Background: Since the passage of the Patient Self-Determination Act, numerous policy mandates and institutional measures have been implemented. It is unknown to what extent those measures have affected end-of-life care, particularly with regard to the do-not-resuscitate order.Methods: Retrospective cohort study to assess associations of the frequency and timing of DNR orders with advance directive status, patient demographics, physician’s specialty and extent of documentation of discussion on end-of-life care.Results: DNR orders were more frequent for patients on a medical service than on (...) a surgical service and were made earlier in the hospital stay for medicine than for surgical patients . 22.18% of all patients had some form of an advance directive in their chart, yet this variable had no impact on the frequency or timing of DNR ordering. Documentation of DNR discussion was significantly associated with the frequency of DNR orders and the time from DNR to death .Conclusions: The physician’s specialty continues to have a significant impact on the frequency and timing of DNR orders, while advance directive status still has no measurable impact. Additionally, documentation of end-of-life discussions is significantly associated with varying DNR ordering rates and timing. (shrink)

Is there a link between how a firm manages its internal and external stakeholders? More specifically, are firms that give employees stock ownership and more say in running the enterprise more likely to engage with external stakeholders? This study seeks to answer these questions by elaborating on mechanisms that link employees to external stakeholders, such as the community, suppliers, and the environment. It tests these relationships using a sample of 347 private, mostly small-to-medium size firms, which completed a stakeholder impact (...) assessment organized by the non-profit B Lab. The results support the hypotheses that both employee ownership and employee involvement are positively associated with external stakeholder engagement. Further, we found that certification plays a role, as employee ownership contributes to external stakeholder engagement only in certified B Corporations, and not in firms that merely completed the B Lab Impact assessment. Our findings have import for stakeholder engagement frameworks, as we show that there is interplay between internal employee stakeholders and external stakeholders that may be important to overall firm–stakeholder management. (shrink)

Important features of the self-concept can be located outside of the individual and inside close or related others. The authors use this insight to reinterpret data previously said to support the empathy-altruism model of helping, which asserts that empathic concern for another results in selflessness and true altruism. That is, they argue that the conditions that lead to empathic concern also lead to a greater sense of self-other overlap, raising the possibility that helping under these conditions is not selfless but (...) is also directed toward the self. In 3 studies, the impact of empathic concern on willingness to help was eliminated when oneness--a measure of perceived self-other overlap--was considered. Path analyses revealed further that empathic concern increased helping only through its relation to perceived oneness, thereby throwing the empathy-altruism model into question. The authors suggest that empathic concern affects helping primarily as an emotional signal of oneness. (shrink)

1 Evidence-based policy requires researchers to provide the answers to ecological questions that are of interest to policy makers. To find out what those questions are in the UK, representatives from 28 organizations involved in policy, together with scientists from 10 academic institutions, were asked to generate a list of questions from their organizations. 2 During a 2-day workshop the initial list of 1003 questions generated from consulting at least 654 policy makers and academics was used as a basis for (...) generating a short list of 100 questions of significant policy relevance. Short-listing was decided on the basis of the preferences of the representatives from the policy-led organizations. 3 The areas covered included most major issues of environmental concern in the UK, including agriculture, marine fisheries, climate change, ecosystem function and land management. 4 The most striking outcome was the preference for general questions rather than narrow ones. The reason is that policy is driven by broad issues rather than specific ones. In contrast, scientists are frequently best equipped to answer specific questions. This means that it may be necessary to extract the underpinning specific question before researchers can proceed. 5 Synthesis and applications. Greater communication between policy makers and scientists is required in order to ensure that applied ecologists are dealing with issues in a way that can feed into policy. It is particularly important that applied ecologists emphasize the generic value of their work wherever possible. (shrink)

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)

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Understanding Wisdom Literature: Conflict and Dissonance in the Hebrew Text. By David Penchansky. Grand Rapids, Mich.: William B. Eerdmans Publishing Co., 2012. Pp. xii + 120. $20.

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

In this paper, I examine one central strand of Lackey’s The Epistemology of Groups, namely her account of group justified belief and the puzzle cases she uses to develop it. Her puzzle cases involve a group of museum guards most of whom justifiably believe a certain claim but do so on different bases. Consideration of these cases leads her to hold that a group justifiably believes p if and only if (1) a significant proportion of its operative members (a) justifiably (...) believe p on (b) bases that are consistent when combined and (2) the total evidence which members of the group do and should have had sufficiently support p. I question her judgement about these cases and condition 2, by examining the nature of group evidence as well as ‘transmission’ principles governing the relationship between the epistemic standing of members of a group and the group itself. (shrink)

