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 apply the distinction between parameter independence and outcome independence to the linear and nonlinear models of a recent nonrelativistic theory of continuous state vector reduction. We show that in the nonlinear model there is a set of realizations of the stochastic process that drives the state vector reduction for which parameter independence is violated for parallel spin components in the EPR-Bohm setup. Such a set has an appreciable probability of occurrence (≈ 1/2). On the other hand, the linear model (...) exhibits only extremely small parameter dependence effects. We investigate some specific features of the models and we recall that, as has been pointed out recently, if one wants to be able to speak of definite outcomes (or equivalently of possessed objective elements of reality) at finite times, one has to slightly change the criteria for their attribution to physical systems. The concluding section is devoted to a detailed discussion of the difficulties which one meets when one tries to take, as a starting point for the formulation of a relativistic theory, a nonrelativistic scheme which exhibits parameter dependence. Here we derive a theorem which identifies the precise sense in which the occurrence of parameter dependence forbids a genuinely relativistic generalization. Finally we show how the appreciable parameter dependence of the nonlinear model gives rise to problems with relativity, while the extremely weak parameter dependence of the linear model does not give rise to any difficulty, provided one takes into account the appropriate criteria for the attribution of definite outcomes. (shrink)

Objectives: To report the attitudes and opinions of subjects in US clinical trials about whether or not, and why, they should receive post-trial access (PTA) to the trial drug, care and information. Design: Focus groups, short self-administered questionnaires. Setting: Boston, Dallas, Detroit, Oklahoma City. Participants: Current and recent subjects in clinical trials, primarily for chronic diseases. Results: 93 individuals participated in 10 focus groups. Many thought researchers, sponsors, health insurers and others share obligations to facilitate PTA to the trial drug, (...) if it benefited the subject, or to a therapeutic equivalent. Some thought PTA obligations include providing transition care (referrals to non-trial physicians or other trials, limited follow-up, short-term drug supply) or care for long-term adverse events. Others held, in contrast, that there are no PTA obligations regarding drugs or care. However, there was agreement that former subjects should receive information (drug name, dosage received, market approval date, long-term adverse effects, trial results). Participants frequently appealed to health need, cost, relationships, reciprocity, free choice and sponsor self-interest to support their views. Many of their reasons overlapped with those commonly discussed by bioethicists. Conclusion: Many participants in US trials for chronic conditions thought there are obligations to facilitate PTA to the trial drug at a “fair” price; these views were less demanding than those of non-US subjects in other studies. However, our participants’ views about informational obligations were broader than those of other subjects and many bioethicists. Our results suggest that the PTA debate should expand beyond the trial drug and aggregate results. (shrink)

