Reconstructive allografts using Vascularized Composite Allotransplantation are providing individuals living with upper limb loss and facial disfigurement with new opportunities for a sensate, esthetically acceptable, and functional alternative to current treatment strategies. Important research attention is being paid to how best to assess and screen candidates for VCA, measure optimal patient outcomes, and support patient adherence to lifelong behaviors and medical regimens. Far less attention, however, has been dedicated to the team science required for these complex VCA teams to form, (...) prepare, and provide the highest quality clinical and psychosocial care to those receiving VCA. VCA teams are unique in that they require specialized team members whose scope of practice may not otherwise overlap. The team also needs to constantly negotiate balancing patient safety with multiple risks throughout the transplant process. This study aimed to elucidate the team science needed for this highly innovative and complex area of medicine. Using in-depth qualitative interviews with 14 VCA team members and observations at team meetings, we found that careful consideration of team composition, team structure, and organizational commitment influences team performance and patient outcomes, but that to be efficient and truly effective, teams need to commit to developing processes that foster collaboration. These processes are action-oriented, strategic and interpersonal. Dedication and commitment to team science allows teams to manage conflict under stress and exercise ways to leverage strengths to provide optimal performance or patient psychosocial and clinical outcomes. This study can provide insight into quality improvement efforts for VCA teams and guidance for other transplant programs that wish to consider expansion into VCA. (shrink)

The past two decades have seen an outpouring of work in legal theory that is self-consciously critical of aspects of American law and the institutions of the liberal state. In this lively volume, eminent scholars in philosophy, law, and political science respond to this recent scholarship by exploring what constitutes a "radical" critique of the law, examining such theories as critical legal studies, feminist theory and theories of "difference," and critical race theory. The authors consider whether the critiques advanced in (...) recent legal theory can truly be called radical and what form a radical critique of American law should take. Writing at the cutting edge of the critique of critical legal theory, they offer insights first on critical legal scholarship, then on feminist political and legal theory. A third group of contributions questions the radicalness of these approaches in light of their failure to challenge fundamental aspects of liberalism, while a final section focuses on current issues of legal reform through critical views on criminal punishment, including observations on rape and hate speech. Each major essay describes the underlying principles in the development of a radical legal theory and addresses unresolved questions relating to it, while accompanying commentaries present conflicting views. The resulting dialogue explores wide-ranging issues like equity, value relativism, adversarial and empathic legal advocacy, communitarianism and the social contract, impartiality and contingency, "natural" law, and corrective justice. A common thread for many of the articles is a focus on the social dimension of society and law, which finds the individualism of prevailing liberal theories too limiting. Radical Critiques of the Law is particularly unique in presenting critical and feminist approaches in one volume-along with skeptical commentary about just how radical some critiques really are. Proposing alternative critiques that embody considerably greater promise of being truly radical, it offers provocative reading for both philosophers and legal scholars by showing that many claims to radicalism are highly problematic at best. (shrink)

The goals of vascular composite allotransplantation for hand are to maximize functional status and psychosocial wellbeing and to improve quality of life. Candidates are carefully vetted by transplant programs through an extensive evaluation process to exclude those patients with contraindications and to select those that are most likely to attain functional or quality of life benefit from transplant. Patient choice for any treatment, however, requires that candidates be able to understand the risks, benefits, and alternatives before choosing to proceed. This (...) study aimed to understand patients’ knowledge and perceptions about treatment options for hand loss, including hand transplant. This study will be used to inform a standardized education approach and develop conversation aids for use by clinicians and patients throughout the treatment decision process. Ten individuals who had experienced hand amputation or had congenital limb loss were interviewed to better understand previous and current decisions about treatment, experiences in adjusting to their treatment, and perceptions about hand VCA. From this qualitative interview data, four findings emerged: knowledge and education around VCA as a treatment option; adaptation of individuals with limb loss; fear of risk associated with transplantation; issues of aging and overuse injuries to existing limbs. Results suggests that there is opportunity for expanding education about all treatment options for patients with new loss, long-term loss, and congenital limb loss. Establishing a baseline of knowledge about all options–prosthetics, rehabilitative strategies, and VCA—can help patients evaluate their values and goals of treatment. Issues associated with aging, including overuse and injury, and adaptability over the life course should be included in considerations about treatment choices. Data indicate the need for routinely assessing patient preferences about treatment choice so patients can plan for their future as they adapt and age and as technology for treatments change. To assure that thorough information is provided for current and future decision-making, education about treatment choices and selection procedures for VCA should be standardized. (shrink)

