Health care services increasingly face patient populations with high levels of ethnic and cultural diversity. Cultures are associated with distinctive ways of life; concepts of personhood; value systems; and visions of the good that affect illness experience, help seeking, and clinical decision-making. Cultural differences may impede access to health care, accurate diagnosis, and effective treatment. The clinical encounter, therefore, must recognize relevant cultural differences, negotiate common ground in terms of problem definition and potential solutions, accommodate differences that are associated with (...) good clinical outcomes, and manage irresolvable differences. Clinical attention to and respect for cultural difference (a) can provide experiences of recognition that increase trust in and commitment to the institutions of the larger society, (b) can help sustain a cultural community through recognition of its distinct language, knowledge, values, and healing practices, and (c) to the extent that it is institutionalized, can contribute to building a pluralistic civil society. (shrink)

Health researchers may have a strategic role to play in confronting the predicament of refugee detainees because they can lend their analytic skills and authority to document the personal cost and impact of this practice. The justification for such ‘subversive’ research comes from the discrepancy between the sources of legitimacy and legality for government action. The practice of detention may be legal but illegitimate, judged against the standards of international human rights. Hence, research to explore the consequences of this policy (...) is both morally and politically legitimate. Morally, it reflects a commitment to uncover and oppose unjustified violence against others; politically, it represents an attempt to identify and challenge abuses of power by the state. However, doing research without official approval or with the use of deception raises concerns for the safety of detainees as vulnerable research subjects as well as the credibility of researchers and the research enterprise. Researchers also may face sanctions that will limit their future effectiveness. An international network of researchers working on issues of human rights and the health of asylum seekers can provide an institutional basis to support work that challenges local practices. (shrink)

The processes underwriting the acquisition of culture remain unclear. How are shared habits, norms, and expectations learned and maintained with precision and reliability across large-scale sociocultural ensembles? Is there a unifying account of the mechanisms involved in the acquisition of culture? Notions such as “shared expectations,” the “selective patterning of attention and behaviour,” “cultural evolution,” “cultural inheritance,” and “implicit learning” are the main candidates to underpin a unifying account of cognition and the acquisition of culture; however, their interactions require greater (...) specification and clarification. In this article, we integrate these candidates using the variational (free-energy) approach to human cognition and culture in theoretical neuroscience. We describe the construction by humans of social niches that afford epistemic resources called cultural affordances. We argue that human agents learn the shared habits, norms, and expectations of their culture through immersive participation in patterned cultural practices that selectively pattern attention and behaviour. We call this process “thinking through other minds” (TTOM) – in effect, the process of inferring other agents’ expectations about the world and how to behave in social context. We argue that for humans, information from and about other people's expectations constitutes the primary domain of statistical regularities that humans leverage to predict and organize behaviour. The integrative model we offer has implications that can advance theories of cognition, enculturation, adaptation, and psychopathology. Crucially, this formal (variational) treatment seeks to resolve key debates in current cognitive science, such as the distinction between internalist and externalist accounts of theory of mind abilities and the more fundamental distinction between dynamical and representational accounts of enactivism. (shrink)

The target article “Thinking Through Other Minds” (TTOM) offered an account of the distinctively human capacity to acquire cultural knowledge, norms, and practices. To this end, we leveraged recent ideas from theoretical neurobiology to understand the human mind in social and cultural contexts. Our aim was bothsynthetic– building an integrative model adequate to account for key features of cultural learning and adaptation; andprescriptive– showing how the tools developed to explain brain dynamics can be applied to the emergence of social and (...) cultural ecologies of mind. In this reply to commentators, we address key issues, including: (1) refining the concept of culture to show how TTOM and the free-energy principle (FEP) can capture essential elements of human adaptation and functioning; (2) addressing cognition as an embodied, enactive, affective process involving cultural affordances; (3) clarifying the significance of the FEP formalism related to entropy minimization, Bayesian inference, Markov blankets, and enactivist views; (4) developing empirical tests and applications of the TTOM model; (5) incorporating cultural diversity and context at the level of intra-cultural variation, individual differences, and the transition to digital niches; and (6) considering some implications for psychiatry. The commentators’ critiques and suggestions point to useful refinements and applications of the model. In ongoing collaborations, we are exploring how to augment the theory with affective valence, take into account individual differences and historicity, and apply the model to specific domains including epistemic bias. (shrink)

