Recent studies show that racism still exists in the American medical profession, the fact of which legitimizes the historically long-legacy of mistrust towards medical profession and health authorities among African Americans. Thus, it was suspected that the participation of black patients in end-of-life care has always been significantly low stemmed primarily from their mistrust of the medical profession. On the other hand, much research finds that there are other reasons than the mistrust which makes African Americans feel reluctant to the (...) end-of-life care, such as cultural-religious difference and genuine misunderstanding of the services. If so, two crucial questions are raised. One is how pervasive or significant the mistrust is, compared to the other factors, when they opt out of the end-of-life care. The other is if there is a remedy or solution to the seemingly broken relationship. While no studies available answer these questions, we have conducted an experiment to explore them. The research was performed at two Philadelphia hospitals of Mercy Health System, and the result shows that Black patients’ mistrust is not too great to overcome and that education can remove the epistemic obstacles as well as overcome the mistrust. (shrink)

Research has demonstrated that feeling-of-knowing judgments are affected by the amount of accessible information related to an inaccessible target. Further, studies have demonstrated that, in some situations, FOK judgment magnitude is not only related to the amount of accessed features, but also the correctness of those features . The present study examined the conditions under which the correctness of features would influence FOK judgment magnitude. We hypothesized that accuracy of retrieved features would influence FOK judgments, but only in situations where (...) semantically meaningful information was accessible. In three experiments, we manipulated accessibility of semantic information. In all experiments, the quantity, or amount of retrieved partial information had a greater impact on FOK judgments than the accuracy of that information. However, in situations where semantic information was accessible, accuracy of retrieved semantic features also influenced FOK judgment magnitude, and later recognition. (shrink)

This is the first volume to bring together original essays that address the theoretical foundations of the concept of autonomy, as well as essays that ...

Invention is an important source of technology, and, to understand invention, one needs a model system or prototype. A candidate model system is the hand tool. Using the hand tool as an example, the authors present a systematic approach to invention, dealing with description, classification, and joining or integrating simpler forms. Heuristics for when to integrate are presented. Finally, the authors introduce a new way of thinking about hand tools: simple spatial transformations applied to an abstract element make possible the (...) re-creation of a large number of tools. (shrink)

The focus on translational research in clinical trials has the potential to generate clinically relevant genetic data that could have importance to patients. This raises challenging questions about communicating relevant genetic research results to individual patients. An exploratory pharmacogenetic analysis was conducted in the international ovarian cancer phase III trial, AGO-OVAR 16, which found that patients with clinically important germ-line BRCA1/2 mutations had improved progression-free survival prognosis. Mechanisms to communicate BRCA results were evaluated, because these findings may be beneficial to (...) patients and their families. Communicating individual BRCA results was not anticipated during clinical trial design. Consequently, options were not available for patients to indicate their preference for receiving their individual results when they signed pharmacogenetic informed consent. Differences in local requirements, clinical practice, and opinion regarding the ethical aspects of how to convey genetic results to patients are all potential barriers to returning individual BRCA results to patients. Communicating the aggregate BRCA result from this study provided clinical investigators with a mechanism to disseminate the overall study finding to patients while taking individual circumstances, local guidelines and clinical practice into account. This study illustrates the importance of increasing the clarity and scope of informed consent and the need for patient engagement to ensure clinical trial participants can indicate their preference regarding receipt of potentially important individual pharmacogenetic results. This study was registered in the NCT Clinical Trial Registry under NCT00866697 on March 19, 2009, following approval from participating ethics committees. (shrink)

