Asymmetric Dimethylarginine Is Associated with the Phenomenon of Coronary Slow Flow in Patients with Nonvalvular Atrial Fibrillation.

INTRODUCTION: Coronary slow flow phenomena (CSFP) are associated with endothelial and blood component abnormalities in coronary arteries. Asymmetric dimethylarginine (ADMA) can damage the endothelium of the heart or blood vessels in patients with non-valvular atrial fibrillation (NVAF), causing changes in levels of biological indicators. Our aim was to analyze the relationship between ADMA and CSFP in NVAF patients. METHODS: We consecutively enrolled 134 patients diagnosed with NVAF and underwent coronary angiography, 50 control patients without a history of atrial fibrillation and with normal coronary angiographic flow were included at the same time. Based on the corrected TIMI frame count (CTFC), the NVAF patients were categorized into two groups, CTFC ≤27 frames and CTFC >27 frames. Plasma ADMA, P-selectin (p-sel), von Willebrand factor (vWF), D-dimer (D-Di), plasminogen activator inhibitor 1 (PAI-1), and nitric oxide (NO) were detected by ELISA in the different groups. RESULTS: We found that plasma ADMA levels were significantly higher among NVAF patients in the CTFC >27 grade group compared with the control or CTFC ≤27 group. In addition, the levels of blood cells and endothelium-related biomarkers (NO, P-selectin, vWF, D-Di, and PAI-1) were significantly altered and correlated with ADMA levels. Multifactorial analysis showed that plasma ADMA (odd ratio [OR; 95% CI]: 1.65 [1.21-2.43], p < 0.001) and left atrial internal diameter (OR [95% CI]: 1.04 [1.02, 1.1], p < 0.001) could be used as independent risk factors for the development of CSFP in patients with NVAF. The ROC curves of ADMA can predict the development of CSFP in NVAF patients. The minimum diagnostic concentration for the development of CSFP in patients was 2.31 µmol/L. CONCLUSION: Our study demonstrated that CSFP in NVAF patients was associated with high levels of ADMA and left atrial internal diameter. Therefore, aggressive preoperative detection and evaluation of ADMA and left atrial internal diameter can help deal with the intraoperative presence of CSFP.

A comparative analysis of the doctoral regulations at the medical faculties in Germany.

Objective: In order to be allowed to use the title "Dr. med." in Germany, an independent scientific achievement under the supervision of an established scientist is necessary. The research question, analysis and results are essentially carried out and developed independently by the doctoral student. The doctorate serves as proof that the doctoral candidate is capable of independent academic work. The acquisition of scientific skills and knowledge is of particular importance in medicine, as Germany´s international competitiveness is based on the education of today´s young academics. Fair conditions and uniform quality standards for doctoral studies are therefore indispensable to attract future young scientists at an early stage. Methods: The currently valid doctoral regulations of the medical faculties in Germany were analysed with regards to the following target criteria; update date, dissertation language, possibility of publication-based dissertation and its details (number of first and total authorships, publication organ), knowledge of methods and consideration of "Good Medical Practice" (GMP), plagiarism check, review process and disputation. Results: All faculties with the right to award doctorates, and, thus 40 valid regulations were included in the analysis. This revealed a great divergence in the requirements for doctoral candidates. Although a publication-based doctorate is now possible at 93% (n=37) of the faculties, in addition to the monographic dissertation, the required first and total authorships vary from one required first authorship (n=26, 70%) to two or three first authorships (n=5, 14%), as well as some faculties having no information regarding the number of publications (n=6, 16%). The quality of the publication organ was not described in detail in seven faculties (19%). To ensure quality, requirements have increasingly been anchored in the regulations, so that 22 regulations (56%) now stipulate participation in courses on GMP or qualification programmes. The regulations leave a lot of room for manoeuvre in terms of content and do not allow for comparability of the conditions for preparing doctoral researchers. The specifications range from mere mention, to instruction, to compulsory course participation. Another means of quality assurance is the prevention of plagiarism through the applications of software systems. However, this simple and effective means is not yet mentioned in 65% of the regulations (n=26). While the other regulations make use of this possibility, it is not an obligatory application. A total of 34 regulations provide for the regular drawing up of a supervision agreement to define the rights and obligations of the actors involved. Conclusion: The analysis showed a divergent picture. Although imprecise regulations or gaps in information allow scope for design, they also prevent transparency. Despite revisions of many regulations in the past, these revisions have not led to any significant harmonisation. The implementation of standardised and structured doctoral programmes is desirable and could be tackled within the framework of the planned amendment of medical studies. This opens up the possibility of dealing efficiently with the scarce resource of time in the face of competing curriculum content and of making a doctoral project more attractive to potential young scientists at an early stage.

