Physicians have an ethical responsibility to their patients to offer the best available medical care. This responsibility conflicts with their role as gatekeepers of the limited health care resources available for all patients collectively. It is ethically untenable to expect doctors to face this trade-off during each patient encounter; the physician cannot be expected to compromise the wellbeing of the patient in the office in favour of anonymous patients elsewhere. Hence, as in other domains of public policy where individual and (...) collective interests conflict, some form of collective solution is required. Collective solutions may take the form of placing explicit resource constraints on resources available to physicians, or clinical practice guidelines that recognise cost-effective care as acceptable. Such solutions will be politically and ethically sustainable only if patients as citizens of the larger population accept the need for rationing of limited resources in health care. (shrink)

The answer to philosophical questions will often depend on the position one takes regarding the fact-value problem. It is, therefore, not surprising that, in the tradition of western philosophy, the past 200 years or so record an animated discussion of it. In the present collection the debate is continued by representatives of various "schools" in contemporary western thought. A number of philosophers from non-western cultures, too, enter into it. The contributions do not all reflect on the same theme, nor do (...) they use the same approach. Essays written by philosophers sympathetic to the analytical tradition are followed by reflections on the part of those inspired by phe nomenology. A third group of contributions is by non-western thinkers, who are more likely to approach the problem in terms of culture. Their engage ment with the issue clearly shows, among other things, that it is almost exclusively in the western tradition that the fact-value distinction is often understood as an outright dichotomy. The occasion for the publication of this collection is Dr. Cornelis Anthonie van Peursen's retirement as Professor of Philosophy. This year he leaves the Free University, Amsterdam; until 1982 he was professor at the University of Leyden as well. In the Netherlands and beyond he has become known for his concern with constructive comparison of diverging philosophical trends and the cross-cultural fertilization of thought. Characteristic of his career are his efforts to render the results of academic philosophizing understand able to a broader audience. (shrink)

The requirement of gauge invariance for the Schwinger-DeWitt equations, interpreted as a manifestly covariant quantum theory for the evolution of a system in spacetime, implies the existence of a five-dimensional pre-Maxwell field on the manifold of spacetime and “proper time” τ. The Maxwell theory is contained in this theory; integration of the field equations over τ restores the Maxwell equations with the usual interpretation of the sources. Following Schwinger's techniques, we study the Green's functions for the five-dimensional hyperbolic field equations (...) for both signatures ± [corresponding to O(4, 1) or O(3, 2) symmetry of the field equations] of the proper time derivative. The classification of the Green's functions follows that of the four-dimensional theory for “massive” fields, for which the “mass” squared may be positive or negative, respectively. The Green's functions for the five-dimensional field are then given by the Fourier transform over the “mass” parameter. We derive the Green's functions corresponding to the principal part ΔP and the homogeneous function Δ 1 ; all of the Green's functions can be expressed in terms of these, as for the usual field equations with definite mass. In the O(3, 2) case, the principal part function has support for x2⩾τ2, corresponding to spacelike propagation, as well as along the light cone x2=0 (for τ=0). There can be no transmission ofinformation in spacelike directions, with this propagator, since the Maxwell field, obtained by integration over τ, does not contain this component of the support. Measurements are characterized by such an integration. The spacelike field therefore can dynamically establish spacelike correlations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:M. C. Henberg GEORGE ELIOT'S MORAL REALISM No moment in the history of ethics could be more propitious than the present for a comprehensive restudy of George Eliot's moral realism. Analysis of the "logic" of moral language has proved barren, prescriptivism is in full flight, and schematic divisions of moral theories into descriptive versus normative, deontological versus teleological, or substantive versus meta-ethical have promised much but delivered little. Such (...) distinctions dominate maps to the modern moral terrain, but awanderer in the land ofchoice itselfstill finds himselfwithout signposts. A particularly unhealthy bias in contemporary ethics has been the belief that moral principles ought to withstand all counterexamples, however plausible or implausible, whether concocted from a sense of men's actual capacities or from a fondness for outrageous possibilities, many of them lifted from the pages of science fiction. If moral rules do not govern in hard cases, it is thought, they do not govern at all. Few philosophers have bothered to distinguish between the hard cases common to men's actual choices and the hard cases confronted by one man in a million or by the imagined inhabitants of some future world. (Witness, for example, the present preoccupation with "lifeboat ethics" and ask yourself how many actual moral choices are so starkly dramatic.) Any logically possible circumstance is too often assumed to qualify as a fruitful area for moral investigation; and any conceivable counterexample, achieved by whatever stretch of the imagination, is assumed to be fair ammunition in the debate over principles. Closely related to this first bad tendency in modern philosophical ethics is another, equally bad. Too often the examples used are of little moral significance, obviously conceived to make a point rather than to direct attention to commonplace but nonetheless important circumstances where informed choice is essential. Philosophy journals have treated us to discussions about whether failing to wear tennis whites is or is not "rude" and about whether a first sinner's crossing of a patch of lawn does or does not have a "threshold-related effect" 20 M. C. Henberg21 which must be considered in assessing later consequences (a bare path ultimately worn in the grass). Such examples rightly earn a contemptuous snort from anyone who expects philosophy to increase our understanding in matters of serious consequence. Whatever her other accomplishments as a moralist and philosophical thinker, George Eliot never commits either of the preceding crimes. Her moral realism constitutes first and foremost an ethics aimed at the bulk of her fellow men. She yields to the theoretic impulse solely in criticizing other theories. When it comes to providing answers, she depicts fictional characters whose struggles, failings, and passions are ultimately akin to what we ourselves are likely to experience. Her ethical precepts are not aimed at proving themselves in every conceivable situation. They are instead precepts which are sometimes susceptible to ruin, just as are the changeable creatures who profess them. To know the natural boundaries of a moral rule, Eliot tells us, is as difficult and important as knowing the rule itself. Moral realism requires a combination of clear-eyed perception and imaginative sympathy—faculties ill-served by lectures on abstract principles. Eliot reminds us that our best moral judgments must be "checked and enlightened by a perpetual reference to the special circumstances that mark the individual lot" (The Mill on the Floss, Book VII, chap. 3). This emphasis in particular—found both in her early essays and early fiction—makes Eliot's moral realism a welcome anodyne to the worst tendencies of modern ethics. The discussion which follows will be confined to early works, including Scenes of Clerical Life, Adam Bede, and The Mill on the Floss. The ruminations of her authorial voice in these novels may conveniently be juxtaposed with her essays, for the works are near to one another both temporally and thematically. Later novels such as Middlemarch and Daniel Deronda—however interesting from an ethical perspective— do not lend themselves to this mode of analysis. To what extent Eliot's views are modified in these later novels constitutes a separate topic whose omission here does not reflect upon its intrinsic interest or importance. Since George Eliot offers no... (shrink)

