The Belmont Report’s distinction between research and the practice of accepted therapy has led various authors to suggest that these purportedly distinct activities should be governed by different ethical principles. We consider some of the ethical consequences of attempts to separate the two and conclude that separation fails along ontological, ethical, and epistemological dimensions. Clinical practice and clinical research, as with yin and yang, can be thought of as complementary forces interacting to form a dynamic system in which the whole (...) exceeds the sum of its parts. Just as effective clinical practice cannot exist without clinical research, meaningful clinical research requires the context of clinical practice. We defend this thesis by triangulation, that is, by outlining how multiple investigators have reached this conclusion on the basis of varied theoretical and applied approaches. More confidence can be placed in a result if different methods/viewpoints have led to that result. (shrink)

Attention is strongly influenced by both external stimuli and internal goals. However, this useful dichotomy does not readily capture the ubiquitous and often automatic contribution of past experience stored in memory. We review recent evidence about how multiple memory systems control attention, consider how such interactions are manifested in the brain, and highlight how this framework for ‘memory-guided attention’ might help systematize previous findings and guide future research.

Volume 20, Issue 10, October 2020, Page 96-98.

Although activated spinal cord glia contribute importantly to neuropathic pain, how nerve injury activates glia remains controversial. It has recently been proposed, on the basis of genetic approaches, that toll-like receptor 4 may be a key receptor for initiating microglial activation following L5 spinal nerve injury. The present studies extend this idea pharmacologically by showing that TLR4 is key for maintaining neuropathic pain following sciatic nerve chronic constriction injury. Established neuropathic pain was reversed by intrathecally delivered TLR4 receptor antagonists derived (...) from lipopolysaccharide. Additionally, -naltrexone, -naloxone, and -naloxone, which we show here to be TLR4 antagonists in vitro on both stably transfected HEK293-TLR4 and microglial cell lines, suppressed neuropathic pain with complete reversal upon chronic infusion. Immunohistochemical analyses of spinal cords following chronic infusion revealed suppression of CCI-induced microglial activation by -naloxone and -naloxone, paralleling reversal of neuropathic pain. Together, these CCI data support the conclusion that neuron-to-glia signaling through TLR4 is important not only for initiating neuropathic pain, as suggested previously, but also for maintaining established neuropathic pain. Furthermore, these studies suggest that the novel TLR4 antagonists -naloxone and -naloxone can each fully reverse established neuropathic pain upon multi-day administration. This finding with -naloxone is of potential clinical relevance. This is because -naloxone is an antagonist that is inactive at the -opioid selective receptors on neurons that produce analgesia. Thus, these data suggest that -opioid antagonists such as -naloxone may be useful clinically to suppress glial activation, yet -opioid agonists suppress pain. (shrink)

At the conclusion of his De lege naturae apodictica methodus, a treatise on the law of nature, how it is grasped by the human mind, and how it coheres with the Decalogue, Niels Hemmingsen claims to have eschewed the use of theological sources in his argument, claiming instead to have demonstrated ‘how far reason is able to progress without the prophetic and apostolic word’. Yet the reader of the treatise will notice several citations of theologians alongside those of pagan poets (...) and philosophers. This essay demonstrates that there is less here than meets the eye, that is, that Hemmingsen quotes theologians only to buttress what one can know from natural reason or the classical tradition, even when he is discussing God, and thus he does not violate his own stated principle. (shrink)

