Over the past two decades ethics committees have proliferated in healthcare institutions across the country. Catalysts for this growth include the endorsement of ethics committees by the New Jersey Supreme Court in the Quinlan case, by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical Research in its report entitled Deciding to Forgo Life Sustaining Medical Treatment, by the U.S. Department of Health and Human Services in its 1985 “Baby Doe” regulations, by numerous other courts in (...) treatment decisionmaking opinions issued after Quinlan, and more recently by the Joint Commission on Accreditation of Healthcare Organizations. (shrink)

Recently, the U.S. House of Representatives voted, for the second time in two years, to ban all human-cloning research, whether the research involves reproduction or creating cells that might be used to understand and treat disease. As I explain in this article, the proposed legislation has important implications not only for human cloning research but also for research in general.

For over a decade, managed care has profoundly altered how healthcare is delivered in the United States. There have been concerns that the patient-physician relationship may be undermined by various aspects of managed care, such as restrictions on physician choice, productivity requirements that limit the time physicians may spend with patients, and the use of compensation formulas that reward physicians for healthcare dollars not spent. We have previously published data on the effects of managed care on the physician-patient relationship from (...) the physician's perspective. In 1999, we collected data on the impact of managed care arrangements on the physician-patient relationship from the patient's perspective. This article discusses our collective findings. (shrink)

Over the past several years, healthcare has been profoundly altered by the growth of managed care. Because managed care integrates the financing and delivery of healthcare services, it dramatically alters the roles and relationships among providers, payers, and patients. While analysis of this change has focused on whether and how managed care can control costs, an increasingly important concern among healthcare providers and recipients is the impact of managed care on the physicianpatient relationship, but little data have been collected and (...) analyzed. We designed a survey for distribution to Wisconsin physicians to analyze the prevalence and types of managed care arrangements in the state, and the impact of these arrangements on physicians and their relationships with patients. (shrink)

I review the recent case of Edna Folz, a 73 year-old woman who was suffering through the end stages of very advanced Alzheimer's dementia when her case was adjudicated by the Wisconsin Supreme Court. I consider this case as an example of how courts are increasingly misinterpreting the ethical and legal decision-making standards known as substituted judgment and best interests and thereby threatening individuals' treatment decision-making rights as developed by other courts over the past two decades and creating serious roadblocks (...) to health-care providers' ability to render appropriate patient care. The Wisconsin Supreme Court held that Edna's legal guardian could not authorize withdrawal of Edna's treatment, ruling that as a matter of law, if an incompetent person is not in a persistent vegetative state, it is not in his or her best interests for life-sustaining treatment to be withdrawn unless (s)he has executed an advance directive or other statement clearly indicating his or her desires. (shrink)

Recent studies have exposed the startling inadequacy of health care providers knowledge about and practice of effective pain management. For example, in one study, it was reported that 79 percent of a random sample of 454 medical-surgical inpatients experienced pain during hospitalization, and that 58 percent of patients with pain considered the pain horrible or excruciating. In another study, 67 percent of 2,415 randomly selected hospitalized patients had pain during the twenty-four hours prior to being interviewed, and 50 percent reported (...) pain at the time of the interview. In a study of seriously ill hospitalized patients reported in 1996, half of the patients complained of pain, and one-sixth reported that they experienced extremely severe pain at least half the time. According to one literature review, 75 percent of cancer patients have reported suffering pain, and one study estimates that 25 percent of cancer patients die with severe unrelieved pain. Chronic nonmalignant pain has been described as an extremely prevalent problem, and over two-thirds of nursing home residents experience serious pain. (shrink)

Recent studies have exposed the startling inadequacy of health care providers knowledge about and practice of effective pain management. For example, in one study, it was reported that 79 percent of a random sample of 454 medical-surgical inpatients experienced pain during hospitalization, and that 58 percent of patients with pain considered the pain horrible or excruciating. In another study, 67 percent of 2,415 randomly selected hospitalized patients had pain during the twenty-four hours prior to being interviewed, and 50 percent reported (...) pain at the time of the interview. In a study of seriously ill hospitalized patients reported in 1996, half of the patients complained of pain, and one-sixth reported that they experienced extremely severe pain at least half the time. According to one literature review, 75 percent of cancer patients have reported suffering pain, and one study estimates that 25 percent of cancer patients die with severe unrelieved pain. Chronic nonmalignant pain has been described as an extremely prevalent problem, and over two-thirds of nursing home residents experience serious pain. (shrink)

