Taking reincarnation seriously: Critical discussion of some central ideas from John Hick

Reincarnation has not been entirely neglected in the philosophy of religion but it has not always been taken seriously or carefully discussed in relation to its role in believers’ lives. John Hick is exceptional insofar as he gave sustained attention to the belief, at least as it features in the philosophies of Vedānta and Buddhism. While acknowledging the value of Hick’s recognition of the variety of reincarnation beliefs, this article critically engages with certain aspects of his approach. It argues that Hick’s search for a ‘criterion’ of reincarnation is misguided, and that his distinction between ‘factual’ and ‘mythic’ forms of the doctrine is over-simplifying

Interobserver Agreement in Hepatitis C Grading and Staging and in the Banff Grading Schema for Acute Cellular Rejection: The “Hepatitis C 3” Multi-Institutional Trial Experience

Abstract Context.—Establishing adequate interobserver agreement is crucial not only for standardization of patient care but also to ensure validity of findings in multi-institutional trials. Objective.—To evaluate interobserver agreement in assessing chronic hepatitis C (HCV) and acute cellular rejection (ACR) among 17 hepatopathologists involved in the “Hepatitis C 3” trial. Design.—The trial is a randomized multicenter (17 institutions) study involving 312 patients undergoing transplantation for HCV. Patients are randomized to 3 treatment arms. For final data analysis, all biopsy specimens are reviewed by a central pathologist (G.J.N.). Recurrence of HCV is evaluated according to the Batts and Ludwig schema. The 1997 Banff schema is used to evaluate ACR. To assess interobserver agreement, hematoxylin-eosin–stained sections from 11 liver biopsy specimens (6 HCV and 5 ACR) were sent by the central pathologist to 16 local pathologists from 13 institutions. Statistical analysis was performed on raw ACR/HCV data as well as data grouped according to clinically significant primary endpoint cutoffs. Results.—Statistically significant agreement was found among all participating pathologists (P &amp;lt; .001). On κ analysis, the degree of agreement was rated “moderate” for HCV grade and stage and ACR global grading (κ = 0.30, 0.33, and 0.37, respectively). Interobserver agreement was weaker for rejection activity index scoring of ACR (κ = 0.15). A stronger degree of agreement was found when scores were grouped based on endpoint cutoffs (κ = 0.76 “almost perfect” for HCV and 0.62 “substantial” for ACR). Conclusions.—An overall statistically significant interobserver agreement was found among 17 pathologists using the 1997 Banff schema and the Batts and Ludwig schema.</jats:p

New directions in childhood obesity research: How a comprehensive biorepository will allow better prediction of outcomes

Background. Childhood obesity is associated with the early development of diseases such as type 2 diabetes and cardiovascular disease. Unfortunately, to date, traditional methods of research have failed to identify effective prevention and treatment strategies, and large numbers of children and adolescents continue to be at high risk of developing weight-related disease. Aim. To establish a unique 'biorepository' of data and biological samples from overweight and obese children, in order to investigate the complex 'gene × environment' interactions that govern disease risk. Methods. The 'Childhood Overweight BioRepository of Australia' collects baseline environmental, clinical and anthropometric data, alongside storage of blood samples for genetic, metabolic and hormonal profiles. Opportunities for longitudinal data collection have also been incorporated into the study design. National and international harmonisation of data and sample collection will achieve required statistical power. Results. Ethical approval in the parent site has been obtained and early data indicate a high response rate among eligible participants (71%) with a high level of compliance for comprehensive data collection (range 56% to 97% for individual study components). Multi-site ethical approval is now underway. Conclusions. In time, it is anticipated that this comprehensive approach to data collection will allow early identification of individuals most susceptible to disease, as well as facilitating refinement of prevention and treatment programs