Taxometric analyses were applied to the construct of psychopathy (as measured by the Psychopathy Checklist) and to several variables reflecting antisocial childhood, adult criminality, and criminal recidivism. Subjects were 653 serious offenders assessed or treated in a maximum-security institution. Results supported the existence of a taxon underlying psychopathy. Childhood problem behaviors provided convergent evidence for the existence of the taxon. Adult criminal history variables were continuously distributed and were insufficient in themselves to detect the taxon.

The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy (...) raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder) from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1) direct participation of a multidisciplinary care team, including palliative care specialists, (2) a concise plan of care for anticipated device-related complications, (3) careful surveillance and counseling for caregiver burden, (4) advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5) a plan to address the long-term financial burden on patients, families, and caregivers. Short-term mechanical circulatory devices (e.g. percutaneous cardiopulmonary bypass, percutaneous ventricular assist devices, etc.) can be initiated in emergency situations as a bridge to permanent implantation of ventricular assist devices in chronic end-stage heart failure. In the absence of first-person (patient) consent, presumed consent or surrogate consent should be used cautiously for the initiation of short-term mechanical circulatory devices in emergency situations as a bridge to permanent implantation of left ventricular assist devices. Future clinical studies of destination therapy with left ventricular assist devices should include measures of recipients' quality of end-of-life care and caregivers' burden. (shrink)

Don Carlos de Sigüenza y sor Juana Inés de la Cruz no solo se encuentran en la encrucijada del paso de la edad media a la moderna, y del viejo al nuevo mundo, sino de la vieja a la nueva vía de reflexión y de la vieja a la nueva ciencia. Es lo que se intenta mostrar en estas páginas.

Una importante causa filosófica e ideológica de la inhumanidad de la sociedad rusa durante las décadas del marxismo-leninismo fue la obsesiva orientación de los marxistas-leninistas hacia el futuro histórico (futuro comunismo) en aras de lo cual, comunidades, culturas y personas podían ser reducidas a medios para alcanzar ese fin histórico. El autor de los debates apoyándose en los propios pensadores rusos de la "tradición clásica", como por ejemplo Herzen, Dostoievsky, Tolstoy, Leontiev y Berdiaev. No se opone a cualquier tipo de (...) orientación de futuro, pero recalca la importancia de las personas actuales. (shrink)

Epaminondas the soldier has been much admired. His two great battles rank as masterpieces of the military art. Epaminondas himself perhaps regarded them as his greatest achievements, to judge by his last words as reported by Diodorus . He had been carried from the battlefield of Mantinea with a spear stuck in his chest. The doctors declared that when the spear was removed he would die. After hearing that his own shield was safe and that the Boeotians had won, he (...) ordered that the spear be removed. One of his friends said to him ‘But you die without a son.’ He answered ‘I do, by God, but I leave two daughters, my victory of Leuctra and my victory of Mantinea’, and then he died. Nor were his ‘daughters’ unadmired. By remarkable chance the future Philip II of Macedon was hostage at Thebes at the very time of Epaminondas' pre-eminence and did not fail to learn, as Chaeronea was to show. (shrink)

This study is based on the 1983 Rural Health Survey of Ethiopia. Patterns and levels of child morbidity by age, sex, geographic region, and sanitary facilities are examined. Morbidity levels peak in the second year of life. Diarrhoeal diseases are of major importance, especially among infants and toddlers. Parasitic diseases, and respiratory diseases other than pneumonia, become increasingly important with age.There are no significant sex differentials in morbidity except for higher rates of diarrhoeal diseases among female children. Geographic differentials are (...) quite marked with particularly high morbidity levels from all disease types in the western mountainous regions of Ethiopia. Access to high quality drinking water, a latrine, and garbage disposal, are strongly related to reduced overall morbidity levels, though not necessarily to reduced diarrhoeal disease levels. (shrink)

