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Disagreement
Kinds of Disagreement Selected AbstractsMORAL REFORM, MORAL DISAGREEMENT, AND ABORTIONMETAPHILOSOPHY, Issue 4 2007KATHLEEN WALLACE Abstract: Bernard Gert argues that legitimate moral disagreement calls for tolerance and moral humility; when there is more than one morally acceptable course of action, then intolerance and what Gert calls "moral arrogance" would be objectionable. This article identifies some possible difficulties in distinguishing moral arrogance from moral reform and then examines Gert's treatment of abortion as a contemporary example of moral disagreement that he characterizes as irresolvable. [source] RELATIVISM (AND EXPRESSIVISM) AND THE PROBLEM OF DISAGREEMENTPHILOSOPHICAL PERSPECTIVES, Issue 1 2009James Dreier First page of article [source] Aggressive behaviour and social problem-solving strategies: a review of the findings of a seven-year follow-up from childhood to late adolescenceCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2001Liisa Keltikangas-Järvinen PhD Professor Objectives In a seven-year follow-up study, the author and colleagues examined the development of social skills from childhood to late adolescence, with a particular focus on aggressive behaviour. This paper presents a review of the most important findings of the project. Results and conclusions Social strategies explained aggressive behaviour, and changes of strategies predicted changes of behaviour. Aggressive behaviour was, however, very stable, and spontaneous change from an aggressive child to a sociable adolescent was not observed. This emphasizes an importance of early prevention of aggression. Disagreement between the children's and their parents' problem-solving strategies was apparent, suggesting that interventions to reduce a child's aggression should be augmented by educating the parents about their children's behaviour. The role of peers was important because the child's concept of his or her strategies was dependent on his or her social acceptance, and this should be taken into account in interventions. Finally, as approval or disapproval of aggression is related to behaviour, moral cognitions should be included in the interventions. Copyright © 2001 Whurr Publishers Ltd. [source] Characterization of Bves expression during mouse development using newly generated immunoreagentsDEVELOPMENTAL DYNAMICS, Issue 6 2006Travis K. Smith Abstract Bves (blood vessel/epicardial substance) is a transmembrane protein postulated to play a role in cell,cell interaction/adhesion. It was independently isolated by two groups as a gene product highly enriched in the developing heart. Disagreement exists about its expression during development. Most notably, the expression of Bves in non-muscle cells is disputed. Determining the expression profile of Bves is a critical initial step preceding the characterization of protein function in development and in the adult. We have generated new monoclonal antibodies against mouse Bves and used these immunoreagents to elucidate Bves expression in development. As expected, we detect Bves in myocytes of the developing heart throughout development. In addition, skeletal and smooth muscle cells including those of the coronary system express Bves. Finally, specific, but not all, epithelial derivatives of the three germ layers are stained positively with these monoclonal antibodies. Protein expression in cultured epithelial and muscle cell lines corroborate our in vivo findings. Taken together, these results demonstrate the expression of Bves in a wide range of epithelial and muscle cells during mouse embryogenesis and indicate a broad function for this protein in development, and show that these newly generated reagents will be invaluable in further investigation of Bves. Developmental Dynamics 235:1701,1708, 2006. © 2006 Wiley-Liss, Inc. [source] Relation-Based Thought, Objectivity and DisagreementDIALECTICA, Issue 1 2010Christopher Peacocke First page of article [source] Genetic and environmental influences on Anxious/Depression during childhood: a study from the Netherlands Twin RegisterGENES, BRAIN AND BEHAVIOR, Issue 8 2005D. I. Boomsma For a large sample of twin pairs from the Netherlands Twins Register who were recruited at birth and followed through childhood, we obtained parental ratings of Anxious/Depression (A/D). Maternal ratings were obtained at ages 3 years (for 9025 twin pairs), 5 years (9222 pairs), 7 years (7331 pairs), 10 years (4430 pairs) and 12 years (2363 pairs). For 60,90% of the pairs, father ratings were also available. Multivariate genetic models were used to test for rater-independent and rater-specific assessments of A/D and to determine the genetic and environmental influences on individual differences in A/D at different ages. At all ages, monozygotic twins resembled each other more closely for A/D than dizygotic twins, implying genetic influences on variation in A/D. Opposite sex twin pairs resembled each other to same extent as same-sex dizygotic twins, suggesting that the same genes are expressed in boys and girls. Heritability estimates for rater-independent A/D were high in 3-year olds (76%) and decreased in size as children grew up [60% at age 5, 67% at age 7, 53% at age 10 (60% in boys) and 48% at age 12 years]. The decrease in genetic influences was accompanied by an increase in the influence of the shared family environment [absent at ages 3 and 7, 16% at age 5, 20% at age 10 (5% in boys) and 18% at age 12 years]. The agreement between parental A/D ratings was between 0.5 and 0.7, with somewhat higher correlations for the youngest group. Disagreement in ratings between the parents was not merely the result of unreliability or rater bias. Both the parents provided unique information from their own perspective on the behavior of their children. Significant influences of genetic and shared environmental factors were found for the unique parental views. At all ages, the contribution of shared environmental factors to variation in rater-specific views was higher for father ratings. Also, at all ages except age 12, the heritability estimates for the rater-specific phenotype were higher for mother ratings (59% at age 3 and decreasing