In this article, we frame men’s club football as an “extremely gendered” organization to explain the underrepresentation of women leaders within the industry. By analyzing women’s leadership work over a 30-year period, we find that women’s inclusion has been confined to a limited number of occupational areas. These areas are removed, in terms of influence and proximity, from the male players and the playing of football. These findings reveal a gendered substructure within club football that maintains masculine dominance in core (...) football leadership roles and relegates women to a position of peripheral inclusion in leadership roles. Through a discourse analysis of gender pay gap reports, we show that men’s football clubs legitimize women’s peripheral inclusion by naturalizing male dominance at the organizational core. These findings are significant because they demonstrate that men’s football clubs, as masculinity-conferring organizations, have excluded women from core roles to maintain their masculine character while superficially accepting women into roles that do not challenge the association of football with hegemonic masculinity. Therefore, organizational change may be possible only if women are granted greater access to core organizational roles. Here, we offer a new theoretical framework for “extremely gendered” organizations that can be applied to other sporting and male-dominated contexts to analyze women’s access to core leadership roles. (shrink)

Mental and substance use disorders have been identified as the leading cause of global disability, and the global burden of mental illness is concentrated among those experiencing disability due to serious mental illness. Music has been studied as a support for SMIs for decades, with promising results; however, a lack of synthesized evidence has precluded increased uptake of and access to music-based approaches. The purpose of this scoping review was to identify the types and quantity of research at intersections of (...) music and SMIs, document evidentiary gaps and opportunities, and generate recommendations for improving research and practice. Studies were included if they reported on music's utilization in treating or mitigating symptoms related to five SMIs: schizophrenia, bipolar disorder, generalized anxiety disorder, major depressive disorder, or post-traumatic stress disorder. Eight databases were searched; screening resulted in 349 included studies for data extraction. Schizophrenia was the most studied SMI, with bipolar disorder studied the least. Demographics, settings, and activity details were found to be inconsistently and insufficiently reported; however, listening to recorded music emerged as the most common musical activity, and activity details appeared to have been affected by the conditions under study. RCTs were the predominant study design, and 271 unique measures were utilized across 289 primary studies. Over two-thirds of primary studies reported positive results, with 2.8% reporting worse results than the comparator, and 12% producing indeterminate results. A key finding is that evidence synthesis is precluded by insufficient reporting, widely varied outcomes and measures, and intervention complexity; as a result, widespread changes are necessary to reduce heterogeneity, increase replicability and transferability, and improve understandings of mechanisms and causal pathways. To that end, five detailed recommendations are offered to support the sharing and development of information across disciplines. (shrink)

We extend attribution and stakeholder theory in the context of crisis reputation management by examining differences in stakeholder perceptions in the form of organization-related blame. We presented eight stakeholder groups with factual information surrounding the Deepwater Horizon Oil Spill and asked them to indicate the extent to which they blamed the leaders and organizations associated with the event. Stakeholders also completed a survey assessing their attribution styles. Results indicated that perceptions of blame were affected by the interaction of stakeholder role (...) (i.e., active vs. passive) with attribution style (i.e., optimistic vs. pessimistic). Our results suggest that organizational leaders’ understanding of their stakeholders may be an important aspect in managing stakeholders’ sensemaking during crises. (shrink)

Mobile devices with health apps, direct-to-consumer genetic testing, crowd-sourced information, and other data sources have enabled research by new classes of researchers. Independent researchers, citizen scientists, patient-directed researchers, self-experimenters, and others are not covered by federal research regulations because they are not recipients of federal financial assistance or conducting research in anticipation of a submission to the FDA for approval of a new drug or medical device. This article addresses the difficult policy challenge of promoting the welfare and interests of (...) research participants, as well as the public, in the absence of regulatory requirements and without discouraging independent, innovative scientific inquiry. The article recommends a series of measures, including education, consultation, transparency, self-governance, and regulation to strike the appropriate balance. (shrink)

This essay uses the 2014 protests in Thailand in which demonstrators silently brandished The Hunger Games’s three-fingered salute as a lens through which to analyze nonverbal communication in contentious politics. Drawing on and extending J.L. Austin’s speech act theory, I explore the conditions of legibility of nonverbal language such as bodily gesture, signs and symbols. While neither verbal nor nonverbal speech guarantees an exact translation between intention and reception, nonverbal utterances operate along a looser terrain of legibility. I contend that (...) the attribution of meaning and intention to the speaker’s nonverbal utterance demands a reflexive consideration from the listener, founding a new community of meaning oriented around a shared context. This interpretive public, with its ambivalent emancipatory potential, is the space of politics. (shrink)

