For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a re-clarification of the difference between a health status and an outcome measure, the paper presents an evaluative checklist for use by clinical audit and research staff to review outcome measures for (...) use in routine care settings. Central features include the user-centredness of the measure, its psychometric properties, feasibility of use and utility. The applicability of the checklist is illustrated for outcome measurement in diabetes and stroke care. A modified form of the checklist is proposed for use by the busy clinician as an aid to the critical review of research papers within the context of evidence-based practice and to aid health care practitioners' choice of which outcome measure(s) to use within routine clinical care. (shrink)

The idea of narrative has been widely discussed in the recent health care literature, including nursing, and has been portrayed as a resource for both clinical work and research studies. However, the use of the term 'narrative' is inconsistent, and various assumptions are made about the nature (and functions) of narrative: narrative as a naive account of events; narrative as the source of 'subjective truth'; narrative as intrinsically fictional; and narrative as a mode of explanation. All these assumptions have left (...) their mark on the nursing literature, and all of them (in our view) are misconceived. Here, we argue that a failure to distinguish between 'narrative' and 'story' is partly responsible for these misconceptions, and we offer an analysis that shows why the distinction between them is essential. In doing so, we borrow the concept of 'narrativity' from literary criticism. Narrativity is something that a text has degrees of, and our proposal is that the elements of narrativity can be 'sorted' roughly into a continuum, at the 'high narrativity' end of which we find 'story'. On our account, 'story' is an interweaving of plot and character, whose organization is designed to elicit a certain emotional response from the reader, while 'narrative' refers to the sequence of events and the (claimed) causal connections between them. We suggest that it is important not to confuse the emotional persuasiveness of the 'story' with the objective accuracy of the 'narrative', and to this end we recommend what might be called 'narrative vigilance'. There is nothing intrinsically authentic, or sacrosanct, or emancipatory, or paradigmatic about narrative itself, even though the recent health care literature has had a marked tendency to romanticize it. (shrink)

We develop a notion of cell decomposition suitable for studying weak p-adic structures definable). As an example, we consider a structure with restricted addition.

Summary A dissertation is an integral part of Higher National Diploma (HND), Bachelor of Science with Honours (BSc(Hons)) and taught Master of Science (MSc) programmes and should reflect differences in learning styles as appropriate to each level. The dissertation requirements and assessment procedures within ten environment?related undergraduate and postgraduate programmes were examined using the ?framework? approach. Two themes were examined in detail: a quantitative evaluation of characteristics which define the physical dimensions of the dissertation; and a qualitative analysis of the (...) academic rationale, aims, objectives and learning outcomes, as well as the associated assessment criteria. It is possible to differentiate between levels in terms of these two themes. There were greater similarities between the dissertations at HND and BSc(Hons) levels than between BSc(Hons) and MSc levels. Each dissertation occupies a separate, distinct place along a progressive development of a deep learning style. (shrink)

Since her death in 1986 and the publication of her letters and diaries in 1990, interest in the philosophy of Simone de Beauvoir has never been greater. In this engaging and timely volume, Margaret A. Simons and an international group of philosophers present 16 essays that reveal Beauvoir as one of the century’s most important and influential thinkers. As they set Beauvoir’s work into dialogue with Husserl, Merleau-Ponty, Heidegger, Foucault, Levinas, and others, these essays consider questions such as Beauvoir’s philosophical (...) relationship with Sartre; her ethic of the erotic; her views on marriage, motherhood, and female friendship; and her interpretations of oppression and liberation. This book discusses the full range of Beauvoir’s work, including The Second Sex, her unpublished diaries, autobiographical writings, novels, and philosophical essays, and broadens the scope and interpretive context of her unique philosophy. Contributors are Nancy Bauer, Debra Bergoffen, Suzanne Laba Cataldi, Edward Fullbrook, Eva Gothlin, Sara Heinämaa, Laura Hengehold, Stacy Keltner, Michèle Le Doeuff, Ann Murphy, Shannon M. Mussett, Margaret A. Simons, Ursula Tidd, Andrea Veltman, Karen Vintges, Julie Ward, Gail Weiss. (shrink)

To find more information about Rowman and Littlefield titles, please visit www.rowmanlittlefield.com.

