Objectives—To assess the process involved in obtaining ethical approval for a single-centre study involving geographically dispersed subjects with an uncommon genetic disorder. Design—Observational data of the application process to 53 local research ethics committees (LRECs) throughout Wales, England and Scotland. The Multicentre Research Ethics Committee (MREC) for Wales had already granted approval. Results—Application to the 53 LRECs required 24,552 sheets of paper and took two months of the researcher's time. The median time taken for approval was 39 days with only (...) seven (13%) of committees responding within the recommended 21 days. In at least nineteen cases (36%) a subcommittee considered the application. Thirty-three committees (62%) accepted the proposal without amendments but, of the remainder, four (8%) requested changes outside of the remit of LRECs. Discussion—Difficulties still exist with the system for obtaining ethical approval for studies involving a single centre but with patients at multiple sites, as is often required for genetic observational research. As such studies differ from true multicentre studies, it may be advantageous to develop a separate and specific process of application to ensure that resources are not unnecessarily expended in the quest for ethical approval. (shrink)

STORY L, MAYFIELD‐JOHNSON S, DOWNEY LH, ANDERSON‐LEWIS C, YOUNG R and DAY P. Nursing Inquiry 2010; 17: 373–384 Getting on Target with Community Health Advisors (GOTCHA): an innovative stroke prevention projectHealth disparities along with insufficient numbers of healthcare providers and resources have created a need for effective and efficient grassroots approaches to improve community health. Community‐based participatory research (CBPR), more specifically the utilization of community health advisors (CHAs), is one such strategy. The Getting on Target with Community Health Advisors (...) (GOTCHA) project convened an interdisciplinary team to answer the call from 10 counties in the rural Mississippi Delta area of ‘The Stroke Belt’ to meet the region’s identified health needs, and to impact the health of a disparaged state. This article explores this CBPR project including the community involvement strategies, innovative CHA training curriculum, evaluation plan, and implications to healthcare professionals, particularly nurses. (shrink)

Some may be convinced that, whether or not Lewis’ defense is successful, realism about possible worlds is unavoidable if sense is to be made of modal locutions. To show that this view is—as I believe-mistaken would be a more ambitious project than I can undertake here. But some brief comments may serve to show how extreme a view this is. If one rejects realism about possible worlds, one has at least these options: to accept that conventional modal logic can (...) be made intelligible only by way of possible worlds, but to try to construe possible worlds syntactically or conceptually; to deny that conventional modal logic can be made intelligible only by way of possible worlds; to retreat from conventional modal calculi to variant systems. I observe that, since the usual systems are wholly insensitive to the differences of tense and mood which are crucial to natural language modal locutions, there is some motivation for scepticism about the adequacy of conventional modal logics. So I resist the suggestion that there is no alternative to thoroughgoing realism. (shrink)

Lewis's account of the role of sensory experience in empirical knowledge rests on the theses: (1) that one's apprehension of what is given in sensory experience is certain; (2) that unless there were such certain apprehension of the given, No knowledge would be possible; (3) that justification of one's other justified empirical beliefs always derives from one's apprehension of the given. I show that all three theses are false. That they are false provides further motivation for the theory of (...) justification I call "foundherentist", Which is fallibilist and permits mutual support (see my "theories of knowledge; an analytic framework", "proceedings of the aristotelian society, Lxxxiii", 1982-3). (shrink)

Researchers from diverse disciplines, including organismal and cellular physiology, sports science, human nutrition, evolution and ecology, have sought to understand the causes and consequences of the surprising variation in metabolic rate found among and within individual animals of the same species. Research in this area has been hampered by differences in approach, terminology and methodology, and the context in which measurements are made. Recent advances provide important opportunities to identify and address the key questions in the field. By bringing together (...) researchers from different areas of biology and biomedicine, we describe and evaluate these developments and the insights they could yield, highlighting the need for more standardisation across disciplines. We conclude with a list of important questions that can now be addressed by developing a common conceptual and methodological toolkit for studies on metabolic variation in animals. (shrink)

This book has been written in the hopes of equipping teachers-in-training—that is, teacher candidates—with the skills needed for action research: a process that leads to focused, effective, and responsive strategies that help students succeed.

The Search for the Legacy of the USPHS Syphilis Study at Tuskegee is a collection of essays from experts in a variety of fields seeking to redefine the legacy of the infamous Tuskegee Syphilis Study. The essayists place the legacy of the study within the evolution of racial and ethnic relations in the United States. Contributors include two leading historians on the study, two former United States Surgeons General, and other prominent scholars from a wide range of fields.

