"The fixed person for fixed duties, who in older societies was such a godsend, in the future ill be a public danger." Twenty years ago, a single legal metaphor accurately captured the role that American society accorded to physicians. The physician was "c- tain of the ship." Physicians were in charge of the clinic, the Operating room, and the health care team, responsible - and held accountabl- for all that happened within the scope of their supervision. This grant of responsibility (...) carried with it a corresponding grant of authority; like the ship's captain, the physician was answerable to no one regarding the practice of his art. However compelling the metaphor, few would disagree that the mandate accorded to the medical profession by society is changing. As a result of pressures from a number of diverse directions - including technological advances, the development of new health professionals, changes in health care financing and delivery, the recent emphasis on consumer choice and patients' rights - what our society expects phy- cians to do and to be is different now. The purpose of this volume is to examine and evaluate the conceptual foundations and the moral imp- cations of that difference. Each of the twelve essays of this volume assesses the current and future validity of the "captain of the ship" metaphor from a different perspective. The essays are grouped into four sections. In Section I, Russell Maulitz explores the physician's role historically. (shrink)

SummaryIntense, sustained nursing lengthens inter-birth intervals and is causally linked with low natural fertility. However, in traditional settings, the effects of such nursing on fertility are difficult to disentangle from those of nutrition. Results from an prospective, direct observational study of reproductive function in well-nourished Amele women who nurse intensively and persistently but who also have high fertility are here presented. Endocrine measures show that ovarian activity resumes by median 11·0 months postpartum. Median duration of postpartum amenorrhoea is 11·3 months, (...) time to next conception is 19·0 months, and the inter-birth interval is 28·0 months. Average life time fertility is 6·8. High fertility in Amele women is due both to refractoriness of reproductive function to suckling stimuli, and to maintenance of equivalent age-specific fertility rates across the reproductive life span. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Introducing the sixth and final installment of the Common Knowledge symposium “Apology for Quietism,” Allen looks at the symposium retrospectively and concludes that it has mainly concerned “sage knowledge,” defined as foresight into the development of situations. The sagacious knower sees the disposition of things in an early, incipient form and knows how to intervene with nearly effortless and undetectable (quiet) effectiveness. Whatever the circumstance, the sage handles it with finesse, never doing too much but also never leaving anything undone (...) that must be accomplished. Quiet, when it is knowingly and effectively quiet (not pusillanimous or poor in spirit), is about what not to do, how not to approach a problem, what not to decide, what is not known, what will not work. Allen explains these principles in terms of traditional Chinese thought, Daoist and Confucian: wei we wei, or “doing-not-doing,” means effective inaction. What makes such wisdom possible is not mystical insight, he argues, but discipline in a certain kind of art. The sage has no need of reasons (let alone doctrines), only effectiveness; and he does not need truth or justice, only subtlety. The detachment of a quietist has little, if anything, to do with transcending perspectives. Detachment is good as a means to flexibility, and instead of transcending perspectives, a sage is skilled in the quiet art of never getting stuck in one. To be effectively quiet is not so much to be silent as to be inaudible, invisible; the sage “vanishes into things.”. (shrink)

Debate continues to rage among philosophers of religion over Anthony Flew's famous little paper ‘Theology and Falsification’ and the responses it provoked, most notably R. M. Hare's response that religious claims are in no way like scientific hypotheses. For now, twenty years later, we still find many theists taking a similar tack to Hare's. A particularly interesting example is J. F. Miller in Religious Studies, 1969, who replies to Flew that propositions like ‘God loves mankind’ cannot be subject to falsifiability (...) conditions because they are used as claims expressing ‘religious first-order principles of the Judaeo-Christian Weltanschauung and as such are not amenable to falsification’ (p. 50). Miller seems to put his faith in some kind of great gulf fixed between what he would consider decently falsifiable scientific hypotheses and what he takes to be unfalsifiable first-order principles both of theology and of contemporary science. In what follows we will try to sketch a more rational strategy for modern believers of a liberal empiricist type, for those whose interest in appealing and deferring to experience includes but is not restricted to so-called ‘sense experience’. This will involve accepting analogies between theological statements and so-called hypotheses, insofar as the latter are propositions held and put forward in a somewhat tentative spirit with a view to explaining what we experience. (shrink)

Background Payment of research participants helps to increase recruitment for research studies, but can pose ethical dilemmas. Research ethics committees (RECs) have a centrally important role in guiding this practice, but standardisation of the ethical approval process in Ireland is lacking. Aim Our aim was to examine REC policies, experiences and concerns with respect to the payment of participants in research projects in Ireland. Method Postal survey of all RECs in Ireland. Results Response rate was 62.5% (n=50). 80% of RECs (...) reported not to have any established policy on the payment of research subjects while 20% had refused ethics approval to studies because the investigators proposed to pay research participants. The most commonly cited concerns were the potential for inducement and undermining of voluntary consent. Conclusions There is considerable variability among RECs on the payment of research participants and a lack of clear consensus guidelines on the subject. The development of standardised guidelines on the payment of research subjects may enhance recruitment of research participants. (shrink)