According to the most important theories of justice, personal dignity is closely related to independence, and the care that people with disabilities receive is seen as a way for them to achieve the greatest possible autonomy. However, human beings are naturally subject to periods of dependency, and people without disabilities are only “temporarily abled.” Instead of seeing assistance as a limitation, we consider it to be a resource at the basis of a vision of society that is able to account (...) for inevitable dependency relationships between “unequals” ensuring a fulfilling life both for the carer and the cared for.**. (shrink)

The author defends nonconceptualism, the claim that perceptual experience is nonconceptual and has nonconceptual content. Continuing the heated and complex debate surrounding this topic over the past two decades, she offers a sustained defense of a novel version of the view, Modest Nonconceptualism, and provides a systematic overview of some of the central controversies in the debate. -/- An explication of the notion of nonconceptual content and a distinction between nonconceptualist views of different strengths starts off the volume, then the (...) author goes on to defend participants in the debate over nonconceptual content against the allegation that their failure to distinguish between a state view and a content view of (non)conceptualism leads to fatal problems for their views. Next, she makes a case for nonconceptualism by refining some of the central arguments for the view, such as the arguments from fineness of grain, from contradictory contents, from animal and infant perception, and from concept acquisition. Then, two central objections against nonconceptualism are rebutted in a novel way: the epistemological objection and the objection from objectivity. -/- Modest Nonconceptualism allows for perceptual experiences to involve some conceptual elements. It emphasizes the relevance of concept employment for an understanding of conceptual and nonconceptual mental states and identifies the nonconceptual content of experience with scenario content. It insists on the possibility of genuine content-bearing perceptual experience without concept possession and is thus in line with the Autonomy Thesis. Finally, it includes an account of perceptual justification that relies on the external contents of experience and belief, yet is compatible with epistemological internalism. -/- . (shrink)

Proponents of the reasoning view analyze normative reasons as premises of good reasoning and explain the normativity of reasons by appeal to their role as premises of good reasoning. The aim of this paper is to cast doubt on the reasoning view by providing counterexamples to the proposed analysis of reasons, counterexamples in which premises of good reasoning towards φ‐ing are not reasons to φ.

Poor Eliza -- Pax Americana : the case of Show boat -- National brands, national body : Imitation of life -- Uncle Sam needs a wife : citizenship and denegation -- Remembering love, forgetting everything else : Now, voyager -- "It's not the tragedies that kill us, it's the messes" : femininity, formalism, and Dorothy Parker -- The compulsion to repeat femininity : Landscape for a good woman and The life and loves of a she-devil.

Having encountered landmines in offering a critique of philosophy based on my experience as the mother of a cognitively disabled daughter, I ask, “Should I continue?” I defend the idea that pursuing this project is of a piece with the invisible care labor that is done by people with disabilities and their families. The value of attempting to influence philosophical conceptions of cognitive disability by virtue of this experience is justified by an inextricable relationship between the personal, the political, and (...) the philosophical. If one grants that the “special relationship” between mother and child requires moral recognition, then I need first to make vivid the case that this relationship in the case of a child who lacks some “normal capacities” is indistinguishable from any mother‐child relationship. If this is so, then I believe I can make a case that has as its conclusion that the moral personhood of even the severely cognitively disabled must be granted. Moreover, such recognition, I argue, necessitates the recognition of others who bear no special relationships to the child. (shrink)

