Ethical and professional conduct of medical students: review of current assessment measures and controversies

As medical education increasingly acknowledges the importance of the ethical and professional conduct of practitioners, and moves towards more formal assessment of these issues, it is important to consider the evidence base which exists in this area. This article discusses literature about the health needs and problems experienced by medical practitioners as a background to a review of the current efforts in medical education to promote ethical conduct and develop mechanisms for the detection and remediation of problems.

Metagenomic analysis of two enhanced biological phosphorus removal (EBPR) sludge communities

Enhanced biological phosphorus removal (EBPR) is one of the best-studied microbially mediated industrial processes because of its ecological and economic relevance. Despite this, it is not well understood at the metabolic level. Here we present a metagenomic analysis of two lab-scale EBPR sludges dominated by the uncultured bacterium, Candidatus Accumulibacter phosphatis.'' The analysis sheds light on several controversies in EBPR metabolic models and provides hypotheses explaining the dominance of A. phosphatis in this habitat, its lifestyle outside EBPR and probable cultivation requirements. Comparison of the same species from different EBPR sludges highlights recent evolutionary dynamics in the A. phosphatis genome that could be linked to mechanisms for environmental adaptation. In spite of an apparent lack of phylogenetic overlap in the flanking communities of the two sludges studied, common functional themes were found, at least one of them complementary to the inferred metabolism of the dominant organism. The present study provides a much needed blueprint for a systems-level understanding of EBPR and illustrates that metagenomics enables detailed, often novel, insights into even well-studied biological systems.

Predestination and freedom in Milton's 'Paradise lost'

John Milton's epic poem Paradise Lost (1667) offers a highly creative seventeenth-century reconstruction of the doctrine of predestination, a reconstruction which both anticipates modern theological developments and sheds important light on the history of predestinarian thought. Moving beyond the framework of post-Reformation controversies, the poem emphasises both the freedom and the universality of electing grace, and the eternally decisive role of human freedom in salvation. The poem erases the distinction between an eternal election of some human beings and an eternal rejection of others, portraying reprobation instead as the temporal self-condemnation of those who wilfully reject their own election and so exclude themselves from salvation. While election is grounded in the gracious will of God, reprobation is thus grounded in the fluid sphere of human decision. Highlighting this sphere of human decision, the poem depicts the freedom of human beings to actualise the future as itself the object of divine predestination. While presenting its own unique vision of predestination, Paradise Lost thus moves towards the influential and distinctively modern formulations of later thinkers like Schleiermacher and Barth.