Clinical trials for acute conditions such as myocardial infarction and stroke pose challenges related to informed consent due to time limitations, stress, and severe illness. Consent processes shou...

Volume 20, Issue 8, August 2020, Page W12-W13.

BackgroundInformed consent forms are intended to facilitate research enrollment decisions. However, the technical language in institutional templates can be unfamiliar and confusing for decision-makers. Standardized language describing financial implications of participation, namely compensation for injury and costs of care associated with participating, can be complex and could be a deterrent for potential participants. This standardized language may also be misleading in the context of comparative effectiveness trials of standard care interventions, in which costs and risk of injury associated with participating (...) may not differ from regular medical care. In addition, the revised U.S. Common Rule contains a new requirement to present key information upfront; the impact of how this requirement is operationalized on comprehension and likelihood of enrollment for a given study is unknown.MethodsTwo online surveys assessed the impact of (1) changes to compensation for injury language (standard vs. tailored language form) and (2) changes to the key information page (using the tailored compensation language form with standard key information vs. modified key information vs. modified key information plus financial information) on both likelihood of enrollment in and understanding of a hypothetical comparative effectiveness trial.ResultsLikelihood of enrolling was not observed to be different between the standard and tailored language forms in Study 1 (73 vs. 75%; p = 0.6); however, the tailored language group had a higher frequency of understanding the compensation for injury process specific to the trial (25 vs. 51%; p < 0.0001). Modifications to the key information sheet in Study 2 did not affect likelihood of enrolling (88 vs. 85 vs. 85%; p = 0.6); however, understanding of randomization differed by form (44 vs. 59 vs. 46%; p = 0.002).ConclusionsThese findings suggest that refining consent forms to clarify key information and tailoring compensation for injury language to the nature of the study, especially in the context of comparative effectiveness trials, may help to improve study comprehension but may not impact enrollment. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Belief and Context Determinacy in Interpreting FictionChristine Richards (bio)1Context Determinacy and the Interpretation of FictionThe Pragmatics of ReadingThe basic pragmatic structure of the reading of fiction has been described as a communicative context which has a speaker who performs the speech acts represented by the text and a hearer (addressee) to whom the speech acts are directed [Adams 12]. This model is based on the assumption that the reader (...) and the writer share not only a common language but a common context, which clearly presents problems for readers of fiction, where generic conventions as well as other cultural conventions of writing, such as satire and irony, or the separation of writers and readers by time, have to be contended with. The code model, which assumes that the writer and the reader share a common context, can be represented as shown in figure 1. Click for larger view View full resolutionFigure 1.W = writer, S = speaker, H = hearer, R = reader.However, it has also been argued [Eco, Role of the Reader 40; Eco, Semiotics 69; Richards 262] that no theory of a text is possible without a theory of contexts, since texts are processed and given meaning by a synthesis of propositions in them with those which originate in readers’ supplied contexts; and since the contexts of readers consist, first and foremost, of their background knowledge, beliefs, and culture, which are fundamentally interrelated, interpretation is inevitably determined by extralinguistic as well as linguistic factors. The context model might be represented as shown in figure 2. Click for larger view View full resolutionFigure 2.W = writer, N = narrator, R = reader.[End Page 81]The Extralinguistic ContextA good example of the role played by extralinguistic contexts in the interpretation of a text is to be found in the multiple interpretations of the sentence “The red sun was pasted in the sky like a wafer,” from Stephen Crane’s The Red Badge of Courage [64]. Susan Horton, in her discussion of accounts of this sentence [10–14], shows both how R. W. Stallman interprets Crane’s antiwar fiction as a Christian allegory where the word “wafer” functions as a symbol of the Eucharist [130], and how Marston La France rejects Stallman’s interpretation on the basis that Crane is not a Christian, and certainly not a Catholic [99–100]. La France’s rejection of Stallman’s Christian context for atheism is rooted in his interpretation of the sun as a repeated image in the co-text, which he believes signifies nature’s indifference to death, war and heroism. Here the lexemes “pasted” and “wafer” become images of a seal at the end of a legal document, implying the finality of death in war. Milne Holton interprets the image of the sun as a characteristic of the symbolic imagination of the character Henry Fleming rather than of the writer (Crane) [90–91].Horton documents but does not theorize the determining features of these contexts, but this problem can be tackled by applying Marcello Pagnini’s theory of “the introjection of the referent” [9] to explain how the contextual semes of readers, determined by different cultural systems, are introjected into texts. Following Jurij M. Lotman’s typology of cultural systems [Lotman and Uspenskij], Pagnini cites as relevant systems ethics, ideology, history, philosophy, myth, the law, anthropology, politics, ethnicity, literature, aesthetics, psychology, rhetoric and symbolism [34], which represent fundamentally interrelated complexes of systems that make up societies. If Pagnini’s model is taken with that of Richards [267], which conceives of interpretation as a synthesis of propositional inferences in texts with those drawn from readers’ contexts, these two models provide a methodological basis for explaining how the contexts of Stallman’s and La France’s conflicting interpretations derive from philosophically opposed belief systems within culture—Christianity and atheism. These models also help to explain Holton’s interpretation as one located within a different philosophical context, that of the convention of character analysis in fiction, which during the last few decades has developed into the more theoretically sophisticated field of narratology. It should be stressed, however, that interpretations themselves always take place within historical and interactive frameworks, which are influenced... (shrink)