In this article, we posit that a cross-scale perspective is valuable for studies of organizational resilience. Existing research in our field primarily focuses on the resilience of organizations, that is, the factors that enhance or detract from an organization’s viability in the face of threat. While this organization level focus makes important contributions to theory, organizational resilience is also intrinsically dependent upon the resilience of broader social-ecological systems in which the firm is embedded. Moreover, long-term organizational resilience cannot be well (...) managed without an understanding of the feedback effects across nested systems. For instance, a narrow focus on optimizing organizational resilience from one firm’s perspective may come at the expense of social-ecological functioning and ultimately undermine managers’ efforts at long-term organizational survival. We suggest that insights from natural science may help organizational scholars to examine cross-scale resilience and conceptualize organizational actions within and across temporal and spatial dynamics. We develop propositions taking a complex adaptive systems perspective to identify issues related to focal scale, slow variables and feedback, and diversity and redundancy. We illustrate our theoretical argument using an example of Unilever and palm oil production in Borneo. (shrink)

Telepsychiatry has long been discussed as a supplement to or substitute for face-to-face therapeutic consultations. The current pandemic crisis has fueled the development in an unprecedented way. More and more psychiatric consultations are now carried out online as video-based consultations. Treatment results appear to be comparable with those of face-to-face care in terms of clinical outcome, acceptance, adherence and patient satisfaction. However, evidence on videoconferencing in a variety of different fields indicates that there are extensive changes in the communication behaviour (...) in online conversations. We hypothesise that this might impact ethically relevant aspects of the therapeutic relationship, which plays a prominent role in psychiatry. In this paper, we review effects of video-based consultations on communication between therapists and patients in psychiatry. Based on a common understanding of video-based consultations as changing the lived experience of communication, we categorise these effects according to sensory, spatial and technical aspects. Departing from a power-based model of therapeutic relationships, we then discuss the ethical significance of this changed communication situation, based on dimensions of respect for autonomy, lucidity, fidelity, justice and humanity. We conclude that there is evidence for ethically relevant changes of the therapeutic relationship in video-based telepsychiatric consultations. These changes need to be more carefully considered in psychiatric practice and future studies. (shrink)

Socially responsible business and ethical behaviour of companies have been of interest to academia and practice for decades. But the focus has almost exclusively been on large corporations while small- and medium-sized enterprises (SME) have not received as much attention. Thus, this paper focuses on socially responsible business practices of SME entrepreneurs or owner–managers in Germany. Based on the assumption that decision-makers in SMEs are the central point where all business activities start, members of a German entrepreneurs association were approached (...) in the course of a qualitative and quantitative survey. They were asked to assess in what way their social responsibility is expressed in specific management practices towards selected stakeholder groups. These practices in turn were assumed to result in perceived positive reactions of the respective stakeholders and subsequently to positively influence the firm's financial performance, i.e. cost reductions and increase in profits. In the paper, a research model is presented that elaborates the relationship between an SME executive's social responsibility and the value creation of a firm, i.e. whether (personal) values create (economic) value. It was found that socially responsible management practices towards employees, customers and to a lesser extent society have a positive impact on the firm and its performance. As such, values can create additional value. (shrink)

This paper maintains that objectivism about practical reasons should be combined with pluralism both about the nature of practical reasons and about action explanations. We argue for an ‘expanding circle of practical reasons’, starting out from an open-minded monist objectivism. On this view, practical reasons are not limited to actual facts, but consist in states of affairs, possible facts that may or may not obtain. Going beyond such ‘that-ish’ reasons, we argue that goals are also bona fide practical reasons. This (...) makes for a genuine pluralism about practical reasons. Furthermore, the facts or states of affairs that function as practical reasons are not exclusively natural or descriptive, but include normative facts. That normative facts can be reasons justifies a pluralism about reason explanations, one which allows for what we call enkratic explanations in addition to teleological ones. (shrink)

In these replies, I react to comments on my paper “Facts about Incoherence as Non-Evidential Epistemic Reasons”, provided by Aleks Knoks, Sebastian Schmidt, Keshav Singh, and Conor McHugh. I discuss potential counterexamples to my claim that the fact that the subject’s doxastic attitudes are incoherent is an epistemic reason for her to suspend; whether such incoherence-based reasons bear on individual attitudes or only on combinations of attitudes; the prospects of restricting evidentialism about epistemic reasons to reasons to believe; whether incoherence-based (...) reasons are truly epistemic; the alleged normative and motivational expendability of incoherence-based reasons; the possibility of incoherence-based reasons to suspend without actual belief in the incoherent propositions; the relationship between suspension, inquiry, and incoherence; and the nature of suspension of judgment. (shrink)

