RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

Darwinian Evolution and Classical Liberalism brings together a collection of new essays that examine the multifaceted ferment between Darwinian biology and classical liberalism.

There is what might be called a ‘majority position’ in the history of Western philosophy according to which causes are sufficient for or ‘necessitate’ their effects. However, there is also a singificant ‘minority position’ according to which causes are necessary relative to their effects. The second/third century A.D. Peripatetic Alexander of Aphrodisias is an ancient representative of the minority position. He attributes his own view — with some justification, I shall suggest – to Aristotle. This paper has two, somewhat loosely (...) connected purposes. The first is to explore the origin of the conception of ‘causes’ as necessary conditions in Aristotle, particularly in On Generation and Corruption 2.11 and Posterior Analytics 2.12, and the development and use of the conception in Alexander's De fato. The second purpose of the paper is to explore and criticize a sophisticated contemporary version of the conception of causes as ‘necessary in the circumstances,’ that of J.L. Mackie. (shrink)

There is what might be called a ‘majority position’ in the history of Western philosophy according to which causes are sufficient for or ‘necessitate’ their effects. However, there is also a singificant ‘minority position’ according to which causes are necessary relative to their effects. The second/third century A.D. Peripatetic Alexander of Aphrodisias is an ancient representative of the minority position. He attributes his own view — with some justification, I shall suggest – to Aristotle. This paper has two, somewhat loosely (...) connected purposes. The first is to explore the origin of the conception of ‘causes’ as necessary conditions in Aristotle, particularly in On Generation and Corruption 2.11 and Posterior Analytics 2.12, and the development and use of the conception in Alexander's De fato. The second purpose of the paper is to explore and criticize a sophisticated contemporary version of the conception of causes as ‘necessary in the circumstances,’ that of J.L. Mackie. (shrink)

SummaryThis paper develops a semantical account of sentences containing performative principal verbs in which these verbs are analyzed as indexical expressions: the proposition picked out by a sentence containing a performative verb depends on aspects of the context of use of the sentence; and these same aspects of context of use also determine the truth value of the proposition picked out. A two‐dimensional modal operator is utilized in analyzing non‐ performative sentences that contain principal verb which, in other contexts, have (...) performative uses. Thus, the analysis developed accounts for the performative — non‐performative distinction within a formal semantic‐pragmatic framework; the more common approach of relegating the distinction to the somewhat vague realm of ‘language use’ is avoided.RésuméCet article développe un traitement sémantique des phrases contenant un verbe principal performatif. Ces verbes sont analysés comme des expressions indicées: la proposition sélectionnée par une phrase contenant un verbe performatif dépend du contexte d'usage de cette phrase; et ces mêmes aspects du contexte d'usage déterminent également la valeur de vérité de la proposition sélectionnée. Un opérateur modal à deux dimensions est utilisé pour l'analyse de phrases non‐performatives contenant un verbe principal performatif dans d'autres contextes. L'analyse développée rend ainsi compte de la distinction performatif — non‐performatif dans un cadre sémantico‐pragmatique; on évite ainsi la solution habituelle consistant à reléguer cette distinction dans le domaine plutôt vague de l'usage linguistique.ZusammenfassungEs wird eine semantische Darstellung von Sätzen entwickelt, die performative Hauptverben enthalten, indem diese Verben als indexikale Ausdrücke analysiert werden: die Proposition, die durch einen Satz mit einem performativen Verb bezeichnet wird, hängt von Aspekten des Gebrauchskontextes des Satzes ab; und gerade diese Aspekte bestimmen auch den Wahrheitswert der Proposition. Ein zweidimensionaler Modaloperator wird verwendet, um nicht‐performative Sätze zu analysieren, die Hauptverben enthalten, welche — in andern Kontexten — einen performativen Gebrauch haben. Auf diese Weise gibt die entwickelte Analyse innerhalb eines formalen semantisch‐syntaktischen Rahmenwerkes Rechenschaft über die Unterscheidung performativ — nicht‐performativ; man vermeidet dadurch das übliche Vorgehen, die Unterscheidung in den etwas vagen Bereich des sog. 〈Sprachgebrauchs〉 abzuschieben. (shrink)

