User:Oliveoilandgarlic/sandbox

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This is my sandbox! Here I play with Wikicode and write things before they're ready to go elsewhere.

structured by disciplines[edit]

Dementia group of related symptoms associated with a gradual decline in brain functioning <nhs website>. There is currently considerable concern about it's exponentially increasing prevelence in due to the ageing population. <science direct from talk intro> The euthanasia of dementia patients is a peticularly contencious issue as it brings up issues

Ethics[edit]

Given the declining role of religion as a supplier and upholder of moral values in western society, medicine and law have been given increasingly more responsibilities in building society-wide value systems {ref from mcgill study} and upholding the strong enough societal consensus on which healthcare and a trustworthy medical law can be built. The case of euthanasia or physician assisted suicide, medical ethicists have had to increasingly approach the issue secularly and provide arguments that reconcile the continually conflicting values of the right to life, self-determination, dignity, and the power of the state. As it is practiced wholly theoretically, and is not bounded by overarching codes or goals, an ethical exploration is able to subsume the biases that could impair an approach by medics or legal scholars. As such, the ethical arguments for and against euthanasia reach only for the four axioms of formal Ethics[gensler] and for the basic values of the ethicist and those who share them. While lending the discipline apparent [ref] impartiality, Ethics’ lack of a uniform approach has done little to attack the underlying dilemma since the 19th century, though our understanding of the practical and moral consequences of each of the values, once agreed upon, has been well developed [ref]. As many ethical arguments (and popular movements advocating) for euthanasia in general stipulate terminal illness as a necessary condition, many progressive debilitating conditions, like dementia are excluded. Thus, dementia patients, who are very often unable to make legally competent decisions, also excluding them from the necessary condition of informed, competent consent, are left out by ethicists ‘strong’ arguments. Legally, even in countries most permissive of physician assisted suicide in particular The Netherlands, many dementia patients would have no recourse but clauses such as the proposed, but not legalised, “Over 70 and Tired of Life” petition [ref].

Practically, the ethical approach to dementia patients who are believed to want to die, whether or not such a desire is recognised legally, has been reduced to

In Ethics, patients of dementia who are believed to want to die, whether or not such a desire is recognised legally, have been excluded from arguments based on long prognoses, infirm mental capacities, and in proposed laws, by not being old enough. Practically it can be argued that medicine has been more effective in

ethics is bad at dealing with dementia and euthanasia because of the fact that d3mentia patients cant give competent consent and are not terminally ill. more practically medicine is able to deal with these patients because many doctors are already practicing it because they are 'double dosing' and using the doctrine of double effect to practice euthanasia. Ethics is limited by its lack of grounding (only axioms are personal values) and so is unable to crystalline a consensus that a healthcare or legal system can be based on.

Medicine[edit]

Medicine as a Discipline[edit]

“Medicine is the science or practice of the diagnosis, treatment, and prevention of disease”[1]. It primarily draws upon quantitative evidence, such as randomised controlled trials (RCTs) and systematic review, which are designed to remove any forms of bias[2]. This objectivity, coupled with medicine's inherent focus on saving and prolonging life[3], makes its empirical approach to euthanasia and dementia one that often meets tension with other disciplines that are more holistic, or grounded in axiology.[4]

QALY[edit]

Quality Adjusted Life Years (QALY) "is routinely used as a summary measure of health outcome for economic evaluation, which incorporates the impact on both the quantity and quality of life."(5) It is a large, useful part of medical economics that allows for the objective comparison of diseases, populations and programs(6), and guides the distribution of healthcare resources. Due to the objective, quantitative nature of its evidence, QALY inevitably favours those in a better position to benefit, and is often criticised by other disciplines for its systematic discrimination against the ageing and disabled. (7)(8) This is especially true in dementia patients, who then face both the stigmatisation of their condition, and financial pressures to carry out their "special duty to die".(9)(10) We must also consider whether the experience of life can be adequately represented by numerical evidence.

The Biomedicalisation of Dementia[edit]

The medical diagnosis of dementia involves cognitive and neuropsychological tests, lab tests, brain scans, psychiatric evaluation, and genetic tests (11). These procedures generate the quantitative evidence that medicine's highly biomedical focus is grounded in. Medicine pays little attention to social or psychological factors, viewing what was once a natural part of ageing as a medical problem, rather than the group of symptoms that dementia is.(12)(13) This biomedicalisation of dementia has led to pressures for timely diagnosis and rapid transition into care programs (14)- programs that are undoubtedly important, but that create a sense of fatalism around the condition, perhaps contributing to many people's decisions to request for euthanasia.

Interdisciplinary Tensions[edit]

Where medicine is a discipline largely centred on objective evidence, ethics draws from qualitative, subjective evidence. This creates inevitable interdisciplinary tension when it comes to the euthanasia of dementia patients. Medicine centres around the culture of "[dedication] completely to life under all circumstances.”(15), as shown in Rurup et al's study that found that physicians were far less likely to demonstrate tolerant behaviour towards life terminating attitudes (16%) in comparison to nurses (57%) and relatives (90%). (16) This tension plays out in the quality of life debate.

The quality-of-life approach to euthanasia believes that a person with dementia should be granted euthanasia when they feel their life is not worth living. Evidence for quality of life is purely subjective, varying from person to person, leaving vulnerable dementia patients at risk of having different values projected onto them by the people around them. In line with this ethical perspective, and in contrast to that of medicine, our palliative care should focus not so much on the protection of life, but of the autonomy of the patient.(16)

Sociology[edit]

Sociology is the science of society; the study of the collective aspects of human behaviour and the dynamics of the groups and organisations that make it up.[5][6] It's demographic, relational, and experiential focus and the complexity of the systems it investigates lead to a greater focus on qualitative data and the use of hypothetical frameworks than many of the other disciplines addressing dementia and euthanasia.[6][7] There are two major branches that generate tension with other disciplines in the sociological work on dementia and euthanasia.

