Bradford C Bemiss, Chad A WittDepartment of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO, USA: Chronic rejection is a major cause of death after the first year following lung transplantation. Bronchiolitis obliterans is the most common pathologic finding on biopsy, characterized by fibrous granulation tissue, which obliterates the lumen of the bronchiole. Clinically, in the absence of tissue for pathology, BO syndrome refers to a progressive irreversible drop in the (...) forced expiratory volume in 1 second. Recently, a broader definition of chronic rejection, termed "chronic lung allograft dysfunction", has been used to encompass a more inclusive definition of posttransplant dysfunction. Recently, the lung transplant community has come to realize that chronic rejection may be the final common result after repetitive epithelial insults. Acute rejection, infection, and alloreactivity to mismatched HLA antigens are a few of these insults that damage the surface of the bronchioles. Recent evidence of autoimmunity to the normally hidden structural proteins collagen V and K-α1 tubulin have been correlated with a BO phenotype as well, perhaps correlating the epithelial damage with a mechanism for developing BO lesions. Many immunomodulatory medications and treatments have been studied for effectiveness for the treatment of chronic lung allograft dysfunction. New drugs, which more precisely target the immune system, are being developed and tested. Further study is required, but recent advances have improved our understanding of the pathogenesis and potential intervention for this common and deadly complication of lung transplantation.Keywords: lung transplant, bronchiolitis obliterans syndrome, rejection. (shrink)

Contemporary epidemiological methods testing the associations between green space and psychological well-being treat all vegetation cover as equal. However, there is very good reason to expect that variations in ecological "quality" (number of species, integrity of ecological processes) may influence the link between access to green space and benefits to human health and well-being. We test the relationship between green space quality and restorative benefit in an inner city urban population in Bradford, UK. We selected 12 urban parks for (...) study where we carried out botanical and faunal surveys to quantify biodiversity and assessed the site facilities of the green space (cleanliness, provision of amenities). We also conducted 128 surveys with park users to quantify psychological restoration based on four self-reported measure of general restoration, attention-grabbing distractions, being away from everyday life, and site preference. We present three key results. First, there is a positive association between site facilities and biodiversity. Second, restorative benefit is predicted by biodiversity, which explained 43% of the variance in restorative benefit across the parks, with minimal input from other variables. Third, the benefits accrued through access to green space were unrelated to age, gender, and ethnic background. The results add to a small but growing body of evidence that emphasise the role of nature in contributing to the well-being of urban populations and, hence, the need to consider biodiversity in the design of landscapes that enhance multiple ecosystem services. (shrink)

Although genocide—a coordinated plan of different actions aiming at the destruction of essential foundations of the life of national groups, with the aim of annihilating the groups themselves—remains a sickeningly frequent phenomenon in the twenty‐first century, it is not an immutable aspect of the human condition. Genocide is a choice, and the civilized world must choose its demise. The unique experience of American Indians—a group subjected to genocide in the process of the creation and expansion of the United States—presents a (...) logical heuristic through which to assess more broadly the requirements of redress for historical episodes of genocide and, even more important, the means to prevent its recurrence. (shrink)

Evidence from a University of Zimbabwe oral history project suggests that many rural women in colonial Rhodesia played an active role in undermining patriarchal customs which they experienced as oppressive. These women defied family norms by choosing their own marriage partners, prioritizing the formal education of their daughters and finding ways to generate income to secure greater degrees of autonomy. This study compliments other research which depicts women's primary form of resistance to be moving from rural to urban areas, by (...) showing what options some women exercised while remaining within rural society. (shrink)

As ever more advanced digital systems are created, it becomes increasingly likely that some of these systems will be digital minds, i.e. digital subjects of experience. With digital minds comes the risk of digital suffering. The problem of digital suffering is that of mitigating this risk. We argue that the problem of digital suffering is a high stakes moral problem and that formidable epistemic obstacles stand in the way of solving it. We then propose a strategy for solving it: Access (...) Monitor Prevent (AMP). AMP uses a ‘dancing qualia’ argument to link the functional states of certain digital systems to their experiences—this yields epistemic access to digital minds. With that access, we can prevent digital suffering by only creating advanced digital systems that we have such access to, monitoring their functional profiles, and preventing them from entering states with functional markers of suffering. After introducing and motivating AMP, we confront limitations it faces and identify some options for overcoming them. We argue that AMP fits especially well with—and so provides a moral reason to prioritize—one approach to creating such systems: whole brain emulation. We also contend that taking other paths to digital minds would be morally risky. (shrink)

