Neoliberalism, an ideology with an emphasis on competition and marketization of things, has increasingly infiltrated many socio-economic sectors, including education in general and early childhood...

The United States’ ambitious Precision Medicine Initiative proposes to accelerate exponentially the adoption of precision medicine, an approach to health care that tailors disease diagnosis, treatment, and prevention to individual variability in genes, environment, and lifestyle. It aims to achieve this by creating a cohort of volunteers for precision medicine research, accelerating biomedical research innovation, and adopting policies geared toward patients’ empowerment. As strategies to implement the PMI are formulated, critical consideration of the initiative's ethical and sociopolitical dimensions is needed. (...) Drawing on scholarship of nationalism and democracy, we discuss the PMI's construction of what we term “genomic citizenship”; the possible normative obligations arising therefrom; and the ethical, legal, and social challenges that will ensue. Although the PMI is a work in progress, discussion of the existing and emerging issues can facilitate the development of policies, structures, and procedures that can maximize the initiative's ability to produce equitable and socially sensitive outcomes. Our analysis can also be applied to other population-based, precision medicine research programs. (shrink)

Affective forecasting refers to the ability to predict future emotions, a skill that is essential to making decisions on a daily basis. Studies of the concept have determined that individuals are often inaccurate in making such affective forecasts. However, the mechanisms of these errors are not yet clear. In order to better understand why affective forecasting errors occur, this article seeks to trace the theoretical roots of this theory with a focus on its multidisciplinary history. The roots of affective forecasting (...) lie mainly in economics, with early claims positing that utility (i.e. satisfaction) played a role in decision-making. Furthermore, the philosopher Jeremy Bentham’s descriptions of utilitarianism played a major role in our understanding of whether to define utility as a hedonic quality. The birth of behavioural economics resulted in a paradigm shift, introducing the concept of cognitive biases as influences on the accuracy of predicted utility. Daniel Gilbert and Timothy Wilson, the earliest researchers of affective forecasting errors, have proceeded with the concept of the accuracy of predicted affective utility to conduct experiments that seek to determine why our predictions of future affect are inaccurate and how such errors play a role in our decision-making. (shrink)

Impaired liver function can be seen from increased levels (SGOT-SGPT) due to proinflammatory cytokines TNF-α, (iL-1) and (iL-6) which inhibit hormone production (PDGF) in the process of liver tissue regeneration. The formulation of Phyllanthus niruri L. and Phyllanthus urinaria L. combined with toman fish albumin is a combination that can work synergistically in suppressing the production of proinflammatory molecules, because the combination contains compounds that are antioxidants. A total of 24 male Rattus norvegicus were divided into four treatment groups, namely: (...) negative control (healthy), CCl4-induced positive control, dose 1 formulation and dose 2 formulation. Male rattus norvegicus induced CCl4 of 3 ml/kg intraperitoneally, to describe impaired liver function. Male rattus norvegicus was given formula (Phyllanthus niruri L. with Toman fish albumin) and (Phyllanthus urinaria L. and Toman fish albumin) orally at a dose of 1 (620 mg/200 g body weight: 62 mg/200 g body weight), and dose 2 (1240 mg/200 g body weight: 124 mg/200 g body weight) for 14 days. SGOT-SGPT levels were analyzed with a flowcytometer on the first day after acclimatization and day 14, and analysis of proinflammatory cytokines (TNF-α + iL-1 + iL-6) was performed with flow cytometry. This study reported that the combination of Phyllanthus niruri L formula with toman fish albumin (PNA) and Phyllanthus urinaria L formula with toman fish albumin (PUA) was able to show striking hepatoprotective effects through a significant decrease in SGOT-SGPT levels in the blood of male Rattus norvegicus and decreased proinflammatory cytokine profiles in Rattus norvegicus liver cells males exposed to CCl4. In addition, the antioxidant defenses of PNA and PUA formulas almost completely prevent the occurrence of degeneration, necrosis, fibrosis and steatosis in liver cells. So that the combination of PNA and PUA formulas given has the potential to be used as an alternative to hepatitis drugs. (shrink)