A frequent objection to the fine-tuning argument has been that although certain necessary conditions for life were admittedly exceedingly improbable, still, the many possible alternative sets of conditions were all equally improbable, so that no special significance is to be attached to the realization of the conditions of life. Some authors, however, have rejected this objection as fallacious. The object of this paper is to state the objection to the fine-tuning argument in a more telling form than has been done (...) hitherto, and to meet the charge of fallacy. (shrink)

The Gesta Normannorum Ducum is one of the most important sources for the history of Normandy and England in the eleventh and twelfth centuries, and contains the earliest prose account of the Norman Conquest. It was written by a succession of authors, the first of whom was William of Jumieges, who wrote for William the Conqueror. Later historians, such as Orderic Vitalis and Robert of Torigni, interpolated and extended the chronicle as far as King Henry I. The later accretions reveal (...) much not only about changing attitudes towards the Norman invasion of England, but also about views of the early Viking foundations of Normandy.Elisabeth van Houts's two-volume edition is based on a study of all forty-seven extant manuscripts of the Gesta, including the earliest surviving copy of c. 1100, unknown until very recently. The full original text of William of Jumieges is supplied, as well as the integral text of the subsequent revisions and additions. Volume I contains Dr van Houts's introduction to the whole work, together with the text and translation of books i-iv. Volume II contains books v-viii. The edition forms an important contribution to our understanding of Anglo-Norman politics. (shrink)

A class K of structures is controlled if for all cardinals λ, the relation of L∞,λ-equivalence partitions K into a set of equivalence classes . We prove that no pseudo-elementary class with the independence property is controlled. By contrast, there is a pseudo-elementary class with the strict order property that is controlled 69–88).

A class K of structures is controlled if, for all cardinals λ, the relation of L ∞,λ-equivalence partitions K into a set of equivalence classes (as opposed to a proper class). We prove that the class of doubly transitive linear orders is controlled, while any pseudo-elementary class with the ω-independence property is not controlled.

Since antiquity, theories of knowledge have had fundamental impacts on understanding the design of the conditions of learning and teaching. As represented in this special issue, these theories may be divided into structural, functional, and biofunctional. Structural models have contributed to knowledge about the organization of information stored in memory. Functional models have contributed to our understanding of how learning occurs and how it can be facilitated. Functional and biofunctional approaches have much in common but differ in their assumptions about (...) the nature of the role of biology in learning. All three types of theories complement one another. This paper focuses on the potential contributions of functional models, including the biofunctional model, to the design of the conditions of learning and teaching. (shrink)

The effects of school inspections on school improvement have been investigated only to a limited degree. The investigation reported on in this article is meant to expand our knowledge base regarding the impact of school inspections on school improvement. The theoretical framework for this research is partly based on the policy theory behind the Dutch Educational School Supervision Act (the latter includes assumptions about how school inspections lead to school improvement). Interviews and a survey with school inspectors gave insight into (...) how school inspectors implement the Supervision Act and how they assess schools, and stimulate schools to improve. The results of ten case studies showed that all schools started to improve after a school visit. The innovation capacity of the school and the school environment do not seem to contribute to school improvement after school inspections. No effects were found on school-improvement processes of the number of insufficient scores that schools received from inspectors, the extent of feedback and suggestions for improvement, and the number of agreements. The provision of feedback about weaknesses, the assessment of these weak points as unsatisfactory, and the agreements between an inspector and the school regarding improvement activities do appear to make a difference in promoting school improvement. (shrink)

Open-mindedness is generally regarded as an intellectual virtue because its exercise reliably leads to truth. However, some theorists have argued that open-mindedness’s truth-conduciveness is highly contingent, pointing out that it is either not truth-conducive at all under certain scenarios or no better than dogmatism or credulity in others. Given such shaky ties to truth, it would appear that the status of open-mindedness as an intellectual virtue is in jeopardy. In this paper, I propose to defend open-mindedness against these challenges. In (...) particular, I show that the challenges are ill-founded because they misconstrue the nature of open-mindedness and fail to consider the requisite conditions of its application. With a proper understanding of open-mindedness and of its requirements, it is clear that recourse to it is indeed truth-conducive. (shrink)

Early psychophysical methods as codified by Fechner motivate the development of quantitative theories of subjective experience. The basic insight is that just noticeable differences between experiences can serve as units for measuring a sensory domain. However, the methods described by Fechner tacitly assume that the experiences being investigated can be linearly ordered. This assumption is not true for all sensory domains; for example, there is no trivial linear order over all possible color sensations. This paper discusses key developments in the (...) history of psychophysical methods for measuring color experience. In particular, a clear distinction between topological and metrical structure allowed Helmholtz to use opponent colors as a standard for measuring the gross structure of color space. Once this gross structure had been determined, lines through color space could be defined and Fechner-style methods employed for determining local structure. Extensions of these methods due to Wright, MacAdam, and others provide detailed evidence for the degree of agreement in the qualities of color experience across individuals. This allows a precise statement of the evidential support for the claim that your experience of color and mine are the same. (shrink)

