Background Little is known about communication between patients, families, and healthcare providers regarding ethical concerns that patients and families experience in the course of illness and medical care. To address this gap in the literature, we surveyed patients and family members to learn about their ethical concerns and the extent to which they discussed them with their healthcare providers. Methods We surveyed adult, English-speaking patients and family members receiving inpatient care in five hospitals in the Washington DC-Baltimore metropolitan area from (...) July 2017 to March 2020. Descriptive statistics were used to determine the frequency, comfortableness, and helpfulness of discussions regarding ethical concerns experienced when sick or receiving medical care. Univariable and multivariable stepwise logistic regression models were used to identify associations between healthcare provider and respondent characteristics and attitudes and (1) the likelihood of speaking to a healthcare provider about their ethical concern and (2) their level of comfort during these discussions. Results Of 468 respondents who experienced ethical issues, 299 (64%) reported discussing the situation with a member of their healthcare team; 74% (197/265) of respondents who had such a discussion found the discussion comfortable, and 77% (176/230) of respondents found the discussion helpful. To make discussions more comfortable and helpful, respondents proposed suggestions in open-ended responses involving (1) content and quality of communication; (2) positive healthcare provider qualities such as empathy, open-mindedness, knowledge, honesty, and trustworthiness; and (3) other contextual factors including having adequate time and available resources. Conclusions Patients and families often have ethical concerns that they discuss with clinicians, and they want clinicians to be routinely receptive and attentive to such discussions. (shrink)

In this paper we show how a student can learn the basics of the system databases using (W3school CSS) which was built as intelligent tutoring educational system by using the authoring tool called (ITSB). The learning material contains CSS and HTML. We divided the material in a group of lessons for novice learner which combines relational system and lessons in the process of learning. The student can learn using example of CSS, and types of CSS color. Furthermore, the intelligent tutoring (...) system supports not only lessons; but exercises of different difficult levels for each lesson. When a student finish successfully the first difficulty level in a lesson, the student is allowed to move to the next difficulty level of the exercises of the lesson. (shrink)

The traditional philosophical questions around human freedom are to do with how to square freedom for human organisms with increasingly scientific understandings of the universe itself. At the beginning of Western philosophical consciousness, Plato, unlike later philosophers eligible of the label rationalist, maintained that there are obstacles to free and rational agency, owing in no small measure to pressures exerted by the human psyche from what later were referred to as biological drives and drives for social status. In subsequent eras, (...) these obstacles came under the heading of “weakness of will”—a conception shared widely in popular and traditional culture. Today the realities of addiction, social stresses, forces of habit, culture, social position, and group identity, together with psychological findings about cognitive biases, have come to dominate the landscape of empirically-based obstacles to agency. Can the image of the human being under the microscope of contemporary science, including cognitive and social science, be reconciled with the “manifest image” of human beings as sources of their individual behaviors (and held responsible accordingly), particularly if the scientific image is best construed in terms of governance by laws of nature? (The phrases manifest image and scientific image were coined by the twentieth-century American philosopher Wilfrid Sellars, see Sellars 1962.) How is it possible to square the idea of laws of nature with the manifest image in which humans exercise free agency as they play their various parts in the drama that is life? Does the manifest image thus square better with a theistic image of the world, as both seventeenth-century French philosopher René Descartes and eighteenth-century German philosopher Immanuel Kant seem to have thought, and by contrast the scientific image square better with atheism? A deterministic universe, such as was proposed during the Enlightenment, was early on thought to pose a threat to the idea of human freedom. (It does not pose the same threat to the idea of a sovereign creator, however, because the notion of a creator of the universe already puts the entity who qualifies for the office outside the regime of those laws, ahead of them both in time and in ontological status.) One traditional answer to the threat has been the notion of compatibilism— which simply asserts that freedom and determinism are not incompatible. The devil, of course, has been in the details of explaining how this can be so, and many schools of thought on the matter exist. It is worthwhile noting that there are enormously compelling reasons, from the quantum regime so well described by quantum theory, to reject determinism: the laws governing the universe are simply not fully deterministic. This, of course, vitiates the need to confront the threat as originally posed. However, the trouble, if one follows along this line of thought, is to make sense of the nature of freedom in a world governed partly by deterministic laws and partly by nondeterministic ones that admit of an element of chance. Is such a world itself any more compatible with the idea of human freedom? In this section we grapple with the question of human freedom, what it could mean, and whether it is best accepted in the context of a form of theism. We find that theism has no more resources for addressing these difficulties than atheism does. (shrink)

