The field of narrative medicine holds that personal narratives about illness have the potential to give illness meaning and to create order out of disparate facets of experience, thereby aiding a patient’s treatment and resisting universalizing medical discourse. Two narratives of bipolar disorder, Kay Redfield Jamison’s prose memoir An Unquiet Mind and Ellen Forney’s graphic memoir Marbles challenge these ideas. These writers demonstrate that one result of bipolar disorder is a rupture to their sense of identity, making straightforward (...) and verbal forms of narrative impossible. During periods of relative mood stability, reliable memories of mania or depression are equally impossible. As a result, these memoirists seek to develop sources of self-knowledge other than memory and introspection, long the foundations of personal narrative. Finally, An Unquiet Mind and Marbles return attention to questions of selfhood at a time when scholarship on memoir rejects interpretations of life stories as clear and reliable expressions of identity. (shrink)

Suicidal Thoughts is a compilation of some of the most moving and insightful writing accomplished on the topic of suicide. It presents the thoughts and experiences of fifteen writers who have contemplated suicide-some on a professional level, others on a personal level, and a few, both personally and professionally. Through this collection, the reader is able to bear witness to the struggle between life and death and to the devastating aftermath of suicide. Suicidal Thoughts provides readers with a better understanding (...) of the reasons why some individuals give serious consideration to killing themselves. (shrink)

This essay describes an instrumental advocate’s development, engagement, and accomplishments in transgender health at the intersection of law and medicine. Reflecting on the evolution of insurance policy reforms in conjunction with the need to increase the availability of clinicians who can understand and respectfully treat transgender patients, the author demonstrates how visibility, tenacity, and ingenuity can create far-reaching change.

Examines the findings of scientific research into the thought processes of animals and argues that animals are capable of conscious thought.

Neuroscience can contribute to economics by inspiring new models, helping to distinguish models that have similar implications for readily available data, and guiding interpretations of decision-making processes by policy-makers. However, there is an additional less straightforward role for it to play: augmenting, along with survey data and other non-revealed-preference sources, assessments of well-being. The need for such augmentation lies in the slightly bizarre stance taken by modern economic theory, namely that economics is concerned only with choices and not with welfare (...) per se. It is shown that this is neither historical nor at all necessary, even within the standard paradigm. Although neuroscience is by no means a panacea for determining true utility, which ultimately remains a subjective concept, it provides a uniquely useful complementary dataset. (shrink)

RATIONALE: The concept of evidence-based medicine is important in providing efficient health care. The process uses research findings as the basis for clinical decision making. Evidence-based practice helps optimize current health care and enables the practitioners to be suitably accountable for the interventions they provide. Little work has been undertaken to examine how allied health professionals change their clinical practice in light of the latest evidence. The use of opinion leaders to disseminate new evidence around the management of low back (...) pain into practice has been proposed. AIMS: The aim of this study was to investigate if physiotherapists' clinical management of patients with low back pain would change following an evidence-based education package, which utilized local opinion leaders and delivered the best evidence. METHOD: Thirty musculoskeletal physiotherapists from a Community Trust in North Staffordshire were cluster randomized by location of work, to two groups. The intervention group received an evidence-based programme on the management of low back pain, including advice regarding increasing activity levels and return to normal activity and challenging patients' fears and beliefs about their pain. The control group received a standard in-service training package on the management of common knee pathologies. The physiotherapists' clinical management of patients with low back pain was measured prior to training and 6 months post training. Outcome measures were based on physiotherapists completing 'discharge summary' questionnaires, which included information relating to the use and importance of therapies for treating their low back pain patients. RESULTS: There were few significant differences in treatment options between the intervention and control groups post training. Whilst there was some indication that physiotherapists were already utilizing aspects of psychosocial management for patients with low back pain, there was little change in what physiotherapists perceived to be important to patient recovery and actual clinical practice following the intervention. CONCLUSIONS: Psychosocial factors have been identified as an important factor in the recovery of patients with low back pain. This project incorporated the latest evidence on the management of low back pain and utilized the theory of opinion leaders to disseminate this evidence into clinical practice. Whilst there were some limitations in the overall size of the study, the results help to give an insight into the challenges faced by the health care system and researchers alike to ensure quality evidence is actually utilized by practitioners for the benefits of patient care. (shrink)

In this fascinating study, the author analyzes the conceptual roots of molecular biology and the social matrix in which it was developed.