Pain, failure and false beliefs all make a life worse, or so it is plausible to think. These things and possibly others seem to be intrinsically bad—no matter what further good comes of them they make a life worse pro tanto. In spite of the obvious badness, this is difficult to explain. While there are many accounts of well-being, few are up to the challenge of a univocal explanation of ill-being. Perfectionism has particular difficulty. Otherwise, it is a theory that (...) has quite a lot in its favour. This paper proposes a new valuation scheme for perfectionism, the tripartite scheme, which affords perfectionism the resources to give a comprehensive account of robust bads and has further additional advantages for the view. (shrink)

Perfectionism, the view that well-being is a matter of developing characteristically human capacities, has relatively few defenders in the literature, but plenty of critics. This paper defends perfectionism against some recent formulations of classic objections, namely, the objection that perfectionism ignores the relevance of pleasure or preference for well-being, and a sophisticated version of the ‘wrong properties’ objection, according to which the intuitive plausibility of the perfectionist ideal is threatened by an absence of theoretical pressure to accept putative wrong properties (...) cases. The paper argues these objections are unsuccessful, but introduce a new worry, the Deep Problem: Perfectionism fails to offer a satisfying foundational justification for why developing the human essence is valuable. The paper responds to the deep problem, ultimately arguing that it is a puzzle put to all theories of well-being to provide a justification for their normative significance. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 33.4 (2000) 303-318 [Access article in PDF] The Threshold of the Self Bradford Vivian The subject has a history. Classical Greek sculpture expressed a fascination with the formal beauty of one's self. Ever gazing outward or upward, the marble figures symbolized the Greek preoccupation with a boldness of being, a constant focus on the ideals of the body and mind, which, through their pursuit, might (...) allow one a foretaste of heaven. Centuries later, as the pagan symbols of the ancient world were replaced with those of the growing Byzantine Empire, blocks of the same marble were fashioned into very different expressions. The ideals of form made manifest in the smooth, taught lines and surfaces of classical Greek sculpture were supplanted by Byzantine art's attention to the less perfect details of the individual: distinctive and common faces, beards, clothing, and less glorified bodies. The gazes of the Byzantine statues were cast down, contemplative, reflecting Byzantium's early Christian emphasis upon the modesty of human existence, the pious appraisal of one's time on Earth. Each of these sculptural styles is a material way of thinking and expressing one's being in the world. In this context, each is also symptomatic of the conditions in which such being was possible.The subject must not be conceived as a transcendent entity. Quite to the contrary, there is a historicity to our being and its expression, to our subjectivity and its elaboration. Within a more sweeping perspective, our epochal narratives of the subject--as well as the modes of thought and speech by which we make sense of ourselves--change with each passing age.At the forefront of the current era is a manifold effort to rethink and elaborate anew the concept of the subject. Feminist scholars have initiated political critique and transformation by arguing that the very notion of a subject in Western discourse has functioned as a trope of masculine privilege cloaked in the language of equality and secular humanism. 1 Postmodernists, of course, define contemporary subjectivity as de-centered and fragmented by nature (e.g., Baudrillard 1994; Latour 1993; Lyotard 1984). And [End Page 303] a variety of interdisciplinary studies illuminate the role of modern science and technology in not only sustaining our being, but actually constituting the human; in short, our daily interdependence and union with artificial body parts, synthetic products, life-support machines, test-tube reproduction, computers, and more, characterizes the arrival of what has been called "the posthuman." 2 Like ancient marble from a quarry, however, all of these materials are sculpted in historically specific ways to simultaneously think and express our subjectivity.What role might rhetoric play in this re-imagining of subjectivity? Modern Western thought has defined the subject according to content--that is, by the nature of the essence or being the subject is said to possess. Drawn around this content, the subject comes to appear enclosed, perhaps autonomous, and identical to itself. In this essay, however, I argue that the self may be conceived as a form--a rhetorical form--that exists only in its continual aesthetic creation, in its indefinite becoming. The self is, by this account, isomorphic with the threshold out of which it is composed. Such a formulation makes the self open to difference, to continual movement and transformation, instead of identical to itself.I aim in this essay to explore the abstract rhetorical forms and functions out of which the self is composed. The distinction here amounts to no longer asking, "What is a subject?" but, "What conditions and forces enable the ongoing production of the self?" Commensurate with such a proposal, it will be essential to ask how this movement--this continual becoming--of the self is brought about. The answer to this question ultimately will amplify the role of rhetoric in, not simply expressing, but actually producing conditions of being. In what follows, I begin by reviewing the very general aspects of subjectivity that I wish to call into question. Thereafter, I explore how the subject might be conceived differently. Finally, I discuss the manner in which rhetoric may... (shrink)