O livro almeja ser representativo nos principais debates contemporâneos, oferecendo uma visão panorâmica sobre o campo na atualidade e permitindo-se aprofundar em algumas discussões selecionadas.O ambiente não pode ser reduzido ao “meio ambiente”, à natureza não humana. Ele não é meramente algo que “nos envolve”, um envoltório: o ambiente somos também nós, seres humanos, histórica e culturalmente situados. Quanto aos territórios, eles se estabelecem em íntima conexão com os ambientes em suas dimensões paisagística e material, quer sejam os processos geoecológicos, (...) quer sejam as formas e as dinâmicas socialmente produzidas. Analisar os territórios significa examinar como, a cada momento, os ambientes, seus recursos e significados são disputados e viram objeto de conflitos.O público-alvo principal são os estudantes dos últimos anos da graduação, além daqueles em nível de pós-graduação, de todas as áreas que lidam com problemas e conflitos ambientais. Afora os pesquisadores iniciantes e os jovens universitários em geral, porém, podemos presumir que profissionais experientes também poderão tirar proveito do material de diversos capítulos. É razoável, por fim, nutrir a expectativa de que muito do que este livro contém possa (retro)alimentar o ativismo ambiental crítico e a prática de combater as iniquidades e as distorções que se acumulam em nossas sociedades, principalmente as muitas situações de flagrante injustiça ambiental. (shrink)

Late Babylonian astronomical texts contain records of the stationary points of the outer planets using three different notational formats: Type S where the position is given relative to a Normal Star and whether it is an eastern or western station is noted, Type I which is similar to Type S except that the Normal Star is replaced by a reference to a zodiacal sign, and Type Z the position is given by reference to a zodiacal sign, but no indication of (...) whether the station is an eastern or western station is included. In these records, the date of the station is sometimes preceded by the terms in and/or EN. We have created a database of station records in order to determine whether there was any pattern in the use of these notation types over time or an association with any bias in the station date or the type of text the station was recorded in. Predictive texts, which include Almanacs and Normal Star Almanacs, almost always use Type Z notation, while the Diaries, compilations, and Goal-Year Texts use all three types. Type Z records almost never include in or EN, while other types seem to include these interchangeably. When compared with modern computed station dates, the records show bias toward earlier dates, suggesting that the Babylonians were observing dates when the planets appeared to stop moving rather than the true station. Overlapping reports, where a station on the same date was recorded in two or more texts, suggest that predicted station dates were used to guide observations, and that the planet’s position on the predicted stationary date was the true point of the observation rather than the specific date of the stationary point. (shrink)

Providing an original and systematic treatment of foundational issues in philosophy of religion, J. L. Schellenberg's new book addresses the structure of..

Professional skepticism is a critical component of the auditor’s skill set. Developing this component takes time for accounting students and new auditors. Rather than waiting until they have an internship or a full-time auditing position, students can begin practicing this essential skill earlier in their academic careers. The case presents students in their first undergraduate auditing course an introduction to the need for more complex thinking and professional skepticism in the auditing and forensic accounting areas. The case focuses on risk (...) assessment and critical evaluation of audit evidence, primarily through audit interviews. In addition, the case allows students to learn the value of preparation and strategy uniquely: their first attempt at the case is almost impossible to solve. (shrink)

Wemay look at the relation of will and motive from another side as follows: Will, we have said, is an individual response to an individual situation. Like the situation itself, it is not a fixed thing persisting through change, but involved in a continuous flow of change, re-adapting itself constantly in one respect or another to recognized changes of circumstance. It can have no more immutability than circumstance, and if it is not to be left behind in the march of (...) events and become old-fashioned, it should have the capacity for the same rapidity of change. Now motives also change, but in a different way. First one motive operates, then another, as circum-. (shrink)

In Wrong Medicine, Lawrence J. Schneiderman, M.D., and Nancy S. Jecker, Ph.D., address issues that have occupied the media and the courts since the time of Karen Ann Quinlan. The authors examine the ethics of cases in which medical treatment is offered--or mandated--even if a patient lacks the capacity to appreciate its benefit or if the treatment will still leave a patient totally dependent on intensive medical care. In exploring these timely issues Schneiderman and Jecker reexamine the doctor-patient relationship and (...) call for a restoration of common sense and reality to what we expect from medicine. They discuss economic, historical, and demographic factors that affect medical care and offer clear definitions of what constitutes futile medical treatment. And they address such topics as the limits on unwanted treatment, the shift from the "Age of Physician Paternalism" to the "Age of Patient Autonomy," health care rationing, and the adoption of new ethical standards. (shrink)

