IntroductionConcussion is a growing public health concern. No uniformly established therapy exists; neurofeedback studies report treatment value. We use infralow frequency neuromodulation to remediate disabling neurological symptoms caused by traumatic brain injury and noted improved outcomes with a novel concussion protocol. Postconcussion symptoms and persistent postconcussion symptoms are designated timelines for protracted neurological complaints following TBI. We performed a retrospective study to explore effectiveness of ILF in PCS/PPCS and investigated the value of using this concussion protocol.MethodPatients with PCS/PPCS seen for (...) their first neurology office visit or received their first neurofeedback session between 1 August 2018 and 31 January 2021 were entered. Outcomes were compared following treatment as usual vs. TAU with ILF neurotherapy. The study cohort was limited to PPCS patients; the TAU+ILF group was restricted further to PPCS patients receiving at least 10 neurotherapy sessions. Within the TAU+ILF group, comparisons were made between those who trained at least 10 sessions using concussion protocol and those who trained for at least 10 sessions of ILF regardless of protocol.ResultsAmong our resultant PPCS cohort leading persistent neurological complaints were headache, memory impairment, and brain fog. PPCS patients in TAU+ILF+CP demonstrated greater net and percent improvement of symptoms compared to PPCS subjects in TAU. PPCS patients in TAU+ILF-CP trended toward significant symptom improvements compared to TAU, and TAU+ILF+CP trended toward greater efficacy than TAU+ILF-CP.ConclusionPPCS patients who received TAU+ILF+CP demonstrated significantly greater improvement as a group when compared to TAU. When used as an integrative modality to treatment as usual in managing patients with PPCS, ILF neuromodulation with use of concussion protocol provided significant symptom improvements. (shrink)

Clinical ethics committees (CECs) have been developing in many countries since the 1980s, more recently in the transitional countries in Eastern Europe. With their increasing profile they are now faced with a range of questions and challenges regarding their position within the health care organizations in which they are situated: Should CECs be independent bodies with a critical role towards institutional management, or should they be an integral part of the hospital organization? In this paper, we discuss the organizational context (...) in which CECs function in Europe focusing on five aspects. We conclude that in Europe clinical ethics committees need to maintain a critical independence while generating acceptance of the CEC and its potential benefit to both individuals and the organization. CECs, perhaps particularly in transitional countries, must counter the charge of “alibi ethics”. CECs must define their contribution to in-house quality management in their respective health care organization, clarifying how ethical reflection on various levels serves the hospital and patient care in general. This last challenge is made more difficult by lack of consensus about appropriate quality outcomes for CECs internationally. These are daunting challenges, but the fact that CECs continue to develop suggests that we should make the effort to overcome them. We believe there is a need for further research that specifically addresses some of the institutional challenges facing CECs. (shrink)

Research questions and backgroundThis study explores a highly controversial issue of medical care in Germany: the decision to withhold or withdraw mechanical ventilation in critically ill patients. It analyzes difficulties in making these decisions and the physicians’ uncertainty in understanding the German terminology of Sterbehilfe, which is used in the context of treatment limitation. Used in everyday language, the word Sterbehilfe carries connotations such as helping the patient in the dying process or helping the patient to enter the dying process. (...) Yet, in the legal and ethical discourse Sterbehilfe indicates several concepts: (1) treatment limitation, i.e., withholding or withdrawing life-sustaining treatment (passive Sterbehilfe), (2) the use of medication for symptom control while taking into account the risk of hastening the patient’s death (indirekte Sterbehilfe), and (3) measures to deliberately terminate the patient’s life (aktive Sterbehilfe). The terminology of Sterbehilfe has been criticized for being too complex and misleading, particularly for practical purposes. Materials and methods An exploratory study based on qualitative interviews was conducted with 28 physicians from nine medical intensive care units in tertiary care hospitals in the German federal state of Baden-Wuerttemberg. The method of data collection was a problem-centered, semi-structured interview using two authentic clinical case examples. In order to shed light on the relation between the physicians’ concepts and the ethical and legal frames of reference, we analyzed their way of using the terms passive and aktive Sterbehilfe. Results Generally, the physicians were more hesitant in making decisions to withdraw rather than withhold mechanical ventilation. Almost half of them assumed a categorical prohibition to withdraw any mechanical ventilation and more than one third felt that treatment ought not to be withdrawn at all. Physicians showed specific uncertainty about classifying the withdrawal of mechanical ventilation as passive Sterbehilfe, and had difficulties understanding that terminating ventilation is not basically illegal, but the permissibility of withdrawal depends on the situation. Conclusions The physicians’ knowledge and skills in interpreting clinical ethical dilemmas require specific improvement on the one hand; on the other hand, the terms passive and aktive Sterbehilfe are less clear than desirable and not as easy to use in clinical practice. Fear of making unjustified or illegal decisions may motivate physicians to continue (even futile) treatment. Physicians strongly opt for more open discussion about end-of-life care to allow for discontinuation of futile treatment and to reduce conflict. (shrink)

