Baumard's thesis that the English Industrial Revolution can be explained by Life History Theory's predictions for psychological development is a progression of much literature in economic and social history. However, the theory suffers from its reliance on increasingly fragile data indicators for “wealth” and its focus on “innovation” as new research begins to explore sectoral dynamics in long run growth.

Advocates of “concordance” describe it as a new model of shared decision-making between physicians and patients based on a partnership of equals. “Concordance” is meant to make obsolete the notion of “compliance,” in which patients are seen as, ideally, following doctors’ orders. This essay offers a critical view of concordance, arguing that the literature itself on concordance, including materials at the web site of Medicines Partnership, the implementation arm in Great Britain of the concordance model, is full of contradiction; concordance, (...) in fact, harbors an ideology of compliance. The essay suggests that an improvement in patient medication use will more likely come from a frank consideration of the relation of compliance issues and commercial ones, and that a key question across domains is, “how are patients/health agents/consumers persuaded to acquire certain drugs and take them as directed?”. (shrink)

Since the terms of the health policy debate in the United States and Canada are largely supplied by biomedicine, the current “crisis” in health care is, in part, a product of biomedical rhetoric. In this essay, three metaphors widely identified as being associated with biomedicine—the body is a machine, medicine is war,and medicine is a business—are examined with a view to the ways in which they influence the health policy debate, not only with respect to outcomes, but also with respect (...) to what can be argued at all. The essay proposes that biomedical language itself be foregrounded as the constitutive material of public discourse on health policy. (shrink)

Mental health care providers increasingly confront challenges posed by the introduction of new neurotechnology into the clinic, but little is known about the impact of such capabilities on practice patterns and relationships with patients. To address this important gap, we sought providers’ perspectives on the potential clinical translation of functional neuroimaging for prediction and diagnosis of mental illness. We conducted 32 semi-structured telephone interviews with mental health care providers representing psychiatry, psychology, family medicine, and allied mental health. Our results suggest (...) that mental health providers have begun to re-conceptualize mental illness with a neuroscience gaze. They report an epistemic commitment to the value of a brain scan to provide a meaningful explanation of mental illness for their clients. If functional neuroimaging continues along its projected trajectory to translation, providers will ultimately have to negotiate its role in mental health. Their perspectives, therefore, enrich bioethical discourse surrounding neurotechnology and inform the translational pathway. (shrink)

Advances in neuroscience are changing how mental health issues such as addiction are understood and addressed as a brain disease. Although a brain disease model legitimizes addiction as a medical condition, it promotes neuro-essentialist thinking and categorical ideas of responsibility and free choice, and undermines the complexity involved in its emergence. We propose a “biopsychosocial systems” model where psychosocial factors complement and interact with neurogenetics. A systems approach addresses the complexity of addiction and approaches free choice and moral responsibility within (...) the biological, lived experience and sociohistorical context of the individual. We examine heroin-assisted treatment as an applied case example within our framework. We conclude with a discussion of the model and its implications for drug policy, research, addiction health care systems and delivery, and treatment of substance use problems. (shrink)

Neurosurgery for psychiatric disorders, also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to (...) set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law, what types of regulations are required, and how to approach international harmonization given the potential migration of researchers and patients. (shrink)

A brain-computer interface technology that can decode the neural signals associated with attempted but unarticulated speech could offer a future efficient means of communication for people with severe motor impairments. Recent demonstrations have validated this approach. Here we assume that it will be possible in future to decode imagined (i.e., attempted but unarticulated) speech in people with severe motor impairments, and we consider the characteristics that could maximize the social utility of a BCI for communication. As a social interaction, communication (...) involves the needs and goals of both speaker and listener, particularly in contexts that have significant potential consequences. We explore three high-consequence legal situations in which neurally-decoded speech could have implications:Testimony, where decoded speech is used as evidence;Consent and Capacity, where it may be used as a means of agency and participation such as consent to medical treatment; andHarm, where such communications may be networked or may cause harm to others. We then illustrate how design choices might impact the social and legal acceptability of these technologies. (shrink)