Background Scientific and technological advancements in mapping and understanding the interrelated pathways through which biological and environmental exposures affect disease development create new possibilities for detecting disease risk factors. Early detection of such risk factors may help prevent disease onset or moderate the disease course, thereby decreasing associated disease burden, morbidity, and mortality. However, the ethical implications of screening for disease risk factors are unclear and the current literature provides a fragmented and case-by-case picture. Methods To identify key ethical considerations (...) arising from the early detection of disease risk factors, we performed a systematic scoping review. The Scopus, Embase, and Philosopher’s Index databases were searched for peer-reviewed, academic records, which were included if they were written in English or Dutch and concerned the ethics of (1) early detection of (2) disease risk factors for (3) disease caused by environmental factors or gene-environment interactions. All records were reviewed independently by at least two researchers. Results After screening 2034 titles and abstracts, and 112 full papers, 55 articles were included in the thematic synthesis of the results. We identified eight common ethical themes: (1) Reliability and uncertainty in early detection, (2) autonomy, (3) privacy, (4) beneficence and non-maleficence, (5) downstream burdens on others, (6) responsibility, (7) justice, and (8) medicalization and conceptual disruption. We identified several gaps in the literature, including a relative scarcity of research on ethical considerations associated with environmental preventive health interventions, a dearth of practical suggestions on how to address expressed concerns about overestimating health capacities, and a lack of insights into preventing undue attribution of health responsibility to individuals. Conclusions The ethical concerns arising with the early detection of risk factors are often interrelated and complex. Comprehensive ethical analyses are needed that are better embedded in normative frameworks and also assess and weigh the expected benefits of early risk factor detection. Such research is necessary for developing and implementing responsible and fair preventive health policies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Criminal Law, Pain Relief, and Physician Aid in DyingFaye Girsh, Ed.D., Executive DirectorMadam:The article by Cantor and Thomas on “Pain Relief, Acceleration of Death, and Criminal Law” (KIEJ, June 1996) was a tortured attempt to develop criteria for the humane and compassionate physician who tries to serve the needs of a patient in unremitting pain. There are three areas that merit comment.The authors dealt with pain medications that might (...) have the undesirable side effect of causing death. They did not mention tolerance, which usually occurs in a patient with chronic pain and which would require exceedingly high doses to be effective. They did not mention barbiturates, which are preferable to opiates in causing death and which are used increasingly by compassionate physicians to answer the pleas of their suffering patients, but for which there is no excuse about alleviating pain. Would the criminal law just call the prescription of a lethal dose of barbiturates a reckless act and require conviction? Fortunately, juries, as the authors point out, do not balance these formulas on the head of a pin. When they see the circumstances under which these doctors do help their patients, they choose to nullify the law and would ignore the suggestions made in this article.The authors refer to the “consent” of the patient. They do not mention that these doctors are operating with more than consent; they are administering these medications because suffering patients are begging them to put them out of their pain and the indignities of the dying process. The article discusses the process as though it were the same as consent to elective surgery. These patients—with AIDS, cancer, and hopeless neurological degeneration—are not simply agreeing to a procedure; they are desperately seeking a way out. If the criminal law were to develop criteria for physician aid in dying, certainly one of them should be the active, witnessed, repeated request of such a patient for a certain, quick, painless, gentle death.The third point is that physicians do not face prosecution when administering no treatment to a patient whose life could be saved with treatment but who chooses not to receive it. This has been upheld by the U.S. Supreme Court; no criteria for suffering, alternatives, terminality, justifiability, or unbearability are required. The doctor can stand by while the patient dies what may be a protracted, difficult death, but it is within the law. What matters in this situation is the decision of the patient to refuse treatment, and that is absolute. How ironic that the patient who cannot refuse treatment must, with his or her doctor, jump through all these hoops to achieve a peaceful death.One worries that the physician who must balance the risk of “risky pain relief” against the accusation of recklessness will err in the direction of allowing [End Page 103] the patient to bear the pain rather than help with a dose of analgesics that might be considered beyond the stipulated “risk.”Why don’t we just be honest about it? Allow dying or hopelessly ill patients to make the decision about what they want by passing a carefully defined law allowing euthanasia rather than balancing the risk and trying to determine the “purpose” of the physician’s ministrations. We protect some patients from themselves while allowing others almost complete autonomy to make the choice of ending their lives. The authors were right in saying that proponents of rational laws consider this sheer hypocrisy.Faye Girsh, Executive DirectorHemlock Society U.S.A. Denver, COFaye Girsh misconceives our article’s objective as an “attempt to develop criteria” for the humane physician. Our goal in writing the paper was to analyze the current criminal law framework in the hope of sharpening debate and engendering normative critiques. We readily acknowledge tensions in the current legal framework and would support changes in that framework.Copyright © 1997 The Johns Hopkins University Press... (shrink)

