Driven by technological innovations, newborn screening (NBS) panels have been expanded and the development of genomic NBS pilot programs is rapidly progressing. Decisions on disease selection for NBS are still based on the Wilson and Jungner (WJ) criteria published in 1968. Despite this uniform reference, interpretation of the WJ criteria and actual disease selection for NBS programs are highly variable. A systematic literature search [PubMED search “Wilson” AND “Jungner”; last search 16.07.22] was performed to evaluate the applicability of the (...) WJ criteria for current and future NBS programs and the need for adaptation. By at least two reviewers, 105 publications (systematic literature search, N = 77; manual search, N = 28) were screened for relevant content and, finally, 38 publications were evaluated. Limited by the study design of qualitative text analysis, no statistical evaluation was performed, but a structured collection of reported aspects of criticism and proposed improvements was instead collated. This revealed a set of general limitations of the WJ criteria, such as imprecise terminology, lack of measurability and objectivity, missing pediatric focus, and absent guidance on program management. Furthermore, it unraveled specific aspects of criticism on clinical, diagnostic, therapeutic, and economical aspects. A major obstacle was found to be the incompletely understood natural history and phenotypic diversity of rare diseases prior to NBS implementation, resulting in uncertainty about case definition, risk stratification, and indications for treatment. This gap could be closed through the systematic collection and evaluation of real-world evidence on the quality, safety, and (cost-)effectiveness of NBS, as well as the long-term benefits experienced by screened individuals. An integrated NBS public health program that is designed to continuously learn would fulfil these requirements, and a multi-dimensional framework for future NBS programs integrating medical, ethical, legal, and societal perspectives is overdue. (shrink)

A 2017 Nature report was widely touted as hailing the arrival of the artificial womb. But the scientists involved claim their technology is merely an improvement in neonatal care. This raises an under-considered question: what differentiates neonatal incubation from artificial womb technology? Considering the nature of gestation—or metaphysics of pregnancy—(a) identifies more profound differences between fetuses and neonates/babies than their location (in or outside the maternal body) alone: fetuses and neonates have different physiological and physical characteristics; (b) characterizes (...) birth as a physiological, mereological and topological transformation as well as a (morally relevant) change of location; and (c) delivers a clear distinction between neonatal incubation and ectogestation: the former supports neonatal physiology; the latter preserves fetal physiology. This allows a detailed conceptual classification of ectogenetive and ectogestative technologies according to which the 2017 system is not just improved neonatal incubation, but genuine ectogestation. But it is not an artificial womb, which is a term that is better put to rest. The analysis reveals that any ethical discussion involving ectogestation must always involve considerations of possible risks to the mother as well as her autonomy and rights. It also adds a third and potentially important dimension to debates in reproductive ethics: the physiological transition from fetus/gestateling to baby/neonate. (shrink)

This paper presents the Obstetric and Neonatal Ontology (OntONeo). This ontology has been created to provide a consensus representation of salient electronic health record (EHR) data and to serve interoperability of the associated data and information systems. More generally, it will serve interoperability of clinical and translational data, for example deriving from genomics disciplines and from clinical trials. Interoperability of EHR data is important to ensuring continuity of care during the prenatal and postnatal periods for both mother and child. (...) As a strategy to advance such interoperability we use an approach based on ontological realism and on the ontology development principles of the Open Biomedical Ontologies Foundry, including reuse of reference ontologies wherever possible. We describe the structure and coverage domain of OntONeo and the process of creating and maintaining the ontology. (shrink)

The current rise of neurodevelopmental disorders poses a critical need to detect risk early in order to rapidly intervene. One of the tools pediatricians use to track development is the standard growth chart. The growth charts are somewhat limited in predicting possible neurodevelopmental issues. They rely on linear models and assumptions of normality for physical growth data – obscuring key statistical information about possible neurodevelopmental risk in growth data that actually has accelerated, non-linear rates-of-change and variability encompassing skewed distributions. Here, (...) we use new analytics to profile growth data from 36 newborn babies that were tracked longitudinally for 5 months. By switching to incremental (velocity-based) growth charts and combining these dynamic changes with underlying fluctuations in motor performance – as the transition from spontaneous random noise to a systematic signal – we demonstrate a method to detect very early stunting in the development of voluntary neuromotor control and to flag risk of neurodevelopmental derail. (shrink)