What should be the role of an institutional ethics committee in resolving conflict concerning patient care decisions in the neonatal intensive care unit? This question takes on added importance in light of recent court decisions which suggest that IEC deliberations may serve as persuasive evidence in court, of proposed state regulations that would establish an IEC as an alternative to judicial review, and of recent Joint Commission on Accreditation of Healthcare Organizations guidelines that require an institutional policy on limitation or (...) withdrawal of treatment to include a specified mechanism for resolving conflict. Unfortunately, despite these developments, prospective case consultation remains one of the most controversial and poorly understood aspects of IEC functions. Questions and concerns persist about the relation the IEC has and should have to actual decisions in specific cases.We briefly examine the clinical, organizational, and regulatory complexity of the NICU environment and suggest five potential sources of uncertainty, disagreement, and conflict among parent and NICU staff. (shrink)

What should be the role of an institutional ethics committee in resolving conflict concerning patient care decisions in the neonatal intensive care unit? This question takes on added importance in light of recent court decisions which suggest that IEC deliberations may serve as persuasive evidence in court, of proposed state regulations that would establish an IEC as an alternative to judicial review, and of recent Joint Commission on Accreditation of Healthcare Organizations guidelines that require an institutional policy on limitation or (...) withdrawal of treatment to include a specified mechanism for resolving conflict. Unfortunately, despite these developments, prospective case consultation remains one of the most controversial and poorly understood aspects of IEC functions. Questions and concerns persist about the relation the IEC has and should have to actual decisions in specific cases.We briefly examine the clinical, organizational, and regulatory complexity of the NICU environment and suggest five potential sources of uncertainty, disagreement, and conflict among parent and NICU staff. (shrink)

An integrated statement is made concerning the semantic status of nodes in a propositional semantic network, claiming that such nodes represent only intensions. Within the network, the only reference to extensionality is via a mechanism to assert that two intensions have the same extension in same world. This framework is employed in three application problems to illustrate the nature of its solutions.The formalism used here utilizes only assertional information and no structural, or definitional, information. This restriction corresponds to many of (...) the psychologically motivated network models. Some of the psychological implications of network processes called node merging and node splitting are discussed. Additionally, it is pointed out that both our networks and the psychologically based networks are prone to memory confusions about knowing unless augmented by domain‐specific inference processes, or by structural information. (shrink)

Harmful algal blooms in Lake Erie’s western basin are caused in large part by nutrient loss from agricultural production. While use of nutrient management practices is encouraged to reduce agricultural nutrient loss and its consequent environmental impacts, such practices are not universally adopted. This study aims to better understand the factors that influence western Lake Erie basin farmers’ risk perceptions associated with agricultural nutrient loss, and thus further our knowledge of how adoption of nutrient management practices may be increased. We (...) propose a conceptual model to explain the relationships that we hypothesize to influence farmers’ risk perceptions associated with agricultural nutrient loss. Specifically, we consider the roles that farmer conservation identity, farmers’ perceived sufficiency of their nutrient management practices, and land vulnerability to nutrient loss play in influencing risk perceptions. We find that many of the hypothesized relationships are not statistically significant, and that risk perception associated with nutrient loss is primarily driven by farmers’ conservation identities. While farmers’ perceived sufficiency of their nutrient management practices plays some role in governing risk perceptions, we do not observe the hypothesized relationship between land vulnerability to nutrient loss and perceived sufficiency of nutrient management practices. (shrink)

We describe a knowledge representation and inference formalism, based on an intensional propositional semantic network, in which variables are structures terms consisting of quantifier, type, and other information. This has three important consequences for natural language processing. First, this leads to an extended, more natural formalism whose use and representations are consistent with the use of variables in natural language in two ways: the structure of representations mirrors the structure of the language and allows re-use phenomena such as pronouns and (...) ellipsis. Second, the formalism allows the specification of description subsumption as a partial ordering on related concepts (variable nodes in a semantic network) that relates more general concepts to more specific instances of that concept, as is done in language. Finally, this structured variable representation simplifies the resolution of some representational difficulties with certain classes of natural language sentences, namely, donkey sentences and sentences involving branching quantifiers. The implementation of this formalism is called ANALOG (A NAtural LOGIC) and its utility for natural language processing tasks is illustrated. (shrink)