With regard to current debates on the ethical implementation of AI, especially two demands are linked: the call for explainability and for ultimate human responsibility. In the medical field, both are condensed into the role of one person: It is the physician to whom AI output should be explainable and who should thus bear ultimate responsibility for diagnostic or treatment decisions that are based on such AI output. In this article, we argue that a black box AI indeed creates a (...) rationally irresolvable epistemic situation for the physician involved. Specifically, strange errors that are occasionally made by AI sometimes detach its output from human reasoning. Within this article it is further argued that such an epistemic situation is problematic in the context of ultimate human responsibility. Since said strange errors limit the promises of explainability and the concept of explainability frequently appears irrelevant or insignificant when applied to a diverse set of medical applications, we deem it worthwhile to reconsider the call for ultimate human responsibility. (shrink)

In 2009, Tennie et al. proposed the theory of the Zone of Latent Solutions, defined as the range of behaviors an individual of a species can invent independently, i.e., which it can acquire without any form of social learning. By definition, species limited to their ZLS are unable to innovate and/or transmit behavioral traits outside their ZLS, i.e., they lack traits which go beyond the level of the individual—traits resulting from a gradual cultural evolution over successive transmission events [“cumulative culture”, (...) Boyd and Richerson ]. However, this does not exclude an influence of social learning on the population frequency of these behaviors: social learning can facilitate the acquisition of latent solutions and thus speed up and consolidate their spread within a population. Cultures—defined as behaviors at least influenced by social learning—are therefore still possible. Here, we elaborate on the ZLS account and relate it to the theories of Vygotsky who studied the role of social learning in human culture. We argue that the ZLS is a missing phylogenetic “baseline” of Vygotsky’s Zone of Actual Development. Vygotsky’s neglect of a need for a human “baseline ZAD” may have been due to his interpretation of Köhler’s work on great ape behaviors: Köhler used his observations on individual chimpanzees to draw conclusions about the chimpanzee species as a whole, stating that chimpanzees can only copy what they could have invented themselves, thus coming close to the ZLS concept. Vygotsky—studying the range of behaviors individuals could achieve independently—seemingly did not see that Köhler was suggesting a species “baseline”, upon which Vygotsky’s idea of an individual’s ZAD could develop. As a result, Vygotsky also did not see the need for a ZLS for his own study subjects: humans. Yet, there is no reason to assume that humans lack a ZLS, and in fact we present evidence for a human ZLS for tool-use behaviors. (shrink)

During the last couple of decades, concurrently with an increased awareness of the complexity of ethical conflicts, political theorists have directed attention to how constitutional democracy should cope with a fact of incommensurable doctrines. Poststructuralists such as Chantal Mouffe claim that ethical conflicts are fundamentally irreconcilable, which is indeed a view shared by many liberal theorists. The question of whether ethical conflicts are in principle irreconcilable is an important one since the answer has implications for what democratic institutions are desirable. (...) In light of this question the article investigates the notion of conflict in agonistic pluralism and discourse theory. At first glance, Mouffe’s agonism seems apt to accommodate ethical conflict in democratic governance, since it focuses on conflict as the core of politics, whereas Habermasian deliberative democracy seems inappropriate for this task, as it focuses on consensus. However, through an inquiry into the conditions of conflict this article will argue the opposite, namely, that conflict cannot be adequately understood within Mouffe’s agonistic framework. The thesis defended is (1) that discourse theory offers a more accurate account of conflict than agonistic theory because it embraces the idea that deliberation is constitutive of conflict, and (2) that some of Habermas’ assumptions concerning ethical discourse need to be revised in order for his democratic theory to fully accommodate this insight. (shrink)