The generation of isometric force at the hand can be mediated by activating a few motor modules. Stroke induces alterations in motor modules underlying steady-state isometric force generation in the human upper extremity. However, how the altered motor modules impact task performance remains unclear as stroke survivors develop and converge to the three-dimensional target force. Thus, we tested whether stroke-specific motor modules would be activated from the onset of force generation and also examined how alterations in motor modules would induce (...) changes in force representation. During 3D isometric force development, electromyographic signals were recorded from eight major elbow and shoulder muscles in the paretic arm of 10 chronic hemispheric stroke survivors and both arms of six age-matched control participants. A non-negative matrix factorization algorithm identified motor modules in four different time windows: three “exploratory” force ramping phases and the stable force match phase. Motor module similarity and between-force coupling were examined by calculating the scalar product and Pearson correlation across the phases. To investigate the association between the end-point force representation and the activation of the motor modules, principal component analysis and multivariate multiple linear regression analyses were applied. In addition, the force components regressed on the activation profiles of motor modules were utilized to model the feasible force direction. Both stroke and control groups developed exploratory isometric forces with a non-linear relationship between EMG and force. During the force matching, only the stroke group showed abnormal between-force coupling in medial-lateral and backward-forward and medial-lateral and downward-upward directions. In each group, the same motor modules, including the abnormal deltoid module in stroke survivors, were expressed from the beginning of force development instead of emerging during the force exploration. The PCA and the multivariate multiple linear regression analyses showed that alterations in motor modules were associated with abnormal between-force coupling and limited feasible force direction after stroke. Overall, these results suggest that alterations in intermuscular coordination contribute to the abnormal end-point force control under isometric conditions in the UE after stroke. (shrink)

Objectives The objectives of the study are to understand the current practice of informed consent in medical research in public hospitals in Shanghai, and to share our views with other countries, especially developing countries. Methods In the study, 145 consent forms (CFs) of the selected research projects in eight public hospitals with ethics committees in Shanghai were audited, and the principle investigators (PIs) of these research projects and 40 student subjects who had participated in clinical drug tests were surveyed by (...) questionnaires. Results The CFs of medical researches in public hospitals with ethics committees in Shanghai were generally acceptable. However, there were some defects in the CFs. Although most of the surveyed PIs had correct recognition of informed consent, some processes of informed consent were not in accordance with generally accepted requirements. A large number of the PIs considered the greatest difficulty with informal consent was lack of correct recognition of subjects or legally authorised representatives on medical research. Discussion Informed consent in medical research should consider the research ethics, the background of potential subjects, the local resources and culture of medical research. In addition, special protection is needed for student subjects in informed consent as well as efforts for building and restoring the public's trust in biomedical research. Conclusion The informed consent in Shanghai's public hospitals with ethics committees was generally acceptable and the achievement of adequate informed consent is influenced by many factors. (shrink)

The garish glow of neon was part of what put Las Vegas on the map—quite literally. The city’s most distinctive form of expression, neon signs tell an elaborate story of the history of Las Vegas, from their debut in 1929 at the onset of the Depression, when their seductive tones lured travelers through the Mojave Desert to part with scarce dollars, to today, when their flickering glow is a vanishing facet of the gaudy spectacle that is contemporary Vegas. Established in (...) 1996 to preserve Las Vegas’s underappreciated neon heritage, the Neon Boneyard houses many of the city's historic casino signs on a three-acre site at the edge of the city. The core of the collection of unrestored signage came from the pioneering Young Electric Sign Company, one of the first to produce neon signs in the area; but, in recent years, it has grown through donations from businesses and individuals who appreciate the key role played by neon in the growth of Las Vegas. Through Judy Natal’s photographs, the Neon Boneyard becomes a dynamic archaeological site that brings Vegas’s past to life in startling ways. The towering figure of Mr. O’Lucky becomes a home for the homeless, while the crumpled sign of a wedding chapel reflects the faded dreams of a lost paradise. Through such juxtapositions of success and failure, of past and present, Neon Boneyard: Las Vegas A–Z returns us to an earlier image of Vegas, suffused with the warm, commercial glow of neon, lighting the desert and inventing modern nightlife. (shrink)

