The increasing effort, both lay and academic, to encourage a transition from an “I-It” to an “I-Thou” relation to nature is located within a typology of ways of “knowing nature.” This typology provides the context for a particular understanding of human conversation which sees the relation as a cyclical process of “immersion” and “realization” from which a model of the dialectic between “I-It” and “I-Thou” relations to nature can be developed. This model can be used to identify practical measures that (...) can be taken as first steps toward a balance between these relations, both in general and in the context of science-oriented nature conservation organizations such as English Nature in Britain. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

Physicians are expected to engage patients as partners in identifying the possible benefits and harms associated with treatment options and selecting from among medically appropriate treatment options, rather than simply dictating what treatments patients will and will not receive. This collaborative model reflects the recognition that citizens in multicultural societies have diverse values and are likely to have different views about whether the possible benefits of a medical intervention outweigh the possible harms. However, there are circumstances in which the collaborative (...) process breaks down due to irresolvable disagreement. Especially challenging are cases in which patients are expected to die if they do not receive a treatment and either the patients or their surrogates insist on the treatment despite the physician's belief that providing it is ill advised. The source of disagreement is often differing appraisals of the risks and potential benefits. In such cases, physicians generally judge that there is insufficient likelihood or magnitude of benefit to justify the burdens or expense of treatment, while patients or surrogates believe that the small chance of preventing the patient's death is sufficient to justify the costs and potential burdens to the patient.There is a perception that surgeons enjoy considerable discretion in deciding when the risks of a procedure outweigh the expected benefits. An important contrast can be drawn between surgeons and intensivists—physicians who specialize in the medical management of critically ill patients. We will argue that there are good reasons for subjecting the decisions of both surgeons and intensivists to some oversight. We begin by showing that, for many cases, major professional society guidelines for intensivists recommend oversight via a procedural mechanism rather than unilateral decision‐making by individual clinicians. Next, we present reasons for adopting a procedural approach to dispute resolution, and we argue that these reasons apply to situations in which intensivists believe that patients or surrogates are requesting inappropriate life support as well as to many disagreements between surgeons and surrogates. Finally, we present and respond to several objections. (shrink)

Introduction: Early recognition of prediabetes may prevent progression to diabetes, yet not all adults are aware of their prediabetes risk. To reach all adults unaware of their risk, additional risk assessment strategies are warranted. Objectives: The objective of this study was to evaluate the potential scope of benefit from prediabetes risk assessment in the dental care setting and to identify characteristics of dental patients likely to unknowingly have prediabetes or diabetes. Methods: Data from 10,472 adults in the National Health and (...) Nutrition Examination Survey from 2013 to 2014 and 2015 to 2016 were analyzed for associations among prediabetes/diabetes risk factors, health care use, and hemoglobin A1C levels according to chi-square tests and multivariate logistic regression. Results: A total of 7.73% of US adults had seen a dentist but not a medical provider in the past 12 mo. The composition of this subpopulation was significantly different from that who saw a medical provider, in ways that might affect their diabetes risk. In addition, 31.27% of this subpopulation would be identified as being at high risk for prediabetes according to the CDC Prediabetes Screening Test, and 15.83% had hemoglobin A1C levels indicative of undiagnosed prediabetes or diabetes. Screening in a dental setting would have the highest odds of identifying someone unaware of his or her diabetes risk among those who were non-White, obese, or ≥45 y old. Conclusion: Extrapolation from this analysis indicates that screening for prediabetes at dental visits has the potential to alert an estimated 22.36 million adults of their risk for prediabetes or diabetes. Incorporating prediabetes or diabetes risk assessment into routine dental visits may enable 1) those with prediabetes to take action to decrease their risk of developing diabetes and 2) those with diabetes to engage in treatment to decrease their risk of diabetes-related complications. Knowledge Transfer Statement: Screening for prediabetes and diabetes during dental visits has the potential to raise patients’ awareness of diabetes risk and prevent prediabetes from progressing to diabetes. For some patients, the dental visit may be the only point of contact with the health care system, which heightens the importance of including diabetes risk assessment for patient well-being. (shrink)