In this article, I argue against Kearns and Star’s reasons-as-evidence view, which identifies normative reasons to ɸ with evidence that one ought to ɸ. I provide a new counterexample to their view, the student case, which involves an inference to the best explanation from means to end or, more generally, from a derivative to a more foundational “ought” proposition. It shows that evidence that one ought to act a certain way is not in all cases a reason so to act. (...) I present a diagnosis of the problem that is brought out by the counterexample. (shrink)

The comment starts with a brief exposition of the Eroteric View put forth by Artūrs Logins. I then provide one friendly comment on the exact form of the normative question which is central to the view, and suggest that in addition to the question, ‘Why ought S to φ?’, Logins should take the question, ‘Why is S permitted to φ?’ as definitive of normative reasons. In a more critical comment, I reflect on how normative explanatory reasons and normative reasoning reasons (...) relate, calling into question Logins’s claim that the two kinds of reasons are fundamentally distinct. First, I argue that being a normative explanatory reason near enough guarantees being a normative reasoning reason; second, I argue that normative explanatory reasons as well as normative reasoning reasons can be weighed, and that they can be weighed against each other. But this causes trouble for the Eroteric View. (shrink)

BackgroundResearch using data from medical care promises to advance medical science and improve healthcare. Academia is not the only sector that expects such research to be of great benefit. The research-based health industry is also interested in so-called ‘real-world’ health data to develop new drugs, medical technologies or data-based health applications. While access to medical data is handled very differently in different countries, and some empirical data suggest people are uncomfortable with the idea of companies accessing health information, this paper (...) aims to advance the ethical debate about secondary use of medical data generated in the public healthcare sector by for-profit companies for medical research (ReuseForPro).MethodsWe first clarify some basic concepts and our ethical-normative approach, then discuss and ethically evaluate potential claims and interests of relevant stakeholders: patients as data subjects in the public healthcare system, for-profit companies, the public, and physicians and their healthcare institutions. Finally, we address the tensions between legitimate claims of different stakeholders in order to suggest conditions that might ensure ethically sound ReuseForPro.ResultsWe conclude that there are good reasons to grant for-profit companies access to medical data if they meet certain conditions: among others they need to respect patients’ informational rights and their actions need to be compatible with the public’s interest in health benefit from ReuseForPro. (shrink)

Rapid Ethical Assessment (REA) is a form of rapid ethnographic assessment conducted at the beginning of research project to guide the consent process with the objective of reconciling universal ethical guidance with specific research contexts. The current study is conducted to assess the perceived relevance of introducing REA as a mainstream tool in Ethiopia.

Ludwik Fleck is remembered for his monograph published in German in 1935. Reissued in 1979 as Genesis and development of a scientific fact Fleck’s monograph has been claimed to expound relativistic views of science. Fleck has also been portrayed as a prominent scientist. The description of his production of a vaccine against typhus during World War II, when imprisoned in Buchenwald, is legendary in the scholarly literature. The claims about Fleck’s scientific achievements have been justified by referring to his numerous (...) publications in international scientific journals. Though frequently mentioned, these publications have scarcely been studied. The present article discusses differences in interpretation and evaluation of science in relation to the background of the interpreters. For this purpose Fleck’s scientific publications have been scrutinized. In conjunction with further sources reflecting the desperate situation at the time in question, the results of the study account for a more restrained picture of Fleck’s scientific accomplishments. Furthermore, based on the review of the latter, certain demands characterizing good science could be articulated. The restricted possibilities of those not trained in science or not possessing field specific knowledge, evaluating science are discussed, as are also formal aspects of scientific papers and questions related to research ethics. (shrink)