Recently, there has been a debate focusing on the question of whether groups can literally have beliefs. For the purposes of epistemology, however, the key question is whether groups can have knowledge. More specifi cally, the question is whether “group views” can have the key epistemic features of belief, viz., aiming at truth and being epistemically rational. I argue that, while groups may not have beliefs in the full sense of the word, group views can have these key epistemic features (...) of belief. However, I argue that on Margaret Gilbert's infl uential “plural subject” account of group belief, group views are unlikely to be epistemically rational. (shrink)

Personal narratives have become one of the most potent vehicles for advancing human rights claims across the world. Human Rights and Narrated Lives explores what happens when autobiographical narratives are produced, received, and circulated in the field of human rights. It asks how personal narratives emerge in local settings how international rights discourse enables and constrains individual and collective subjectivities in narration how personal narratives circulate and take on new meanings in new contexts and how and under what conditions they (...) feed into, affect, and are affected by the reorganization of politics in post-cold war, postcolonial, globalizing human rights contexts. (shrink)

This book is a collection of essays by a variety of specialists with a particular interest in palliative care. It contains seven chapters by six different authors. The first chapter Why is the study of ethics important? is by Patricia Webb, a lecturer in palliative care with a background in nursing. She tells us that studying ethics encourages logical reasoned thinking in the face of difficult decisions such as allocation of resources, access to services, best care, clinical research, and rights (...) to life. Webb reminds us that clinical guidelines may not be much help in the face of an ethical dilemma with no clear right or wrong answer. The chapter called Care versus cure by David Jeffrey, a consultant in palliative medicine and writer on medical ethics, reminds us that care is concerned as much with the subjective feelings of the patient as with the physical disease, and aims …. (shrink)

In this paper I take up a critical position in regard to the theme of debility around which this collection is framed. I argue that theorisations of ‘debility’ do little to progress theory and policy in regard to disability and share many of the problems inherent to the social model. I also suggest that the theorisation of debility is rooted in and reinforces ablebodied privilege. I begin with a critical analysis of the social model of disability and explore the dualisms (...) by which it either negates the body altogether or can only conceive the disabled body in negative terms. I then go on to explore how Puar's work on debility continues this negation of the disabled body. From this position I use the work of Inahara to excavate the foundations of ablebodied privilege. In Inahara's work gender is the analytic starting point, but for me white privilege is a much more effective mechanism through which to understand the impact and reproduction of ablebodied privilege— what McRuer refers to as ‘compulsory ablebodiedness'—which I argue underpins Puar's work. I conclude with some reflections upon how a critical analysis of ablebodied privilege might function and I reiterate its importance for a critical theory that goes beyond the mere repetition of binary structures of ablebodiedness and disability. (shrink)

The doctrine of double effect, together with other moral principles that appeal to the intentions of moral agents, has come under attack from many directions in recent years, as have a variety of rationales that have been given in favor of it. In this paper, our aim is to develop, defend, and provide a new theoretical rationale for a secular version of the doctrine. Following Quinn (1989), we distinguish between Harmful Direct Agency and Harmful Indirect Agency. We propose the following (...) version of the doctrine: that in cases in which harm must come to some in order to achieve a good (and is the least costly of possible harms necessary), the agent foresees the harm, and all other things are equal, a stronger case is needed to justify Harmful Direct Agency than to justify Harmful Indirect Agency. We distinguish between two Kantian rationales that might be given for the doctrine, a “dependent right” rationale, defended by Quinn, and an “independent right” rationale, which we defend. We argue that the doctrine and the “independent right” rationale for it are not vulnerable to counterexamples or counterproposals, and conclude by drawing implications for the larger debate over whether agents' intentions are in any way relevant to permissibility and obligation. (shrink)

In delineating a trajectory of human history, anthropology and other social sciences have tended to describe traditional life in particular geographic terms while leaving modem experience universal in scope. Studies of science and technology, while helping to locate and describe centers of modern practice, have less frequently explored their edges. Using a case study of the location of the primary French/european space launch site in French Guiana, this article examines technologies associated with the development of space beyond the atmosphere by (...) evaluating the impact of rockets and satellites on the construction of human space on the ground. Exploring the social significance of a modem sky and its transformation of one tropical margin into a technical center, the question of where things are becomes one of how they are defined. The modem appears less a placeless universal center and more a moving boundary, one dividing humans, nature, and technology into less stable domains. (shrink)

The work reported in this monograph was begun in the winter of 1967 in a graduate seminar at Berkeley. Many of the basic data were gathered by members of the seminar and the theoretical framework presented here was initially developed in the context of the seminar discussions. Much has been discovered since1969, the date of original publication, regarding the psychophysical and neurophysical determinants of universal, cross-linguistic constraints on the shape of basic color lexicons, and something, albeit less, can now also (...) be said with some confidence regarding the constraining effects of these language-independent processes of color perception and conceptualization on the direction of evolution of basic color term lexicons. (shrink)