Since the inception of large‐scale human genome research, there has been much caution about the risks of exacerbating a number of socially dangerous attitudes linked to human genetics. These attitudes are usually labeled with one of a family of genetic or genomic “isms” or “ations” such as “genetic essentialism,” “genetic determinism,” “genetic reductionism,” “geneticization,” “genetic stigmatization,” and “genetic discrimination.” The psychosocial processes these terms refer to are taken to exacerbate several ills that are similarly labeled, from medical racism and psychological (...) fatalism to economic exploitation and social exclusion. But as genomic information becomes more familiar in clinical and research settings as well as other life activities, do we need to continue to worry so much about this family of attitudes and their impact on existing problems?In genomics, the underlying anxiety has been that disclosure of genomic information will trigger a series of (seemingly unavoidable) negative responses that will affect individuals, their families, and their communities at large. The fundamental social challenges that hyperbolic genomic messaging, low genomic literacy, and “folk biology” help sustain remain to be addressed. If we hope to break the cycle of genomic isms and ations, we will have to get better at resisting overinterpretations of the relevance that genomics has for people’s future potentials, ancestral vulnerabilities, community memberships, and ethnic affiliations. (shrink)

Through the use of culturally appropriate videos on precision medicine research (PMR) that were developed and tailored to five racial and ethnic groups of patients, and subsequent focus-group discu...

Pandemics first and foremost hit those who are most vulnerable, and the COVID-19 pandemic is not different. Although the infection rate in the nation’s poorest neighborhoods is twice as it is in th...

Resemblances obtain not only between objects but between properties. Resemblances of the latter sort - in particular resemblances between quantitative properties - prove to be the downfall of a well-known theory of universals, namely the one presented by David Armstrong. This paper examines Armstrong's efforts to account for such resemblances within the framework of his theory and also explores several extensions of that theory. All of them fail.

The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can and should (...) be challenged on the grounds of how ‘evidence’ has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause. (shrink)

Whole genome and exome sequencing techniques raise hope for a new scale of diagnosis, prevention, and prediction of genetic conditions, and improved care for children. For these hopes to materialize, extensive genomic research with children will be needed. However, the use of WGS/WES in pediatric research settings raises considerable challenges for families, researchers, and policy development. In particular, the possibility that these techniques will generate genetic findings unrelated to the primary goal of sequencing has stirred intense debate about whether, which, (...) how, and when these secondary or incidental findings should be returned to parents and minors. The debate is even more pronounced when the subjects are adolescents, for whom decisions about return of SFs may have particular implications. In this paper, we consider the rise of “genomic citizenship” and the main challenges that arise for these stakeholders: adolescents' involvement in decisions relating to return of genomic SFs, the types of SFs that should be offered, privacy protections, and communication between researchers and adolescents about SFs. We argue that adolescents' involvement in genomic SF-related decisions acknowledges their status as valuable stakeholders without detracting from broader familial interests, and promotes more informed genomic citizens. (shrink)

This study examined whether the Flipped Classroom (FC) approach is the most effective approach for teachers to create a stimulating and interactive environment that helps students overcome speaking challenges and enhance their English-speaking performance in the context of EFL learners. The study employed quantitative research with a quasi-experimental design. An oral speaking test and a Likert-scale questionnaire were used in this study. The oral speaking test was used to investigate students' improvement in speaking performance before and after the implementation of (...) the FC approach in speaking class. A Likert scale was distributed to determine the students' perspectives on using the FC approach in speaking class. A paired t-test was used to compare the pre and post-test results of the EFL students. Percentage analysis was used to interpret the questionnaire results. The results show that there is a statistically significant difference between the total score of the learners on the post-test (M = 24.53, SD = 5.518) and the total score on the pre-test (M = 21.25, SD = 4.711). This indicates that the participants' performance on the post-test was superior to their performance on the pre-test. In other words, the learners' English-speaking performance has significantly improved in the post-test results. Furthermore, based on the analysis of the questionnaire, the data revealed that most students have positive perspectives or views on the use of FC in speaking class based on the indicator of (1) students' perspectives; (2) students' feedback; and (3) the role of the video materials. (shrink)