Richard Taylor was born in Charlotte, Michigan on 5 November 1919. He received his A. B. from the University of illinois in 1941, his M. A. from Oberlin College in 1947, and his Ph. D. from Brown University in 1951. He has been William H. P. Faunce Professor of Philosophy at Brown University, Professor of Philosophy (Graduate Faculties) at Columbia University, and Professor of Philosophy at the University of Rochester. He is the author of about fifty articles and (...) of five philosophical books. This volume consists of essays presented to Richard Taylor on the occa sion of his sixtieth birthday. Some of the contributors have been Taylor'S students; some have been his colleagues; and all have been, and continue to be, his admirers. I have made several attempts to articulate what it is I (I would not presume to speak for anyone else) admire about Richard Taylor: (1) There is a particular 'flavor' to Taylor's philosophical writing and con versation that is wholly delightful. Like any other flavor, it can be tasted and enjoyed and remembered but never adequately described. (If there should be someone who has picked up this book who does not know what I mean, I recommend that he read the chapter on 'God' in Taylor's Metaphysics. ) (2) Taylor is a masterful dialectician. (shrink)

Boghossian has argued that Putnam's externalism is incompatible with privileged access, i.e., the claim that a subject can have nonempirical knowledge of her thought contents ('What the externalist can know a priori', PAS 1997). Boghossian's argument assumes that Oscar can know a priori that (1) 'water' aims to name a natural kind; and (2) 'water' expresses an atomic concept. However, I show that if Burge's externalism is correct, then these assumptions may well be false. This leaves Boghossian with two options: (...) (a) (heroically) to show that Burge's externalism is false; or (b) to reformulate the argument such that it does not require the two assumptions in question. I suggest one way of reformulating the argument. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:242 HISTORY OF PHILOSOPHY his political and religious predispositions prodded him to demonstrate that the roots of modern science were in the Christian Middle Ages. Sarton's particular foibles are best understood by referring them to his pacifist commitments and the moralistic assumption that the values of science are transferable to other human endeavors. Categories such as inductivism, conventionalism and Popperianism are of little help in gaining historical understanding. For (...) this, they are in fact Platonic ideals which have little heuristic value. I would venture that a truly historical historiography of science would aid us in spotting errors in the past and help us in the future. My guess is that a good analysis would reveal a major source of trouble to have stemmed from preconceived notions which the history of science was meant to illustrate. Surely some of them have been philosophical in character, and even Baconian or conventionalist. But until recent times, most of these preconceptions have stemmed from religious, nationalistic, or personal motivations, or from scientists who wanted support for a particular concept. I agree with Agassi only in the suggestion that a parti pris was at the root of our troubles. Why, then, substitute a Popperian preconception for a conventionalist one? Why not, on the contrary, combat their distorting influence and reduce their impact? This is in fact what has happened in recent times. As the history of science has fallen into the hands of a gradually organized profession, the blatant motivations --of any type--which colored past historical writings have slowly receded. By a constant and critical confrontation of opposing views among specialists, the purpose for examining the history of science has slowly been transformed. The older external motivations have given way to an interest in the subject for its own sake and a gradual transformation has been in the making for the last few decades. As happens in other human endeavors, professionalization has already raised the standards in the discipline and there is every reason to think it will continue to do so in the future. We need not really be as pessimistic as Agassi, nor embrace his particular salvation. ROGEa HAm~ University o] Cali]ornia, Berkeley A MEDIEVAL ANALYSIS OF INFINITY IN THE COURSEof arguing that time must have had a beginning, St. Bonaventure (1221-74) put forward a demonstration which in some ways seems to anticipate Cantor's definition of infinity.1 Bonaventure pointed out that, if the world were infinitely old, then there would have been an infinite number of annual revolutions of the sun around the ecliptic. But during each such period there occur (roughly) twelve revolutions of the moon, i.e. lunar months or lunations. Thus there would be one infinity which was twelve times another--which, says Bonaventure, is impossible. This attempted proof might be formulated as the following For other adumbrationsof this definition,see I. Thomas,"A TwelfthCentury Paradoxof the Infinite,"Journal o] Symbolic Logic, XXIII (1958), 133-134, and W. & M. Kneale, The Development of Logic (Oxford,1962),p. 440. NOTES AND DISCUSSIONS 243 reductio ad absurdum, in which a revolution of the sun is specified as the period between successive vernal equinoxes. If there could be an infinite set of past lunations, then clearly it could be put in a one-to-one correspondence with a proper sub-set of itself--viz., with the set of past lunar months during which vernal equinoxes occurred. But this consequence is preposterous; no set could be so correlated with its own sub-set. Therefore the set of past lunar months cannot be infinite, and the world must have had a beginning. The passage, which is found in Bonaventure's commentary on the Sentences of Peter Lombard, reads as follows :2 Si mundus est aeternus, revolutiones solis in orbe suo sunt infmitae ; rursus, pro una revolutions solis necesse est fuisse duodecim ipsius lunae: ergo plus revoluta est luna quam sol; et sol infinities: ergo infinitorum ex ea parle, qua infinita sunt, est reperire excessum. Hoe autem est impossibile : ergo etc. PA~-r~asoN BROWN Harpur College, State University o] New York Sententiarum L/b. H, Dist. I, P.I, Art. I, Quaest. II, as found in S. Bonaventurme, Opera Omnla... (shrink)