Conscientious refusal or conscientious provision: We can't have both.

Some authors argue that it is permissible for clinicians to conscientiously provide abortion services because clinicians are already allowed to conscientiously refuse to provide certain services. Call this the symmetry thesis. We argue that on either of the two main understandings of the aim of the medical profession-what we will call "pathocentric" and "interest-centric" views-conscientious refusal and conscientious provision are mutually exclusive. On pathocentric views, refusing to provide a service that takes away from a patient's health is professionally justified because there are compelling reasons, based on professional standards, to refuse to provide that service (e.g., it does not heal, and it is contrary to the goals of medicine). However, providing that same service is not professionally justified when providing that service would be contrary to the goals of medicine. Likewise, the thesis turns out false on interest-centric views. Refusing to provide a service is not professionally justified when that service helps the patient fulfill her autonomous preferences because there are compelling reasons, based on professional standards, to provide that service (e.g., it helps her achieve her autonomous preferences, and it would be contrary to the goals of medicine to deny her that service). However, refusing to provide that same service is not professionally justified when refusing to provide that service would be contrary to the goals of medicine. As a result, on either of the two most plausible views on the goals of medicine, the symmetry thesis turns out false.

Being effective and supervising for thesis success in nursing coursework master degrees: A qualitative descriptive study.

BACKGROUND: Master's degrees for nurses have various foci including clinical practice, leadership and education, with some programs consisting of coursework, while others offer hybrid study that combines coursework and research. Multiple formats are associated with offering the research component. The research component is often termed the minor thesis. Limited knowledge exists regarding the supervision of the research component. AIM(S): To capture the practices and perspectives of experienced nurse academics regarding effective supervision of the masters-level minor thesis in nursing coursework master degrees. THE STUDY: Design Qualitative descriptive. Methods Semi-structured interviews with 28 experienced nurse academics recruited from 15 Australian and three New Zealand universities linked to the Council of Deans in Australia and New Zealand. Inclusion criteria were having experience of supervising masters-level minor theses and higher degrees. Interviews were face-to-face using the internet platform Zoom©. Thematic analysis was undertaken. Findings The analysis revealed three themes and associated sub-themes: (i) establishing the framework (setting up the student's research; building the student-supervisor relationship; setting clear expectations), (ii) supervisors' knowledge and actions: driving for success (supervisors' knowledge for a satisfactory and timely outcome; supervisors' actions to develop students' capabilities; supervisors' actions of drawing in other expertise) and (iii) supervisor savviness: Attending to the finer points of supervision for student success (using your attributes as a supervisor; being savvy to teach and engage students; creatively seeking a smooth process for student success). CONCLUSION: The findings highlight three themes crucial to effective supervision of masters-level minor theses in nursing: Establishing a strong research framework, emphasizing supervisors' knowledge and proactive engagement and attending to nuanced aspects of supervision for student success. These insights contribute to deeper understanding of the multifaceted nature of supervising minor theses, providing a valuable foundation for refining supervisory practices and enhancing the educational experience within coursework nursing master degree programs. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The findings highlight the supervisors' pivotal practices in guiding students through the minor thesis. These insights will be useful for inexperienced and experienced supervisors and for degree program directors. The findings should inform supervision training and supervision practices in the future. IMPACT: The study addressed a gap in knowledge about what experienced supervisors do to be effective and achieve success in the research component in a hybrid master degree for registered nurses. Effective supervision for student success in the minor thesis requires supervisors to establish and maintain a project and supervisory framework with appropriate boundaries and that is attuned to both the supervisor and student capabilities and preferences. Supervisors have an active role in directing the focus, scale and scope of a minor theses in keeping with university requirements and the short timeframe. Supervisors pay attention to the development of multiple student literacies (research, academic, professional, feedback and cultural) as core aspects of the masters research journey. Supervisors use their savviness and customize supervision to student contexts and capabilities as they guide development to achieve student success. The research findings have implications for targeted supervisor training and enhancing educational strategies for research supervision of minor thesis students. REPORTING METHOD: COREQ reporting was adhered to as the relevant EQUATOR guideline. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

A visionary platform for decolonization: The Red Deal.