This paper establishes a Kantian duty against screen overexposure. After defining screen exposure, I adopt a Kantian approach to its morality on the ground that Kant’s notion of duties to oneself easily captures wrongdoing in absence of harm or wrong to others. Then, I draw specifically on Kant’s ‘duties to oneself as an animal being’ to introduce a duty of self-government. This duty is based on the negative causal impact of the activities it regulates on a human being’s mental and (...) physical powers, and, ultimately, on the moral employment of these powers. After doing so, I argue that the duty against screen overexposure is an instance of the duty of self-government. Finally, I consider some objections. (shrink)

Do cinematic representations of the natural world only put us in further remove from nature? A phenomenological approach shows that nature screened can produce a richer understanding of human–nature relations as these unfold in visual contact. If vision accesses the world in a unique relationship of sight, in which our contact with the world is defined by vision prior to any other interaction, the cinema offers a special setting for a phenomenology that seeks to draw-out the significance of human relations (...) with the world of nature that come before utility or action. A detailed analysis of the opening sequence of Terrence Malick’s The New World demonstrates how the act of viewing positions the viewer in relation to what she sees. This position, prior to action and with the impossibility to act is seen here as an ethical position, a position of responsibility in the Levinasian sense. Merleau-Ponty’s phenomenology of vision is put here to use alongside the hermeneutic phenomenology of Heidegger and the existential responsibility of Levinas, while subverting Levinas’ anthropocentrism and rejecting Heidegger’s limiting view of technology. The approach taken in this essay, of bringing phenomenology into productive and reflexive interaction with ecology and with film is dubbed an “eco-film-phenomenology.”. (shrink)

Is evidential support transitive? The answer is negative when evidential support is understood as confirmation so that X evidentially supports Y if and only if p(Y | X) > p(Y). I call evidential support so understood “support” (for short) and set out three alternative ways of understanding evidential support: support-t (support plus a sufficiently high probability), support-t* (support plus a substantial degree of support), and support-tt* (support plus both a sufficiently high probability and a substantial degree of support). I also (...) set out two screening-off conditions (under which support is transitive): SOC1 and SOC2. It has already been shown that support-t is non-transitive in the general case (where it is not required that SOC1 holds and it is not required that SOC2 holds), in the special case where SOC1 holds, and in the special case where SOC2 holds. I introduce two rather weak adequacy conditions on support measures and argue that on any support measure meeting those conditions it follows that neither support-t* nor support-tt* is transitive in the general case, in the special case where SOC1 holds, or in the special case where SOC2 holds. I then relate some of the results to Douven’s evidential support theory of conditionals along with a few rival theories. (shrink)

Whereas recent commentators have suggested that consumer demand, typecasting and marketing lead performers to maintain continuities across films, I argue that cinema has historically made it difficult to subtract performers from roles, leading to relatively constant comportment, and that casting, marketing and audience preference are not only causes but also effects of this. I do so using thought experiments and empirical experiments, for example, by pondering why people say they see Jesus in paintings of him and rarely mention models, but (...) stress that they see actors when encountering photographic stills of performers portraying him. Arguably, this relates to what photographs have historically come to mean, and these meanings would make it difficult for audiences to subtract and not see the actor. Based on such thinking, along with what filmmakers have said and done, and adding to classic accounts of Cavell, Santayana and others, I build the case that cinematic media invite performers to play themselves. (shrink)

A newborn baby is an infant within the first 28 days of birth. Diagnosis and treatment of infant diseases require specialized medical resources and expert knowledge. However, there is a shortage of such professionals globally, particularly in low-income countries. To address this challenge, a knowledge-based system was designed to aid in the diagnosis and treatment of neonatal diseases. The system utilizes both machine learning and health expert knowledge, and a hybrid data mining process model was used to extract knowledge (...) from a clinical dataset. The PART algorithm achieved the highest performance result with 98.06% accuracy under 10-fold cross-validation, and the generated rules were used to develop the knowledge-based system. The system achieved 90.9% accuracy in system performance testing and 89.2% in user acceptance testing, and is intended to serve as an assistant tool for healthcare experts. (shrink)

The practice of screening potential users of reproductive services is of profound social and political significance. Access screening is inconsistent with the principles of equality and self-determination, and violates individual and group human rights. Communities that strive to function in accord with those principles should not permit access screening, even screening that purports to be a benign exercise of professional discretion. Because reproductive choice is controversial, regulation by law may be required in most jurisdictions to provide (...) effective protection for reproductive rights. In Canada, for example, equal access can, and should be, guaranteed by federal regulations imposing strict conditions on the licences of fertility clinics. (shrink)

By looking at videogame production through a two-vector model of design – a practice determined by the interplay between economic and technological evolution – we argue that shared screen play, as both collaboration and competition, originally functioned as a desirable pattern in videogame design, but has since become problematic due to industry transformations. This is introduced as an example of what we call design vestigiality: momentary loss of a design pattern’s contextual function due to techno-economical evolution.

