Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. -/- Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. -/- The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations.

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)

© 2014 Taylor Francis. The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus testing of every client presenting for services in venues where HIV prevalence is high. Because older adults have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent and ever HIV testing in a probability sample of at-risk (...) adults seeking services in needle exchange sites, sexually transmitted disease clinics, and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months or ever. Aging-related disparities in HIV testing exist among clients of these high HIV prevalence venues and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis. (shrink)

Throughout his life, John Tyler Bonner contributed to major transformations in the fields of developmental and evolutionary biology. He pondered the evolution of complexity and the significance of randomness in evolution, and was instrumental in the formation of evolutionary developmental biology. His contributions were vast, ranging from highly technical scientific articles to numerous books written for a broad audience. This historical vignette gathers reflections by several prominent researchers on the greatness of John Bonner and the implications of his work.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Évangile et Providence: Une théologie de l’action de Dieu by Emmanuel DurandMichael J. Dodds, O.P.Évangile et Providence: Une théologie de l’action de Dieu. By Emmanuel Durand. Paris: Cerf, 2014. Pp. 345. €35.00 (paper). ISBN: 978-2-204-10201-8.Emmanuel Durand offers a refreshing perspective on the question of divine action, so much discussed in recent years in the dialogue between theology and science. While not neglecting the fruit of that discussion, his (...) framing of the question under the headings of “Gospel” and “Providence” opens a new vista that is evident in his opening question: “What theology of Providence is needed today for the Gospel of salvation?” (7).Although contemporary theology readily affirms the biblical proclamation of God’s universal offer of salvation, its account of God’s salvific action on behalf of each person has become “uncertain and problematic.” Discussions of divine “kenosis, self-limitation, retreat, and powerlessness” have led many to the conviction God’s action must somehow be “limited” (8). The result is the paradox of a limited God attempting to offer universal salvation. The remedy lies in the recovery of a correct understanding of “the sovereignty of God”—the God who acts not only in the “intimacy of human hearts” but also in and through the “happy and unhappy contingencies” of human life (8-9).Durand begins by placing the question of divine action in the context of contemporary theology and culture, considering first the relationship between divine and human action, then the question of God’s action in history, and finally the understanding of divine action that has surfaced in the dialogue between theology and science (chap. 1). His next task is to clarify the notion of “action” itself. This entails an account of analogy (chap. 2). The discussion then turns to the “creative reappropriation” (10) of three classical theologies of divine providence, those of St. Augustine, St. Thomas Aquinas, and John Henry Newman. This involves a careful consideration of the Confessions of Augustine, the Summa contra gentiles of Aquinas, and the sermons of Newman (chaps. 3-5).The flip side of the question of divine action is of course the problem of evil and why a God who is capable of overcoming evil does not do so. Durand proposes not to “resolve” (résoudre) such problems here, but simply to help us “press” (serrer) them (11) as a preparation for listening to what revelation may say of them (chap. 6). The question of evil serves as the background for the discussion of Scripture that follows, where aspects of the books of Wisdom, Luke, and John are considered (chap. 7). Durand concludes with a [End Page 133] constructive proposal for understanding Providence in the world as we find it today, afflicted with evil (chap. 8).Durand begins his book with a discussion of the widespread opinion in contemporary philosophy and theology that divine and human action are somehow opposed to or in competition with each other. He traces this notion to Sartre, arguing that it now seems to pervade our culture despite the efforts of theologians such as Sertillanges to refute it. God’s action in the world is thought to diminish as humanity matures historically. The sovereign God gives place to the suffering God, who can act only through the actions of humans. The contemporary notion of history itself poses problems for divine action. It is difficult to affirm God’s saving and directing action in history, when history itself has lost its direction: “The loss of confidence in the intelligibility of history also jeopardizes the representation of God as sovereign, cause, author, director or guarantor of history” (29). Finally, the ability of science to explain natural events has led some to the conviction that there is simply no room for God to act in the world without interfering with the order of scientific laws. Durand presents a fine summary and critique of the responses to this dilemma that have surfaced in the ongoing dialogue between theologians and scientists, especially under the auspices of the Center for Theology and the Natural Sciences at the Graduate Theological Union in Berkeley (31-60).Durand... (shrink)