Partiendo de las preguntas planteadas por Patočka a propósito de su filosofía fenomenológica de la historia, el objetivo de este artículo es arrojar luz sobre la manera cómo, en la reflexión del autor checo, la política y la historia han venido vinculándose alrededor del problema del cuidado de sí y de los otros, allí donde éste último coincide con la filosofía en tanto instauración de una inédita perspectiva de comprensión –acontecimiento por el que, según Patočka, se desencadena el curso de (...) la historia. (shrink)

Si es cierto que la cuestión de las relaciones entre subjetividad y verdad es aquello que vertebra el discurso y la práctica filosófica de Foucault, el objetivo de este artículo es mostrar la manera cómo los estudios postreros del autor francés sobre la “parrhesía” y el “cuidado de sí” se han ido desplegando –y han venido vinculándose– alrededor del problema de la verdad, a fin de pensar la filosofía en términos de crítica ético–política de nuestro pre-sente, cuyo quehacer apunta a (...) la posibilidad de organizar nuevas formas de experiencia capaces de transformar ese mismo presente. (shrink)

Research questions and backgroundThis study explores a highly controversial issue of medical care in Germany: the decision to withhold or withdraw mechanical ventilation in critically ill patients. It analyzes difficulties in making these decisions and the physicians’ uncertainty in understanding the German terminology of Sterbehilfe, which is used in the context of treatment limitation. Used in everyday language, the word Sterbehilfe carries connotations such as helping the patient in the dying process or helping the patient to enter the dying process. (...) Yet, in the legal and ethical discourse Sterbehilfe indicates several concepts: (1) treatment limitation, i.e., withholding or withdrawing life-sustaining treatment (passive Sterbehilfe), (2) the use of medication for symptom control while taking into account the risk of hastening the patient’s death (indirekte Sterbehilfe), and (3) measures to deliberately terminate the patient’s life (aktive Sterbehilfe). The terminology of Sterbehilfe has been criticized for being too complex and misleading, particularly for practical purposes. Materials and methods An exploratory study based on qualitative interviews was conducted with 28 physicians from nine medical intensive care units in tertiary care hospitals in the German federal state of Baden-Wuerttemberg. The method of data collection was a problem-centered, semi-structured interview using two authentic clinical case examples. In order to shed light on the relation between the physicians’ concepts and the ethical and legal frames of reference, we analyzed their way of using the terms passive and aktive Sterbehilfe. Results Generally, the physicians were more hesitant in making decisions to withdraw rather than withhold mechanical ventilation. Almost half of them assumed a categorical prohibition to withdraw any mechanical ventilation and more than one third felt that treatment ought not to be withdrawn at all. Physicians showed specific uncertainty about classifying the withdrawal of mechanical ventilation as passive Sterbehilfe, and had difficulties understanding that terminating ventilation is not basically illegal, but the permissibility of withdrawal depends on the situation. Conclusions The physicians’ knowledge and skills in interpreting clinical ethical dilemmas require specific improvement on the one hand; on the other hand, the terms passive and aktive Sterbehilfe are less clear than desirable and not as easy to use in clinical practice. Fear of making unjustified or illegal decisions may motivate physicians to continue (even futile) treatment. Physicians strongly opt for more open discussion about end-of-life care to allow for discontinuation of futile treatment and to reduce conflict. (shrink)

