In recent years, the opioid crisis in the United States has sparked significant discussion on doctor–patient interactions concerning chronic pain treatments, but little to no attention has been given to investigating the vocal aspects of patient talk. This exploratory sociolinguistic study intends to fill this knowledge gap by employing prosodic discourse analysis to examine context-specific linguistic features used by the interlocutors of two distinct medical interactions. We found that patients employed both low pitch and creak as linguistic resources when describing (...) chronic pain, narrating symptoms and requesting opioids. The situational use of both features informs us about the linguistic ways in which patients frame fraught issues like chronic pain in light of the current opioid crisis. This study expands the breadth of phonetic analysis within the domain of discourse analysis, serving to illuminate discussions surrounding the illocutionary role of the lower vocal tract in expressing emotions. (shrink)

Medicine is in a very self-reflective mood. There is a revival of interest not only in medical ethics but also in medical history, the Hippocratic corpus, and various kinds of literature that indicate physicians are reexamining the foundations of medicine and what it is that gives meaning to medicine. That is, they are reexamining the physician's vocation, in the true sense of vocation as a calling. This interest has coincided with the concern of third parties such as accreditation agencies about (...) the professionalism of physicians. (shrink)

Use of presence and instant messaging applications has grown very rapidly recently, not only at home, but also at work. Early studies on the use of PIM applications in the workplace, however, indicate that PIM applications need to be adapted towards the workplace context. In our research, we explore such adaptations, towards place-based presence systems, i.e., presence systems that are not only able to answer people-oriented presence queries such as “Who is online?” next to place-oriented presence queries, such as “Who (...) is near?”. In this article, we describe a design space for place-based presence systems, in which we identify the most important aspects and options that designers of place-based presence systems need to consider. We also report on our exploratory research in this design space, comprising two cycles of designing, implementing and evaluating place-based presence prototypes. We conclude with lessons learned for future research in place-based presence systems. (shrink)

This volume presents a collection of about 80 very brief, accessible essays written by international experts from medicine, social sciences, and the humanities, ...

With the world grappling with continued spread of monkeypox internationally, vaccines play a crucial role in mitigating the harms from infection and preventing spread. However, countries with the greatest need - particularly historically endemic countries with the highest monkeypox case-fatality rates - are not able to acquire scarce vaccines. This is unjust, and requires rectification through equitable allocation of vaccines globally. We propose applying the Fair Priority Model for such allocation, which emphasizes three key principles: 1) preventing harm; 2) prioritizing (...) the disadvantaged; and 3) treating people with equal moral concern. Post-exposure prophylaxis (PEPV) has the most potential to mitigate harm, and so ensuring countries have sufficient supply for PEPV should be the first priority. And historically endemic countries, which face disadvantages that compound potential harms from monkeypox, should be the first recipients of such vaccines. Once sufficient supply is allocated for countries to apply PEPV, global allocation could move on to pre-exposure prophylaxis (PrEP), again prioritizing historically endemic countries first before distribution to the rest of the global community, based on projected number of cases and vulnerability to harm. (shrink)

Central to many issues surrounding reduction in science is the relation between a physical system and its components. In this article we examine how thermodynamic theory relates properties of whole systems to properties of their components. In order to keep the analysis general, we focus our study on universal properties like volume, heat capacity, energy and temperature. In the cases examined we find that scientific explanation requires appeal to properties of components that are spatially as extensive as the whole system. (...) We discuss some implications of our study for the purported paradigmatic reductions of heat and temperature to molecular motion. We conclude that while macro systems reduce ontologically to micro components, epistemologically the reduction of theoretical concepts in general fails. (shrink)

The evidence-based medicine movement advocates basing all medical decisions on certain types of quantitative research data and has stimulated protracted controversy and debate since its inception. Evidence-based medicine presupposes an inaccurate and deficient view of medical knowledge. Michael Polanyi’s theory of tacit knowledge both explains this deficiency and suggests remedies for it. Polanyi shows how all explicit human knowledge depends on a wealth of tacit knowledge which accrues from experience and is essential for problem solving. Edmund Pellegrino’s classic treatment of (...) clinical judgment is examined, and a Polanyian critique of this position demonstrates that tacit knowledge is necessary for understanding how clinical judgment and medical decisions involve persons. An adequate medical epistemology requires much more qualitative research relevant to the clinical encounter and medical decision making than is currently being done. This research is necessary for preventing an uncritical application of evidence-based medicine by health care managers that erodes good clinical practice. Polanyi’s epistemology shows the need for this work and provides the structural core for building an adequate and robust medical epistemology that moves beyond evidence-based medicine. (shrink)

