Epistemic Schmagency?

Constructivist approaches in epistemology and ethics offer a promising account of normativity. But constructivism faces a powerful Schmagency Objection, raised by David Enoch. While Enoch’s objection has been widely discussed in the context of practical norms, no one has yet explored how the Schmagency Objection might undermine epistemic constructivism. In this paper, I rectify that gap. First, I develop the objection against a prominent form of epistemic constructivism, Belief Constitutivism. Belief Constitutivism is susceptible to a Schmagency Objection, I argue, because it locates the source of normativity in the belief rather than the agent. In the final section, I propose a version of epistemic constructivism that locates epistemic normativity as constitutive of agency. I argue that this version has the resources to respond to the Schmagency Objection

Updated guidelines, updated curriculum: The GAISE College Report and introductory statistics for the modern student

Since the 2005 American Statistical Association's (ASA) endorsement of the Guidelines for Assessment and Instruction in Statistics Education (GAISE) College Report, changes in the statistics field and statistics education have had a major impact on the teaching and learning of statistics. We now live in a world where "Statistics - the science of learning from data - is the fastest-growing science, technology, engineering, and math (STEM) undergraduate degree in the United States," according to the ASA, and where many jobs demand an understanding of how to explore and make sense of data. In light of these new reports and other changes and demands on the discipline, a group of volunteers revised the 2005 GAISE College Report. The updated report was endorsed by the Board of Directors of the American Statistical Association in July 2016. To help shed additional light on the revision process and subsequent changes in the report, we review the report and share insights into the committee's thoughts and assumptions.Comment: in press, CHANC

Concerns about medication and medication adherence in patients with chronic pain recruited from general practice

This study examines the concerns and beliefs about medication reported by patients with nonmalignant chronic pain encountered within general practice. Two hundred thirty-nine patients with chronic pain took part in this research. Patients completed the Pain Medication Attitudes Questionnaire, a measure of patient concerns and beliefs relating to addiction, withdrawal, side effects, mistrust in doctors, perceived need of medication, scrutiny from others, and tolerance. The data revealed that patient concerns and beliefs predicted general medication nonadherence. In addition, concerns were related to the direction of nonadherence: overuse of medication was related to increased perceived need for medication and greater concern over side effects; underuse was related to decreased concerns over withdrawal and increased mistrust in the prescribing doctor. Analyses also indicated that patient attitudes and concerns about medication were more predictive of nonadherence than both level of pain and the reported frequency of experienced side effects. This research contributes to the increasing evidence that patient attitudes and beliefs about pain medication are associated with adherence behavior. Training general practitioners to identify and address these concerns may reduce concerns, improve adherence, and facilitate the doctor-patient relationship

Bereavement through substance use: findings from an interview study with adults in England and Scotland

Background Deaths associated with alcohol and/or drugs belong to a category of ‘special’ deaths due to three characteristics: traumatic circumstances of the death, stigma directed to both the bereaved and the deceased, and resulting disenfranchised grief experienced by the bereaved. These factors can impede those who are bereaved in this way from both grieving and accessing support. In response to a lack of research in this area this paper reports on an interview study that has aimed to better understand the experiences and needs of this neglected group of bereaved people. Method Interviews with 106 adults (parents, children, spouses, siblings, nieces and friends) bereaved through substance use in Scotland and England. Results Five themes describe interviewee experiences: possibility of death, official processes, stigma, grief and support. These findings suggest what is dominant or unique in this group of bereaved people; namely, that living with substance use (including anticipatory grief), experiencing the subsequent death (often traumatic and stigmatised) and the responses of professionals and others (more likely negative than positive) can disenfranchise grief and negatively impact bereavement and seeking support. Conclusions This article describes a large and unique sample, the largest in the world to be recruited from this population. Our study raises awareness of a hitherto largely ignored and marginalised group of bereaved people, highlighting what might be particular to their bereavement experience and how this may differ from other bereavements, thereby providing an evidence base for improving the availability, level and quality of support. © 2016 Taylor & Franci