The article proposes to model the phenomenon of the cell phone as a wall-window. This model aims at explicating some of the perceptions and experiences associated with cellular technology. The wall-window model means that the cell phone simultaneously separates the user from the physical surroundings (the wall), and connects the user to a remote space (the window). The remote space may be where the interlocutor resides or where information is stored (e.g. the Internet). Most cell phone usage patterns are modeled (...) as a single dimension according to the level of distraction or attention of the user. In order to accommodate nuanced situations such as augmented reality, I suggest a two-dimensional layout: the wall-window. The wall represents the attention to the immediate physical environment, while the window represents the attention to a remote space. The wall-window model further evolves once a screen is woven into this layout. This addition is easily understood due to the screen’s etymology, which is associated with the concepts of shield or barrier. From a technical perspective, the screen has become an integral part of the cell phone. Furthermore, a screen itself is both a wall and a window. Lastly, once a cell phone is supplemented with a screen, it is easier to refer to it as media. And again, media fits into the wall-window model. (shrink)

In “Risk Based Passenger Screening in Aviation Security: Implications and Variants of a New Paradigm”, Sebastian Weydner-Volkmann describes the current paradigm shift from ‘traditional’ forms of screening to ‘risk based passenger screening’ (RBS) in aviation security. This paradigm shift is put in the context of the wider historical development of risk management approaches. Through a discussion of Michel Foucault, Herfried Münkler and Ulrich Beck, Weydner-Volkmann analyses the shortcomings of such approaches in public security policies, which become especially (...) evident in the aviation security context. As he shows, the turn towards methods of RBS can be seen as an attempt to address a trade-off ‘trilemma’ between the effective provision of security, the implied costs for industry and passengers, and the ethical, legal and societal implications of the screening procedures. In order to analyse foreseeable outcomes of embracing RBS, he differentiates three prototypical variants of the new paradigm on the basis of their main referent and rationale. For each variant, he then subsequently assesses the implications for the ‘trilemma’, after having unveiled the criteria of analysis that will necessarily have to be followed within a serious appraisal of RBS methods. (shrink)

In the age of web 2.0, the university is constantly challenged to re-adapt its ‘old-fashioned’ pedagogies to the new possibilities opened up by digital technologies. This article proposes a rethinking of the relation between university and (digital) technologies by focusing not on how technologies function in the university, but on their constituting a meta-condition for the existence of the university pedagogy of inquiry. Following Ivan Illich’s idea that textual technologies played a crucial role in the inception of the university, we (...) will first show the structural similarities between university thinking and the text as a profanation of the book. Secondly, we describe university thinking as a type of critical thinking based on the materiality of the text-on-the-page, explaining why the text has been at the centre of university pedagogy since the beginning. In the third part, we show how Illich came to see the end of the culture of the text as a challenge for the university, by describing the new features of the text-as-code incompatible with the idea of reading as study. Finally, we challenge this pessimistic reading of Illich’s and end with a call for a profanatory pedagogy of digital technologies that could mirror the revolutionary thinking behind the mediaeval invention of the text. (shrink)

This paper sets out a novel response to the ‘screening off problem’ for naïve realism. The aim is to resist the claim (which many naïve realists accept) that the kind of experience involved in hallucinating also occurs during perception, by arguing that there are causal constraints that must be met if an hallucinatory experience is to occur that are never met in perceptual cases. Notably, given this response, it turns out that, contra current orthodoxy, naïve realists need not adopt (...) any particular view about the psychological nature of hallucinatory experience to handle the screening off problem. Consequently, room opens up for naïve realists to endorse whatever theory of hallucinatory experience seems to best capture the distinctive nature of such episodes. (shrink)