Objective: The objectives of this study are to understand the current functions, structure and operation of hospital ethics committees (HECs) in Shanghai and to facilitate their improvement. Methods: (1) A questionnaire survey, (2) interviews with secretaries and (3) on-site document reviews of HECs in Shanghai were used in the study, which surveyed 33 hospitals. Results: In Shanghai, 57.56% of the surveyed hospitals established HECs from 1998 to 2005. Most HECs used bioethical review of research involving human subjects as well as (...) bioethical review or consultation regarding medical care services and administrative decision- making. Of the surveyed HECs, 14.3% did not provide any formal bioethical training to the HECs’ members and many HECs had no standard operating procedures. Some HECs had no clear definition of what was “conflict of interest” that should be considered by the HECs, while 44.4% of the HECs did not perform continuing review. Discussion: After the issues of related national regulations, more and more hospitals established HECs in Shanghai, but the functions of HECs need to be further developed and formal training on bioethics should be provided to HEC members. To assure the independence and good performance of HECs, the conflict of interest procedure, the standard operating procedures and bioethical review should be improved. Conclusion: HECs in Shanghai had developed in the preceding 10 years and they played great roles in protecting the rights and welfare of human subjects and patients; some areas need improvement. (shrink)

This paper studies two dual notions in module theory—namely, radicals and socles—from the standpoint of reverse mathematics. We first consider radicals of Z-modules, where the radical of a Z-module M is defined as the intersection of pM={px:x∈M} with p taken from all primes. It shows that ACA0 is equivalent to the existence of radicals of Z-modules over RCA0. We then study socles of modules over commutative rings with identity. The socle of an R-module M is the largest semisimple submodule of (...) M. We show that the existence of socles of modules over a commutative ring with identity is equivalent to ACA0 over RCA0. Vector spaces are semisimple modules over fields. In general, semisimple modules possess nice properties of vector spaces. Lastly, we study characterizations of semisimple modules over commutative rings using techniques of reverse mathematics. (shrink)

Background. Herpes zoster is a disease that mainly causes severe segmental neuralgia and vesicles after infection with herpes zoster virus. At the same time, more than 9 to 34 percent of patients have postherpetic neuralgia present with chronic pain for months or even years. Moxibustion has been used to treat herpes zoster and postherpetic neuralgia for many years; however, there has been no comprehensive study to evaluate the efficacy and safety of moxibustion in the treatment of herpes zoster and postherpetic (...) neuralgia. More studies evaluated the combined effects of acupuncture and moxibustion. Therefore, the purpose of this systematic review is to evaluate their efficacy and safety, so as to provide an evidence-based basis for the clinical application of moxibustion in the treatment of HZ and PHN. Method. The literature search was conducted in nine Chinese and English databases, and randomized controlled trials were pooled from their inceptions to June 2020. The included literature was screened, and data were extracted. RevMan 5.3 software and Stata software were used for statistical analysis. The primary outcome was the total effect. The secondary outcomes include VAS, NRS, and time of analgesia. Outcomes. From a total of 1957 identified studies, 31 were included in analysis. 31 RCTs contained the experimental sample of 1185 cases and the control sample of 1149 cases reported efficiency of different moxibustions in the treatment of herpes zoster, statistical heterogeneity inspection without heterogeneity. So, we used the fixed-effects model, merge effect quantity OR = 3.89, Z = 8.86, and it suggested sample merger analysis was statistically significant. Also, the moxibustion, compared to other methods in the treatment of herpes zoster and herpes zoster neuralgia efficiency, increased significantly. The VAS scales, WMD = 1.69, and the time of analgesia, WMD = 2.41, indicated that moxibustion surpassed others in the relief of pain. NRS was just reported in one study. It was not statistically significant. There was no significant difference in adverse effects OR = 0.61, Z = 1.56. Conclusion. Moxibustion has obvious advantages over other therapies in the treatment of HZ and PHN. However, due to the obvious publication bias, the interpretation of the results should be cautious, and more rigorous randomized controlled clinical studies should be included to further confirm the results in the future. (shrink)