Rogers, C. R. and Skinner, B. F. Some issues concerning the control of human behavior.--Broudy, H. S. Didactics, heuristics, and philetics.--Craig, R. An analysis of the psychology of moral development of Lawrence Kohlberg.--Scudder, J. R., Jr. Freedom with authority: a Buber model for teaching.--Hook, S. Some educational attitudes and poses.--Strike, K. A. Freedom, autonomy, and teaching.--Elkind, D. Piaget and Montessori.--Raywid, M. A. Irrationalism and the new reformism.--Doll, W. E., Jr. A methodology of experience: the process of inquiry.--Neff, F. C. Competency-based (...) teaching and trained fleas.--Brown, A. "What could be bad?" Some reflections on the accountability movement. (shrink)

In this essay, I read Stuart Hall’s idea of “politics without guarantees” as meaning that all concepts are saturated with history and that no use of a concept can prevent it from being co-opted. The contribution of this reading is that it shifts the task of critical theory: if all concepts carry limitations and can be used to advance domination, then critical theorists need not search for pure concepts or worry about how to prevent our concepts from being captured. Instead, (...) our task is to strategically leverage always already imperfect concepts with a view toward shared political goals. For an example of this kind of critical theory, I look to W. E. B. Du Bois’s uses of “human,” “humanity,” and “human rights” in Black Reconstruction, which I suggest were informed by how he came to understand “humanity” in John Brown. (shrink)

This letter to the editor responds to commentaries in the September‐October 2021issue of the Hastings Center Report by Douglas B. White and Bernard Lo, by Govind Persad, and by Virginia A. Brown, which were themselves responding, in part, to the article “Life‐Years and Rationing in the Covid‐19 Pandemic: A Critical Analysis,” by MaryKatherine Gaurke, Bernard Prusak, Kyeong Yun Jeong, Emily Scire, and Daniel P. Sulmasy.

A hippocampal patient is described who shows preserved item recognition and simple recognition-based recollection but impaired recall and associative recognition. These data and other evidence suggest that contrary to Aggleton & Brown's target article, Papez circuit damage impairs only complex item-item-context recollection. A patient with perirhinal cortex damage and a delayed global memory deficit, apparently inconsistent with A&B's framework, is also described.

Central to Thomas Sprat's History of the Royal Society was the description and justification of the method adopted and advocated by the Fellows of the Society, for it was thought that it was their method which distinguished them from ancients, dogmatists, sceptics, and contemporary natural philosophers such as Descartes. The Fellows saw themselves as furthering primarily a novel method, rather than a system, of philosophy, and the History gave expression to this corporate self-perception. However, the History's description of their method (...) was not necessarily accurate. Rather, as will be argued below, by a combination of subtle misrepresentation and selective exposition, Sprat portrayed a method which would further the aims of social and ecclesiastical stability and material prosperity, essential for the Royal Society since its continued existence depended upon the creation of a social basis for the institutionalized pursuit of natural philosophy. Some link had to be forged between the activities of the Society and the intellectual and social aspirations of the Restoration. To understand the intent and meaning of Sprat's History and the method there portrayed, we must therefore look to the institutional needs which it fulfilled. (shrink)

Consider the concept combination ‘pet human’. In word association experiments, human subjects produce the associate ‘slave’ in relation to this combination. The striking aspect of this associate is that it is not produced as an associate of ‘pet’, or ‘human’ in isolation. In other words, the associate ‘slave’ seems to be emergent. Such emergent associations sometimes have a creative character and cognitive science is largely silent about how we produce them. Departing from a dimensional model of human conceptual space, this (...) article will explore concept combinations, and will argue that emergent associations are a result of abductive reasoning within conceptual space, that is, below the symbolic level of cognition. A tensor-based approach is used to model concept combinations allowing such combinations to be formalized as interacting quantum systems. Free association norm data is used to motivate the underlying basis of the conceptual space. It is shown by analogy how some concept combinations may behave like quantum-entangled particles. Two methods of analysis were presented for empirically validating the presence of non-separable concept combinations in human cognition. One method is based on quantum theory and another based on comparing a joint probability distribution with another distribution based on a separability assumption using a chi-square goodness-of-fit test. Although these methods were inconclusive in relation to an empirical study of bi-ambiguous concept combinations, avenues for further refinement of these methods are identified. (shrink)