The Experience of the Community[edit]

First, there is a tension between the perspective of individualist ethicists and a significant portion of the sociological literature adressing this issue. This can be understood in terms of ethics drawing on the evidence of subjective experience that suggests that decisions are autonomous and should therefore be respected, paying less attention to the influences on their decisions than sociology.[citation needed] By definition sociology finds the comonalites between the behaviour and experience of individuals based on their demographic groups, and is therefore concerned with the influences on decision making and the effects of those decisions associated with a group as a whole. [6][5][7]

Although many of the relevant studies are published in medical journals, the value of their sociological approach in adding to the medical and ethical discussion is evident. In these studies some important conclusions are drawn which contrast with the individualist ethical naratives. Several studies explore the effects of euthanasia and dementia on the experiences of family members, suggesting that euthanasia may decrease the levels of grief, trauma and depression experienced.[8][9][10] Roest (2019) conducted a study which found that despite the legal, ethical and medical narratives suggesting otherwise, family relations and values played a key role in both physician and patient decisions regarding assisted suicide, especially relevantly it is suggested that the suffering that may be experienced by the patients family should be considered, questioning the individualist narrative of autonomy and the primacy of the individual.[11][citation needed]

Social Construction[edit]

The second branch explores the issue through a social constructionist framework, looking at the cultural, social and demographic factors that impact the prevelence and perception of the disease. This approach leads to a view of dementia very much at odds with the prevailing medical view by studying the experience of living with dementia as an intersection of demographic class and the concept and symptoms of dementia itself.[12][13][11] Due to this wider evidential pool and understanding dementia as socially constructed by medical classifications and media presentation, Johnstone (2013) and others argue that the stigma and fear around the ageing process has been generated by the biomedicalisation of dementia leads to the depersonalisation of patients.[14][15][16] This combined with the literature showing how dementia prevelence and the suffering of patients is increased by low economic status and experiences of descrimination has lead to considerable concern that allowing the euthanasia of dementia patients would become discriminatory.[13][17][18][19]

Beard (2017) encapsulates the tensions between this view and that of the medical community as an unresolved dichotomy between the medical view of dementia as a pesemistic 'black hole of aging', drawing paralells to the living dead archetype, in contrast to the sociological literature presenting the possibity of living and ageing well despite the disease. They also critisise the neglect of research into the social factors and management of the disease in preference of finding a cure.[15] This tension is the result of the different forms of evidence the two disciplines are exposed to and value. Sociology studies individuals with dementia across the course of the disease and by dividing them by demographics and gathering qualititive evidence sees the affects of thier position in society and subjective experience on the course of the disease and the wider benefits and risks of allowing them euthanasia.[13][18][19] Medicine on the other hand focuses on the quantitively measurable indicators of the disease and physical causes proposing corresponding interventions that may extend the life of a patient, often focussing on the later stages of the disease with little regard for their personal experience or social situation. There is, however, an encouraging movement towards holistic care and incorperation of sociological methods and evidence throughout the medical journals studying dementia and euthanasia as can be seen in many of the citations in this section.

[20]

References[edit]

Sociological Perspective[edit]

Sociology is the science of society, the study of the collective aspects of human behavior and the dynamics of the groups and organisations that make it up. It's collective, relational and experiential focus and the complexity of the systems it investigates leads to a greater focus on qualititive data and the use of hypothetical frameworks than many of the other disciplines adressing dementia and euthanasia.

The sociological work on dementia tends to explore

experience of carers and family and how this interacts with the experience of patients https://academic.oup.com/gerontologist/article/59/5/e597/5033595 the affects of race and class on dementia prevelance, experience and treatement https://journals.sagepub.com/doi/full/10.1177/1039856219878645 the affectiveness of care from an experiencial perspective https://journals.sagepub.com/doi/full/10.1177/0269216311423443 https://journals.sagepub.com/doi/pdf/10.1191/0969733002ne554oa


there is also a considerable amount of literature critisizing the 'biomedicalization' of humans and their incorperation into the economy in reference to the allocation of medical resources and euthanasia

(oliveoilandgarlic)

Topic Sentance[edit]

Sociology is the science of society: the study of the collective aspects of human behavior and the dynamics of the groups and organisations that make it up. https://onlinelibrary.wiley.com/doi/pdf/10.1002/%28SICI%291520-6696%28199610%2932%3A4%3C379%3A%3AAID-JHBS4%3E3.0.CO%3B2-M https://www.britannica.com/topic/sociology It's collective and relational focus, as well as its interest in human experience focus and the complexity of the systems and causal relationships it studies leads to a greater focus on qualititive data and the use of hypothetical frameworks than other disciplines. https://www.jstor.org/stable/2096141?seq=1 https://www.britannica.com/topic/sociology DONE What is the consensus stance on euthanasia and dementia in sociology?

https://academic.oup.com/gerontologist/article/59/5/e597/5033595 meta analysis of 26 studies on the experience of carers of people with dementia, found that up to 80% of carer's experience depression. but that the literature is unclear as to a causal relationship. this highlights the sociological focus on human experience and relations etc

what is the DALY measure for dementia? are DALY's more the work of sociology, economics or medicine?

what is the distribution of dementia acrosses the divisions between groups sociology draws?

https://jamanetwork.com/journals/jamaneurology/article-abstract/2729093 economic status as well of health are greater predictors of dementia than race or culture. This is thought to be due to access to education and nutrition as well as healthcare.

https://journals.sagepub.com/doi/full/10.1177/0269216311423443 meta analysis of qualitive research conducted in the uk into the transition into paliative care (the closest thing to euthanasia that exists in the uk) for dementia patients, highlights the lack of the 'long view' in the medical community, also a failure to except that dementia might be a cause of death in it's own right was noted, as patients usually die from complications or accidents caused by the disease rather than the disease itself.

How is sociology defined? DONE

Google definition:

-the study of the development, structure, and functioning of human society.
-the study of social problems.

Encyclopedia Britannica https://www.britannica.com/topic/sociology

-studies the dynamics of society by looking at its organisations and drawing division within it, looking at the interactions between these parts.
-studies the "collective aspects of human behaviour" especially looking at the way an individual's group influences their behaviour


Methods and Evidence[edit]

What types of evidence are prioritised in sociology and how are they wieghted? DONE Encyclopedia Britannica https://www.britannica.com/topic/sociology :

-ecological patterning - the way groups, behaviour, wealth, industry and land value change over time and relate to one another
Experimental methods - observing social interactions in controlled enviroments,


https://www.jstor.org/stable/2096141?seq=1 an analysis of the uncertainties around this issue and the confusion interaction between theory and evidence in the evidence's interpretation, mentions as a side point the importance of statistical methods and computing in sociology.

What theoretical frameworks and axiomatic assumptions are used to interpret this data? especially in reference to euthanasia in dementia.

How do tensions form?[edit]

Differences in evidence, assumptions and interpretation? - maybe best summerised once we have the methods and evidence section for all the disciplines

https://journals.sagepub.com/doi/pdf/10.1191/0969733002ne554oa this study interviewing carers at one hospital found that carer's understoon dementia patients decision to starve but thier moral and ethical beliefs hampered them in respecting patients autonomy.