Objectives—To assess perceptions of the informed consent process in patients undergoing urgent abdominal surgery.Design—A prospective observational study was carried out using structured questionnaire-based interviews. Patients who had undergone urgent abdominal surgery were interviewed in the postoperative period to ascertain their perceptions of the informed consent process. Replies were compared to responses obtained from a control group undergoing elective surgery, to identify factors common to the surgical process and those specific to urgent surgery. Patients' perceptions of received information were also compared (...) to the information perceived to have been provided by the consent obtainers. Setting—Gastrointestinal surgical service of a university teaching hospital.Patients—Seventy-four consecutive patients undergoing urgent abdominal surgery and 80 control patients undergoing elective surgery. Main measurements—Principal outcome measures were patients' perceptions of factors interfering with the ability to give informed consent, assessment of the quality of informed consent and the degree of discussion of the expected outcomes. Results—Forty-nine of the seventy-four (66%) patients undergoing urgent surgery perceived that pain did not affect their ability to give informed consent. Twenty-seven reported an adverse effect of analgesia on the ability to give informed consent. Only 22% of patients undergoing urgent surgery perceived that there had been any discussion of potential side effects and complications of surgery. Conclusion–The majority of patients in this series with acute intra-abdominal surgical conditions perceive that they retain the ability to give informed consent for surgery. There is a need for improved discussion of therapeutic options and likely outcomes. (shrink)

Phosphatidylinositol 3‐phosphate (PtdIns3P) is generated on the cytosolic leaflet of cellular membranes, primarily by phosphorylation of phosphatidylinositol by class II and class III phosphatidylinositol 3‐kinases. The bulk of this lipid is found on the limiting and intraluminal membranes of endosomes, but it can also be detected in domains of phagosomes, autophagosome precursors, cytokinetic bridges, the plasma membrane and the nucleus. PtdIns3P controls cellular functions through recruitment of specific protein effectors, many of which contain FYVE or PX domains. Cellular processes known (...) to be controlled by PtdIns3P and its effectors include endosomal fusion, sorting and motility, autophagy, cytokinesis, regulated exocytosis and signal transduction. Here we discuss how Ptdins3P is generated on specific cellular membranes, how its localizations and functions can be studied, and how its effectors serve to control cellular functions.Editor's suggested further reading in BioEssays:Phosphatidylinositol 4,5‐bisphosphate: Targeted production and signalingAbstractHow does SHIP1/2 balance PtdIns(3,4)P2 and does it signal independently of its phosphatase activity?AbstractPhosphatidylinositol‐3,4,5‐trisphosphate: Tool of choice for class I PI 3‐kinasesAbstractPhosphatidylinositol‐4‐phosphate: The Golgi and beyondAbstract. (shrink)

This paper starts by investigating Ackermann's interpretation of finite set theory in the natural numbers. We give a formal version of this interpretation from Peano arithmetic (PA) to Zermelo-Fraenkel set theory with the infinity axiom negated (ZF−inf) and provide an inverse interpretation going the other way. In particular, we emphasize the precise axiomatization of our set theory that is required and point out the necessity of the axiom of transitive containment or (equivalently) the axiom scheme of ∈-induction. This clarifies the (...) nature of the equivalence of PA and ZF−inf and corrects some errors in the literature. We also survey the restrictions of the Ackermann interpretation and its inverse to subsystems of PA and ZF−inf, where full induction, replacement, or separation is not assumed. The paper concludes with a discussion on the problems one faces when the totality of exponentiation fails, or when the existence of unordered pairs or power sets is not guaranteed. (shrink)

Sandplay is a growing field of interest for Jungian and other psychotherapists. _Sandplay - Silent Workshop of the Psyche_ by Kay Bradway and Barbara McCoard, provides an introduction to sandplay as well as extensive new material for those already using this form of therapy. Based on the authors' wide-ranging clinical work, it includes: in-depth sandplay case histories material from a wide range of adults and children over 90 illustrations in black and white and colour detailed notes on interpretation of sand (...) trays an examination of symbols and concepts used in sandplay. Clearly written and soundly based in theory, this book provides historical background for understanding sandplay as well as helpful discussion of how it works in a clinical context. Kay Bradway and Barbara McCoard bring their indispensable personal experience to the subject to stress the healing potential of sandplay. They also reflect on the nature of a therapy where the psyche works largely in silence. (shrink)

Sociology and Animals : Beginnings -- Animals and Biology as Destiny -- Animals, Social Inequalities and Oppression -- Animals, Crime and Abuse -- Town and Country : Animals, Space and Place -- Consumption of the Animal -- Animals, Leisure and Culture -- Animal Experiments and Animal Rights -- Conclusion: Sociology for Other Animals.

