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Reconstructive allografts using Vascularized Composite Allotransplantation are providing individuals living with upper limb loss and facial disfigurement with new opportunities for a sensate, esthetically acceptable, and functional alternative to current treatment strategies. Important research attention is being paid to how best to assess and screen candidates for VCA, measure optimal patient outcomes, and support patient adherence to lifelong behaviors and medical regimens. Far less attention, however, has been dedicated to the team science required for these complex VCA teams to form, (...) prepare, and provide the highest quality clinical and psychosocial care to those receiving VCA. VCA teams are unique in that they require specialized team members whose scope of practice may not otherwise overlap. The team also needs to constantly negotiate balancing patient safety with multiple risks throughout the transplant process. This study aimed to elucidate the team science needed for this highly innovative and complex area of medicine. Using in-depth qualitative interviews with 14 VCA team members and observations at team meetings, we found that careful consideration of team composition, team structure, and organizational commitment influences team performance and patient outcomes, but that to be efficient and truly effective, teams need to commit to developing processes that foster collaboration. These processes are action-oriented, strategic and interpersonal. Dedication and commitment to team science allows teams to manage conflict under stress and exercise ways to leverage strengths to provide optimal performance or patient psychosocial and clinical outcomes. This study can provide insight into quality improvement efforts for VCA teams and guidance for other transplant programs that wish to consider expansion into VCA. (shrink)

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Objective: To determine whether the marks in the third year Objective Structured Clinical Examination were affected by the collusion reported by the students themselves on an electronic discussion board.Design: A review of the student discussion, examiners’ feedback and a comparison of the marks obtained on the 2 days of the OSCE.Participants: 255 third year medical students.Setting: An OSCE consisting of 15 stations, administered on three sites over 2 days at a UK medical school.Results: 40 students contributed to the discussion on (...) the electronic discussion board. The main points raised were perceived inequity between students who did, or did not, have prior knowledge of the station content, and the lack of honesty and professionalism of their peers. Most contributors claimed to have received, or knew of others receiving, prior knowledge, but none confessed to passing on information. No significant difference was observed in the overall mark for the OSCE on day 1 ) and day 2 ). On day 2, marks were considerably greater for four stations and markedly lower for three stations. It was not obvious why collusion should affect these station marks. A clear indication of the effects of collusion could only be obtained from a single subsection of an individual station where 82 students on day 2 incorrectly gave the diagnosis from day 1.Conclusion: Marks do not provide a sound inference of student collusion in an OSCE and may mask the aspects of professional development of students. (shrink)

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> Wealthy nations must do much more, much faster. The United Nations General Assembly in September 2021 will bring countries together at a critical time for marshalling collective action to tackle the global environmental crisis. They will meet again at the biodiversity summit in Kunming, China, and the climate conference 26) in Glasgow, UK. Ahead of these pivotal meetings, we—the editors of health journals worldwide—call for urgent action to keep average global temperature increases below 1.5°C, halt the destruction of nature (...) and protect health. Health is already being harmed by global temperature increases and the destruction of the natural world, a state of affairs health professionals have been bringing attention to for decades.1 The science is unequivocal; a global increase of 1.5°C above the preindustrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse.2 3 Despite the world’s necessary preoccupation with COVID-19, we cannot wait for the pandemic to pass to rapidly reduce emissions. Reflecting the severity of the moment, this editorial appears in health journals across the world. We are united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory. The risks to health of increases above 1.5°C are now well established.2 Indeed, no temperature rise is ‘safe’. In the past 20 years, heat-related mortality among people aged over 65 has increased by more than 50%.4 Higher temperatures have brought increased dehydration and renal function loss, dermatological malignancies, tropical infections, adverse mental health outcomes, pregnancy complications, allergies, and cardiovascular and pulmonary morbidity and mortality.5 6 Harms disproportionately affect the most vulnerable, including children, older populations, ethnic minorities, poorer communities and those with underlying health problems.2 4 Global heating is also contributing to the decline in …. (shrink)