"O'Meara masterfully situates Pryzwara in relation to the traditional and contemporary theological, philosophical, ecclesial, cultural, and social contexts within which he wrote." --_William P. Loewe, professor of religious studies, Catholic University of America_ Erich Przywara, S.J. is one of the important Catholic intellectuals of the twentieth century. Yet, in the English-speaking world Przywara remains largely unknown. Few of his sixty books or six hundred articles have been translated. In this engaging new book, Thomas O'Meara offers a comprehensive study of the (...) German Jesuit Erich Przywara and his philosophical theology. Przywara's scholarly contributions were remarkable. He was one of three theologians who introduced the writings of John Henry Cardinal Newman into Germany. From his position at the Jesuit journal in Munich, _Stimmen der Zeit_, he offered an open and broad Catholic perspective on the cultural, philosophical, and theological currents of his time. As one of the first Catholic intellectuals to employ the phenomenologies of Edmund Husserl and Max Scheler, he was also responsible for giving an influential, more theological interpretation of the Spiritual Exercises of Ignatius Loyola. Przywara was also deeply engaged in the ideas and authors of his times. He was the first Catholic dialogue partner of Karl Barth and Paul Tillich. Edmund Husserl was counted among Przywara's friends, and Edith Stein was a close personal and intellectual companion. Through his interactions with important figures of his age and his writings, ranging from speculative systems to liturgical hymns, Przywara was of marked importance in furthering a varied dialogue between German Catholicism and modern culture. Following a foreword by Michael Fahey, S.J., O'Meara presents a chapter on Pryzwara's life and a chronology of his writings. O'Meara then discusses Pryzwara's philosophical theology, his lecture-courses at German universities on Augustine and Aquinas, his philosophy of religion, and his influence on important intellectual contemporaries. O'Meara concludes with an in-depth analysis of Pryzwara's theology, focusing particularly on his Catholic views of person, liturgy, and church. (shrink)

Présentation de cinq grands intellectuels catholiques. Réflexion sur la foi et la raison. Essai engagé et sujet à débat.

The foundations of law. The digest title, De diversis regulis iuris antiqui, and the general principles of law, by P. Stein. Equity in Chinese customary law, by W. Y. Tsao. Prolegomena to the theory and history of Jewish law, by H. Cohn. Juridical evolution and equity, by J.P. Brutau. Reflections on the sources of the law, by P. Lepaulle. The true nature and province of jurisprudence from the viewpoint of Indian philosophy, by M.J. Sethna. On the functions and aims of (...) the state, by G. Del Veccchio.--Concepts of jurisprudence. Legal language and reality, by K. Olivecrona. The logic of the reasonable as differentiated from the logic of the rational (human reason in the making and the interpretation of the law) by L. Recaséns-Siches. Some refections on status and freedom, by W.G. Friedmann. Law and power and their correlation, by M. Reale. The notion of canonical auctoritas with respect to statute, custom and usage, by B.F. Brown. Two theories of "the institution," by J. Stone. (shrink)

The use of tensed language and the metaphor of set ‘formation’ found in informal descriptions of the iterative conception of set are seldom taken at all seriously. Both are eliminated in the nonmodal stage theories that formalise this account. To avoid the paradoxes, such accounts deny the Maximality thesis, the compelling thesis that any sets can form a set. This paper seeks to save the Maximality thesis by taking the tense more seriously than has been customary (although not literally). A (...) modal stage theory, MST, is developed in a bimodal language, governed by a tenselike logic. Such a language permits a very natural axiomatisation of the iterative conception, which upholds the Maximality thesis. It is argued that the modal approach is consonant with mathematical practice and a plausible metaphysics of sets and shown that MST interprets a natural extension of Zermelo set theory less the axiom of Infinity and, when extended with a further axiom concerning the extent of the hierarchy, interprets Zermelo–Fraenkel set theory. (shrink)

Context: Strict finitism is usually not taken seriously as a possible view on what mathematics is and how it functions. This is due mainly to unfamiliarity with the topic. Problem: First, it is necessary to present a “decent” history of strict finitism and, secondly, to show that common counterarguments against strict finitism can be properly addressed and refuted. Method: For the historical part, the historical material is situated in a broader context, and for the argumentative part, an evaluation of arguments (...) and counterarguments is presented. Results: The main result is that strict finitism is indeed a viable option, next to other constructive approaches, in mathematics. Implications: Arguing for strict finitism is more complex than is usually thought. For future research, strict finitist mathematics itself needs to be written out in more detail to increase its credibility. In as far as strict finitism is a viable option, it will change our views on such “classics” as the platonist-constructivist discussion, the discovery-construction debate and the mysterious applicability problem . Constructivist content: Strict finitism starts from the idea that counting is an act of labeling, hence the mathematician is an active subject right from the start. It differs from other constructivist views in that the finite limitations of the human subject are taken into account. (shrink)

Onderwerp en gezegde, door D. M. Bakker.--Enkele opmerkingen over het Godsbegrip van Justinus Martyr, door J. den Boeft.--Heidegger, Descartes, Luther, door J. van der Hoeven.--"Geschichtlichkeit" bij Carl Friedrich von Weizsäcker, door G. Horsman.--Menselijke ontmaskering en Bijbels démasqué , door R. Huson.--Kleine geschiedenis van het begrip "niets" in de antieke wijsbegeerte (tot e met de Sofisten en Plato), door P. A. Meijer.--De structuur van opvoeden en opvoedkunde, door J. W. Mojet.--Individualiteit in de fysica, door M. D. (...) Stafleu. (shrink)