This essay explores some concerns about the quality of informed consent in patients whose autonomy is diminished by fatal illness. It argues that patients with diminished autonomy cannot give free and voluntary consent, and that recruitment of such patients as subjects in human experimentation exploits their vulnerability in a morally objectionable way. Two options are given to overcome this objection: (i) recruit only those patients who desire to contribute to medical knowledge, rather than gain access to experimental treatment, or (ii) (...) provide prospective subjects the choice to participate in standard doubleblind study or receive the experimental treatment. Either option would guarantee that patients in desperate conditions are given a more meaningful choice and a richer freedom, and thus a higher quality of informed consent, than under standard randomized trials. (shrink)

Einstein regarded as one of the triumphs of his 1915 theory of gravity - the general theory of relativity - that it vindicated the action-reaction principle, while Newtonian mechanics as well as his 1905 special theory of relativity supposedly violated it. In this paper we examine why Einstein came to emphasise this position several years after the development of general relativity. Several key considerations are relevant to the story: the connection Einstein originally saw between Mach's analysis of inertia and both (...) the equivalence principle and the principle of general covariance, the waning of Mach's influence owing to de Sitter's 1917 results, and Einstein's detailed correspondence with Moritz Schlick in 1920. (shrink)

Predation and escaping from predation through hiding are two fundamental phenomena in ecology. The most common approach to reducing the chance of predation is to use a refuge. Here, we consider a three species fishery model system with prey refuge induced by a Holling type-II functional response. These three species of fish populations are named prey, middle predator, and top predator. Harvesting is employed in most fishery models to achieve both ecological and commercial benefits. Research proves that non-linear harvesting (Michaelis–Menten (...) type) returns more realistic outcomes. So, we have combined the Michaelis–Menten type of harvesting efforts for all populations. Uniform boundedness conditions for the solutions of the model are discussed. The existence conditions for possible equilibrium points with stability are presented. We explain the dynamical behavior at each equilibrium point through bifurcation analysis. The persistent criteria of the system are examined. Bionomic equilibrium and optimal harvesting control using Pontryagin’s maximum principle are calculated. For validation of the model in the real world, we have implemented this in the freshwater ecosystem of Lake Victoria. Extraction of native fish species and ecological balances are the foremost solicitude of Lake Victoria. We may resolve this concern partially by implementing prey refuge, since it may sustain the ecology of Lake Victoria, and therefore also its economical importance. Lake Victoria is acclaimed worldwide for the trade of fishing. Also, it provides the largest employment in east-central Africa and is beneficial to fishing equipment manufacturers. So, the bionomic equilibrium and harvesting control have significant applications in the fisheries. All the analytical studies are verified by numerical simulations. We have plotted phase portraits, bifurcation diagrams, Lyapunov exponents to explore the dynamics of the proposed model. (shrink)

There is currently a debate over whether cognitive architecture is classical or connectionist in nature. One finds the following three comparisons between classical architecture and connectionist architecture made in the pro-connectionist literature in this debate: (1) connectionist architecture is neurally plausible and classical architecture is not; (2) connectionist architecture is far better suited to model pattern recognition capacities than is classical architecture; and (3) connectionist architecture is far better suited to model the acquisition of pattern recognition capacities by learning than (...) is classical architecture. If true, (1)-(3) would yield a compelling case against the view that cognitive architecture is classical, and would offer some reason to think that cognitive architecture may be connectionist. We first present the case for (1)-(3) in the very words of connectionist enthusiasts. We then argue that the currently available evidence fails to support any of (1)-(3). (shrink)

By utilizing new information from both clinical and experimental (lesion, electrophysiological, and gene-activation) studies with animals, the anatomy underlying anterograde amnesia has been reformulated. The distinction between temporal lobe and diencephalic amnesia is of limited value in that a common feature of anterograde amnesia is damage to part of an comprising the hippocampus, the fornix, the mamillary bodies, and the anterior thalamic nuclei. This view, which can be traced back to Delay and Brion (1969), differs from other recent models in (...) placing critical importance on the efferents from the hippocampus via the fornix to the diencephalon. These are necessary for the encoding and, hence, the effective subsequent recall of episodic memory. An additional feature of this hippocampalanterior thalamic and the perirhinal–medial dorsal thalamic systems are compromised, leading to severe deficits in both recall and recognition. (shrink)