In seinen Vorlesungen über die Ästhetik hat Hegel einen der wichtigsten und wirkmächtigsten Beiträge zur Ästhetik und Philosophie der Kunst entwickelt. Von der systematischen Klärung der Idee des Schönen über die geschichtliche Unterscheidung der symbolischen, klassischen und romantischen Kunstform bis hin zur Darstellung der einzelnen Künste (Architektur, Skulptur, Malerei, Musik, Poesie) werden alle relevanten Aspekte entfaltet und miteinander vernetzt. Eindrucksvoll ist nicht nur Hegels plastischer Zugriff auf die Fülle konkreten Materials. Bedeutsam ist vor allem sein kulturphilosophischer Ansatz, der die Kunst (...) auf dem Rang des "absoluten Geistes" als zentrales Medium menschlicher Selbstverständigung begreift. Die vieldiskutierte These vom "Ende der Kunst" in der Moderne hängt damit direkt zusammen. Hegel hat seine vier Berliner Ästhetik-Kollegien nicht selbst publiziert. Dieser Kommentarband orientiert sich an der Edition des Hegel-Schülers H.G. Hotho und zieht ergänzend die Nachschriften, insbes. des letzten Kollegs von 1828/29 hinzu. In dieser Form wird Hegels Ästhetik auf dem aktuellen Forschungsstand für ein breites philosophisches und kulturwissenschaftliches Interessenfeld erschlossen. Mit Beiträgen von B. Collenberg-Plotnikov, N. Hebing, G. Hindrichs, S. Houlgate, W. Jaeschke, R. Pippin, B. Sandkaulen, U. Seeberg, M. Seel, A. Speight u. J. Stolzenberg. (shrink)

It is argued that the so-called fitting attitude- or buck-passing pattern of analysis may be applied to personal values too if the analysans is fine-tuned in the following way: An object has personal value for a person a, if and only if there is reason to favour it for a’s sake. One benefit with it is its wide range: different kinds of values are analysable by the same general formula. Moreover, by situating the distinguishing quality in the attitude rather than (...) the reason part, the analysis admits that personal value is recognizable as a value not only by the person for whom it has personal value, but for everyone else too. We thereby avoid facing two completely different notions of value, viz., one pertaining to impersonal value, and another to personal value. The analysis also elucidates why we are justified in our concern for objects that are valuable for us; if value just is, as it is suggested, the existence of reasons for such a concern, the justification is immediately forthcoming. (shrink)

Cognitive Science, Volume 45, Issue 11, November 2021.