The archipelago context of Maluku represents the living dynamics of Christian communities in that area, which becomes an ecclesiological foundation of the Gereja Protestan Maluku. Christianity, the embryo of the GPM, is the fruit of the evangelical works by European missionaries, particularly Dutch missions from the 18th century onwards. The Dutch-type Christianity had been adapted into models so that the form of institution and Protestant teachings in Maluku moved dynamically following socio-political and cultural changes along with the colonial and the (...) post-colonial history of Indonesian and Malukan society. It attempts to describe the manifestation of the Calvinism-model of Christianity that is continuously being contextualised through absorbing various elements of worldview, tradition, and the religiosity of the archipelago society. Cultural hermeneutics is used to interpret the socio-cultural phenomena in which the church lives in and to construct its theological understanding about Christian identity. The ecclesiological construction of GPM, in turn, is structured by plural social orders. The reality also influences the perspective about GPM from many different worldviews of the Malukan archipelago society. The contextual ecclesiological perspective, therefore, is constructed based on intermingled understandings that theology of the church can only be built by considering multifold dimensions of a particular society. The result of this research pertains to the constructive understanding of a specific ecclesial context of the GPM in their struggles for theologising their existence as God’s people and, at the same time, as an integral part of certain society in Maluku and Indonesia.Contribution: As the living contextual church that struggles for proclaiming God’s love, the GPM has a theological responsibility to conduct its church mission based on its ecclesiological understanding and practices contextually. The article contributes to the enrichment of the theological discourse on the crucial roles of a church in Maluku, in the eastern part of Indonesia. (shrink)

This book integrates philosophy of science, data acquisition methods, and statistical modeling techniques to present readers with a forward-thinking perspective on clinical science. It reviews modern research practices in clinical psychology that support the goals of psychological science, study designs that promote good research, and quantitative methods that can test specific scientific questions. It covers new themes in research including intensive longitudinal designs, neurobiology, developmental psychopathology, and advanced computational methods such as machine learning. Core chapters examine significant statistical topics, for (...) example missing data, causality, meta-analysis, latent variable analysis, and dyadic data analysis. A balanced overview of observational and experimental designs is also supplied, including preclinical research and intervention science. This is a foundational resource that supports the methodological training of the current and future generations of clinical psychological scientists. (shrink)

Upshot: According to Biology of Cognition and Language (Maturana’s approach) the immune system is not a cognitive system and defining of a cognitive paradigm is not what we understand as a Maturanian approach to immunology. The true cognitive actions in immunology are performed by immunologists acting as observers, not by body organs or systems. Stimuli and responses are not adequate concepts in the description of systems. As a closed network of cellular/molecular interactions, the immune system yields patterns of activity as (...) is transparent in robust conserved profiles of reactivity of natural immunoglobulins, as investigated by Nóbrega et al. and Cohen et al., which offer the opportunity to unravel its natural, spontaneous activity. Dietary materials, products of the commensal microbiome are the most abundant and common elements continuously incorporated to the network activity and, thus, also represent an important avenue of investigation. (shrink)

The discovery of the inscription with the name of [M]iltiades, which confirmed the statement in Dionysius Halicarnassensis 7. 3. 1 that a Miltiades was archon at Athens in 524/3, prompts a reconsideration of the problems presented by the accounts in Herodotus and in Marcellinus Life of Thucydides concerning the Philaid family. To the question, who is this Miltiades, the following answers have been given. ‘He is not a Philaid.’ The objection to this answer is that the Peisistratids either occupied the (...) archonship themselves or gave it to members of leading families, such as Cleisthenes the Alcmeonid in 525/4; if then this Miltiades was a member of a leading family, he is almost certainly a member of the Philaid family. ‘He is the elder Miltiades who founded the settlement in the Chersonese.’ In Herodotus' account Miltiades left Athens, where he was already powerful, at the beginning of a tyranny by Peisistratus; then after several operations in the Chersonese Miltiades was rescued by Croesus. The year in which Miltiades left Athens was either 561/0 or 556/5 and almost certainly the latter; for in 561/0 Croesus was not on the throne. The year 546 may be excluded; for in 546 autumn and winter Croesus had neither the time nor the opportunity to concern himself with Miltiades, since Cyrus was then at war with Lydia and seized Sardis.2 If Miltiades was powerful in 556/5, he was at that date no youngster but at least in his thirties—a man born say c. 590. In 524/3, being well on in his sixties and having spent thirty years and more in the Chersonese, this Miltiades is unlikely to have been the eponymous archon. We conclude, then, that the archon Miltiades in 524/3 was a different and younger Miltiades. Having cleared the ground on these two points, I turn to the central problem, whether there were two men called Miltiades, one born c. 590 and the other the general who died of a wound soon after 489, or whether there were three men called Miltiades, one of whom was in a generation intermediate between Miltiades born c. 590 and Miltiades dead c. 489. Either solution is chronologically possible. (shrink)