It is well known that the probabilistic relation of confirmation is not transitive in that even if E confirms H1 and H1 confirms H2, E may not confirm H2. In this paper we distinguish four senses of confirmation and examine additional conditions under which confirmation in different senses becomes transitive. We conduct this examination both in the general case where H1 confirms H2 and in the special case where H1 also logically entails H2. Based on these analyses, we argue that (...) the Screening-Off Condition is the most important condition for transitivity in confirmation because of its generality and ease of application. We illustrate our point with the example of Moore’s “proof” of the existence of a material world, where H1 logically entails H2, the Screening-Off Condition holds, and confirmation in all four senses turns out to be transitive. (shrink)

A recent study by Castellani et al. (JAMA 302(23):2573–2579, 2009) describes the population-level effects of the choices of individuals who underwent molecular carrier screening for cystic fibrosis (CF) in Veneto, in the northeastern part of Italy, between 1993 and 2007. We discuss some of the ethical issues raised by the policies and individual choices that are the subject of this study. In particular, (1) we discuss the ethical issues raised by the acquisition of genetic information through antenatal carrier testing; (...) (2) we consider whether by choosing to procreate naturally these couples can harm the resulting child and/or other members of society, and what the moral implications of such harm would be; (3) we consider whether by choosing to avoid natural procreation carrier couples can harm current or future individuals affected by cystic fibrosis; (4) we discuss whether programs that make carrier testing available can be considered eugenic programs. (shrink)

The technological virtual converges with our contemporary existence in a multitude of ways, which suggests a need to interrogate the question of the virtual existentially. Merleau-Ponty’s existential phenomenological account of embodiment is invaluable in this regard because the virtual is encountered from the basis of the facticity of the embodied individual – a facticity that is closely related to perception and motor intentionality. The current article argues that these characteristics of the body-subject should be taken into consideration in order to (...) develop a clearer description of the virtual. However, beyond an embodied account that relates to early technologies, Merleau-Ponty also presents through his concept of the flesh a novel avenue for the ontological investigation of the virtual. The flesh describes the intertwining of the body-subject and the world, which is suggestive of a new account of the individual’s sensibility in relation to the virtual. An original concept is suggested to describe the existential-ontological structure of the virtual: The embodied screen. The embodied screen as neologism presents an alternative conceptualisation of the coincidence of the body-subject (who understands the world spatially) with the virtual (as non-spatial). By tracing imaginative signification and embodied habitude in terms of the virtual, this article suggests certain existential implications of the virtual for contemporary being. (shrink)

Three common ethical principles for establishing the limits of parental authority in pediatric treatment decision making are the harm principle, the principle of best interest, and the threshold view. This paper consider how these principles apply to a case of a premature neonate with multiple significant comorbidities whose mother wanted all possible treatments, and whose health care providers wondered whether it would be ethically permissible to allow him to die comfortably despite her wishes. Whether and how these principles help to (...) understand what was morally right for the child is questioned. The paper concludes that the principles were of some value in understanding the moral geography of the case, but that the case reveals common bioethical principles for medical decision making are problematically value-laden because they are inconsistent with the widespread moral value of medical vitalism. (shrink)

The church-funded CARFO or KARFO (Afrikaans Christian Filmmaking Organisation) was established in 1947, and aimed to ‘[socialise] the newly urbanized Afrikaner into a Christian urban society’ (Tomaselli 1985:25; Paleker 2009:45). This initiative was supported and sustained by the Dutch Reformed Church (DRC), which had itself been part of the sociopolitical and ideological fabric of Afrikaans religious life for a while and would guide Afrikaners through tensions between religious conservatism and liberalism and into apartheid. Given Afrikaans cinema’s ties with Christian religious (...) and political conservatism, we explore the role – even the centrality – of the Afrikaans church in cultural activity before 1994, and then after 1994. Here, Afrikaans church is an inclusive term that brings together various denominations of Afrikaans-speaking churches, but which mainly suggests the domination of the DRC. After establishing the role of the Afrikaans church in the way described above, we move towards the primary focus of our study: exploring the representation of clergy in the contemporary Afrikaans film Faan se Trein in order to describe certain theological implications of this representation. With reference to Faan se Trein, our article notes and comments on the shifts that have occurred in clergy representation in Afrikaans cinema over the past decades. Osmer’s four tasks of practical theology, namely, descriptive, interpretive, normative and strategic are used for theological reflection. With due contextual reference to Afrikaans film dramas such as Broer Matie [Brother Matie], Saak van Geloof [A Matter of Faith], Roepman [Stargazer], Stilte [Silence], Suiderkruis [Southern Cross] and Faan se Trein, we arrive at some preliminary conclusions about the representation of clergy in mainly contemporary Afrikaans cinema. (shrink)