Moet er strenger gestraft worden of juist niet? Mag de rechter door de wetgever aan banden worden gelegd? In hoeverre mag de overheid ingrijpen in het privéleven van haar burgers? Deze vragen zijn inzet van menig opiniërend krantenartikel of discussieprogramma. Ook degenen die zich beroepshalve met het recht bezighouden zullen zich van tijd tot tijd moeten bezinnen op taak en functie van het recht. Moeten we regels toepassen als ze tot onrechtvaardige uitkomsten leiden? Leiden regels wel tot het doel waarvoor (...) ze zijn opgesteld? Dit zijn allemaal vragen over het recht waarop door het recht zelf geen antwoorden kunnen worden gegeven. Betekent dit dat discussies over deze kwesties zinloos zijn omdat zij ontaarden in politieke welles-nietes spelletjes? Deze inleiding in de rechtsfilosofie beoogt te laten zien dat dit niet hoeft. (shrink)

Training for members of research ethics committees varies from state to state in Europe. To follow this up, the European Forum for Good Clinical Practice organised a workshop in March 2007 to explore these issues and look for solutions. This article summarises the discussion, providing ways forward to develop REC training.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 35.3 (2002) 223-243 [Access article in PDF] Style, Rhetoric, and Postmodern Culture Bradford Vivian Modern rhetoricians habitually avoid the canon of style. The reasons for this avoidance should be familiar to those versed in the disciplinary lore of rhetoric. Since the fifth and fourth centuries B. C. E., when oratorical virtuosos like Gorgias proclaimed that "Speech is a powerful lord, which by means of the (...) finest and most invisible body effects the divinest works" (41), the suspicion that rhetorical style amounts to irrational verbal excess has dogged those who would argue for the moral integrity of the art. Most recently, twentieth-century rhetoricians, Toulmin (1958) and Perelman (1969, 1979, 1982) in particular, realigned rhetoric with the study of argumentation after its apparent reduction, during the eighteenth and nineteenth centuries, to innocuous matters of form and taste by the elocutionist and belletristic movements. Consequently, the aesthetic capacities of rhetoric have received scant attention from modern rhetoricians, who resign considerations of style largely to supposedly regrettable episodes in the history of the discipline. For better or worse, then, modern rhetorical theory lacks a contemporary rationale and methodology for the study of style. 1Beyond unfortunate equations of rhetoric with grandiloquence, this scarcity in recent rhetorical scholarship corresponds to general humanistic and social scientific prejudices against the topic of style. Robert Hariman posits, "Established academic conceptions of style hardly prepare one to take seriously the aesthetic dimension of political experience" (7). As evidence for this claim, he cites Stuart Ewen's reflections on the "frustration" peculiar to research on style: "It seemed to be a universal category," Ewen writes, "transcending topical boundaries, an accolade applied to people, places, attitudes and things... a subject that was, at best, amorphous" (quoted in Hariman, 7-8). Yet the social ubiquity of style—"[o]n news magazines, sports magazines, music-oriented magazines, magazines about [End Page 223] fashion, architecture and interior design, automobiles, and sex"—indicates that it offers "a key to understanding the contours of contemporary culture" (qtd. in Hariman, 7-8). Hence, the paradox of style as a scholarly topic: that which exhibits its cultural importance makes it seem intellectually vacuous.Hariman's treatise on political style offers the most noteworthy attempt in rhetorical studies to remedy these trends; brief consideration of his insights will suggest further objectives for the study of rhetoric and style. 2 In Hariman's estimation, "style ultimately is a significant dimension of every human experience" because "relations of control and autonomy are negotiated through the artful composition of speech, gesture, ornament, decor, and any other means for modulating perception and shaping response. In a word, our political experience is styled" (3, 2). The distinctive contribution of rhetorical inquiry into political style involves "understanding the dynamics of our social experience or the relationship between rhetorical appeals and political decisions" rather than merely "cataloging discursive forms in the artistic text alone" (Hariman, 8).Accordingly, Hariman acknowledges that one must recognize the substantive social and political influences of style apart from its traditional connotations of individual artistic performance. "In this context," he explains, "although style still highlights aesthetic reactions it no longer enforces artistic autonomy. Style becomes an analytic category for understanding a social reality; in order to understand the social reality of politics, we can consider how political action involves acting according to a particular political style" (9). Thus, for Hariman, rhetorical choices in political style need not amount to a valorization of "artistic autonomy": "each political style draws on universal elements of the human condition and symbolic repertoire but organizes them into a limited, customary set of communicative designs... Each is thoroughly conventional, yet the means for personal improvisation and intelligent, innovate responses to unique problems" (11-12). His treatise therefore appears to dissociate style from its outmoded definitions while recommending the utility of rhetorical principles to the study of political culture.What Hariman calls the "cautious postmodernism" (6) of his project, however, hinders its innovative aspirations. The postmodern portion of his work endorses the study of style according to the aesthetic dimensions of social relations rather than "artistic autonomy" alone; but its... (shrink)