Recognising and responding appropriately to emotions is critical to adaptive psychological functioning. Psychopathic traits (e.g. callous, manipulative, impulsive, antisocial) are related to differences in recognition and response when emotion is conveyed through facial expressions and language. Use of emotional music stimuli represents a promising approach to improve our understanding of the specific emotion processing difficulties underlying psychopathic traits because it decouples recognition of emotion from cues directly conveyed by other people (e.g. facial signals). In Experiment 1, participants listened to clips (...) of emotional music and identified the emotional content (Sample 1, N = 196) or reported on their feelings elicited by the music (Sample 2, N = 197). Participants accurately recognised (t(195) = 32.78, p <.001, d = 4.69) and reported feelings consistent with (t(196) = 7.84, p <.001, d = 1.12) the emotion conveyed in the music. However, psychopathic traits were associated with reduced emotion recognition accuracy (F(1, 191) = 19.39, p <.001) and reduced likelihood of feeling the emotion (F(1, 193) = 35.45, p <.001), particularly for fearful music. In Experiment 2, we replicated findings for broad difficulties with emotion recognition (Sample 3, N = 179) and emotional resonance (Sample 4, N = 199) associated with psychopathic traits. Results offer new insight into emotion recognition and response difficulties that are associated with psychopathic traits. (shrink)

Although much of great interest has been written recently about the period of the socalled Peace of Philocrates, little or nothing has been said of a passage which provides important information in Justin's Epitome of the Historiae Philippicae of Pompeius Trogus. This passage, 8.3.12–15, comes between the destruction of Olynthus and the arrival of the Athenian envoys at Pella . In subject matter it corresponds with ‘the subjugation of Thrace and Thessaly’ in Prologue 8 of Pompeius Trogus – a topic (...) which Justin began in 8.3.1–6 and continued in our passage, 8.3.12–15. (shrink)

It was a characteristic of Macedonian custom that a name was used in a special and in a general sense. For example, ‘Foot-Companions’ was the name of a Bodyguard of Philip and also of the men of the Phalanx-Brigades from Lower Macedonia, and ‘Hypaspists’ was the name of Infantry-Guardsmen of Alexander and also of the men of three Hypaspist Phalanx-Brigades. Geographical names were repeated: there were at least two regions and two cities called ‘Emathia’, two or three regions called ‘Doberus’, (...) four cites called Philippi or Philippopolis, and Alexandrias galore. To a modern mind this makes for confusion. That is certainly the case with the names ‘Macedonia’ and ‘Macedones’, which I shall treat separately in this article. (shrink)

The evidence of ancient books points to the surprising conclusion that in texts of drama or prose dialogue changes of speaker were not usually marked by the name of the new speaker. Instead the ancient reader had a colon, sometimes combined with a paragraphus or stroke in the margin, to guide him. The inconvenience of this practice and the muddle it caused need no emphasis. The facts have been assembled for the text of Plato and Lucian by J. Andrieu , (...) and for Aristophanes by J. C. B. Lowe , 27–42). As far as prose dialogues are concerned confirmation can be found in an unexpected source: the prologue to the dialogue Eranistes by the fifth-century church father Theodoret. (shrink)

The evidence of ancient books points to the surprising conclusion that in texts of drama or prose dialogue changes of speaker were not usually marked by the name of the new speaker. Instead the ancient reader had a colon, sometimes combined with a paragraphus or stroke in the margin, to guide him. The inconvenience of this practice and the muddle it caused need no emphasis. The facts have been assembled for the text of Plato and Lucian by J. Andrieu, and (...) for Aristophanes by J. C. B. Lowe, 27–42). As far as prose dialogues are concerned confirmation can be found in an unexpected source: the prologue to the dialogue Eranistes by the fifth-century church father Theodoret. (shrink)