Nel dibattito sui fondamenti filosofici della fisica, la teoria dell'organismo di Whitehead svolge un ruolo essenziale. Nonostante gli sforzi compiuti da molti studiosi, la posizione realista di Whitehead invalida qualsiasi tentativo di mettere in relazione la sua filosofia con l'interpretazione ortodossa della meccanica quantistica. Sia nelle sue opere matematiche che nelle filosofiche il suo «compito costruttivo» è stato «una protesta contro l'esenzione del cambiamento da qualsiasi parte dell'universo». Whitehead mirava a fondere la sua conoscenza nella logica matematica e nella fisica (...) matematica al fine di ottenere uno modello assiomatico e cosmologico diverso dal sistema newtoniano: la nozione di campo, introdotta per la prima volta dall'elettromagnetismo, non è riconciliabile con l'immagine meccanicista del mondo; inoltre, sia nella teoria della relatività che nella teoria quantistica, i fenomeni non lineari hanno mostrato i limiti di applicabilità dei postulati classici. La formalizzazione simbolica portata avanti da Whitehead ha come suo referente la nozione ontologica di periodicitá e ritmo, comuni in tutte le scale della complessitá: un quantum di energia, una molecola di ferro, una nota musicale, un organismo biologico, una marea oceanica, un pianeta e una stella sono sistemi periodici che hanno bisogno di un «lasso di tempo» per funzionare, per manifestarsi come entità e per esprimere la loro individualità. Ognuno di questi sistemi deve «essere concepito come una modifica delle condizioni nello spazio-tempo, estendendosi in tutta la suo campo». Inoltre, questi sistemi periodicamente, ritmicamente pulsanti, questi «stati di agitazione», sono analizzabili in una «regione focale» e in un flusso esterno, ma non separato, dal momento che «per la fisica, la cosa stessa è ciò che fa e ciò che fa è questo flusso di influenza divergente». (shrink)

Although the Philosophy for/with Children (P4wC) movement seems to have overcome two major points of criticism, these critical concerns can still be found in the literature today. The first question is whether P4wC can be placed in the field of philosophy at all, and the second asks whether children possess the cognitive abilities necessary to engage in philosophical discourse. One of the more recent articles voicing these concerns is authored by Caroline Heinrich, who describes P4wC as “an assault on philosophy (...) and an assault on children” and argues that P4wC is a “concept imposed by adults on children.” She maintains that P4wC ignores “children’s thinking, questioning and play.” Furthermore, Heinrich states that P4wC cannot be called philosophy because children are not able to philosophize. In most of her argumentation, refering to Jan Piaget’s theoretical account of the cognitive development of children. Although the P4wC discourse has already dealt with these questions over the last few decades, it seems that there is still a need for further clarification. This paper provides an overview of the main points of criticism, which form the starting point of the author’s Polylogical Process Model of (Elementary-)Philosophical Education (PPEE model). This interdisciplinary approach, which is based on the constructivist conceptual change/growththeory of Stella Vosniadou and William Brewer, attempts to add new perspectives to two central questions addressing the P4wC movement: first, can P4wC actually be called philosophy?; second, do children have the cognitive abilities to engage in philosophical discourse? In addition, the question arises as to which pedagogical considerations based on constructivist learning theory could be added to P4wC methodology? The aim of the interdisciplinary PPEE model is to build a broader scientific foundation that has the potential to reduce the main points of criticism of the P4wC movement. (shrink)

A student's future as a knowledge worker (one who "thinks for a living" with the task of problem solving) is the starting point of this book. With this in mind, the book combines a review of philosophical positions and problems with practical examples and perspectives gained from everyday challenges faced by knowledge workers in their businesses and organizations. Through the use of summative chapters, highlighted key concepts, questions for reflection, and illustrative examples on how to work with the theories presented, (...) the book provides a clear and accessible introduction to this challenging subject. Philosophy of Science primarily addresses students studying language, communication, marketing, economics, and management. However, the survey of the theoretical schools of thought - as well as the discussions on research ethics and the role of research in society - will be equally relevant for other students in the humanities and the natural and social sciences. (shrink)

This paper explains why and how we should introduce birth into the canon of subjects explored by philosophy. It focuses on the epistemology of birth, namely, on the nature, origin, and limits of the knowledge produced by and/or related to giving birth. The paper provides a view on the philosophy of birth, i.e., an approach to construct a new logos for genos.