Chemical structures are among the trademarks of our profession, as surely chemical as flasks, beakers and distillation columns. When someone sees one of us busily scribbling formulas or structures, he or she has no trouble identifying a chemist. Yet these familiar objects, which accompany our work from start to end, from the initial doodlings (Fig. I) to the final polished artwork in a publication (Fig. II), are deceptively simple. They raise interesting and difficult questions about representation. It is the intent (...) of this article to reflect upon molecular graphics. (shrink)

This distinction has sometimes been read as purely epistemic, resting not on things, but on our knowledge of them: there is one world, not two, though it may be apprehended in two ways. But this view is patently at odds with the text. Knowledge and opinion are δυνάμεις, "faculties," to be distinguished and defined by their objects, no less than by the state of mind they produce, and Plato clearly states that the fallibility and unclearness of opinion is rooted in (...) the relative unreality of opinables. (shrink)

R T Allen; The Meaning of Life and Education, Journal of Philosophy of Education, Volume 25, Issue 1, 30 May 2006, Pages 47–58, https://doi.org/10.1111/j.1467-9.

Objectives—To assess perceptions of the informed consent process in patients undergoing urgent abdominal surgery.Design—A prospective observational study was carried out using structured questionnaire-based interviews. Patients who had undergone urgent abdominal surgery were interviewed in the postoperative period to ascertain their perceptions of the informed consent process. Replies were compared to responses obtained from a control group undergoing elective surgery, to identify factors common to the surgical process and those specific to urgent surgery. Patients' perceptions of received information were also compared (...) to the information perceived to have been provided by the consent obtainers. Setting—Gastrointestinal surgical service of a university teaching hospital.Patients—Seventy-four consecutive patients undergoing urgent abdominal surgery and 80 control patients undergoing elective surgery. Main measurements—Principal outcome measures were patients' perceptions of factors interfering with the ability to give informed consent, assessment of the quality of informed consent and the degree of discussion of the expected outcomes. Results—Forty-nine of the seventy-four (66%) patients undergoing urgent surgery perceived that pain did not affect their ability to give informed consent. Twenty-seven reported an adverse effect of analgesia on the ability to give informed consent. Only 22% of patients undergoing urgent surgery perceived that there had been any discussion of potential side effects and complications of surgery. Conclusion–The majority of patients in this series with acute intra-abdominal surgical conditions perceive that they retain the ability to give informed consent for surgery. There is a need for improved discussion of therapeutic options and likely outcomes. (shrink)

Among Plato's later dialogues, the _Parmenides_ is one of the most significant. Not only a document of profound philosophical importance in its own right, it also contributes to the understanding of Platonic dialogues that followed it, and it exhibits the foundations of the physics and ontology that Aristotle offered in his _Physics_ and _Metaphysics _VII. In this book, R.E. Allen provides a superb translation of the _Parmenides_ along with a structural analysis that procedes on the assumption that formal elements, logical (...) and dramatic, are important to its interpretation and that the argument of the _Parmenides_ is aporetic, a statement of metaphysical perplexities. Allen's original translation of and commentary on the _Parmenides_ were published in 1983 to great acclaim and have now been revised by the author. (shrink)

