The diagnosis of Functional Neurological Disorder (FND) requires differentiation from other neurologic diseases/syndromes, and from the comparatively rare diagnosis of feigning (Malingering and Factitious Disorder). Analyzing the process of diagnosing FND reveals a necessary element of presumption, which I propose underlies some of the uncertainty, discomfort, and stigma associated with this diagnosis. A conflict between the neurologist’s natural social cognition and professional judgement (cognitive dissonance) can be understood by applying a framework originally designed for the determination of moral responsibility. Understanding (...) the source of this cognitive dissonance may effect its alleviation, and in turn, allow more compassionate treatment of patients with FND. (shrink)

There are many reports about the digital divideand many discrepant interpretations of what thereports indicate. This pattern of competinganalyses, often in relation to identical datasets, has endured for a good part of the lastdecade. It is argued here that a major problemwith much of the digital divide research is afailure to include ethical concerns as anexplicit part of analyzing and interpretingdigital divide gaps. If researchers includemore recognition of ethics with their findingsabout divide gaps, it is likely that they willproduce better (...) research and findings as well asmore defensible linkages between study reportsand policy deliberations. (shrink)

After acquiring knowledge of the neuroscience of learning, memory, stress and emotions, teachers incorporate more cognitive engagement and student-centered practices into their lessons. However, the role understanding neuroscience plays in teachers own affective and motivational competencies has not yet been investigated. The goal of this study was to investigate how learning neuroscience effected teachers’ self-efficacy, beliefs in their ability to teach effectively, self-responsibility and other components of teacher motivation. A pilot training-of-trainers program was designed and delivered in Liberia combining basic (...) neuroscience with information on social, emotional, behavioral and mental health issues faced by students. Tier I of the professional development was a 2 weeks workshop led by a visiting neuroscientist. A subset of the 24 Tier I secondary science teachers formed a Leadership Team who adapted the content to the Liberian context and subsequently led additional workshops and follow-up sessions for the Tier II secondary science teachers. Science teachers in both tiers completed the affective-motivational scales from the internationally vetted, multiscale Innovative Teaching for Effective Learning Teacher Knowledge Survey from the OECD. Tier II teachers completed the survey in a pre-post-delayed post design. Tier I teachers completed the survey after the workshop with their attitudes at that time and separately with retrospective projections of their pre-workshop attitudes. Ten of the 92 Tier II teachers participated in structured interviews at follow-up. Statistical analysis of survey data demonstrated improved teacher self-efficacy, self-responsibility for student outcomes, and motivation to teach. Qualitatively, teachers expressed more confidence in their ability to motivate students, engage them through active learning, and manage the class through positive rather than negative reinforcement. Teachers’ own self-regulation improved as they made efforts to build supporting relationships with students. Together, these results demonstrated that (i) teacher affective-motivational attitudes can be altered with professional development, (ii) basic neuroscience, as knowledge of how students learn, can improve teacher competency, and (iii) a training-of-trainers model can be effective in a low and middle income country for disseminating neuroscience knowledge, increasing teachers’ knowledge of students’ social and emotional needs, and promoting educational improvement. (shrink)

Brexit activists demonstrating outside the British Houses of Parliament were studied in situ to examine their potential for pro-group extreme behavior. This involved activists of two polarized, opposing views; those of Leave and Remain. The research engaged concepts linking the different theoretical perspectives of identity fusion and personal construct psychology. The study measured participants' degree of fusion to their group using a verbal measure. Willingness to undertake extreme acts was assessed in several ways: a measure of willingness to fight for (...) the group, adaptations of the trolley dilemma and questions regarding political violence. Individual construing was examined using repertory grid technique and a semi-structured interview. Results were similar for both Leave and Remain participants. The majority of activists identified as “fused” to their group and, if so, were more likely to undertake hypothetical extreme behavior compared to those who did not identify as “fused.” Repertory grid technique indicated that becoming an activist provided individuals with a clearer and more positive view of themselves. Opposition activists were construed more negatively and extremely than fellow activists, and this construal was associated with an increased willingness to undertake extreme pro-group behavior. This was consistent with the personal construct model of radicalization and was heightened in those who were “fused.” Interview data provided support for the constructivist model and revealed characteristics and concerns of the two groups. Overall, the findings indicate that campaigning organizations contain fused individuals, who are more likely to undertake hypothetical pro-group violence including self-sacrifice. This has broader implications which may be particularly pertinent, given the violent impact of extremist activists around the globe. (shrink)