ABSTRACTThis research investigated whether precues engage proactive control to reduce emotional interference during speech production. A picture-word interference task required participants to name target pictures accompanied by taboo, negative, or neutral distractors. Proactive control was manipulated by presenting precues that signalled the type of distractor that would appear on the next trial. Experiment 1 included one block of trials with precues and one without, whereas Experiment 2 mixed precued and uncued trials. Consistent with previous research, picture naming was slowed in (...) both experiments when distractors were taboo or negative compared to neutral, with the greatest slowing effect when distractors were taboo. Evidence that precues engaged proactive control to reduce interference from taboo distractors was found in Experiment 1. In contrast, mixing precued trials in Experiment 2 resulted in no taboo cueing benefit. These results suggest that item-level proactive control can b... (shrink)

This essay results from a common interest in the history of emotions shared by an academic with appointments in philosophy and psychiatry (Charland) and a literary historian (White). Where our interests converge is in the early modern concept of 'the passions,' as explanatory of what we now call mental illness. The task we have set ourselves is to see how this might: (a) be exemplified in a 'case study' of the dramatic revelation of Leontes's jealousy in the first half (...) of William Shakespeare's The Winter's Tale, and his 'cure' which takes sixteen years. Both events have troubled literary critics as implausible, lacking in realistic motivation, and clumsy as narrative devices, but can be explained in terms of theories of the passions ; and (b) open up a greater, modern understanding of irrational, pathological states, their onset and termination, by using as an explanatory model the early modern understanding of passions as revived and refined in the nineteenth century by Théodule Ribot. Janus-like, this chapter faces into the past and the future (our present) via a play written in 1610 that is still performed to receptive audiences today. We hope to show that the theory can illuminate a playtext, and that the play can revivify the theory, and to contend that historical analysis can shed light on modern clinical problems. The particular historical distinction which lies at the heart of our approach derives from early modern terminology offered by Thomas Wright in his book, The Passions of the Minde in Generall (first published in 1601; corrected, enlarged and augmented in 1604), and presented in more modern fashion in the nineteenth century by Théodule Ribot, in his La Psycholgie des sentiments * We dedicate this essay to Philippa Maddern, whose inspiration has generated so much inter-disciplinary research in the history of emotions and has brought so many like-minded scholars into fertile contact—in our cases, linking Western Ontario and Western Australia. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

Analytic philosophers have been rather timid about moving beyond the relatively well defined epistemological issues and meta-ethical issues which have been the central concern of Anglo-Saxon philosophers. Yet there has always been the implicit claim that analytic tools could be extended to a much larger horizon. While there is little that is dramatic in this collection of essays, it does present some of the best contemporary Anglo-Saxon philosophers attempting to chart the logical geography of the concept of education and to (...) clear up a number of muddles that persistently cling to discussions of education. In addition to Peters, there are essays by Hamlyn, Hirst, Vesey, Dearsen, Black, Ryle, Scheffler, Oakeshott, J. P. White and Passmore.--R. J. B. (shrink)

Trust has been identified as an indicator within Social Quality theory. As an important component of social quality, trust has become increasingly important in modern society because literature suggests that trust in a number of democratic countries is declining. Modern technologies and specialties are often beyond the understanding of lay individuals and thus, the need for trusting relations between lay individuals and organizations/individuals has grown. The purpose of the study was to examine the extent to which Australians (dis)trust individuals and (...) organizations/institutions. A national postal survey was conducted with 1,044 respondents recruited using the electronic white pages directory. Findings from multivariate analyses suggest that income, age, sex, and health status are associated with trust in groups of individuals and trust in organizations/institutions. The findings highlight populations where trust needs to be (re)built. Future government policy and practice should utilize these findings as a means of facilitating social quality. (shrink)

Many clinical and psychological constructs are conceptualized to have multivariate higher-order constructs that give rise to multidimensional lower-order traits. Although recent measurement models and computing algorithms can accommodate item response data with a higher-order structure, there are few measurement models and computing techniques that can be employed in the context of complex research synthesis, such as meta-analysis of individual participant data or integrative data analysis. The current study was aimed at modeling complex item responses that can arise when underlying domain-specific, (...) lower-order traits are hierarchically related to multiple higher-order traits for individual participant data from multiple studies. We formulated a multi-group, multivariate higher-order item response theory (HO-IRT) model from a Bayesian perspective and developed a new Markov chain Monte Carlo (MCMC) algorithm to simultaneously estimate the (a) structural parameters of the first- and second-order latent traits across multiple groups and (b) item parameters of the model. Results from a simulation study support the feasibility of the MCMC algorithm. From the analysis of real data, we found that a bivariate HO-IRT model with different correlation/covariance structures for different studies fit the data best, compared to a univariate HO-IRT model or other alternate models with unreasonable assumptions (i.e., the same means and covariances across studies). Although more work is needed to further develop the method and to disseminate it, the multi-group multivariate HO-IRT model holds promise to derive a common metric for individual participant data from multiple studies in research synthesis studies for robust inference and for new discoveries. (shrink)

This book is not a study of Plato's philosophy, but a contribution to the literary interpretation of the dialogues, through analysis of their formal structure, ...