Ralph Ellison consistently relied on a small set of terms in order to guide his writing practice and his interpretation of literature, history, and society. Following Kenneth Burke, an acquaintance of Ellison, I call this his terministic screen. Perhaps the most important elements of Ellison’s terministic screen are consciousness–conscience and purpose–passion–perception. The first set of terms represents what he saw as our democratic obligations: the pursuit of a progressively clearer consciousness of democratic ideals and a more refined conscientiousness in pursuing (...) these ideals. The second set of terms provided a narrative framework for showing how consciousness and conscience are attained or evaded. This essay analyzes the intellectual history of these terms and how they function in Ellison’s essays and novels. Special attention is given to Ellison’s unfinished second novel. (shrink)

I argue elsewhere (Roche 2014) that evidence of evidence is evidence under screening-off. Tal and Comesaña (2017) argue that my appeal to screening-off is subject to two objections. They then propose an evidence of evidence thesis involving the notion of a defeater. There is much to learn from their very careful discussion. I argue, though, that their objections fail and that their evidence of evidence thesis is open to counterexample.

Suppose a rational agent S has some evidence E that bears on p, and on that basis makes a judgment about p. For simplicity, we’ll normally assume that she judges that p, though we’re also interested in cases where the agent makes other judgments, such as that p is probable, or that p is well-supported by the evidence. We’ll also assume, again for simplicity, that the agent knows that E is the basis for her judgment. Finally, we’ll assume that the (...) judgment is a rational one to make, though we won’t assume the agent knows this. Indeed, whether the agent can always know that she’s making a rational judgment when in fact she is will be of central importance in some of the debates that follow. (shrink)

The aim of this commentary is to discuss the axiology of the cost–benefit approach assumed by Travis Rieder (2017) to analyze medical decision making in the case of extremely preterm infants.

Domestic violence is identified across the globe as a menace as it poses a threat to the mental health of its victims, the significant others of the victim and the security of a nation at large. In some cases, the victim of domestic violence is a pregnant woman and harm is caused not only to a woman but her fetus also and this calls for urgent psychological assessment and intervention. Although there is no doubt that psychological tests are effective in (...) the assessment of domestic violence, using the psychometric properties obtained from a different population may produce generate inaccurate findings. This paper therefore attempts the validation study of Women Abuse Screening Tool (WAST) using a sample of 379 pregnant women attending antenatal clinic at the State Specialist Hospital, Osogbo, Osun State, Nigeria. The study derived a Cronbach’s Alpha Reliability of 0.758, p <.05 and a Guttman split-half coefficient of 0.683, p <.05. Furthermore, concurrent validity of Women Abuse Screening Tool (WAST) and Ongoing Abuse Screen (OAS) was established as 0.29, p<.05. The norms of the instrument were given as 2.38 for tolerable level of domestic violence and 5.79 for severe and pathological level of domestic violence. Authors conclude that Women Abuse Screening Tool has acceptable psychometric properties to justify its usage for the assessment of level of domestic violence among pregnant women in Nigeria and other nations with similar socio-cultural backgrounds. (shrink)

We argue in Roche and Sober (2013) that explanatoriness is evidentially irrelevant in that Pr(H | O&EXPL) = Pr(H | O), where H is a hypothesis, O is an observation, and EXPL is the proposition that if H and O were true, then H would explain O. This is a “screening-off” thesis. Here we clarify that thesis, reply to criticisms advanced by Lange (2017), consider alternative formulations of Inference to the Best Explanation, discuss a strengthened screening-off thesis, and (...) consider how it bears on the claim that unification is evidentially relevant. (shrink)