In this study, we discuss the colonial project as an eliminatory structure of indigenous ways of knowing and doing that is built into Canadian social and health institutions. We elaborate on the role nursing plays in maintaining systemic racism, marginalization and discrimination of Indigenous Peoples. Based on historical practices and present-day circumstances, we argue that changing language in research and school curriculums turns decolonization into what Tuck and Yang call a 'metaphor'. Rather, we propose decolonization as a political project where nurses acknowledge their involvement in colonial harms and disrupt the assumptions that continue to shape how nurses interact with Indigenous people, including knowledge systems that perpetuate colonial interests and privilege. Decolonization requires nurses to understand the colonial practices that led to dispossession of land, erasure of knowledge, culture and identity, while upholding indigenous ways of knowing and doing in health, healing and living. As a political manifesto that liberates indigenous life from oppressive structures of colonialism and capitalism, The Red Deal is presented as a visionary platform for decolonization. The aim of this study is to articulate three dimensions of caretaking within The Red Deal as a framework to decolonize nursing knowledge development and practice. Based on the philosophical dimension embedded in The Red Deal that revoke norms and knowledge assumptions of capitalism that destroy indigenous ways of knowing and doing, we underscore an approach toward decolonizing nursing. Our approach rejects the apolitical nature of nursing as well as the unilateral western scientific knowledge approach to knowledge development and recognition. A critical emancipatory approach that addresses the socio-political and historical context of health care, recognizes dispossession of land and adopts a 'multilogical' vision of knowledge that gives space for representation and voice is needed for true decolonization of nursing.

Mary Hesse on the role of the human imagination in the philosophy and practice of science.

Although Mary Hesse remains an influential figure within the history of the philosophy of science her reflections on the role of the human imagination in science have, to date, been mostly neglected. In her first, and often overlooked monograph-Science and the Human Imagination-Hesse described the imagination as composed of four dimensions. Defined as the historical, the critical, the fertile and the creative imagination, these dimensions played, for Hesse, various roles in both the philosophy and practice of science. Suffice to say, Hesse's discussion of the role of the imagination in science challenges the idea that philosophy and science are logically determined forms of practice through an appeal, as will be argued, to Immanuel Kant's seminal reflections on the 'indispensable function' of the imagination. Accordingly, a detailed elucidation of Science and the Human Imagination not only situates Hesse's reflections within the long history of the philosophy of the imagination; it revitalises anew contemporary debates on the role of the imagination in the philosophy and practice of science.

Responding to historical injustices: Collective inheritance and the moral irrelevance of group identity.

I argue that changes in the numerical identity of groups do not necessarily speak in favour of the supersession of some historical injustice. I contend that the correlativity between the perpetrator and the victim of injustices is not broken when the identity of groups changes. I develop this argument by considering indigenous people's claims in Argentina for the injustices suffered during the Conquest of the Desert. I argue that present claimants do not need to be part of the same entity whose members suffered injustices many years ago. For identifying the proper recipients of reparation, all that is necessary is that the group who suffered the historical injustice under consideration has survived into the present. I also support a view upon which present living members of a certain group have reasons to redress those injustices perpetrated by their predecessors if they are relevantly connected with each other. In particular, by relying on the notion of collective inheritance, I argue that if present-day members of a certain group claim that they are the continuation of the group whose past members bequeathed them certain goods, they cannot consistently reject such a membership when the very same people legated them certain evils.

Identification of alternative topics to diversify medicine, dentistry, and pharmacy student theses: a mixed method study.