Sustained attention, a key cognitive skill that improves during childhood and adolescence, tends to be worse in some emotional and behavioural disorders. Sustained attention is typically studied in non-affective task contexts; here, we used a novel task to index performance in affective versus neutral contexts across adolescence (N = 465; ages 11–18). We asked whether: (i) performance would be worse in negative versus neutral task contexts; (ii) performance would improve with age; (iii) affective interference would be greater in younger adolescents; (...) (iv) adolescents at risk for depression and higher in anxiety would show overall worse performance; and (v) would show differential performance in negative contexts. Results indicated that participants performed more poorly in negative contexts and showed age-related performance improvements. Those at risk of depression performed more poorly than those at lower risk. However, there was no difference between groups as a result of affective context. For anxiety there was no difference in performance as a function of severity. However, those with higher anxiety showed less variance in their reaction times to negative stimuli than those with lower anxiety. One interpretation is that moderate levels of emotional arousal associated with anxiety make individuals less susceptible to the distracting effects of negative stimuli. (shrink)

Three impo r tant tasks in the f i eld of human rights w e re achi e v ed in the Enlightenment: the secularization of ancient natural rights, d r a wing up a list of rights and co n v e r ting them into an inst r ument of political demands. Since then there has been no fu r ther theoretical d e v elopment of the idea. In our d a ys, the concept of human rights (...) is much more indete r minate than in the eighteenth centu r y because w e lack consensus about the e xamples that ma k e that abstract idea specific. In our time the task in the f ield of human rights m a y w ell be that of correcting that indete r mina c y , so completing the labour of the Enlightenment. (shrink)

This paper scrutinises the tenability of a strict conceptual distinction between space and matter via the lens of the debate between modified gravity and dark matter. In particular, we consider Berezhiani and Khoury's novel 'superfluid dark matter theory' as a case study. Two families of criteria for being matter and being spacetime, respectively, are extracted from the literature. Evaluation of the new scalar field postulated by SFDM according to these criteria reveals that it is as much matter as anything could (...) possibly be, but alsoꟷbelow the critical temperature for superfluidityꟷas much spacetime as anything could possibly be. A sequel paper examines possible interpretations of SFDM in light of this result, as well as the consequences for our understanding of the modified gravity/ dark matter distinction and the broader spacetime–matter distinction. (shrink)

Laplace wondered about the minimal choice of initial variables and parameters corresponding to a well-posed initial value problem. Discussions of Laplace’s problem in the literature have focused on choosing between spatiotemporal variables relative to absolute space or merely relative to other material bodies and between absolute masses or merely mass ratios. This paper extends these discussions of Laplace’s problem, in the context of Newtonian Gravity, by asking whether mass needs to be included in the initial state at all, or whether (...) a purely spatiotemporal initial state suffices. It is argued that mass indeed needs to be included; removing mass from the initial state drastically reduces the predictive and explanatory power of Newtonian Gravity. (shrink)