Background: Screen time among adults represents a continuing and growing problem in relation to health behaviors and health outcomes. However, no instrument currently exists in the literature that quantifies the use of modern screen-based devices. The primary purpose of this study was to develop and assess the reliability of a new screen time questionnaire, an instrument designed to quantify use of multiple popular screen-based devices among the US population. -/- Methods: An 18-item screen-time questionnaire was created to quantify use of (...) commonly used screen devices (e.g. television, smartphone, tablet) across different time points during the week (e.g. weekday, weeknight, weekend). Test-retest reliability was assessed through intra-class correlation coefficients (ICCs) and standard error of measurement (SEM). The questionnaire was delivered online using Qualtrics and administered through Amazon Mechanical Turk (MTurk). -/- Results: Eighty MTurk workers completed full study participation and were included in the final analyses. All items in the screen time questionnaire showed fair to excellent relative reliability (ICCs = 0.50–0.90; all < 0.000), except for the item inquiring about the use of smartphone during an average weekend day (ICC = 0.16, p = 0.069). The SEM values were large for all screen types across the different periods under study. -/- Conclusions: Results from this study suggest this self-administered questionnaire may be used to successfully classify individuals into different categories of screen time use (e.g. high vs. low); however, it is likely that objective measures are needed to increase precision of screen time assessment. (shrink)

Although digital breast tomosynthesis has higher sensitivity than digital mammography and at least as high specificity, digital mammography remains the most common method for conducting mammographic screening. At the same time, mammography systems are now delivered “DBT-ready” and can be used for either digital mammography or digital breast tomosynthesis. In this paper, we ask whether it is ethically permissible to use such equipment for digital mammography, given its lower sensitivity. We argue it is not, and that clinics are ethically (...) required to use their DBTready equipment to screen with digital breast tomosynthesis whenever this is practically possible. Our argument relies on a comparison between digital breast tomosynthesis and a hypothesized improvement in the image quality of digital mammography. (shrink)

Although there is a growing recognition that older adults and those with extensive comorbid conditions undergo cancer screening too frequently, there is little information about patients’ perceptions regarding cessation of cancer screening. Information on older adults’ views of screening cessation would be helpful both for clinicians and for those designing interventions to reduce overscreening.

While several tests and strategies are recommended for colorectal cancer (CRC) screening, studies suggest that primary care providers often recommend colonoscopy without providing information about its risks or alternatives. These observations raise concerns about the quality of informed consent for screening colonoscopy.

In an era where digital screens are as ubiquitous as the air we breathe, Toward an Anthropology of Screens by Mauro Carbone and Graziano Lingua offers a seminal exploration into screens’ crucial functions and profound impact on human culture. This scholarly work dissects the screen’s evolution, anthropological significance and philosophical implications, offering an enlightening narrative on our mediated reality.

A simple definition of consciousness is sensory awareness of the body, the self, and the world. The fetus may be aware of the body, for example by perceiving pain. It reacts to touch, smell, and sound, and shows facial expressions responding to exter- nal stimuli. However, these reactions are probably preprogrammed and have a subcortical nonconscious origin. Furthermore, the fetus is almost continuously asleep and unconscious partially due to endog- enous sedation. Conversely, the newborn infant can be awake, exhibit sensory (...) awareness, and process memorized mental representations. It is also able to differentiate between self and nonself touch, express emotions, and show signs of shared feelings. Yet, it is unreflective, present oriented, and makes little reference to concept of him/herself. Newborn infants display features characteristic of what may be referred to as basic consciousness and they still have to undergo considerable maturation to reach the level of adult consciousness. The preterm infant, ex utero, may open its eyes and establish minimal eye contact with its mother. It also shows avoidance reactions to harmful stimuli. However, the thalamocortical connections are not yet fully established, which is why it can only reach a minimal level of consciousness. (shrink)

Thesis --University of Stellenbosch, 2004 Acceptance of the concept of medical futility facilitates a paradigm shift from curative to palliative medicine, accommodating a more humane approach and avoiding unnecessary suffering in the course of the dying process. This should not be looked upon as abandoning the patient but rather as providing the patient and family with an opportunity to come to terms with the dying process. It also does not entail withdrawal or passivity on the part of the health care (...) professional. In addition to medical skills, the treating physician is responsible for guiding this process by demonstrating sensitivity and compassion, respecting the values of patients, their families and the medical staff. The need for training to equip medical staff to take responsibility as empathetic participants in end-of-life decision-making is underscored. S Afr Med J 2008; 98: 284-286. (shrink)

Some experts have argued that patients should routinely be told the specific magnitude and absolute probability of potential risks and benefits of screening tests. This position is motivated by the idea that framing risk information in ways that are less precise violates the ethical principle of respect for autonomy and its application in informed consent or shared decisionmaking. In this Perspective, we consider a number of problems with this view that have not been adequately addressed. The most important challenges (...) stem from the danger that patients will misunderstand the information or have irrational responses to it. Any initiative in this area should take such factors into account and should consider carefully how to apply the ethical principles of respect for autonomy and beneficence. (shrink)