Electrotunable nanoplasmonic liquid mirror

Recently, there has been a drive to design and develop fully tunable metamaterials for applications ranging from new classes of sensors to superlenses among others. Although advances have been made, tuning and modulating the optical properties in real time remains a challenge. We report on the first realization of a reversible electrotunable liquid mirror based on voltage-controlled self-assembly/disassembly of 16 nm plasmonic nanoparticles at the interface between two immiscible electrolyte solutions. We show that optical properties such as reflectivity and spectral position of the absorption band can be varied in situ within ±0.5 V. This observed effect is in excellent agreement with theoretical calculations corresponding to the change in average interparticle spacing. This electrochemical fully tunable nanoplasmonic platform can be switched from a highly reflective ‘mirror’ to a transmissive ‘window’ and back again. This study opens a route towards realization of such platforms in future micro/nanoscale electrochemical cells, enabling the creation of tunable plasmonic metamaterials

Anterior cruciate ligament injuries of the knee: Patterns of association between the mechanism of injury and pathology visualised on magnetic resonance imaging

Background: Anterior cruciate ligament (ACL) injuries are common among athletes and the general public. These injuries may lead to significant absence from all activities with associated financial and social burdens for the patient. No definitive association has been described between the mechanism of injury and the pathology to enable the implementation of preventative measures to limit these injuries.Aim: To determine whether there is an association between the mechanism of injury and the pathology seen on a magnetic resonance imaging (MRI) scan in ACL injuries.Methods: This was a cross-sectional analytical study. Eighty-seven male patients with an ACL injury and who had an MRI scan of the knee within the last two years participated in this study. Participants were contacted to give their informed consent to participate in this study. The mechanism of injury and the pathology seen on the MRI scan was noted and categorised into different groups of injuries and associated pathologies. Statistical analyses included summaries of the data and a test for the association between the mechanism of injury and the pathology. Since there were multiple pathology responses to each mechanism, a modified version of the chi-square test for independence was used. A five percent level of significance was specified.Results: MRI scans of ACL injuries indicated that the mechanism of a solid foot plant with rotation of the knee has a greater tendency to be associated with medial meniscal injuries (77%). There was also a 54% possibility for it to be associated with lateral meniscal injuries. A solid foot plant with a valgus stress on the knee showed a higher incidence of associated medial collateral ligament (MCL) injuries (41%) and femoral bone bruising (62%). These two mechanisms of injury are the most common in ACL injuries and contribute to the clinical significance found in this study. The p-value was, however, not statistically significant (p=0.44, chi-square value=20.27, df=45) for any association between the pathology and the mechanism of injury.Conclusion: Some injury mechanisms causing an ACL injury were more common than others and had more associated pathologies. The most common mechanism of injury noted in this study was a solid foot plant with either rotation of the knee or valgus stress on the knee. Strengthening the tissue structures involved in those movement patterns causing these mechanisms can possibly limit future ACL injuries in athletes and the general public.Keywords: knee injury, mechanism, association, pathology, MRI scan, preventio

The Validity of a New Low-Dose Stereoradiography System to Perform 2D and 3D Knee Prosthetic Alignment Measurements

INTRODUCTION:The EOS stereoradiography system has shown to provide reliable varus/valgus (VV) measurements of the lower limb in 2D (VV2D) and 3D (VV3D) after total knee arthroplasty (TKA). Validity of these measurements has not been investigated yet, therefore the purpose of this study was to determine validity of EOS VV2D and VV3D. METHODS:EOS images were made of a lower limb phantom containing a knee prosthesis, while varying VV angle from 15° varus to 15° valgus and flexion angle from 0° to 20°, and changing rotation from 20° internal to 20° external rotation. Differences between the actual VV position of the lower limb phantom and its position as measured on EOS 2D and 3D images were investigated. RESULTS:Rotation, flexion or VV angle alone had no major impact on VV2D or VV3D. Combination of VV angle and rotation with full extension did not show major differences in VV2D measurements either. Combination of flexion and rotation with a neutral VV angle showed variation of up to 7.4° for VV2D; maximum variation for VV3D was only 1.5°. A combination of the three variables showed an even greater distortion of VV2D, while VV3D stayed relatively constant. Maximum measurement difference between preset VV angle and VV2D was 9.8°, while the difference with VV3D was only 1.9°. The largest differences between the preset VV angle and VV2D were found when installing the leg in extreme angles, for example 15° valgus, 20° flexion and 20° internal rotation. CONCLUSIONS:After TKA, EOS VV3D were more valid than VV2D, indicating that 3D measurements compensate for malpositioning during acquisition. Caution is warranted when measuring VV angle on a conventional radiograph of a knee with a flexion contracture, varus or valgus angle and/or rotation of the knee joint during acquisition