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Research suggests that the reaching hand automatically deviates toward a target that changes location during the reach. In the current study, we investigated whether movement intention can influence the target jump’s impact on the hand. We compared the degree of trajectory deviation to a jumped target under three instruction conditions: GO, in which participants were told to go to the target if it jumped, STOP, in which participants were told to immediately stop their movement if the target jumped, and IGNORE, (...) in which participants were told to ignore the target if it jumped and to continue to its initial location. We observed a reduced response to the jump in the IGNORE condition relative to the other conditions, suggesting that the response to the jump is contingent on the jump being a task-relevant event. (shrink)

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Research suggests that perceptual experience of our movements adapts together with movement control when we are the agents of our actions. Is this agency critical for perceptual and motor adaptation? We had participants view cursor feedback during elbow extension–flexion movements when they actively moved their arm, or had their arm passively moved. We probed adaptation of movement perception by having participants report the reversal point of their unseen movement. We probed adaptation of movement control by having them aim to a (...) target. Perception and control of active movement were influenced by both types of exposure, although adaptation was stronger following active exposure. Furthermore, both types of exposure led to a change in the perception of passive movements. Our findings support the notion that perception and control adapt together, and they suggest that some adaptation is due to recalibrated proprioception that arises independently of active engagement with the environment. (shrink)

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This collection of essays on themes in the work of John Locke , George Berkeley , and David Hume , provides a deepened understanding of major issues raised in the Empiricist tradition. In exploring their shared belief in the experiential nature of mental constructs, The Empiricists illuminates the different methodologies of these great Enlightenment philosophers and introduces students to important metaphysical and epistemological issues including the theory of ideas, personal identity, and skepticism. It will be especially useful in courses devoted (...) to the history of modern philosophy. (shrink)

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Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially (...) in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

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Cognitive Science, Volume 46, Issue 6, June 2022.

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The recent upsurge in “brain-training and perceptual-cognitive-training", proposing to improve isolated processes such as brain function, visual perception and decision-making, has created significant interest in elite sports practitioners, seeking to create an ‘edge’ for athletes. The claims of these related 'performance-enhancing industries' can be considered together as part of a process training approach proposing enhanced cognitive and perceptual skills and brain capacity, to support performance in everyday life activities, including sport. For example, the 'process-training industry' promotes the idea that playing (...) games not only makes you a better player, but also smarter, more alert, and a faster learner. In this position paper we critically evaluate the effectiveness of both types of process-training programmes in generalizing transfer to sport performance. These issues are addressed in three stages. First, we evaluate empirical evidence in support of perceptual-cognitive process training, and its application to enhancing sport performance. Second, we critically review putative modularised mechanisms underpinning this kind of training, addressing limitations and subsequent problems. Specifically, we consider merits of this highly specific form of training, which focuses on training of isolated processes such as cognitive processes (attention, memory, thinking) and visual perception processes, separately from performance behaviors and actions. We conclude that these approaches may, at best, may provide some 'general transfer' of underlying processes to specific sport environments, but lack 'specificity of transfer' to contextualize actual performance behaviors. A major weakness of process training methods is their focus on enhancing performance in body “modules” (e.g., eye, brain, memory, anticipatory sub-systems). What is lacking is evidence on how these isolated components are modified and subsequently interact with other process “modules”, which are considered to underlie sport performance. Finally, we propose how an ecological dynamics approach, aligned with an embodied framework of cognition undermines the rationale that modularised processes can enhance performance in competitive sport. An ecological dynamics perspective proposes that the body is a complex adaptive system, interacting with performance environments in a functionally integrated manner, emphasising that the inter-relation between motor processes, cognitive and perceptual functions and the constraints of a sport task is best understood at the performer-environment scale of analysis. (shrink)

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BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

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A growing literature testifies to the persistence of place as an incorrigible aspect of human experience, identity, and morality. Place is a common ground for thought and action, a community of experienced particulars that avoids solipsism and universalism. It draws us into the philosophy of the ordinary, into familiarity as a form of knowledge, into the wisdom of proximity. Each of these essays offers a philosophy of place, and reminds us that such philosophies ultimately decide how we make, use, and (...) understand places, whether as accidents, instruments, or fields of care. (shrink)