Examples of direct clashes or contrasting quotes[edit]

note: assess how sociological these papers and articles actually are

points, there is a considerable push back against the 'biomedicalization' of human being in the sociological literature https://onlinelibrary.wiley.com/doi/full/10.1111/1467-9566.12152 more sociological literature on the dehumanisation of dementia patients by the media, and how this leads to increased use of euthanasia


https://journals.sagepub.com/doi/full/10.1177/1471301217709661 critisizing the 'hegemony of american allopathic medicine' due to is depersonalization of people with dementia using fairly strong language. It argues that the combination of medical attitudes and media presentation conflate dementia with it's final stages (loss of agency, contact with reality and finally life). It critisises the dichotomy between positive and negative aging, and claims that this medical view eclipses the diversity between aging processes and the effects of race, culture and sex on these processes. It argues that is 'a social construct created by people and within social institutions'. 'it says 'If forgetfulness in seniors continues to be medicalised, then we might well find that we have destroyed the precious little space within which we as modern humans can age meaningfully'. criticises the medical perspective as 'oversimplifying the lived experience'- this is a clear example of the clash between empirical scientific evidence and sociology's qualitive more experience focussed aproach

https://rgs-ibg.onlinelibrary.wiley.com/doi/full/10.1111/tran.12055 a critique of the DALY (disability adjusted life year) a common measure used in medicine to evaluate treatment efficiency and make decisions on it's distribution due to it's assumption that the life of someone with a disibility is less valuable than the life of someone without it, it argues this is due to the blurring of the line between the human biological being, and the economy and political sphere. It also speaks of how the DALY measurement leaves out the poorest classes due to thier lack of access to medical care leading to a lack of generation of data. this is a direct tension between the medical and economic perspectives and the ethical and sociological perspectives. although it does not mention dementia specifically it is highly revavent due to the increasing importance of the DALY and QALY in medical decisions.

https://journals.sagepub.com/doi/full/10.1177/1039856219878645 in oregon over 50% of people requesting euthanaisa claim 'being a burden to their families' as the main reason for the decision, this article argues that poverty and old age contribute largely to these decisions, creating a class discrepancy.

https://www.researchgate.net/profile/Bernadette_Roest/publication/332237833_The_involvement_of_family_in_the_Dutch_practice_of_euthanasia_and_physician_assisted_suicide_a_systematic_mixed_studies_review/links/5caaebc5299bf118c4ba88be/The-involvement-of-family-in-the-Dutch-practice-of-euthanasia-and-physician-assisted-suicide-a-systematic-mixed-studies-review.pdf doctors struggled to empathise with patients citing existential reasons for thier request for euthanasia, and psychological suffering was given less consideration than physical symptoms. the more sociological aspects of the paper reveal the importance of family relations and 'being a burden' in decision making, doctors are resistant to consider the suffering of the family as a whole due to the medical focus on the experience, especially the physical experience, of thier single patient over wider more sociological considerations of the suffering of the family unit as a whole and the impacts of the implimentation or non implementation of euthanasia at these different levels.


Influences of Philosophy and Scientific Theory on Psychology through the 19th and 20th centuries[edit]

Introduction[edit]

There is an ardent debate as to how facts should be determined and the way the models of philosophy and science can be mapped onto reality, both within and between both disciplines, psychology has had a fruitful interplay with both of these areas.[21][22]

The roots of psychology reach deep into the philosophical tradition. In the late 18th century Immanuel Kant hypothesized the first dimensional model of personality, paving the way for a huge variety of personality models as well as statistical psychology.[23] Friedrich Nietzsche, although now thought of as a philosopher, often referred to himself as a psychologist and criticized much of the preceding philosophical tradition as overly introspective and self-indulgent.[24][25] This foreshadowed the rift that formed over the coming century between the psychologist-philosophers and the institutions of psychology.

The Rift[edit]

This rift was largely due to the rapid progress was made in understanding the brain and human behavior and the desire of psychology departments to establish themselves as equals to the already established natural sciences.[6][26] Psychology suceeded in this through the use of empirical and statistical methods and rigorous scientific methodology and experimental protocols in conjunction with technologies such as magnetic resonance imaging and advances in biochemistry that were facilitated by quantum mechanics.[27][28][29] However, this materialistic focus led to a loss of confidence in the utility of psychoanalytic theories and widespread criticism of the psycho-philosophers that claimed knowledge or predictions about human behavior individually and societally based on introspective experiences or enumerative inductivism (the repeated observation instances which fit a framework or hypothesis). [6][30][31][32][33]

Conclusion[edit]

Freud, Jung, and Addler, for example, thought of themselves as psychologists and scientists.[32][34] However, by the end of the twentieth century their work was respected and taught more in fringe institutions, humanities, and social science departments.[35][26] In psychology departments, if taught, these thinker's work is usually in the context of a historical artifact rather than a working theory.[36][30][32][31] The discussion that lead to this view of psychoanalytical work helped separate psychology, based on empirical evidence and methods of experimentation developed in the natural sciences, from the multitude of observation, interpretation, introspection and enumerative inductivism based hypotheses developed by early 'psychologists', both turned psychology into a true science and advanced the scientific method as a whole as well as producing some fascinating, important and useful philosophies and interpretive models.[26][6][37] However, the psychoanalitic discipline has been left in disarray by its dissociation from academic institutions, which still considerably hampers it's developement despite it's continueing importance in theraputic settings and culture.[33][26]

References[edit]

