Although Next Generation Sequencing (NGS) has increased our ability to test and diagnose, its results are often not clear-cut and require a complex interpretation and negotiation process by both healthcare professionals and patients involved. In this paper, we explore how diagnoses identified through NGS are socially shaped under influence of the broader social context. Using an analytical framework stemming from the sociology of health and illness and science and technology studies, with a focus on the construction of diagnosis and the (...) role of uncertainty in medicine, we analyze the existing corpus of literature on NGS diagnostic practices. We show how in this early implementation phase of NGS, in which standardization efforts are not yet solidified, the boundary struggles around diagnoses obtained through NGS are particularly visible. We discuss the different steps in the diagnosis shaping process and what it subsequently entails to give and a receive a diagnosis using NGS. (shrink)

”This paper describes a new and innovative measure that is developed to predict workplace deviance through the measurement of Machiavellianism and Compliant Behavior. Two field studies were conducted to study the validity of the digital work simulation. In Study 1, support was found for the construct validity of the simulation. The constructs as measured with the simulation correlated significantly with self-reported measures of the constructs and were related to personality and self-esteem. Study 2 examined the criterion-related validity of the simulation (...) and showed that through the assessment of Machiavellianism the simulation was able to predict workplace deviance, and incrementally predicted organizational deviance over and above the Machiavellianism Personality Scale. Machiavellianism as measured with the simulation was less susceptible to social desirable answering compared to the Machiavellianism self-report. The paper finishes with study limitations, future research directions, and practical implications. (shrink)

The introduction of non-invasive prenatal testing in healthcare systems around the world offers an opportunity to reconsider funding policies for prenatal screening. In some countries with universal access healthcare systems, pregnant women and their partners are asked to pay for NIPT. In this paper, we discuss two important rationales for charging women for NIPT: to prevent increased uptake of NIPT and to promote informed choice. First, given the aim of prenatal screening, high or low uptake rates are not intrinsically desirable (...) or undesirable. Using funding policies to negatively affect uptake, however, is at odds with the aim of screening. Furthermore, copayment disproportionally affects those of lower socioeconomic status, which conflicts with justice requirements and impedes equal access to prenatal screening. Second, we argue that although payment models may influence pregnant women’s choice behaviours and perceptions of the relevance of NIPT, the copayment requirement does not necessarily lead to better-informed choices. On the contrary, external influences on women’s personal choices for or against prenatal screening should ideally be avoided. To improve informed decision-making, healthcare systems should instead invest in adequate non-directive, value-focused pretest counselling. This paper concludes that requiring copayments for NIPT in universal access healthcare systems fails to promote reproductive autonomy and is unfair. (shrink)

Oxford Scholarly Classics is a new series that makes available again great academic works from the archives of Oxford University Press. Reissued in uniform series design, the reissues will enable libraries, scholars, and students to gain fresh access to some of the finest scholarship of the last century.

Objective—To explore the opinions of unpaid healthy volunteers on the payment of research subjects.Design—Prospective cohort.Setting—Southern Alberta, Canada.Participants—Medically eligible persons responding to recruiting advertisements for a randomised vaccine trial were invited to take part in a study of informed consent at the point at which they formally consented or refused trial participation. Of 72 invited, 67 returned questionnaires at baseline and 54 at follow-up.Outcome measures—Proportions of persons who agreed or disagreed with three close-ended statements on the payment of research subjects; themes (...) and categories identified by content analysis of responses to an open-ended question.Results—A minority agreed with paying either patient or healthy volunteer participants. Opinions did not change over time. Participants' comments addressed: benefits and drawbacks to research participation; benefits and drawbacks to paying research participants; conditions under which payment of research subjects would be acceptable, and the nature of acceptable recognition. Acceptable conditions were to improve problematic recruitment, to reimburse costs, and to recognise participants, particularly for their time investment. Both non-monetary and monetary recognition of volunteers were thought to be appropriate.Conclusions—Most unpaid volunteers disagreed with paying research participants. The themes arising from their comments are similar to those that have been raised by ethicists and suggest that recognising the time and effort of participants should receive greater emphasis than presently occurs. (shrink)