In lieu of an abstract, here is a brief excerpt of the content:Secrecy and Autonomy in Lewis CarrollSusan ShererVictorian novels quiver with morbid secrets and threatening discoveries. Unseen rooms, concealed doors, hidden boxes, masked faces, buried letters, all appear (and disappear) with striking regularity in the fiction of Victorian England. So many of these secret spaces contain children, and especially little girls, little girls in hidden spaces. The young Jane Eyre sits behind a curtain in the hidden window seat, (...) escaping the vindictive wrath of John Reed. Repulsed by her angry brother, Maggie Tulliver flees to the house attic, fantasizing that her family will fear that she has died. Little Dorrit withdraws from the common space of the Marshalsea into her private room above the prison, and Little Nell hides behind trees and walls, silently observing clandestine meetings. Finally the seven-year-old Alice falls down a rabbit-hole into a Wonderland, the dreamspace of her own psyche.Of these images, none can be more embedded in our cultural imagination than the child Alice dropping into the subterranean well of Wonderland. Indeed, of the many celebrated scenes in the Alice narratives, the most memorable, most potent, most quoted is Alice’s initial descent to the bottom of the rabbit-hole. The lastingness of this scene seems even greater when we realize that, although neither Carroll in Alice’s Adventures Underground nor Tenniel in the first edition of Wonderland illustrated the moment with a picture, it still became (along with the Mad Hatter’s tea party) one of the signature images of the Alice stories. Why, we must ask, did the Victorians retain, with a powerful tenacity, this vision of a little girl moving through a tight space toward the hidden world of Wonderland?The answer to this question is not—at least not wholly—that the scene simply represents a child’s metaphorical progress through the [End Page 1] birth canal 1 and that this, in turn, symbolizes some kind of rite of passage, a movement towards some deeper knowledge. For then how do we explain Alice’s conspicuous lack of internal development in both stories? Indeed, for a narrative that thematizes motion, Alice’s psychical growth remains disturbingly static. Throughout both narratives, Alice displays little emotional variation, for when she is not frustrated or anxious, she is, for the most part, vapid or expressionless. In fact, one is immediately struck by her coolness and indifference as she drops through the rabbit-hole. 2 Thus, because scene changes in Wonderland and Looking-Glass rarely betoken any emotional or intellectual modulations, Alice’s falling into Wonderland signals no internal transition.But the image does relocate her body and within this fictive world, location is everything. The scene gestures Alice’s departure, her separation, her movement towards an autonomy of which every child dreams when, in play, retreating to a hidden space. A child’s impulse to hide, to create a secret space, is one of the most compelling of all human wishes, the wish for autonomy and autarchy—“to be cut off from the word and yet owner of the world.” 3 Throughout Victorian literature, the fantasy of autonomy sets children dreaming of far-away worlds and hidden gardens. The young Cathy and Heathcliff flee to the isolated moors, filling the open, empty space with dreams of unrestricted freedom. Little Dorrit envisages the locked garden behind the Marshalsea as an alternative world to the foul prison atmosphere. And what are the Brontës’s Angria and Gondol but disconnected, self-governing realms imagined from the standpoint of childhood powerlessness? The image, then, of Alice’s fall begins to fulfill this powerful wish for autonomy, which culminates, finally, in Alice’s self-coronation at the end of Looking-Glass. Yet it is only within the child’s willing imagination that a secret space can encroach so closely upon autonomy, for as we shall see, secrecy and autonomy are irreconcilable not only in the demanding world of realism, but even in the more elastic world of Carrollian fantasy.IAlice’s descent into Wonderland and her entrance into the Looking-Glass kingdom would seem like ripe metaphors for Carroll to explore the thoughts and fantasies of Alice’s psyche. What could be more... (shrink)

The twenty-sixth volume in the highly acclaimed Library of Living Philosophers series is devoted to the work of British philosopher of logic and metaphysician, P. F. Strawson. Following the Library of Living Philosophers series format, the volume contains an intellectual autobiography, twenty critical and descriptive essays by leading philosophers from around the world, Strawson's replies to the essays, and a bibliography of Strawson's works. Born in 1919, Strawson was a leading proponent of ordinary language philosophy. He is the author of (...) the early and extremely influential paper "On Referring" in which he criticized Russell's theory of definite descriptions. His most influential book, Individuals, helped to raise the status of metaphysics as a philosophical enterprise. Themes first addressed in this book continued to be of concern to him in his later work, including the possibility of objective knowledge, the subject-predicate distinction, the ontological status of persons, and the problem of individuation. Contributors to the book include: Ruth Garrett Millikan, Susan Haack, E. M. Adams, Panayot Butchvarov, Richard Behling, John McDowell, Simon Blackburn, Tadeusz Szubka, David Frederick Haight, Joseph S. Wu, Andrew G. Black, David Pears, Robert Boyd, Hilary Putnam, Paul F. Snowdon, Arindam Chakrabarti, Wenceslao J. Gonzalez, Ernest Sosa, Chung-M. Tse, John R. Searle, P. F. Strawson. (shrink)