According to the standard model of cosmology, Λ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\Lambda $$\end{document}CDM, the mass-energy budget of the current stage of the universe is not dominated by the luminous matter that we are familiar with, but instead by some form of dark matter (and dark energy). It is thus tempting to adopt scientific realism about dark matter. However, there are barely any constraints on the myriad of possible properties of this entity—it is not even certain (...) that it is a form of matter. In light of this underdetermination I advocate caution: we should not (yet) be dark matter realists. The “not(-yet)-realism” that I have in mind is different from Hacking’s (Philos Sci 56 (4), 555–581, 1989) anti-realism, in that it is semantic rather than epistemological. It also differs from the semantic anti-realism of logical empiricism, in that it is naturalistic, such that it may only be temporary and does not automatically apply to all other unobservables (or even just to all other astronomical unobservables, as with Hacking’s anti-realism). The argument is illustrated with the analogy of the much longer history of the concept of a gene, as the current state of the concept of dark matter resembles in some relevant ways that of the early concept of genes. (shrink)

Two approaches have emerged to resolve discrepancies between predictions and observations at galactic and cosmological scales: introducing dark matter or modifying the laws of gravity. Practitioners of each approach claim to better satisfy a different explanatory ideal, either unification or simplicity. In this chapter, we take a closer look at the ideals and at the successes of these approaches in achieving them. Not only are these ideals less divisive than assumed, but moreover we argue that the approaches are focusing on (...) different aspects of the same ideal. This realisation opens up the possibility of a more fruitful trading zone between dark matter and modified gravity communities. (shrink)

Bazzocchi disposes the text of the Tractatus in a user-friendly manner, exactly as Wittgenstein's decimals advise. This discloses the logical form of the book by distinct reading units, linked into a fashioned hierarchical tree. The text becomes much clearer and every reader can enjoy, finally, its formal and literary qualities.

This article examines the development of Russell's treatment of propositions, in relation to the topic of psychologism. In the first section, we outline the concept of psychologism, and show how it can arise in relation to theories of the nature of propositions. Following this, we note the anti-psychologistic elements of Russell's thought dating back to his idealist roots. From there, we sketch the development of Russell's theory of the proposition through a number of its key transitions. We show that Russell, (...) in responding to a variety of different problems relating to the proposition, chose to resolve these problems in ways that continually made concessions to psychologism. (shrink)

The optimal design of cables under selfweight and concentrated loads is considered and the maximum feasible span for a given permissible stress is evaluated. All solutions are obtained in a closed analytical form.

Since the BBS article in which Premack and Woodruff (1978) asked “Does the chimpanzee have a theory of mind?,” it has been repeatedly claimed that there is observational and experimental evidence that apes have mental state concepts, such as “want” and “know.” Unlike research on the development of theory of mind in childhood, however, no substantial progress has been made through this work with nonhuman primates. A survey of empirical studies of imitation, self-recognition, social relationships, deception, role-taking, and perspective-taking suggests (...) that in every case where nonhuman primate behavior has been interpreted as a sign of theory of mind, it could instead have occurred by chance or as a product of nonmentalistic processes such as associative learning or inferences based on nonmental categories. Arguments to the effect that, in spite of this, the theory of mind hypothesis should be accepted because it is more parsimonious than alternatives or because it is supported by convergent evidence are not compelling. Such arguments are based on unsupportable assumptions about the role of parsimony in science and either ignore the requirement that convergent evidence proceed from independent assumptions, or fail to show that it supports the theory of mind hypothesis over nonmentalist alternatives. Progress in research on theory of mind requires experimental procedures that can distinguish the theory of mind hypothesis from nonmentalist alternatives. A procedure that may have this potential is proposed. It uses conditional discrimination training and transfer tests to determine whether chimpanzees have the concept “see.” Commentators are invited to identify flaws in the procedure and to suggest alternatives. Key Words: apes; associative learning; concepts; convergence; deception; evolution of intelligence; folk psychology; imitation; mental state attribution; monkeys; parsimony; perspective-taking; primates; role-taking; self-recognition; social cognition; social intelligence; theory of mind. (shrink)