INTRODUCTION: The impact of medicine, dentistry, and pharmacy student theses on public health is a crucial concern for policymakers in medical science universities. If student theses correspond to the needs of society, they can significantly affect students' scientific and practical abilities and lead to the provision of more efficient health services. This study aimed to identify alternative topics to diversify medicine, dentistry, and pharmacy student theses. METHODS: This mixed method study with an exploratory sequential design was conducted at Kerman University of Medical Science from February to June 2021. The qualitative component entailed a focus group of faculty members (n = 16) and students (n = 4) to extract alternative topics to diversify medicine, dentistry, and pharmacy student theses. The quantitative component included a questionnaire based on emerging subjects and literature review to evaluate the extracted alternative topics. Qualitative data were analyzed using conventional content analysis and quantitative data were analyzed descriptively. RESULTS: A total of 20 key participants took part in the focus group meeting, and from 20 questionnaires, 15 were returned with a response rate of 75%. A list of 18 alternative topics was generated and five categories were identified: individual development, research, education, healthcare, and social services. CONCLUSIONS: The gap between what we know and what is seen in practice is quite large in medical and health-related professions. Alternative topics for medicine, dentistry, and pharmacy student theses contribute to turning knowledge into practice.

Does the 'Educational Alliance' conceptualize the student - supervisor relationship when conducting a master thesis in medicine? An interview study.

BACKGROUND: Completing a master thesis (MT) is mandatory in many undergraduate curricula in medicine but a specific educational framework to guide the supervisor-student relationship during the MT has not been published. This could be helpful to facilitate the MT process and to more effectively reach the learning objectives related to science education in medicine. An attractive model for this purpose is the 'Educational Alliance' (EA), which focusses on the three components 'clarity and agreement on (a) goals, (b) tasks and (c) relationship & roles'. This study investigated factors that can either facilitate or hinder the process of MTs, and related these to the components of the EA. METHODS: We conducted semi-structured face-to-face interviews with 20 students and - separately - with their 20 corresponding supervisors, after the MT had been accepted. The interviews included open questions on factors facilitating or hindering the success of the MT. Audio recordings of the interviews were anonymized and transcribed, and then analysed by qualitative content analysis. Also, quantitative data were gathered on satisfaction with the MT process and the supervisory quality (using Likert-type questions). RESULTS: We were able to analyse all 40 interviews, related to 20 MTs. From the transcripts, we extracted 469 comments related to the research question and categorized these into the four main categories (a) 'Preparation', (b) 'Process', (c) 'Atmosphere', (d) 'Value of the MT'. Interviewees highlighted the importance of a careful preparation phase, clear expectations, a clear research plan, thorough and timely feedback, mutual agreement on timelines, and a positive working atmosphere. Each of these factors could be brought in line with the three components of the EA framework: agreement and clarity of goals, tasks, relationships & roles. Satisfaction with the MT process was rated 8.75 ± 1.22 SD (of 10) points by supervisors, and 7.80 ± 1.61 SD points by students, while supervision quality was rated + 1.51 ± 0.63 SD (scale from - 2 to + 2) by supervisors, and + 1.26 ± 0.93 SD by students. CONCLUSION: We propose the EA framework as a useful guidance for students, supervisors, and the university towards conducting successful MTs in medicine. Based on the findings, we provide specific recommendations for students, supervisors, and university.

The same everywhere? Exploring structural homologies of national social fields using the case of journalism.

Pierre Bourdieu argued for the existence of general properties and even laws of social fields. In contrast to spaces of class relations and patterns of cultural lifestyles, however, almost no systematic comparative research exists on the homologies of national social fields of a more specialised nature. Also, the large majority of research is done on Western countries, raising concerns about the relevance of the concept for less differentiated societies. Using the field of journalism as a case, typical structures of 67 national fields (n = 27,567) are in this article investigated using a reverse approach: First, the subjective spaces of journalists' experienced constraints and imperatives in their jobs are sketched as a proxy for field structure using variants of multiple correspondence analysis, and second, the distribution of the social and professional properties of journalists are used to suggest capital structures. The results suggest great stability in the fundamental organising principles of fields of journalism around the world, although with considerable variation in their autonomy.

Counterpossibles in science: an experimental study.