Philosophers have proposed many alleged examples of non-causal explana- tions of particular events. I discuss several well-known examples and argue that they fail to be non-causal.

We motivate five constraints on theorizing about sensory experience. We then propose a novel form of naturalistic intentionalism that succeeds where other theories fail by satisfying all of these constraints. On the proposed theory, which we call structure matching tracking intentionalism, brains states track determinables. Internal structural features of those states select determinates of those determinables for presentation in experience. We argue that this theory is distinctively well-positioned to both explain internal-phenomenal structural correlations and accord external features a role in (...) fixing phenomenology. In addition, we use the theory to shed light on how one comes to experience “missing shades”. (shrink)

Byun et al. describe how deaf signers deal with communication problems in first encounters with signers of different languages. They show that the basic Conversation Analytic repair mechanisms for dealing with verbal troubles are largely reproduced in gesture and sign, including details of turn‐taking structure, timing and form. This underlines the role of repair as a basic resource for linguistic and interactional creativity across modalities.

Byun et al. describe how deaf signers deal with communication problems in first encounters with signers of different languages. They show that the basic Conversation Analytic repair mechanisms for dealing with verbal troubles are largely reproduced in gesture and sign, including details of turn‐taking structure, timing and form. This underlines the role of repair as a basic resource for linguistic and interactional creativity across modalities.

Byun et al. describe how deaf signers deal with communication problems in first encounters with signers of different languages. They show that the basic Conversation Analytic repair mechanisms for dealing with verbal troubles are largely reproduced in gesture and sign, including details of turn‐taking structure, timing and form. This underlines the role of repair as a basic resource for linguistic and interactional creativity across modalities.

A gender revolution allegedly occurred in the British Cape Colony in the nineteenth century. African patriarchs, traditionally pastoralists, took over women's agricultural work, adopted Victorian gender attributes, and became prosperous peasants . Scholars have accepted the plausibility of these seismic shifts in masculinity, postulated in Colin Bundy's classic, The Rise & Fall of the South African Peasantry. I re-examine them, for Bundy's "Case Study" of Herschel, acclaimed as one of the regions that best fits his thesis. This Case Study omits (...) women, who were the typical peasant producers. It marginalizes men failing to conform to bourgeois Victorian gender norms. It misrepresents class formation, causation, periodization, and peasant well-being. It misdates proletarianization by at least three decades. The zenith of commodity production is misdated by at least half a century. A labor reservoir characterized by severe subsistence problems is represented as a prosperous peasantry. Bundy postulates that patriarchs "rose" into women's work and colonial masculine scripts in response to favorable conditions; I argue instead that younger men "fell" into these domains in response to disasters. A silent gender bias-towards black Englishmen, against African women-had a marked impact on Bundy's analysis of class formation. The purpose of this article is to interrogate this silence and to show how it has warped a classic text. (shrink)