to 27% at age 12 years) than for father ratings (between 14 and 29%). Differences between children, even as young as 3 years, in A/D are to a large extent due to genetic differences. As children grow up, the variation in A/D is due in equal parts to genetic and environmental influences. Anxious/Depression, unlike many other common childhood psychopathologies, is influenced by the shared family environment. These findings may provide support for why certain family therapeutic approaches are effective in the A/D spectrum of illnesses. [source] Long-term reliability and observer comparisons in the radiographic diagnosis of periapical diseaseINTERNATIONAL ENDODONTIC JOURNAL, Issue 2 2002O. Molven Abstract Aim The aim of this study was to evaluate and compare the long-term diagnostic consistency of two examiners, an endodontist and a radiologist, and to make comparisons with findings recorded by an observer with more recent scientific and clinical experience in endodontics. Methodology Three groups, each consisting of 20 full mouth series of intraoral radiographs, with 79, 93 and 85 endodontically-treated roots, respectively, were successively evaluated for periapical disease. Evaluations were at first performed separately by the three observers. Disagreement and difficult, borderline cases were subjected to joint evaluation. Intra- and interexaminer comparisons were made. For two of the observers the observations were compared with findings recorded several years before for the same cases in the same radiographs. Results The intra- and interobserver long-term reliability of the two original examiners resulted in 83% overall agreement, the kappa values were 0.54, 0.57 and 0.53. Comparisons between all three observers disclosed 82%, 85% and 86% agreement and kappa values 0.55, 0.58 and 0.60. The joint evaluations and decisions did not indicate a dominating influence from any of the observers. Conclusions The long-term reliability of the two original observers was judged as being satisfactory. All three observers judged the overall disease status of the material in the same way. The joint discussions of selected cases might reduce observer variation to an acceptable level, avoid a number of false recordings and increase the reliability and validity of the findings. [source] Long term care staff beliefs about evidence based practices for the management of dementia and agitationINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2009Liat Ayalon Abstract Context Despite a growing literature on effective interventions for Alzheimer's disease (AD) and agitation, the management of these conditions in long term care (LTC) often is inadequate. The goals of the present study were: (a) to evaluate existing beliefs about evidence based practices (EBP) for the management of Alzheimer's disease and agitation among LTC staff; and (b) to evaluate the contribution of demographic and attitudinal variables to LTC staff beliefs about these EBP. Method A cross sectional study of 371 LTC staff members completed an EBP questionnaire, a short demographic questionnaire, and an attitudinal questionnaire about AD and agitation. Results Paraprofessional caregivers, those of lower educational level, and ethnic minorities were more likely to be in disagreement with the EBP views examined in this study. Those in disagreement with the EBP views also reported a preference towards not working with residents with AD and agitation and a sense of helplessness associated with such work. Disagreement with EBP views was associated with both normalization and stigmatization of AD and agitation. Conclusions Paraprofessional caregivers, ethnic minorities, and people of lower educational level are most at need for educational activities about AD and neuropsychiatric symptoms. Educational efforts geared towards changing the belief system of LTC staff should target not only EBP but also information about AD and agitation as conditions that are deviant from the normal aging process, yet non-stigmatizing. It is expected that following EBP will empower staff and improve staff motivation to work with residents with AD and agitation. Copyright © 2008 John Wiley & Sons, Ltd. [source] A comparison of GMS-A/AGECAT, DSM-III-R for dementia and depression, including subthreshold depression (SD),results from the Berlin Aging Study (BASE)INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2003R. T. Schaub Abstract Background Empirical evaluation of the agreement between different diagnostic approaches is crucial for the understanding of epidemiological results in geriatric psychiatry. Objectives In this paper, we analyse differences between widely used diagnostic approaches of dementia and depression and offer evidence that diagnostic thresholds vary substantially on quantitative dimensions, but that conceptual and other differences between approaches must also been taken into account. Methods In an epidemiological study of n,=,516 persons, aged 70,103 years, we compared psychiatric diagnoses of dementia and depression obtained by GMS-A/HAS-AGECAT, DSM-III-R and clinician's diagnoses of subthreshold depression (SD). Results For depression, cumulative prevalence of clinician's diagnosis (including SD, GMS-A/HAS-AGECAT and DSM-III-R defined forms) was highest, followed by GMS-A/HAS-AGECAT-diagnosis and DSM-III-R, while for dementia DSM-III-R was followed by GMS-A/HAS-AGECAT. Overall agreement between DSM-III-R and GMS-A/HAS-AGECAT was moderate. Adapting thresholds for AGECAT resulted in slightly better diagnostic efficiency. Diagnostic disagreement was found predominantly for cases with intermediate symptom severity, supporting the hypothesis of differing thresholds between DSM-III-R and GMS-A/HAS-AGECAT, while cases with lower or higher symptom severity were similarily seen as cases or non-cases. Conclusion Disagreement is not only caused by conceptual differences, but also different thresholds of diagnostic algorithms. Adaptation of threshold levels should be feasible, depending on the purpose of the analysis. Copyright © 2003 John Wiley & Sons, Ltd. [source] Unmet Desire for Caregiver-Patient Communication and Increased Caregiver BurdenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2005Terri R. Fried