Adult humans show exceptional relational ability relative to other species. In this research, we trace the development of this ability in young children. We used a task widely used in comparative research—the relational match-to-sample task, which requires participants to notice and match the identity relation: for example, AA should match BB instead of CD. Despite the simplicity of this relation, children under 4 years of age failed to pass this test (Experiment 1), and their performance did not improve even with (...) initial feedback (Experiment 2). In Experiments 3 and 4, we found that two kinds of symbolic-linguistic experience can facilitate relational reasoning in young children. Our findings suggest that children learn to become adept analogical thinkers, and that language fosters this learning in at least two distinct ways. (shrink)

The current quality assurance culture demands the explicit articulation, by means of publication, of what have been hitherto tacit norms and conventions underlying disciplinary genres. The justification is that publication aids student performance and guarantees transparency and accountability. This requirement makes a number of questionable assumptions predicated upon what we will argue is an erroneous epistemology. It is not always possible to articulate in a publishable form a detailed description of disciplinary practices such as assessment. As a result publication cannot (...) achieve its stated goals. There are always elements of our knowledge that cannot be linguistically articulated. (shrink)

Traditionally, the manufacturer/operator of a machine is held (morally and legally) responsible for the consequences of its operation. Autonomous, learning machines, based on neural networks, genetic algorithms and agent architectures, create a new situation, where the manufacturer/operator of the machine is in principle not capable of predicting the future machine behaviour any more, and thus cannot be held morally responsible or liable for it. The society must decide between not using this kind of machine any more (which is not a (...) realistic option), or facing a responsibility gap, which cannot be bridged by traditional concepts of responsibility ascription. (shrink)

The current quality assurance culture demands the explicit articulation, by means of publication, of what have been hitherto tacit norms and conventions underlying disciplinary genres. The justification is that publication aids student performance and guarantees transparency and accountability. This requirement makes a number of questionable assumptions predicated upon what we will argue is an erroneous epistemology. It is not always possible to articulate in a publishable form a detailed description of disciplinary practices such as assessment. As a result publication cannot (...) achieve its stated goals. There are always elements of our knowledge that cannot be linguistically articulated. (shrink)

Neural devices have the capacity to enable users to regain abilities lost due to disease or injury – for instance, a deep brain stimulator (DBS) that allows a person with Parkinson’s disease to regain the ability to fluently perform movements or a Brain Computer Interface (BCI) that enables a person with spinal cord injury to control a robotic arm. While users recognize and appreciate the technologies’ capacity to maintain or restore their capabilities, the neuroethics literature is replete with examples of (...) concerns expressed about agentive capacities: A perceived lack of control over the movement of a robotic arm might result in an altered sense of feeling responsible for that movement. Clinicians or researchers being able to record and access detailed information of a person’s brain might raise privacy concerns. A disconnect between previous, current, and future understandings of the self might result in a sense of alienation. The ability to receive and interpret sensory feedback might change whether someone trusts the implanted device or themselves. Inquiries into the nature of these concerns and how to mitigate them has produced scholarship that often emphasizes one issue – responsibility, privacy, authenticity, or trust – selectively. However, we believe that examining these ethical dimensions separately fails to capture a key aspect of the experience of living with a neural device. In exploring their interrelations, we argue that their mutual significance for neuroethical research can be adequately captured if they are described under a unified heading of agency. On these grounds, we propose an “Agency Map” which brings together the diverse neuroethical dimensions and their interrelations into a comprehensive framework. With this, we offer a theoretically-grounded approach to understanding how these various dimensions are interwoven in an individual’s experience of agency. (shrink)

M. Lipman and P. Freire are two thinkers who support the practice of liberty. Liberty is liberty to learn to think, and to exist in communities of dialogue, questioning, and search. This is the project that leads human beings to understand themselves and recognize others. Without liberty there..

“A mouth that speaks, many ears, and half the hands that write. These are the ac a demic ap - pa ra tus, these are the ac tive ma chines of Bildung in the Uni ver sity”, as writen by Nietz sche.. What should we do? Nietz sche gave us some an swers, in his ha bit ual form: ques tions, met a phor..

Betr. den Drucker Michael Martinus Stella und seine Beziehung zu Basel, speziell zu Thomas und Felix Platter, Johannes Oporin, Andreas Vesalius.

