The ethical challenges of caring for the chronically ill are of increasing concern to nurses as they attempt to create humanitarian environments for long-term care. This article suggests two ethical perspectives to guide the agenda of the nursing profession to achieve social change in the care of the chronically ill and aging. First, a reemphasis on the public duties of the professions is recommended which extends beyond serving the interests of the nursing profession to recognizing the need to serve the (...) common good. Second, the limitations of the autonomy paradigm are explored and the foundation for the development of a new moral paradigm is analyzed in terms of its' potential usefulness in addressing ethical problems of chronic illness. Several initiatives that nursing must undertake to facilitate the emergence of this paradigm are proposed. (shrink)

Cognitive reappraisal is an important emotion regulation strategy that shows considerable developmental change in its use and effectiveness. This paper presents a systematic review of the evidence base regarding the development of cognitive reappraisal from early childhood through adolescence and provides methodological recommendations for future research. We searched Scopus, PsycINFO, and ERIC for empirical papers measuring cognitive reappraisal in normative samples of children and youth between the ages of 3 and 18 years published in peer-reviewed journals through August 9th, 2018. (...) We identified 118 studies that met our inclusion criteria. We first present a quantitative review of the methodologies used to investigate cognitive reappraisal in children and adolescents, with attention to variations in methodologies by the sample age range. We then present a qualitative review of findings with attention to: the age at which children begin to effectively use cognitive reappraisal to regulate their emotions, and developmental changes in cognitive reappraisal from early childhood through adolescence. We consider how methodological differences may contribute to inconsistencies in findings, highlight gaps in the literature that remain to be addressed, and make recommendations for future directions. (shrink)

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

Introduction: Although deep brain stimulation often improves levodopa-responsive gait symptoms, robust therapies for gait dysfunction from Parkinson's disease remain a major unmet need. Walking speed could represent a simple, integrated tool to assess DBS efficacy but is often not examined systematically or quantitatively during DBS programming. Here we investigate the reliability and functional significance of changes in gait by directional DBS in the subthalamic nucleus.Methods: Nineteen patients underwent unilateral subthalamic nucleus DBS surgery with an eight-contact directional lead in the most (...) severely affected hemisphere. They arrived off dopaminergic medications >12 h preoperatively and for device activation 1 month after surgery. We measured a comfortable walking speed using an instrumented walkway with DBS off and at each of 10 stimulation configurations at the midpoint of the therapeutic window. Repeated measures of ANOVA contrasted preoperative vs. maximum and minimum walking speeds across DBS configurations during device activation. Intraclass correlation coefficients examined walking speed reliability across the four trials within each DBS configuration. We also investigated whether changes in walking speed related to modification of step length vs. cadence with a one-sample t-test.Results: Mean comfortable walking speed improved significantly with DBS on vs. both DBS off and minimum speeds with DBS on. Pairwise comparisons showed no significant difference between DBS off and minimum comfortable walking speed with DBS on. Intraclass correlations were ≥0.949 within each condition. Changes in comfortable walk speed were conferred primarily by changes in step length.Conclusion: Acute assessment of walking speed is a reliable, clinically meaningful measure of gait function during DBS activation. Directional and circular unilateral subthalamic DBS in appropriate configurations elicit acute and clinically significant improvements in gait dysfunction related to PD. Next-generation directional DBS technologies have significant potential to enhance gait by individually tailoring stimulation parameters to optimize efficacy. (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)

A. R. W. Harrison in The Law of Athens, i , 63–5, argued that the exclusion of bastards from the phratries and the severe restriction of their right of inheritance does not entail their exclusion from Athenian citizenship; and that the form of Pericles' citizenship law, not stating that were to be , and Solon's law restricting the inheritance rights of , both point to the conclusion that bastards were not ipso facto debarred from citizenship. D. M. MacDowell in (...) CQ N.S. 26 , 88–91, rightly finds Harrison's positive arguments inconclusive, but suggests that three texts provide more definite support for this conclusion. (shrink)