MD Objectives: To examine the adequacy of caregiver-patient communication in serious illness and its relationship to caregiver burden. Design: Cross-sectional cohort study. Setting: Participants' homes. Participants: One hundred ninety-three persons aged 60 and older seriously ill with cancer, congestive heart failure, or chronic obstructive pulmonary disease and their caregivers. Measurements: Communication concerns, measured in terms of agreement with statements regarding desire for and difficulty with communication about the patient's illness. Caregiver burden, measured using a 10-item subset of the Zarit Burden Inventory, with scores ranging from 0 to 40 and higher scores indicating greater burden. Results: Of caregivers, 39.9% desired more communication, and 37.3% reported that communication was difficult. Of patients, 20.2% desired more communication, and 22.3% reported that communication was difficult. Disagreement regarding communication concerns was frequent in caregiver-patient pairs; of caregivers who desired more communication, 83.1% of patients did not, and of patients who desired more communication, 66.7% of caregivers did not. Caregivers who desired more communication had significantly higher caregiver burden scores than did caregivers who did not (9.2 vs 4.7, P<.001), even after adjusting for patient's diagnosis, income, and functional status and caregivers' age, sex, and relationship to the patient. Conclusion: A large proportion of caregivers and seriously ill older persons had an unmet desire for increased communication, although they frequently disagreed with each other about this desire. Caregivers' desire for increased communication may be a modifiable determinant of caregiver burden. [source] Online Groups and Political Discourse: Do Online Discussion Spaces Facilitate Exposure to Political Disagreement?JOURNAL OF COMMUNICATION, Issue 1 2009Magdalena E. Wojcieszak To what extent do online discussion spaces expose participants to political talk and to cross-cutting political views in particular? Drawing on a representative national sample of over 1000 Americans reporting participation in chat rooms or message boards, we examine the types of online discussion spaces that create opportunities for cross-cutting political exchanges. Our findings suggest that the potential for deliberation occurs primarily in online groups where politics comes up only incidentally, but is not the central purpose of the discussion space. We discuss the implications of our findings for the contributions of the Internet to cross-cutting political discourse. Resumen Los Grupos Online y el Discurso Político: ¿Facilitan los Espacios de Discusión online la Exposición a los Desacuerdos Políticos? ¿Hasta qué punto los espacios de discusión online exponen a los participantes a hablar de política y sobre sus visiones en temas relevantes de política? Recurriendo a una muestra nacional representativa de más de 1000 Estadounidenses que reportaron haber participado en salones de conversación ó foros de mensajes, examinamos los tipos de espacios de discusión online que crearon oportunidades para intercambios de temas relevantes de política. Nuestros resultados sugieren que el potencial para la deliberación ocurre primariamente en los grupos online donde los temas políticos aparecen solo en forma incidental, pero no es el propósito central del espacio de discusión. Discutimos las implicancias de nuestros hallazgos para las contribuciones del Internet sobre los temas del discurso político relevante. ZhaiYao Yo yak [source] Kinetics of styrene emulsion polymerization above the critical micelle concentration: Effect of the initial monomer concentration on the molecular weightJOURNAL OF POLYMER SCIENCE (IN TWO SECTIONS), Issue 9 2005Jorge Herrera-Ordonez Abstract The emulsion polymerization of styrene above the critical micelle concentration has been experimentally studied from a low final polymer content up to a high polymer content (,50%). A maximum in the molecular weight (M) evolution has been observed in all cases. The presence or absence of such a maximum depends on the relative values of the rate of free-radical entry (,) and the rate of chain transfer to the monomer (KtrCMp, where Ktr is the chain transfer to monomer rate coefficient and CMp is the monomer concentration in particles). If , , KtrCMp, M is constant and equal to Kp/Ktr (where Kp is the propagation rate coefficient), except at very low particles sizes typical of the early stages of the reaction, in which the chain length is limited by the particle size. On the other hand, if , , KtrCMp, M is determined by both CMp and ,. It is proposed that , is determined by the sum of the entry of the oligomeric radicals formed in the aqueous phase and those contained in particles that undergo limited coagulation. This coagulative entry can become very significant; therefore, reactor hydrodynamics can play a major role in the kinetic behavior observed. Disagreement between Clay and Gilbert's model and molecular weight distribution data can be ascribed, to a lesser or greater extent, to the degree of correctness of the quasi-steady-state and instantaneous-termination approaches. © 2005 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 43: 1963,1972, 2005 [source] Disagreement between subjective and actigraphic measures of sleep duration in a population-based study of elderly persons,JOURNAL OF SLEEP RESEARCH, Issue 3 2008JULIA F. VAN DEN BERG Summary Sleep duration is an important concept in epidemiological studies. It characterizes a night's sleep or a person's sleep pattern, and is associated with numerous health outcomes. In most large studies, sleep duration is assessed with questionnaires or sleep diaries. As an alternative, actigraphy may be used, as it objectively measures sleep parameters and is feasible in large studies. However, actigraphy and sleep diaries may not measure exactly the same phenomenon. Our study aims to determine disagreement between actigraphic and diary estimates of sleep duration, and to investigate possible determinants of this disagreement. This investigation was embedded in the population-based Rotterdam Study. The study population consisted of 969 community-dwelling participants