The recently reported cases of coerced sterilisation of women at a privately operated immigration detention facility in the USA are egregious in their disregard for human dignity and professional ethics, but sadly not surprising. These abuses represent a continuation of efforts to control the reproductive capacity of women, fueled by racist and xenophobic motives. Physicians helped create and legitimise the pseudoscientific framework for the eugenics movement, which would implement forceful sterilisation as its tool of choice to eliminate undesirable traits that (...) were thought to be biologically inherited and predominant among racial and ethnic minorities. Although state-endorsed forcible sterilisation programs have ended, incarcerated women have remained particularly vulnerable to sterilisation abuse. The intersectional vulnerabilities of racism, xenophobia and carcerality must be addressed to prevent such abuses from recurring. There are no data in this work. (shrink)

The present paper aims to explore the medieval philosopher Abū al-Barakāt al-Baghdādī’s (d. pre- 560 AH/1164-5) position concerning the problem of divine foreknowledge and human free will and argues Abū al-Barakāt to have considered the argument for compatibility between divine foreknowledge and human free will to be invalid. One can defend either divine foreknowledge or human free will; no other solution is available. By examining his accounts on this issue through the logic and metaphysics of his book al-Muʿtabar fi-l-ḥikma, Abū (...) al-Barakāt defense of human free will shall become evident. (shrink)

Memorisation of the Qur’ān occupies a central position in Muslim conception of religious education. The awareness of preserving the Qur’ān through memorisation is becoming prevalent and is still continued in these modern days in many educational institutions in many parts of the Muslim countries. This article examines different methods of Qur’ānic memorization being practiced in Malaysia. Similarities and uniqueness of those methods will be presented. The evaluation of those Qur’ānic memorisation techniques brings to the foreground the educative value of memorisation (...) as a learning tool and the implications memorisation methods have in enhancing an individual’s learning performance. (shrink)

The German philosopher, writer, and statesman Wilhelm von Humboldt (1767–1835) has played a key role in the transformation and development of education in Prussia and beyond its borders. If time is change and can be measured as progress towards social transformation, then time serves some concrete utility transposed in the field of education. For the purpose of social transformation and development of education, Humboldt has used various strategies, among which ethics or morals had a certain impact on education. Despite the (...) importance of this aspect, the ethical understanding of the philosopher has not been researched deeply yet. The following paper analyses this question according to Humboldt’s writings and shows its relevance for education. The aim of this research is to reveal insights that have the potential to serve the development of education even now. (shrink)

PurposeThis study aimed to apply “multi-criteria decision approach and attitude-change theory” to examine post-COVID-19 impact on entrepreneurial mindset by investigating the link between entrepreneurs social capital and entrepreneurial success. Specifically, this study analyzed entrepreneurs' dispositional factor as an underlying mechanism to bridge trust and entrepreneurial success. Furthermore, it also analyzed entrepreneurs' situational factor as boundary condition.Design/methodology/approachWe applied time-lagged data collection from 505 industrial entrepreneurs. Survey method was used for data collection. A 7-point Likert scale was used for the respondent response. (...) Hayes developed PROCESS models 4 and 7 were used to test the hypothesis.FindingsThe direct impact of trust on three elements of the ecosystem was found significantly positive on both startup behavior and entrepreneurial success. The direct impact of startup behavior on entrepreneurial success is also significantly positive. The impact of startup behavior on indirect mediation between trust and entrepreneurial success is visibly positive. The moderated and moderated mediation impact of entrepreneurial strategy found positively significant at low and medium values. However, this study found an insignificant moderated impact at high values of entrepreneurial strategy between trust on media and startup behavior. Furthermore, this study also found insignificant moderated mediation impact at high values of entrepreneurial strategy by interacting with two elements of ecosystem through startup behavior on entrepreneurial success.Originality/valueThe authors suggested that startup behavior is an underlying mechanism through which industrial entrepreneurs trust achieved desired entrepreneurial success. The authors also suggested that the influencing role of “low level of entrepreneurial strategy” in comparison with “high level entrepreneurial strategy” is more helpful to achieve entrepreneurial success.ImplicationsThis study contributed to the literature on entrepreneurial strategy for its conditional indirect moderated impact on startup behavior and moderated mediation impact on firm entrepreneurial success. It also contributed to owners of the manufacturing industry for their startup behavior as an underlying mechanism through which trust influences entrepreneurial success. (shrink)