Experts identified water quality, manure, good handling practices (including personal hygiene and equipment sanitation), and traceability as critical farm problem areas that, if addressed, are likely to decrease risk associated with microbial contamination of fresh produce from all scales of agriculture. However, the diverse nature of production strategies used by produce farmers presents multiple options for addressing foodborne illness issues while simultaneously creating potential complications. We use a mental models methodology to enhance our understanding of the underlying factors and assumptions (...) of small, medium, and large produce growers that influence their decision-making processes for contamination prevention and control. This empirical evidence demonstrates how challenges and opportunities to food safety are related to the scale of production and marketing strategies. We believe that refining the development of standards and existing extension and outreach food safety programs are important to both consumer protection and supporting agricultural communities. Additionally, this approach will help develop and refine food safety programs that will result in empirically grounded recommendations based on identified grower information needs. (shrink)

The Patient Self-Determination Act imposes new requirements on health care providers for informing patients of their rights to make decisions concerning their medical care. The Act is intended to, and is likely to, encourage patients and residents of certain healhtcare facilities to consider their treatment preferences in advance of incapacity and, in particular, to determine the circumstances in which life-sustaining treatment will be provided to them. However, many questions concerning how healthcare providers will implement the Act remain unanswered.

This book explores the central questions and themes lying at the heart of a vibrant area of philosophical inquiry. Aligning core issues in psychiatry with traditional philosophical areas, it presents a focused overview of the historical and contemporary problems dominating the philosophy of psychiatry. -/- Beginning with an introduction to research issues, it addresses what psychiatry is and distinguishes it from other areas of medical practice, other health care professions and psychology. With each section of the companion corresponding to a (...) philosophical subject, contributors systematically relate themes in philosophy of psychiatry to topics in philosophy of mind, phenomenology, philosophy of science, ethics, social and political philosophy, metaphysics, epistemology, and philosophy of medicine. Looking ahead to new research directions, chapters address recent issues including the metaphysics of mental disorders, gender and race in psychiatry and psychiatric ethics. -/- Featuring discussion questions, suggestions for further reading and an annotated bibliography, The Bloomsbury Companion to Philosophy of Psychiatry is an accessible survey of the debates and developments in the field suitable for undergraduates in philosophy and professional philosophers new to philosophy of psychiatry. (shrink)

In our article, we share the lessons we have learned after creating and running a successful legal laboratory over the past seven years at Yale Law School. Our legal laboratory, which focuses on the intersection of law and severe brain injury, represents a unique pedagogical model for legal academia, and is closely influenced by the biomedical laboratory.

The number of women living with HIV/AIDS is increasing worldwide, and there is an urgent public health need to develop new user-initiated HIV prevention methods, including microbicides. Although funding for microbicide development has increased since 2000, financial support is provided predominantly by governmental agencies and private foundations. Many donors, including the US Agency for International Development (USAID) and the US National Institutes of Health (NIH), have policies that restrict how research funds may be used. Among these are the now-rescinded Mexico (...) City Policy, elements of the US Foreign Assistance Act, and restrictions on non-study-related care. The effect of these restrictions on the design and conduct of clinical research is poorly understood. As part of a recent mapping exercise conducted by the Global Campaign for Microbicides, we reviewed the impact of donor restrictions on seven HIV prevention trials. We found considerable confusion within the HIV prevention field as to whether and how Mexico City and other policies affect the use of research funds. We also found that these donor-imposed policies limited the level of care provided to trial participants and the types of capacity building projects undertaken. (shrink)

It should come as no surprise that we will get three different answers to the same question since we have three lawyers on the panel. The law is a matter of policy, and there is usually no single “right” answer to these questions. Each lawyer will come to a question from a very different perspective and bring a different approach to the answer.

