We conducted focus groups to assess patient attitudes toward research on medical practices in the context of usual care. We found that patients focus on the implications of this research for their relationship with and trust in their physicians. Patients view research on medical practices as separate from usual care, demanding dissemination of information and in most cases, individual consent. Patients expect information about this research to come through their physician, whom they rely on to identify and filter associated risks. (...) In general, patients support this research, but worry that participation in research involving randomization may undermine individualized care that acknowledges their unique medical histories. These findings suggest the need for public education on variation in practice among physicians and the need for a collaborative approach to the governance of research on medical practices that addresses core values of trust, transparency, and partnership. (shrink)

Volume 19, Issue 10, October 2019, Page 99-101.

The increasing complexity of human subjects research and its oversight has prompted researchers, as well as institutional review boards, to have a forum in which to discuss challenging or novel ethical issues not fully addressed by regulations. Research ethics consultation services provide such a forum. In this article, we rely on the experiences of a national Research Ethics Consultation Collaborative that collected more than 350 research ethics consultations in a repository and published 18 challenging cases with accompanying ethical commentaries to (...) highlight four contexts in which REC can be a valuable resource. REC assists: 1) investigators before and after the regulatory review; 2) investigators, IRBs, and other research administrators facing challenging and novel ethical issues; 3) IRBs and investigators with the increasing challenges of informed consent and risk/benefit analysis; and 4) in providing flexible and collaborative assistance to overcome study hurdles, mediate conflicts within a team, or directly engage with research participants. Institutions that have established, or plan to establish, REC services should work to raise the visibility of their service and engage in open communication with existing clinical ethics consult services as well as the IRB. While the IRB system remains the foundation for the ethical review of research, REC can be a valuable service for investigators, regulators, and research participants aligned with the goal of supporting ethical research. (shrink)

In the target article, McGuire and colleagues (2009) found that 54% of social networkers would consider using direct-to-consumer personal genome testing (DTC PGT) for their child and that 63% agree...

Intrateam competition is an inherently social and interactional process, yet it is not often studied as such. Research on competition is mostly limited to studying it as an individual state and assumes that the resulting team outcomes are equivalent across different competition types. Often overlooked in competition research are the means through which competition can lead to constructive outcomes for the team. Constructive competition occurs when the primary motivation is not to win at the expense of others, but rather to (...) make social comparisons and gain knowledge of relative competence. This study furthers insight into constructive competition by studying its interpersonal characteristics as it develops within a team, and its impact on task conflict, perceived performance, and team satisfaction. The conversations of 24 student project teams were recorded over 4 weeks and analyzed, operationalizing competition as an attempt to exert control and influence on the team. Each individual then provided sociometric ratings of perceived performance of each team member, and rated the level of task conflict and satisfaction of the team. The effects of competition on perceived performance and team satisfaction, both directly and indirectly through task conflict, were examined. Findings demonstrated a negative direct effect of competition on the range of perceived performance ratings, and a positive indirect effect of competition on team satisfaction as mediated through task conflict. The study broadens understanding on the construct of competition and underscores the positive implications competition can bring to the teams. (shrink)

BackgroundRandomized controlled trials (RCTs) are often complex and expensive to perform. Less than one third achieve planned recruitment targets, follow-up can be labor-intensive, and many have limited real-world generalizability. Designs for RCTs conducted using cohorts and routinely collected health data, including registries, electronic health records, and administrative databases, have been proposed to address these challenges and are being rapidly adopted. These designs, however, are relatively recent innovations, and published RCT reports often do not describe important aspects of their methodology in (...) a standardized way. Our objective is to extend the Consolidated Standards of Reporting Trials (CONSORT) statement with a consensus-driven reporting guideline for RCTs using cohorts and routinely collected health data.MethodsThe development of this CONSORT extension will consist of five phases. Phase 1 (completed) consisted of the project launch, including fundraising, the establishment of a research team, and development of a conceptual framework. In phase 2, a systematic review will be performed to identify publications (1) that describe methods or reporting considerations for RCTs conducted using cohorts and routinely collected health data or (2) that are protocols or report results from such RCTs. An initial “long list” of possible modifications to CONSORT checklist items and possible new items for the reporting guideline will be generated based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statements. Additional possible modifications and new items will be identified based on the results of the systematic review. Phase 3 will consist of a three-round Delphi exercise with methods and content experts to evaluate the “long list” and generate a “short list” of key items. In phase 4, these items will serve as the basis for an in-person consensus meeting to finalize a core set of items to be included in the reporting guideline and checklist. Phase 5 will involve drafting the checklist and elaboration-explanation documents, and dissemination and implementation of the guideline.DiscussionDevelopment of this CONSORT extension will contribute to more transparent reporting of RCTs conducted using cohorts and routinely collected health data. (shrink)

