Defining ethical challenge(s) in healthcare research: a rapid review

Background Despite its ubiquity in academic research, the phrase ‘ethical challenge(s)’ appears to lack an agreed definition. A lack of a definition risks introducing confusion or avoidable bias. Conceptual clarity is a key component of research, both theoretical and empirical. Using a rapid review methodology, we sought to review definitions of ‘ethical challenge(s)’ and closely related terms as used in current healthcare research literature. Methods Rapid review to identify peer-reviewed reports examining ‘ethical challenge(s)’ in any context, extracting data on definitions of ‘ethical challenge(s)’ in use, and synonymous use of closely related terms in the general manuscript text. Data were analysed using content analysis. Four databases (MEDLINE, Philosopher’s Index, EMBASE, CINAHL) were searched from April 2016 to April 2021. Results 393 records were screened, with 72 studies eligible and included: 53 empirical studies, 17 structured reviews and 2 review protocols. 12/72 (17%) contained an explicit definition of ‘ethical challenge(s), two of which were shared, resulting in 11 unique definitions. Within these 11 definitions, four approaches were identified: definition through concepts; reference to moral conflict, moral uncertainty or difficult choices; definition by participants; and challenges linked to emotional or moral distress. Each definition contained one or more of these approaches, but none contained all four. 68/72 (94%) included studies used terms closely related to synonymously refer to ‘ethical challenge(s)’ within their manuscript text, with 32 different terms identified and between one and eight different terms mentioned per study. Conclusions Only 12/72 studies contained an explicit definition of ‘ethical challenge(s)’, with significant variety in scope and complexity. This variation risks confusion and biasing data analysis and results, reducing confidence in research findings. Further work on establishing acceptable definitional content is needed to inform future bioethics research.

What is behavior? No seriously, what is it?

Studying 'behavior' lies at the heart of many disciplines. Nevertheless, academics rarely provide an explicit definition of what 'behavior' actually is. What range of definitions do people use, and how does that vary across disciplines? To answer these questions we have developed a survey to probe what constitutes 'behavior'. We find that academics adopt different definitions of behavior according to their academic discipline, animal model that they work with, and level of academic seniority. Using hierarchical clustering, we identify at least six distinct types of 'behavior' which are used in seven distinct operational archetypes of 'behavior'. Individual respondents have clear consistent definitions of behavior, but these definitions are not consistent across the population. Our study is a call for academics to clarify what they mean by 'behavior' wherever they study it, with the hope that this will foster interdisciplinary studies that will improve our understanding of behavioral phenomena.

Encoding polylexical units with TEI Lex-o: A case study

The modelling and encoding of polylexical units, i.e. recurrent sequences of lexemes that are perceived as independent lexical units, is a topic that has not been covered adequately and in sufficient depth by the Guidelines of the Text Encoding Initiative (TEI), a de facto standard for the digital representation of textual resources in the scholarly research community. In this paper, we use the Dictionary of the Portuguese Academy of Sciences as a case study for presenting our ongoing work on encoding polylexical units using TEI Lex-0, an initiative aimed at simplifying and streamlining the encoding of lexical data with TEI in order to improve interoperability. We introduce the notion of macro- and microstructural relevance to differentiate between polylexicals that serve as headwords for their own independent dictionary entries and those which appear inside entries for different headwords. We develop the notion of lexicographic transparency to distinguish between those units which are not accompanied by an explicit definition and those that are: the former are encoded as <form>–like constructs, whereas the latter becomes <entry>–like constructs, which can have further constraints imposed on them (sense numbers, domain labels, grammatical labels etc.). We codify the use of attributes on <gram> to encode different kinds of labels for polylexicals (implicit, explicit and normalised), concluding that the interoperability of lexical resources would be significantly improved if dictionary encoders would have access to an expressive but relatively simple typology of polylexical units.

Introduction

This is the Introduction to the book. It introduces the four parts of the book: a prolegomenon discussing different ways one might travel in time; a discussion of some of the paradoxes of time travel; a discussion of the most important paradox—the Grandfather Paradox—and its proposed resolutions; and finally, a discussion of what the world would be like were the chosen response to the Grandfather Paradox, ‘Impossability Theory’, true. This Introduction also includes a discussion about defining ‘time travel’ and why the chapter declines to offer an explicit definition.