As the hospice movement continues to grow, caregivers are increasingly required to interact with dying patients for longer periods and in more intimate and more meaningful ways. Practical models of competent and compassionate communication and understanding need to be developed to accommodate the changing environment of the patient and caregiver and their relationship. We therefore: examine current death education trends in hospice care and education; and describe the need for a more expansive and transpersonal view, and ways of fulfilling that (...) need. The aware patient and the aware caregiver can learn much during the dying trajectory. We hope that someday the potential for expansiveness during the dying trajectory will be more commonly recognized and accommodated as a doorway to the transpersonal. (shrink)

Over the last 20+ years, multinational corporations have been confronted with accusations of abuse of market power and unfair and unethical business conduct especially as it relates to their overseas operations and supply chain management. These accusations include, among others, worker exploitation in terms of unfairly low wages, excessive work hours, and unsafe work environment; pollution and contamination of air, ground water and land resources; and, undermining the ability of natural government to protect the well-being of their citizens. MNCs have (...) responded to these accusations by creating voluntary codes of conduct which commit them to specific standards for addressing these issues. These codes are created at both the industry-wide and the individual company level. Unfortunately, these codes have generated little credibility and public trust because their compliance claims cannot be independently verified, and they lack transparency and full public disclosure. In this article, we present a case study of the voluntary code of conduct by Mattel, Inc., the world’s largest toy company. The code, called the Global Manufacturing Principles, confronts the general criticism leveled against voluntary codes of conduct by creating detailed standards of compliance, independent external monitoring of the company’s compliance with its code of conduct, and making full, and uncensored public disclosure of the audit findings and company’s response in terms of remedial action. We present a detailed account of how Mattel’s voluntary code of conduct was created, implemented, and ultimately abandoned over 9 years. We provide an evaluative analysis of the company’s GMP compliance throughout its life span, which suggests a bell-shaped curve, where early top management commitments were met with pockets of resistance from operational groups, who were concerned about balancing GMP compliance efforts with traditional performance criteria. The early stage response from Mattel’s top management was quick and supported with the requisite resources. As a result, the compliance process accelerated, becoming increasingly more robust and effective. The success of code compliance and increased transparency in public disclosure energized field managers with a sense of professional satisfaction and publicly recognized accomplishments. The decline in GMP compliance was equally steep. When all the easily attainable targets had been reached at the company-operated plants, addressing vendor plants’ compliance presented a new set of challenges, which taxed corporate resources and management commitment. It would seem that value-based and ethics-oriented considerations, i.e., doing the right thing for the right reason, were no longer the driving force for Mattel’s management. Mattel did not see any economic benefit from its proactive stance, when competitors did not seem to suffer adverse consequences for not following suit. The final contributing factor to the code’s abandonment was a widely publicized series of product recalls which absorbed top management’s attention. (shrink)

Michael Lynch’s Truth as One and Many is a contribution to the large body of philosophical literature on the nature of truth. Within that genre, advocates of truth-as-correspondence, advocates of truth-as-coherence, and the like, all hold that truth has a single underlying metaphysical nature, but they sharply disagree as to what this nature is. Lynch argues that many of these views make good sense of truth attributions for a limited stretch of discourse, but he adds that each of the contenders (...) also faces a ‘scope problem’, in that none of them makes sense of all legitimate truth attributions. Some deflationists make similar observations – usually less concessive – and conclude that truth simply has no substantial, underlying nature. There is nothing for the philosopher to articulate and defend. Lynch agrees with deflationists that the realm of discourse is too diverse for any single ‘first-level’ property, such as correspondence or coherence, to fully characterize it, but against deflationism, he holds that truth does have a nature. He presents a functionalist theory. The definition is this: x is true if, and only if, x has a property that plays the truth-role. According to Lynch, the truth-role is given in terms of what he calls the ‘core truisms’ of the folk concept of truth. These are platitudes that hold of the everyday notion, and are such that anyone who denies all of them can be accused of changing the subject – of not talking about truth. A given property T plays the truth-role for a batch of propositions, just in case, for any proposition P in the batch: P is T if, and only if, where P is believed, things are as they are believed to be; other things being equal, it is a worthy goal …. (shrink)

The purpose of this article is show that second-order logic, as understood through standard semantics, is intimately bound up with set theory, or some other general theory of interpretations, structures, or whatever. Contra Quine, this does not disqualify second-order logic from its role in foundational studies. To wax Quinean, why should there be a sharp border separating mathematics from logic, especially the logic of mathematics?

