This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

Extending a normal 24 hours day by four hours is unexpectedly highly disruptive to daily rhythms in gene expression in the blood. Using a paradigm in which human subjects were exposed to a 28 hours day, Archer and colleagues show how this sleep‐altering forced desynchrony protocol caused complex disruption to daily rhythms in distinct groups of genes. Such perturbations in the temporal organisation of the blood transcriptome arise quickly, and point to the fragile nature of coordinated genomic activity. Chronic disruption (...) of the daily and circadian rhythms in sleep compromise health and well‐being and this study reveals potential new molecular targets to combat the disruptive effects of shift work and jetlag. (shrink)

Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

Young children judge that violations of ordinary, causal constraints are impossible. Yet children’s religious beliefs typically include the assumption that such violations can occur via divine agency in the form of miracles. We conducted two studies to examine this potential conflict. In Study 1, we invited 5- and 6-year-old Colombian children attending either a secular or a religious school to judge what is and is not possible. Children made their judgments either following a minimal prompt or following a reminder of (...) God’s extraordinary powers. Irrespective of their education, and whether or not they had been reminded of God’s extraordinary powers, children systematically judged violations of ordinary, causal constraints to be impossible. In Study 2, we asked if more extensive reminders of God’s special powers would prompt religious children to say that the impossible can happen. Five- and 6-year-old Colombian children attending either a secular or a religious school were presented with narratives in which the protagonist desired an ordinarily impossible outcome. In half the stories, the protagonist prayed to God for the desired outcome. Irrespective of education and of whether the protagonist prayed, children systematically concluded that the desired outcome would not occur and justified that conclusion by reference to ordinary causal constraints. Nevertheless, in a minority of their replies children did assert that violations of ordinary causality are possible. Overall, irrespective of their religious education, young children judge that events rarely deviate from their natural course; only occasionally do they acknowledge exceptions. (shrink)

Learning to see the continuity between our everyday decision-making and our decision-making around new biotechnologies is key to acclimatizing to our enhanced future. By excavating this decision-making, Singh helps us see that Ritalin isn’t really that big a deal and helps dispel what Malcolm Gladwell (1999) noted as the “strange inversion of moral responsibility” encouraged by books like ‘Ritalin Nation’ and ‘Running on Ritalin,’ whose authors “seek to make those parents and physicians trying to help children with A.D.H.D. feel guilty (...) for doing so.”. (shrink)

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1865 edition. Excerpt:... PART II. BERKELEY'S PHILOSOPHY: SECTION XIV. Bishop Berkeley is best known by the system of idealism developed by him. This theory is unfolded in two works, called "The Principles of Human Knowledge/' and "Three Dialogues between Hylas and Philonous."t If it were not for this system, the (...) name and works of Berkeley, like many more good and great men, would have fallen into a state of entire obscurity. But so long as the various systems of mental science will be studied, the name of Berkeley will be mentioned and his works studied. As yet his theory of idealism, and works in general, have not been so generally read and digested, as they have been The book called, The Principles of Human Knowledge, was published in 1710, by Aaron Rhonies, for Jeremy Pepyat, bookseller in Skinner Row, Dublin; and was the only edition published in Dr. Berkeley's life. t His Three Dialogues between Hylas and Philonout was published in London in 1713. It shows much acuteness, great precision and elegance of expression, bat considerable repetition, and often appears as one turning in a circle. D ignorantly referred to and flippantly treated with a smile. The demonstration of the great lexicographer, Dr. Johnson, against the idealism of Berkeley, kicking a stone, is as faithfully and generally copied as it is familiarly known His system of idealism is considered, generally, so absurd, and contrary to common sense and universal experience, that the best answer it is worthy of is to treat it lightly and indifferently, as the production of one whose brain was not sound at the time in all its organs and powers.t On this ground the philosopher has just reason to complain, and appeal against his critics and judges. We think that the views and sincere convictions of... (shrink)

Le visage est-il un phénomène simple ou complexe? Serait-il juste de le définir comme cet aspect de l’être humain qui dépasse tout effort de compréhension et de totalisation, ou bien y a-t-il d’autres caractéristiques de ce phénomène qu’il faut inclure dans toute définition ou description du visage? Le visage est un événement fondamental. Parmi les multiples manières d’approcher l’être, de se rapporter...