Consider the following hypothetical scenario: A patient suffering constant abdominal pain is referred to State Hospital A from her local clinic after not responding to simple analgesics for chronic pelvic pain associated with irregular menstruation. The doctors at State Hospital A discover that she has a suspicion of adenomyosis. She gives written informed consent for a hysterectomy. During routine postoperative check-ups she reports no alleviation of the pelvic pain, urinary frequency along with burning on micturition and a persistent vaginal discharge. (...) Preoperatively, she was not told that the surgeons had inserted a surgical mesh to prevent vault prolapse. She is given antibiotics and further simple analgesia. As her symptoms do not improve she self-refers to State Hospital B. She is informed that she needs a CAT scan. However, the hospital’s scanner has been out of order for three years. She is advised to go to State Hospital C, where the scanner works, but is not given a referral note. She is told by Hospital C that the doctors are too busy to see her, and as she does not have an appointment, and is not an emergency case she should go back to Hospital A. She does not want to go back to Hospital A, as during her last visit there, nursing staff accused her of being a nuisance and escorted her off the premises. She approaches Private Hospital D, where her abdomen and pelvis are scanned. The scan shows the surgical mesh inside her pelvis which had disintegrated. She is told that it is too risky to remove all the fragments, but that some could be removed at a cost - which she could not afford. The surgeon refers her back to State Hospital A with a referral note and copy of the CAT scan report. (shrink)

The 2024 U.S. election will shape the future of global health policy, with crucial implications for continuing U.S. leadership in global health. The United States has long played a critical role in global health governance, through multilateral institutions under the United Nations (UN) and bilateral assistance to advance U.S. priorities. However, political shifts have challenged U.S. engagement in global health, with the politicization of global health policy threatening global governance under the World Health Organization (WHO) and dividing global health support (...) across political parties. This political polarization in global health proved catastrophic in the COVID-19 pandemic response and influential in the 2020 Presidential Elections. With the United States again seeking to advance global health policy, the 2024 Elections present a clear contrast in global health visions across U.S. political parties – with sweeping impacts on global governance, health funding, sexual and reproductive health, corporate regulations, tax equity, humanitarian challenges, and climate change. The future of U.S. leadership in global health hangs in the balance of this election, raising an imperative for candidates to highlight their global health positions and for voters to consider the global health implications. (shrink)

Here we identify approximately 40,000 healthy human volunteers who were intentionally exposed to infectious pathogens in clinical research studies dating from late World War II to the early 2000s. Microbial challenge experiments continue today under contemporary human subject research requirements. In fact, we estimated 4,000 additional volunteers who were experimentally infected between 2010 and the present day. We examine the risks and benefits of these experiments and present areas for improvement in protections of participants with respect to safety. These are (...) the absence of maximum limits to risk and the potential for institutional review boards to include questionable benefits to subjects and society when weighing the risks and benefits of research protocols. The lack of a duty of medical care by physician–investigators to research subjects is likewise of concern. The transparency of microbial challenge experiments and the safety concerns raised in this work may stimulate further dialogue on the risks to participants of human experimentation. (shrink)

Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...) a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. (shrink)