BackgroundFear of cancer recurrence is an important cause of suffering for cancer survivors, and both empirical evidence and theoretical models suggest that prognostic uncertainty plays a causal role in its development. However, the relationship between prognostic uncertainty and FCR is incompletely understood.ObjectiveTo explore the relationship between prognostic uncertainty and FCR among patients with ovarian cancer.DesignA qualitative study was conducted utilizing individual in-depth interviews with a convenience sample of patients with epithelial ovarian cancer who had completed first-line treatment with surgery and/or (...) chemotherapy. Semi-structured interviews explored participants’ understanding of their prognosis; experiences, preferences, and attitudes regarding prognostic information; and strategies for coping with prognostic uncertainty. Inductive qualitative analysis and line-by-line software-assisted coding of interview transcripts was conducted to identify key themes and generate theoretical insights on the relationship between prognostic uncertainty and FCR.ResultsThe study sample consisted of 21 participants, nearly all of whom reported experiencing significant FCR, which they traced to an awareness of the possibility of a bad outcome. Some participants valued and pursued prognostic information as a means of coping with this awareness, suggesting that prognostic uncertainty causes FCR. However, most participants acknowledged fundamental limits to both the certainty and value of prognostic information, and engaged in various strategies aimed not at reducing but constructing and maintaining prognostic uncertainty as a means of sustaining hope in the possibility of a good outcome. Participants’ comments suggested that prognostic uncertainty, fear, and hope are connected by complex, bi-directional causal pathways mediated by processes that allow patients to cope with, construct, and maintain their uncertainty. A provisional dual-process theoretical model was developed to capture these pathways.ConclusionAmong patients with OC, prognostic uncertainty is both a cause and an effect of FCR—a fear-inducing stimulus and a hope-sustaining response constructed and maintained through various strategies. More work is needed to elucidate the relationships between prognostic uncertainty, fear, and hope, to validate and refine our theoretical model, and to develop interventions to help patients with OC and other serious illnesses to achieve an optimal balance between these states. (shrink)

Background: When adolescent boys experience close, secure relationships with their parents and peers, the implications are potentially far reaching, including lower levels of mental health problems in adolescence and young adulthood. Here we use rare prospective intergenerational data to extend our understanding of the impact of adolescent attachments on subsequent postpartum mental health problems in early fatherhood.Methods: At age 17–18 years, we used an abbreviated Inventory of Parent and Peer Attachment to assess trust, communication, and alienation reported by 270 male (...) participants in their relationships with mothers, fathers, and peers. More than a decade later, we assessed the adult males, now fathers, at 12 months postpartum for symptoms of depression, anxiety, and stress. Logistic regression was used to examine the extent to which attachment dimensions predicted paternal postpartum mental health, adjusting for potential confounding, and with assessment for interactions between parent and peer attachments.Results: Trust in mothers and peers, and good communication with fathers during adolescence, were associated with 5 to 7 percentage point reductions in postpartum mental health symptoms in early fatherhood. Weak evidence of parent-peer interactions suggested secure attachments with either parent or peer may compensate for an insecure attachment with the other.Conclusions: Our results suggest that fostering trust and communication in relationships that adolescent boys have with parents and peers may have substantial effects on rates of paternal postpartum mental health problems. The protective benefits may be preventative in intergenerational cycles of risk for mental health problems. (shrink)

Athens and Wittenberg explores how Luther and early Lutheranism did not neglect the classics of Greece and Rome, but continued to draw from the philosophy and poetry of antiquity in their quest to reform the church.

THIS PAPER CONCERNS A CONTROVERSY about priorities between J. D. Forbes, Professor of Natural Philosophy at the University of Edinburgh, and the noted Swiss scientist Louis Agassiz, later to be a distinguished teacher at Harvard. Its origins lie in the visit which Forbes made at Agassiz' invitation to the Unteraar glacier in Switzerland, in the summer of 1841, during which a major topic of interest was their observations of the bandes bleues, markings in the ice previously little discussed. Both men, (...) in independent later publications, were to establish the importance of the bandes in the theory of glacial ice and its movement. The question of credit for the discovery, and priority in its publication, was unclear at the time and has remained so despite bitter debate. Examination of surviving papers in Great Britain and in Switzerland suggests that previous discussions have not closed the question,' and our purpose is to review the evidence and if possible to clarify the issue. (shrink)