The notion of superhigh computably enumerable (c.e.) degrees was first introduced by (Mohrherr in Z Math Logik Grundlag Math 32: 5–12, 1986) where she proved the existence of incomplete superhigh c.e. degrees, and high, but not superhigh, c.e. degrees. Recent research shows that the notion of superhighness is closely related to algorithmic randomness and effective measure theory. Jockusch and Mohrherr proved in (Proc Amer Math Soc 94:123–128, 1985) that the diamond lattice can be embedded into the c.e. tt-degrees preserving 0 (...) and 1 and that the two atoms can be low. In this paper, we prove that the two atoms in such embeddings can also be superhigh. (shrink)

ObjectiveTo explore the effect of modified constraint-induced movement therapy on upper limbs residual dysfunction for infancy with the sequelas of unilateral brachial plexus injury.MethodsSingle blind randomized controlled trial of mCIMT vs. standard care. An enrolling 31 infants with a uBPI exhibiting residual dysfunction of the affected upper limb for over 6 months was conducted. And functional outcomes pertaining to the affected upper limb were assessed via AMS, GRES, RHS, and MSS at 0, 3, and 6 months after treatment.ResultsNo differences were (...) found in baseline AMS, MSS, GRES, or RHS between the control and mCIMT groups [F = 0.062, P = 0.086; F = 0.483, P = 0.499; F = 0.272, P = 0.610; Z = −0.336, P = 7.373]. At the 3- and 6-month follow-up time points, AMS, MSS, and GRES scores were significantly improved over baseline in both groups [mCIMT: F = 183.750, 128.614, 110.085, P < 0.05; Control: F = 204.007, 75.246, 51.070, P < 0.05]. No significant differences were found between two treatment groups at the 3-month follow-up time point [F = 0.565, P = 0.465; F = 0.228, P = 0.641; F = 0.713, P = 0.413; Z = −0.666, P = 0.505]. However, at the 6-month follow-up time point, AMS and MSS scores were significantly improved in the mCIMT group relative to the control group [F = 8.077, P = 0.013; F = 18.692, P = 0.001].ConclusionmCIMT may benefit the rehabilitation of residual upper limb dysfunction associated with a uBPI in infants.Clinical Trial Registration[www.chictr.org.cn], identifier [ChiCTR1900022119]. (shrink)

Tomasz Ignacy Szpot Dunin SJ w swoim dziele poświęconym historii Chin nie ominął postaw znaczących chińskich dowódców w okresie przełomu historycznego jakim był upadek dynastii Ming i jej zastąpienie przez mandżurską dynastię Qing. Jednym z nich był Wu Sangui, który początkowo wspierał Mingów w walce z zewnętrznymi i wewnętrznymi wrogami, by w kluczowym momencie przyczynić się do powodzenia najazdu mandżurskiego, a po niemal trzech dekadach działania pod zwierzchnością nowej dynastii wypowiedzieć jej posłuszeństwo i stanąć na czele tzw. Rebelii Trzech Lenników. (...) Sprawa ta była znana w Europie i stała się nawet przedmiotem zainteresowania literackiego w XVIII w. Szpot Dunin nie poddaje się w swoim opisie skrajnym tendencjom, umiejętnie rozważa okoliczności decyzji i przedstawia zniuansowany, ale jednocześnie wyrazisty obraz postaci Wu Sangui, jego zamiarów i niepowodzeń. (shrink)

Perceptual attention is essential to both thought and agency, for there is arguably no demonstrative thought or bodily action without it. Psychologists and philosophers since William James have taken attention to be a ubiquitous and distinctive form of consciousness, one that leaves a characteristic mark on perceptual experience. As a process of selecting specific perceptual inputs, attention influences the way things perceptually appear. It may then seem that it is a specific feature of perceptual representation that constitutes what it is (...) like to consciously attend to an object. In fact conscious attention is more complicated. In what follows, I argue that the phenomenology of conscious attention to what is perceived involves not just a way of perceptually locking on to a specific object. It necessarily involves a way of cognitively locking on to it as well. (shrink)

This study draws on Kohlberg''s Cognitive Moral Development Theory and Hofstede''s Culture Theory to examine whether cultural differences are associated with variations in ethical reasoning. Ethical reasoning levels for auditors from Australia and China are expected to be different since auditors from China and Australia are also different in terms of the cultural dimensions of long term orientation, power distance, uncertainty avoidance and individualism. The Defining Issues Tests measuring ethical reasoning P scores were distributed to auditors from Australia and China (...) including Hong Kong and The Chinese Mainland. Results show that auditors from Australia have higher ethical reasoning scores than those from China, consistent with Hofstede''s Culture Theory predictions. (shrink)

This article provides a detailed overview of the neuroscience of consciousness.