IntroductionResilience is a factor in how youth respond to adversity. The 88-item Adolescent Resilience Questionnaire is a comprehensive, multi-dimensional self-report measure of resilience developed with Australian youth.MethodsUsing a cross-sectional adolescent population, confirmatory factor analysis was conducted to replicate the original factor structure. Over half of the adolescents were non-white and 9th graders with a mean age of 15.5.ResultsOur exploratory factor analysis shortened the measure for which we conducted the psychometric analyses. The original factor structure was not replicated. The exploratory (...) factor analysis provided a 49-item measure. Internal consistency reliability for all 12 factors ranged from acceptable. The revised factor total scores were highly and significantly correlated with item–total correlation coefficients.ConclusionThis revised shorter 49-item version of the Adolescent Resilience Questionnaire could be deployed and has acceptable psychometric properties. (shrink)

A large number of cellular proteins bind ATP, frequently utilizing the free energy of ATP hydrolysis to drive specific biological reactions. Recently, a family of closely related ATP‐binding proteins has been identified, the members of which share considerable sequence identity. These proteins, from both prokaryotic and eukaryotic sources, presumably had a common evolutionary origin and include the product of the white locus of Drosophila, the P‐glycoprotein which confers multidrug resistance on mammalian tumours, and prokaryotic proteins associated with such diverse (...) processes as membrane transport, cell division, nodulation and DNA repair. A comparison of these various proteins provides valuable insights into the function and evolution of the multicomponent systems with which they are associated. (shrink)

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)

It is often argued that belief is partly constituted by a norm of truth. Most recent discussions have assumed that the norm is deontic concerning what may or ought to be believed. I criticize two proposals, one canvassed by Krister Bykvist and Anandi Hattiangadi, and the other defended by Daniel Whiting. Instead, I argue in favour of an evaluative norm, according to which we would do well to believe the truth. I show that an evaluative norm fares better than its (...) deontic competitors with respect to the demandingness of truth, the aim of truth, and epistemic blame. -/- On soutient souvent que la croyance est en partie constituée par une norme de vérité. La plupart des discussions récentes ont supposé que la norme est déontique concernant ce qui peut ou doit être cru. Je critique deux propositions, l’une mise de l’avant par Krister Bykvist et Anandi Hattiangadi, et l’autre défendue par Daniel Whiting. Je plaide plutôt en faveur d’une norme évaluative selon laquelle nous ferions bien de croire la vérité. Je montre qu’une norme évaluative réussit mieux que ses concurrentes déontiques en ce qui a trait au caractère exigeant de la vérité, au but de la vérité et au blâme épistémique. (shrink)

Readers of C.L.R. James are familiar with the thinker’s careful reading of Melville’s Moby-Dick in his text Mariners, Renegades, and Castaways. In that work James proposes that Melville exposes the foundations of societal level fascism as exemplified by the monomaniacal purpose of Ahab. The purpose of this effort is to push further into the concept of societal division as exemplified by Moby-Dick by proposing that Melville is taking on the discourse of color (black vs. white) and its relationship to (...) ontological value (bad vs. good) by imploding the internal logic of Plato’s Phaedrus. What concerns this project is the relationship between the phenotypic “blackness” of the characters of African descent in Moby-Dick and ways in which Melville endeavors to destabilize skin color in the western imaginary as a means to correct the negative consequences of this flattening of the hierarchical nature of society on the part of Ahab. (shrink)

__Adolescents at Schoo_l brings together the perspectives of scholars, educators, and researchers to address the many issues that affect adolescents’ emerging identities, especially in relation to students’ experience of and engagement with school._ The book offers current and preservice teachers a practical understanding of the concept of identity development, particularly as impacted by such factors as race, ethnicity, gender, sexual orientation, ability/disability, immigration, and social class. This third edition includes new chapters on boys’ emotional lives, risk and resilience in girls, (...) the experiences of undocumented immigrant students, Muslim-American youth, and income inequality; features on “teaching while white”; and an extensively updated chapter on LGBTQ+ students. The book expands on the strengths and insights of the previous editions while also touching on issues highly relevant to contemporary youth such as social media, youth activism, and immigration. A practical and insightful volume, _Adolescents at School_ points to ways to foster the success of every student in our schools and classrooms. (shrink)