aged 57,97 years. Participants wore an actigraph and kept a sleep diary for, on average, six consecutive nights. Both measures were used to determine total sleep time (TST). In 34% of the participants, the estimated TST in the sleep diaries deviated more than 1 h from actigraphically measured TST. The level of disagreement between diary and actigraphic measures decreased with subjective and actigraphic measures of sleep quality, and increased with male gender, poor cognitive function and functional disability. Actigraphically measured poor sleep was often accompanied by longer subjective estimates of TST, whereas subjectively poor sleepers tended to report shorter TST in their diaries than was measured with actigraphy. We recommend, whenever possible, to use multiple measures of sleep duration, to perform analyses with both, and to examine the consistency of the results over assessment methods. [source] Moral Relativism and the Argument from DisagreementJOURNAL OF SOCIAL PHILOSOPHY, Issue 3 2003James A. Ryan First page of article [source] Disagreement between acute and chronic haemodynamic effects of nadolol in cirrhosis: a pathophysiological interpretationALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2005C. MERKEL Summary Background :,The acute effects of , -blockers may be different from chronic; mechanisms underlying this difference are poorly elucidated. Aim :,To assess portal pressure and its pathophysiological determinants after acute and chronic administration of nadolol. Methods :,In 24 patients with cirrhosis and portal hypertension hepatic venous pressure gradient, portal blood flow and resistance to portal blood flow were measured before, 60,90 min after acute administration of nadolol, and after 1 month. Patients were good-responders if hepatic venous pressure gradient was ,12 mmHg, or decreased by at least 20%. Results :,Eleven and 13 patients were good- and poor-responders to acute administration, respectively. Acute poor-responders showed a lower decrease in portal blood flow (P = 0.04) and a less evident decrease in mean arterial pressure (P < 0.001). Eleven and 13 patients were good- and poor-responders to chronic administration, respectively. Chronic poor-responders showed a larger increase in resistance to portal blood flow compared with good-responders (P = 0.01). Disagreement between acute and chronic effects was seen in 12 patients: six were acute good-responders chronic poor-responders and six were acute poor-responders chronic good-responders. Acute good-responders chronic poor-responders patients had the smallest decreases in portal blood flow and in mean arterial pressure after acute administration, while acute poor-responders chronic good-responders showed the largest (P = 0.05 and 0.01). Conclusions :,Disagreement between acute and chronic effects of nadolol on hepatic venous pressure gradient is common. The mechanism responsible is complex, the acute effect being mainly modulated by arterial hypotension and the chronic effect by changes in portal resistance. [source] Disagreement and Deference: Is Diversity of Opinion a Precondition for Thought?PHILOSOPHICAL PERSPECTIVES, Issue 1 2003Stacie Friend First page of article [source] Religious Belief and the Epistemology of DisagreementPHILOSOPHY COMPASS (ELECTRONIC), Issue 8 2010Michael Thune Consider two people who disagree about some important claim (e.g. the future moral and political consequences of current U.S. economic policy are X). They each believe the other person is in possession of relevant evidence, is roughly equally competent to evaluate that evidence, etc. From the epistemic point of view, how should such recognized disagreement affect their doxastic attitude toward the original claim? Recent research on the epistemology of disagreement has converged upon three general ways of answering this question. The focus of this article is twofold: first, we summarize and give a brief evaluation of the main accounts of the epistemic significance of disagreement; then, we look at what these accounts suggest about how to epistemically assess both inter-religious and intra-religious disagreements. A final section offers recommendations for further research. [source] Clinician-Assigned and Parent-Report Questionnaire-Derived Child Psychiatric Diagnoses: Correlates and Consequences of DisagreementAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 3 2010Jesse B. Klein The objectives of this study were to determine (a) if child characteristics relate to disagreement between clinician-assigned diagnoses and diagnoses derived from parent-report questionnaire, which were available to clinicians, and (b) if disagreement predicts subsequent number of clinic visits attended. This study evaluated the odds of agreement versus disagreement for internalizing and externalizing problems as a function of child age, gender, race, public-aid status, symptom severity, and impairment among 900 children (3,19 years) in a large, urban, child psychiatry clinic. A mixed-effects regression approach was used to evaluate the relationship between disagreement and visit attendance. Internalizing problem disagreement was more likely for children who were males, older, less symptomatic, and receiving Medicaid. Externalizing problem disagreement was more likely for children who were female, older, less impaired, and less symptomatic. Internalizing disagreement predicted significantly fewer visits; externalizing disagreement did not. Clinician,parent disagreement about the nature of child problems may have clinical consequences, especially for internalizing disorders. Attention to child characteristics that predict agreement may diminish discrepancies and reduce attrition from treatment. [source] VIII,Cognitive Expressivism, Faultless Disagreement, and Absolute but Non -Objective TruthPROCEEDINGS OF THE ARISTOTELIAN SOCIETY (HARDBACK), Issue 2pt2 2010Stephen Barker I offer a new theory of faultless disagreement, according to which truth is absolute (non-relative) but can still be non-objective. What's relative is truth-aptness: a sentence like ,Vegemite is tasty' (V) can be truth-accessible and bivalent in one context but not in another. Within a context in which V fails to be bivalent, we