care. Although a respect for autonomy is necessary to protect the self-determination and agency of birthing women in hospital settings, I suggest that enactments of autonomy that are independent of relationships offer only an incomplete interpretation of such a vital concept. In this article I explore an understanding of autonomy situated within the context of a relational birthing narrative. In so doing, autonomy becomes conceptualized as contextual and concrete, giving (...) rise to an embodied view of the birthing woman. (shrink)

With increasing complexity in the evolving structure of work in organizations, employees’ preferences for working from home (WFH) relative to working on-site can lead to systematic differences in perceived career implications. An emerging tension associated with WFH versus work-at-work is whether this locational divide is associated with concerns over career progression, especially among racial minorities. Here, we seek to determine whether Black employees, relative to their White counterparts, have more concerns over career progression relating to WFH compared with their on-site (...) colleagues. From a sample of employees in the May 2021 cross-section of the Survey of Working Arrangements and Attitudes (SWAA), we find that relative to higher (lower) income White employees, higher (lower) income Black WFH employees have significantly higher (lower) concerns over career progression than their on-site counterparts. These findings speak both to the nontrivial choices employees may be forced to make as the structure of work continues to evolve and consequences for racial inequality. (shrink)

In this Article I argue that the emerging public/private nexus of surveillance involves the augmentation of state power and calls for new models of constitutional constraint. The key phenomenon is the role played by communications intermediaries in collecting the information that the state subsequently accesses. These intermediaries are not just powerful companies engaged in collecting and analyzing the information of users and the information they hold are not just business records. The key feature of these companies is that, through their (...) information practices and architecture, they mediate other relationships. I argue that this mediating function, and its underlying technological form, interacts with legal and social norms in ways that can lead to the erosion of constraints on state power. This Article maps two stories of erosion, rooted in two kinds of community displacement. The first involves the displacement of community participation in law enforcement and the emergence of “technological tattletales” where intermediaries cooperate with the state. Unlike citizen cooperation, this practice augments state power and undermines more traditional informal modes of constraint on state power. The second involves the displacement of national legal and political community. Communications intermediaries are often large multinational companies that operate in multiple jurisdictions and move their data to various datacenters across the world even as the individual data subject remains in one geographical location. Laws that treat nonresident aliens differently from residents and citizens can create “constitutional black holes” where the communications data of an individual is not protected by any constitutional constraints. (shrink)

This paper analyzes the fecal metaphor utilized in the philosophies of Jean Baudrillard and Slavoj Zizek; and considers how the fecal metaphor explain social relations mediated by consumption and production. For both philosophers, the fecal metaphor exposes epistemological and practical processes latent in both biological and artificial production. Adding to their questions, Dominique LaPorte and his, 1978 History of Shit, couples civilization with the publicly legislated private containment of shit. This paper investigates the relevance of these metabolic metaphors of consumption (...) for design history and studies. I suggest that the metaphors offer a systematic approach to design consumption and prompt us to consider the role of material context in design production, as reality altering material conceptualizations. (shrink)

Chinese philosophy has long recognized the importance of the body and emotions in extensive and diverse self-cultivation traditions. Philosophical debates about the relationship between mind and body are often described in terms of mind-body dualism and its opposite, monism or some kind of "holism." Monist or holist views agree on the unity of mind and body, but with much debate about what kind, whereas mind-body dualists take body and mind to be metaphysically distinct entities. The question is important for several (...) reasons. Several humanistic and scientific disciplines recognize embodiment as an important dimension of the human condition. One version, the problem of mind-body dualism, is central to the history of both philosophy and religion. Some account of relations between body and mind, spirit or soul is also central to any understanding of the self. Recent work in cognitive and neuroscience underscores the importance of our somatic experience for how we think and feel. (shrink)

Nietzsche ist trotz seiner selbst attestieren Unzeitgemäßheit auch ein Kind seiner Zeit. Seine Philosophie entsteht im Kontext des 19. Jahrhunderts, der Zeit des rasanten Aufstiegs der Naturwissenschaften als Instrumente der praktischen und theoretischen Gestaltung der Welt. Während die Naturwissenschaften zunehmend an kultureller Hegemonie gewinnen, ringen die Geistes- und Sozialwissenschaften um ein entsprechendes disziplinäres Selbstverständnis, aber in allen Feldern zeigt sich eine bemerkenswerte Dynamik. Diese Entwicklungen ziehen massive weltanschauliche Auseinandersetzungen nach sich, um Materialismus, Reduktionismus und Evolution, aber auch um die Möglichkeiten (...) und Aussichten menschlicher Wahrheitserkenntnis. Nietzsches Philosophie steht zeitlich und inhaltlich inmitten dieses Spannungsfeldes und ist von verschiedenen Wirkungslinien beeinflusst. Diese Entwicklungen und ihre Bedeutung für Nietsches Werk werden hier in 18 Artikeln zu den zentralen Disziplinen wie etwa Medizin und Physik, Philologie und Religionswissenschaft, Ökonomie und Psychologie von ausgewiesenen internationalen Experten erörtert. Ergänzt wird der Band durch einleitende Übersichtsartikel und Indizes. (shrink)