This paper explores how open-mindedness and its exercise can be social in nature. In particular, it argues that an individual can be regarded as open-minded even though she does not conduct all of the intellectual tasks as required by open-mindedness _by herself;_ that is, she delegates some of these tasks to her epistemic peers. Thinking about open-mindedness in such social terms not only opens up the possibility that there are different and surprising ways for an individual to be open-minded, but (...) can also help offset some recent criticisms raised against open-mindedness and its status as an intellectual virtue. (shrink)

This is a book about the between: the place that "does not occupy any space", between phenomenology and structuralism. Silverman writes from this place between Husserl, Heidegger, Sartre, and Merleau-Ponty, on one side, and de Saussure, Piaget, Levi-Strauss, Lacan, and Barthes, on the other. His writing draws from all of the figures mentioned, yet does not align itself with any one of them. The place between phenomenology and structuralism is both historically and conceptually beyond both traditions: what Silverman says about (...) the writing of Foucault and Derrida might as well be applied to his own, that is, that this writing "might be described as a post-phenomenology post-structuralism". But this is not the amorphous location of a loosely constructed eclecticism; it is a carefully conceived philosophical doctrine designed for two interrelated purposes. (shrink)

Concept Pluralism and Concept Eliminativism are two positions recently proposed in the philosophy and the psychology of concepts. Both of these theories are motivated by the view that all current theories of concepts are empirically and methodologically inadequate and hold in common the assumption that for any category that can be represented in thought, a person can possess multiple, distinct concepts of it. In this paper, I will challenge these in light of a third theory, Conceptual Atomism, which addresses and (...) dispels the contentious issues. In particular, I contend that Conceptual Atomism, when properly understood, is empirically adequate and can overcome difficulties that plague Pluralism and Eliminativism. (shrink)

Mechanism realists assert the existence of mechanisms as objective structures in the world, but their exact metaphysical commitments are unclear. We introduce Local Hierarchy Realism (LHR) as a substantive and plausible form of mechanism realism. The limits of LHR reveal a deep tension between two aspects of mechanists’ explanatory strategy. Functional decomposition identifies locally relevant entities and activities, while these same entities and activities are also embedded in a nested hierarchy of levels. In principle, a functional decomposition may identify entities (...) engaging in causal interactions that crosscut the hierarchical structure of composition relations, violating the mechanist’s injunction against interlevel causation. We argue that this possibility is realized in the example of ephaptic coupling, a subsidiary process of neural computation that crosscuts the hierarchy derived from synaptic transmission. These considerations undermine the plausibility of LHR as a general view, yet LHR has the advantages that (i) its metaphysical implications are precisely stateable; (ii) the structure it identifies is not reducible to mere aggregate causation; and (iii) it clearly satisfies intuitive and informal definitions of mechanism. We conclude by assessing the prospects for a form of mechanism realism weaker than LHR that nevertheless satisfies all three of these requirements. (shrink)

The Gesta Normannorum Ducum is one of the most important sources for the history of Normandy and England in the eleventh and twelfth centuries, and contains the earliest prose account of the Norman Conquest. It was written by a succession of authors, the first of whom was William of Jumièges, who wrote for William the Conqueror. Later writers, such as Orderic Vitalis and Robert of Torigni, interpolated and extended the chronicle as far as King Henry I. The later accretions reveal (...) much not only about changing attitudes towards the Norman invasion of England, but also about views of the early Viking foundation of Normandy. Elisabeth van Houts's two-volume edition is based on a study of all forty-seven extant manuscripts of the Gesta, including the earliest surviving copy of c. 1100, hitherto unknown. The full original text of William of Jumièges is supplied, as well as the integral text of the subsequent revisions and additions. Volume I contains Dr van Houts's introduction to the whole work, together with the text and translation of books i-iv. Books v-viii will appear in Volume II. The edition forms an important contribution to our understanding of Anglo-Norman politics. (shrink)

It has long been thought that Romans did not hunt before the time of Scipio Aemilianus because hunting was not an activity for respectable citizens. This article shows that this tradition arose from a nineteenth-century bias for hunting on horseback. The tradition was supported principally by Polybius' account of Scipio's hunting and a quotation from Sallust. Although we now recognize that Greeks and Romans in general hunted on foot, this bias has predisposed the discussion against the discovery of evidence for (...) the actual practice of hunting among the early Romans. The archaeological evidence from new excavations in Latium and previously uncited historical and legal evidence for hunting in the Republican period demonstrate that, precisely as we would expect, Romans from the earliest days hunted. Hunting as an aristocratic sport, as a communal activity associated with the military preparation of soldier-citizens, and as a practical means of survival for the poorer countrymen, were all present in Roman society. Further, Polybius' account of Scipio's hunting, contrary to what has been argued, indicates that the cause of disapproval was not the fact that Scipio hunted, but rather that he hunted instead of pleading cases in the forum. Supporting evidence from Cato the Elder, Ennius, and Plautus shows that hunting was a common and accepted activity among Romans of the mid-Republic. Finally, Sallust's criticism of hunting cannot be assumed to represent Roman views, since he condemns farming and hunting together, and we know Romans highly respected farming. No evidence supporting a negative view of hunting in Roman society is found, and the positive evidence in sum demonstrates conclusively that in all periods Romans did indeed hunt. (shrink)

Nolan, Ann MC In the past fifty years there has been a stream of commentary on the documents of Vatican II. Have we not had so much commentary, so much interpretation, that further commentary is unnecessary? Fifty years on, one might ponder how to interpret the sixteen documents for the church of our times, indeed to wonder whether they continue to have any relevance at all. Faced with this thought, we could turn to one scholar whose works span almost the (...) whole of this fifty-year period, yet whose thought in relation to the documents has not remained static: the renaissance historian John O'Malley SJ. (shrink)