can affirm that there is no issue of truth or falsity about V, still disputants, affirming and denying V, were not at fault, since, in their context of assertion V was bivalent. This theory requires a theory of assertion that is a form of cognitive expressivism. [source] On Law and Disagreement.RATIO JURIS, Issue 2 2003Some Comments on "Interpretative Pluralism" According to both Michelman and Waldron, the epistemic indeterminacy of interpretation,that is, the fact that principles do not possess stable meanings beyond, and independent of, their application to concrete cases,puts its finger on a point of the contractualist and prevailing political theory. But, if neither the legitimacy of any democratic order nor the standard of internal criticism can be founded on a broad background consensus on constitutional essentials, "what else makes a deliberative process of legislation and adjudication a generator of legitimacy so that citizens are induced to accept controversial results as ,worthy of respect'?" The route pursued goes beyond all views that require legitimacy to be based on sharing a set of "thick" ethical beliefs. In this perspective, the author argues that the performative meaning of constitution-making "provides a thin yet sufficiently strong base," which corresponds to the minimal requirements inherent in the very practice of framing a constitution. [source] Diagnosing Rejection in Renal Transplants: A Comparison of Molecular- and Histopathology-Based ApproachesAMERICAN JOURNAL OF TRANSPLANTATION, Issue 8 2009J. Reeve The transcriptome has considerable potential for improving biopsy diagnoses. However, to realize this potential the relationship between the molecular phenotype of disease and histopathology must be established. We assessed 186 consecutive clinically indicated kidney transplant biopsies using microarrays, and built a classifier to distinguish rejection from nonrejection using predictive analysis of microarrays (PAM). Most genes selected by PAM were interferon-,,inducible or cytotoxic T-cell associated, for example, CXCL9, CXCL11, GBP1 and INDO. We then compared the PAM diagnoses to those from histopathology, which are based on the Banff diagnostic criteria. Disagreement occurred in approximately 20% of diagnoses, principally because of idiosyncratic limitations in the histopathology scoring system. The problematic diagnosis of ,borderline rejection' was resolved by PAM into two distinct classes, rejection and nonrejection. The diagnostic discrepancies between Banff and PAM in these cases were largely due to the Banff system's requirement for a tubulitis threshold in defining rejection. By examining the discrepancies between gene expression and histopathology, we provide external validation of the main features of the histopathology diagnostic criteria (the Banff consensus system), recommend improvements and outline a pathway for introducing molecular measurements. [source] THE DEATH OF BIOETHICS (AS WE ONCE KNEW IT)BIOETHICS, Issue 5 2010RUTH MACKLIN ABSTRACT Fast forward 50 years into the future. A look back at what occurred in the field of bioethics since 2010 reveals that a conference in 2050 commemorated the death of bioethics. In a steady progression over the years, the field became increasingly fragmented and bureaucratized. Disagreement and dissension were rife, and this once flourishing, multidisciplinary field began to splinter in multiple ways. Prominent journals folded, one by one, and were replaced with specialized publications dealing with genethics, reproethics, nanoethics, and necroethics. Mainstream bioethics organizations also collapsed, giving way to new associations along disciplinary and sub-disciplinary lines. Physicians established their own journals, and specialty groups broke away from more general associations of medical ethics. Lawyers also split into three separate factions, and philosophers rejected all but the most rigorous, analytic articles into their newly established journal. Matters finally came to a head with global warming, the world-wide spread of malaria and dengue, and the cost of medical treatments out of reach for almost everyone. The result was the need to develop plans for strict rationing of medical care. At the same time, recognition emerged of the importance of the right to health and the need for global justice in health. By 2060, a spark of hope was ignited, opening the door to the resuscitation of bioethics and involvement of the global community. [source] Co-operation despite disagreement: from politics to healthcareBIOETHICS, Issue 2 2003Noam J. Zohar Political interaction among citizens who hold opposing moral views commonly requires reaching beyond toleration, toward actual co-operation with policies one opposes. On the more personal level, however, regarding (e.g.) interactions between healthcare providers and patients, several authors emphasise the importance of preserving integrity. But those who oppose any ,complicity in evil' often wrongly conflate instances in which the other's position is (and should be) totally rejected with instances of legitimate, although deep, disagreement. Starting with a striking example from the context of a particular tradition, I argue generally that in the latter sort of disagreements, talk of ,complicity' should be largely replaced with a more co-operative moral stance, grounded in a pluralistic framework. Co-operation Despite Disagreement (CDD) should be sought either for institutional reasons , akin to the political , or for relational reasons. CDD involves sharing another's perspective and sometimes calls for adopting another's moral judgements in preference to one's own. I seek to identify some of the conditions and circumstances that would justify such a shift, particularly in scenarios involving assistance, such as physician-assisted suicide (PAS) or the role of an anaesthesiologist in abortion. This discussion is meant to provide examples of the kind of second-order reasons appropriate for determining the terms for CDD , in distinction from first-order considerations (e.g., the much-contested ,active/passive' distinction) which are likely to be the subject of the initial disagreement and hence cannot serve to resolve it. [source] The