The lettering of this inscription begins at the very top of the block, just below the straight edge, and stops half-way down the block, the lower part being smoothed but uninscribed. As the inscription is not set centrally on the block, it is probably the continuation of an inscription which ran on a block once superimposed upon it. Doubtful letters are those which are marked by the dot underneath; and W. Peek reported in Ath. Mitt. lxvi, 200 n. 2, that (...) he had seen the top of the v which Vollgraff suggested in the restorationThe inscription is dated to the seventh century B.C. by epigraphists. The stone itself was seen in 1729 by Fourmont and rediscovered in 1928 by Vollgraff; it was in the wall of a Venetian tower on the Larissa or acropolis of Argos. No one knows whence the Venetians had taken it. Therefore Vollgraff's suggestion that it had originally been set up in porta arcis regiae is no more than an attractive speculation. (shrink)

Those who have studied the Athenian system of command in the fifth century have confined themselves almost entirely to the period after 440 B.C. They have raked over the evidence to discover signs of double representation of one tribe on the board of strategi, or of a supreme among the or of a chairman at least of the board of strategi. On the other hand little attention is paid to the progressive diminution of the military functions of the archon polemarchus (...) within the state and to the great problems created in external affairs by the Persian Wars with the formation of the Greek League and then of the Athenian Alliance. Yet these matters are vital to the evolution of the system of command which can be seen in operation after 440 B.C. In particular the decisive steps were probably taken in 480–466 B.C., when Athens' national system of command had first to be integrated into a command-system of combined forces headed by Sparta in the Persian Wars and then adapted to take over the command of combined forces in continuous warfare against Persia. In this article I try to study the whole field and to avoid applying to the early part of the period the theories which have been evolved hitherto with special reference to Pericles in 440–428 B.C. The article consists of the following sections. A, Strategos and Hegemon in 501/0. B, C, current ideas on the modern term D, the historical origins of the so-called E, summary of conclusions. (shrink)

Those who have studied the Athenian system of command in the fifth century have confined themselves almost entirely to the period after 440 B.C. They have raked over the evidence to discover signs of double representation of one tribe on the board of strategi, or of a supreme among the or of a chairman at least of the board of strategi. On the other hand little attention is paid to the progressive diminution of the military functions of the archon polemarchus (...) within the state and to the great problems created in external affairs by the Persian Wars with the formation of the Greek League and then of the Athenian Alliance. Yet these matters are vital to the evolution of the system of command which can be seen in operation after 440 B.C. In particular the decisive steps were probably taken in 480–466 B.C., when Athens' national system of command had first to be integrated into a command-system of combined forces headed by Sparta in the Persian Wars and then adapted to take over the command of combined forces in continuous warfare against Persia. In this article I try to study the whole field and to avoid applying to the early part of the period the theories which have been evolved hitherto with special reference to Pericles in 440–428 B.C. The article consists of the following sections. A, Strategos and Hegemon in 501/0. B, C, current ideas on the modern term D, the historical origins of the so-called E, summary of conclusions. (shrink)

The problem of the composition of Thucydides' History, first raised by Ullrich in 1846, has evoked a mass of controversial literature. In this article I shall confine myself to the main arguments and conclusions. Thucydides' history is unfinished, not only because it breaks off at 411 b.c., but also because the style is uneven. The history of the Archidamian War to 424 b.c. and of the Sicilian War is fully polished and complete; the remainder is lacking in stylistic finish and (...) particularly in the set speeches which characterize the completed books. This unevenness can be explained by the circumstances of Thucydides' life. For the period 431–424 b.c. he could obtain full information at Athens and, after his exile in 424 b.c., at Sparta and elsewhere; for the Sicilian War he could obtain full information in Sicily from the Siceliotes and from the Athenian prisoners. He was thus in a position to complete his history for these two periods. During his exile from 424 b.c. to 404 or 403 b.c. he lacked the information from the Athenian side, which was necessary for the completion of the remainder of his work. Further light is shed on the unevenness of finish by Thucydides' method of composition. He informs us that he began his work at the beginning of the war, and that he was watching and applying his judgement throughout the Twenty-seven Years War; and the statement that he wrote the history down to the capture of the Peiraeus implies his collection of material down to 404 b.c. The working up of this material must have been conditioned partly by the circumstances of the war; in particular, the conception of the Twenty-seven Years War cannot have been formed until after 415 or 412 b.c. (shrink)