Résumé : Le PPBS a été conçu comme un instrument destiné à ceux qui décident de l'allocation des ressources publiques : il doit leur permettre de prendre de meilleures décisions. S'il est très difficile de repérer et de juger les choix que le développement du système a inspirés aux Etats-Unis, il n'en est pas mains certain que ses résultats tangibles sant maigres car la masse des anciens programmes, principale source potentielle de moyens nouveaux, n'a guère été remise en question.La valeur (...) intrinsèque du PPBS ne peut être mise en cause. Ce qui doit l'être, c'est la lenteur de son développement, qui demeure peu avancé. Cette lenteur s'explique, car le système ne peut produire des fruits dans une terre stérile qu'on n'a pas préparée.La brutalité et les maladresses de l'opération déclenchée en 1965 dans le gouvernement fédéral américain ne pouvaient que renforcer la résistance au changement et retarder, sinon compromettre, le succès final. Les perspectives demeurent heureusement favorables, puisque la nouvelle administration ne semble pas décidée à faire machine arrière et que les Etats et Villes ont démarré sous de bien meilleurs auspices.La principale conclusion qu'imposent les expériences américaines est que toute juridiction intéressée par le PPBS doit impérativement développer, de la façon la plus générale, la volonté d'instaurer le système et s'assurer les moyens de le faire. C'est dire qu'il est peu sage d'engager la bataille sur tous les fronts à la fois : il faut tenter des percées. Mais c'est dire aussi combi en l'information et la formation sant essentielles. A cet égard, l'installation généralisée de certains éléments du système, à savoir la structure de programmes et le budget-programme, loin de présenter des inconvénients, peut constituer un excellent exercice en dehors de son utilité directe pour le preneur de décision. La bataille en cause est surtout celle de la conviction: l'outil est prêt, il est bon, encore faut-il que l' ouvrier accepte de s'en servir.Samenvatting:Planning-programming-budgeting werd ontworpen als een instrument voor diegenen die beslissen over de toewijzing van de overheidsmiddelen.Dit instrument moet de beslissers in staat stellen betere beslissingen te treffen. Het is niet makkelijk deze beslissingen op te sporen en te beoordelen welke in de Verenigde Staten getroffen werden onder invloed van de ontwikkeling van deze systeembenadering. Toch is het met vrij grote zekerheid te stellen dat de tastbare resultaten gering zijn omdat de veelheid aan oude programma's die tenslotte toch de voornaamste potentiële bronnen zijn van nieuwe middelen, nooit werden aangevochten.De intrinsieke waarde van PPBS kan daarom evenwel niet worden genegeerd. Wat wel dient aangeklaagd is de traagheid van zijn aanslepende ontwikkeling. Deze traagheid is te verklaren door het feit dat het systeem slechts vruchten kan afwerpen zo het ingeplant wordt in degelijk voorbereid terrein.De brutaliteit en de onhandigheden bij de operatie die in 1965 werd ingezet in het amerikaans federaal overheidsbestel konden niets anders dan de weerstand tegen de verandering versterken en afbreuk doen aan het uiteindelijk slagen van het systeem. Gelukkiglijk blijven de vooruitzichten gunstig want de nieuwe beleidsvoerders sinds de presidentsverkiezingen, blijken ermee te willen doorgaan en de staten en lokale overheden zijn ermee van wal gestoken onder veel betere omstandigheden. Het doorslaggevend besluit uit de amerikaanse ervaringen terzake is wel dat elke instantie welke belangstelling heeft voor PPBS, nodig moet op zo breed mogelijk vlak de wil doen groeien om het systeem te ontwikkelen en er ook de nodige middelen toe ter beschikking stellen. Dit betekent tevens dat het weinig aan te bevelen is de strijd op alle fronten terzelvertijd aan te binden maar wel geleidelijk doorbraken te verwezenlijken. Dit brengt dan evenwel ook met zich dat informatie en vorming essentieel zijn bij deze strategie. In dit verband moet dan ook gezegd worden dat reeds het invoeren van sommige deelementen van het systeem, zoals de programmastructuur en het programmabudget, voor de beslisser nuttig kan zijn voor zijn persoonlijk inzicht en vorming.De te voeren actie dient nog slechts te worden toegespitst op het overtuigen van de verantwoordelijken. Het instrument is immers gebruiksklaar en degelijk, er is alleen nog het wachten op de wil van de gebruiker dit instrument ter hand te nemen. (shrink)

Theocritus' four known Aeolic poems, 28–31, are all in metres used by Sappho and Alcaeus. 28, 30, and apparently 31, are in greater Asclepiads, and 29 is in Sapphic fourteen-syllable lines. Neither of these metres was in common use, and Theocritus is likely to have based his metrical practice, like his dialect, on the Lesbian models.

A Papyrus commentary on Alcman published in 19571 brings us news of a poem in which Alcman “physiologized”. The lemmata and commentary together witness to a semi-philosophical cosmogony unlike any other hitherto known from Greece. The evidence is meagre, but it seems worth while to see what can be made of it; for it is perhaps possible to go a little farther than has so far been done.

Tragedy is superior to comedy. This is the received view in much philosophical aesthetics, literary criticism and amongst many ordinary literary appreciators. The paper outlines three standard types of reasons given to underwrite the conceptual nature of the superiority claim, focusing on narrative structure, audience response and moral or human significance respectively. It sketches some possible inter-relations amongst the types of reasons given and raises various methodological worries about how the argument for tragedy’s superiority typically proceeds. The paper then outlines (...) a new normative account of a type of literary or dramatic comedy – ‘high comedy’ – which proves to be tragedy’s equal. High comedies, it will be argued, have complex narrative structures shaping audience responses underwriting the moral significance of the comic mode. The received view is unjustified and appreciating why this is so casts light on the nature and value of comedy. (shrink)

On the fundamentals of Advaita and Viśiṣṭādvaita philosophy.

A Papyrus commentary on Alcman published in 19571 brings us news of a poem in which Alcman “physiologized”. The lemmata and commentary together witness to a semi-philosophical cosmogony unlike any other hitherto known from Greece. The evidence is meagre, but it seems worth while to see what can be made of it; for it is perhaps possible to go a little farther than has so far been done.

The paper is concerned with explaining some of the principal theoretical developments in elementary particle physics and discussing the associated methodological problems both in respect of heuristics and appraisal. Particular reference is made to relativistic quantum field theory, renormalization, Feynman diagram techniques, the analytic S-matrix and the Chew — Frautschi bootstrap.

In the long section of anapaests with which they make their entry, the old men of Argos methodically deliver three essential messages to the audience: 40–71. It is the tenth year of the Trojan War. 72–82. We are men who were too old to go and fight in it. 83–103. Some new situation seems to be indicated by the fact that Clytemnestra is organizing sacrifices throughout the town.