Cet article esquisse les angles morts d’une histoire, celle de la qualification du savoir au xix e siècle, à partir de l’apparition conjointe du néologisme épistémologie et du syntagme philosophie des sciences. Au-delà des déterminations linguistiques et institutionnelles, il s’efforce de cerner la logique de leur assise commune, en un siècle qui consolida à la fois le rôle central de l’histoire et celui de la recherche d’un statut propre à la pensée. Ainsi, il espère suppléer aux confusions dues à l’impact (...) de la circulation des idées (traductions, traditions et réceptions) et souhaite exposer le lieu d’une profusion conceptuelle, en s’attachant à rendre compte de l’unité d’habitudes générées par l’héritage d’une époque. (shrink)

This book explores philosophical ethics in Arabo-Islamic thought.

This book demonstrates how and why vitalism—the idea that life cannot be explained by the principles of mechanism—matters now. Vitalism resists closure and reductionism in the life sciences while simultaneously addressing the object of life itself. The aim of this collection is to consider the questions that vitalism makes it possible to ask: questions about the role and status of life across the sciences, social sciences, and humanities and questions about contingency, indeterminacy, relationality and change. All have special importance now, (...) as the concepts of complexity, artificial life and artificial intelligence, information theory, and cybernetics become increasingly significant in more and more fields of activity. (shrink)

The radical probabilist counsels the prudent never to put away uncertainty, and hence always to balance judgment with probabilities of various sizes. Against this counsel I shall advise in favor of the practice of full belief — at least for some occasions. This advice rests on the fact that it is sometimes in a person's interests to accept certain propositions as a means of bringing it about that others recognize oneself as having accepted those propositions. With the pragmatists, therefore, I (...) shall reject the view that belief formation must in every instance be a truth-directed affair. Unlike the pragmatists, however, I shall conclude that the enterprise of belief formation is not directed exclusively, or even primarily, at attaining knowledge. In other words, pursuit of that which it profits to believe, on the one hand, and pursuit of knowledge on the other, are distinct enterprises, which overlap (when they do) only accidentally. (shrink)

İşbu makale Ebü’l-Berekât el-Bağdâdî’nin (ö. 560/ 1164-65’ten önce) ilâhî önbilgi ve insanın özgür iradesi sorununa dair konumunu tetkik etme amacındadır. Metin, Ebü’l-Berekât’ın ilâhî önbilgi ve insanın özgür iradesinin bağdaşması argümanın geçerli olmadığını düşündüğünü iddia ediyor. Bir kişi ya ilâhî önbilgiyi ya da insanın özgür iradesini savunabilir, başka bir çözüm yoktur. Kitâbu’l-Mu‘teber fi’l-hikme adlı kitabının mantık ve metafizik bölümleri içerisindeki bu meseleye dair açıklamalarını inceleyerek, Ebü’l- Berekât’ın ikinci alternatifi seçtiği belirgin kılınacaktır.