“Here then may be lived a life of the senses so pure, so untouched by any mode of apprehension but their own, that the body may be said to think.”Crossing a steep scree-field path demands concentration. The surface slips a little with each step and often, just a short way below, are large rocks or perhaps a cliff. Such experience is at some distance from the concentration intellectuals bring to the specifics of thought, the rigors of reason. Scree concentration works (...) through feet and legs, hands and trekking poles. If it is thought, it is thinking with the body and the world traversed, thinking with surface, weather, time, and risk. I have walked thousands of miles as a long-distance backpacker and puzzled about... (shrink)

Deleuze and Guattari develop a notion of “minor literature” in their short book on Kafka, and the opposition major/minor has been used with varying degrees of success by critics working in a range of disciplines including architectural theory. Teasing out the potentially subversive implications of the major/minor opposition requires reading it in relation to other binarisms developed by Deleuze and Guattari in those same years, e.g., state/nomadic science, striated/smooth space, optic/haptic, as well as Guattari’s useful concept “machinic heterogenesis.” Then, one (...) ends up with a minor architecture concerned with partially subversive practices rather than with structure per se. A building’s minor status is figured through its deployment in and production of a space that is a technological, social and political pattern as well as a line of flight. This paper reads minor architecture by examining the minor house built by Henry David Thoreau at Walden Pond and those currently being assembled by the Mad Housers in Atlanta, Georgia. (shrink)

Uncoupling proteins (UCPs) regulate mitochondrial function, and thus cellular metabolism. Angiotensin‐converting enzyme (ACE) is the central component of endocrine and local tissue renin–angiotensin systems (RAS), which also regulate diverse aspects of whole‐body metabolism and mitochondrial function (partly through altering mitochondrial UCP expression). We show that ACE expression also appears to be regulated by mitochondrial UCPs. In genetic analysis of two unrelated populations (healthy young UK men and Scandinavian diabetic patients) serum ACE (sACE) activity was significantly higher amongst UCP3‐55C (rather than (...) T) and UCP2 I (rather than D) allele carriers. RNA interference against UCP2 in human umbilical vein endothelial cells reduced UCP2 mRNA sixfold (P < 0·01) whilst increasing ACE expression within a physiological range (<1·8‐fold at 48 h; P < 0·01). Our findings suggest novel hypotheses. Firstly, cellular feedback regulation may occur between UCPs and ACE. Secondly, cellular UCP regulation of sACE suggests a novel means of crosstalk between (and mutual regulation of) cellular and endocrine metabolism. This might partly explain the reduced risk of developing diabetes and metabolic syndrome with RAS antagonists and offer insight into the origins of cardiovascular disease in which UCPs and ACE both play a role. (shrink)

Pain may appear to undermine the radically intentionalist view that the phenomenal character of any experience is entirely constituted by its representational content. That appearance is illusory. After categorizing versions of pain intentionalism along two dimensions, I argue that an 'objectivist' and 'non-mentalist' version is the most promising, if it can withstand two objections concerning what we say when in pain, and the distinctiveness of pain. I rebut these objections, in a way available to both opponents of and adherents to (...) the view that experiential content is entirely conceptual. (shrink)

The self seems to be a unitary entity remaining stable across time. Nevertheless, current theorizing conceptualizes the self as a number of interacting sub-systems involving perception, intention and action (self-model). One important function of such a self-model is to distinguish between events occurring as a result of one's own actions and events occurring as the result of somebody else's actions. We conducted an fMRI experiment that compared brain activation after an abrupt mismatch between one's own movement and its visual consequences (...) with an abrupt mismatch between one's own movement and somebody else's visually perceived hand movement. A right fronto-parietal network was selectively active during a sudden mismatch between one's own observed and performed hand action. (shrink)

This Paper Offers A New Interpretation of Phaedo 96a–103a. Plato has devoted the dialogue up to this point to a series of arguments for the claim that the soul is immortal. However, one of the characters, Cebes, insists that so far nothing more has been established than that the soul is durable, divine, and in existence before the incarnation of birth. What is needed is something more ambitious: a proof that the soul is not such as to pass out of (...) existence. According to Socrates’s initial response to Cebes at 95e8–96a1, giving such a demonstration requires a thorough investigation into “the reason for coming to be and passing away in general” (ὅλως γὰϱ δεῖ πεϱὶ γενέσεως ϰαὶ Φθοϱᾶς τὴν αἰτίαν διαπϱαγματεύσασθαι .. (shrink)

Dictionary of Viśiṣṭādvaita school in Hindu philosophy.

Jehovah's Witnesses are students of the Bible. They refuse transfusions out of obedience to the scriptural directive to abstain and keep from blood. Dr Muramoto disagrees with the Witnesses' religious beliefs in this regard. Despite this basic disagreement over the meaning of Biblical texts, Muramoto flouts the religious basis for the Witnesses' position. His proposed policy change about accepting transfusions in private not only conflicts with the Witnesses' fundamental beliefs but it promotes hypocrisy. In addition, Muramoto's arguments about pressure to (...) conform and coerced disclosure of private information misrepresent the beliefs and practices of Jehovah's Witnesses and ignore the element of individual conscience. In short, Muramoto resorts to distortion and uncorroborated assertions in his effort to portray a matter of religious faith as a matter of medical ethical debate. (shrink)