Mechanism realists assert the existence of mechanisms as objective structures in the world, but their exact metaphysical commitments are unclear. We introduce Local Hierarchy Realism (LHR) as a substantive and plausible form of mechanism realism. The limits of LHR reveal a deep tension between two aspects of mechanists’ explanatory strategy. Functional decomposition identifies locally relevant entities and activities, while these same entities and activities are also embedded in a nested hierarchy of levels. In principle, a functional decomposition may identify entities (...) engaging in causal interactions that crosscut the hierarchical structure of composition relations, violating the mechanist’s injunction against interlevel causation. We argue that this possibility is realized in the example of ephaptic coupling, a subsidiary process of neural computation that crosscuts the hierarchy derived from synaptic transmission. These considerations undermine the plausibility of LHR as a general view, yet LHR has the advantages that (i) its metaphysical implications are precisely stateable; (ii) the structure it identifies is not reducible to mere aggregate causation; and (iii) it clearly satisfies intuitive and informal definitions of mechanism. We conclude by assessing the prospects for a form of mechanism realism weaker than LHR that nevertheless satisfies all three of these requirements. (shrink)

For all his peculiarities, man is not the only animal who knows. But he is, as far as it is possible to judge, the only animal who knows that he knows, and who seeks to understand the nature and meaning of the act of knowing itself. Michael Polanyi has been engaged in this search for more than twenty years, and the book here under review is an ‘interim report’ on the development of his thought since the publication of Personal Knowledge (...) and The Study of Man just ten years ago. Its three short chapters are substantially the Terry Lectures which he delivered at Yale University in 1962. This review will attempt no more than to summarise the central theme of Polanyi’s argument. A detailed, critical analysis of its philosophical significance is beyond the competence of a biologist. (shrink)

Sows housed in stalls are kept insuch extreme confinement that they are unableto turn around. In some sectors of the porkindustry, sows are subjected to this degree ofconfinement for almost their entire lives(apart from the brief periods associated withmating). While individual confinement isrecognized by farmers and animal welfarecommunity organizations alike, as a valuabletool in sow husbandry (to mitigate againstaggression), what remains questionable from ananimal welfare point of view is the necessityto confine sows in such small spaces.In 2001, the Australian Journal (...) ofAgricultural Research published a reviewarticle on the science associated with the useof the sow stall, and claimed that ``noscientific evidence to support therecommendation in the Code of Practice advisingagainst housing of sows in stalls followed byhousing in crates'''' (Barnett et al., 2001, p. 21).If all the available scientific publications onthe animal welfare implications of sow stallsare consulted (many of which did not feature inthe above review), then one will indeed findscientific evidence to support recommendationsagainst the housing of sows in stalls. Becausethere is science on both sides of this policydivide, the argument to defend the use of sowstalls, therefore, is not one of science vspublic opinion, but one of ethics. (shrink)

This collection of essays celebrates the seventieth birthday of one of the great scientist-philosophers of the century. The list of subscribers in the front of the book contains the names of some of the most distinguished scientists, academics, writers and educators living today, not to mention the names of organizations like the Fund for the Republic and the Congress for Cultural Freedom, and of more than twenty universities, colleges and research institutes throughout the world. In all, one hundred and seventy-eight (...) names, a unique tribute to a remarkable man whose contributions to science, philosophy, sociology and that frontier region between science and religion, comprise one of the major intellectual achievements of our time. (shrink)

The number of discriminable colours is often assumed to be of the order of several million but the extent of detectable chromatic diversity present in individual natural scenes is an open question. Here, the aim was to estimate the number of discriminable colours seen in natural scenes. Hyperspectral data were obtained from a set of natural scenes over the range 400 - 720 nm at 10 nm intervals (Nascimento et al, 2002 Journal of the Optical Society of America A 19 (...) 1484 - 1490) and the representation of each scene in CIELAB space computed for all pixels of the image. The number of discriminable colours was estimated by counting the number of unit volumes in the three-dimensional volume defined by the scene when represented in CIELAB space. We found that the number of discriminable colours estimated in a scene could vary by an order of magnitude from scene to scene, but rarely exceeded 105, indicating a limited chromatic diversity. (shrink)

© 2016 Regents of the University of California.The Review summarizes much of particle physics and cosmology. Using data from previous editions, plus 3,062 new measurements from 721 papers, we list, evaluate, and average measured properties of gauge bosons and the recently discovered Higgs boson, leptons, quarks, mesons, and baryons. We summarize searches for hypothetical particles such as supersymmetric particles, heavy bosons, axions, dark photons, etc. All the particle properties and search limits are listed in Summary Tables. We also give numerous (...) tables, figures, formulae, and reviews of topics such as Higgs Boson Physics, Supersymmetry, Grand Unified Theories, Neutrino Mixing, Dark Energy, Dark Matter, Cosmology, Particle Detectors, Colliders, Probability and Statistics. Among the 117 reviews are many that are new or heavily revised, including those on Pentaquarks and Inflation. The complete Review is published online in a journal and on the website of the Particle Data Group. The printed PDG Book contains the Summary Tables and all review articles but no longer includes the detailed tables from the Particle Listings. A Booklet with the Summary Tables and abbreviated versions of some of the review articles is also available. (shrink)

Background Genuine uncertainty on superiority of one intervention over the other is called equipoise. Physician-investigators in randomized controlled trials need equipoise at least in studies with more than minimal risks. Ideally, this equipoise is also present in patient-participants. In pediatrics, data on equipoise are lacking. We hypothesize that 1) lack of equipoise at enrolment among parents may reduce recruitment; 2) lack of equipoise during participation may reduce retention in patients assigned to a less favoured treatment-strategy. Methods We compared preferences of (...) parents/patients at enrolment, documented by a questionnaire, with preferences developed during follow-up by an interview-study to investigate equipoise of child-participants and parents in the BeSt-for-Kids-study. This trial in new-onset Juvenile Idiopathic Arthritis-patients consists of three strategies. One strategy comprises initial treatment with a biological disease-modifying-antirheumatic-drug, currently not standard-of-care. Semi-structured interviews were conducted with 23 parents and 7 patients, median 11 months after enrolment. Results Initially most parents and children were not in equipoise. Parents/patients who refused participation, regularly declined due to specific preferences. Many participating families preferred the biological-first-strategy. They participated to have a chance for this initial treatment, and would even consider stopping trial-participation when not randomized for it. Their conviction of superiority of the biological-first strategy was based on knowledge from internet and close relations. According to four parents, the physician-investigator preferred the biological-first-strategy, but the majority stated that she had no preferred strategy. In phase 2, preferences tended to change to the treatment actually received. Conclusions Lack of equipoise during enrolment did not reduce study recruitment, mainly due to the fact that preferred treatment was only available within the study. Still, when developing a trial it is important to evaluate whether the physicians’ research question is in line with preferences of the patient-group. By exploring so-called ‘informed patient-group’-equipoise, successful recruitment may be enhanced and bias avoided. In our study, lack of equipoise during trial-participation did not reduce retention in those assigned to a less favoured option. We observed a change for preference towards treatment actually received, possibly explained by comparable outcomes in all three arms. (shrink)