The usefulness of machine learning algorithms has led to their widespread adoption prior to the development of a conceptual framework for making sense of them. One common response to this situation is to say that machine learning suffers from a “black box problem.” That is, machine learning algorithms are “opaque” to human users, failing to be “interpretable” or “explicable” in terms that would render categorization procedures “understandable.” The purpose of this paper is to challenge the widespread agreement about the existence (...) and importance of a black box problem. The first section argues that “interpretability” and cognates lack precise meanings when applied to algorithms. This makes the concepts difficult to use when trying to solve the problems that have motivated the call for interpretability. Furthermore, since there is no adequate account of the concepts themselves, it is not possible to assess whether particular technical features supply formal definitions of those concepts. The second section argues that there are ways of being a responsible user of these algorithms that do not require interpretability. In many cases in which a black box problem is cited, interpretability is a means to a further end such as justification or non-discrimination. Since addressing these problems need not involve something that looks like an “interpretation” of an algorithm, the focus on interpretability artificially constrains the solution space by characterizing one possible solution as the problem itself. Where possible, discussion should be reformulated in terms of the ends of interpretability. (shrink)

Kurikulum Merdeka, implemented across schools in Indonesia, emphasizes the development of students' communicative competence through a more flexible and contextual approach. However, its implementation faces significant challenges, particularly due to cultural differences across regions. This study aims to explore the cultural challenges faced by district teachers and to what extend fostering students' communicative practices in line with the new curriculum demands. It includes 50 English teachers from the Musyawarah Guru Mata Pelajaran (MGMP) Bahasa Inggris kabupaten Gowa, or English Teachers Assembly (...) of Gowa District, representing diverse backgrounds and experiences. Data collection included surveys (n=50) using a Likert scale questionnaire and semi-structured interviews (n=6) constructed according to Han (2022) and Lei & Medwell (2022). The study reveals communicative practices show moderate implementation with meaningful communicative practices (mean=3.37), humanistic values and learner autonomy (mean=3.66), and cooperative learning (mean=3.48). The highest approval is in adopting a task-based approach (mean=4.00). Cultural challenges in contextual alignment is strongly emphasized (mean=4.18), highlighting the importance of aligning educational practices with local contexts. Recommendations include targeted professional development, promoting collaborative learning, establishing clear assessment frameworks, leveraging technology for resource sharing, and strengthening local community partnerships. (shrink)

Nursing as a profession seems to avoid considering the problem of racism. There is, however, a need to address this topic and to evaluate its implications for nursing practice. This article attempts to establish a rationale for nursing to address racism and introduce it into academic discourse. The results of a small-scale study by the author are analysed and the implications for ethical-moral reasoning in nursing practice are discussed in relation to professional codes of conduct developed by nurses’ professional organizations (...) in the UK and elsewhere. (shrink)

This paper offers a theoretical discussion on why the nursing profession has had a delayed response to the issue of climate change. We suggest this delay may have been influenced by the early days of nursing's professionalization. Specifically, we examine nursing's professional mandate, the generally accepted metaparadigm, and the grand theorists’ conceptualizations of both the environment and the nurse–environment relationship. We conclude that these works may have encouraged nurses to conceptualize the environment, as well as their relationship with it, mainly (...) in terms of the individual patient, and as such, nurses have not been encouraged to understand these concepts from a broader perspective. By not having the philosophical and theoretical foundations to understand the environment in relation to society, it is not surprising that nurses have had a delayed response to climate change and may not have viewed it as a professional concern. A planetary health perspective is suggested as a theoretical basis for nursing education, research and practice. Taking on a planetary health perspective could help nurses progress the profession and move healthcare systems towards supporting a climate‐resilient future. (shrink)

Jamieson, Hangen, Lee, and Yaeager present their empirical findings as evidence for the effects of reappraising arousal on affective responses. This comment highlights the important contribution of the research by Jamieson and colleagues, but offers alternative ways of conceptualizing it.

Wiggins and Wilbanks (2019) raise a number of interesting concerns vis-à-vis citizen science and research. However, one area of innovation in citizen science that has seen significant advancements...