Recent policy developments in the area of livestock husbandry have suggested that, from the perspective of optimizing animal welfare, new animal husbandry systems should be developed that provide opportunities for livestock animals to be raised in environments where they are permitted to engage in “natural behavior.” It is not known whether consumers regard animal husbandry issues as important, and whether they differentiate between animal husbandry and other animal welfare issues. The responsibility for the development of such systems is allocated jointly (...) between farmers, regulators, different actors in the food chain, and consumers. This research focuses on understanding consumer attitudes and preferences regarding the development and introduction of such systems, to ensure that they are acceptable to consumers as well as producers, regulators, and scientists. Consumer perceptions of animal welfare and animal husbandry practices were evaluated using quantitative consumer survey, which focused on two animal husbandry issues – farmed pigs and farmed fish. Following pilot work, 1000 representative Dutch consumers were sampled about their attitudes to either pig or fish husbandry. The results indicated that consumers think about animal welfare in terms of two broad categories related to their health and living environment, but do not think about welfare issues at a more detailed level. Greater concern was expressed about the welfare of pigs compared to fish. Consumer trust in labeling also emerged as an important issue, since consumers need to trust different food chain actors with responsibility for promoting animal welfare, and are reluctant to consider the details of animal husbandry systems. As a consequence, a transparent, enforceable, and traceable monitoring system for animal welfare friendly products is likely to be important for consumers. (shrink)

Ultimism and the aims of human immaturity -- Faith without details, or how to practice skeptical religion -- Simple faith and the complexities of tradition -- The structure of faith justification -- How skeptical faith is true to reason -- Anselm's idea -- Leibniz's ambition -- Paley's wonder -- Pascal's wager -- Kant's postulate -- James's will -- Faith is positively justified : the many modes of religious vision.

Individuals with autistic spectrum disorder (ASD) display diverse deficits in social, cognitive and behavioral functioning. To date, there has been mixed findings on the profile of executive function deficits for high-functioning adults (IQ >70) with ASD. A conceptual distinction is commonly made between “cold” and “hot” executive functions. Cold executive functions refer to mechanistic higher-order cognitive operations (e.g., working memory), whereas hot executive functions entail cognitive abilities supported by emotional awareness and social perception (e.g., social cognition). This study aimed to (...) determine the independence of deficits in hot and cold executive functions for high-functioning adults with ASD. Forty-two adults with ASD (64% male, aged 18-66 years) and 40 age and gender matched controls were administered The Awareness of Social Inference Test (TASIT; emotion recognition and social inference), Letter Number Sequencing (working memory) and Hayling Sentence Completion Test (response initiation and suppression). Between-group analyses identified that the ASD group performed significantly worse than matched controls on all measures of cold and hot executive functions (d =.54-1.5). Hierarchical multiple regression analyses revealed that the ASD sample performed more poorly on emotion recognition and social inference tasks than matched controls after controlling for cold executive functions and employment status. The findings also indicated that the ability to recognise emotions and make social inferences was supported by working memory and response initiation and suppression processes. Overall, this study supports the distinction between hot and cold executive function impairments for adults with ASD. Moreover, it advances understanding of higher-order impairments underlying social interaction difficulties for this population which, in turn, may assist with diagnosis and inform intervention programs. (shrink)

The idea of a 'logic of quantum mechanics' or quantum logic was originally suggested by Birkhoff and von Neumann in their pioneering paper [1936]. Since that time there has been much argument about whether, or in what sense, quantum 'logic' can be actually considered a true logic (see, e.g. Bell and Hallett [1982], Dummett [1976], Gardner [1971]) and, if so, how it is to be distinguished from classical logic. In this paper I put forward a simple and natural semantical framework (...) for quantum logic which reveals its difference from classical logic in a strikingly intuitive way, viz. through the fact that quantum logic admits (suitably formulated versions of) the characteristic quantum-mechanical notions of superposition and incompatibility of attributes. That is, precisely the features that distinguish quantum from classical physics also serve, within this framework, to distinguish quantum from classical logic. Some light is shed on the question of whether quantum logic is a genuine logical system by introducing a natural entailment relation for quantum-logical formulas with the implication symbol. The novelty is that, although implication behaves as it should (i.e. the 'deduction theorem' holds), the order of introduction of premises is significant. The fact that a reasonable entailment relation can be formulated for quantum logic supports the view that it is a genuine logical system and not merely an algebraic formalism. (shrink)