Deficits in social cognition and more specifically in communication have an important impact on the real-life functioning of people with schizophrenia. In particular, patients have severe problems in communicative-pragmatics, for example, in correctly inferring the speaker’s communicative intention in everyday conversational interactions. This limit is associated with morphological and functional alteration of the left middle temporal gyrus, a cerebral area involved in various communicative processes, in particular in the distinction of ironic communicative intention from sincere and deceitful ones. We performed (...) an fMRI study on 20 patients with SZ and 20 matched healthy controls while performing a pragmatic task testing the comprehension of sincere, deceitful, and ironic communicative intentions. We considered the L-MTG as the region of interest. SZ patients showed difficulties in the correct comprehension of all types of communicative intentions and, when correctly answering to the task, they exhibited a higher activation of the L-MTG, as compared to HC, under all experimental conditions. This greater involvement of the L-MTG in the group of patients could depend on different factors, such as the increasing inferential effort required in correctly understanding the speaker’s communicative intentions, and the higher integrative semantic processes involved in sentence processing. Future studies with a larger sample size and functional connectivity analysis are needed to study deeper the specific role of the L-MTG in pragmatic processes in SZ, also in relation to other brain areas. (shrink)

BackgroundWork stress is a serious problem in primary education. Decades of research underline the importance of participatory, organizational-level work stress prevention approaches. In this approach, measures are planned to tackle causes of work stress in a participatory manner and implemented by a working group consisting of members of the organization. This approach can only be effective if the measures contain effective ingredients to decrease work stress risks and are successfully implemented. The aim of this paper is to present an outline (...) of a work stress prevention approach that is evaluated in primary education. To ensure the appropriateness of measures, a logic model of change is built as part of the risk assessment to facilitate the selection of appropriate measures. Progression on target behaviors as well as implementation factors are real-time monitored during implementation and fed back to the working groups, to provide the opportunity to adjust action plans when needed to optimize implementation.MethodsThe approach consists of five steps: preparation: installing an advisory board and working groups, risk assessment: inventory of work stress risks. In addition, a behavioral analysis is performed to build a logic model of change to facilitate selection of measures, action planning: conducting an action plan with appropriate measures, implementation: implementing the action plan. During implementation progression on target behaviors and implementation factors are monthly monitored and fed back to the working groups, and evaluation: effects of the approach are studied in a controlled trial with measurements at baseline, 1 year, and 2 years follow-up. A process evaluation is carried out using quantitative and qualitative data to study the implementation process of all steps of the work stress approach.DiscussionWe believe that building a logic model of change and real-time monitoring of implementation could be of added value to improve the success of the work stress prevention approach. With this study, we aim to provide more insights into work stress intervention research, especially in primary education.Clinical Trial RegistrationThe study is registered in Netherlands Trial Register. (shrink)

Background Regulations on research ethics in France have evolved considerably over the past four years: the implementation of the Jardé law and of the General Data Protection Regulations have changed the landscape of research ethics for research involving or not involving human persons. In a context of creation of an Institutional Review Board at the University of Bordeaux, France, we sought to explore research ethics practices and perceptions in the medical community of our University Hospital. Methods A short questionnaire was (...) sent to all physicians of the University Hospital of Bordeaux. The questionnaire included closed questions and main topics were: physicians’ education in research ethics, ethics practices concerning researches non implying human persons, and physicians’ perceptions about current regulations. Results 86 questionnaires were sent back. If a majority of physicians have validated Good Clinical Practices trainings, there was a low rate of specific training on fundamental references in research ethics and a high proportion of responders do not consider themselves as educated in research ethics after completion of GCPs. Regulations on research ethics have many implications on medical research, especially by inducing changes in protocols in order to alleviate ethical requirements. Malpractices were acknowledged like false mention of positive opinion from an ethics committee. If If a majority of responders considers regulations as a positive answer to research ethics, a large majority considers it as a constraint and a complexification of research process. For 58%, regulations in research ethics are perceived as a hindrance for research initiatives. Conclusion Because of their impact on research process, regulations seem to constitute a scarecrow for physicians. Lack of training, bad representations and questionable practices highlight the need to improve education and to propose concrete guidance for medical researchers. (shrink)

The optimal design of cables under selfweight and concentrated loads is considered and the maximum feasible span for a given permissible stress is evaluated. All solutions are obtained in a closed analytical form.