In 404 Sparta stood supreme, militarily and politically master of Greece, in concord with Persia. By 362, the year at which Xenophon terminated his history on the sad note of ‘even greater confusion and uncertainty’, she was eclipsed militarily, never to win a great battle again; and so far from being master even of the Peloponnese that she would spend the rest of time struggling to recover her own ancestral domain of Messenia, no longer a world power, merely a local (...) wrangler. The reasons for all this which are to seek are of absorbing interest and prime importance for the history of Greece, but it is hard to resist the temptation to connect the change with the policies of Agesilaus whose reign virtually coincided with the period in question. He was king for forty-one years and over thirty of them well before the battle of Leuctra and he had influence in the state unequalled as far as we can tell by any other king. (shrink)

It is commonly supposed that in the eighth century B.c. there was a ‘population explosion’ in Greece which moved the Greeks to send out colonies. A. J. Graham in the Cambridge Ancient History iii, 3 is typical: ‘The basic active cause of the colonizing movement was overpopulation’; ‘at the very time when the Archaic colonising movement began, in the second half of the eighth century, there was a marked increase in population in Greece’ . The presumed connection between overpopulation and (...) colonisation is not immediately obvious. The evidence for the population explosion is found in the increased number of burials in Attica and the Argolid, but Athens sent out no colony before the very end of the seventh century and Argos probably none at all, certainly none in this period. So special explanations have to be formulated for Athens' and Argos' lack of colonies while their postulated ‘population explosion’ is presumed for Greece as a whole and called in to explain the burst of colonising in the eighth century. The hypothesis is not used for seventh-century colonisation when the number of burials declines. (shrink)

For Hannah Arendt, the promise serves as currency in a world where predictability of outcome in the realm of human action is impossible, where courage is required in order to submit oneself in word and deed in the public realm, and where forgiveness serves as recourse when things go differently than hoped. Each of these points in Arendt's political philosophy is indebted to Immanuel Kant, a thinker who is often characterized as rejecting rhetoric on aesthetic and moral grounds alike. In (...) Kant and the Promise of Rhetoric, Scott Stroud takes up the apparently straightforward but ultimately complicated question of Immanuel Kant's treatment of, and disposition toward, rhetoric.While Kant is typically characterized as... (shrink)

From the materialist stance that I find compelling, the metaproblem of consciousness -- explaining why the problem of consciousness seems hard -- is hardly distinct from the 'easy' problem of explaining how the underlying physical/computational system works, and how it gives rise to perceptions of its own functioning. I discuss several confusions that might plausibly arise in that process, and propose that these confusions could create apparent gaps, ontological and epistemic, in materialist accounts of consciousness, thereby making the hard problem (...) hard. Inversely, resolving these confusions may help solve the hard problem. (shrink)

Over sixty years ago, it was written of early Greek tyranny that it ‘had arisen only in towns where an industrial and commercial regime tended to prevail over rural economy, but where an iron hand was needed to mobilize the masses and to launch them in assault on the privileged classes… But tyranny nowhere endured. After it had performed the services which the popular classes expected of it, after it had powerfully contributed to material prosperity and to the development of (...) democracy, it disappeared with an astonishing rapidity… The people regarded tyranny only as an expedient. They used it as a battering ram with which to demolish the citadel of the oligarchs, and when their end had been achieved they hastily abandoned the weapon which wounded their hands.’ Thus Gustav Glotz, whose view found favour with de Ste Croix. He too concluded with appeal to Aristotle, who in a famous passage declared that unlike monarchy, which arises to help ‘the great and good’ against the People, and the monarch who is appointed as one of ‘the great and good’, ‘the tyrant comes from the People and the multitude to confront the men of note and prevent the People being unjustly treated by them. This is clear from what actually happened, for, generally speaking, the majority of the tyrants became tyrants from being demagogues so to speak, having got themselves trusted by their abusive attacks on the men of note.’ Against this view of Aristotle and all his latter-day satellites, this paper is directed. (shrink)