reliability and validity of patient self-rating of their own voice qualityCLINICAL OTOLARYNGOLOGY, Issue 4 2005M. Lee Objectives:, To provide preliminary data on the reliability and validity of dysphonic patients rating their own voice quality. Design:, Prospective reliability/validity assessment of voice ratings in dysphonic patients. Setting:, The Royal Free Hampstead NHS Primary Care Trust. Participants:, Thirty-five adult dysphonia patients recruited from ENT referrals to a speech and language therapy department. Exclusion criteria were (i) a hearing impairment which may affect auditory discrimination and (ii) a diagnosis of cognitive impairment which may affect task comprehension. Main outcome measures:, Patient intra-rater reliability was assessed by test,retest ratings, using G (Grade), R (Rough), B (Breathy), A (Asthenic), S (Strained) (GRBAS). Validity was assessed by comparing (i) patient,clinician inter-rater reliability, (ii) patients' GRBAS ratings with their Vocal Performance Questionnaire (VPQ) responses. Result:, (i) Patients had lower intrarater reliability than clinicians (for G of GRBAS, kappa = 0.51 versus 0.74); (ii) patients consistently rated their voices more severely than clinicians (for G of GRBAS, mean rating = 1.4 versus 1.0); (iii) clinician,patient inter-rater agreement was no better than chance (paired t -test, all P < 0.05); (iv) patient ratings correlated significantly with vocal performance scores (r > 0.4, P < 0.05). Conclusions:, Patients appear to have good validity and consistency using GRBAS as a self-perception tool. However, validity measured in terms of agreement with clinician ratings is poor. Voice patients may rate what they perceive rather than what they hear. Disagreement between patient and clinician ratings has implications for therapy aims, prognosis, patient expectations and outcomes. Where disagreement persists, the clinician may have to determine whether therapy priorities need redesigning to reflect patients' perceived needs, or to evaluate whether patient perceptions and expectations are unrealistic. [source] Teaching & Learning Guide for: Moral Realism and Moral NonnaturalismPHILOSOPHY COMPASS (ELECTRONIC), Issue 3 2008Stephen Finlay Authors' Introduction Metaethics is a perennially popular subject, but one that can be challenging to study and teach. As it consists in an array of questions about ethics, it is really a mix of (at least) applied metaphysics, epistemology, philosophy of language, and mind. The seminal texts therefore arise out of, and often assume competence with, a variety of different literatures. It can be taught thematically, but this sample syllabus offers a dialectical approach, focused on metaphysical debate over moral realism, which spans the century of debate launched and framed by G. E. Moore's Principia Ethica. The territory and literature are, however, vast. So, this syllabus is highly selective. A thorough metaethics course might also include more topical examination of moral supervenience, moral motivation, moral epistemology, and the rational authority of morality. Authors Recommend: Alexander Miller, An Introduction to Contemporary Metaethics (Cambridge: Polity Press, 2003). This is one of the few clear, accessible, and comprehensive surveys of the subject, written by someone sympathetic with moral naturalism. David Brink, Moral Realism and the Foundations of Ethics (Cambridge: Cambridge University Press, 1989). Brink rehabilitates naturalism about moral facts by employing a causal semantics and natural kinds model of moral thought and discourse. Michael Smith, The Moral Problem (Oxford: Blackwell, 1994). Smith's book frames the debate as driven by a tension between the objectivity of morality and its practical role, offering a solution in terms of a response-dependent account of practical rationality. Gilbert Harman and Judith Jarvis Thomson, Moral Relativism & Moral Objectivity (Cambridge, MA: Blackwell, 1996). Harman argues against the objectivity of moral value, while Thomson defends it. Each then responds to the other. Frank Jackson, From Metaphysics to Ethics (Oxford: Clarendon Press, 1998). Jackson argues that reductive conceptual analysis is possible in ethics, offering a unique naturalistic account of moral properties and facts. Mark Timmons, Morality without Foundations (Oxford: Oxford University Press, 1999). Timmons distinguishes moral cognitivism from moral realism, interpreting moral judgments as beliefs that have cognitive content but do not describe moral reality. He also provides a particularly illuminating discussion of nonanalytic naturalism. Philippa Foot, Natural Goodness (New York, NY: Oxford University Press, 2001). A Neo-Aristotelian perspective: moral facts are natural facts about the proper functioning of human beings. Russ Shafer-Landau, Moral Realism: A Defence (New York, NY: Oxford University Press, 2003). In this recent defense of a Moorean, nonnaturalist position, Shafer-Landau engages rival positions in a remarkably thorough manner. Terence Cuneo, The Normative Web (New York, NY: Oxford University Press, 2007). Cuneo argues for a robust version of moral realism, developing a parity argument based on the similarities between epistemic and moral facts. Mark Schroeder, Slaves of the Passions (New York, NY: Oxford University Press, 2007). Schroeder defends a reductive form of naturalism in the tradition of Hume, identifying moral and normative facts with natural facts about agents' desires. Online Materials: PEA Soup: http://peasoup.typepad.com A blog devoted to philosophy, ethics, and academia. Its contributors include many active and prominent metaethicists, who regularly post about the moral realism and naturalism debates. Metaethics Bibliography: http://www.lenmanethicsbibliography.group.shef.ac.uk/Bib.htm Maintained by James Lenman, professor of philosophy at the University of Sheffield, this online resource provides a selective list of published research in metaethics. Stanford Encyclopedia of Philosophy: http://plato.stanford.edu See especially the entries under ,metaethics'. Sample Syllabus: Topics for Lecture & Discussion Note: unless indicated otherwise, all the readings are found in R. Shafer-Landau and T. Cuneo, eds., Foundations