A counterpossible is a counterfactual whose antecedent is impossible. The vacuity thesis says all counterpossibles are true solely because their antecedents are impossible. Recently, some have rejected the vacuity thesis by citing purported non-vacuous counterpossibles in science. One limitation of this work, however, is that it is not grounded in experimental data. Do scientists actually reason non-vacuously about counterpossibles? If so, what is their basis for doing so? We presented biologists (N = 86) with two counterfactual formulations of a well-known model in biology, the antecedents of which contain what many philosophers would characterize as a metaphysical impossibility. Participants consistently judged one counterfactual to be true, the other to be false, and they explained that they formed these judgments based on what they perceived to be the mathematical relationship between the antecedent and consequent. Moreover, we found no relationship between participants' judgments about the (im)possibility of the antecedent and whether they judged a counterfactual to be true or false. These are the first experimental results on counterpossibles in science with which we are familiar. We present a modal semantics that can capture these judgments, and we deal with a host of potential objections that a defender of the vacuity thesis might make.

The many histories of the conflict thesis: the science vs. religion narrative in nineteenth-century Germany.

The idea of an inevitable conflict between science and religion leading to relentless hostility between the two emerged in the nineteenth century and has become a powerful narrative of modernity. Most historians of science trace the origins of the so-called 'conflict thesis' to the English-speaking world, more precisely to scientist-historian John William Draper and literary scholar Andrew Dickson White. Their books on the history of scientific-religious conflict turned into bestsellers. Yet, if we look beyond the Anglo-American world, the conflict thesis appears in new historical settings. This paper argues that the science vs. religion narrative flourished already in Germany before Draper and White announced the warfare between science and religion in England and the USA. Focusing on Germany, we aim to show that the conflict thesis emerged in a polycentric process shaped by various political, cultural, and social struggles. It became a rhetorical weapon for liberal scientists in Germany to oppose Ultramontanism and, at the same time, to discredit their rivals as unscientific, fanatic, or even as 'henchmen' of the Pope. Our paper makes a case for a decentred approach to the history of the conflict thesis, which brings to the fore specific political and cultural tensions shaping this narrative in the nineteenth century.

An RNA-based theory of natural universal computation.

Life is confronted with computation problems in a variety of domains including animal behavior, single-cell behavior, and embryonic development. Yet we currently do not know of a naturally existing biological system that is capable of universal computation, i.e., Turing-equivalent in scope. Generic finite-dimensional dynamical systems (which encompass most models of neural networks, intracellular signaling cascades, and gene regulatory networks) fall short of universal computation, but are assumed to be capable of explaining cognition and development. I present a class of models that bridge two concepts from distant fields: combinatory logic (or, equivalently, lambda calculus) and RNA molecular biology. A set of basic RNA editing rules can make it possible to compute any computable function with identical algorithmic complexity to that of Turing machines. The models do not assume extraordinarily complex molecular machinery or any processes that radically differ from what we already know to occur in cells. Distinct independent enzymes can mediate each of the rules and RNA molecules solve the problem of parenthesis matching through their secondary structure. In the most plausible of these models all of the editing rules can be implemented with merely cleavage and ligation operations at fixed positions relative to predefined motifs. This demonstrates that universal computation is well within the reach of molecular biology. It is therefore reasonable to assume that life has evolved - or possibly began with - a universal computer that yet remains to be discovered. The variety of seemingly unrelated computational problems across many scales can potentially be solved using the same RNA-based computation system. Experimental validation of this theory may immensely impact our understanding of memory, cognition, development, disease, evolution, and the early stages of life.

The theoretical and practical arguments against the unilateral withdrawal of life-sustaining treatment during crisis standards of care: Does the Knobe effect apply to unilateral withdrawal?