Expanded edition with new chapters and updates to the translation and bibliography. Borges cites innumerable authors in the pages making up his life’s work, and innumerable authors have cited and continue to cite him. More than a figure, then, the quotation is an integral part of the fabric of his writing, a fabric made anew by each reading and each re-citation it undergoes, in the never-ending throes of a work-in-progress. Block de Behar makes of this reading a plea for the (...) very art of communication; a practice that takes community not in the totalized and totalizable soil of pre-established definitions or essences, but on the ineluctable repetitions that constitute language as such, and that guarantee the expansiveness—through etymological coincidences of meaning, through historical contagions, through translinguistic sharings of particular experiences—of a certain index of universality. This edition includes a new introduction by the author and three entirely new chapters, as well as updated images and corrections to the original translation. Lisa Block de Behar is Professor of Communications at the Universidad de la República in Montevideo, Uruguay and is a renowned Jorge Luis Borges scholar. William Egginton is Andrew W. Mellon Professor in the Humanities and Chair of the Department of German and Romance Languages and Literatures at Johns Hopkins University. He is the author of several books, including In Defense of Religious Moderation. Christopher RayAlexander is a graduate student and language instructor in the Department of German and Romance Languages and Literatures at Johns Hopkins University. (shrink)

Levinas’s Humanism of the Other may be seen as a meditation of King Lear. His philosophy offers what a critique of traditional and modern anti-humanism urgently needs: an ethics that precedes being. It provides a necessary ethical foundation needed to investigate questions of the human and humanity that Shakespeare examines so thoroughly in this powerful tragedy. Prefiguring Levinas’s later philosophy, Shakespeare dramatizes this humanism of the other through the suffering and vulnerability of the body. Lear’s and Gloucester’s parallel journeys are (...) both grounded in this vulnerability of the body and fragility of the mind that lead them to a humanism of the other. Moreover, the ethical good that precedes ontology, the saying, is profoundly staged through the characters of Cordelia and Edgar. This vision of King Lear, therefore, underlies and informs Levinas’s radical critique of traditional humanism and contemporary anti-humanism in his insistence on a humanism of the other. (shrink)

The steady growth of international labour mobility has been one of the defining features of globalization. Alongside the liberalization of international trade, labour mobility has been a key dynamic propelling economic development in the new millennium. In recent years, migrant labour is increasingly regulated via temporary schemes, deepening and widening migrant precarity. This paper argues that a growing reliance on temporary migrant workers reflects the financialization of global agriculture. Drawing on conceptual debates among scholars of critical finance studies, migration governance (...) and food systems, it explores the implications of financialization for social justice work, asking how a systemic understanding of the migrant experience with financial institutions and practices might enhance rights-based advocacy. (shrink)

What is the relationship between prisons designed to lock people in and suburban fortresses designed to lock people out? Building on Jonathan Simon’s account of “homeowner citizenship,” I argue that the gated community is the structural counterpart to the prison in a neoliberal carceral state. Levinas’s account of the ambiguity of dwelling—as shelter for our constitutive relationality, as a site of mastery or possessive isolation, and as the opening of hospitality—helps to articulate what is at stake in homeowner citizenship, beyond (...) the spectre of stranger danger: namely, my own capacity for murderous violence, and my investment in this violence through the occupation of territory and the accumulation of private property. Given the systemic nature of such investments, the meaning of hospitality in the carceral state is best expressed in abolitionist social movements like the Movement for Black Lives, which holds space for a radical restructuring of the world. (shrink)

The concept of reflection plays an equivocal role in the Treatise. It is identified as both the key to the formation of more accurate beliefs and the means to the destruction of belief altogether. I attempt to resolve this apparent paradox by showing that there are two distinct kinds of reflection in Book 1: legitimate, or “proper,” reflection and illegitimate reflection. Despite evidence to the contrary—including Hume’s own claim that he cannot establish that excessive reflections (one variant of illegitimate reflection) (...) should not affect our beliefs—I argue that Hume can justifiably draw a distinction between proper and illegitimate reflection based on epistemological grounds available to him that he does not recognize. (shrink)

In this exclusive Interview Ada María Isasi-Díaz responds to questions about her work in theology, and the social and political challenges for Mujerista Theology in the first half of the twenty-first century. She discusses some of the biggest shifts in theology since she first engaged with it, and the challenges of growing ‘a Hispanic garden in a foreign land.’ A focus of the interview is Mujerista Theology and how it has developed over the last 20 years and is adapting for (...) the future. (shrink)