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Recent work in cognitive science of religion (CSR) is beginning to converge on a very interesting thesis—that, given the ordinary features of human minds operating in typical human environments, we are naturally disposed to believe in the existence of gods, among other religious ideas (e.g., seeAtran [2002], Barrett [2004; 2012], Bering [2011], Boyer [2001], Guthrie [1993], McCauley [2011], Pyysiäinen [2004; 2009]). In this paper, we explore whether such a discovery ultimately helps or hurts the atheist position—whether, for example, it lends (...) credence to atheism by explaining away religious belief or whether it actually strengthens some already powerful arguments against atheism in the relevant philosophical literature.We argue that the recent discoveries of CSR hurt, not help, the atheist position—that CSR, if anything, should not give atheists epistemic assurance. (shrink)

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We present a one per cent measurement of the cosmic distance scale from the detections of the baryon acoustic oscillations in the clustering of galaxies from the Baryon Oscillation Spectroscopic Survey, which is part of the Sloan Digital Sky Survey III. Our results come from the Data Release 11 sample, containing nearly one million galaxies and covering approximately 8500 square degrees and the redshift range 0.2< z< 0.7. We also compare these results with those from the publicly released (...) DR9 and DR10 samples. Assuming a concordance Λ cold dark matter cosmological model, the DR11 sample covers a volume of 13 Gpc3 and is the largest region of the Universe ever surveyed at this density. We measure the correlation function and power spectrum, including density-field reconstruction of the BAO feature. The acoustic features are detected at a significance of over 7σ in both the correlation function and power spectrum. Fitting for the position of the acoustic features measures the distance relative to the sound horizon at the drag epoch, rd, which has a value of rd,fid = 149.28 Mpc in our fiducial cosmology. We find DV = at z = 0.32 and DV = at z = 0.57. At 1.0 per cent, this latter measure is the most precise distance constraint ever obtained from a galaxy survey. Separating the clustering along and transverse to the line of sight yields measurements at z = 0.57 of DA = and H =. Our measurements of the distance scale are in good agreement with previous BAO measurements and with the predictions from cosmic microwave background data for a spatially flat CDM model with a cosmological constant. © 2014 The Author Published by Oxford University Press on behalf of the Royal Astronomical Society. (shrink)

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A case could be made that the practice of philosophy demands a certain humility, or at least intellectual humility, requiring such traits as inquisitiveness, openness to new ideas, and a shared interest in pursuing truth. In the positive psychology movement, the study of both humility and intellectual humility has been grounded in the methods and approach of personality psychology, specifically the examination of these virtues as traits. Consistent with this approach, the chapter begins with a discussion of the examination of (...) intellectual humility as a “character trait,” comparing intellectual humility to various well-known traits in the personality psychology literature (e.g the “Big 5” and the “Big 2”) as well as other key traits such as the need for cognition and the need for closure. The chapter then turns to the proverbial issue of whether virtues in general, and intellectual humility in particular, are a matter of “nature”- that is, an innate trait determined by heritability, or “nurture” – a trait mostly shaped by situation and environment. While the chapter does not resolve the issue, it provides occasion for an examination of the role of situations in the expression of intellectual humility, and for the interaction of “situation” and “trait.” The chapter concludes with a discussion of how the interaction of trait with situation provides the most robust understanding of the psychology of any character virtue, including humility and intellectual humility. (shrink)

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Applying machine learning algorithms to automatically infer relationships between concepts from large-scale collections of documents presents a unique opportunity to investigate at scale how human semantic knowledge is organized, how people use it to make fundamental judgments (“How similar are cats and bears?”), and how these judgments depend on the features that describe concepts (e.g., size, furriness). However, efforts to date have exhibited a substantial discrepancy between algorithm predictions and human empirical judgments. Here, we introduce a novel approach to generating (...) embeddings for this purpose motivated by the idea that semantic context plays a critical role in human judgment. We leverage this idea by constraining the topic or domain from which documents used for generating embeddings are drawn (e.g., referring to the natural world vs. transportation apparatus). Specifically, we trained state-of-the-art machine learning algorithms using contextually-constrained text corpora (domain-specific subsets of Wikipedia articles, 50+ million words each) and showed that this procedure greatly improved predictions of empirical similarity judgments and feature ratings of contextually relevant concepts. Furthermore, we describe a novel, computationally tractable method for improving predictions of contextually-unconstrained embedding models based on dimensionality reduction of their internal representation to a small number of contextually relevant semantic features. By improving the correspondence between predictions derived automatically by machine learning methods using vast amounts of data and more limited, but direct empirical measurements of human judgments, our approach may help leverage the availability of online corpora to better understand the structure of human semantic representations and how people make judgments based on those. (shrink)