  1. Oliver, C., 2020. Guide To Studying Medicine. [online] Thecompleteuniversityguide.co.uk. Available at: <https://www.thecompleteuniversityguide.co.uk/subject-guide/medicine#:~:text=Medical%20practice%20is%20generally%20defined,%2C%20nurses%2C%20surgeons%20and%20physicians.> [Accessed 1 December 2020].
  2. Lachin JM, Matts JP, Wei LJ (Dec 1988). "Randomization in Clinical Trials: Conclusions and Recommendations". Controlled Clinical Trials 9 (4): 365-74. PMID 3203526.
  3. Brülde, B., 2001. The Goals Of Medicine. Towards A Unified Theory.. [online] Available at: <https://link.springer.com/article/10.1023/A:1011385310274> [Accessed 2 December 2020].
  4. Boudreau, J. and Somerville, M., 2013. Euthanasia is not medical treatment. British Medical Bulletin, 106(1), pp.45-66.
  5. a b Brooks, John I. (1996). "THE DEFINITION OF SOCIOLOGY AND THE SOCIOLOGY OF DEFINITION: DURKHEIM’S RULES OF SOCIOLOGICAL METHOD AND HIGH SCHOOL PHILOSOPHY IN FRANCE". Journal of the History of the Behavioral Sciences 32 (4). https://onlinelibrary.wiley.com/doi/pdf/10.1002/%28SICI%291520-6696%28199610%2932%3A4%3C379%3A%3AAID-JHBS4%3E3.0.CO%3B2-M. Retrieved December 05, 2020. 
  6. a b c d e f Form, William; Faris, Robert E.L. (May 06, 2020). "Sociology". Sociology. Encyclopædia Britannica. https://www.britannica.com/topic/sociology. Retrieved December 05, 2020.  Invalid <ref> tag; name ":02" defined multiple times with different content
  7. a b Lieberson, Stanley. "Einstein, Renoir, and Greeley: Some Thoughts About Evidence in Sociology". American Sociological Review 57 (1). https://search.proquest.com/scholarly-journals/einstein-renoir-greeley-some-thoughts-about/docview/218813913/se-2?accountid=14511. Retrieved December 05, 2020. 
  8. Swarte, Nikkie B; van der Lee, Marije L; van der Bom, Johanna G; van den Bout, Jan; Heintz, A Peter M (2003). "Effects of euthanasia on the bereaved family and friends: a cross sectional study". BMJ 327 (189). https://doi.org/10.1136/bmj.327.7408.189. Retrieved Dec 10, 2020. 
  9. Ganzini, Linda; Goy, Elizabeth R; Dobscha, Steven K; Prigerson, Holly (2009). "Mental Health Outcomes of Family Members of Oregonians Who Request Physician Aid in Dying". Journal of Pain and Symptom Management 38 (6). https://doi.org/10.1016/j.jpainsymman.2009.04.026. 
  10. Watson, Brittany; Tatangelo, Gemma; McCabe, Marita (2019). "Depression and Anxiety Among Partner and Offspring Carers of People With Dementia: A Systematic Review". The Gerontologist 59 (5). https://doi.org/10.1093/geront/gny049. Retrieved Dec 06, 2020. 
  11. a b Roest, Bernadette; Trappenburg, Margo; Leget, Carlo (2019). "The involvement of family in the Dutch practice of euthanasia and physician assisted suicide: a systematic mixed studies review". BMC Medical Ethics 20 (23). https://doi.org/10.1186/s12910-019-0361-2. 
  12. Resende EDPF; Llibre Guerra JJ; Miller BL (2019). "Health and Socioeconomic Inequities as Contributors to Brain Health". Jama Neurology 76 (6). https://doi.org/10.1001/jamaneurol.2019.0362. 
  13. a b c Sutin, Angelina R.; Stephan, Yannick; Robinson, Eric; Daly, Micheal; Terracciano, Antonio (2019). "Perceived weight discrimination and risk of incident dementia". International Journal of Obesity 43. https://doi.org/10.1038/s41366-018-0211-1. 
  14. Johnstone, Megan-Jane (2013). Alzhiemer's Disease, Media Representations and the Politics of Euthanasia: Constructing Risk and Selling Death in an Ageing Society. Ashgate. ISBN 9781409451921. https://books.google.co.uk/books?hl=en&lr=&id=byEGDAAAQBAJ&oi=fnd&pg=PP1&dq=personhood+dementia+euthanasia+medicalization+sociology+fate+worse+than+death&ots=JiFSW-91qI&sig=weCme471RQ-vpSn01k2IVVHUZMA&redir_esc=y#v=onepage&q&f=false. Retrieved 2020-12-10. 
  15. a b Beard, Renée L (2017). "Dementia and the privilege of growing old". Dementia 16 (6). https://doi.org/10.1177%2F1471301217709661. Retrieved Dec 10, 2020. 
  16. shakespeare, Tom; Zeilig, Hannah; Mittler, Peter (2019). "Rights in Mind: Thinking Differently About Dementia and Disability". Dementia 18 (3). https://doi.org/10.1177/1471301217701506. Retrieved Dec 10, 2020. 
  17. Gale, Chris; Barak, Yoram (2019). "Euthanasia, medically assisted dying or assisted suicide: time for psychiatrists to say no". Australasian Psychiatry 28 (2). https://doi.org/10.1177%2F1039856219878645. Retrieved Dec 10, 2020. 
  18. a b Plassman B.L. · Langa K.M. · Fisher G.G. · Heeringa S.G. · Weir D.R. · Ofstedal M.B. · Burke J.R. · Hurd M.D. · Potter G.G. · Rodgers W.L. · Steffens D.C. · Willis R.J. · Wallace R.B. (2007). "Prevalence of Dementia in the United States: The Aging, Demographics, and Memory Study". Neuroepidemiology 29 (1-2). https://doi.org/10.1159/000109998. Retrieved Dec 10, 2020. 
  19. a b Zhang M. (1990). "Prevalence study on dementia and Alzheimer disease". Zhonghua yi xue za zhi 70 (8). https://europepmc.org/article/med/2174278. Retrieved Dec 10, 2020. 
  20. Ryan, Tony; Gardiner, Clare; Bellamy, Gary; Gott, Merryn; Ingleton, Christine (2011). "Barriers and facilitators to the receipt of palliative care for people with dementia: The views of medical and nursing staff". Palliative Medicine 26 (7). https://doi.org/10.1177/0269216311423443. Retrieved December 06, 2020. 
  21. Hamilton, V. (1993). Truth and Reality in Psychoanalytic Discourse. Int. J. Psycho-Anal., 74:63-79.
  22. Jammer, Max (1974). The philosophy of quantum mechanics. Wiley-Interscience. ISBN 0-471-439. 
  23. Kant, I. (1798). Anthropology from a pragmatic point of view. trans. (Mary Gregor). The Hague: Martinus Nijhoff, 1974 (VII).
  24. Nietzche, Friedrich (1990). Götzen-Dämmerung. Penguin Classics. ISBN 978-0140445145. 
  25. Kaufmann, Walter (1950). Nietzsche: Philosopher, Psychologist, Antichrist. Princeton University Press. ISBN 9780691160269. https://books.google.co.uk/books?hl=en&lr=&id=VVezAAAAQBAJ&oi=fnd&pg=PP1&dq=nietzsche%27s+contribution+to+psychology&ots=TinoSVaLeD&sig=7uXMrT2fF2d-vdlSOIldPplrjVA#v=onepage&q&f=false. 
  26. a b c d Paul Whittle (1999) Experimental Psychology and Psychoanalysis: What We Can Learn from a Century of Misunderstanding, Neuropsychoanalysis, 1:2, 233-245, DOI: 10.1080/15294145.1999.10773264
  27. (NAS Colloquium) Neuroimaging of Human Brain Function. National Academies Press. 1998. ISBN 0-309-06027-3. 
  28. Gribbin, John. In Search of Schrodinger's Cat: Quantum Physics and Reality. Bantam Books. ISBN 9780552125550. 
  29. E. L. Hahn (1950) Nuclear Induction Due to Free Larmor Precession, Physical Review
  30. a b Eysenck, Hans J. (2004). Decline & fall of the Freudian Empire. Transaction Publishers. ISBN 0-7658-0945-1. 
  31. a b Crews, F. (1996) ‘The Verdict on Freud’, Psychological Science, 7(2), pp. 63–68. doi: 10.1111/j.1467-9280.1996.tb00331.x.
  32. a b c Coan, R. W. (1987). Theoretical orientation in psychology and the traditions of Freud, Jung, and Adler. Professional Psychology: Research and Practice, 18(2), 134–139. https://doi.org/10.1037/0735-7028.18.2.134
  33. a b Peter Fonagy (2000) On the Relationship of Experimental Psychology and Psychoanalysis: Commentary by Peter Fonagy (London), Neuropsychoanalysis, 2:2, 222-232, DOI: 10.1080/15294145.2000.10773311
  34. Samuels, Andrew; Shorter, Bani; Plaut, Alfred (1986). A Critical Dictionary of Jungian Analysis. Routledge. ISBN 9780415059107. https://books.google.co.uk/books?id=ozJiZrCTlRsC&printsec=frontcover&dq=isbn:9780415059107&hl=en&sa=X&ved=2ahUKEwi6_cPC5r7sAhWvShUIHTftCj0Q6AEwAHoECAAQAg#v=onepage&q=empirical&f=false. Retrieved 18.10.2020. 
  35. "What Uni search for Psychoanalysis". https://www.whatuni.com/degree-courses/search?q=psychoanalysis. Retrieved 19/10/2020. 
  36. Ricœur, Paul (1970). Freud and Philosophy: An Essay on Interpretation. New Haven: Yale University Press. ISBN 0-300-02189-5. 
  37. Peterson, Jordan B.. Maps of Meaning. Routledge. ISBN 0415922216. https://books.google.co.uk/books?hl=en&lr=&id=8Siqb_pbg0MC&oi=fnd&pg=PR11&dq=maps+of+meaning+peterson&ots=570sf6Q1ZB&sig=Bs57oHiWLvxMNgF_s1DyYMTIIgM#v=onepage&q=maps%20of%20meaning%20peterson&f=false. Retrieved 2020-10-19. 