Building on the success and importance of three previous volumes, _Relational Psychoanalysis_ continues to expand and develop the relational turn. Under the keen editorship of Lewis Aron and Adrienne Harris, and comprised of the contributions of many of the leading voices in the relational world, _Volume 4_ carries on the legacy of this rich and diversified psychoanalytic approach by taking a fresh look at recent developments in relational theory. Included here are chapters on sexuality and gender, race and class, (...) identity and self, thirdness, the transitional subject, the body, and more. Thoughtful, capacious, and integrative, this new volume places the leading edge of relational thought close at hand, and pushes the boundaries of the relational turn that much closer to the horizon. Contributors: Neil Altman, Jessica Benjamin, Emanuel Berman, Jeanne Wolff Bernstein, Susan Coates, Ken Corbett, Muriel Dimen, Martin Stephen Frommer, Jill Gentile, Samuel Gerson, Virginia Goldner, Sue Grand, Hazel Ipp, Kimberlyn Leary, Jonathan Slavin, Malcolm Owen Slavin, Charles Spezzano, Ruth Stein, Melanie Suchet. (shrink)

events all seem to have something in common, metaphysically speaking, and some philosophers have inquired into what this common nature is. The main aim of a theory of events is to propose and defend an identity condition on events; that is, a condition under which two events are identical. For example, if Brutus kills Caesar by stabbing him, are there two events, the stabbing and the killing, or only one event? Each of the leading theories of events is surveyed in (...) this article. According to Jaegwon Kim, events are basically property instantiations. In contrast, Donald Davidson attempts to individuate events by their causes and effects. However, Davidson eventually rejects this view and, together with W.V.O. Quine, individuates events with respect to their location in spacetime. According to David Lewis, an event is a property of a spatiotemporal region. (shrink)

In this important new work, Haack develops an original theory of empirical evidence or justification, and argues its appropriateness to the goals of inquiry. In so doing, Haack provides detailed critical case studies of Lewis's foundationalism; Davidson's and Bonjour's coherentism; Popper's 'epistemology without a knowing subject'; Quine's naturalism; Goldman's reliabilism; and Rorty's, Stich's, and the Churchlands' recent obituaries of epistemology.

Carpendale & Lewis's theoretical reconstruction of the “theory of mind” problem offers new hope but still has far to go. The study of atypical development may provide some useful insights for dealing with the work ahead. In particular I discuss three issues – the boundary problem, the question of end states, and the issue of the centrality of triadic interaction.

Recently, proponents of Humean Supervenience have challenged the plausibility of the intuition that the laws of nature ‘govern’, or guide, the evolution of events in the universe. Certain influential thought experiments authored by John Carroll, Michael Tooley, and others, rely strongly on such intuitions. These thought experiments are generally regarded as playing a central role in the lawhood debate, suggesting that the Mill-Ramsey-Lewis view of the laws of nature, and the related doctrine of the Humean Supervenience of laws, are (...) false. In this paper, I take on these recent challenges, arguing that the intuition that the laws govern should be taken seriously. Still, I find the recent discussions insightful, in certain ways. Employing some ideas from one of the critics, I draw some non-standard conclusions about the significance of the thought experiments to the lawhood debate. (shrink)

The reformist philosophy of the classical pragmatist tradition has gradually evolved into the now-fashionable revolutionary styles of pragmatism, some scientistic, some literary. This evolution is traced from Peirce, James, Dewey, and Mead, through Schiller, Lewis, Hook,and Quine, to Rorty’s literary-political neo-pragmatism. Rather than get hung up on the question of which variants qualify as authentic pragmatism, it is better — more fruitful, and appropriately forward looking— to ask what we can learn from the older tradition, and what we can (...) salvage from the new. (shrink)

How are beliefs efficacious? One answer is: via rational intentional action. But there are other ways that beliefs are efficacious. This dissertation examines these other ways, and sketches an answer to the question of how beliefs are efficacious that takes into account how beliefs are involved in the full range of behavioral disciplines, from psychophysiology and cognition to social and economic phenomena. The account of how beliefs are efficacious I propose draws on work on active accounts of perception. I develop (...) an account based on a proposal sketched by the cognitive scientist Ulrich Neisser. Neisser sketched an active account of perception, on which dynamic anticipatory schemata direct an organism's exploration and action, and are in turn revised as a result of exploration and action. This notion of schema has roots in nineteenth century neurophysiology and in Frederick Bartlett's subsequent work on memory. Neisser appealed to it to unite what he thought was right about information-processing accounts of perception with what he thought was right about ecological accounts of perception. The point that we must anticipate in order to perceive has been recognized by philosophers in the form of the "theory-ladenness of observation." I extend the concept of anticipatory schema to include its role in social perception and social interaction; the concept of anticipatory schema provides a more interactive account of the role of expectations in the maintenance and existence of social institutions, and can be used to enrich the account of convention David Lewis provided. I also show that the concept of rational expectations, which explains the neutrality of money in terms of the efficacy of anticipatory expectations, is compatible with the proposed account of how beliefs are efficacious. I discuss how the proposal accounts for the three main modes by which beliefs can be efficacious: via their role in causing intentional action, via their role in causing economic phenomena and the existence and maintenance of social institutions, and via their role in causing unintentional physiological responses, including anticipatory physiological responses that can enable perception, cause involuntary actions and give rise to the placebo effect. (shrink)