The vision of legendary criminologist Cesare Lombroso to use scientific theories of individual causes of crime as a basis for screening and prevention programmes targeting individuals at risk for future criminal behaviour has resurfaced, following advances in genetics, neuroscience and psychiatric epidemiology. This article analyses this idea and maps its ethical implications from a public health ethical standpoint. Twenty-seven variants of the new Lombrosian vision of forensic screening and prevention are distinguished, and some scientific and technical limitations are (...) noted. Some lures, biases and structural factors, making the application of the Lombrosian idea likely in spite of weak evidence are pointed out and noted as a specific type of ethical aspect. Many classic and complex ethical challenges for health screening programmes are shown to apply to the identified variants and the choice between them, albeit with peculiar and often provoking variations. These variations are shown to actualize an underlying theoretical conundrum in need of further study, pertaining to the relationship between public health ethics and the ethics and values of criminal law policy. (shrink)

The shift from print to screen has bodily effects on how we read. We distinguish two dimensions of embodied reading: the spatio-temporal and the imaginary. The former relates to what the body does during the act of reading and the latter relates to the role of the body in the imagined scenarios we create from what we read. At the level of neurons, these two dimensions are related to how we make sense of the world. From this perspective, we explain (...) how the bodily activity of reading changes from print to screen. Our focus is on the decreased material anchoring of memories. (shrink)

Research on the folk psychology of free will suggests that people believe free will is incompatible with determinism and that human decision-making cannot be exhaustively characterized by physical processes. Some suggest that certain elements of Western cultural history, especially Christianity, have helped to entrench these beliefs in the folk conceptual economy. Thus, on the basis of this explanation, one should expect to find three things: (1) a significant correlation between belief in dualism and belief in free will, (2) that people (...) with predominantly incompatibilist commitments are likely to exhibit stronger dualist beliefs than people with predominantly compatibilist commitments, and (3) people who self-identify as Christians are more likely to be dualists and incompatibilists than people who do not self-identify as Christians. We present the results of two studies (n = 378) that challenge two of these expectations. While we do find a significant correlation between belief in dualism and belief in free will, we found no significant difference in dualist tendencies between compatibilists and incompatibilists. Moreover, we found that self-identifying as Christian did not significantly predict preference for a particular metaphysical conception of free will. This calls into question assumptions about the relationship between beliefs about free will, dualism, and Christianity. (shrink)

Background: Liver cancer is one of the malignant tumors worldwide, while the prevention and control situation is grim at present, and the diffusion of its early screening technology still faces some challenges. This study aims to investigate the influencing mechanism of perceived ease of use, organizational support mechanism, and industry competitive pressure on hepatic early screening technologies use by physicians, so as to promote the wider use of corresponding technologies. -/- Methods: Under the theoretical guidance of technology-organization-environment framework (...) and mindsponge theory, this study took hepatic contrast-enhanced ultrasound as an example, and conducted a cross-sectional questionnaire by randomly selecting physicians from Fujian and Jiangxi provinces in China with a high and low incidence of liver cancer, respectively. Structural equation modeling was used to determine the correlation among perceived ease of use, organizational support mechanism, and industry competitive pressure, as well as their impact on the physicians’ behavior toward contrast-enhanced ultrasound use. -/- Results: The hypothesis model fits well with the data (χ2/df = 1.863, GFI = 0.937, AGFI = 0.908, RMSEA = 0.054, NFI = 0.959, IFI = 0.980, CFI = 0.980). Under technology-organization-environment framework, the perceived ease of use (β = 0.171, p < 0.05), organizational support mechanism (β = 0.423, p < 0.01), industry competitive pressure (β = 0.159, p < 0.05) significantly influenced physicians’ use of hepatic contrast-enhanced ultrasound. Besides, perceived ease of use and organizational support mechanism (β = 0.216, p < 0.01), perceived ease of use and industry competitive pressure (β = 0.671, p < 0.01), organizational support mechanism and industry competitive pressure (β = 0.330, p < 0.01) were all associated significantly. -/- Conclusion: From the lens of information processing (mindsponge theory) and technology-organization-environment framework, this study clarified the social and psychological influencing mechanism of perceived ease of use, organizational support mechanism, and industry competitive pressure on physicians’ use of hepatic contrast-enhanced ultrasound. The results will directly propose recommendations for expanding hepatic contrast-enhanced ultrasound utilization and indirectly promoting other appropriate and effective health technologies diffusion within the integrated health system. (shrink)