Issues and evidence in the prescription of pharmaceutical drugs[edit]

Introduction[edit]

The process of prescribing Pharmaceuticals is a complex and difficult to manage process, easily influenced by a multitude of biases.[1][2][3][4] There are several strands that collide in the prescription process. Firstly, the information received by the consumer, through advertising and other sources.[5][2] Secondly the experiments and trials through which the drugs are produced, the efficacy, risks and benefits assessed, and uses determined.[6] And thirdly, the experience, training, and expertise of the doctors.[7]

Consumer information[edit]

The advertising of prescription medication is a highly contentious issue.[8][9] In the United Kingdom direct-to-consumer advertising (DTCA) of prescription medication is outlawed.[10] However, since late 1997 DTCA of prescription medication has been leniently regulated in the United States. Between 1996 and 2004 there was a 500% increase in DTCA spending for drug promotion.[11][2] This spending appears to be highly effective, in 2019 80% of the money spent on prescription and over the counter drugs went to branded products rather than their generic counterparts.[12]

Some studies support the use of DTCA, citing the fear that if consumers do not know about the drugs then they may not get the treatments they need.[13][3][8] However, according to an article published in Sage Journals, 75% of doctors take issue with the quality of information contained in the DTCA of medical products.[14] Studies have found that much of the information easily availiable to consumers through advertising and search engines is emotive or anecdotal. Furthermore, the information is reported to be misrepresentative of the risk benefit relationship and frequently fails to mention alternative treatments and medications.[2][14][15][16][5]

Drug assessment process[edit]

It takes an average of twelve years and in excess of a billion dollars in the USA to take a drug from the lab to the general public.[6] There are five main stages in the drug development process that have to be successfully completed in sequence[17]. The animal testing phase (pre-clinical research) tests drug toxicity and identifies key information about dosage before moving to human trials. In vivo experimentation is also used to investigate a drugs long term affects using animals with a short life-span (often mice). [18][19] After animal testing, research moves to clinical trials which consist of phased testing on incrementally larger human cohorts. The drugs are monitored for dosage, safety and efficacy before being released to the general public.[6]

There are some interesting issues emerging from the use of mice for gathering data on drug toxicity and side effects. In comparison to humans and their wild counterparts, laboratory mice have been shown to have excessively long telomeres. This endows them with unrepresentative abilities to repair from body and cell damage.[19][20][21] This is one example of how evidence could be misrepresentative in drug testing. Another is implied by a review of studies analysing the dollars per quality assessed life year (QALY) gained. Large variations were found in the median reported cost-effectiveness dependent on the source of funding for the study. Industry-funded studies weighed in at $6000 per QALY, less than half the median value reported by non-industry funded analyses.[13]

Faults such as these in drug assessment can have detrimental effects. In the year 1997-1998 five drugs prescribed to 19.8 million patients were withdrawn from the market due to concern over their side effects. In the case of the diet drug fen-phen, a study found that 30% of people taking the drug had developed specific heart problems only present in 1% of the wider population. [22][23] Faults in the assessment process aside, the quantity of research into the affects of pharmaceuticles presents an arguably much larger problem for the prescription process.[24][25][26]

Prescription process[edit]

Doctors make difficult decisions when medicating patients, caught between their care for the patient's wellbeing and potential sanctions or lawsuits for under or over-prescription.[27][4] An interview based study of GP decision making processes found that decisions were affected more by the doctors and their peers anecdotal or qualititive experience, and patients requests than the doctors training or research, it was also found that the doctors often simplified options and risk benefit analysis so as not to overwhelm their patients.[4][16][28]

Evidence based prescribing is the use of clinical studies and research by doctors to make decisions in prescription, this is a possible solution to the web of less reliable influences that affect the medication prescribed to patients.[29][30][28] However, there is critisism of this method, that physicians lack the time required to explore the vast quantity of information availiable to assess the merits of medications and Kahneman argues that intuitive thinking is an important part of complex decision making, especially under time constraints.[25][26][31][24]

Conclusion[edit]

The evidence used to assess pharmaceutical prescription is, on the side of the consumer overly simplified and often misrepresentative, and in the scientific literature overwhelming and sometimes conflicting leading to anecdotal, social and qualitative influences largely taking precedence.[1][7][28][16][32] Movements to address this have been partially successful.[30][29] However, with time constraints on consultations and doctor time and the complexity, quantity and variability of scientific and empirical evidence available limited progress has been made improving the process, even with the implementation of computer systems to aid decision making.[32][29][30][33] With more time for consultations, better organised clinical records and computer systems, and more representative information supplied to consumers, it may be possible to move towards a more empirically based and scientific process for medicating patients, however it is not in the interest of the pharmaceutical industry to make these changes, as the premium they can charge for new and or branded drugs is a large source of income.[12]

References[edit]