A high percent of oxidative energy metabolism is needed to support brain growth during infancy. Unhealthy diets and limited nutrition, as well as other environmental insults, can compromise these essential developmental processes. In particular, iron deficiency anemia has been found to undermine both normal brain growth and neurobehavioral development. Even moderate ID may affect neural maturation because when iron is limited, it is prioritized first to red blood cells over the brain. A primate model was used to investigate the neural (...) effects of a transient ID and if deficits would persist after iron treatment. The large size and postnatal growth of the monkey brain makes the findings relevant to the metabolic and iron needs of human infants, and initiating treatment upon diagnosis of anemia reflects clinical practice. Specifically, this analysis determined whether brain maturation would still be compromised at 1 year of age if an anemic infant was treated promptly once diagnosed. The hematology and iron status of 41 infant rhesus monkeys was screened at 2-month intervals. Fifteen became ID; 12 met clinical criteria for anemia and were administered iron dextran and B vitamins for 1–2 months. MRI scans were acquired at 1 year. The volumetric and diffusion tensor imaging measures from the ID infants were compared with monkeys who remained continuously iron sufficient. A prior history of ID was associated with smaller total brain volumes, driven primarily by significantly less total gray matter and smaller GM volumes in several cortical regions. At the macrostructual level, the effect on white matter volumes was not as overt. However, DTI analyses of WM microstructure indicated two later-maturating anterior tracts were negatively affected. The findings reaffirm the importance of iron for normal brain development. Given that brain differences were still evident even after iron treatment and following recovery of iron-dependent hematological indices, the results highlight the importance of early detection and preemptive supplementation to limit the neural consequences of ID. (shrink)

Objective:Prior research examining sexual and intimacy concerns among metastatic breast cancer patients and their intimate partners is limited. In this qualitative study, we explored MBC patients’ and partners’ experiences of sexual and intimacy-related changes and concerns, coping efforts, and information needs and intervention preferences, with a focus on identifying how the context of MBC shapes these experiences.Methods:We conducted 3 focus groups with partnered patients with MBC [N = 12; M age = 50.2; 92% White; 8% Black] and 6 interviews (...) with intimate partners [M age = 47.3; 83% White; 17% Black]. Participants were recruited through the Fox Chase Cancer Center Tumor Registry and the Cancer Support Community. Qualitative data were analyzed using the Framework Method and Dedoose software.Results:Qualitative analyses revealed several key themes reflecting ways in which MBC shapes experiences of sex/intimacy: the heavy disease/treatment burden leads to significant, long-term sexual concerns and consequent heightened emotional distress for both patients and partners ; viewing the relationship as having “an expiration date” influences patients’ and partners’ concerns related to sex/intimacy and complicates coping efforts; and information needs extend beyond managing sexual side effects to include emotional aspects of intimacy and the added strain of the life-limiting nature of the disease on the relationship. The heightened severity of sexual concerns faced by patients with MBC, compounded by the terminal nature of the disease, may place patients and partners at risk for significant adverse emotional and interpersonal consequences.Conclusion:Findings suggest unique ways in which sex and intimate relationships change after a diagnosis of metastatic breast cancer from both patients’ and partners’ perspectives. Consideration of the substantial physical and emotional burden of MBC and the broader context of the relationship and intimacy overall is important when developing a sexuality-focused intervention in this population. Addressing sexual concerns is a critical part of cancer care with important implications for patients’ health and quality of life. (shrink)

The primary goal of the peer review of research grant proposals is to evaluate their quality for the funding agency. An important secondary goal is to provide constructive feedback to applicants for their resubmissions. However, little is known about whether review feedback achieves this goal. In this paper, we present a multi-methods analysis of responses from grant applicants regarding their perceptions of the effectiveness and appropriateness of peer review feedback they received from grant submissions. Overall, 56–60% of applicants determined the (...) feedback to be appropriate, although their judgments were more favorable if their recent application was funded. Importantly, independent of funding success, women found the feedback better written than men, and more white applicants found the feedback to be fair than non-white applicants. Also, perceptions of a variety of biases were specifically reported in respondents’ feedback. Less than 40% of applicants found the feedback to be very useful in informing their research and improving grantsmanship and future submissions. Further, negative perceptions of the appropriateness of review feedback were positively correlated with more negative perceptions of feedback usefulness. Importantly, respondents suggested that highly competitive funding pay-lines and poor inter-panel reliability limited the usefulness of review feedback. Overall, these results suggest that more effort is needed to ensure that appropriate and useful feedback is provided to all applicants, bolstering the equity of the review process and likely improving the quality of resubmitted proposals. (shrink)