In his article ‘A Cavalry Unit in the Army of Antigonus Monophthalmus: Asthippoi’, N. G. L. Hammond argues that the reading of the manuscript R at Diodorus 19. 29. 2 should be retained and that we should read ⋯π⋯ π⋯σι δ⋯ το⋯ς τε ⋯σθ⋯ππους ⋯νομαζομ⋯νους κα⋯ τοὺς ⋯κ τ⋯ν ἄνω κατοικο⋯ντων ⋯κτακοσιο⋯ς. The readings of F and its copy X, ⋯νθ⋯ππους, and the commonly accepted conjecture of Wesseling ⋯μɸ⋯ππους, should both be abandoned. Hammond's arguments for retaining this reading are that (...) between the variant readings of R and F, R ‘is the more often correct’ ; ⋯σθ⋯ππους, the reading of R, is preferable to F's ⋯νθ⋯ππους on the principle of ‘lectio difficilior’; the ‘difficulty’ of his lectio difficilior is made less by the arguments presented by A. B. Bosworth, 245 ff.), for the restoration at several places in the text of Arrian's Anabasis the word ⋯σθ⋯ταιροι, in place of the editorial emendation of πεζ⋯ταιροι. ‘For just as asthetairoi meant an élite group of Macedonian infantrymen,’ says Hammond, ‘so asthippoi should mean an élite group of Macedonian cavalrymen.’ He then proceeds to examine the passage and its context in an attempt to find confirmation of this proposition and comes to the conclusion that Diodorus' text says that there were 800 cavalrymen, broken into two groups, the asthippoi and ‘the men from the up-country settlers’; these, though having different names, had a close relationship to each other, as is shown by their being brigaded together. Following his derivation of asthetairoi as meaning ‘townsmen-companions’, i.e. companions recruited from the towns of Upper Macedonia, he argues that asthippoi were cavalry recruited from the towns of Upper Macedonia and that τοὺς ⋯κ τ⋯ν ἄνω κατοικο⋯ντων means ‘the sons of settlers in up-country Macedonia’. These 800, says Hammond, were both among Antigonus' best troops and ‘were Macedonians from Europe’. We thus appear, on Hammond's interpretation, to have here a group of 800 Macedonian élite cavalrymen, all of whom were recruited in Upper Macedonia's townships, but of whom some were chosen to be the cavalry-equivalent of the élite ‘townsmen-companions’ by their title of ‘townsmen-cavalry’, whilst the others, similarly recruited – but perhaps of a younger generation? – had no particular distinguishing title beyond ‘sons of settlers in up-country Macedonia’.Now, while it would be exciting to be able to add another one, possibly two Macedonian cavalry units to the Macedonian army of Philip, Alexander and the Successors, there are several aspects of Hammond's arguments that, it seems to me, are less than convincing. Thus, whilst it seems beyond reasonable doubt that ⋯σθ⋯ταιροι should be retained in the text of Arrian, appearing, as it does, six times, this is not an argument that ⋯σθ⋯ππους should be read in Diodorus' text. Both it and F's reading of ⋯νθ⋯ππους are hapax legomena and it is possible that both readings are wrong. But even if we retain ⋯σθ⋯ππους as the correct reading, Hammond's explanation of its meaning is open to objection on several counts. (shrink)

Before talking about the vision of Orikhov's essence of the relationship between the church and the state, one must first determine what the church is about - Catholic or Orthodox. After all, the thinker lived in Poland when there were still strong, even parity positions of both denominations. He himself was brought up in a family where his father was Catholic and his mother was Orthodox. This was reflected in his mentality: he repeatedly publicly stated the benefits of certain tenets (...) of the Orthodox faith. But most of all he settled on the problem of relations between the Catholic Church and the state. (shrink)

For all the time and effort expended on empowerment and participation ‘programmes’, many fail each year. This paper argues that the cause is a faulty view of communication widespread among managers and their teachers: the conduit, transmission model. It frustrates participation and is an ideology of management control. It rests on untenable beliefs about meaning and how language relates to the world. The paper proposes a new model of communication in terms of ‘communicating other/wise’ and offers examples of how it (...) can be practised in management education and by managers aiming to bring empowered and participatory workplaces into being. (shrink)

In the coverage of the problems of war and peace in Catholicism, researchers sometimes omit the regional component of their manifestation. We are talking about local traditions in Catholicism, which have their own specific approach to solving this problem and sometimes may differ significantly from the "conventional" position. The study of this field is necessary because in the delineated field the position of those theologians who were on the "outskirts" of Catholicism in the intercultural dialogue, on the one hand, led (...) to a deviation from the humanistic orientation about Catholicism. the war. An example would be the concept of a "holy war" of the Crusades, which had the anti-Islamic rhetoric generated not only in the West but also in the East. (shrink)