THE WORLD OUTSIDE THE WINDOW: THE PREFACE TO THE TRANSLATION OF THE ARTICLE “DEFENESTRATION” BY MARС RICHIR

This paper is a presentation of Russian translation of the article « La Défenestration » (1971) by Marc Richir. In this paper we depict the philosophical context in which the article was written and define its place in the totality of Richir’s works. Our main goal is to help the reader to understand the features of Richir’s complex thought and to give explicit definition to the term “defenestration.” The defenestration, understood as a philosophical concept, is a process of reconsideration of major phenomenological presuppositions. Thus, we distinguish three main steps of defenestration basing on Richir’s critique of previous phenomenologists: 1) the abolition of the transcendental ego as a structure external to “the world”; 2) the rejection of the universe of beings as the one and only universe people inhabit (moreover, such a universe of beings should not be anymore considered as homogenous space of representation); 3) rethinking the phenomenalisation on the basis of “nothing” (rien) as a primary universe and, therefore, overcoming the classical dualism of the sensible and the intelligible. We conclude that by analyzing systems of previous philosophers through the concept of defenestration Richir in this early work determines the direction of his future philosophical research.

OPERADIC APPROACH TO COHOMOLOGY OF ASSOCIATIVE TRIPLE AND N-TUPLE SYSTEMS

The cup product in the cohomology of algebras over quadratic operads has been studied in the general setting of Koszul duality for operads. We study the cup product on the cohomology of n-ary totally associative algebras with an operation of even (homological) degree. This cup product endows the cohomology with the structure of an n-ary partially associative algebra with an operation of even or odd degree depending on the parity of n. In the cases n=3 and n=4, we provide an explicit definition of this cup product and prove its basic properties.

Gravitational Energy in Newtonian Gravity: A Response to Dewar and Weatherall

The paper investigates the status of gravitational energy in Newtonian Gravity (NG), developing upon recent work by Dewar and Weatherall. The latter suggest that gravitational energy is a gauge quantity. This is potentially misleading: its gauge status crucially depends on the spacetime setting one adopts. In line with Møller-Nielsen’s plea for a motivational approach to symmetries, we supplement Dewar and Weatherall’s work by discussing gravitational energy–stress in Newtonian spacetime, Galilean spacetime, Maxwell-Huygens spacetime, and Newton–Cartan Theory (NCT). Although we ultimately concur with Dewar and Weatherall that the notion of gravitational energy is problematic in NCT, our analysis goes beyond their work. The absence of an explicit definition of gravitational energy–stress in NCT somewhat detracts from the force of Dewar and Weatherall’s argument. We fill this gap by examining the supposed gauge status of prima facie plausible candidates—NCT analogues of gravitational energy–stress pseudotensors, the Komar mass, and the Bel-Robinson tensor. Our paper further strengthens Dewar and Weatherall’s results. In addition, it sheds more light upon the subtle link between sufficiently rich inertial structure and the definability of gravitational energy in NG.

Defining undertreatment and overtreatment in older patients with cancer: A scoping review of the literature.

e23020 Background: The terms “undertreatment” and “overtreatment” are often used to describe the management of older adults with cancer. The aim of this scoping review was to explore the explicit and implicit definitions associated with the use of these terms. Methods: We searched PubMed (NCBI), Embase (Elsevier), and CINAHL (EBSCO) for titles and abstracts that included the terms "undertreatment" or "overtreatment" (overtreat OR undertreat OR over treat OR under treat) of older adults with cancer. We included all types of articles, cancers, and treatments. We excluded studies that only included patients younger than 60 years old or studies without a defined focus on older adults. CD and KL independently reviewed a subset of included articles to assess for inter-reviewer reliability. Results: We identified 224 primary and secondary research articles that used the terms “undertreatment” (192), “overtreatment” (72), or both (45) regarding the management of older adults with cancer. Only 14 (6.3%) articles provided an explicit definition; for the remaining articles, we derived the implicit definitions from the terms’ surrounding context. There was substantial agreement between CD and KL in their interpretation of definitions of these terms (kappa 0.81). “Undertreatment” was commonly used to imply less than “standard” therapy (130 articles, 67.7%), or less than “standard” therapy that contributed to worse outcomes (62, 32.3%). Many articles did not account for the underrepresentation of older adults in trials leading to “standard” therapy, and 24 primary studies performed no or limited adjustment for geriatric domains (e.g., function) in their analyses that suggested worse survival in older adults treated with substandard therapy. “Overtreatment” was commonly used to imply cancer treatment in an older adult whose cancer would not have caused symptoms in his/her remaining lifetime (31, 43.1%), or aggressive treatment in whom the harms of treatment outweigh its benefits (41, 56.9%). Conclusions: Nearly all articles used the terms “undertreatment” and/or “overtreatment” without an explicit definition, and we identified variability and limitations in the meanings implied by these terms.