Recent scholarship has emphasized the contributions of the great Maliki jurist Shihāb al-Dīn al-Qarāfī to Islamic legal thought. However, al-Qarāfī’s compilation of legal maxims and distinctions, al-Furūq, has not yet been studied, nor has the collection of his teacher, the prominent Shafiʿi jurist Ibn ʿAbd al-Salām, known as al-Qawāʿid al-kubrā. Furthermore, the original thought of Ibn ʿAbd al-Salām and his formative influence on al-Qarāfī have been understated. This article compares their two works to demonstrate that al-Qarāfī based his collection in (...) large part on Ibn ʿAbd al-Salām’s al-Qawāʿid and it examines the techniques that al-Qarāfī used, which included reordering, refining, and supplementing borrowed maxims, and anonymizing references to his teacher. Most salient, however, is al-Qarāfī’s “Malikization” of maxims, which entailed replacing Shafiʿi doctrines and authorities with their Maliki counterparts and deploying maxims to defend Maliki doctrines. The article concludes by explaining al-Qarāfī’s authorial choices in light of his Maliki affiliation and the politics between the legal schools in Mamluk Cairo. (shrink)

Section 75 of the Criminal Justice Act (CJA) of 2003 overturned the principle in English law that a person cannot be retried for an offense of which he has been acquitted, recognizing advances in forensic science that uses modern analysis of DNA in adducing in evidence. The special plea of autrefois acquit can be overturned based on finding of compelling evidence after a previous acquittal of a suspect who can now be tried again for the same offense. The double jeopardy (...) arises only after a lawful acquittal or autrefois convict of the accused for the first offense and these principles have allowed exceptions to the rule against double jeopardy developed by the courts. There is an analogous rule in common law courts based on the unreasonable splitting of the case when there is a severing of indictments which overrides the bar on the accused being retried for the same offense. This paper examines the difficulty of trying a defendant fairly in the English courts when the defense has pleaded an abuse of process and there is no clear overall argument for trial. This question needs an appraisal of legal ethics in criminal courts because a retrial of the accused on the same charge breaches the autrefois acquit doctrine, and severing of an indictment can cause the fair trial process to be undermined. (shrink)

This article argues that there has been a significant turn in the discourse of feminist politics in the Islamic Republic of Pakistan. The author suggests that the rise of a new feminism – rooted in Islamic discourse, non-confrontational, privatized and personalized, whose objective is to ‘empower’ women within Islam – is not a post-9/11 development but rather a result of unresolved debates on the issue of religion within the progressive women's movement. It has been due to the accommodation of religion-based (...) feminist arguments by the stronger secular feminist movement of the 1980s that paved the way for its own marginalization by giving feminist legitimacy to such voices. The author argues that the second wave of feminism may have become diluted in its effectiveness and support due to discriminatory religious laws, dictatorship, NGO-ization, fragmentation, co-option by the state and political parties in the same way as the global women's movement has. Yet it has been the internal inconsistency of the political strategies as well as the personal, Muslim identities of secular feminists that have allowed Islamic feminists to redefine the feminist agenda in Pakistan. This article voices the larger concern over the rise of a new generation of Islamic revivalist feminists who seek to rationalize all women's rights within the religious framework and render secular feminism irrelevant while framing the debate on women's rights exclusively around Islamic history, culture and tradition. The danger is that a debate such as this will be premised on a polarized ‘good’ vs ‘bad’ Muslim woman, such that women who abide by the liberal interpretation of theology will be pitted against those who follow a strict and literal interpretist mode and associate themselves with male religio-political discourse. This is only likely to produce a new, radicalized, religio-political feminism dominating Pakistan's political future. (shrink)

The rule against bias is a central tenet of English law and it also impacts on collegiate courts which typically exercise appellate/review jurisdictions over their professional or student members. This is true of the Bar Standards Board which has established the adjudicatory bodies to enforce its regulatory framework and has vested the procedure of fair trials upon the Council of the Inns of Court which is responsible for appointing the Disciplinary Tribunal panels that conduct hearings for professional misconduct. The COIC (...) has been exposed for ‘irregularities’ in the findings of guilt against barristers who have been adjudged by non-qualified judges. In R v Visitors to the Inns of Court and Ors [2014] EWCA Civ 1630, the Court of Appeal ruled that a disciplinary tribunal or a panel of visitors appointed from barristers or lay representatives outside its pool of enrolled judges would still ensure independence and guarantee freedom from outside pressure. The impugned tribunal members who were not entitled to sit nevertheless had authority to act as de facto judges. This part of the ruling reinforces the regulatory bodies inherent power to appoint its own tribunal to adjudicate and it needs a more rigorous application of natural justice principle on the part of the BSB. (shrink)