While logical principles seem timeless, placeless, and eternal, their discovery is a story of personal accidents, political tragedies, and broad social change. If A, Then B begins with logic's emergence twenty-three centuries ago and tracks its expansion as a discipline ever since. -/- The book treats logic as more than a tale of individual abstraction; it sees logic as also being a result of politics, economics, technology, and geography, because all these factors helped to generate an audience for the discipline (...) from the start. The book thus relates developments in logical theory to the social history of different historical periods. -/- The book defends a number of controversial philosophical theses: (1) that rationally persuasive arguments must always proceed from premises that are initially more convincing than the conclusions to be proved (a position derived from Aristotle), (2) that intuitive logical judgments, though sometimes mistaken, can also count as certain knowledge, independent of the techniques used to construct formal logical systems, (3) that Wittgenstein was mistaken in thinking that philosophy was riddled with unintelligible language and that the real problems, instead, have been ambiguity and pretentious diction, and (4) that Nelson Goodman's argument to the effect that deductive logic can be "virtuously circular" is founded on a non sequitur. -/- . (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)

Professor Girle suggests that the ancient Athenian interest in Aristotle’s syllogistic flowed from a preoccupation with debate in the form of a dialogue game. But other cultures, especially in India, also had a preoccupation with debate that could be characterized in the same way. This kind of explanation seems to us to ignore the elephant in the room: the fact that, in ancient Athens, dialogue and debate were not merely a game. They were the life and death of the state. (...) Many Athenians felt that foolish policies had cost the state dearly, especially during the Peloponnesian War, and many of them blamed those policies on shoddy political reasoning in the Assembly. (Plato hammers at this theme relentlessly.) And tellingly, it is only in the wake of such tragedies that Aristotle’s syllogistic finally emerged. We think that any credible explanation of the ancient Greek interest in formal logic needs to include this grim political reality. (shrink)

Why do logical truths exist at all, and how can our belief in them be justified? In an earlier article we contended that at least some aspects of logic must always be assumed, without argument, and that ‘logic is a horizon beyond which none of our earnest and self-reflecting arguments can help us see’. We also contended that logical truths are independent of physical facts, of social rules, and of the anatomical features of our brains. Nevertheless, in a further article (...) in this volume, Jeremiah Joven Joaquin and Jose Emmanuel Agregado have challenged our view. We respond to their criticisms.Export citation. (shrink)

This book presents a series of informal biographies about major figures in the history of psychology. A unique combination of expertise and human appeal, the volume places the contributions of each pioneer in a new and fascinating perspective. For instance, several of the authors use the novel approach of having the pioneers return to the present day to reflect back on their work as it relates to the here and now. Revisions of speeches given in a popular series of invited (...) addresses at psychological conventions, the chapters offer appealing glimpses into the lives of individuals who made a difference in the early years of psychology as a field of study. Each of the five volumes in this series contains different profiles thereby bringing more than 100 of the pioneers in psychology more vividly to life. (shrink)

The luminaries of late thirteenth-century Europe took great interest in the mysterious fifth-century author known as Dionysius the Areopagite. They typically read Dionysius not in the original Greek, but in a Latin edition prepared sometime in the middle of the thirteenth century. This edition, which appeared first in Paris and later circulated all over Western Europe, was no mere translation. In addition to the famous translation made by Eriugena in the ninth century, it contained translations of scholia on the Dionysian (...) texts made by Anastasius the Librarian, alternative readings provided by Anastasius and other Latin readers, as well as excerpts from Eriugena's own theological masterwork, the Periphyseon. University scholars such as Albert the Great and Thomas Aquinas thus learned Dionysian mystical theology not only from his text, but from the seven-hundred year interpretive tradition that literally surrounded it on the page. (shrink)

The medieval fascination with the mysterious language of Dionysius the Areopagite is nowhere more evident than in the thirteenth-century textbook edition of his treatise on liturgical rites. Dionysius employed unfamiliar Greek to describe people, actions, and texts that would have been perfectly familiar to his readers. The Latin translation used in the thirteenth-century textbook strives to preserve this unfamiliarity, but commentaries are introduced between its lines and paragraphs, disrupting its ability to bewilder and surprise. These commentaries make the Dionysian text (...) less mysterious, while also slightly altering its meaning. In the hands of the commentators, Dionysius becomes less interested in the aesthetic mystery of the liturgy, and more interested in credal orthodoxy. To read text and commentary together is to confront seven hundred years of competing voices speaking on the nature and purpose of the Christian church. (shrink)