Most clinicians take for granted a simple, reductionist understanding of medical knowledge that is at odds with how they actually practice medicine; routine medical decisions incorporate more complicated kinds of information than most standard accounts of medical reasoning suggest. A better understanding of the structure and function of knowledge in medicine can lead to practical improvements in clinical medicine. This understanding requires some familiarity with epistemology, the study of knowledge and its structure, in medicine. Michael Polanyi's theory of tacit knowing (...) is advanced as the basis for developing a more accurate understanding of medical knowledge. Tacit knowing, which explores the taken-for-granted background knowledge that underlies all human knowing, is explained in detail with a focus on its relevance for clinical medicine. The implications of recognizing tacit knowing in medicine and medical decisions are discussed. These include the ability to explain the importance of the clinical encounter in medical practice, mechanisms for analysing patient and doctor as persons, and the need for humility given the uncertainty that the tacit dimension injects into all medical decisions. This more robust medical epistemology allows clinicians to better articulate the nature and importance of patient-centred care, to avoid pitfalls inherent in reductionist approaches to medical knowledge, and to think more clearly about the relationships between medicine and health care at the individual and population levels. (shrink)

H. G. Liddell & R. Scott, A Greek-English Lexicon, rev. and aug. by Sir H. S. Jones. with the ass. of R. McKenzie, Oxford, Clarendon Press, 1940. ῥυθμός , Ion. ῥυσμός (v. infr. 111, IV), ὁ : (ῥέω) :— A. any regular recurring motion (“πᾶς ῥ. ὡρισμένῃ μετρεῖται κινήσει” Arist.Pr.882b2) : I. measured motion, time, whether in sound or motion, Democr.15c ; = ἡ τῆς κινήσεως τάξις, Pl.Lg.665a, cf. 672e ; “ὁ ῥ. ἐκ τοῦ ταχέος (...) - Études grecques et (...) latines. (shrink)

This paper explores the salient features of Chinese social and workplace values in offering an alternative to the established Western approach to the notion and practice of organizational devel opment. The authors argue that the emphasis of the Chinese traditional values on trust, fidelity, altruism and unspecified obligations of reciprocity norms is an important source of strategic advantage which gives a Chinese firm its resilience and flexibility to cope with change. The paper thus goes on to examine the cultural disposition (...) of the Chinese mentality as it applies in the context of such East Asian economies as Mainland China, Taiwan and Hong Kong for the organization of the workplace and its 'reformation'. With the help of organizational data the authors trace out a corporate approach to 'national harmony' in the Confucian domain in the big Chinese enterprises. The paper also reflects on the organizational practices in the small Chinese firms and explores the 'nexus' of informality and personalized trust in these firms. Finally, the authors contend that the propensities of the Chinese communities to transfer the features of traditional governance within the family milieu to the domain of business organizations have instigated a Western academic consciousness to search for Oriental inspiration in order to overcome the sterility of their post-industrial syndrome. (shrink)

The difficulty is serious, and unless we find a satisfactory solution we must admit that Descartes' thought moves in a vicious circle, or that the ideas, the building blocks of his philosophy, contain incompatible elements inasmuch as they appear both as self-sufficient and as dependent on extrinsic support. The problem of the cartesian circle, as it is customarily called, is therefore more than a special difficulty and would seem to warrant a careful re-examination in the light of recent contributions to (...) the study of Descartes' philosophy. (shrink)

The assignment of this pseudo-explanatory function in a supernatural realm, beyond the pale of any kind of verification, seems, however, of dubious value and can hardly be said to do justice to the power and subtlety of Plato's myths. For it would not raise them appreciably above the level of the whimsical products of an artist's imagination, designed to please or to relieve the mind after a strenuous intellectual exercise, rather than to uncover significant philosophic truths.