Recent studies have provided evidence of associations between neurochemistry and reading (dis)ability (Pugh et al., 2014). Based on a long history of studies indicating that fluent reading entails the automatic convergence of the written and spoken forms of language and our recently proposed Neural Noise Hypothesis (Hancock et al., 2017), we hypothesized that individual differences in cross-modal integration would mediate, at least partially, the relationship between neurochemical concentrations and reading. Cross-modal integration was measured in 231 children using a two-alternative forced (...) choice cross-modal matching task with three language conditions (letters, words, and pseudowords) and two levels of difficulty within each language condition. Neurometabolite concentrations of Choline (Cho), Glutamate (Glu), gamma-Aminobutyric (GABA), and N- acetyl-aspartate (NAA) were then measured in a subset of this sample (n = 70) with Magnetic Resonance Spectroscopy (MRS). A structural equation mediation model revealed that the effect of cross-modal word matching mediated the relationship between increased Glu (which has been proposed to be an index of neural noise) and poorer reading ability. In addition, the effect of cross-modal word matching fully mediated a relationship between increased Cho and poorer reading ability. Multilevel mixed effects models confirmed that lower Cho predicted faster cross-modal matching reaction time, specifically in the hard word condition. These Cho... (shrink)

Following from sweeping law reforms across the global health landscape, there is a need to prepare the next generation to advance global health law to ensure justice for a healthier world. Educational programs across disciplines have increasingly incorporated the field of global health law, with new courses examining the law and policy frameworks that apply to the new set of public health threats, non-state actors, and regulatory instruments that structure global health. Such interdisciplinary training must be expanded throughout the world (...) to prepare future practitioners to strengthen global health law — ensuring a foundation for global health in legal studies and law and global health studies. Meeting this imperative for global health law teaching — establishing academic courses and textbooks on global legal responses to shared health threats — will be necessary to support students to address the global health challenges of the future. (shrink)

The following note is based upon a re-examination of the binding, the quire signatures, and the enumeration of the plays of Euripides in L first made at Florence in 1948 and checked in 1952. Its purpose is to suggest that conjectures are still current about L and the exemplar from which it was copied, which cannot be regarded as sufficiently supported by good evidence to justify their retention; and to attempt some further clarification of L's relationship with the MS. Palatinus (...) 287. (shrink)

Part One of Montesquieu's Idea of Justice comprises a survey of the currency in philosophical, ethical and aesthetic debate during the second half of the 17th century of the terms rapport and convenance, which are central to the enigmatic definition given to justice by Mon tesquieu in Lettres Persanes LXXXllI. In this survey, attention is concen trated on the way in which the connotations of these terms fluctuate with the divergent development of the methodological and speculative outgrowths of Cartesian ism (...) into two schools of thought, materialist and idealist, often widely at variance in their views of the nature and orga nization of the universe. In Part Two, Montesquieu's definition of justice is set against this background, whose doctrinal conflicts, because of the characteristic as sociations of its key terms, it may be taken to reflect, just as it may be held to epitomize, by virtue of its elaboration in the opening chapter of De l' Esprit des Lois and its close terminological affinities with the defini tion of law there given, an undoubtedly related conflict between the implications of causal determinism and the aspirations of idealist meta physics surviving at the heart of Montesquieu's outlook, and, remaining unresolved, often said to impair the coherence if not the validity of his theory of society. (shrink)

A dream team of philosophers relentlessly cross-examines the Perry Mason stories.