This paper argues that current iterations of lesbian, gay, bisexual, transgender and intersex rights are limited by an overreliance on particular representations of sexuality, in which homosexuality is defined negatively through a binary of homosexual/heterosexual. The limits of these representations are explored in order to unpick the possibility of engaging in a form of sexuality politics that is grounded in difference rather than in sameness or opposition. The paper seeks to respond to Braidotti’s call for an “affirmative politics” that is (...) open to forms of creative, future-oriented action and that might serve to answer some of the more common criticisms of current LGBTI rights activism. (shrink)

This article reports original research examining characteristics of the active followers of the American animal rights movement. Typical respondents were Caucasian, highly educated urban professional women approximately thirty years old with a median income of $33,000. Most activists think of themselves as Democrats or as Independents, and have moderate to liberal political views. They were often suspicious of science and made no distinctions between basic and applied science, or public versus private animal-based research. The research suggests that animal rights activism (...) is in part a symbolic manifestation of egalitarian social and political views concerning scientific and technological change. (shrink)

Adult playfulness describes individual differences in framing everyday situations as personally interesting, and/or entertaining, and/or intellectually stimulating. We aimed at extending initial evidence on the interconnectedness between language use and adult playfulness by asking 264 participants to provide written descriptions of their understanding of playfulness and collected self-reports of their playfulness. We used the Linguistic Inquiry and Word Count methodology to quantitatively analyze the language use in these descriptions and tested the associations with individual differences in participants’ age, gender, and (...) playfulness. While higher expressions in all measures of playfulness did go along with writing more content when describing playfulness, facet-wise analyses revealed differential findings ; but the effects were small. We found that being a women and younger age were related to writing longer texts, and we discovered additional associations between certain LIWC categories and age and gender. Our study expands the knowledge about adult playfulness and its manifestations in natural language use. We embed our findings into previous research and discuss limitations and potential approaches for replication studies. (shrink)

This pioneering study is one of the first English-language books to address Jewish theology from a postmodern perspective, probing the question of how it has the potential to survive the postmodern onslaught that some see as heralding the collapse of religion. Basing her arguments on both philosophical and theological scholarship, the author shows how postmodernism might actually be a resource for rejuvenating religion. Her response to the conception of theology and postmodernism as competing systems of thought is based on a (...) close critical study of Rav Shagar (Shimon Gershon Rosenberg) and Tamar Ross. She analyzes their writings through the lens of the most radical continental postmodern philosophers and cultural critics in order to offer a compelling theology compatible with their world-view. Whether the reader considers postmodernism to be inherently problematic or merely inconsequential, this study demonstrates why reconsidering these preconceptions is one of the most pressing issues in contemporary Jewish thought. (shrink)

In this paper we present an equivalence between the category of commutative regular rings and the category of Boolean-valued fields, i.e., Boolean-valued sets for which the field axioms are true. The author used this equivalence in [12] to develop a Galois theory for commutative regular rings. Here we apply the equivalence to give an alternative construction of an algebraic closure for any commutative regular ring.Boolean-valued sets were developed in 1965 by Scott and Solovay [10] to simplify independence proofs in set (...) theory. They later were applied by Takeuti [13] to obtain results on Hilbert and Banach spaces. Ellentuck [3] and Weispfenning [14] considered Boolean-valued rings which consisted of rings and associated Boolean-valued relations. To the author's knowledge, the present work is the first to employ the Boolean-valued sets of Scott and Solovay to obtain results in algebra.The idea that commutative regular rings can be studied by examining the properties of related fields is not new. For several years algebraists and logicians have investigated commutative regular rings by representing a commutative regular ring as a subdirect product of fields or as the ring of global sections of a sheaf of fields over a Boolean space. These representations depend, as does the work presented here, on the fact that the set of central idempotents of any ring with identity forms a Boolean algebra. The advantage of the Boolean-valued set approach is that the axioms of classical logic and set theory are true in the Boolean universe. Therefore, if the axioms for a field are true for a Boolean-valued set, then other properties of the set can be deduced immediately from field theory. (shrink)

In this essay, I explore this idea of a collective consciousness. I propose that individuals can share in a collective consciousness by forming a collective subject. I begin the essay by considering and rejecting three possible pictures of collective subjectivity: the group mind, the emergent mind, and the socially embedded mind. I argue that each of these accounts fails to provide one of the following requirements for collective subjectivity: (1) plurality, (2) awareness, and (3) collectivity. I then look to Edmund (...) Husserl’s idea of ‘social subjectivities’ for a possible account, but I agree with Alfred Schutz that Husserl fails to explain how such subjectivities are constituted by the conscious acts of individuals. In an effort to provide such an explanation, I turn to a discussion of our basic capacities for social intentionality: empathy, intersubjectivity, and co-subjectivity. In the final section of the essay, I argue that individuals can form a collective subject by taking a first-person plural perspective and ‘simulating’ the consciousness of the collective that they form. This account has the required features of plurality, awareness, and collectivity. (shrink)