  1. a b Helen Prosser, Solomon Almond, Tom Walley (1/02/2003). "Influences on GPs’ decision to prescribe new drugs—the importance of who says what". Oxford Academic Family Practice. https://academic.oup.com/fampra/article/20/1/61/498919. Retrieved 23/10/2020. 
  2. a b c d Joel Lexchin; Barbara Mintzes (1/09/2002). "Direct-to-Consumer Advertising of Prescription Drugs: The Evidence Says No". Sage Journals. https://journals.sagepub.com/doi/full/10.1509/jppm.21.2.194.17595. Retrieved 23/10/2020. 
  3. a b Julie M. Donohue, Ph.D.; Marisa Cevasco, B.A.; Meredith B. Rosenthal, Ph.D. (16/08/2007). "A Decade of Direct-to-Consumer Advertising of Prescription Drugs". The New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMsa070502. Retrieved 23/10/2020. 
  4. a b c Robin Gregory; Ellen Peters; Paul Slovic (05/01/2010). "Making decisions about prescription drugs: A study of doctor–patient communication". Health, Risk & Society. 27/05/2011. https://www.tandfonline.com/doi/full/10.1080/13698575.2011.575455. Retrieved 24/10/2020. 
  5. a b Graber, Mark A.; Weckmann, Michelle (29/08/2012). "Pharmaceutical Company Internet Sites As Sources of Information About Antidepressant Medications". CNS Drugs. https://link.springer.com/article/10.2165/00023210-200216060-00005#citeas. Retrieved 23/10/2020. 
  6. a b c Gail A. Van Norman (25/04/16). "Drugs, Devices, and the FDA: Part 1 An Overview of Approval Processes for Drugs". JACC Journals. https://basictranslational.onlinejacc.org/content/1/3/170.full. Retrieved 23/10/2020. 
  7. a b Gregory, Robin; Peters, Ellen; Slovic, Paul (27/05/2011). "Making decisions about prescription drugs: A study of doctor–patient communication". Taylor & Francis. https://www.tandfonline.com/doi/full/10.1080/13698575.2011.575455. Retrieved 23/10/2020. 
  8. a b Michael Sinkinson; Amanda Starc (March 2019). "Ask Your Doctor? Direct-to-Consumer Advertising of Pharmaceuticals". https://academic.oup.com/restud/article/86/2/836/4817061. https://academic.oup.com/restud/article/86/2/836/4817061. Retrieved 23/10/2020. 
  9. Julie Donohue (December 2006). "A History of Drug Advertising: The Evolving Roles of Consumers and Consumer Protection". The Milbank Quarterly. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690298/. Retrieved 23/10/2020. 
  10. Medicines and Healthcare products Regulatory Agency. "GOV.UK: Guidance: Advertise your medicines". https://www.gov.uk/guidance/advertise-your-medicines#:~:text=about%20an%20advert-,Overview,medicines%2C%20to%20the%20general%20public.&text=You%20can't%20advertise%20any,the%20legal%20requirements%20when%20advertising.. Retrieved 23/10/2020. 
  11. Ziad F. Gellad MD; Kenneth W. Lyles MD (30/09/2007). "Direct-to-Consumer Advertising of Pharmaceuticals". The American Journal of Medicine. https://www.sciencedirect.com/science/article/pii/S0002934306012654#bib10. Retrieved 23/10/2020. 
  12. a b Matej Mikulic (18/08/2020). "Proportion of branded versus generic prescription drug revenues in the United States from 2005 to 2019". Statista. https://www.statista.com/statistics/205036/proportion-of-brand-to-generic-prescription-sales/. Retrieved 24/10/2020. 
  13. a b Peter J. Neumann; Eileen A. Sandberg; Chaim M. Bell; Patricia W. Stone; Richard H. Chapman (April 2000). "Are Pharmaceuticals Cost-Effective? A Review Of The Evidence". Health Affairs. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.19.2.92. Retrieved 23/10/2020. 
  14. a b Michael Friedman; James Gould (01/01/2007). "Physicians' Attitudes toward Direct-to-Consumer Prescription Drug Marketing". Sage Journals. https://journals.sagepub.com/doi/abs/10.1057/palgrave.jmm.5050063. 
  15. ROBERT A. BELL; MICHAEL S. WILKES; RICHARD L. KRAVITZ (Dec 2000). "The Educational Value of Consumer-Targeted Prescription Drug Print Advertising". Journal of Family Practice. https://go.gale.com/ps/anonymous?id=GALE%7CA68913016&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=00943509&p=AONE&sw=w. Retrieved 23/10/2020. 
  16. a b c David Spurgeon (20/11/1999). "Doctors feel pressurised by direct to consumer advertising". BMJ. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117069/. Retrieved 23/10/2020. 
  17. "Step 3: Clinical Research". https://www.fda.gov/patients/drug-development-process/step-3-clinical-research. Retrieved 30/10/2020. 
  18. Richard D. Storer; Frank D. Sistare; M. Vijayaraj Reddy; Joseph J. Degeorge (5/09/2009). "An Industry Perspective on the Utility of Short-Term Carcinogenicity Testing in Transgenic Mice in Pharmaceutical Development". Sage Journals. https://journals.sagepub.com/doi/abs/10.1177/0192623309351718. Retrieved 23/10/2020. 
  19. a b Bret S. Weinstein; Deborah Ciszek (29/01/2002). "The reserve-capacity hypothesis: evolutionary origins and modern implications of the trade-off between tumor-suppression and tissue-repair". Science Direct. https://www.sciencedirect.com/science/article/pii/S0531556502000128#BIB43. Retrieved 23/10/2020. 
  20. M T Hemann; C W Greider (01/11/2000). "Wild-derived inbred mouse strains have short telomeres.". Europe PMC. https://europepmc.org/article/pmc/113886. Retrieved 23/10/2020. 
  21. David Kipling; Howard J. Cooke (27/09/1990). "Hypervariable ultra-long telomeres in mice". Nature. https://www.nature.com/articles/347400a0. Retrieved 23/10/2020. 
  22. Alastair J. J. Wood, MD (12/05/1999). "The Safety of New Medicines The Importance of Asking the Right Questions". JAMA Network. https://jamanetwork.com/journals/jama/fullarticle/189774. Retrieved 23/10/2020. 
  23. Michael A. Friedman, MD; Janet Woodcock, MD; Murray M. Lumpkin, MD (12/05/1999). "The Safety of Newly Approved Medicines Do Recent Market Removals Mean There Is a Problem?". JAMA Network. https://jamanetwork.com/journals/jama/article-abstract/189872. Retrieved 23/10/2020. 
  24. a b Sarah Kleijnen, Elisabeth George, Scott Goulden, Anned Andon, Pauline Vitré, Boguslawa Osińska, Rafal Rdzany, Steffen Thirstrup, Belen Corbacho, Bence Z. Nagy, Hubert G. Leufkens, Anthoniusde Boer, Wim G. Goettsch (20/06/2012). "Relative Effectiveness Assessment of Pharmaceuticals: Similarities and Differences in 29 Jurisdictions". Value in Health. https://www.sciencedirect.com/science/article/pii/S1098301512016099. Retrieved 24/10/2020. 
  25. a b C Salisbury; N Bosanquet; E Wilkinson; A Bosanquet; J Hasler (Dec 1998). "The implementation of evidence-based medicine in general practice prescribing.". British Journal of General Practice. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1313292/. Retrieved 24/10/2020. 
  26. a b Muhammad Mamdani; Andrew Ching; Brian Golden; Magda Melo; Ulrich Menzefricke (May 2008). "Challenges to Evidence-Based Prescribing in Clinical Practice". The Annals of Pharmacotherapy. https://journals.sagepub.com/doi/pdf/10.1345/aph.1K283. Retrieved 24/10/2020. 
  27. Jacob B. Nist (2002). "LIABILITY FOR OVERPRESCRIPTION OF CONTROLLED SUBSTANCES: CAN IT BE JUSTIFIED IN LIGHT OF THE CURRENT PRACTICE OF UNDERTREATING PAIN?". The Journal of Legal Medicine. 10/11/2010. https://www.tandfonline.com/doi/pdf/10.1080/019476402317276687. Retrieved 24/10/2020. 
  28. a b c Helen Prosser; Tom Walley (30/09//2005). "New drug prescribing by hospital doctors: The nature and meaning of knowledge". Science Direct. https://www.sciencedirect.com/science/article/pii/S0277953605004557. Retrieved 24/10/2020. 
  29. a b c Simon R J Maxwell (28/07/2005). "Evidence based prescribing". BMJ. https://www.bmj.com/content/331/7511/247.short. Retrieved 23/10/2020. 
  30. a b c Titus J. Bradley; MBChB, Alison P. Round; MBChB; MFPHM; Marilyn Ramsden; BPharm; MRPharmS (1/07/2000). "The success of an evidence-based rational prescribing intervention: a retrospective study". The Pharmaceutical Journal. https://www.pharmaceutical-journal.com/the-success-of-an-evidence-based-rational-prescribing-intervention-a-retrospective-study/20002075.article?firstPass=false. Retrieved 23/10/2020. 
  31. DANIEL KAHNEMAN (08/12/2002). "MAPS OF BOUNDED RATIONALITY: A PERSPECTIVE ON INTUITIVE JUDGMENT AND CHOICE". Nobel Prize Lecture. https://valuewalkpremium.com/wp-content/uploads/2014/06/kahnemann-lecture.pdf. Retrieved 24/10/2020. 
  32. a b Liat Vidal; Maya Shavit; Abigail Fraser; Mical Paul; Leonard Leibovici (28/07/2005). "Systematic comparison of four sources of drug information regarding adjustment of dose for renal function". BMJ. https://www.bmj.com/content/331/7511/263. Retrieved 23/10/2020. 
  33. Lindsey Yourman; John Concato; Joseph V. Agostini (1/08/2008). "Use of computer decision support interventions to improve medication prescribing in older adults: A systematic review". The American Journal of Geriatric Pharmacotherapy. https://www.sciencedirect.com/science/article/abs/pii/S1543594608000214. Retrieved 24/10/2020. 