Two recently published inscriptions afford new insights into this subject. They were published separately and independently within a year or two of one another. Much is now to be gained by considering them together. The first inscription, found at Philippi in 1936, published by C. Vatin in Proc. 8th Epigr. Conf. , 259–70, and published with a fuller commentary by L. Missitzis in The Ancient World 12 , 3–14, records the decision by Alexander the Great on the use of lands (...) given by his father, Philip II, and in some cases confirmed by himself. The second inscription, found at the site of ancient Kalindoia in 1982, was published with exemplary speed and an excellent commentary by I. P. Vokotopoulou in Ancient Macedonia 4 , 87–114. It records the names of the priests of Asclepius on a stele dedicated to Apollo; and in the preamble it mentions the name of Alexander, being Alexander the Great. Philippi and Kalindoia were both within the limits of the kingdom of Philip and Alexander. (shrink)

The objective of the study was to investigate the relationship between childhood IQ of parents and characteristics of their adult offspring. It was a prospective family cohort study linked to a mental ability survey of the parents and set in Renfrew and Paisley in Scotland. Participants were 1921-born men and women who took part in the Scottish Mental Survey in 1932 and the Renfrew/Paisley study in the 1970s, and whose offspring took part in the Midspan Family study in 1996. There (...) were 286 offspring from 179 families. Parental IQ was related to some, but not all characteristics of offspring. Greater parental IQ was associated with taller offspring. Parental IQ was inversely related to number of cigarettes smoked by offspring. Higher parental IQ was associated with better education, offspring social class and offspring deprivation category. There were no significant relationships between parental IQ and offspring systolic blood pressure, diastolic blood pressure, cholesterol, glucose, lung function, weight, body mass index, waist hip ratio, housing, alcohol consumption, marital status, car use and exercise. Structural equation modelling showed parental IQ associated with offspring education directly and mediated via parental social class. Offspring education was associated with offspring smoking and social class. The smoking finding may have implications for targeting of health education. (shrink)

The cornerstone of any system of livestock production is the stockpeople responsible for the welfare and productivity of the animals they work with. Nevertheless, it has been suggested that the industrialization of livestock production is breaking down the traditional relationship between stockpeople and their animals. Commercial livestock production creates a situation of structurally induced ambivalence for those working in these contexts. Besides, the scientific literature on stockpeople is limited, dispersed and specially focused on animals. Whereby, a review of current knowledge (...) about the compatibilities, contradictions, and unresolved ethical dilemmas faced by stockpeople in their daily work and their implications on farm animals’ welfare was carried out. The topics reviewed included: Attitudes and personality; Empathy towards animals; Workplace well-being; One-health issues; and Sustainability challenges. Understanding the stockpeople emotional relationship with animals, gender, ethnicity, occupational roles, educational backgrounds, culture, and generational differences can be valuable for technicians, advisors, scientists, consultants, and owners when developing training for sustainability programs. (shrink)

A new answer to an old question: The critical realism of Wentzel van HuyssteenIn this article a critical investigation is made into the theological model of Professor Wentzel van Huyssteen. His model is placed in the context of the age-old issue of theological rationality and the question whether or not theology is science or as such has a scientific character. His utilisation of latterday philosophical insights into the nature of science in an attempt to arrive at a positive answer, is (...) treated positively - as is his concept and model as such. The gist of his argument is conceded. Conclusions with special relevance to the South African theological situation are drawn while some critical remarks, indicative of the fact that this concept should also only be valued as provisional and not final, are made. (shrink)

A well-documented defense of the thesis that St. Augustine held the city of man, especially Rome, to contain many relative goods, however evil it was from the absolute standpoint of goodness consisting in the worship of the true God. O'Meara discusses in some detail many contemporary critics, e.g., Ernest Barker, who oppose this interpretation, and argues on the basis of historical circumstance and Augustine's own declarations in works other than the City of God.--R. C. N.