Debate continues to rage among philosophers of religion over Anthony Flew's famous little paper ‘Theology and Falsification’ and the responses it provoked, most notably R. M. Hare's response that religious claims are in no way like scientific hypotheses. For now, twenty years later, we still find many theists taking a similar tack to Hare's. A particularly interesting example is J. F. Miller in Religious Studies , 1969, who replies to Flew that propositions like ‘God loves mankind’ cannot be subject to (...) falsifiability conditions because they are used as claims expressing ‘ religious first-order principles of the Judaeo-Christian Weltanschauung and as such are not amenable to falsification’ . Miller seems to put his faith in some kind of great gulf fixed between what he would consider decently falsifiable scientific hypotheses and what he takes to be unfalsifiable first-order principles both of theology and of contemporary science. In what follows we will try to sketch a more rational strategy for modern believers of a liberal empiricist type, for those whose interest in appealing and deferring to experience includes but is not restricted to so-called ‘sense experience’. This will involve accepting analogies between theological statements and so-called hypotheses, insofar as the latter are propositions held and put forward in a somewhat tentative spirit with a view to explaining what we experience. (shrink)

Conceptualization and measurement of organizational commitment involve different dimensions that include economic, affective, as well as moral aspects labelled in the literature as: ‘continuance’, ‘affective’ and ‘normative’ commitment. This multidimensional framework emerges from the convergence of different research lines. Using Aristotle’s philosophical framework, that explicitly considers the role of the will in human commitment, it is proposed a rational explanation of the existence of mentioned dimensions in organizational commitment. Such a theoretical proposal may offer a more accurate definition of ‘affective (...) commitment’ that distinguishes feelings from rational judgments. The use of a philosophical explanation coherent with psychological findings also allows the discovery of a wider moral concept of ‘normative commitment’. (shrink)

Bear Suppression Inventory (WBSI), was I'ound to correlate with n>casurcs of obsessional thinking and depressive and anxious al'lect, t pridic( signs «I' clinical «hscssion ainong individuals prone (oward «h»c»»i«n >I (hi>>king, (« predict depression tive (h (», and to predict I''iilurc «I' electr«dermal responses to habituate am«ng pci>pic having emotional thoughts. The WBSI was inversely correlated with repression as assessed by the Repression-Sensitization Scale, and so tap» a trait that i» itc unlike rcprc»si«n:is traditi«n;illy c«nccivcd.

Summary Tycho Brahe's lunar theory, mostly the work of his assistant Christian Longomontanus, published in the Progymnasmata (1602), was the most advanced and accurate lunar theory yet developed. Its principal innovations are: the introduction of equant motion for the first inequality in order to separate the determination of direction and distance; a more accurate limit for the second inequality although requiring a more complex calculation; additional inequalities of the variation and, in place of the annual inequality in Tycho's earlier theory, (...) a reduction in the equation of time; in the latitude theory a variation of the inclination of the orbital plane and an inequality of the motion of the nodes; a reduction in the range of variation of distance, parallax, and apparent diameter. Some of these were already present in Tycho's earlier lunar theory (1599), but all were changed in notable ways. Twenty years later Longomontanus published a modified version of the lunar theory in Astronomia Danica (1622), for the purpose of facilitating the calculation through new correction tables, and also explained his reasons for parts of the theory in the Progymnasmata. This paper is a technical study of both lunar theories. (shrink)

Context: Immunity includes cognitive concepts: the organism is thought to specifically recognize foreign materials and develop a memory of these encounters. Vaccines are thought to work by enhancing this immunological memory. Lymphocytes are key cells and specific antibodies are key molecules in immune recognition. Antibodies are blood proteins called “immunoglobulins.” Spontaneously formed immunoglobulins are seen as “natural” antibodies to dietary components and commensal bacteria. Immune cognition is used simply as a didactic metaphor. Problem: Do the cognitive aspects of immunology stem (...) from the activities of cells and molecules, or are they ascribed by the immunologist operating as a human observer? (1) An immense variety of immunoglobulins may bind to the same antigen with different binding energies. It is the immunologist who arbitrates the boundary between those that are specific (and declared antibodies) and those that are not. Specific antibodies serve as functional labels pasted onto natural immunoglobulins, as if they were recognizing elements. Is this “arbitration” the true cognitive event ascribed to immunoglobulins and lymphocytes? (2) A major impasse exists between progress in experimental immunology and its translation into clinical results. A proper understanding of immunological activity demands a wider view of an organism’s biology and, also, of the interference of human observers in delineating experimental realities, such as the specificity of immune recognition. Maturana’s biology of cognition and language provides one such approach. Method: Use of Maturana’s biology of cognition and language concepts to describe immunological activity. Results: A whole new understanding of immunological activity is suggested. Implications: A major change in the way of seeing is proposed that may eventually help the translation of this knowledge into clinical results. Furthermore, the immune system may also become a proper model for cognitive analyses. (shrink)