Power in the Discipline of Physics[edit]

Introduction[edit]

Generational Issues[edit]

Planck's principle, as well as similar ideas presented by Dawin and Lavoisier, state that new idea's do not come to dominate by converting the proponants of the theories it is overturning but by their death and the next generation learning the ideas as given.[1][2][3] This is likely to be a result of the power imbalance between the young and old in the universities as it takes a long time to climb to the top of these institutions as older people including scientists are generally less reseptive to new ideas.[4][3][5] Research into age discrimination within academia also provides evidence for the presence of power dynamics in academic progression; implying that age and 'time surved' plays large part in decisions regarding promotion as well as competance and experience.[6] This is an example of institutional power, younger people are simply not considered for higher positions in departements due to the observation that most of those with the skills for these positions are older.[6] Overall the issue of idea's and individuals making their way up the academic ladder is a intersection of institutional power and individual's unconcious biases against idea's that they are unfamiliar with.

Gender Issues[edit]

In the united states only 20% of physics degrees and PHDs are earned by Women, and similar figures are reflected around the world.[7][8] The lack of representation of multiple issues of power as well as sex differences in traits. The power issues between genders in physics departments mostly constist of preconceptional biases perpatrated by physics being primerily dominated by men and overrepresented in textbooks and other physics.[9] This is one cause that contributes to most women not considering a career in physics from an early age.[10]

Other power issues contributing to fewer women reaching higher positions in physics include difficulty fitting into a male dominated workplace and the decision making processes affecting career progression.[11][12] Some factors that contribute to this are; men being likely more to overestimate their skills and women being more likely to underestimate, women being more to feel excluded from making connections across and up the hierachy and expectations of female steriotypes playing out in microagressions and the decision making process.[11][13][14] These create an intersectional power imbalance between men and women in physics leading to an inneficient hierachy which is likely to hamper scientific progress by excluding potentially innovative women.

However, it is unlikely that power imbalances and descriminatory biases within physics account for all of the gender discrepancy in the discipline. One factor that explains part of the underrepresentation of women in physics is differences in interests and priorities between men and women. Especially that women are, on average, more likely than men to prioritise 'balance and relationships' over material success and have a considerable statistical tendancy towards an interest in people (in the broadest sence refering to arts, humanities, care, etcetera) in contrast to the male tendancy towards interest in things (again in a very broad sense; STEM, data, construction, etcetera).[15] Some more possible factor is the female bias towards verbal intelligence as opposed to the male average tending towards spacial intelligence and maternity (especially in the high status and income positions that require a long and constant career path to reach).[16][17]

Some argue that the difference is due to the width of the male general intelligence distribution increasing the male to female ratio at the extremes.[16][18] However, measuring mean gender differences is extremely difficult due to the huge overlap in distrabution and the time and energy required on the part of the respondants to collect good psychometric data and many of the studies contradict oneanother.[16][17]

Conclusion[edit]

Generational issues of power in physics and other sciences may well hamper scientific progress. Gender issues of power represent a portion of the reasons for the underepresentation of women in physics but it is unlikely that by eliminating the power issues the outcome would be equal representation due to the statistical differences in interests and traits.[19]