Betr. den Drucker Michael Martinus Stella und seine Beziehung zu Basel, speziell zu Thomas und Felix Platter, Johannes Oporin, Andreas Vesalius.

Wittgenstein’s and Heidegger’s objections against the possibility of a science of aesthetics were influential on different sides of the analytic/continental divide. Heidegger’s anti-scientism leads him to an alētheic view of artworks which precedes and exceeds any possible aesthetic reduction. Wittgenstein also rejects the relevance of causal explanations, psychological or physiological, to aesthetic questions. The main aim of this paper is to compare Heidegger with Wittgenstein, showing that: there are significant parallels to be drawn between Wittgenstein’s and Heidegger’s anti-scientism about aesthetics, (...) and that their anti-scientism leads both towards partly divergent criticisms of what I will call ‘aestheticism’. The divergence is mainly due to a broader metaphilosophical disagreement concerning appeals to ordinary language. Thus situating the two philosophers’ positions facilitates a possible critical dialogue between analytic and continental approaches in aesthetics. (shrink)

This book is a rich blend of analyses by leading experts from various cultures and disciplines. A compact introduction to a complex field, it illustrates biotechnology's profound impact upon the environment and society. Moreover, it underscores the vital relevance of cultural values. This book empowers readers to more critically assess biotechnology's value and effectiveness within both specific cultural and global contexts.

Anche se siamo comunemente abituati a pensare alla scienza come a un qualcosa di assolutamente atemporale e indipendente da tutto, in realtà essa è profondamente influenzata dalla cultura e dalla società del tempo in cui vive. Infatti né la scienza è isolabile dalla società, né la società è isolabile dalla scienza, tanto meno come si sta configurando oggi. Per approfondire questi aspetti, esistono però due visioni antagoniste che bisogna superare: secondo la visione scolastica, retaggio del positivismo ottocentesco ancora molto diffuso (...) fra scienziati e pubblico di non esperti, la scienza è conoscenza senza soggetto conoscente. All'opposto, la visione cinica della scienza, sull'onda di talune elaborazioni della sociologia della scienza, la riduce a nient'altro che a una costruzione di soggetti che partecipano al gioco scientifico, una cultura come altre e da "mediare", e comunque una conoscenza relativa, se non frutto di una costruzione puramente soggettiva, arbitraria, ideologica. Un'analisi della costituzione sociale della scienza può, invece, mirare a un'indagine scientifica sulla scienza proprio configurando una relatività della conoscenza che supera sia l'assolutismo idealistico sia il relativismo soggettivistico. (shrink)

Chronic pain is associated with high levels of mental health issues and alterations in cognitive processing. Cognitive-behavioral models illustrate the role of memory alterations in the development and maintenance of chronic pain as well as in mental health disorders which frequently co-occur with chronic pain. This study aims to expand our understanding of specific cognitive mechanisms underlying chronic pain which may in turn shed light on cognitive processes underlying pain-related psychological distress. Individuals who reported a history of chronic pain and (...) individuals who reported no history of chronic pain were recruited from MTurk to complete an online survey including standardized measures of anxiety and depression and two sentence completion tasks that assessed autobiographical memory and future thinking specificity and content. Chi square analyses revealed that participants who endorsed experiencing chronic pain were significantly more likely to recall at least one painful and negative event and to imagine at least one anticipated painful event in their future. Two ANCOVAs were performed to examine the degree to which chronic pain endorsement influenced specificity in memory and future imagining. Individuals with a history of chronic pain and higher levels of depression symptom severity generated autobiographical memories with significantly less specificity; whereas, individuals with a history of chronic pain also generated future autobiographical events with significantly less specificity. In addition, individuals with a history of chronic pain were more likely to generate episodes related to pain when asked to recall the past or imagine the future. Further research is needed to improve our understanding of the etiology of autobiographical memory and future thinking specificity and content in the pathogenesis of mental health conditions in the context of chronic pain. (shrink)