Is the United States "the land of equal opportunity" or is the playing field tilted in favor of those whose parents are wealthy, well educated, and white? If family background is important in getting ahead, why? And if the processes that transmit economic status from parent to child are unfair, could public policy address the problem? Unequal Chances provides new answers to these questions by leading economists, sociologists, biologists, behavioral geneticists, and philosophers.New estimates show that intergenerational inequality in the (...) United States is far greater than was previously thought. Moreover, while the inheritance of wealth and the better schooling typically enjoyed by the children of the well-to-do contribute to this process, these two standard explanations fail to explain the extent of intergenerational status transmission. The genetic inheritance of IQ is even less important. Instead, parent-offspring similarities in personality and behavior may play an important role. Race contributes to the process, and the intergenerational mobility patterns of African Americans and European Americans differ substantially.Following the editors' introduction are chapters by Greg Duncan, Ariel Kalil, Susan E. Mayer, Robin Tepper, and Monique R. Payne; Bhashkar Mazumder; David J. Harding, Christopher Jencks, Leonard M. Lopoo, and Susan E. Mayer; Anders Björklund, Markus Jäntti, and Gary Solon; Tom Hertz; John C. Loehlin; Melissa Osborne Groves; Marcus W. Feldman, Shuzhuo Li, Nan Li, Shripad Tuljapurkar, and Xiaoyi Jin; and Adam Swift. (shrink)

Despite All Critique (2014) -- World Politics and Western Reason (1980) -- The Doubled Outsides of the Modern International (2005) -- The Subject of Security (1995) -- The Protection of Nature and the Nature of Protection (2005) -- Social Movements/World Politics (1994) -- Europe is Not Where It is Supposed to Be (2000) -- They Seek it Here, They Seek it There : Looking for Politics in Clayoquot Sound (2003) -- Violence, Modernity, Silence : From Weber to International Relations (1993) (...) -- Hobbes, Origins, Limits (2011) -- War, Terror, Judgement (2002) -- International, Imperial, Exceptional (2005) -- Which Democracy for Which Demos? (2013) -- The Political Theory of Boundaries and the Boundaries of Political Theory : Interview With Raia Prokhovnik (2012). (shrink)

We are grateful for Roy T. Cook's attention to our work in his recent review of our book If A, Then B: How the World Discovered Logic. But Professor Cook leaves two misimpressions that we should like to correct. First, we have never maintained (as he phrases it) that "one's premises must be more certain than the conclusions that follow from them, ignoring the obvious logical fact that, if B logically follows from A, then B is provably at least as (...) probable as A." Instead, we assert that one must be *initially* more certain of one's premises than the conclusions that follow from them; otherwise, we contend, no argument that relies on those premises to prove such a conclusion can be rationally persuasive. On this view, one might still be equally certain of both the premises and the conclusion after being persuaded by the argument, especially in cases where the premises entail the conclusion. By analogy, Aristotle asserts in the Posterior Analytics that the premises of demonstration must be "better known" than the conclusion—meaning, in part, that the premises must be initially more convincing. But this hardly shows that Aristotle thinks that, if A is invoked to demonstrate B, then A and B can never be regarded as equally probable…. (shrink)

Real life applications and case studies -- Commmunication and computing systems -- Mobile and ubiquitous computing -- Electrical and electronics systems -- Green computing and e-waste minimizations -- Image processing and applications -- Material science & technology -- Wired and wireless networks.

