A deep investigation of proprioceptive processes is necessary to understand the relationship between sensory afferent inputs and motor outcomes. In this work, we investigate whether and how perception of wrist position is influenced by the direction along which the movement occurs. Most previous studies have tested Joint Position Sense through 1 degree of freedom wrist movements, such as flexion/extension or radial/ulnar deviation. However, the wrist joint has 3-DoF and many activities of daily living produce combined movements, requiring at least 2-DoF (...) wrist coordination. For this reason, in this study, target positions involved movement directions that combined wrist flexion or extension with radial or ulnar deviation. The chosen task was a robot-aided Joint Position Matching, in which blindfolded participants actively reproduced a previously passively assumed target joint configuration. The JPM performance of 20 healthy participants was quantified through measures of accuracy and precision, in terms of both perceived target direction and distance along each direction of movement. Twelve different directions of movement were selected and both hands tested. The left and right hand led to comparable results, both target extents and directions were differently perceived according to the target direction on the FE/RUD space. Moreover, during 2-DoF combined movements, subjects’ perception of directions was impaired when compared to 1-DoF target movements. In summary, our results showed that human perception of wrist position on the FE/RUD space is symmetric between hands but not isotropic among movement directions. (shrink)

BackgroundDespite consensus about the importance of implementing shared decision-making (SDM) in clinical practice, this ideal is inconsistently enacted today. Evidence shows that SDM practices differ in the degree of involvement of patients or family members, or in the amount of medical information disclosed to patients in order to “share” meaningfully in treatment decisions. Little is known on which representations and moral justifications physicians hold when realizing SDM. This study explored physicians’ experiences of SDM in the management of paediatric patients with (...) prolonged disorders of consciousness (PDOC). Specifically, we focused on physicians’ SDM approaches, representations, and ethical justifications for engaging in SDM.MethodsWe used a qualitative approach to explore the SDM experiences of 13 ICU physicians, paediatricians, and neurologists based in Switzerland who have been or were involved in the care of paediatric patients living with PDOC. A semi-structured interview format was used and interviews were audio-recorded and transcribed. Data were analysed through thematic analysis.ResultsWe found that participants followed three main decision-making approaches: the “brakes” approach, characterized by maximized family’s decisional freedom, though conditional to physician’s judgment regarding the medical appropriateness of a treatment; the “orchestra director” approach, characterized by a multi-step decision-making process led by the main physician aimed at eliciting the voices of the care team members and of the family; and the “sunbeams” approach, characterized by a process oriented to reach consensus with family members through dialogue, where the virtues of the physician are key to guide the process. We also found that participants differed in the moral justifications sustaining each approach, citing the duty to respect parental autonomy, to invest in an ethics of care, and to employ physicians’ virtues to guide the decision-making process.ConclusionOur results show that physicians come to perform SDM in different ways, with several representations, and distinct ethical justifications. SDM training among health care providers should clarify the ductility of SDM and the several ethical motivations underpinning it, rather than insisting on the principle of respect for patient’s autonomy as its only moral foundation. (shrink)

Referenciado na Análise Institucional do Discurso, o estudo investigou os sentidos atribuídos ao "ser alguém na vida" no discurso de estudantes do ensino médio de uma escola pública do litoral paranaense. Realizaram-se entrevistas, cuja análise buscou delinear os modos de produção de subjetividade, ..

An examination of verbal hallucinations and thought insertion as examples of "alienated self-consciousness.".

Can you draw a clear line through American history from the Puritans to the "Nones" of today? On the surface, there is not much connective tissue between the former, who often serve as shorthand for a persistent religious fanaticism in the United States, and the almost one quarter of the population who now regularly check the "None" or "None of the above" box when responding to surveys of religious preference. But instead of seeing a disconnect between these two groups separated (...) by time, historian Catherine Albanese insists there is a deep connection that spans the centuries. With a targeted romp through American history from the seventeenth century to the present, Albanese ties together these seemingly disparate groups through a shared and distinctively American preoccupation with delight and desire. Albanese begins our journey with the role of delight and desire in the brand of Calvinism championed by renowned Puritan minister Cotton Mather and later Jonathan Edwards. She then traces the development of these themes up through the present, treating the reader to revelatory readings of Ralph Waldo Emerson, Horace Bushnell, Andrew Jackson Davis, William James, Emma Curtis Hopkins, Elizabeth Towne, and others, revealing the contours of an evolving theology of desire. The result is an original and entertaining take on an underexamined through line in American history. (shrink)

This study began with some questions about the saying and doings of a group of Transcendentalists in nineteenth-century New England. Renowned for their role in the creation of a distinctively philosophical thought, the Transcendentalists have long been regarded in twentieth-century scholarship as a major movement in American culture... Recently, they have become heroes for a generation concerned with ecological problems and seeking new models for respect toward the land and the environment.

In six compelling chapters, this book recounts conversations that discuss what is ethical, why it does not occur more often, and how can we improve ethical conduct in our personal and public lives. The conversations include Knowing Ethical Principles, Learning How to Apply Principles in Practice, Moral Reminders, Accountability for Conduct, Addressing Structural Problems, and Ethical Vigilance. Major ethical perspectives are discussed in conversational format, as are fascinating ethical dilemmas taken from actual cases to evaluate and improve our ability to (...) identify ethical principles and make decisions that reflect concerns beyond self-interest. (shrink)