Context: The dominant approach to the study of perception is representational/computational, with an emphasis on the achievements of the brain and the nervous system, which are taken to construct internal models of the world. Alternatives include ecological, embedded, embodied, and enactivist approaches, all of which emphasize the centrality of action in understanding perception. Problem: Despite sharing many theoretical commitments that lead to a rejection of the classical approach, the alternatives are characterized by important contrasts and points of divergence. Here we (...) focus on the enactive and ecological approaches, in particular, on how they construe the status of the environment and the content of perception. Method: We begin with a review of James Gibson’s ecological psychology, highlighting it as a psychology for all organisms not just humans. Against this backdrop, we consider enactivist arguments against direct perception - a central assertion of the ecological approach - and in favor of interpreting the activity of perceptual agents as a kind of construction of a perceptually meaningful world. Results: We assess the merits of this interpretation and we conclude that it cannot be grounded on fundamental principles such as thermodynamics and organism-environment mutuality. Implications: As a consequence, enactivism remains close to representationalism and entails a form of dualism. Constructivist content: We advance a criticism of the constructivist foundations of the enactive approach to perception. Perception-action mutuality at the heart of enactivism does not require mental construction; indeed, perception-action mutuality obviates construction. (shrink)

This paper examines the conflict between conventional and non-conventional moral obligations by focusing on the specific case of political lies. It argues that political candidates are under a conventional obligation to try and win their election, and sometimes the most moral way to discharge this obligation involves lying. In such cases, candidates face a conflict between the conventional obligation to try and win and the non-conventional obligation to not lie. Oftentimes, candidates that face this conflict should lie because because voters, (...) contributors, staffers and political allies all legitimately rely on that candidate to try and win. To make this point, the paper defends a framework for understanding conventional obligations that applies far beyond the specific case of political lies. (shrink)

In E.N. I. c. 5 Aristotle is considering divers views as to what constitutes Eudaimonia. He told us in c. 4, 2–3 that there are many conflicting opinions on the subject. The Many identify Happiness with some palpable good, such as pleasure, wealth, honour, but the Wise identify it with something beyond the Many, while [Plato] denied it to be any specific good at all. Of all these views we should consider such as have many adherents or are considered to (...) be reasonable. Accordingly, the Universal Good is considered in c. 6 after consideration in c. 5 of five particular goods—pleasure in the form of bodily pleasure, honour, wealth, virtue [and, implied in the theoretic Life, wisdom]. These five goods are brought into relation with four Lives—viz. pleasure with the apolaustic; honour and virtue with the political; [wisdom] with the theoretic; wealth with the business or money-making Life; and the first three Lives are called προέχοντες. There is nothing in this introduction of the Lives to astonish us; for, as Aristotle himself tells us, τò ληθς ν τοȋς πρακτικοȋς κ τν ργων κα τοû βίου κρίνεται . But there is much difference of opinion as to the argument he draws from the Lives. According to the view now submitted for consideration, the argument is that when a specific good, which some suppose to be Eudaimonia, is also the end of a ‘pre-eminent’ Life, then there is some prima facie probability in the view that that specific good is Eudaimonia. (shrink)

Background If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical - trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the (...) 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. (shrink)

Merleau-Ponty hat in keiner seiner Schriften eine systematische Hermeneutik ausgearbeitet, doch finden sich in fast allen seinen Arbeiten Bemerkungen über hermeneutisch relevante Sachverhalte. Dies gilt vornehmlich für Passagen über die Erfahrung anderer Subjektivität, über die dialogische Erfahrung und über das Produzieren und Verstehen sprachlicher Äusserungen. In diesem Beitrag wird versucht, Merleau-Ponty's Auffassungen hinsichtlich der Fragen nach Sinn, Genesis und Struktur des Verstehens vorzustellen. Hierbei wird in erste Linie das Problem berücksichtigt, was sich eigentlich vollzieht, wenn man als Leser die Bekanntschaft (...) eines klassischen, bzw. ursprünglichen Werkes macht. Das Werk spricht eine neue Sprache (parole parlante, langage conquérante), die die vorgegebene Sprache (parole parlée, langage institué) neugestaltet, so wie auch die in der neuen Sprache sich niederschlagende Erfahnings- und Gedankenwelt unsere alten Gedanken auflöst und uns eine neue Sicht auf die Wirklichkeit vermittelt. Hermeneutisch relevant ist, dass der Sinn dieser parole pensante, bzw. der pensée parlante niemals vollständig gegeben ist, noch auch durch welche Auslegung dann auch je erschöpft werden kann. Das bei der Lektüre eines solchen ursprünglichen Werkes sich bildende primäre Verständnis ist als Grundlage einer sekundären Verstehensleistung anzusehen, die das Thema der Hermeneutik, insofern sie Auslegungskunst ist, darstellt. Die Rekonstruktion des ursprünglichen Sinnes eines solchen Werkes ist in den Augen Merleau-Ponty's nicht nur in ihrer Möglichkeit beschränkt, sie ist vielmehr auch nur von untergeordneter Bedeutung. Was das erste betrifft, so sieht sich jeder solcher Rekonstruktionsversuch, (der bei der Restitution des ursprünglichen Textsinnes auch die Biographie des Autors und den historischen Kontext zu berücksichtigen hat – das Werk muss ja als Antwort auf Fragen verstanden werden, die sich im Lebenszusammenhang einer Zeit gestellt haben –) mit der Tatsache konfrontiert, dass die Gedanken und Erfahrungen, die sich in einem Werk niedergeschlagen haben, häufig so sehr miteinander verwoben sind, zum andern sich im Laufe des Lebens ihres Urhebers sich verändern, dass ihre völlige Inventarisierung zu einer unmöglichen Aufgabe wird. Zudem gehört zum Sinn eines solchen Werkes auch die Wirkung, die es in der Nachwelt hervorgerufen hat. So ist der „Wahre Descartes” keine gleichsam sich selbst erhellende Ganzheit, kein absoluter Entwurf im Sinne Sartres – sondern das Ganze von Leben, Werk und Interpretationen, das niemals definitiv entziffert werden kann. Für Merleau-Ponty ist der Sinn in fortwährendem Werden begriffen. Hierin ist jedoch auch die Bedeutung der wahren Interpretation, bzw. des wahren Denkens gelegen. Wichtiger als die in sich begrenzte Möglichkeit der Rekonstruktion ist dann auch das „penser derechef”. Merleau-Ponty beruft sich ausdrücklich auf einen Gedanken von Heidegger, demzufolge der Sinn des Denkens vor allem darin gelegen ist, das noch Ungesagte und Ungedachte in einem klassischen Werk zu entfalten. In der Tat prägt dies auch die Weise, in der Merleau-Ponty mit dem Werk Husserls oder anderer Denker umgeht. Es ist Merleau-Ponty leider nicht mehr gegeben gewesen, die rudimentären Bemerkungen über die Geschichte der Philosophie, die sich in seinem letzten Werk finden, weiter auszuarbeiten, noch auch alle Konsequenzen seiner Hermeneutik zu durchdenken, in der das Fundament der Wahrheit sowohl in der Zeit lokalisiert bleibt als auch zugleich einer die Zeit überspannenden Teleologie eingefügt ist. (shrink)