Recent policy developments in the area of livestock husbandry have suggested that, from the perspective of optimizing animal welfare, new animal husbandry systems should be developed that provide opportunities for livestock animals to be raised in environments where they are permitted to engage in “natural behavior.” It is not known whether consumers regard animal husbandry issues as important, and whether they differentiate between animal husbandry and other animal welfare issues. The responsibility for the development of such systems is allocated jointly (...) between farmers, regulators, different actors in the food chain, and consumers. This research focuses on understanding consumer attitudes and preferences regarding the development and introduction of such systems, to ensure that they are acceptable to consumers as well as producers, regulators, and scientists. Consumer perceptions of animal welfare and animal husbandry practices were evaluated using quantitative consumer survey, which focused on two animal husbandry issues – farmed pigs and farmed fish. Following pilot work, 1000 representative Dutch consumers were sampled about their attitudes to either pig or fish husbandry. The results indicated that consumers think about animal welfare in terms of two broad categories related to their health and living environment, but do not think about welfare issues at a more detailed level. Greater concern was expressed about the welfare of pigs compared to fish. Consumer trust in labeling also emerged as an important issue, since consumers need to trust different food chain actors with responsibility for promoting animal welfare, and are reluctant to consider the details of animal husbandry systems. As a consequence, a transparent, enforceable, and traceable monitoring system for animal welfare friendly products is likely to be important for consumers. (shrink)

In this second of two essays responding to critical discussion of my " Divine Hiddenness and Human Reason," I show how an ' accommodationist ' strategy can be used to defuse objections that were not exposed as irrelevant by the first essay. This strategy involves showing that the dominant concern of reasons for divine withdrawal can be met or accommodated within the framework of divine - human relationship envisaged by the hiddenness argument. I conclude that critical discussion leaves the argument (...) very much alive and kicking, and indeed strengthened as it moves into its second decade of life. (shrink)

In a single volume intended for philosophy students of all levels as well as their teachers, this reader provides modern, accurate translations of the texts necessary for a careful study of most aspects of Aristotle's philosophy. Professor Ackrill has drawn on his broad experience of teaching graduate classes in selecting the texts, and his choice reflects issues of current philosophical interest as well as the perennial themes. Only recent translations which achieve a high level of accuracy have been chosen: the (...) aim is to place the reader without Greek, as nearly as possible, in the position of a reader of Greek. As an aid to study, a valuable guide to the key topics covered is also suppied, giving references to works or passages contained in the reader, an indication of their interrelation, and a currnet bibliography. (shrink)

Examining those risk and benefit perceptions utilised in the formation of attitudes and opinions about emerging technologies such as nanotechnology can be useful for both industry and policy makers involved in their development, implementation and regulation. A broad range of different socio-psychological and affective factors may influence consumer responses to different applications of nanotechnology, including ethical concerns. A useful approach to identifying relevant consumer concerns and innovation priorities is to develop predictive constructs which can be used to differentiate applications of (...) nanotechnology in a way which is meaningful to consumers. This requires elicitation of attitudinal constructs from consumers, rather than measuring attitudes assumed to be important by the researcher. Psychological factors influencing societal responses to 15 applications of nanotechnology drawn from different application areas were identified using repertory grid method in conjunction with generalised Procrustes analysis. The results suggested that people differentiate nanotechnology applications based on the extent to which they perceive them to be beneficial, useful, necessary and important. The benefits may be offset by perceived risks focusing on fear and ethical concerns. Compared to an earlier expert study on societal acceptance of nanotechnology, consumers emphasised ethical issues compared to experts but had less concern regarding potential physical contact with the product and time to market introduction. Consumers envisaged fewer issues with several applications compared to experts, in particular food applications. (shrink)

Criticises G. E. Moore’s highly influential proposal that ascriptions of agent ability implying freedom of choice or action, what the agent could do, are analyzable as conditional statements regarding what the agent would do under certain circumstances. Austin objects against Moore that some uses of ‘if’ are non-conditional and goes on to examine the uses of these non-conditional cases. Moore’s proposal also lies at the heart of some compatibilist theories of free will and determinism. Austin argues determinism to be a (...) pseudo-problem, so long as it remains a notion that is not itself clear cut. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

This paper argues that, while there is a difference between personal and sub‐personal explanation, claims of autonomy should be treated with scepticism. It distinguishes between horizontal and vertical explanatory relations that might hold between facts at the personal and farts at the sub‐personal level. Noting that many philosophers are prepared to accept vertical explanatory relations between the two levels, I argue for the stronger claim that, in the case of at least three central personal level phenomena, the demands of explanatory (...) adequacy require postulating horizontal explanatory relations. (shrink)

In this brief reply I argue that criticisms of the hiddenness argument recently published in this journal by Imran Aijaz and Markus Weidler are without force. As will be shown, their critique of my conceptual version of the argument misses the mark by missing crucial distinctions. Their critique of my analogical version of the argument misunderstands that argument and also misapplies the work of W. H. Vanstone. And their critique of my view that belief is necessary for a certain kind (...) of relationship with God overlooks both some central features of that kind of relationship and some good reasons for not accepting acceptance or anything similarly nonbelieving as a substitute for belief in this context. (shrink)