It remains unclear in the literature how the power issues can be adressed as a whole.[20][19] However, there is evidence that diversity cognative learning and reactions training had small but significant and lasting effects in combating unconcious biases.[21] It is also suggested that increasing the representation of women in physics related content would increase the number of women enroling in physics courses.[19][17] This is likely to increase the number progressing onto PHD level and academic posts, diluting the male dominated culture and increasing the likelyhood of innovation by a greater proportion of humanities best minds working in the field of study. [10]

References[edit]

  1. Sharon G. Levin; Paula E. Stephan; Mary Beth Walker (01/05/1995). "Planck's Principle Revisited: A Note". Social Studies of Science. https://journals.sagepub.com/doi/abs/10.1177/030631295025002003. 
  2. Gribbin, John. In Search of Schrodinger's Cat. Transworld Publishers. ISBN 9780552125550. 
  3. a b Youth and Scientific Innovation: The Role of Young Scientists in the Development of a New Field. MINERVA (LONDON).. https://link.springer.com/content/pdf/10.1007/BF01096169.pdf. Retrieved 2020-11-09. 
  4. David Smith; Jean Bocock; Catherine Bargh. New Leaders at the Top? The Educational and Career Paths of UK University Vice-chancellors (1960-1996). "Higher education management". JOURNAL OF THE PROGRAMME ON INSTITUTIONAL MANAGEMENT IN HIGHER EDUCATION 11 (2): 118. https://www.oecd.org/education/imhe/37446807.pdf#page=108. 
  5. Schwaba, T., Luhmann, M., Denissen, J. J. A., Chung, J. M., & Bleidorn, W. (2018). Openness to experience and culture-openness transactions across the lifespan. Journal of Personality and Social Psychology, 115(1), 118–136. https://doi.org/10.1037/pspp0000150
  6. a b Rodham, Karen. "Ageism, young academics and the buffalo stance". Ageism in Work and Employment. Ashgate Publishing. ISBN 9781138736399. https://books.google.co.uk/books?hl=en&lr=&id=JR8uDwAAQBAJ&oi=fnd&pg=PT206&dq=ageism+in+academia&ots=wbdboSsDhX&sig=3xOzISJho0aDR3eccvUE-AYwoso#v=onepage&q=academia&f=false. Retrieved 2020-11-09. 
  7. Robin Bjorkquist, Abigail M. Bogdan, Nicole L. Campbell, Mary Chessey, Geraldine L. Cochran, Beth Cunningham, ... (03/06/2019). "Women in Physics in the United States: Reaching Toward Equity and Inclusion". AIP Conferance Proceedings. https://aip.scitation.org/doi/pdf/10.1063/1.5110114. Retrieved 09/11/2020. 
  8. Rohini M. Godbole, Neelima Gupte, Pratibha Jolly, Shobhana Narasimhan, and Sumathi Rao (31/10/2005). "Women in Physics in India, 2005". AIP Conference Procedings 795 (123). https://aip.scitation.org/doi/pdf/10.1063/1.2128297#:~:text=In%20physics%2C%20women%20constitute%2030,the%20PhD%20level%20in%20physics.. Retrieved 09/11/2020. 
  9. Ramón S. Barthelemy; Melinda McCormick; Charles Henderson (01/08/2016). "Gender discrimination in physics and astronomy: Graduate student experiences of sexism and gender microaggressions". PHYSICAL REVIEW PHYSICS EDUCATION RESEARCH 12. https://journals.aps.org/prper/pdf/10.1103/PhysRevPhysEducRes.12.020119. Retrieved 09/11/2020. 
  10. a b Peter Whiteley (1996). "The gender balance of physics textbooks: Caribbean and British books, 1985-91". Physics Education 31 (169). https://iopscience.iop.org/article/10.1088/0031-9120/31/3/018/pdf. 
  11. a b Sherry Towers (19/04/2008). "A Case Study of Gender Bias at the Postdoctoral Level in Physics, and its Resulting Impact on the Academic Career Advancement of Females". Physics and Society. https://arxiv.org/pdf/0804.2026.pdf. Retrieved 09/11/2020. 
  12. Helen Peterson (2010). "The Gendered Construction of Technical SelfConfidence: Women’s Negotiated Positions in Maledominated, Technical Work Settings". International Journal of Gender, Science and Technology 2 (1). http://genderandset.open.ac.uk/index.php/genderandset/article/view/61. 
  13. Sylvia Beyer (1990). "Gender Differences in the Accuracy of Self-Evaluations of Performance". Journal of Personality and Social Psychology 59 (5). https://www.researchgate.net/profile/Sylvia_Beyer/publication/232546479_Gender_Differences_in_the_Accuracy_of_Self-Evaluations_of_Performance/links/55e0c63008ae2fac471cb8fe.pdf. 
  14. Geoff Brumfiel (23/04/2008). "Data show extent of sexism in physics". Nature. https://www.nature.com/news/2008/080423/full/452918a.html. Retrieved 09/11/2020. 
  15. Lorraine S. Dyke; Steven A. Murphy (21/09/2006). "How We Define Success: A Qualitative Study of What Matters Most to Women and Men". Sex Roles 55. https://link.springer.com/article/10.1007%252Fs11199-006-9091-2. 
  16. a b c Helmuth Nyborg (August 2005). "Sex-related differences in general intelligence g, brain size, and social status". Personality and Individual Differences 39 (3). https://www.sciencedirect.com/science/article/pii/S019188690400385X. 
  17. a b c Anna T. Danielsson. "Exploring woman university physics students ‘doing gender’ and ‘doing physics’". Gender and Education 24 (1). https://www.tandfonline.com/doi/full/10.1080/09540253.2011.565040. Retrieved 09/11/2020. 
  18. Sebastian Bergold, Heike Wendt, Daniel Kasper, and Ricarda Steinmayr (2017). "Academic Competencies: Their Interrelatedness and Gender Differences at Their High End". Journal of Educational Psychology 109 (3). https://www.gwern.net/docs/psychology/2017-bergold.pdf. 
  19. a b c Adrian Madsen; Sarah B. McKagan; Eleanor C. Sayre. "Gender gap on concept inventories in physics: What is consistent, what is inconsistent, and what factors influence the gap?". Physical Review Physics and Education Research 9 (2). https://journals.aps.org/prper/abstract/10.1103/PhysRevSTPER.9.020121. 
  20. Suzette Caleo; Madeline E. Heilman (2019). "What Could Go Wrong? Some Unintended Consequences of Gender Bias Interventions". Archives of Scientific Psychology 7 (1). https://psycnet.apa.org/fulltext/2019-71045-001.html. 
  21. Bezrukova, K., Spell, C. S., Perry, J. L., & Jehn, K. A. (2016). A meta-analytical integration of over 40 years of research on diversity training evaluation. Psychological Bulletin, 142(11), 1227–1274. https://doi.org/10.1037/bul0000067