The purpose of the paper is an analysis of the transformation of the concept “transcendentalism” in history of modern philosophy. I first reconstruct the Kantian idea of transcendental philosophy. After that I analyze the notion of transcendentalism, its definition and functions in the theories of Cohen and Cassirer and demonstrate that Neo-Kantian understanding of transcendentalism distinguishes itself from the Kantian and receives some features which allow for a transition from theory of knowledge to theory of culture and prepare the so (...) called “cultural turn”. Finally, I briefly consider the main directions of modern transcendentalism and their main features. (shrink)

Color conveys critical information about the flavor of food and drink by providing clues as to edibility, flavor identity, and flavor intensity. Despite the fact that more than 100 published papers have investigated the influence of color on flavor perception in humans, surprisingly little research has considered how cognitive and contextual constraints may mediate color–flavor interactions. In this review, we argue that the discrepancies demonstrated in previously-published color–flavor studies may, at least in part, reflect differences in the sensory expectations that (...) different people generate as a result of their prior associative experiences. We propose that color–flavor interactions in flavor perception cannot be understood solely in terms of the principles of multisensory integration but that the role of higher-level cognitive factors, such as expectations, must also be considered. (shrink)

Because “evidence” is at issue in evidence-based medicine (EBM), the critical responses to the movement have taken up themes from post-positivist philosophy of science to demonstrate the untenability of the objectivist account of evidence. While these post-positivist critiques seem largely correct, I propose that when they focus their analyses on what counts as evidence, the critics miss important and desirable pragmatic features of the evidence-based approach. This article redirects critical attention toward EBM’s rigid hierarchy of evidence as the culprit of (...) its objectionable epistemic practices. It reframes the EBM discourse in light of a distinction between objectivist and pragmatic epistemology, which allows for a more nuanced analysis of EBM than previously offered: one that is not either/or in its evaluation of the decision-making technology as either iconoclastic or creedal. -/- . (shrink)

It has been almost 20 years since the field of bioethics was galvanized by a controversial series of multinational AZT trials employing placebo controls on pregnant HIV-positive women in the developing world even though a standard of care existed in the sponsor countries. The trove of ethical investigations that followed was thoughtful and challenging, yet an important and problematic methodological assumption was left unexplored. In this article, I revisit the famous “double standard of care” case study in order to offer (...) novel consideration of the placebo orthodoxy that underlies much of the ethical debate. This majority view found in medical research is that placebo-controlled trials are methodologically superior to comparative trials that use active controls. I challenge this orthodoxy and argue that lives were unnecessarily lost in these trials as a result. Furthermore, current HIV research on vaccines and microbicides is now poised to repeat the error of subscribing to the placebo orthodoxy. (shrink)

Written in an effort “to frame questions of culture and power in different terms” from those of Edward Said, this case study of Ottoman Alexandria before the French invasion in 1798 reveals “lines between empowered and powerless, even East and West,” blurred or erased by “cosmopolitan mixing.... So much attention is paid to the way that empires divide people against each other that it is easy to forget how empires have also brought populations together, forcibly at times, yet often with (...) enduring effects. The cosmopolitan possibilities of empire, as opposed to narrower definitions of national belonging, would shape the life of Etienne Roboly,” whose complicated existence in Egypt—as a citizen of both or neither the French state and/nor the Ottoman—is the focus of this study. The author asks her readers to glean from this article two “lessons”: first, that “nation-states, as the briefest glance at twentieth-century history will confirm, have often proved themselves hostile toward minority populations. Yet we have also been taught to see empires as evil things, which makes the second lesson— that empires have sometimes been more accommodating of difference than many independent nations—seem somewhat counterintuitive.... The history of Alex-andria invites us to look at how empire may provide an umbrella of common security for a range of cultures to coexist, and even at times intermingle.” Still, “the larger question is whether and how inclusionary definitions of belonging can be made to oughtweigh exclusionary ones,” regardless of the political context. (shrink)