Outstanding translations by leading contemporary scholars--many commissioned especially for this volume--are presented here in the first single edition to include the entire surviving corpus of works attributed to Plato in antiquity. In his introductory essay, John Cooper explains the presentation of these works, discusses questions concerning the chronology of their composition, comments on the dialogue form in which Plato wrote, and offers guidance on approaching the reading and study of Plato's works. Also included are concise introductions by Cooper and (...) class='Hi'>Hutchinson to each translation, meticulous annotation designed to serve both scholar and general reader, and a comprehensive index. This handsome volume offers fine paper and a high-quality Smyth-sewn cloth binding in a sturdy, elegant edition. (shrink)

Doing Ethics in a Pluralistic World is an apt title for this collection of essays in honour of Roger C. Hutchinson who, over many decades, has encouraged and participated in shaping a Canadian contextual social ethics. His abiding interest in social ethics and in religious engagement with public issues is reflected in his life’s work — seeking the consensus and self-knowledge required to achieve cooperation in the search for a just, participatory, and sustainable society. One of Roger Hutchinson’s (...) many notable accomplishments is his development of a method of dialogue for ethical clarification in situations of diversity. Some of the essays collected here apply this method to specific issues, while others discuss how religious persons and organizations can and do co-operate in a pluralistic world to achieve social and ecological well-being. All essays are of keen interest to those concerned with the role and function of ethics at the matrix of religious conviction and social transformation. For nearly three decades Roger Hutchinson has been based at Victoria University in Toronto, first in religious studies, then at Emmanuel College, where he completed his teaching career as professor of church and society while serving as principal from 1996 to 2001. (shrink)

Diagrams refer to the phenomena overtly represented, to analogous phenomena, and to previous pictures and their graphic conventions. The diagrams of ecologists Clarke, Hutchinson, and H.T. Odum reveal their search for physical analogies, building on the success of World War II science and the promise of cybernetics. H.T. Odum's energy circuit diagrams reveal also his aspirations for a universal and natural means of reducing complexity to guide the management of diverse ecological and social systems. Graphic conventions concerning framing and (...) translation of ecological processes onto the flat printed page facilitate Odum's ability to act as if ecological relations were decomposable into systems and could be managed by analysts external to the system. (shrink)

J. N. Adams, Michael Lapidge, and Tobias Reinhardt: IntroductionJ. H. W. Penney: Connections in Archaic Latin ProseJ. Briscoe: Language and Style of the Fragmentary Republican HistoriansJ. N. Adams: The Bellum AfricumChristina Shuttleworth Kraus: Hair, Hegemony, and Historiography: Caesar's Style and its Earliest CriticsJ. G. F. Powell: Cicero's Adaptation of Legal Latin in the De legibusTobias Reinhardt: Language of Epicureanism in Cicero: The Case of AtomismG. O. Hutchinson: Pope's Spider and Cicero's WritingR. G. Mayer: The Impracticability of 'Kunstprosa'H. M. Hine: (...) Poetic Influence on Prose: The Case of the Younger SenecaHarm Pinkster: The Language of Pliny the ElderD. R. Russell: Omisso speciosiore stili genereS. J. Harrison: The Poetics of Fiction: Poetic Influence on the Languages of Apuleius' MetamorphosesD. R. Langslow: 'Langues réduites au lexique'? The Languages of Latin Technical ProseDanuta Shanzer: of Tours and Poetry: Prose into Verse and Verse into ProseMichael Lapidge: Poeticism in Pre-Conquest Anglo-Latin ProseRichard Sharpe: The Varieties of Bede's ProseCarlotta Dionisotti: Translator's LatinWalter Berschin: Realistic Writing in the Tenth Century: : Gerhard of Ausburg's Vita S. UodalriciR. M. Thomson: William of Malmesbury and the Latin Classics RevisitedGiovanni Orlandi: Metrical and Rhythmical Clausulae in Medieval Latin Prose: Some Aspects and Problems. (shrink)