The Communist Manifesto’s salient point was set out in Critics of the Gotha Program as “From Each According to Their Abilities, to Each According to Their Needs”. The demise of communism in the former Soviet Union has caused its critics to claim that ‘revolutionary’ political theory has no basis for legal or philosophical development. The contention of those who oppose radical socialism achieved by the levelling of the classes proclaim that this is an unattainable goal. They argue that a ‘withering (...) of the state’ is not possible for the implementation of Marx’s theory because of the centralisation that is inevitable in socialism which leads to an aggregate of relationships that redistributes power at the apex of the hierarchy. However, this appraisal has to be viewed with reference to the adoption by Marxists of socio legal theory as an analytical tool that has spawned arguments based on legal realism. This article examines the construction of these arguments within the sociology of law and looks at the inception of critical race theory which projects historical injustices towards a racial minority and seeks to transform society by exposing law as an instrument of oppression. (shrink)

Background:Africa is increasingly becoming an important region for health research, mainly due to its heavy burden of disease, socioeconomic challenges, and inadequate health facilities. Regulatory...

Using C. Wright Mills' book The Sociological Imagination as a touchstone for its discussion, this article addresses the relations between the sociological problem, relevance and experience as they are and could potentially be understood within sociology. Beginning with the historical relation between sociology, science and literature — a relation which has been productively but differently complicated by poststructuralist and postconstructivist theories — this article asks: to what extent does the empirical offer a referent for the sociological problem? To what is (...) sociology obliged to be relevant? Arguing for the continued relevance of relevance, particularly in the light of recent reforms in higher education in the UK and the USA, the article explores how the sociological problem might be transformed — and perhaps, more importantly, might be transformative — if the basic commitments of a research project were not to historical social structures but to virtual structures. (shrink)

This article addresses the relations between ‘nature’ and ‘culture’ (and those characteristics associated with ‘the natural’ and ‘the cultural’) in the context of the debates about Prozac. Following Marilyn Strathern, I focus specifically on the contested issue of enablement - that is, on what Prozac does or does not enable, and on the relation between enablement and enhancement, normality and pathology. I argue that the implications of the model of the brain that accompanies explanations of Prozac are such that commentators (...) are obliged to address not only the nature of normality but also the nature of nature itself. Through a close analysis of these debates, I suggest that critiques of Prozac should be understood not as objections to reductionism - to a biology that closes things down - but rather to one that opens things up: that opens up the relations between nature, culture, biology and the individual, relations that are now cross-cut and thrown about by artificiality. Objections to Prozac, then, might be characterized as an attempt to put these concepts back into their ‘proper’ positions, to re-establish the relationality between them. In conclusion, I argue that the biology put forward by proponents of psychopharmacology, regardless of the desirability of the latter, challenges not only the frequent assumptions that are made about the claims of materialist science, but also some of the terms and concepts that are commonly deployed in the social sciences. (shrink)

Ghosn, Mariam Predictive genetic testing Part 2 will examine the issues and ethical aspects that must be considered when adolescents below the age of majority make a request to undergo predictive genetic testing for Huntington's disease.

Ghosn, Mariam Huntington's disease (HD) is an inherited disorder. Sufferers usually develop symptoms in midlife between the ages of 30 and 50 years. HD causes neurodegeneration resulting in the progressive development of physical, cognitive and emotional symptoms. The impact on sufferers worsens over time with the final stage of the disease resulting in the need for professional assistance in a long-term care facility. More rarely HD develops in children and young adults, with less than 5% of HD sufferers being (...) affected by Juvenile HD. This article considers the ethical aspects of such testing. (shrink)

Ghosn, Mariam The causes of obesity are complex. Both our attitudes and lifestyles will need to change in order to successfully address this issue.

Ghosn, Mariam; Ford, Norman The adult stem cells are capable of self-renewal and are responsible for replenishing cells throughout an individual's lifetime, residing not only at embryonic stage but also in children and adults. The latest advancements and updates in adult stem cell technology demonstrate that it might be possible to generate stem cells for therapeutic uses without the creation or destruction of human embryos.