The emerging area of philosophy of birth is invaluable, first, to diagnose fallacious assumptions about the relation between the womb and reason, and, ultimately, to challenge potentially damaging narratives with major impact on birth care. With its analysis of eighteenth-century epistemic and medical discussions about the role of the uterus in women's reasoning, this article supports two arguments: first, that women's “flawed thinking” was a premise drawn by many modern intellectual men, one that was presented as based upon empirical evidence; (...) and second, that the pervasive construction of the uterus as an element that renders women wild, uncontrollable, and irrational continues to influence contemporary obstetrics, even as today's medicine and science consider themselves to be free of any such prejudices.This article shows the role that Giacomo Casanova played in debunking these prejudices and presents his short manuscript on the issue as an important contribution to the literature of the Enlightenment, with its argument against women's supposed “natural” inferiority and for the idea that differences in education were to blame for women's subordinate position in society.Detailed analysis of the “thinking uterus” debate illuminates the different ways in which various arguments from/by the “anti-uterine” lobby were used to justify the subordination of women: sometimes emphasizing the connection between the uterus and thought and sometimes negating it, but always concluding that women's inferiority is to be found in some known or yet-to-be-discovered anatomical, and mainly sexual, deficiency or problem. (shrink)

The article proposes to sketch an analogy between, on the one hand, linguistic learning and sound dialogue in humanist music therapy and, on the other hand, certain reflections of Maurice Merleau-Ponty: in particular, the centrality of corporeality in the learning, treated in the Phenomenology of Perception and in the courses on the psychology and pedagogy of the child, and the status of inter-corporeality developed through reflections on passivity and the metaphor of flesh. We will trace an analysis of the music (...) therapy of Giulia Cremaschi Trovesi, with reference to the linguistic and musical gesture, through the Merleau-Pontian notion of praktognosia, and of the sound dialogue with reference to institution and intercorporeity. Through an interpretation of music in the terms adopted by Stéphanie Ménasé and in reference to Merleau-Pontian passivity in artistic creation, our objective is to define the musical institution of the vibrating body in music therapy in terms analogous to the institution of the subject according to Merleau-Ponty and, consequently, to find, in the sound dialogue, the intercorporeity which anticipates the individuation of the subject, by describing the communicative authenticity of the musical-therapeutic encounter. (shrink)

Prior research has investigated the recruitment of inhibition in the use of science/mathematics concepts in tasks that require the rejection of a conflicting, nonscientific initial concept. The present research examines if inhibition is the only EF skill recruited in such tasks and investigates whether shifting is also involved. It also investigates whether inhibition and/or shifting are recruited in tasks in which the use of science/mathematics concepts does not require the rejection of an initial concept, or which require only the use (...) of initial concepts. One hundred and thirty‐three third‐ and fifth‐grade children participated in two inhibition and shifting tasks and two science and mathematics conceptual understanding and conceptual change (CU&C) tasks. All the tasks were on‐line, and performance was measured in accuracy and RTs. The CU&C tasks involved the use of initial concepts and of science/mathematics concepts which required conceptual changes for their initial formation. Only in one of the tasks the use of the science/mathematics concepts required the concurrent rejection of an initial concept. The results confirmed that in this task inhibition was recruited and also showed that the speed of shifting was a significant predictor of performance. Shifting was a significant predictor of performance in all the tasks, regardless of whether they involved science/mathematics or initial concepts. It is argued that shifting is likely to be recruited in complex tasks that require multiple comparisons of stimuli and the entertainment of different perspectives. Inhibition seems to be a more selective cognitive skill likely to be recruited when the use of science/mathematics concepts requires the rejection of a conflicting initial concept. (shrink)

This work explores disempowerment caused by discourses surrounding the life-altering gynaecological disease of endometriosis. Despite affecting one in 10 women, the worldwide average diagnosis time is 7.5 years, and it is mainly diagnosed when exploring infertility rather than complaints about incapacitating pain and other associated manifestations. The aim of this article is to identify dis/empowerment caused by discourses in the healthcare and social environment of women as manifested in their accounts of endometriosis experiences. Having been informed and shaped by a (...) corpus analysis of online forum data, this work explores accounts collected through interviews with women who have endometriosis using discourse analytical tools. Through an examination of the dialectics between micro-level language choices inscribing agency, or lack of, and macro-level discourses in the contexts in which women interact, the findings indicate that disempowerment is mostly a consequence of the perceived lack of agency over achieving diagnosis and knowledge of the condition in order to understand and learn coping strategies. The article concludes with implications for endometriosis communication practices and suggestions for broader enquiries in the field. (shrink)