Some argue that it is ethically justifiable to unilaterally withdraw life-sustaining treatment during crisis standards of care without the patient's consent in order to reallocate it to another patient with a better chance of survival. This justification has been supported by two lines of argument: the equivalence thesis and the rule of the double effect. We argue that there are theoretical issues with the first and practical ones with the second, as supported by an experiment aimed at exploring whether the Knobe effect, which affects the folk concept of intention, applies to situations of unilateral withdrawal. Fifty-two critical care physicians from one university were asked to ascribe intention in two hypothetical scenarios A and B in which outcomes differ-the patient from whom life-sustaining treatment is withdrawn dies in scenario A but survives in scenario B-but the intention, to save the other patient regardless of the outcome of the other, is the same. The survey was administered via a web-based survey and all answers were anonymous. A paired proportion test was used to compare responses to both questions. All 52 surveyed individuals responded in scenario A and 30 (57.7%) ascribed intention when outcomes were unfavorable, whereas 50 responded in scenario B and 8 (16%) ascribed intention when outcomes were favorable, a difference that was statistically significant (p < 0.001). There are theoretical and practical issues with the arguments proposed to justify the unilateral withdrawal of life-sustaining treatment based on the equivalence thesis and the rule of double effect.

Withdrawing or withholding treatments in health care rationing: an interview study on ethical views and implications.

BACKGROUND: When rationing health care, a commonly held view among ethicists is that there is no ethical difference between withdrawing or withholding medical treatments. In reality, this view does not generally seem to be supported by practicians nor in legislation practices, by for example adding a 'grandfather clause' when rejecting a new treatment for lacking cost-effectiveness. Due to this discrepancy, our objective was to explore physicians' and patient organization representatives' experiences- and perceptions of withdrawing and withholding treatments in rationing situations of relative scarcity. METHODS: Fourteen semi-structured interviews were conducted in Sweden with physicians and patient organization representatives, thematic analysis was used. RESULTS: Participants commonly express internally inconsistent views regarding if withdrawing or withholding medical treatments should be deemed as ethically equivalent. Participants express that in terms of patients' need for treatment (e.g., the treatment's effectiveness and the patient's medical condition) withholding and withdrawing should be deemed ethically equivalent. However, in terms of prognostic differences, and the patient-physician relation and communication, there is a clear discrepancy which carry a moral significance and ultimately makes withdrawing psychologically difficult for both physicians and patients, and politically difficult for policy makers. CONCLUSIONS: We conclude that the distinction between withdrawing and withholding treatment as unified concepts is a simplification of a more complex situation, where different factors related differently to these two concepts. Following this, possible policy solutions are discussed for how to resolve this experienced moral difference by practitioners and ease withdrawing treatments due to health care rationing. Such solutions could be to have agreements between the physician and patient about potential future treatment withdrawals, to evaluate the treatment's effect, and to provide guidelines on a national level.

Research supervisors' views of barriers and enablers for research projects undertaken by medical students; a mixed methods evaluation of a post-graduate medical degree research project program.

BACKGROUND: Medical degree programs use scholarly activities to support development of basic research skills, critical evaluation of medical information and promotion of medical research. The University of Sydney Doctor of Medicine Program includes a compulsory research project. Medical student projects are supervised by academic staff and affiliates, including biomedical science researchers and clinician-academics. This study investigated research supervisors' observations of the barriers to and enablers of successful medical student research projects. METHODS: Research supervisors (n = 130) completed an anonymous, online survey after the completion of the research project. Survey questions targeted the research supervisors' perceptions of barriers to successful completion of projects and sources of support for their supervision of the student project. Data were analysed by descriptive statistics and using manifest content analysis. Further quantitative investigation was made by cross-tabulation according to prior research supervision experience. RESULTS: Research supervisors reported that students needed both generic skills (75%) and research-based skills (71%) to successfully complete the project. The major barrier to successful research projects was the lack of protected time for research activities (61%). The assessment schedule with compulsory progress milestones enabled project completion (75%), and improved scientific presentation (90%) and writing (93%) skills. Supervisors requested further support for their students for statistics (75%), scientific writing (51%), and funding for projects (52%). Prior research supervision experience influenced the responses. Compared to novice supervisors, highly experienced supervisors were significantly more likely to want students to be allocated dedicated time for the project (P < 0.01) and reported higher rates of access to expert assistance in scientific writing, preparing ethics applications and research methodology. Novice supervisors reported higher rates of unexpected project delays and data acquisition problems (P < 0.05). Co-supervision was favoured by experienced supervisors but rejected by novice supervisors. CONCLUSIONS: Both generic and research-related skills were important for medical student research project success. Overall, protected research time, financial and other academic support were identified as factors that would improve the research project program. Prior research supervision experience influences perceptions of program barriers and enablers. These findings will inform future support needs for projects and research supervisor training for the research supervision role.