I advance a type of conceptualist argument for substance dualism – minimally, the view that we are spiritual substances that have bodies – based on the understandability of what it would be for something to be a spirit, e.g. what it would be for God to be a spirit. After presenting the argument formally, I clarify and defend its various premises with a special focus on what I take to be the most controversial one, namely, if thinking matter is metaphysically (...) possible, it is not the case that we have a distinct positive concept of God's being a divine spirit. (shrink)

There are two tasks for any adequate philosophy of mind: (1) articulate one’s position and explain why dualism is the commonsense view; (2) defend one’s position. I believe that there is an argument that simultaneously satisfies both desiderata in a non–ad hoc way and, thus, the argument can thereby claim the virtue of theoretical simplicity in its favor. In what follows, I shall present the argument and defend its most crucial premise, respond to three criticisms that have been raised against (...) it, and draw out one dialectical implication of the argument. (shrink)

The appearance of consciousness in the world is an amazing and puzzling fact in its own right. Indeed, consciousness is one of the most mystifying features of the cosmos. The unity of consciousness is something that cries out for analysis and explanation as well. This chapter provides a way of relating the three types of unity: objectual phenomenal unity; subject phenomenal unity; and subsumptive phenomenal unity. According to Tim Bayne and David Chalmers, this sort of unity is irrelevant for investigating (...) the nature of consciousness' unity because it is trivially true by definition and tells us nothing about consciousness. Many thinkers, including Bayne himself, believe there is no self or subject that unifies consciousness. Bayne's position amounts to a bunch of mere assertions that allow him to avoid an obvious solution: substance dualism. (shrink)

For some time now, Nancey Murphy has been a major voice on behalf of a certain form of Christian physicalism. This is a part of her project of reconciling science with Christian faith. In what follows, I shall state and criticize the three central components of her Christian physicalism, followed by a presentation of a dualist alternative along with a clarification of its advantages over Murphy-style physicalism.

While most philosophers agree that libertarian agency and naturalism are incompatible, few attempts have been offered to spell out in some detail just why this is the case. My purpose in this article is to fill this gap in the literature by expanding on and clarifying the connection between naturalism as it is widely understood today and the rejection of libertarian agency. To accomplish this end I begin by clarifying different forms of libertarian agency and identity the key philosophical components (...) that constitute libertarian agency per se. Second, three different aspects of contemporary scientific naturalism are analyzed and the relations among them clarified: the naturalist epistemic attitude, etiology, and ontology. This is followed by a presentation of six arguments for the claim that libertarian agency should be rejected by advocates of scientific naturalism. Finally, I criticize a recent attempt by Randolf Clarke to reconcile libertarian agency and scientific naturalism. (shrink)

Philosophy is experiencing a resurgence of property (PD) and generic substance dualism (SD). One important argument for SD that has played a role in this resurgence is some version of a modal argument. Until recently, premise (3) of the argument (Possibly, I exist, and no wholly physical objects exist.) has garnered most of the attention by critics. However, more recently, the focus has also been on (2) (Wholly physical objects are essentially, wholly, and intrinsically physical and wholly spiritual substances are (...) essentially, wholly, and intrinsically immaterial.). Andrew Bailey has provided one of the best criticisms of (2) on offer. In what follows, I present and clarify one form of the argument and defend premise (2) by responding to important defeaters proffered by Andrew Bailey and his contingent physicalism. (shrink)

One of the most important features of living beings that seems universal is perhaps their ability to be modified in a functional way.In order to modelize this characteristic, we designed automata with a finite number of instantaneous internal descriptions, with input(s) and output(s) and which are able to be functionally modified.