In this exploratory study, higher education faculty perceptions regarding acceptability of social media use for out-of-class student engagement are identified. Hypotheses are developed and tested using a survey to address the impact of factors such as awareness, faculty/student relationship status, gender, academic discipline, and rank on faculty attitudes toward out-of-class social media use for student engagement. Findings indicate that faculty members are aware of social media, but use varies. Overall, they do not view social media as an important part of (...) out-of-class engagement, but it is viewed as more acceptable for engagement with former students. In addition, faculty from Marketing and Communications disciplines and Associate/Full Professors perceive social media use to be more acceptable for student engagement when compared with their colleagues from other disciplines and lower ranks. Implications and conclusions are discussed for development of university social media usage policies and directions for future research. (shrink)

Patient decision aids enable patients to be better informed about the potential benefits and harms of their healthcare options. Certification of patient decision aids at the national level in the United States is a critical step towards responsible governance—primarily as a quality measure that increases patients’ safety, as mandated in the U.S. Patient Protection and Affordable Care Act (PPACA). Certification would provide a verification process to identify conflicts of interest that may otherwise bias the scientific evidence presented in decision aids. (...) Certification also benefits clinicians who may otherwise face malpractice claims based on harm to patients caused by possible reliance on patient decision aids that are inaccurate, incomplete, or presented in a manner that biases the patient’s decision. Existing work by the International Patient Decision Aid Standards Collaboration could guide the establishment of a certification process within the U.S. This article argues for national certification of patient decision aids and discusses how that may be achieved. (shrink)

Little research has explored the perceptions of military medical providers in the deployed environment and how their perceptions may change over time across an extended military conflict. To our knowledge, no studies have examined military medical providers’ opinions on readiness for their roles in the post-9/11 contingency operations. What has been published indicates that, during the height of Operation Iraqi Freedom, military medical providers often deployed with little notice and minimal formal training. The present report examines data obtained from multiple (...) cohorts of military medical providers (N = 321) deployed to Iraq between 2005 and 2009. Despite varying degrees of support from the U.S. public, our findings indicate that U.S. Air Force military medical providers’ support for the people of Iraq, their belief in the mission, and their ability to influence change did not vary with time. (shrink)

James Stacy Taylor advances a thorough argument for the legalization of markets in current (live) human kidneys. The market is seemly the most abhorrent type of market, a market where the least well-off sell part of their body to the most well off. Though rigorously defended overall, his arguments concerning exploitation are thin. I examine a number of prominent bioethicists’ account of exploitation: most importantly, Ruth Sample’s exploitation as degradation. I do so in the context of Taylor’s argument, with the (...) aim of buttressing Taylor’s position that a regulated kidney market is morally allowable. I argue that Sample fails to provide normative grounds consistent with her claim that exploitation is wrong. I then reformulate her account for consistency and plausibility. Still, this seemingly more plausible view does not show that Taylor’s regulated kidney market is prohibitively exploitative of impoverished persons. I tack into place one more piece of support for Taylor’s conclusion. (shrink)

Philosophical discussion tends to converge on the view that narratives are at the center of the emotion of grief. In this article, I expand on this kind of view. On the one hand, I argue that key strands of phenomenological and neuroscientific studies suggest that grief consists in a complex emotional process of disconfirmation-and-updating of the narrative self-model. By heuristically drawing on an analogy between binocular rivalry and grief, I show that certain salient aspects of the phenomenology of grief, such (...) as self-alienation and ambiguity, are straightforwardly reflected by this account. On the other hand, I argue that this hierarchical approach has the resources to: (i) show that both narratable and unnarratable experiences of personal loss are both instances of grief; and (ii) differentiate between narratable and unnarratable experiences of grief, without compromising the view that self-constituting narratives are at the center of the phenomenon. (shrink)