Draws upon Taoist wisdom and photographic artistry to provide insight into creativity, spirituality, and awareness training, with black-and-white photographs, passages from ancient Taoist writings, and practical exercises to explain the fundamentals of Taoist photography.

Recent data indicate that under a specific posthypnotic suggestion to circumvent reading, highly suggestible subjects successfully eliminated the Stroop interference effect. The present study examined whether an optical explanation could account for this finding. Using cyclopentolate hydrochloride eye drops to pharmacologically prevent visual accommodation in all subjects, behavioral Stroop data were collected from six highly hypnotizables and six less suggestibles using an optical setup that guaranteed either sharply focused or blurred vision. The highly suggestibles performed the Stroop task when naturally (...) vigilant, under posthypnotic suggestion not to read, and while visually blurred; the less suggestibles ran naturally vigilant, while looking away, and while visually blurred. Although visual accommodation was precluded for all subjects, posthypnotic suggestion effectively eliminated Stroop interference and was comparable to looking away in controls. These data strengthen the view that Stroop interference is neither robust nor inevitable and support the hypothesis that posthypnotic suggestion may exert a top-down influence on neural processing. (shrink)

Drawing on 38 in-depth, qualitative interviews, this article explores how people working in the equality sector in England and Wales view and use the current law around sex and gender, and how they imagine law’s future, particularly potential decertification, where the state would withdraw from certifying and regulating a person’s sex/gender. Whilst situated in the bureaucratic strand of the literature, the paper also contributes to wider legal consciousness studies. This literature has generally focused on people’s relationships to law in terms (...) of domination, alienation and game-playing. Drawing on idioms and the language of touch, the paper unpacks the way in which equality actors talked about law not as remote or alienating, but as close and familiar; not as oppressive, but as “precious” and hard-won. Some also regarded law as a place of safety in unsafe times. These proposed ‘attached to law’ and ‘protective of law’ strands of consciousness enrich and extend Ewick and Silbey’s classic ‘before the law’ narrative. The findings are also useful for critical legal and feminist scholarship. Combined with the equality sector’s pragmatic and tactical use of law to problem-solve, this close and protective orientation towards law reproduces its hegemony. The paper concludes by exploring a recurrent refrain that, in relation to decertification, “we’re not there yet” and that gender equality would need to be achieved before decertification would “fly”. (shrink)

This article concerns the ongoing neo-logicist program in the philosophy of mathematics. The enterprise began life, in something close to its present form, with Crispin Wright’s seminal [1983]. It was bolstered when Bob Hale [1987] joined the fray on Wright’s behalf and it continues through many extensions, objections, and replies to objections . The overall plan is to develop branches of established mathematics using abstraction principles in the form: Formula where a and b are variables of a given type , (...) Σ is a higher-order operator denoting a function from items of the given type to objects in the range of the first-order variables, and E is an equivalence relation over items of the given type. In what follows, I will sometimes omit the initial quantifiers.Frege [1884, 1893] himself employed three abstraction principles. One of them, used for illustration, comes from geometry: "The direction of l1 is identical to the direction of l2 if and only if l1 is parallel to l2."Call this the direction principle. The second was dubbed N= in [Wright, 1983] and is now called Hume’s principle: Formula where F≈G is an abbreviation of the second-order statement that there is a one-to-one relation mapping the F’s onto the G’s. In words, states that the number of F is identical to the number of G if and only if F is equinumerous with G. Unlike the direction-principle, the relevant variables, F, G here are second-order. Georg Cantor …. (shrink)