Hume's Reception in Early America: Expanded Edition brings together the original American responses to one of Britain's greatest men of letters, David Hume. Now available as a single volume paperback, this new edition includes updated further readings suggestions and dozens of additional primary sources gathered together in a completely new concluding section. From complete pamphlets and booklets, to poems, reviews, and letters, to extracts from newspapers, religious magazines and literary and political journals, this book's contents come from a wide variety (...) of sources published in colonial America and the early United States between 1758 and 1850. As well as classics by Thomas Jefferson, John Adams and Alexander Hamilton, it contains scores of unknown and hard-to-locate items, many of which have not been reprinted since their original publication. These responses are divided into four parts covering Hume's Essays; his Philosophical Writings; his History of England; and his Character and Death. Each of those parts has a separate introductory essay, and every selection is introduced by a short headnote that sets the piece in its historical context and provides bibliographical references. Packed with new insights into Hume and American thought and culture, Hume's Reception in Early America reveals the relevance and impact of Hume on American political, philosophical, historical, religious, and aesthetic debates. (shrink)

Abstract Context: Established in 1997, Summa Health System’s Medical Ethics Committee (EC) serves as an educational, supportive, and consultative resource to patients/families and providers, and serves to analyze, clarify, and ameliorate dilemmas in clinical care. In 2009 the EC conducted its 100th consult. In 2002 a Palliative Care Consult Service (PCCS) was established to provide supportive services for patients/families facing advanced illness; enhance clinical decision-making during crisis; and improve pain/symptom management. How these services affect one another has thus far been (...) unclear. Objectives: This study describes EC consults: types, reasons, recommendations and utilization, and investigates the impact the PCCS may have on EC consult requests or recommendations. Methods: Retrospective reviews of 100 EC records explored trends and changes in types of consults, reasons for consults, and EC recommendations and utilization. Results: There were 50 EC consults each in the 6 years pre- and post-PCCS. Differences found include: (1) a decrease in number of reasons for consult requests (133–62); (2) changes in top two reasons for EC consult requests from ‘Family opposed to withdrawing life-sustaining treatment (LST)’ and ‘Patient capacity in question’ to ‘Futility’ and ‘Physician opposed to providing LST’; (3) changes in top two recommendations given by the EC from ‘Emotional Support for Patient/Family’ and ‘Initiate DNR Order’ to ‘Comfort Care’ and ‘Withdraw Treatment.’ Overall, 88% of recommendations were followed. Conclusion: PCCS availability and growth throughout the hospital may have influenced EC consult requests. EC consults regarding family opposition to withdrawing LST and EC recommendations for patient/family support declined. Content Type Journal Article Pages 1-16 DOI 10.1007/s10730-011-9170-9 Authors Jessica Richmond Moeller, Department of Psychiatry and Behavioral Sciences, Akron General Medical Center, 400 Wabash Ave, Akron, OH 44307, USA Teresa H. Albanese, Health Services Research and Education Institute, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Kimberly Garchar, Kent State University, 6000 Frank Ave., N.W, North Canton, OH 44720, USA Julie M. Aultman, Department of Family and Community Medicine, Northeast Ohio Medical University, P.O. Box 95, Rootstown, OH 44272, USA Steven Radwany, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Dean Frate, Internal Medicine, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737. (shrink)

Biological evolution is a complex blend of ever changing structural stability, variability and emergence of new phe- notypes, niches, ecosystems. We wish to argue that the evo- lution of life marks the end of a physics world view of law entailed dynamics. Our considerations depend upon dis- cussing the variability of the very ”contexts of life”: the in- teractions between organisms, biological niches and ecosys- tems. These are ever changing, intrinsically indeterminate and even unprestatable: we do not know ahead of (...) time the ”niches” which constitute the boundary conditions on selec- tion. More generally, by the mathematical unprestatability of the ”phase space”, no laws of mo- tion can be formulated for evolution. We call this radical emergence, from life to life. The purpose of this paper is the integration of variation and diversity in a sound concep- tual frame and situate unpredictability at a novel theoretical level, that of the very phase space. Our argument will be carried on in close comparisons with physics and the mathematical constructions of phase spaces in that discipline. The role of symmetries as invariant preserving transformations will allow us to under- stand the nature of physical phase spaces and to stress the differences required for a sound biological theoretizing. In this frame, we discuss the novel notion of ”enablement”. Life lives in a web of enablement and radical emergence. This will restrict causal analyses to differential cases. Mutations or other causal differ- ences will allow us to stress that ”non conservation princi- ples” are at the core of evolution, in contrast to physical dynamics, largely based on conservation principles as sym- metries. Critical transitions, the main locus of symmetry changes in physics, will be discussed, and lead to ”extended criticality” as a conceptual frame for a better understanding of the living state of matter. (shrink)

Editor James Fetzer presents an analytical and historical introduction and a comprehensive bibliography together with selections of many of Carl G. Hempel's most important studies to give students and scholars an ideal opportunity to appreciate the enduring contributions of one of the most influential philosophers of science of the 20th century.

One of Hume's most well-known works and a masterpiece of philosophy, A Treatise of Human Nature is indubitably worth taking the time to read.

Lycan not only uses the numerous arguments against materialism, and functionalist theories of mind in particular, to gain a more detailed positive view of the ..

This is a welcome reprint of a book that continues to grow in importance.

Throughout his career, Schelling assigns knowledge of the absolute first principle of philosophy to intellectual intuition. Schelling's doctrine of intellectual intuition raises two important questions for interpreters. First, given that his doctrine undergoes several changes before and after his identity philosophy, to what extent can he be said to “hold onto” the same “sense” of it by the 1830s, as he claims? Second, given that his doctrine of intellectual intuition restricts absolute idealism to what he calls a “science of reason”, (...) which he says cannot prove the absolute’s existence, what other doctrine does he require in order to prove this? I will answer these questions by tracing the shifts in Schelling’s doctrine of intellectual intuition from the 1790s to the 1830s and drawing out its evolving methodological role within his science of intelligibility. (shrink)