Simple Heuristics That Make Us Smart invites readers to embark on a new journey into a land of rationality that differs from the familiar territory of cognitive science and economics. Traditional views of rationality tend to see decision makers as possessing superhuman powers of reason, limitless knowledge, and all of eternity in which to ponder choices. To understand decisions in the real world, we need a different, more psychologically plausible notion of rationality, and this book provides it. It is about (...) fast and frugal heuristics--simple rules for making decisions when time is pressing and deep thought an unaffordable luxury. These heuristics can enable both living organisms and artificial systems to make smart choices, classifications, and predictions by employing bounded rationality. But when and how can such fast and frugal heuristics work? Can judgments based simply on one good reason be as accurate as those based on many reasons? Could less knowledge even lead to systematically better predictions than more knowledge? Simple Heuristics explores these questions, developing computational models of heuristics and testing them through experiments and analyses. It shows how fast and frugal heuristics can produce adaptive decisions in situations as varied as choosing a mate, dividing resources among offspring, predicting high school drop out rates, and playing the stock market. As an interdisciplinary work that is both useful and engaging, this book will appeal to a wide audience. It is ideal for researchers in cognitive psychology, evolutionary psychology, and cognitive science, as well as in economics and artificial intelligence. It will also inspire anyone interested in simply making good decisions. (shrink)

On 5 August 1968, publication of the Harvard Committee’s report on the subject of “irreversible coma” established a standard for diagnosing death on neurological grounds. On the same day, the 22nd World Medical Assembly met in Sydney, Australia, and announced the Declaration of Sydney, a pronouncement on death, which is less often quoted because it was overshadowed by the impact of the Harvard Report. To put those events into present-day perspective, the authors reviewed all papers published on this subject and (...) the World Medical Association web page and documents, and corresponded with Dr A G Romualdez, the son of Dr A Z Romualdez. There was vast neurological expertise among some of the Harvard Committee members, leading to a comprehensible and practical clinical description of the brain death syndrome and the way to diagnose it. This landmark account had a global medical and social impact on the issue of human death, which simultaneously lessened reception of the Declaration of Sydney. Nonetheless, the Declaration of Sydney faced the main conceptual and philosophical issues on human death in a bold and forthright manner. This statement differentiated the meaning of death at the cellular and tissue levels from the death of the person. This was a pioneering view on the discussion of human death, published as early as in 1968, that should be recognised by current and future generations. (shrink)

Background One of the objectives of medicine is to relieve patients' suffering. As a consequence, it is important to understand patients' perspectives of suffering and their ability to cope. However, there is poor insight into what determines their suffering and their ability to bear it. Purpose To explore the constituent elements of suffering of patients who explicitly request euthanasia or physician-assisted suicide (EAS) and to better understand unbearable suffering from the patients' perspective. Patients and methods A qualitative study using in-depth (...) face-to-face interviews was conducted with 31 patients who had requested EAS. The grounded theory approach was used to analyse the data. Results Medical, psycho-emotional, socio-environmental and existential themes contributed to suffering. Especially fatigue, pain, decline, negative feelings, loss of self, fear of future suffering, dependency, loss of autonomy, being worn out, being a burden, loneliness, loss of all that makes life worth living, hopelessness, pointlessness and being tired of living were constituent elements of unbearable suffering. Only patients with a psychiatric (co)diagnosis suffered unbearably all the time. Conclusions Unbearable suffering is the outcome of an intensive process that originates in the symptoms of illness and/or ageing. According to patients, hopelessness is an essential element of unbearable suffering. Medical and social elements may cause suffering, but especially when accompanied by psycho-emotional and existential problems suffering will become ‘unbearable’. Personality characteristics and biographical aspects greatly influence the burden of suffering. Unbearable suffering can only be understood in the continuum of the patients' perspectives of the past, the present and expectations of the future. (shrink)

Fractal time fluctuations of the spectral “1/f” form are universal in natural self-organizing systems. Neurobiology is uniquely infused with fractal fluctuations in the form of statistically self-similar clusters or bursts on all levels of description from molecular events such as protein chain fluctuations, ion channel currents and synaptic processes to the behaviors of neural ensembles or the collective behavior of Internet users. It is the thesis of this essay that the brain self-organizes via a vertical collation of these spontaneous events (...) in order to perceive the world and generate adaptive behaviors. REM sleep, which coalesces from self-similar clusters of burst-within-burst behavior during ontogeny, is essential to cognitive-emotional function, and has recurrent fractal organization. Empirical fMRI observations further support the association of fractal fluctuations in the temporal lobes, brainstem and cerebellum during the expression of emotional memory, spontaneous fluctuations of thought and meditative practice. Cognitive-emotional integration arises as amygdaloid-brainstem-cerebellar systems harmonize the vertical “1/f” symphony of coupled isochronous cortical oscillations in the pursuit of mindfulness. (shrink)

It has been known for many years that inscriptions in the Arcadian dialect contain a considerable number of words which occur commonly in the Homeric poems and rarely, if at all, elsewhere. The first attempt at a complete list was made by Otto Hoffmann in Die grieckischen Dialekte, I. pp. 276–278. He gives as Homeric ασα, βóλομαι νυ πυέσΘω, ρτύω σκηΘές, δεάτοι, δμα, 'Eκατόνβοια and 'Eκατόμβοια, hίκοντα, κελεύθω, μέστ', πληθύς, and πλός. Buck, in Greek Dialects, p. 132, added εùΧωλά and (...) ἆμαρ and we might with as much justification add ρπειν λεύσοντες and λεύσοντες. In each case a Homeric word, unusual in later Greek except in verse, is used in ordinary Arcadian epigraphic prose. (shrink)