The articles in this special issue of Environmental Values have a shared significance. In one way or another, all of them reflect contemporary concerns about issues of trust, risk, uncertainty, and the cultural shaping of science.These are matters of mounting significance for the politics of the environment in countries like Britain, and indeed for politics more generally, as we have seen in a succession of recent controversies. The Brent Spar oil platform farrago, the hugely costly BSE-CJD upsets, the continuing uproars (...) around genetically modified plants and foods ­ central in all of these have been challenges to the political authority of official patterns of scientifically-backed reassurance, concerning the impacts of deep and open-ended trajectories of technological transformation.To understand what is likely to be at stake in such matters for the politics of industrial democracies in the 21st century, there is now an urgent need to develop richer pictures than those currently dominant, of the cultural and epistemological architecture on which our regulatory institutions have been coming to rely. The contributions to this special issue can be pictured as building blocks in such a process.The present article offers a complementary perspective ­ one grounded in a degree of more hands-on personal experience of related matters. (shrink)

The increasing effort, both lay and academic, to encourage a transition from an “I-It” to an “I-Thou” relation to nature is located within a typology of ways of “knowing nature.” This typology provides the context for a particular understanding of human conversation which sees the relation as a cyclical process of “immersion” and “realization” from which a model of the dialectic between “I-It” and “I-Thou” relations to nature can be developed. This model can be used to identify practical measures that (...) can be taken as first steps toward a balance between these relations, both in general and in the context of science-oriented nature conservation organizations such as English Nature in Britain (formerly, the Nature Conservancy Council). (shrink)

The increasing effort, both lay and academic, to encourage a transition from an “I-It” to an “I-Thou” relation to nature is located within a typology of ways of “knowing nature.” This typology provides the context for a particular understanding of human conversation which sees the relation as a cyclical process of “immersion” and “realization” from which a model of the dialectic between “I-It” and “I-Thou” relations to nature can be developed. This model can be used to identify practical measures that (...) can be taken as first steps toward a balance between these relations, both in general and in the context of science-oriented nature conservation organizations such as English Nature in Britain. (shrink)

Transpersonal psychology: Dean, S. R. The ultraconscious mind. Arasteh, A. R. Final integration in the adult personality.--The nature of madness: First, E. Visions, voyages, and new interpretations of madness. Van Dusen, W. Hallucinations as the world of spirits.--Biofeedback: White, J. The yogi in the lab. Kiefer, D. EEG alpha feedback and subjective states of consciousness.--Meditation research: Griffith, F. F. Meditation research: its personal and social implications. Kiefer, D. Intermeditation notes: reports from inner space.--Psychic research: Honorton, C. Tracing ESP through (...) altered states of consciousness. Johnson, C. W. Unexplored areas of parapsychology.--Paraphysics: White, J. Plants, polygraphs, and paraphysics. Reiser, O. L. Messages to and from the galaxy.--Biotechnology: Beal, J. B. The new biotechnology. Tiller, W. A. Energy fields and the human body.--The neurosciences: Conway, H. Life, death, and antimatter. Floyd, K. Of time and mind: from paradox to paradigm.--Ecological consciousness: Smith, R. A. Our passport to evolutionary awareness. Esser, A. H. Synergy and social pollution in the communal imagery of mankind.--Space travel and extraterrestrial life: Mitchell, E. D. Global consciousness and the view from space. White, J. Exobiology--where science fiction meets science fact.--Death as an altered state of consciousness: Tietze, T. R. Some perspectives on survival. Noyes, R. Dying and mystical consciousness. (shrink)

To controlforceaccurately under a wide range of behavioral conditions, the central nervous system would either require a detailed, continuously updated representation of the state of each muscle (and the load against which each is acting) or else force feedback with sufficient gain to cope with variations in the properties of the muscles and loads. The evidence for force feedback with adequate gain or for an appropriate central representation is not sufficient to conclude that force is the major controlled variable in (...) normal limb movements.Morton's hypothesis, thatlengthis controlled by a follow-up servo, has a number of difficulties related to the delays, gains, variability, and specificity in feedback pathways comprising potential servo loops. However, experimental evidence is consistent with these pathways providing servo assistance for some movements produced by coactivation of α- and static γ-motoneurons. Dynamic γ-motoneurons may provide an additional input for adaptive control of different types of movements.The idea that feedback is used to compensate for changes in musclestiffnesshas received experimental support under static postural conditions. However, reflexes tend to increase rather than decrease the range of variation in muscle stiffness during some cyclic movements. Theoretical problems associated with the regulation of stiffness are also discussed. The possibilities of separate control systems forvelocityorviscosityare considered, but the evidence is either negative or lacking. I conclude that different physical variables can be controlled depending on the type of limb movement required. The concept of stiffness regulation is also useful under some conditions, but should probably be extended to the regulation of the visco-elastic properties (i.e., the mechanical impedance) of a muscle or joint. (shrink)