of Ethics: An Anthology (Malden: Blackwell, 2007). (FE) Week 1: Realism I (Classic Nonnaturalism) G. E. Moore, Principia Ethica, 2nd ed. (FE ch. 35). W. K. Frankena, ,The Naturalistic Fallacy,'Mind 48 (1939): 464,77. S. Finlay, ,Four Faces of Moral Realism', Philosophy Compass 2/6 (2007): 820,49 [DOI: 10.1111/j.1747-9991.2007.00100.x]. Week 2: Antirealism I (Classic Expressivism) A. J. Ayer, ,Critique of Ethics and Theology' (1952) (FE ch. 3). C. Stevenson, ,The Nature of Ethical Disagreement' (1963) (FE ch. 28). Week 3: Antirealism II (Error Theory) J. L. Mackie, ,The Subjectivity of Values' (1977) (FE ch. 1). R. Joyce, Excerpt from The Myth of Morality (2001) (FE ch. 2). Week 4: Realism II (Nonanalytic Naturalism) R. Boyd, ,How to be a Moral Realist' (1988) (FE ch. 13). P. Railton, ,Moral Realism' (1986) (FE ch. 14). T. Horgan and M. Timmons, ,New Wave Moral Realism Meets Moral Twin Earth' (1991) (FE ch. 38). Week 5: Antirealism III (Contemporary Expressivism) A. Gibbard, ,The Reasons of a Living Being' (2002) (FE ch. 6). S. Blackburn, ,How To Be an Ethical Anti-Realist' (1993) (FE ch. 4). T. Horgan and M. Timmons, ,Nondescriptivist Cognitivism' (2000) (FE ch. 5). W. Sinnott-Armstrong, ,Expressivism and Embedding' (2000) (FE ch. 37). Week 6: Realism III (Sensibility Theory) J. McDowell, ,Values and Secondary Qualities' (1985) (FE ch. 11). D. Wiggins, ,A Sensible Subjectivism' (1991) (FE ch. 12). Week 7: Realism IV (Subjectivism) & Antirealism IV (Constructivism) R. Firth, ,Ethical Absolutism and the Ideal Observer' (1952) (FE ch. 9). G. Harman, ,Moral Relativism Defended' (1975) (FE ch. 7). C. Korsgaard, ,The Authority of Reflection' (1996) (FE ch. 8). Week 8: Realism V (Contemporary Nonnaturalism) R. Shafer-Landau, ,Ethics as Philosophy' (2006) (FE ch. 16). T. M. Scanlon, What We Owe to Each Other (Cambridge, MA: Harvard University Press, 1998), ch. 1. T, Cuneo, ,Recent Faces of Moral Nonnaturalism', Philosophy Compass 2/6 (2007): 850,79 [DOI: 10.1111/j.1747-9991.2007.00102.x]. [source] A systematic review of the diagnostic classifications of traumatic dental injuriesDENTAL TRAUMATOLOGY, Issue 2 2006Karla Maria Pugliesi da Costa Feliciano Abstract,,, A systematic review of the literature was undertaken to evaluate the criteria used for the diagnostic classification of traumatic dental injuries from an epidemiological standpoint. The methodology used was that suggested by the Cochrane Collaboration and the National Health Service. A total of 12 electronic bibliographical databases (BBO, BioMed Central, Blackwell Synergy, Cochrane, DARE, EMBASE, HighWire, LILACS, MEDLINE, PubMed Central, SciELO, SciSearch) and the World Wide Web were searched. There was no attempt to specify the strategy in relation to date, study design, or language. The last search was performed in May 2003. Two reviewers screened each record independently for eligibility by examining titles, abstracts, keywords and using a standardized reference form. Disagreements were resolved through consensus. The final study collection consisted of 164 articles, from 1936 to 2003, and the population sample ranged from 38 to 210 500 patients. 54 distinct classification systems were identified. According to the literature, the most frequently used classification system was that of Andreasen (32%); as regards the type of injury, the uncomplicated crown fracture was the most mentioned lesion (88.5%). Evidence supports the fact that there is no suitable system for establishing the diagnosis of the studied injuries that could be applied to epidemiological surveys. [source] Child sexual abuse in the etiology of depression: A systematic review of reviewsDEPRESSION AND ANXIETY, Issue 7 2010Roberto Maniglio Psy.D. Ph.D. Abstract Background: Despite a large amount of research, there is considerable controversy about the role that child sexual abuse plays in the etiology of depression. To prevent interpretative difficulties, mistaken beliefs, or confusion among professionals who turn to this literature for guidance, this article addresses the best available scientific evidence on the topic, by providing a systematic review of the several reviews that have investigated the literature on the issue. Methods: Seven databases were searched, supplemented with hand search of reference lists from retrieved papers. The author and a psychiatrist independently evaluated the eligibility of all studies identified, abstracted data, and assessed study quality. Disagreements were resolved by consensus. Results: Four reviews, including about 60,000 subjects from 160 studies and having no limitations that could invalidate their results, were analyzed. There is evidence that child sexual abuse is a significant, although general and nonspecific, risk factor for depression. The relationship ranges from small-to-medium in magnitude and is moderated by sample source. Additional variables may either act independently to promote depression in people with a history of sexual abuse or interact with such traumatic experience to increase the likelihood of depression in child abuse survivors. Conclusions: For all victims of abuse, programs should focus not only on treating symptoms, but also on reducing additional risk factors. Depressed adults who seek psychiatric treatment should be enquired about early abuse within admission procedures. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Severe mental illness and criminal victimization: a systematic reviewACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2009R. Maniglio Objective:, To estimate the prevalence of criminal victimization among people with severe mental illness and to explore risk factors. Method:, Four databases (MEDLINE, ScienceDirect, ERIC, and AMED) were searched for articles published between January 1966 and August 2007, supplemented with hand-search of reference lists from retrieved papers. The author and a Medical Doctor independently abstracted data and assessed study quality. Disagreements were resolved by consensus after review of the article and the review protocol. Results:, Nine studies, including 5195 patients, were identified. Prevalence estimates of criminal victimization ranged from 4.3% to 35.04%. Rates of victimization among severely mentally ill persons were 2.3,140.4 times higher than those in the general population. Criminal victimization was most frequently associated with alcohol and/or illicit drug use/abuse, homelessness, more severe symptomatology, and engagement in criminal activity. Conclusion:, Prevention and intervention programs should target high-risk groups and improve patients' mental health and quality of life. [source] Would you like to shrink the welfare state?ECONOMIC POLICY, Issue 32 2001A survey of European citizens The fundamental problems facing European welfare states , high unemployment and unsustainable public pensions plans in particular , have been in the political debate for years, so why have we seen so little reform? To find out, we surveyed the opinions of citizens in France, Germany, Italy and Spain on their welfare states and on various reform options. This is what we found. First, most workers underestimate the costs of public pensions, though they are aware of their unsustainability. Second, the status quo is a majoritarian outcome: a majority of citizens opposes cuts to social security and welfare spending, but also opposes further increases. Since population ageing without reform implies an automatic expansion, our results suggest that most citizens would favour reforms that stabilize but do not shrink the current welfare states. Third, many would welcome changes in the allocation of benefits. A large number of workers in Italy and Germany would be willing to opt out of public pensions and replace them with private pensions, though the details of how this scheme is formulated matter for its popularity. And many Italians and Spaniards would welcome an extension of the coverage of unemployment insurance. Fourth, conflicts over the welfare state are mainly shaped by the economic situation of the respondent, while political ideology plays a limited role. Disagreements are found along three dimensions: young versus old, rich versus poor, and ,outsider' versus ,insider' in terms of labour market status. From a practical point of view, this suggests that there is scope to bundle reforms strategically in order to build a large and mixed coalition of supporters. , Tito Boeri, Axel Börsch-Supan and Guido Tabellini [source] Effectiveness of simulation on health profession students' knowledge, skills, confidence and satisfactionINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 3 2008Susan Laschinger Abstract Background, Despite the recent wave of interest being shown in high-fidelity simulators, they do not represent a new concept in healthcare education. Simulators have been a part of clinical education since the 1950s. The growth of patient simulation as a core educational tool has been driven by a number of factors. Declining inpatient populations, concerns for patient safety and advances in learning theory are forcing healthcare educators to look for alternatives to the traditional clinical encounter for skill acquisition for students. Objective, The aim of this review was to identify the best available evidence on the effectiveness of using simulated learning experiences in pre-licensure health profession education. Inclusion criteria,Types of studies: This review considered any experimental or quasi-experimental studies that addressed the effectiveness of using simulated learning experiences in pre-licensure health profession practice. In the absence of randomised controlled trials, other research designs were considered for inclusion, such as, but not limited to: non-randomised controlled trials and before-and-after studies. Types of participants: This review included participants who were pre-licensure practitioners in nursing, medicine, and rehabilitation therapy. Types of intervention(s)/phenomena of interest: Studies that evaluated the use of human physical anatomical models with or without computer support, including whole-body or part-body simulators were included. Types of outcome measures, Student outcomes included knowledge acquisition, skill performance, learner satisfaction, critical thinking, self-confidence and role identity. Search strategy, Using a defined search and retrieval method, the following databases were accessed for the period 1995,2006: Medline, CINAHL, Embase, PsycINFO, HealthSTAR, Cochrane Database of Systematic Reviews and ERIC. Methodological quality, Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using the standardised critical appraisal instruments for evidence of effectiveness, developed by the Joanna Briggs Institute. Disagreements were dealt with by consultations with a third reviewer. Data collection, Information was extracted from each paper independently by two reviewers using the standardised data extraction tool from the Joanna Briggs Institute. Disagreements were dealt with by consultation with a third reviewer. Data synthesis, Due to the type of designs and quality of available studies, it was not possible to pool quantitative research study results in statistical meta-analysis. As statistical pooling was not possible, the findings are presented in descriptive narrative form. Results, Twenty-three studies were selected for inclusion in this review including partial task trainers and high-fidelity human patient simulators. The results indicate that there is high learner satisfaction with using simulators to learn clinical skills. The studies demonstrated that human patient simulators which are used for teaching higher level skills, such as airway management, and physiological concepts are useful. While there are short-term gains in knowledge and skill performance, it is evident that performance of skills over time after initial training decline. Conclusion, At best, simulation can be used as an adjunct for clinical practice, not a replacement for everyday practice. Students enjoyed the sessions and using the models purportedly makes learning easier. However, it remains unclear whether the skills learned through a simulation experience transfer into real-world settings. More research is needed to evaluate whether the skills acquired with this teaching methodology transfer to the practice setting such as the impact of simulation training on team function. [source] | |||||||||||||||||||||||||||||||||||||