Before there was the digital divide there was the analog divide– and universal service was the attempt to close that analogdivide. Universal service is becoming ever more complex in terms ofregulatory design as it becomes the digital divide. In order to evaluatethe promise of the next generation Internet with respect to the digitaldivide this work looks backwards as well as forwards in time. Byevaluating why previous universal service mechanisms failed andsucceeded this work identifies specific characteristics ofcommunications systems – in particular (...) in billing and managinguncertainty – and argues that these characteristics underliesuccess or failure in terms of technological ubiquity. Developing a setof characteristics of services rather than a set of services is afundamental break with the tradition of universal service. In fact, theimplications of our proposal is that basic characteristics in theoffering of the service rather than the absolute price are critical toclose the digital divide: certainty of total charge, ability to avoiddeposits or disconnection via best effort service, and payer-basedcontrol of all charges. While all of these principles sound obvious infact none of these hold in the telephony network. Universal service hasevolved from common carriage (serve all with no discrimination) to aright to basic services (100% penetration). Universal service isnow discussed as the digital divide, as the access to information asopposed to services becomes increasingly critical. However, we arediscussing in this paper access to the bits and the network rather thanaccess to the information (or intellectual property) once connected. Theprovision of universal service is seen as a technical problem only in thatthe technology costs money – universal service debates have longbeen the domain of economists. Yet the design of protocols has been thedomain of engineers, the building of systems the corporate domain, andthe discussion of equity the interest of ethicists. The design ofprotocols can define the parameters of the corporate decision-makers,the variables of the economist, and the questions for the ethicist. Thedesign decisions made at the fundamental levels can make communicationsequity more or less likely. In this work I focus on the design ofprotocols for the next generation Internet, protocols which willfundamentally change the best-effort nature of Internet services.Building on the economic and ethnographic work of others I argue thatthe effects of protocols adoption on universal service can be predictedto some degree. By examination of past and current technologies Iexamine a set of technical mechanisms to determine how such mechanismsmight harm or enhance universal service. I define each mechanism (e.g.denial of entry) and offer observations about each particularmechanism''s implicit pricing assumptions. I close with a discussion ofinterest to ethicists and regulators on evaluating communicationsprotocols with respect to universal access. Protocols for developingmultiple qualities of service for packet-switched networks have focusedon economic efficiency (e.g. Mackie-Mason, 1995; Choi, Stahl &Winston, 1997; Shapiro & Varian, 1998), billing to encouragewidespread adoption of network innovations (e.g. Xie & Sirbu, 1985)and billing in a manner consistent with the underlying network (e.g.Clark, 1996). Here we examine a set of protocols which include varyingquality of service mechanisms with respect to the compatibility of theprotocols with universal access. (shrink)

Excerpt from Der Echte: Und der Xenophontische Sokrates Der xen0phontische Sokrates selbst wieder zwang, die Fuh rung der Untersuchung weit mehr, als bisher geschehen, zu ver breitem. Die Memorabilien sind das Gegentheil eines selbst herrlichen Kunstwerks, weisen an allen Ecken und Enden uber sich hinaus, stehen als ein schwaches Glied in der Kette der sokratischen Literatur und zunachst in der der xenophontischen Schriften. Es galt, sie zunachst als solches zu begreifen und das volle Licht der Parallelen bei Xenophon auf sie (...) einwirken zu lassen. Dabei enthullten sich die Mem. Oft nur als durftiger Abklatsch anderer xenophontischen Schriften, von denen sie erst die farbige Beleuchtung, die Erklarung ihrer Motive, die Auf hellung ihrer Ordnung erhalten. So ward nun moglichst psycho logisch aus Xenophon erklart, was sich aus ihm erklaren liess. Indessen fur die Hauptsache, das Philosophische, stellte Xeno phon's notorische Unselbstandigkeit neue Fragen und Aufgaben, und hier ergab nun eine weitschichtige Vergleichung seine fast vollige philosophische Abhangigkeit im Ganzen wie im Einzelnen vom Kynismus, die in Grad und Art und plausiblen Motiven genau der Abhangigkeit der romischen Praktiker von den stoischen Nachfolgern der Kyniker_ entspricht. Nicht nur die Memorabilien, auch die andern Socratica Xenophon's, sowie vor Allem Cyropadie Hiero Agesilaus, de rep. Lac. Prolog und Epilog des Oynegeticus offenbarten sich mehr und mehr als durchaus kynisirende Schriften, und auch hier liegt dem Verf. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

The advent of social networking sites has changed the face of the information society Mason wrote of 23 years ago necessitating a reevaluation of the social contracts designed to protect the members of the society. Despite the technological and societal changes that have happened over the years, the information society is still based on the exchange of information. This paper examines various historical events involving social networking sites through the lens of the PAPA framework (Mason 1986 ) to (...) highlight select ethical issues regarding the sharing of information in the social-networking age. Four preliminary principles are developed to guide the ethical use of social networking sites (SNS). (shrink)

In their contribution to the rapidly developing field of research on psychedelic medicine, Glenn Cohen and Mason Marks shed light on a frequently overlooked but critical aspect of ethical considera...