Ghosn, Mariam A seven-year $1 million dollar study conducted by Dr. M. Soffritti found that significant trend of increasing lymphoma and leukaemia incidence in female rats fed aspartame with a significant increase in the number of female rats affected at dosages of 20 mg/kg per day and upward, thus questioning aspartame's safety. However, the European Food Safety Authority's (EFSA's) Scientific Panel on Food Additives, Flavourings, Processing Aids and Materials in Contact with Food (AFC) argued that there was not enough (...) evidence to conclude that aspartame causes an increased incidence of lymphomas and leukaemias, also arguing that the increase in the number of rats affected with lymphomas and leukaemias could be due to chronic respiratory infections of the rats used in the study. (shrink)

In this introduction we shall array a family of fundamental questions pertaining to probability, especially as it has been judged to bear upon the guidance of life. Applications and uses of probability theory need either to address some or all of these questions, or to tell us why they don’t. The essays assembled in this volume bring integrative perspectives on this family of questions. We asked the authors to describe in their own voices the intellectual histories of their contributions, so (...) as to shed further light upon the philosophical interest of their projects, and their particular integrative approaches, within the broader context we have sketched. The authors’ comments precede the essays. (shrink)

There is a certain tangle of philosophical questions around which much philosophy, especially in our time, has circled, to the point where now there is something that deserves to be called a holding pattern around these issues: What are causes? How do they compare with reasons? What is Reason, with a capital R? How does it participate in the production of intentions that lead to action, particularly in arenas rife with uncertainty? Where do formal systems of symbols come into all (...) of this? And how - if at all - can formal methods be harnessed to serve science and public policy, through guiding belief formation and decision-making? Henry Kyburg, Jr., has himself circled around this tangle of questions, at least once or twice. And so in his honor, and in the no-nonsense spirit of empiricism that marks his work as the work of a scientist, I'd like to sketch a way to cut through some of the Gordian knots at the center of this tangle. The theme will be that natural science has much of value to offer that has been willfully neglected by philosophers. This by itself is nowise surprising, as philosophy, particularly in the most exclusive parts of the academy, has suffered from an excessive transcendentalism - a theme to which I will return in this piece periodically. Now Kyburg has not been guilty of contributing to the causes for the decline of philosophy. He has, instead, been courageously working out the implications of his convictions regarding the virtues of vigorous formal systems, contributing to the advancement of empiricist methodologies, and generously supporting the causes of realism. In emulation of that courage, I offer this essay in the service of bold and vigorous formal systems, realism and - most emphatically - empiricism. (shrink)

The subfield of philosophy that treats fundamental questions pertaining to science. The philosophy of science explores the fundamental principles, purposes, methodologies, implications, and reliability of the human enterprise known as science. It seeks to describe our best understanding of the universe, at all scales, as well as to engage with the question of how we can—as fallible organisms—reliably come to possess such knowledge. How can it be possible for us to arrive at theories that describe the world as it really (...) is, seeing as how our efforts to model it are based on the qualities and features available to human perception and experience, as limited and biased as we know these can be? (shrink)

In his magnum opus, The Logic of Scientific Discovery (first published in German in 1934, English translation, 1959), Karl Popper make two fundamental philosophical moves. First, he relocates the center of gravity of the philosophical treatment of science around what he calls the problem of demarcation. This is the problem of distinguishing between science, on the one hand, and everything else on the other. (By contrast, his contemporaries of the Vienna Circle, whose positivism would prove the most influential brand of (...) empiricism of the day, located the center of gravity around the problem of linguistic meaning, and use a criterion according to which a statement is meaningful to the extent that one can identify verification conditions for it.) Popper excludes from science such things as logic, metaphysics, Freudian psychoanalysis, and Marx’s theory of history. Second, Popper propounds the doctrine of falsification, which handles the problem of demarcation, as well as answers David Hume’s shattering attack on science as the premier form of knowledge centuries before. The arguments he mounts for falsification would function also as an attack on any account of the scientific enterprise that, like positivism, adheres to the idea that science progresses logically from instances (given in observation or experience) to the high-order generalizations characteristic of mature scientific theory. In this small space I shall undertake neither to illuminate the nuances of Popper’s position, nor to trace the (numerous) lines of criticism that have accumulated against it some seventy years later. I shall busy myself instead with tracing a trajectory of thought on the subject of scientific reasoning and its relation to individual decision-making, reflecting on Popper’s contribution and on how his legacy might be further enlarged. (shrink)