The issue of climate change poses an important problem that requires immediate collaboration from everyone, including individuals, governments, and businesses. While consumption culture constitutes a significant proportion of greenhouse gas emissions, most of these emissions are caused by the consumption of the wealthiest. In this article, we will explore the challenges that consumer culture has exacerbated regarding climate change and propose that transitioning to a simpler and more sustainable lifestyle could be an effective solution in the fight against climate change. (...) Such transitions can be leveraged through the inspiration of celebrities (e.g., Keanu Reeves, Chow Yun-fat, Kristen Bell, Leonardo DiCaprio) that pursue simple, non-glamorous lifestyles that do not promote excessive consumerism. (shrink)

Background The purpose of this study was to examine whether extended use of a variety of screen-based devices, in addition to television, was associated with poor dietary habits and other health-related characteristics and behaviors among US adults. The recent phenomenon of binge-watching was also explored. -/- Methods A survey to assess screen time across multiple devices, dietary habits, sleep duration and quality, perceived stress, self-rated health, physical activity, and body mass index, was administered to a sample of US adults using (...) the Qualtrics platform and distributed via Amazon Mechanical Turk (MTurk). Participants were adults 18 years of age and older, English speakers, current US residents, and owners of a television and at least one other device with a screen. Three different screen time categories (heavy, moderate, and light) were created for total screen time, and separately for screen time by type of screen, based on distribution tertiles. Kruskal-Wallis tests were conducted to examine differences in dietary habits and health-related characteristics between screen time categories. -/- Results Aggregate screen time across all devices totaled 17.5 h per day for heavy users. Heavy users reported the least healthful dietary patterns and the poorest health-related characteristics – including self-rated health – compared to moderate and light users. Moreover, unique dietary habits emerged when examining dietary patterns by type of screen separately, such that heavy users of TV and smartphone displayed the least healthful dietary patterns compared to heavy users of TV-connected devices, laptop, and tablet. Binge-watching was also significantly associated with less healthy dietary patterns, including frequency of fast-food consumption as well as eating family meals in front of a television, and perceived stress. -/- Conclusions The present study found that poorer dietary choices, as well as other negative health-related impacts, occurred more often as the viewing time of a variety of different screen-based devices increased in a sample of US adults. Future research is needed to better understand what factors among different screen-based devices might affect health behaviors and in turn health-related outcomes. Research is also required to better understand how binge-watching behavior contributes impacts health-related behaviors and characteristics. (shrink)

An important question in the current debate on the epistemic significance of peer disagreement is whether evidence of evidence is evidence. Fitelson argues that, at least on some renderings of the thesis that evidence of evidence is evidence, there are cases where evidence of evidence is not evidence. I introduce a condition and show that under this condition evidence of evidence is evidence.

This paper analyzes ethical issues relating to lawyer mobility.

MEMS is a structural technology, an example of the design and development of sophisticated, well integrated electronics systems and mechanical devices utilizing single-stage manufacturing techniques . Techniques for making the MEMS enables the components and equipment with performance and increased production are combined with the advantages of the ordinary, such as reducing the size of the physical volume, weight and cost and providing a basis for the production of non-manufacturing methods, the other is the reality of internal order Technology MEMS (...) and its micro-machining techniques are well versed in its application to an unprecedented range of MEMS devices over previous dependent fields (for example Biology and Microelectronics) These agents make MEMS far more comprehensive than IC microchips technology . (shrink)

The switch to online education that occurred during the Corona pandemic brought to the fore questions about the value and desirability of a fully online university. This article explores to what extent is a fully online university desirable from an educational perspective, whereby education is seen as a valuable experience taken in itself, regardless of its output. I start from the hypothesis that a fundamental dimension of study practices at the university is the experience of collective thinking triggered by specific (...) material and social arrangements. I proceed to describe material conditions for triggering thinking in terms of what I call mediatic displacement, which is a way of integrating media into educational practices that enables a fluctuating type of attention. The paper concludes by arguing that we need to develop new technologies for online education and train our attention deliberately for online environments by establishing new protocols for dealing with the digital scattering of attention. (shrink)