Background The increase in empirical methods of research in bioethics over the last two decades is typically perceived as a welcomed broadening of the discipline, with increased integration of social and life scientists into the field and ethics consultants into the clinical setting, however it also represents a loss of confidence in the typical normative and analytic methods of bioethics. Discussion The recent incipiency of "Evidence-Based Ethics" attests to this phenomenon and should be rejected as a solution to the current (...) ambivalence toward the normative resolution of moral problems in a pluralistic society. While "evidence-based" is typically read in medicine and other life and social sciences as the empirically-adequate standard of reasonable practice and a means for increasing certainty, I propose that the evidence-based movement in fact gains consensus by displacing normative discourse with aggregate or statistically-derived empirical evidence as the "bottom line". Therefore, along with wavering on the fact/value distinction, evidence-based ethics threatens bioethics' normative mandate. The appeal of the evidence-based approach is that it offers a means of negotiating the demands of moral pluralism. Rather than appealing to explicit values that are likely not shared by all, "the evidence" is proposed to adjudicate between competing claims. Quantified measures are notably more "neutral" and democratic than liberal markers like "species normal functioning". Yet the positivist notion that claims stand or fall in light of the evidence is untenable; furthermore, the legacy of positivism entails the quieting of empirically non-verifiable considerations like moral claims and judgments. As a result, evidence-based ethics proposes to operate with the implicit normativity that accompanies the production and presentation of all biomedical and scientific facts unchecked. Summary The "empirical turn" in bioethics signals a need for reconsideration of the methods used for moral evaluation and resolution, however the options should not include obscuring normative content by seemingly neutral technical measure. (shrink)

While most of healthcare research and practice fully endorses evidence-based healthcare, a minority view borrows popular themes from philosophy of science like underdetermination and value-ladenness to question the legitimacy of the evidence-based movement’s philosophical underpinnings. While the feminist origins go unacknowledged, those critics adopt a feminist reading of the “gap argument” to challenge the perceived objectivism of evidence-based practice. From there, the critics seem to despair over the “subjective elements” that values introduce to clinical reasoning, demonstrating that they do not (...) subscribe to feminist science studies’ normative program——where contextual values can enable good science and justified decisions. In this paper, I investigate why it is that the critics of evidence-based medicine adopt feminist science’s characterization of the problem but resist the productive solutions offered by those same theorists. I suggest that the common feminist empiricist appeal to idealized epistemic communities is impractical for those working within the current biomedical context and instead offer an alternate stream of feminist research into the empirical content of values (found in the work of Elizabeth Anderson and Sharyn Clough) as a more helpful recourse for facilitating the important task of legitimate and justified clinical decision-making. I use a case study on clinical decision-making to illustrate the fruitfulness of the latter feminist empiricist framework. -/- See response by Sharyn Clough: http://wp.me/p1Bfg0-1aN See reply by Maya Goldenberg: http://wp.me/p1Bfg0-1oY. (shrink)

Medical discourse currently manages two broad visionary movements: "evidence-based medicine," the effort to make clinical medicine more responsive to the medical research, and "patient-centered care," the platform for a more humane health-care encounter. There have been strong calls to synthesize the two as "evidence-based patient-centred care" (Lacy and Backer 2008; see also Borgmeyer 2005; Baumann, Lewis, and Gutterman 2007; Krahn and Naglie 2008), yet many question the compatibility of the two competing programs.This might sound to some like a new version (...) of an old story. Despite the fact that evidence-based medicine and patient-centered care are relatively new programs, the story of their oppositional .. (shrink)

This article seeks to explore the relationship between populism, 21st-century socialism, and the emergence of what has been referred to as an ‘ estado delincuente’ (criminal state), in the case of Venezuela. That is, a state structure permeated with transnational organized crime mafias in the executive and the judiciary, in the financial system, the prosecutor’s office, the police, the armed forces, the prison system, state-owned companies, governorships, and city councils, among other state institutions. First, I review conceptual aspects of populism (...) to understand how this served as the basis for creating the postulates of 21st-century socialism, which promoted the institutional destruction of Venezuelan democracy and created the conditions for the unbridled dissemination of state corruption. Second, emblematic cases of white-collar and blood crimes, nepotism and other corrupt activities are discussed to provide an idea of the magnitude of the issues that permeate the state apparatus. To conclude, I provide a critical summary of the consequences of this way of doing politics in contemporary Venezuela. (shrink)

The standard counterexamples to David Lewis’s account of intrinsicality involve two sorts of properties: identity properties and necessary properties. Proponents of the account have attempted to deflect these counterexamples in a number of ways. This paper argues that none of these moves are legitimate. Furthermore, this paper argues that no account along the lines of Lewis’s can succeed, for an adequate account of intrinsicality must be sensitive to hyperintensional distinctions among properties.