This essay places Foucault's work into a philosophical context, recognizing that Foucault is difficult to place and demonstrates that Foucault remains in the Kantian tradition of philosophy, even if he sits at the margins of that tradition. For Kant, the forms of intuition—space and time—are the a priori conditions of the possibility of human experience and knowledge. For Foucault, the a priori conditions are political space and historical time. Foucault sees political space as central to understanding both the subject and (...) objects of medicine, psychiatry, and the social sciences. Through this analysis one can see that medicine's metaphysics is a metaphysics of efficient causation, where medicine's objects are subjected to mechanisms of efficient control. (shrink)

Three experiments explore the role of working memory in motor skill acquisition and performance. Traditional theories postulate that skill acquisition proceeds through stages of knowing, which are initially declarative but later procedural. The reported experiments challenge that view and support an independent, parallel processing model, which predicts that procedural and declarative knowledge can be acquired separately and that the former does not depend on the availability of working memory, whereas, the latter does. The behaviour of these two processes was manipulated (...) by providing or withholding visual (and auditory) appraisal of outcome feedback. Withholding feedback was predicted to inhibit the use of working memory to appraise success and, thus, prevent the formation of declarative knowledge without affecting the accumulation of procedural knowledge. While the first experiment failed to support these predictions, the second and third experiments demonstrated that procedural and declarative knowledge can be acquired independently. It is suggested that the availability of working memory is crucial to motor performance only when the learner has come to rely on its use. (shrink)

I-theories of bare demonstratives take the semantic referent of a demonstrative to be determined by an inner state of the utterer. E-theories take the referent to be determined by factors external to the utterer. I argue that, on the Standard view of communication, neither of these theories can be right. Firstly, both are committed to the existence of conventions with superfluous content. Secondly, any claim to the effect that a speaker employs the conventions associated with these theories cannot have any (...) content, i.e. nothing can count as following these conventions. Bare demonstratives may well not be devices of semantic reference at all, i.e. may not actually contribute a referent to the proposition semantically expressed by an utterance. (shrink)

Humanity does not gradually progress from combat to combat until it arrives at universal reciprocity, where the rule of law finally replaces warfare; humanity installs each of its violences in a system of rules and thus proceeds from domination to domination. (Foucault, 1984, 85)In this essay, I take a note from Michel Foucault regarding the notion of biopolitics. For Foucault, biopolitics has both repressive and constitutive properties. Foucault's claim is that with the rise of modern government, the state became exceedingly (...) concerned about the body politic, the bodies that make up the polis, including the health of those bodies. However, Giorgio Agamben claims that Foucault and all western political philosophy misses the relationship between power and Sovereignty, with disastrous results and totalizing tendencies. I explore the case of Terri Schiavo claiming that the social conservatives have attempted to politicize bare life in its legal maneuverings, but I also show how the social liberals open an uncontrollable space between life and death. Both the left and the right miss the aporia at the heart of western political philosophy, and bioethics is complicit in the totalizing effects of contemporary medicine. (shrink)

Graham Oppy had criticized my argument for God from consciousness (AC) in my recent book ’Consciousness and the Existence of God’ (N.Y.: Routledge, 2008). In this article I offer a rejoinder to Oppy. Specifically, I respond to his criticisms of my presentation of three forms of AC, and interact with his claims about theism, consciousness and emergent chemical properties.

Modernism is both a contested aesthetic category and a powerful political statement. Modernist music was condemned as degenerate by the Nazis and forcibly replaced by socialist realism under the Soviets. Sympathetic philosophers and critics have interpreted it as a vital intellectual defence against totalitarianism, yet some American critics consider it elitist, undemocratic, and even unnatural. Drawing extensively on the philosophy of Heidegger and Badiou, Quilting Points proposes a new dialectical theory of faithful, reactive, and obscure subjective responses to musical modernism, (...) which embraces all the music of Western modernity. (shrink)

Despite Vancil’s (1979) proclamation over twenty years ago that topoi have been abandoned in argument theory, this essay contends that topoi should have a vital role in contemporary argumentation theory. Four key areas are identified where topoi are (or can be) essential tools for argumentation: Locating argument, building argument, development of critical thinking, and argument pedagogy. As a result, teachers and students of argument can both benefit from a (re)discovery of topoi.

A repulsive core force is derived which, assuming π mesons are the field particles, gives binding energies in good agreement with binding energies per nucleon of heavy nuclei. The physical model consists of a field of relatively short range, in which emission of a π meson by a nucleon and subsequent absorption by a neighboring nucleon is equivalent to a potential well. The binding energy at the equilibrium spacing of the nucleons is the self-energy of the π mesons, which is (...) calculated by analogy with classical electric fields. (shrink)

Naturalism provides a rigorous analysis and critique of the major varieties of contemporary philosophical naturalism. The authors advocate the thesis that contemporary naturalism should be abandoned, in light of the serious objections raised against it. Contributors draw on a wide range of topics including: epistemology, the philosophy of science, the philosophy of mind and agency, and natural theology.