Here’s a problem that any reliability theory must face, whether it’s one that holds that beliefs are justified just when they’re products of belief-forming mechanisms with the potential of having good records of yielding true beliefs, or one that holds that a belief meets the standards for knowledge if and only if its causal basis rules out any relevant chance of mistake. The problem is made evident when cast in probabilistic terms. Let r be S’s reason for tokening the true (...) belief that p under conditions c. Then, according to reliabilism, Sis justified in believing that p under c iff r makes it sufficiently probable that p, whileS knows that p iff the conditional probability that p on r and c is unity. But how do we specify the belief context c to be counted as epistemically relevant? As urged recently by John Pollock, on the face of it there seems to be no principled reason for excluding mention of the truth value of the proposition believed. As he says, ‘The only obvious way to construct an objective non-epistemic kind of definite probability is to make it conditional on everything that is true [at the belief’s tokening]’ ; and, as he notes, ‘one feature of the present circumstances is a characterization of the belief as a belief in [p ], and another feature is the truth value of [p]’. But if we allow both the belief token and its truth value membership in the relevant belief context, we then have the hopeless task of explaining how the probability of the token’s being true can be anything but one or zero, one if what is believed is true, and zero if it’s false. This in tum would commit reliabilism to the foolish doctrines that a belief’s truth is sufficient for knowledge, while no false belief is ever even justified. No wonder, then, that Pollock says ‘there is no way to construct an intelligible notion of reliability which does the job required by the reliabilist’. And he is surely right in this: Neither knowledge nor justification can be explained as the chance of a belief’s being true if the relevant belief context is required to mention both the belief tokened and its truth value. We would be engaged in a comparably pointless task were we to try to explain the likelihood of a wager’s being a good bet on a horse race when we had to include among the givens both which horse was picked and its finish, or were we to try to make sense of the assertion that a theory’s predictions have a good chance of being true when both what the theory predicts and its outcome had to be included among the givens. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:R. D. Ackerman BELIEVING IN A FICTION: WALLACE STEVENS AT THE LIMITS OF PHENOMENOLOGY The "ring of men" of "Sunday Morning" will chant their "devotion to the sun, / Not as a god, but as a god might be, / Naked among them, like a savage source" (CP, pp. 69-70).' Solar nakedness is deferred even as it is named. The problem for belief is the question of appearance and (...) representation. Things appear as and like.... The phenomenological return to things is also a turn to fiction, as Husserl understood: "If anyone loves a paradox, he can really say... that the element which makes up the life of phenomenology... is fiction. ' " The sun is divine, and it is not; it is both naked and clothed, savage and civilized, source (or end) and means. But such paradox is ultimately unsatisfying, and as we will see with Stevens, the need for belief—for an image or idea of totality—forces the issue of fiction and reality. The Stevens we will have in view is not the Stevens—as if there were such a creature. Our Stevens is the one most persuaded by promises such as those of phenomenology, the one most concerned with decreation (reduction) and fresh beginnings, with discovery and recognition, with imagination, the body, and the earth. This is the Stevens for whom the barrier of language presages at last not absence and difference but fictive recovery of presence and identity, the one for whom poetry represents a way of belief beyond mysticism even as it bodes mythic proximity. Finally, this is the Stevens who predominates throughout the prose (as well as in much of the poetry), who tries mightily to secure a belief while disencumbering himself of metaphysics—but alas, I think, with small success. Although Stevens's association of the problem of belief with the idea of fiction occurs in early poems such as "A High-Toned Old Christian 79 80Philosophy and Literature Woman" and "To the One of Fictive Music," his most intensive involvement with fiction as belief dates from the early 1940s and spans the period of his major essays and his last four volumes of poems. He recounts, for instance, a 1942 conversation with a student: "I said that I thought that we had reached a point at which we could no longer really believe in anything unless we recognized that it was a fiction. The student said that that was an impossibility, that there was no such thing as believing in something that one knew was not true. It is obvious, however, that we are doing that all the time" (L, p. 430). What does it mean to believe in a fiction? That is my main subject here, as we seek out the limits of the phenomenological Stevens. His letters of this period are preoccupied with the problem of fictive belief: "If one no longer believes in God (as truth), it is not possible merely to disbelieve; it becomes necessary to believe in something else.... A good deal of my poetry recently has concerned an identity for that thing.... In one of the short poems that I have just sent to the harvard advocate, I say that one's final belief must be in a fiction. I think that the history of belief will show that it has always been in a fiction" (L, p. 370). The poem referred to, "Asides on the Oboe," begins: The prologues are over. It is a question now, Of final belief. So, say that final belief Must be in a fiction. It is time to choose. (CP, p. 250) Acknowledging that "in the long run, poetry would be the supreme fiction" (L, pp. 430-31), Stevens nonetheless singles out the nominative function of poetry as the essence of its claim to supremacy: "Poetry means not the language of poetry but the thing itself.... The subject matter is what comes to mind when one says of the month of August... 'Thou art not August, unless I make thee so'" (L, p. 377). The quoted line (also from "Asides") underscores the paradox that for Stevens the essence of fiction (the nontrue) is its capacity to nominate the true or the real. This... (shrink)