Features include a comprehensive review of existing material, combined with new perspectives to equip students for the challenges in the work environment; chapter overviews and student learning objectives offer a solid and useful framework in which to organise study; diagrams and charts present overviews and contexts for the subject to act as useful revision aids; effective pedagogy including a review of the arguments considered, a menu of seminar topics, and questions in every chapter, serving as an ideal basis for seminar (...) study; and additional open-ended simulations to allow students to work through unfolding scenarios. (shrink)

Sleep onset is associated with marked changes in behavioral, physiological, and subjective phenomena. In daily life though subjective experience is the main criterion in terms of which we identify it. But very few studies have focused on these experiences. This study seeks to identify the subjective variables that reflect sleep onset. Twenty young subjects took an afternoon nap in the laboratory while polysomnographic recordings were made. They were awakened four times in order to assess subjective experiences that correlate with the (...) (1) appearance of slow eye movement, (2) initiation of stage 1 sleep, (3) initiation of stage 2 sleep, and (4) 5 min after the start of stage 2 sleep. A logistic regression identified control over and logic of thought as the two variables that predict the perception of having fallen asleep. For sleep perception, these two variables accurately classified 91.7% of the cases; for the waking state, 84.1%. (shrink)

Most liberals agree that governments should protect certain basic liberties, such as freedom of speech, freedom of religion and freedom of the person. Liberals disagree, however, about whether free market rights should also be protected. By “free market rights,” we mean those rights typically associated with laissez-faire economic systems such as freedom of contract, a right to market returns, and claims to privately own the means of production.We do not use the phrase “economic liberties,” as Tomasi does, because it does (...) not distinguish between the “economic rights” defended by classical liberal and those defended by socialists. Those on the right often see such freedoms as core liberal commitments, while those on the left argue that an economic system should be organized to protect the interests of the less advantaged members of society. If free market rights should be protected, then most existing societies are unjust. These societies fail the liberal standard in the same ways as th .. (shrink)

To be a conventionalist about a specific obligation or right is to believe that the obligation or right is dependent on the existence of a social practice. A conventionalist about property, for example, believes that a moral right to property is generated by conventional norms rather than by any natural right. One problem with dominant conventionalist theories is that they do not adequately justify conventional moral claims. They can justify why it is wrong to steal, for example, but they do (...) not justify the claim that you have on me to not steal from you. As a remedy, this article develops and defends the Principle of Legitimate Expectations. Suggested by John Rawls, this principle grants individuals a moral claim to what the rules of morally justified practices entitle them. This article addresses common objections to the principle to show how it can ground a wide range of conventional moral claims. (shrink)

This third edition offers increased coverage of sustainability and more chances for illustration and discussion of ethics in the messy day to day practicalities ...

Visual imagery is a form of sensory imagination, involving subjective experiences typically described as similar to perception, but which occur in the absence of corresponding external stimuli. We used the Activation Likelihood Estimation algorithm (ALE) to identify regions consistently activated by visual imagery across 40 neuroimaging studies, the first such meta-analysis. We also employed a recently developed multi-modal parcellation of the human brain to attribute stereotactic co-ordinates to one of 180 anatomical regions, the first time this approach has been combined (...) with the ALE algorithm. We identified a total 634 foci, based on measurements from 464 participants. Our overall comparison identified activation in the superior parietal lobule, particularly in the left hemisphere, consistent with the proposed ‘top-down’ role for this brain region in imagery. Inferior premotor areas and the inferior frontal sulcus were reliably activated, a finding consistent with the prominent semantic demands made by many visual imagery tasks. We observed bilateral activation in several areas associated with the integration of eye movements and visual information, including the supplementary and cingulate eye fields (SCEFs) and the frontal eye fields (FEFs), suggesting that enactive processes are important in visual imagery. V1 was typically activated during visual imagery, even when participants have their eyes closed, consistent with influential depictive theories of visual imagery. Temporal lobe activation was restricted to area PH and regions of the fusiform gyrus, adjacent to the fusiform face complex (FFC). These results provide a secure foundation for future work to characterise in greater detail the functional contributions of specific areas to visual imagery. (shrink)