Including the perspectives of scientists about the nature and process of science is important for an authentic and nuanced portrayal of science in science education. The small number of studies that have explored scientists’ worldviews about science has thus far generated contradictory findings, with recent studies claiming that scientists simultaneously hold contradictory sophisticated and naïve views. This article reports on an exploratory study that uses the framework of Bhaskar’s critical realism to elicit and separately analyse academic scientists’ ontological and epistemological (...) views about science in semi-structured interviews. When the views of scientists are analysed through the lens of critical realism, it is clear that it is possible to hold a realist ontological commitment about what knowledge is of, simultaneously with a fallibilist epistemological commitment about knowledge itself. The apparent incongruence of scientists’ so-called naïve and sophisticated views about science is resolved when analysed using a critical realist framework. Critical realism offers a simple and coherent framework for science educators that avoids many of the problems of positivism and social constructivism by finding a middle ground between them. The three pillars of critical realism: ontological realism, epistemological fallibilism and judgmental rationality help to make sense of how socially constructed scientific knowledge can be anchored in an independent reality. (shrink)

Recent data indicate that under a specific posthypnotic suggestion to circumvent reading, highly suggestible subjects successfully eliminated the Stroop interference effect. The present study examined whether an optical explanation could account for this finding. Using cyclopentolate hydrochloride eye drops to pharmacologically prevent visual accommodation in all subjects, behavioral Stroop data were collected from six highly hypnotizables and six less suggestibles using an optical setup that guaranteed either sharply focused or blurred vision. The highly suggestibles performed the Stroop task when naturally (...) vigilant, under posthypnotic suggestion not to read, and while visually blurred; the less suggestibles ran naturally vigilant, while looking away, and while visually blurred. Although visual accommodation was precluded for all subjects, posthypnotic suggestion effectively eliminated Stroop interference and was comparable to looking away in controls. These data strengthen the view that Stroop interference is neither robust nor inevitable and support the hypothesis that posthypnotic suggestion may exert a top-down influence on neural processing. (shrink)

Political representation lies at the core of modern politics. Democracies, with their vast numbers of citizens, could not operate without representative institutions. Yet relations between the democratic ideal and the everyday practice of political representation have never been well defined and remain the subject of vigorous debate among historians, political theorists, lawyers, and citizens. In this volume, an eminent group of scholars move forward the debates about political representation on a number of fronts. Drawing on insights from political science, history, (...) political theory, economics, and anthropology, the authors provide much-needed clarity to some of the most vexing questions about political representation. They also reveal new and enlightening perspectives on this fundamental political practice. Topics discussed include representation before democracy, political parties, minorities, electoral competition, and ideology. This volume is essential reading for anyone interested in the ideal and the reality of political representation. (shrink)

Teaching students to ask and answer questions is critically important if they are to engage in reasoned argumentation, problem-solving, and learning. This study involved 35 groups of grade 6 children from 18 classrooms in three conditions (cognitive questioning condition, community of inquiry condition, and the comparison condition) who were videotaped as they worked on specific inquiry-based science tasks. The study also involved the teachers in these classrooms who were audio-taped as they interacted with the children during these tasks. The results (...) show that while there were no significant differences in the children's explanatory behaviour across the two time periods, there were significant differences in the total verbal interactions between the children in the cognitive questioning condition and their peers in the community of inquiry and comparison conditions. Furthermore, the children in the cognitive questioning condition obtained higher reasoning and problem-solving scores than peers in the other conditions. Interestingly, while there were no significant differences between the teachers’ basic and extended mediating behaviours in the three conditions at Times 1 and 2, there was a significant difference in extended mediation behaviours with the teachers demonstrating nearly three times more extended mediation to promote students’ learning at Time 2 than they did at Time 1. Teacher intervention in providing guidance in how to interact during cooperative, inquiry-based science appears to be critical to helping students engage in higher-level thinking and learning. (shrink)

In Free Will and Luck, Mele presents a case of an agent Ernie, whose zygote was intentionally designed so that Ernie A-s in 30 years, bringing about a certain event E. Mele uses this case of original design to outline the zygote argument against compatibilism. In this paper I criticize the zygote argument. Unlike other compatibilists who have responded to the zygote argument, I contend that it is open to the compatibilist to accept premise one, that Ernie does not act (...) freely and is not morally responsible for anything he does. I argue that compatibilists should deny premise two. Diana’s effective intention to create Ernie’s zygote such that Ernie A-s in 30 years and her intervention to bring about his A-ing mark a significant difference between Ernie and normal agents in a deterministic universe with regard to how their zygotes were created that affects whether those agents act freely and are morally responsible for so acting. (shrink)

This article draws from the reading protocols developed by José Esteban Muñoz to advance a political reading of Georges Bataille. It argues for a consistent and coherent anti-fascism across Bataille’s work, from the early “political” writings to the mature turn toward mysticism. Focusing in particular on his writings from the 1930s, this article clarifies some of the key concepts in Bataille’s critical theory of fascism: expenditure, heterology, base materialism, and democratic anguish.

