In the UK, current policies and services for people with mental disorders, including those with intellectual disabilities (ID), presume that these men and women can, do, and should, make decisions for themselves. The new Mental Capacity Act (England and Wales) 2005 (MCA) sets this presumption into statute, and codifies how decisions relating to health and welfare should be made for those adults judged unable to make one or more such decisions autonomously. The MCA uses a procedural checklist to guide this (...) process of substitute decision-making. The personal experiences of providing direct support to seven men and women with ID living in residential care, however, showed that substitute decision-making took two forms, depending on the type of decision to be made. The first process, ‘strategic substitute decision-making’, paralleled the MCA’s legal and ethical framework, whilst the second process, ‘relational substitute decision-making’, was markedly different from these statutory procedures. In this setting, ‘relational substitute decision-making’ underpinned everyday personal and social interventions connected with residents’ daily living, and was situated within a framework of interpersonal and interdependent care relationships. The implications of these findings for residential services and the implementation of the MCA are discussed. (shrink)

Metabolic pathways underlying brain function remain largely unexplored during neurodevelopment, predominantly due to the lack of feasible techniques for use with awake infants. Broadband near-infrared spectroscopy provides the opportunity to explore the relationship between cerebral energy metabolism and blood oxygenation/haemodynamics through the measurement of changes in the oxidation state of mitochondrial respiratory chain enzyme cytochrome-c-oxidase alongside haemodynamic changes. We used a bNIRS system to measure ΔoxCCO and haemodynamics during functional activation in a group of 42 typically developing infants aged between (...) 4 and 7 months. bNIRS measurements were made over the right hemisphere over temporal, parietal and central cortical regions, in response to social and non-social visual and auditory stimuli. Both ΔoxCCO and Δ[HbO2] displayed larger activation for the social condition in comparison to the non-social condition. Integration of haemodynamic and metabolic signals revealed networks of stimulus-selective cortical regions that were not apparent from analysis of the individual bNIRS signals. These results provide the first spatially resolved measures of cerebral metabolic activity alongside haemodynamics during functional activation in infants. Measuring synchronised changes in metabolism and haemodynamics have the potential for uncovering the development of cortical specialisation in early infancy. (shrink)

Alfred North Whitehead called Isabel Scribner Stearns the most talented female philosopher in America. Drawing on Whitehead and her other teachers, Paul Weiss, C.I. Lewis, H.H. Price, and Grace de Laguna, as well as the traditions of ancient Greek philosophy, Continental Rationalism, German Idealism, and American Pragmatism, Stearns has created an epistemologically and logically sound systematic account of the ontology of individuation and the relational genesis and endurance of individual beings.

Both Carnap and Quine made significant contributions to the philosophy of mathematics despite their diversedviews. Carnap endorsed the dichotomy between analytic and synthetic knowledge and classified certainmathematical questions as internal questions appealing to logic and convention. On the contrary, Quine wasopposed to the analytic-synthetic distinction and promoted a holistic view of scientific inquiry. The purpose of thispaper is to argue that in light of the recent advancement of experimental mathematics such as Monte Carlosimulations, limiting mathematical inquiry to the domain of (...) logic is unjustified. Robustness studies implemented inMonte Carlo Studies demonstrate that mathematics is on par with other experimental-based sciences. (shrink)

In this essay, I have rejected the inductive interpretation of the paradigm of contextual implication (to say “p”; is to imply that one believes that ) and proposed in its stead an explicatory model according to which a speaker in making a statement contextually implies whatever one is entitled to infer on the basis of the presumption that his act of stating is normal. In developing this model, I show how contextual implication depends on three distinct matters: a stating context, (...) presumptions of normality, and rules for the correct use of expressions. (shrink)

It is traditionally believed that cerebral activation (the presence of low voltage fast electrical activity in the neocortex and rhythmical slow activity in the hippocampus) is correlated with arousal, while deactivation (the presence of large amplitude irregular slow waves or spindles in both the neocortex and the hippocampus) is correlated with sleep or coma. However, since there are many exceptions, these generalizations have only limited validity. Activated patterns occur in normal sleep (active or paradoxical sleep) and during states of anesthesia (...) and coma. Deactivated patterns occur, at times, during normal waking, or during behavior in awake animals treated with atropinic drugs. Also, the fact that patterns characteristic of sleep, arousal, and waking behavior continue in decorticate animals indicates that reticulo-cortical mechanisms are not essential for these aspects of behavior. (shrink)