In The Tyranny of the Ideal, Gerald Gaus gives an extended argument on behalf of the “Open Society.” Instead of claiming that it is uniquely best from some privileged moral perspective, he argues for the Open Society by showing why it is acceptable to many perspectives. In this way, Gaus argues for a liberal market-based society in a way that treats deep diversity as a fundamental feature of social life. However, the argument falters at four important points. When taken together, (...) these four problems significantly limit the significance of Gaus’s conclusions. (shrink)

Background If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical - trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the (...) 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. (shrink)

This article challenges a reductive analysis of social practices by distinguishing five kinds of reason for following the rules of conventional practices. Depending on one’s preferred intellectual tradition, conventional practices enable coordination, facilitate cooperation, constitute activities, fulfil reciprocity, or specify abstract rights. Instead of being rival theories of social practices, these different models complement one another in a normative analysis of social practices. By distinguishing five kinds of reasons to follow conventional rules, this paper supports a more dynamic conventionalist analysis (...) of subjects like property, the law, professional obligation, civic responsibility, and culture. (shrink)

The dominant conventionalist view explains the wrong of breaking a promise as failing to do our fair share in supporting the practice of promise-keeping. Yet, this account fails to explain any unique moral standing that a promisee has to demand that the promisor keep the promise. In this paper, I provide a conventionalist response to this problem. In any cooperative practice, participants stand as both beneficiary and contributor. As a beneficiary, they are morally required to follow the rules of the (...) practice. As a contributor, they have claims on other participants to follow the rules. According to the rules of promise-keeping, a promisee has a unique claim on the promisor, and the personal wrong of breaking a promise should be understood as the violation of this unique and practice-dependent claim. (shrink)

Rawlsians argue for principles of justice that apply exclusively to the basic structure of society, but it can seem strange that those who accept these principles should not also regulate their choices by them. Valid moral principles should seemingly identify ideals for both institutions and individuals. What justifies this nonintuitive distinction between institutional and individual principles is not a moral division of labor but Rawls’s dual commitments to conventionalism and constructivism. Conventionalism distinguishes the relevant ideals for evaluating institutions from those (...) for evaluating actions, while constructivism explains why this distinction is morally fundamental. (shrink)

Since 1995, students, researchers, and professionals have turned to The Craft of Research for clear and helpful guidance on how to conduct research and report it effectively. Now, master teachers Wayne C. Booth, Gregory G. Colomb, and Joseph M. Williams have completely revised and updated their classic handbook. The new edition will continue to help thousands of students and writers plan, carry out, and report on research to produce effective term papers, dissertations, articles, or books -- in any field, at (...) any level. (shrink)

I argue that acknowledging Hume as a doxastic naturalist about belief in a deity allows an elegant, holistic reading of his Dialogues. It supports a reading in which Hume's spokesperson is Philo throughout, and enlightens many of the interpretive difficulties of the work. In arguing this, I perform a comprehensive survey of evidence for and against Philo as Hume's voice, bringing new evidence to bear against the interpretation of Hume as Cleanthes and against the amalgamation view while correcting several standard (...) mistakes. I ultimately isolate the interpretation of Philo's Reversal at the end of the Dialogues as of paramount importance, and show how my naturalistic interpretation makes this, and other notoriously difficult passages, unproblematic. (shrink)

The first section takes up some main details of American constitutional history. At the end of that section and in section two, we concentrate on one constitutional doctrine in particular, judicial review. We argue that this doctrine rests, traditionally, on the foundational idea of a permanent tension between democratic institutions and basic rights. In section three, we deal with the problem just raised, by suggesting an alternative view of the relationship that exists between these fundamental constitutional elements. Here we attempt (...) to show that there is an essential principled harmony between basic constitutional rights and democratic majority rule. And we try to locate judicial review within this alternative conception. Then in section four and in the conclusion we discuss the institutional arrangements for the practice of judicial review in the light of this alternative conception. (shrink)