© 2014 Shapiro, Tassone, Choudhary and Simon.Chromosome 22q11.2 Deletion Syndrome is caused by the most common human microdeletion, and it is associated with cognitive impairments across many domains. While impairments in cognitive control have been described in children with 22q11.2DS, the nature and development of these impairments are not clear. Children with 22q11.2DS and typically developing children were tested on four well-validated tasks aimed at measuring specific foundational components of cognitive control: response inhibition, cognitive flexibility, and working memory. Molecular (...) assays were also conducted in order to examine genotype of catechol-O-methyltransferase, a gene located within the deleted region in 22q11.2DS and hypothesized to play a role in cognitive control. Mixed model regression analyses were used to examine group differences, as well as age-related effects on cognitive control component processes in a cross-sectional analysis. Regression models with COMT genotype were also conducted in order to examine potential effects of the different variants of the gene. Response inhibition, cognitive flexibility, and working memory were impaired in children with 22q11.2DS relative to TD children, even after accounting for global intellectual functioning. When compared with TD individuals, children with 22q11.2DS demonstrated atypical age-related patterns of response inhibition and cognitive flexibility. Both groups demonstrated typical age-related associations with working memory. The results of this cross-sectional analysis suggest a specific aberration in the development of systems mediating response inhibition in a sub-set of children with 22q11.2DS. It will be important to follow up with longitudinal analyses to directly examine these developmental trajectories, and correlate neurocognitive variables with clinical and adaptive outcome measures. (shrink)

This article responds to Marzia Milazzo's article ‘On white ignorance, white shame, and other pitfalls in critical philosophy of race’, in which Milazzo argues that the concepts white shame, white guilt, white privilege, white habits, white invisibility and white ignorance are pitfalls in the process of decolonisation. Milazzo contends that the way these concepts are theorised in much critical philosophy of race minimises white people's active interest in reproducing the racial status quo. While I agree with Milazzo's critique of white (...) shame and white guilt, I argue that these affective responses are fundamentally different to the remaining concepts. Drawing on critical whiteness studies and agnotology, I argue that white privilege, white invisibility and white ignorance are valuable conceptual tools for revealing white people's active investment in maintaining racial inequality. Whereas Milazzo sees a contradiction between white people's active interest in maintaining racial inequality and concepts like white invisibility and white ignorance, I argue that, correctly theorised, these concepts resolve this apparent contradiction. I contest Milazzo's call to reject white privilege, white invisibility and white ignorance, arguing that these concepts are useful tools in the project of decolonisation. (shrink)

Hegel's "highway of despair," introduced in his _Phenomenology of Spirit_, represents the tortured path traveled by "natural consciousness" on its way to freedom. Despair, the passionate residue of Hegelian critique, also indicates fugitive opportunities for freedom and preserves the principle of hope against all hope. Analyzing the works of an eclectic cast of thinkers, Robyn Marasco considers the dynamism of despair as a critical passion, reckoning with the forms of historical life forged along Hegel's highway. _The Highway of Despair_ (...) follows Theodor Adorno, Georges Bataille, and Frantz Fanon as they each read, resist, and reconfigure a strand of thought in Hegel's _Phenomenology of Spirit_. Confronting the twentieth-century collapse of a certain revolutionary dialectic, these thinkers struggle to revalue critical philosophy and recast Left Hegelianism within the contexts of genocidal racism, world war, and colonial domination. Each thinker also re-centers the role of passion in critique. Arguing against more recent trends in critical theory that promise an escape from despair, Marasco shows how passion frustrates the resolutions of reason and faith. Embracing the extremism of what Marx, in the spirit of Hegel, called the "ruthless critique of everything existing," she affirms the contemporary purchase of radical critical theory, resulting in a passionate approach to political thought. (shrink)