BackgroundResuscitation and treatment of critically ill newborn infants is associated with relatively high mortality, morbidity and cost. Guidelines relating to resuscitation have traditionally focused on the best interests of infants. There are, however, limited resources available in the neonatal intensive care unit, meaning that difficult decisions sometimes need to be made. This study explores the intuitions of lay people regarding resource allocation decisions in the NICU.MethodsThe study design was a cross-sectional quantitative survey, consisting of 20 hypothetical rationing scenarios. There were (...) 119 respondents who entered the questionnaire, and 109 who completed it. The respondents were adult US and Indian participants of the online crowdsourcing platform Mechanical Turk. Respondents were asked to decide which of two infants to treat in a situation of scarce resources. Demographic characteristics, personality traits and political views were recorded. Respondents were also asked to respond to a widely cited thought experiment involving rationing.ResultsThe majority of respondents, in all except one scenario, chose the utilitarian option of directing treatment to the infant with the higher chance of survival, higher life expectancy, less severe disability, and less expensive treatment. As discrepancy between outcomes decreased, however, there was a statistically significant increase in egalitarian responses and decrease in utilitarian responses in scenarios involving chance of survival, life expectancy, and cost of treatment. In the classic ‘lifeboat’ scenario, all but two respondents were utilitarian.ConclusionsThis survey suggests that in situations of scarcity and equal clinical need, non-health professionals support rationing of life-saving treatment based on probability of survival, duration of survival, cost of treatment or quality of life. However, where the difference in prognosis or cost is very small, non-health professionals preferred to give infants an equal chance of receiving treatment. (shrink)

The ‘right to the truth’ involves disclosing all the pertinent facts to a patient so that an informed decision can be made. However, this concept of a ‘right to the truth’ entails certain ambiguities, especially since it is difficult to apply the concept in medical practice based mainly on current evidence-based data that are probabilistic in nature. Furthermore, in some situations, the doctor is confronted with a moral dilemma, caught between the necessity to inform the patient (principle of autonomy) and (...) the desire to ensure the patient's well-being by minimising suffering (principle of beneficence). To comply with the principle of beneficence as well as the principle of non-maleficence ‘to do no harm’, the doctor may then feel obliged to turn to ‘therapeutic privilege’, using lies or deception to preserve the patient's hope, and psychological and moral integrity, as well as his self-image and dignity. There is no easy answer to such a moral dilemma. This article will propose a process that can fit into reflective practice, allowing the doctor to decide if the use of therapeutic privilege is justified when he is faced with these kinds of conflicting circumstances. We will present the conflict arising in practice in the context of the various theoretical orientations in ethics, and then we will suggest an approach for a ‘practice of truth’. Last, we will situate this reflective method in the broader clinical context of medical practice viewed as a dialogic process. (shrink)

This paper starts with an overview of C.G. Jung’s notion of archetypes. His ideas imply that Jungian archetypes can be viewed as the most general examples of the shared awarenesses that occur in groups of people of all sizes, ranging from families to humanity as a whole. The term ‘archetype’ is used in connection with such shared awarenesses in the subsequent discussion. The distinction that Jung made between archetypal representations and archetypes themselves is retained and emphasized. It is then pointed (...) out that archetypal representations are sets of Dawkins’ memes appearing in awareness. Pursuing the line of thought suggested by this, it is further proposed that the meme set can be regarded as analogous to the genotype in biology, while the representation itself resembles the phenotype in heuristically useful respects. Archetypes, as opposed to their representations, are the factors which predispose particular sets of memes to spread within a group of people and enter their awarenesses. It follows from the biological analogy that archetypes can be thought of as regularities that occur in an ‘ecology’ of representations. Because memes are subject to pseudo-Darwinian influences, parallels between the behaviour of representations and the phenomena of parasitology and epidemiology will sometimes be observed. The view of archetypes arrived at opens up a possibility that they might be responsible for some mass behaviours; e.g. those involved in the production of social movements such as Nazism or certain medical conditions of obscure aetiology. Archetypal representations possess in some circumstances the power to fill the consciousnesses of individuals ‘infected’ by them for long periods of time. These points are illustrated in a brief account of fatigue syndromes. Finally, should consciousness have a quantum theoretical basis, details of the epidemiology of archetypal representations will differ from those to be expected if it has no such basis. The phenomenon of alien abduction, presumed to be of archetypal origin, is discussed as an example. (shrink)

A system of nonlinear integro-differential equations is derived for the motion of the classical electron with a rigid and spherically symmetric 3D gaussian distribution of charge. The equations are analyzed for stability around the state of rest and of uniform rectilinear motion with velocity small with respect to the velocity of light. The extremely high-frequency and radiationless micro-oscillations that the electron executes when disturbed from the equilibrium states show the inconsistency of the Abraham-Lorentz equation and of all concepts associated with (...) this equation, like the notion that the electron may have a mass of electromagnetic origin. (shrink)

Singles are an understudied yet growing segment of the adult population. The current study aims to expand the lens of relationship science by examining the well-being of unpartnered, single adults using latent profile analysis. We recruited singles closely matched to the United States census for an exploratory cross-sectional survey using five variables that strongly predict well-being. All five variables significantly predicted life satisfaction for the full sample. Latent profile analyses detected 10 groups of singles. Half of the profiles were happy (...) and half of the profiles were unhappy. Each profile had its own unique patterns relating to personal relationships, self-esteem, and personality traits. The happiest profile had the best relationships, self-esteem, and personality, while the unhappiest profile had the worst relationships, self-esteem, and personality. The profiles in between these two extremes had more nuanced patterns. For example, one relatively happy profile in the middle had high friendship satisfaction but low family satisfaction, while an adjacent profile showed the opposite pattern. Overall, singles who had positive relationships—both with themselves and others—were happiest. (shrink)