The Commission on the Accreditation of Law Enforcement employs rigorous evaluation techniques. Objective accreditation, such as made possible by CALEA, is important from the public’s perspective and in the national community of law enforcement.To counteract a general distrust of law enforcement agencies, the Law Enforcement Assistance Administration developed a grant to develop standards by which the quality and performance of law enforcement could be measured. LEAA developed 107 standards and, though well received by the law enforcement community, no single group (...) or agency took the initiative to begin a program to evaluate and implement the standards. In 1979, the Department of Justice established an additional grant that effectively organized the four major law enforcement groups: the International Association of Chiefs of Police, the National Sheriff’s Association, the National Organization of Black Law Enforcement Executives, and the Police Executive Research Forum. (shrink)

Preparing the Next Generation of Oral Historians is an invaluable resource to educators seeking to bring history alive for students at all levels. Filled with insightful reflections on teaching oral history, it offers practical suggestions for educators seeking to create curricula, engage students, gather community support, and meet educational standards. By the close of the book, readers will be able to successfully incorporate oral history projects in their own classrooms.

This study examines values and value types as well as scores in levels of moral reasoning for␣students enrolled in a business program. These two factors are measured using the Schwartz Personal Values␣Questionnaire and the Defining Issues Test 2. No statistically significant differences in levels of moral␣reasoning, rankings of values, and value types could be attributed to gender. However, eight significant correlations between value types and levels of moral reasoning provide evidence that a systematic relationship exists. The relationships are not only (...) internally consistent but also consistent with the model of values based on motivational goals (Schwartz S. H. and K. Boenke: 2004, Journal of Research in Personality, 38 230–255). (shrink)

Objective:Prior research examining sexual and intimacy concerns among metastatic breast cancer patients and their intimate partners is limited. In this qualitative study, we explored MBC patients’ and partners’ experiences of sexual and intimacy-related changes and concerns, coping efforts, and information needs and intervention preferences, with a focus on identifying how the context of MBC shapes these experiences.Methods:We conducted 3 focus groups with partnered patients with MBC [N = 12; M age = 50.2; 92% White; 8% Black] and 6 interviews with (...) intimate partners [M age = 47.3; 83% White; 17% Black]. Participants were recruited through the Fox Chase Cancer Center Tumor Registry and the Cancer Support Community. Qualitative data were analyzed using the Framework Method and Dedoose software.Results:Qualitative analyses revealed several key themes reflecting ways in which MBC shapes experiences of sex/intimacy: the heavy disease/treatment burden leads to significant, long-term sexual concerns and consequent heightened emotional distress for both patients and partners ; viewing the relationship as having “an expiration date” influences patients’ and partners’ concerns related to sex/intimacy and complicates coping efforts; and information needs extend beyond managing sexual side effects to include emotional aspects of intimacy and the added strain of the life-limiting nature of the disease on the relationship. The heightened severity of sexual concerns faced by patients with MBC, compounded by the terminal nature of the disease, may place patients and partners at risk for significant adverse emotional and interpersonal consequences.Conclusion:Findings suggest unique ways in which sex and intimate relationships change after a diagnosis of metastatic breast cancer from both patients’ and partners’ perspectives. Consideration of the substantial physical and emotional burden of MBC and the broader context of the relationship and intimacy overall is important when developing a sexuality-focused intervention in this population. Addressing sexual concerns is a critical part of cancer care with important implications for patients’ health and quality of life. (shrink)

The possibility of historical knowledge is a problem that occupied Nietzsche’s thought from beginning to end. Because the meanings of values, customs, and even truth itself are historically contingent phenomena, neither timeless nor unchanging, Nietzsche’s most fundamental statements about the character of the world and our place in it are typically framed within a historical account. Several scholars have recently suggested that his means of expositing history are consistent throughout his career. 1 From his early philological articles to his genealogical (...) method, Nietzsche is said to offer a consistent and sustained way of uncovering and evaluating the past. The studies of James I. Porter and Christian Benne are .. (shrink)

Biologists, historians of biology, and philosophers of biology often ask what is it to be an individual, really. This book does not answer that question. Instead, it answers a much more interesting one: How do biologists individuate individuals? In answering that question, the authors explore why biologists individuate individuals, in what ways, and for what purposes. The cross-disciplinary, dialogical approach to answering metaphysical questions that is pursued in the volume may seem strange to metaphysicians who are not biologically focused, but (...) it is adroitly achieved by the editors. Scott Lidgard (a paleontologist and marine ecologist) and Lynn K. Nyhart (a historian of biology) orchestrate a dialogue among historians of biology, philosophers of biology, and practicing biologists over 10 chapters. These are followed by three reflective commentaries written to frame the different disciplinary perspectives and to highlight the historical, biological, and philosophical themes across the chapters. The result is a volume—in structure and in content—that has much to be generously commended. Biological individuality is a hotly discussed topic, but it is also part of a series of long-standing arguments within both the history and philosophy of biology (HPB) and metaphysics. Notable and fervent debates have centered on evolution and the units of selection, predominantly on Michael T. Ghiselin’s and David L. Hull’s notion of species as individuals, Peter Godfrey-Smith’s Darwinian individuals, and Ellen Clarke’s individuating mechanisms. Lately, it has encompassed non-Darwinian individuals, symbiotic associations like Thomas Pradeu’s immunological individuals, and John Dupré and Maureen A. O’Malley’s metabolic individuals.2 The present volume is curated in a way to introduce the reader to new research in HPB that articulates these debates as well as to introduce and engage in the study of further notions of biological individuality. But its aim is more than an introduction. As the subtitle suggests, it is also intended to give the reader insight into the working together of biologists, historians of biology, and philosophers of biology in figuring out how the notion of biological individuality is instantiated. As such, the problem-centered dialogue that results does more than talk through biological individuality. It shows how the different and often divergent goals of the authors’ disciplines shape not only how they think about individuality but how they communicate this thinking in reciprocal collaboration with others in different disciplines. … cont’d…. (shrink)