Sender–receiver games, first introduced by David Lewis ([1969]), have received increased attention in recent years as a formal model for the emergence of communication. Skyrms ([2010]) showed that simple models of reinforcement learning often succeed in forming efficient, albeit not necessarily minimal, signalling systems for a large family of games. Later, Alexander et al. ([2012]) showed that reinforcement learning, combined with forgetting, frequently produced both efficient and minimal signalling systems. In this article, I define a ‘dynamic’ sender–receiver game in which (...) the state–action pairs are not held constant over time and show that neither of these two models of learning learn to signal in this environment. However, a model of reinforcement learning with discounting of the past does learn to signal; it also gives rise to the phenomenon of linguistic drift. 1 Introduction2 Dynamic Signalling Games with Reinforcement Learning2.1 Introducing new states2.2 Swapping state–action pairs3 Discounting the Past3.1 Learning to signal in a dynamic world3.2 An unexpected outcome: linguistic drift4 ConclusionAppendix: A Markov Chain Analysis. (shrink)

This volume is dedicated to Mario Bunge in honor of his sixtieth birthday. Mario Bunge is a philosopher of great repute, whose enormous output includes dozens of books in several languages, which will culminate with his Treatise on Basic Philosophy projected in seven volumes, four of which have already appeared [Reidel, I 974ff. ]. He is known for his works on research methods, the foundations of physics, biology, the social sciences, the diverse applications of mathematical methods and of systems analysis, (...) and more. Bunge stands for exact philosophy, classical liberal social philosophy, rationalism and enlightenment. He is brave, even relentless, in his attacks on subjectivism, mentalism, and spiritualism, as well as on positivism, mechanism, and dialectics. He believes in logic and clarity, in science and open-mindedness - not as the philosopher's equivalent to the poli tician's rhetoric of motherhood and apple pie, but as a matter of everyday practice, as qualities to cultivate daily in our pursuit of the life worth living. Bunge's philosophy often has the quality of Columbus's egg, and he is prone to come to swift and decisive conclusions on the basis of argu ments which seem to him valid; he will not be perturbed by the fact that most of the advanced thinkers in the field hold different views. (shrink)

Although the theory of definability had many important antecedents—such as the descriptive set theory initiated by the French semi-intuitionists in the early 1900s—the main ideas were first laid out in precise mathematical terms by Alfred Tarski beginning in 1929. We review here the basic notions of languages, explicit definability, and grammatical complexity, and emphasize common themes in the theories of definability for four important languages underlying, respectively, descriptive set theory, recursive function theory, classical pure logic, and finite-universe logic. We review (...) the history of previous studies of the similarities and differences in the theories of definability of the first three of these four languages. A seminal role leading toward unification of the theories has been played by the separation principles introduced by Nikolai Luzin in 1927. Emphasizing analogies and driving toward further unification embracing finite-universe logic we concentrate on a simple example—the first and second separation principles for existential-universal first-order sentences . Using this as a test case for the fundamental problem of how to “finitize” arguments in classical pure logic to the finite-universe case, we are led to the analogous negative solution by using the theory of certain special graphs: a graph is - special for any positive integers m , n , p , q iff it is bipartite with m red points and n blue points and for every p -tuple of red points there is a blue point to which they are all connected . As an aside we introduce for further study a natural “Ramseyesque” increasing sequence A of positive integers, where A is the least positive integer n for which an -special graph exists. (shrink)

This article aims to show that Locke’s discussion of tacit consent and the right to punish aliens in the Second Treatise of Government has important bearings on the moral status of undocumented immigrants. It argues that Locke conceptualized both friendly and hostile aliens, counting the former as tacit consenters to whom host states owed rights and protection. Moreover, it highlights how his approach, unlike theorists before and after him, was one that saw individuals as capable of shaping their own relationship (...) with the host. The article also examines Locke’s discussion of the federative power of the state, which includes the power to vet aliens within the country. Seen through this Lockean lens, the article argues that the vast majority of undocumented immigrants can be understood as tacit consenters or potential citizens who should be judged by how they choose to relate to the host, and not by their country of origin. While noting that the Lockean approach is not incompatible with border control, the article also shows how it puts the onus on the host to justify the power it exercises and to engage in dialogue with undocumented immigrants about what their status should be in the country. (shrink)