ZusammenfassungBei den meisten Patienten, die heute erwartet an einer unheilbaren Krankheit versterben, wird vor ihrem Tod eine bewusste Entscheidung zum Therapieverzicht getroffen. Während dem Therapieverzicht auf Wunsch des Patienten ein wichtiger Stellenwert in der medizinethischen Diskussion zukommt, hat der Umgang mit Forderung nach „unangemessener“ Maximaltherapie bislang weniger Beachtung gefunden. In einer empirischen Studie zur Einbeziehung von Patienten in Entscheidungen zum Therapieverzicht konnten wir zeigen, dass etwa ein Drittel der Patienten auch bei infauster Prognose Lebenszeit durch Maximaltherapie gewinnen möchte. Diese Patienten (...) wurden im Gegensatz zu Patienten mit palliativem Therapieziel häufig nicht in Entscheidungen zur Therapiebegrenzung einbezogen. Hier werden die ethischen Implikationen dieser Praxis untersucht und gefragt, ob ein Therapieverzicht am Lebensende auch gegen den Wunsch des Patienten ethisch zu rechtfertigen ist oder ob Ärzte dem Wunsch des Patienten nach Lebenszeitgewinn auch bei infauster Prognose durch Maximaltherapie nachkommen sollen. Vor dem Hintergrund der gängigen Konzepte zur Rechtfertigung eines einseitigen Therapieverzichts, die für sich genommen zu kurz greifen, wird ein alternatives Entscheidungsmodell vorgestellt, das vier bewertungsrelevante Kriterien vorsieht: die Wirksamkeit einer Maßnahme, die Autonomiefähigkeit des Patienten, die patientenseitige Nutzenbewertung und die Kosten für die Solidargemeinschaft. Je nachdem, welche Kriterien erfüllt sind, rechtfertigen sie eine Entscheidung zum Therapieverzicht oder eine Fortsetzung der Therapie entsprechend dem Patientenwillen. (shrink)

What makes a word easy to learn? Early‐learned words are frequent and tend to name concrete referents. But words typically do not occur in isolation. Some words are predictable from their contexts; others are less so. Here, we investigate whether predictability relates to when children start producing different words (age of acquisition; AoA). We operationalized predictability in terms of a word's surprisal in child‐directed speech, computed using n‐gram and long‐short‐term‐memory (LSTM) language models. Predictability derived from LSTMs was generally a better (...) predictor than predictability derived from n‐gram models. Across five languages, average surprisal was positively correlated with the AoA of predicates and function words but not nouns. Controlling for concreteness and word frequency, more predictable predicates and function words were learned earlier. Differences in predictability between languages were associated with cross‐linguistic differences in AoA: the same word (when it was a predicate) was produced earlier in languages where the word was more predictable. (shrink)

At the end of the 1990s, Brazil was faced with a potentially explosive HIV/AIDS epidemic. Through an innovative and multifaceted campaign, and despite initial resistance from multinational pharmaceutical companies, the government of Brazil was able to negotiate price reductions for HIV medications and develop local production capacity, thereby averting a public health disaster. Using interview data and document analysis, the authors show that the exercise of corporate social responsibility can be viewed in practice as a dynamic negotiation and an interaction (...) between multiple actors. Action undertaken in terms of voluntary CSR alone may be insufficient. This finding highlights the importance of a strong role for national governments and international organizations to pressure companies to perform better. (shrink)

As a metaphysical theory, radical ontic structural realism is characterised mainly in terms of the ontological primacy it places on relations and structures, as opposed to the individual relata and objects that inhabit these relations/structures. The most popular criticism of ROSR is that its central thesis is incoherent. Bain attempts to address this criticism by arguing that the mathematical language of category theory allows for a coherent articulation of ROSR’s key thesis. Subsequently, Wüthrich and Lam and Lal and Teh have (...) criticised Bain’s arguments and claimed that category theory fares no better than set theory in coherently articulating the main ideas of ROSR. In this paper, we defend Bain’s main arguments against these critiques, and attempt to elaborate on the sense in which category theory can be seen as providing a coherent articulation of ROSR. We also consider the relationship between ROSR and Categorical Quantum Mechanics. (shrink)