Some people have supposed that utility is good in itself, non-in-strumentally good, as distinct from good because conducive to other good things. And in modern versions of this view, utility often means want-satisfaction, as distinct from pleasure or happiness. For your want that p to be satisfied, is it necessary that you know or believe that p, or sufficient merely that p is true? However that question is answered, there are problems with the view that want-satisfaction is a non-instrumental good. (...) What if you want something only because you have a false belief? What if the time at which you want that p is fifty or five hundred years before the time to which p itself refers? To meet these difficulties, qualifications have to be introduced, and much has been written about how exactly these qualifications are to be framed.1 There is however what may be a rather more serious objection to the view that want-satisfaction is a non-instrumental good, or rather to the combination of that view with the principle that it is sufficient for your want that p to be satisfied simply that p is true. The objection is that this combination forces you to give undue weight to the mere acquisition of desires when you come to make judgements about changes in the value of things. It forces you to say that for any true proposition p, which initially you do not want to be true, your mere acquisition of a desire that p will, other things being equal, make the world better. Non-instrumental value can be increased merely by multiplying desires, even though everything else remains the same. Surely, however, improving the world is not as easy as that. (shrink)

When do two mental items belong to the same life? We could be content with the answer -just when they have certain volitional qualities in common. An affinity is noted between that theory and Berkeley's early doctrine of the self. Some rivals of the volitional theory invoke a spiritual or physical owner of mental items. They run a risk either of empty formality or of causal superstition. Other rivals postulate a non-transitive and symmetrical relation in the set of mental items. (...) They must allow in consequence either for joint ownership of one and the same mental item, or for incompatible simultaneous decisions by one and the same person, or for new forms of death. This makes them disquieting. Another rival invokes a transitive and symmetrical relation defined in terms of co-consciousness. Even that allows for incongruous simultaneities. The volitional theory is free from such disadvantages. (shrink)

В книге рассматривается феномен параллельного развития, взаимодействия, взаимовлияния и сближения языка русской философии и поэзии 10-21 вв. Книга предназначена для филологов и философов и преподавателей русского языка.

vyp. 1. [Without special title] -- vyp. 2. Ėpokhi svobodnoĭ konkurent︠s︡ii i burzhuaznykh revoli︠u︡t︠s︡iĭ -- vyp. 3 Ėpokha monopolisticheskogo kapitala, imperializma, sot︠s︡ialisticheskikh revoli︠u︡t︠s︡iĭ, protivostoi︠a︡nii︠a︡ dvukh sistem, osvobozhdeniia︡︠ koloniĭ, krizisa "realʹnogo sot︠s︡ializma" i formirovanii︠a︡ za Zapade "sot︠s︡ialʹnogo gosudarstva".

The purpose of this essay is to show that there was one person, perhaps only one, who developed a rigorously scientific cosmology nearly two thousand years ago. Cosmology is the largest of all subjects, with a long history, and the cosmology considered here is the one that endured for the longest part, nearly three-quarters, of that history. By cosmology I mean a description of the universe as a whole and of the arrangement of its principal parts. But by scientific cosmology, (...) I mean something more. For a cosmology to be considered scientific, three criteria must be met: it must be quantitative, physical, and empirical. Quantitative means that it must assign some scale of distances and sizes to its parts. Physical means that it must rest upon some kind of physical or mechanical principles, causes, for the ordering and motion of its parts. Finally, empirical means that it must either be derived from observation or, if derived theoretically, as from physical or mechanical principles, it must be confirmed by observation. I set out these criteria, which may not be exclusive or exhaustive but are surely within reason, in order to define our subject and exclude mythological or theological cosmologies, which generally meet none of the criteria, and philosophical cosmologies, as those of Plato, Aristotle, and Descartes, which may meet one or two in some way, although not rigorously, but surely do not meet all three. I am not concerned with whether the cosmology or the criteria upon which it is based are correct. Compared to our present understanding, the scale may be off by orders of magnitude, the physics may be entirely mistaken, and the observations may be inaccurate. But if all three are present I would call the cosmology scientific, and if not I would not call the cosmology scientific. (shrink)