How to Deal with Counter-Examples to Common Morality Theory: A Surprising Result.

Tom Beauchamp and James Childress are confident that their four principles-respect for autonomy, beneficence, non-maleficence, and justice-are globally applicable to the sorts of issues that arise in biomedical ethics, in part because those principles form part of the common morality (a set of general norms to which all morally committed persons subscribe). Inevitably, however, the question arises of how the principlist ought to respond when presented with apparent counter-examples to this thesis. I examine a number of strategies the principlist might adopt in order to retain common morality theory in the face of supposed counter-examples. I conclude that only a strategy that takes a non-realist view of the common morality's principles is viable. Unfortunately, such a view is likely not to appeal to the principlist.

Williamson on indicatives and suppositional heuristics.

Timothy Williamson has defended the claim that the semantics of the indicative 'if' is given by the material conditional. Putative counterexamples can be handled by better understanding the role played in our assessment of indicatives by a fallible cognitive heuristic, called the Suppositional Procedure. Williamson's Suppositional Conjecture has it that the Suppositional Procedure is humans' primary way of prospectively assessing conditionals. This paper raises some doubts on the Suppositional Procedure and Conjecture.

The Critical Theory of World Risk Society: A Retrospective Analysis.

In terms of the evolution of sociological theory, it is difficult to overstate the impact of Risk Society: Towards a New Modernity. Aside from achieving voluminous sales and mass citations, the book is one of few academic monographs that can lay claim to transforming the ways in which people understand the world and their own experiences within it. The major hypothesis of author Ulrich Beck is that a fundamental shift has occurred in capitalist economies from a focus on the material production of goods to avoidance of "bads." Crucially, while social science thinkers had previously sought to understand the foundational dynamics of society with recourse to established categories-such as class, gender, economy, and power-Beck postulated that the key contours of the modern age were best understood through the prism of risk. Despite revolving around the concept of risk, Beck's work has not influenced the field of risk research as heavily as one might expect. In line with the ambitions of this special issue, this article contextualizes and situates the contribution made by Beck and connects his thesis to the broader evolution of risk theory over the last four decades. In documenting both catalytic effects and elisions, an appeal is made for reconsideration of the utility of the risk society perspective for future work in risk studies.

Faculty perceptions of factors that indicate successful educational outcomes of medical students' research projects: a focus group study.

BACKGROUND: A growing number of medical schools have individual scholarly projects as a component of their curricula. The fact that all students, and not only those with research interests, have to carry out a project puts high demands on the projects and their supervision. Evidence is lacking for how to produce scholarly projects with satisfactory outcomes. This study aimed to explore the observations of faculty teachers regarding factors that predict the educational outcomes of medical students' scholarly projects. METHODS: Two focus group interviews were held with seven of the 16 faculty coordinators who were external reviewers of students' research projects. The audio-recorded interview transcripts were analyzed using qualitative content analysis. We employed a constant comparative approach to create categories firmly grounded in the participants' experiences. A successful project was defined as coordinators' perception that the stated learning outcomes were achieved, in terms of students' ability to demonstrate a scientific attitude. RESULTS: Five categories emerged from the data: Supervision, Project setup, Student characteristics, Curriculum structure, and Institutional guidance. The supervisors' experience and availability to students were mentioned as key factors for successful outcomes. Further, a clear aim and adaptation to the time frame were stated to be project-related factors that were also supervisors' responsibilities. Important student-related factors were skills related to scientific writing, taking ownership of and managing the projects, and making use of feedback. Finally, the course requirements, support, and control accomplished by faculty coordinators played important roles. CONCLUSIONS: Contributing factors to achievement of the learning outcomes were supervisors' commitment and experience, and the projects being suitable for the time frame and having a clearly stated research question. Furthermore, the students' prowess at scientific writing, adequate handling of feedback, and ability to assume ownership of the project contributed to the final outcome, as did adherence to curricular instructions.