Hume and Descartes, arguably the most important figures in modern philosophy, disagreed on everything fundamental save one: that human motivation is divided between two quite different and non-overlapping sources—the mind and the body—and that each of these contributes something very different to behavior. This particular doctrine is deeply rooted in Descartes’ mechanistic philosophy. (Still, while they agreed on the core doctrine, they diverged in important details—with Hume being especially unwilling to attribute much in the way of real control over behavior (...) to Reason.) In not countering Descartes on this important idea about motivation, Hume unwittingly conspired to create a dogma—a doctrine handed down unopposed by a competitor into the next generation’s philosophical legacy. And this is rather unfortunate. Only Hume—or, at any rate, someone coming from his angle on things—could have helped to provide his posterity with philosophical substance that counters the mechanistic option. (And if we are ever to climb out of the mechanistic hole, we will have to invent an anti-mechanistic philosophy that has little or no continuity with others in its immediate history.) The moral is that philosophy adds real value when it is able to provide, in an uninterrupted way, foundations for a variety of different perspectives on a fundamental question—or at any rate, to keep received options alive. Philosophy can, in this way, prevent ossification of opinion into dogma. Because Hume did not provide a counter to Descartes on this particular occasion, one that might have drawn on ideas we find in the ancients (Plato or Aristotle), science has paid an enormous price. (shrink)

Background The post-trial period is the time period after the end of study drug administration. It is unclear whether post-trial arrangements for patient surveillance are routinely included in study protocols and consents, and whether research ethics boards (REB) consider the post-trial period. Objectives The objective was to determine whether trial protocols and consent forms reviewed by the REB describe procedures for post-trial period surveillance. Methods An observational study of protocols of randomised trials of chronic therapies for cardiac conditions, approved by (...) the REB of two academic institutions affiliated with the University of Toronto in Canada (University Health Network and Mount Sinai Hospital) from 1995 to 2007. Plans for patient surveillance in the post-trial period described in the protocol or in the consent form before and after REB approval were recorded. Results 42 studies were identified including 18 heart failure and 15 coronary artery disease trials. Only four studies planned a clinical visit after trial termination, and an additional three planned a telephone contact after trial completion. Five trials submitted consent forms to the REB with a discussion of the post-trial period. Conclusions The majority of protocols and consent forms did not discuss plans for post-trial period surveillance. The post-trial period and the REB approval process could be improved by systematic follow-up being described in the protocol and consent form. The small number of trial protocols evaluated in the study may impair the degree to which the results can be generalised. (shrink)

Multi-level institutional designs with distributed power and authority arrangements among federal, state, regional, and local government agencies could lead to the emergence of differential patterns of socioeconomic and infrastructure development pathways in complex social–ecological systems. Both exogenous drivers and endogenous processes in social–ecological systems can lead to changes in the number of “basins of attraction,” changes in the positions of the basins within the state space, and changes in the positions of the thresholds between basins. In an effort to advance (...) the theory and practice of the governance of policy systems, this study addresses a narrower empirical question: how do intergovernmental institutional rules set by federal, state, and regional government agencies generate and sustain basins of attraction in funding infrastructure projects? A pattern-oriented, agent-based model (ABM) of an intergovernmental network has been developed to simulate real-world transportation policy implementation processes across the federal, the state of Vermont, regional, and local governments for prioritizing transportation projects. The ABM simulates baseline and alternative intergovernmental institutional rule structures and assesses their impacts on financial investment flows. The ABM was calibrated with data from multiple focus groups, individual interviews, and analysis of federal, state, and regional scale transportation projects and programs. The results from experimental simulations are presented to test system-wide effects of alternative multi-level institutional designs, in particular different power and authority arrangements between state and regional governments, on the emergence of roadway project prioritization patterns and funding allocations across regions and towns. (shrink)