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Many recent evolutionary psychology and human behavioral ecology studies have tested hypotheses by examining correlations between variables measured at a group level (e.g., state, country, continent). In such analyses, variables collected for each aggregation are often taken to be representative of the individuals present within them, and relationships between such variables are presumed to reflect individual-level processes. There are multiple reasons to exercise caution when doing so, including: (1) the ecological fallacy, whereby relationships observed at the aggregate level do not (...) accurately represent individual-level processes; (2) non-independence of data points, which violates assumptions of the inferential techniques used in null hypothesis testing; and (3) cross-cultural non-equivalence of measurement (differences in construct validity between groups). We provide examples of how each of these gives rise to problems in the context of testing evolutionary hypotheses about human behavior, and we offer some suggestions for future research. (shrink)

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Aus dem Inhalt: I. Maclean, Introduction M.J. B. Allen, In principio: Marsilio Ficino on the Life of Text D. Perler, Diskussionen uber mentale Sprache im 16. Jahrhundert E. Kessler, Die verborgene Gegenwart und Funktion des Nominalismus in der Renaissance-Philosophie: das Problem der Universalien A. De Pace, Copernicus against a Rhetorical Approach to the Beauty of the Universe. The Influence of the Phaedo on the De revolutionibus H. Mikkeli, Art and Nature in the Renaissance Commentaries and Textbooks on Aristotle's Physics U. (...) Langer, The Ring of Gyges in Plato, Cicero, and Lorenzo Valla: The Moral Force of Fictional Examples I. Maclean, Legal fictions and fictional entities in Renaissance jurisprudence M.-L. Demonet, Les etres de raison, ou les modes d'etre de la litterature M.L. Bianchi, Signs, Signaturae and Natursprache in Paracelsus and Bohme N. G. Siraisi, Disease and symptom as problematic concepts in Renaissance medicine J. Rohls, Schrift, Wort und Sache in der fruhen protestantischen Theologie C. Lohr, Possibility and Reality in Suarez's Disputationes metaphysicae Weitere Beitrage von: B. Vickers, C. Leijenhorst, M. Friedrich. (shrink)

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In relation to a thesis put forward by Marx Wartofsky, we seek to show that a historiography of mathematics requires an analysis of the ontology of the part of mathematics under scrutiny. Following Ian Hacking, we point out that in the history of mathematics the amount of contingency is larger than is usually thought. As a case study, we analyze the historians’ approach to interpreting James Gregory’s expression ultimate terms in his paper attempting to prove the irrationality of \. Here (...) Gregory referred to the last or ultimate terms of a series. More broadly, we analyze the following questions: which modern framework is more appropriate for interpreting the procedures at work in texts from the early history of infinitesimal analysis? As well as the related question: what is a logical theory that is close to something early modern mathematicians could have used when studying infinite series and quadrature problems? We argue that what has been routinely viewed from the viewpoint of classical analysis as an example of an “unrigorous” practice, in fact finds close procedural proxies in modern infinitesimal theories. We analyze a mix of social and religious reasons that had led to the suppression of both the religious order of Gregory’s teacher degli Angeli, and Gregory’s books at Venice, in the late 1660s. (shrink)