In his own writings, Rawls purposively used only a loose characterization of the basic structure, but two prominent misinterpretations highlight the current need for a more detailed account. First, G.A. Cohen argues that the Rawlsian focus on the basic structure is arbitrary due to the Rawlsian appeal to profound effects. Second, some theorists conflate the justification of coercion with the assessment of a basic structure by defining the basic structure as the coercive structure. Both misinterpretations can be corrected by carefully (...) specifying what social institutions are and explaining which social institutions come together to form the basic structure of society. (shrink)

Most criticism and exposition of John Rawls’s political theory has focused on his account of distributive justice rather than on his support for liberalism. Because of this, much of his argument for protecting the basic liberties remains under explained. Specifically, Rawls claims that representative citizens would agree to guarantee those social conditions necessary for the exercise and development of the two moral powers, but he does not adequately explain why protecting the basic liberties would guarantee these social conditions. This gap (...) in his argument leads to two problems. First, the Rawlsian argument for the priority of liberty would fail if the gap could not be filled. His argument would still support the protection of individual freedoms, but these freedoms would be treated like other primary goods and regulated by the difference principle. Second, without a full argument, there is not sufficient reason to favor Rawls’s left-liberal conception of the basic liberties over a more right-leaning conception that would prioritize the protection of free-market rights. To address these two problems, this paper fills in the gap in order to better explain Rawls’s full argument for egalitarian liberalism. (shrink)

Objective: To examine the current ethical review process of ethics committees in a non-pharmacological trial from the perspective of a clinical investigator.Design: Prospective collection of data at the Study Centre of the German Surgical Society on the duration, costs and administrative effort of the ERP of a randomised controlled multicentre surgical INSECT Trial between November 2003 and May 2005.Setting: Germany.Participants: 18 ethics committees, including the ethics committee handling the primary approval, responsible overall for 32 clinical sites throughout Germany. 8 ethics (...) committees were located at university medical schools and 10 at medical chambers. Duration was measured as days between submission and receipt of final approval, costs in euros and administrative effort by calculation of the product of the total number of different types of documents and the mean number of copies required .Results: The duration of the ERP ranged from 1 to 176 days. The median duration was 26 days at MSUs compared with 34 days at medical chambers. The total cost was €2947. 1 of 8 ethics committees at universities and 8 of 10 at medical chambers charged a median fee of €162 . The administrative effort for primary approval was 30. Four ethics committees required a higher administrative effort for secondary approval .Conclusion: The ERP for non-pharmacological multicentre trials in Germany needs improvement. The administrative process has to be standardised: the application forms and the number and content of the documents required should be identical or at least similar. The fees charged vary considerably and are obviously too high for committees located at medical chambers. However, the duration of the ERP was, with some exceptions, excellent. A centralised ethics committee in Germany for multicentre trials such as the INSECT Trial can simplify the ERP for clinical investigators in and outside the country. (shrink)

The precise position to be assigned to the Categories in the Aristotelian system has always been somewhat of a puzzle. On the one hand, they seem to be worked into the warp of its texture, as in the classification of change, and Aristotle can argue from the premiss that they constitute an exhaustive division of the kinds of Being . On the other hand, both in the completed scheme of his logic and in his constructive metaphysic they retire into the (...) background, giving place to other notions, such as causation, change, actuality and potentiality. Investigation has, moreover, been hampered, especially in Germany, by attempts to correlate them with the Kantian Categories, with which they have obvious points of contact. But Kant's formal a priori concepts by which the mind makes for itself a world, to use Mr. Bosanquet's phrase, imply an attitude to knowledge and reality so utterly opposed to the Aristotelian that the comparison has tended to confusion rather than elucidation. Scholars now realize better that the Aristotelian Categories can only be understood in connexion with the problems of Aristotle's own age. (shrink)