On the morning of Friday, June 24, 2022, over half of the population of the United States was stripped of a fundamental constitutional right. And, within minutes, the reverberations of the Supreme...

Benjamin Libet has argued that electrophysiological signs of cortical movement preparation are present before people report having made a conscious decision to move, and that these signs constitute evidence that voluntary movements are initiated unconsciously. This controversial conclusion depends critically on the assumption that the electrophysiological signs recorded by Libet, Gleason, Wright, and Pearl are associated only with preparation for movement. We tested that assumption by comparing the electrophysiological signs before a decision to move with signs present before a decision (...) not to move. There was no evidence of stronger electrophysiological signs before a decision to move than before a decision not to move, so these signs clearly are not specific to movement preparation. We conclude that Libet’s results do not provide evidence that voluntary movements are initiated unconsciously. (shrink)

The mental patients' liberation movement, which started in the early 1970s, is a political movement comprised of people who have experienced psychiatric treatment and hospitalization. Its two main goals are developing self-help alternatives to medically-based psychiatric treatment and securing full citizenship rights for people labeled "mentally ill." The movement questions the medical model of "mental illness," and insists that people who have been labeled as "mentally ill" speak on their own behalf and not be represented by others who claim to (...) speak "for" them. The movement has developed its own philosophy, and operates a variety of self-help and mutual support programs in which ex-patients themselves control the services that are offered. Despite obstacles, the movement continues to grow and develop. (shrink)

In this article we explore the role of data custodians in establishing and maintaining social licence for the use of personal information in health research. Personal information from population‐level data collections can be used to make significant contributions to health and medical research, but this use is dependent on community acceptance or a social licence. We conducted semi‐structured interviews with data custodians across Australia to better understand data custodians’ views on their roles and responsibilities. This inductive, thematic analysis of the (...) interview data focuses on three factors that contribute to social licence – reciprocity, non‐exploitation and the public good. While the data custodians interviewed did not explicitly frame their role in the context of social licence, their descriptions of their roles and responsibilities clearly indicated that they did have some role to play in building and maintaining social licence. (shrink)

The idea that our conscious decisions determine our actions has been challenged by a report suggesting that the brain starts to prepare for a movement before the person concerned has consciously decided to move . Libet et al. claimed that their results show that our actions are not consciously initiated. The current article describes two experiments in which we attempted to replicate Libet et al.'s comparison of participants' movement-related brain activity with the reported times of their decisions to move and (...) also the reported times of their decisions of which hand to move. We also looked at the distribution of participants' reports over time to evaluate an alternative explanation of Libet et al.'s results. Although the Readiness Potential was usually present before all of the decisions to move, consistent with the findings of Keller and Heckhausen and Libet et al. , we found that many reported decision times were before the onset of the Lateralized Readiness Potential, which measures hand-specific movement preparation. The latter finding is consistent with the conclusion that the LRP always started after the conscious decision to move. We conclude that even though activity related to movement anticipation may be present before a conscious decision to move, the cortical preparation necessary for the movement to happen immediately may not start until after the conscious decision to move. (shrink)

Biobanks for long-term research pose challenges to the legal and ethical validity of consent to participate. Different models of consent have been proposed to answer some of these challenges. This paper contributes to this discussion by considering the meaning and value of consent to participants in biobanks. Empirical data from a qualitative study is used to provide a participant view of the consent process and to demonstrate that, despite limited understanding of the research, consent provides the research participants with some (...) level of control and a form of self determination that they value. Participation is framed as a moral act of a responsible citizen providing reinforcement of self identity. Consent symbolizes the trust invested in researchers and research institutions to use the biobank for the public good. The paper argues that consent continues to play an important role in biobank participation and that a participant view should inform proposals to modify consent processes. (shrink)

Harm reduction initiatives such as the distribution of naloxone have been crucial in saving lives during the opioid crisis in North America. Despite these efforts, today’s drug supply contaminated...