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This anthology is intended primarily to provide students of theology with some of the basic writings of the major thinkers who have contributed to the development of the movement known as "process theology." Because of the content students of philosophy will likewise find it useful. The editor begins the work with an introduction in which he ably traces in broad perspective the various ways in which a mental attitude stressing process is reflected in contemporary culture, philosophy, and theology. The first (...) part of the volume then provides essays that center on process thought as this has emerged from the writings of Alfred North Whitehead and his American disciples. Two essays in this part are concerned with tracing the development of process thought, the one by Norman Pittenger centering on its historical evolution from Whitehead through Hartshorne and others into a distinct theological movement, whereas the one by Charles Hartshorne is concerned with the inner development of process thought as a noetic capable of dealing with relational reality. In other essays in this part Bernard Meland comments on the value of process thought in providing an imagery and concepts congenial to contemporary man in his struggle to understand his experience, and Bernard M. Loomer examines in detail the empirical basis and methodology central to Whitehead’s philosophy. The essays in the second part focus on the relationship between God and the world as this relationship is interpreted by process thinkers. Here selections include the final chapter of Whitehead’s Process and Reality, Hartshorne’s suggestive account of the philosophical and religious uses of the term "God," Schubert Ogden’s attempt to defend a concept of God modeled on process thought as more conformable to biblical testimony than the concept of God classical in Christian thought, Walter Stoke’s endeavor to integrate features of process thought within a more Thomistic framework relative to the being of God, and two essays by Daniel Day Williams and John B. Cobb, Jr. on the relationship between God and world and God and man. Essays in the third part, called "Christ and Redemption," reflect the efforts of three Whiteheadian-inspired theologians, Meland, Pittenger, and Henry Nelson Wieman, to rethink the Christian doctrine of the incarnation within the framework provided by process thought. In the fourth part of the work attention is directed from Whitehead to another major source of contemporary process theology, Teilhard de Chardin. The essays include Theodosius Dobzhansky’s lengthy critical appreciation of the major directions in Teilhard’s vision of the universe, Teilhard’s own views on a cosmic Christology, a development of his views on this topic by Henri de Lubac, and other studies of aspects of Teilhard’s thought by N. M. Wildiers, George Crespy, and Christopher F. Mooney. An appendix includes a comparative study of the metaphysics of Teilhard and Whitehead by Ian G. Barbour. A useful bibliography completes the anthology.—W. E. M. (shrink)

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First published 1966 Includes index Includes bibliographical references Campion Collection.

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An expanded & revised version of Religion in an Age of Science. Three new chapters on physics & metaphysics in the 18th century and biology & theology in the 19th century. Other new sections included.

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. In responding to Taede Smedes, I first examine his thesis that the recent dialogue between science and religion has been dominated by scientism and does not take theology seriously. I then consider his views on divine action, free will and determinism, and process philosophy. Finally I use the fourfold typology of Conflict, Independence, Dialogue, and Integration to discuss his proposal for the future of science and religion.

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There are two fundamentally different approaches to innovation: incremental and radical. In Economics as Anatomy, G.M. Peter Swann argues that economics as a discipline needs both perspectives in order to create the maximum beneficial effect for the economy. Chapters explore how and why mainstream economics is very good at incremental innovation but seems uncomfortable with radical innovation. Swann argues that economics should follow the example of many other disciplines, transitioning from one field to a range of semi-autonomous sub-disciplines. In this (...) book, he compares the missing link in empirical economics to being the economic equivalent of anatomy, the basis of medical discourse. Working as a sequel to Swann's Putting Econometrics in its Place, this book will be a vital resource to those who are discontent with the state of mainstream economics, especially those actively seeking to promote change in the discipline. Students wishing to see progress in the teaching of economics will also benefit from this timely book. (shrink)

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Approaches to environmental verification, broadly defined, including varieties of certification and testing, is always intended to change production processes, and cause structural changes. However, sometimes these approaches can differ substantially—based on values and objectives—and thus structure farming processes in varied ways. They can also affect nature-society relations, by determining what differences matter, emphasizing ways of assessing standards that are deemed important, and deciding whether those standards have been met. Here, I compare two types of environmental verification systems for organic and (...) “safe” or “clean” rice, one in northeastern Thailand and the other in southern Laos. The approach used in northeastern Thailand is designed predominantly to gain access to Europe and the United States markets, and is dependent on regular and detailed farm documentation, inspections, and interviews. The other is more of a residue testing and marketing system, one that also has important environmental implications and is being applied for rice from southern Laos. I call the first process-based verification, and the second product-based verification. It is contended here that we need to consider how environmental verification in different forms variously structures production systems, although there are also other important factors, such as China-Laos relations. Crucially, these practices variously affect cultivation and production practices, and thus have important environmental implications, whether fully intended or not. (shrink)

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