Susan Hurley's shared circuits model (SCM) rightly begins in action and progresses through a series of layers; but it fails to reach action understanding because it relies on mirroring as a driving force, draws on heavily criticized theories, and neglects the need for shared experience in our grasp of social understanding.

Susan Wolf defines a meaningful life as one that is somewhat successfully engaged in promoting positive value. I grant this claim; however, I disagree with Wolf’s theory about why we desire meaningfulness, so understood. She suggests that the human desire for meaningfulness is derived from an awareness of ourselves as equally insignificant in the universe and a resulting anti-solipsistic concern for promoting goodness outside the boundaries of our own lives. I accept that this may succeed in explaining why people (...) want to engage in projects that happen to be meaningful. Nevertheless, I argue that Wolf fails to explain why people have a desire for meaningfulness itself. In other words, she has told us one reason we may be motivated to promote positive value, but not why we personally want to be the people who promote it—why we think it is a good thing that meaningful acts be done, but not why we want them to be our meaningful acts. In detailing my response, I follow Wolf in relating our desire for meaningfulness to a kind of love-based motivation. However, I argue that it has more in common with a selfish form of love than the altruistic kind of love proposed by Wolf. Finally, I suggest an alternative explanation which I believe can more fully account for our desire for meaningfulness: the prospect of disappearing from the universe without a trace makes us anxious, so we pursue meaningful achievements in an attempt to make our own physical deaths less final. (shrink)

First published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

This article examines the contribution that poetry written over the last fifty years might make to the established and burgeoning field of Medical Humanities. It takes poems by women about cancer and depression as a case study of how they can offer insight into the impact of these conditions on the sufferer. Collectively, the poems document and effect shifts in knowledge about, and the associated stigmas concerning, illnesses that carry secrecy and shame, specifically cancer and depression. Additionally, drawing on Virginia (...) Woolf’s remarkable essay “On Being Ill”, we see how the non-verbal features of poems, particularly metaphors and symbols, mark the space of what a patient cannot fully articulate. Accordingly, the poems discussed illuminate how literature can express human interiority but at the same time remind the reader – or health professional – that interiority can never be fully presented. Thus, poetry both contributes to and also checks the ways in which literature is appropriated by the biomedical sciences. The poets included are Eavan Boland, Julia Darling, U.A. Fanthorpe, Jackie Kay, Gwyneth Lewis, Carol Satyamurti and Jo Shapcott. Some poems specify a female subjectivity, some express agency as autonomous individuals, while others presume to speak of common human experience. (shrink)

Biographical sketch.--Miscellaneous papers and extracts from letters.--Lectures on logic.--Plato's conception of goodness and the good.--Index.

This book provides a variety of diverse perspectives related to the ethics of anger, some more analytical in nature, others focused on practical issues, some in defense of anger, and others arguing against its necessity. This book is an essential resource for scholars who want to reflect critically on the place of anger in contemporary life.

On June 17, 2015, white supremacist Dylann Roof marched into the Emanuel African Methodist Episcopal Church in Charleston, South Carolina, and massacred nine black people in prayer. He credited his radicalization to the Council for Conservative Citizens, which was, in his words, "his gateway into the world of white nationalism."1 When Roof's selfies began to circulate—brandishing Confederate battle flags and standing in front of Greenville, South Carolina's own Museum and Library of Confederate History—the Southern civic sphere stammered in response. Governor (...) Nikki Haley had promised in 2014 never to remove the Confederate flag at the South Carolina State House, but after Roof's massacre and his flag-waving pride... (shrink)

It is not uncommon for early-modern philosophers to portray a perfectly philosophical way of life as a condition that approaches the divine. The philosopher becomes as like God as a human being can, and in doing so experiences unparalleled and unalloyed joy. Spinoza advocates a version of this view and defends it with impressive consistency. To suggest that the process of philosophical enlightenment involves any affective cost, he argues, is simply to display a lack of understanding, and thus to fall (...) short of the insight and joy that understanding ultimately yields. Nevertheless, something seems to be missing. I turn to a pair of novels by J.M. Coetzee - The Childhood of Jesus and The Schooldays of Jesus - to elucidate a significant though suppressed form of emotional loss that is integral to Spinoza’s image of the philosophical life. (shrink)