Van Fraassen believes our current best theories enable us to make accurate predictions because they have been subjected to a selection process similar to natural selection. His explanation for the predictive success of our best theories has been subjected to extensive criticism from realists. I aim to clarify the nature of van Fraassen’s selectionist explanation for the success of science. Contrary to what the critics claim, the selectionist can explain why it is that we have successful theories, as well as (...) why it is reasonable to expect past successful theories to be successful in the future. I also argue that the plausibility of the realists’ explanation rests on an inaccurate understanding of the nature of predictive success . The predictive success of our best theories is a relative success. (shrink)

Rejectionists argue that collective belief ascriptions are best understood as instances of collective acceptance rather than belief. Margaret Gilbert objects to rejectionist accounts of collective belief statements. She argues that rejectionists rely on a questionable methodology when they inquire into the nature of collective belief ascriptions, and make an erroneous inference when they are led to believe that collectives do not really have beliefs. Consequently, Gilbert claims that collective belief statements are best understood as instances of belief. I critically examine (...) Gilbert’s criticisms of rejectionism. I argue that rejectionism is still a viable account of collective belief ascriptions. I also argue that Gilbert’s most powerful criticism provides important insight into what really stands between her and the rejectionists. Gilbert and the rejectionists do not yet agree about what background assumptions can be made in developing an account of collective belief ascriptions. (shrink)

The article questions the concept of post-normal science and emphasizes that despite the declarative detachment from social practice and freedom from politics, de facto science has always been social. On the one hand, the scientific community has always been aristocratic. The “classical ethos” of science presupposes openness and equality on conditions that require enormous efforts and self-sacrifice, this equality is beyond the norm, because a “normal” scientist is, as K. Popper noted, mediocrity. On the other hand, scientists at all times (...) have taken an active social position, and the development of science has always been closely intertwined with social practices and the political process, as is well shown by T. Porter, L. Pinto, S. Shapin and S. Schaffer. From this point of view, science has always been post-normal – the “solutions” are always “urgent”, and the corresponding “stakes” are invariably “high”. However, the aristocracy of the scientific ethos and the declarative isolation of the scientific community from policy and politics are of fundamental importance for the reproduction of science, which practically cannot, but is morally obliged to remain outside of them. To help practice, the scientist must be impractical; to create a norm, a scientist must be abnormal. (shrink)

These are exciting times for philosophy and psychiatry. After drifting apart for most of this century, the two disciplines, if not yet fully reconciled, are suddenly at least on speaking terms. With hindsight we may wonder why they should have ignored each other for so long. As Anthony Quinton pointed out in a lecture to the Royal Institute of Philosophy a few years ago, it is remarkable that philosophers, in a sense the experts on rationality, should have had so little (...) to say about the phenomena of irrationality. There have been partial exceptions, of course. Descartes and Kant both touched on madness; and there were, notably, important philosophical influences on the development of modern psychiatry in the late nineteenth and early twentieth centuries. Yet even John Locke, who was a doctor as well as philosopher, confined himself to a fair-l y superficial distinction between what we should now call mental illness and mental defect—those with, in Locke's view, respectively too many ideas and too few. (shrink)

Basic issues in the recent ‘death-of-God’ movement can be illuminated by comparison and contrast with the relevant ideas of two American philosophers, John Dewey and William James. Dewey is an earlier spokesman for ideas that are central to the ‘radical theology’ of Thomas J. J. Altizer, William Hamilton, and Paul Van Buren. His reasons for rejecting theism closely resemble propositions maintained by these ‘death-of-God’ theologians. James, on the other hand, points toward a theological alternative. He takes cognizance of ideas similar (...) to those in the ‘radical theology’, but he does not opt for either a metaphorical or real elimination of God. Thus, the contentions of this paper are that there has been a version of the ‘death-of-God’ perspective in American thought before, and that there are resources in the American tradition that suggest a viable option to this perspective. (shrink)