Background: Nurses and student nurses in Malawi often encounter challenges in taking a moral course of action. Several studies have demonstrated a need for increased awareness of ethical issues in the nursing education. Objective: To explore the challenges experienced by nurse teachers in Malawi in their efforts to enhance students’ moral competence in clinical practice. Research design: A qualitative hermeneutic approach was employed to interpret the teachers’ experiences. Participants and research context: Individual interviews (N = 8) and a focus group (...) interview with teachers (N = 9) from different nursing colleges were conducted. Ethical considerations: Ethical approval was granted and all participants signed their informed consent. Findings: Two overall themes emerged: (1) authoritarian learning climate, with three subthemes: (a) fear of making critical comments about clinical practice, (b) fear of disclosing mistakes and lack of knowledge and (c) lack of a culture of critical discussion and reflection that promotes moral competence; and (2) discrepancy between expectations on learning outcome from nursing college and the learning opportunities in practice comprising three subthemes: (a) gap between the theory taught in class and learning opportunities in clinical practice, (b) lack of good role models and (c) lack of resources. Discussion: Our findings indicated that showing respect was a central objective when the students were assessed in practice. A number of previous studies have enlightened the need for critical reflection in nursing education. Few studies have linked this to challenges experienced by teachers for development of moral competence in practice. This is one of the first such studies done in an African setting. Conclusion: There is a clear relationship between the two themes. A less authoritarian learning climate may enhance critical reflection and discussion between students, teachers and nurses. This can narrow the gap between the theory taught in college and what is demonstrated in clinical practice. Moral competence must be enhanced in order to ensure patients’ rights and safety. (shrink)

The aim of this paper is to connect the traditional epistemological issue of justification with what one might call the “new reasons paradigm” coming from the philosophy of action and metaethics. More specifically, I will show that Conee and Feldman’s mentalism, a version of internalism about justification, can profitably be spelled out in terms of subjective normative reasons. On the way to achieving this aim, I will argue that it is important to ask not just the oft-discussed ontological question about (...) epistemic reasons—what kind of entities are they?—but also: Reasons in which sense are fundamental to justification? (shrink)

6 and 14 recently proposed taxonomies that distinguish between four processing states, based on bottom-up stimulus strength and top-down attentional amplification. The aim of the present study was to empirically test these processing states using the priming paradigm. Our results showed that attention and stimulus strength significantly modulated priming effects: either receiving top-down attention or possessing sufficient bottom-up strength was a prerequisite for a stimulus to elicit priming. When both top-down attention and sufficient bottom-up strength were present, the priming effect (...) was boosted. The origins of the observed priming effects also varied between different processing states. We can conclude that our empirical study using the priming paradigm confirmed the presence of four processing states, which displayed a differential pattern of response priming effects and differential origins of the response priming effects. (shrink)

This article on the potential for patient online records access (ORA) to increase the likelihood of nocebo effects is timely, 1 given the recent introduction of full prospective records access for primary care patients in England. 2 Blease provides a convincing overview of the evidence for the nocebo effect and examines the complex interplay with health inequities. The article proposes two mechanisms for ORA augmenting nocebo effects through: (A) patients reading about possible negative outcomes of treatments and (B) a negative (...) clinician tone or less supportive content in the notes diminishing patient trust and setting up negative expectations. Blease notes a small percentage of those who had used ORA at least once during the previous year in one study reported feeling more worried about their medications, 3 and that those with mental health diagnoses were significantly more prone to this than those without such diagnoses.shrink)

ABSTRACT:What more can be said about COVID-19 and the social determinants of health? This article describes neglected perspectives that derive from the history of social epidemiology, a field that identifies the social etiology of disease and variations in disease incidence among people differentially located in the social structure. The "discovery" of social determinants of diseases like COVID-19 is nothing new for epidemiology: debate over how to analyze structural determinants versus individual-level risk factors persisted throughout the 19th and 20th centuries. By (...) the late 20th century, research had highlighted fundamental causes of health disparities, such as social conditions and structural racism; these are structural factors, embedded in the social fabric of life. Measurement of structured inequalities within systems faces complex and challenging problems, as research aims to better account for these lived realities at different levels of analysis and as multiple factors merge to influence outcomes (revealed in intersectionality theory). At each of these intersections, there are opportunities for bioethicists to consider their ethical implications. It is imperative to understand the social and ethical roots of our present conversations about health inequalities, in order to partner intelligently with researchers on the forefront of advocating for change. (shrink)