I criticize the view that top-down causation is a proper model for depicting and justifying belief in mental causation. When properly interpreted, I believe that there are no clear examples of top-down causation, and there is a persuasive case against it. In order to defend these claims, I, first, clarify three preliminary considerations; second, undermine alleged examples of top-down causation; third, present a case for why there is no top-down mental causation; fourth, explain an important option for moving forward in (...) preserving what we all know to be the case—that mental causation is real. (shrink)

I present and clarify one form of the modal argument for substance dualism, and go on to state and provide defeaters for five of the major arguments raised against the modal argument as a whole. I do not provide an unabridged defence of the modal argument. Instead, I focus on a range of defeaters scattered throughout the literature that are raised against the modal argument. In my view, these have not been gathered in one place and freshly evaluated. Accordingly, my (...) limited purpose is to fill this lacuna. Thus, I present a representative version of the modal argument to set the context for what follows. Next, I clarify and critique the five major objections directed at the modal argument in general. (shrink)

Hume fully recognised, and partially explained, the role of inductions from single experiments in human knowledge - something his Scottish critics, and some more recent ones, failed to understand. Those inferences, he maintains, depend on the use of a Newtonian rule and the removal of superfluous circumstances. But that rule is not sufficient, and Hume never stated the exact conditions of this removal. We should distinguish between survey and experience in his philosophy, to understand how experience of conjunctions where inductive (...) knowledge has accumulated, in uniform or regular classes or sets of phenomena, may produce cognitive situations when once is enough - without relying on any mysterious innate principles. (shrink)

Hume fully recognised, and partially explained, the role of inductions from single experiments in human knowledge - something his Scottish critics, and some more recent ones, failed to understand. Those inferences, he maintains, depend on the use of a Newtonian rule and the removal of superfluous circumstances. But that rule is not sufficient, and Hume never stated the exact conditions of this removal. We should distinguish between survey and experience in his philosophy, to understand how experience of conjunctions where inductive (...) knowledge has accumulated, in uniform or regular classes or sets of phenomena, may produce cognitive situations when once is enough - without relying on any mysterious innate principles. (shrink)

Steve Cowan had criticized my defense of theistic science on four grounds: (1) my critique of compatibilism attacks a straw man; (2) libertarianism cannot meet some of the conditions for responsible action; (3) attributing libertarian agency to God has the unacceptable implication that God can do evil; and (4) we don’t need libertarianism to provide a model of divine actions sufficient to justify the scientific detectability of miracles. I clarify and respond to these points in the order listed and conclude (...) that Cowan’s critique fails. (shrink)

This article reflects on three issues: the past twenty years of the Evangelical Philosophical Society, ideas for EPS's future, and some words of advice to my younger EPS colleagues. Regarding, I identify four values that were central to the rebirth of the EPS and that have guided us for twenty years. Regarding, I issue a warning and a challenge. Regarding, I provide three words of advice for keeping us on course.

In a previous article, I argue that on the assumption that God exercises libertarian agency, a primary causal divine miracle could, in principle, leave a scientifically detectable gap in the natural world. In a subsequent publication, Evan Fales offered a critique of my argument and this article is my rejoinder. I justify my employment of Divine libertarian agency and respond to Fales’s two, closely-related questions: How much energy could one add to a room by making a lot of decisions? Would (...) the increase in energy be measurable? (shrink)

The progress in artificial intelligence enables us to conceive adaptive systems whose characteristics are nearer and nearer to those of living beings. These characteristics though depend on ingenious choices by the designer of these systems: Initial conditions, parameters, optimisation functions, gradient and measure of fitness within the environment. Nevertheless, in living systems which are non-finalist, there are no programmers or designers to conceive of such ingenious choices. Our paper “Self-Programming Machines (I)” presents a non-finalist model since initial states and functions (...) are randomly chosen at the beginning and once and for all. In spite of the fact that they are non-finalist, these machines always stabilise at fixed points when they are connected to an external process. (shrink)

The first comprehensive study of Nietzsche's earliest book, The Birth of Tragedy, this important volume by M. S. Silk and J. P. Stern examines the work in detail: its place in Nietzsche's philosophical career; its value as an account of ancient Greek culture; its place in the history of German ideas, and its value as a theory of tragedy and music. Presented in a fresh twenty-first-century series livery, and including a specially commissioned preface written by Lesley Chamberlain, illuminating its enduring (...) importance and relevance to philosophical enquiry, this accessible study has been revived for a new generation of readers. (shrink)