The Dionysian corpus makes virtually no statement about the authority of kings or the structure of nations, but it has nevertheless repeatedly been the subjectof political analysis. Several scholars have recently sketched out a Dionysian politics by drawing analogies between the Dionysian church and the city, and between the Dionysian bishop and the emperor. These analogies are of limited usefulness. They show that Dionysius does employ Platonic political language to describe the ecclesiastical hierarchy, but they risk overlooking or downplaying the (...) hierarchy’s non-temporal, and therefore non-political, activity. A more fruitful ground for developing a Dionysian politics may be found in his brief discussion of the legal hierarchy, which provides practical instruction for action in the temporal realm without direct reference to the contemplative activity of the church. (shrink)

The twentieth century discovered the concept of sacred place largely through the work of Martin Heidegger and Mircea Eliade. Their writings on sacred place respond to the modern manipulation of nature and secularization of space, and so may seem distinctively postmodern, but their work has an important and unacknowledged precedent in the Neoplatonism of Late Antiquity and the early Middle Ages. Sacred Place in Early Medieval Neoplatonism traces the appearance and development of sacred place in the writings of Neoplatonists from (...) the third to ninth centuries, and sets them in the context of present-day debates over place and the sacred. (shrink)

Apparently alone among medieval Christians, Eriugena argues that all life is immortal. He relies on Plato’s Timaeus as his primary source for this claim, but he modifies the argument of the Timaeus considerably. He turns Plato’s cosmic soul into the genus of life, thereby taking a treatise that originally dealt with cosmology and using it to explore the ontological significance of definition. All species that fall under the genus of life must be immortal, because a mortal species would contradict the (...) genus. No later medieval author would take up Eriugena’s arguments explicitly, although Aquinas comes close. The two thirteenth-century thinkers to address universal immortality seriously—Aquinas and Bonaventure—argue against it, but they are more faithful than Eriugena himself to a literal reading of the Timaeus. (shrink)

The knowability paradox threatens metaphysical or semantical antirealism, the view that truth is epistemic, by revealing an awful consequence of the claim [i] that all truths are knowable. Various attempts have been made to find a way out of the paradox.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Clement of AlexandriaL. Michael HarringtonEric Osborn. Clement of Alexandria. Cambridge-New York: Cambridge University Press, 2005. Pp. xviii + 324. Cloth, $85.00.With Clement of Alexandria, Eric Osborn returns to the subject of his 1957 book, The Philosophy of Clement of Alexandria, but its style and themes more closely resemble his more recent studies of second-century Christian thinkers: Tertullian, First Theologian of the West (Cambridge, 1997) and Irenaeus of (...) Lyons (Cambridge, 2001). Osborn's Clement, Tertullian, and Irenaeus are bound together by more than the century in which they happened to live. They share an optimism—a confidence that the world is finally comprehensible—and an argumentative theology, developed in response to the Gnostics, who, Osborn says in his book on Irenaeus, "were strong on picture and myth but weak on argument" (xiii).Osborn's approach to Clement is, as he describes it, analytic or problematic, meaning that "we simply ask what problems forced Clement to write and where he found Christian teaching in need of elucidation" (xii-xiii). Three problems concern Clement: (1) "how can the narrative of the kerygma (what God does) be translated into a metaphysic (who God is)?"; (2) "how two distinct beings, father and son, constitute one God"; and (3) "an answer had to be found for those who divided faith and knowledge." Each problem is addressed by means of a theme—divine economy for the first, reciprocity for the second, and salvation by faith for the third—and each of the book's three major parts devotes itself to one of these themes.Having laid out this systematic division, Osborn generally follows the logic of Clement's own thought rather than an imposed structure, developing his argument by careful collation and paraphrase. As a result, by the end of the book, the reader will feel thoroughly and effortlessly initiated in Clement's major works: the Protrepticus, the Paedagogus, and the Stromateis. The book thus serves as a thorough introduction to Clement, without aiming so low that it is of no interest to the scholar.Osborn's central argument unfolds from his observation that "Clement, more than any other early Christian writer, knew and enjoyed Greek philosophy and literature" (2). Clement defends the rationality shared between Christians and Greeks against the irrationalists of his time: the theosophers, or Gnostics (215). Osborn, in turn, defends Clement against the irrationalists of our own time, represented in his book by Wolfhart Pannenberg. The "divine irrational freedom" praised by Pannenberg is replaced in Osborn's Irenaeus and Clement by "universal wisdom" (47). The universality of wisdom allows great and dispassionate natures to reach the truth—whether they are Christians or Greeks—though each is like one limb of the truth, severed from the rest. Convinced that Christ will reunite these disiecta membra, "Clement converses with them and joins their broken lights" (104).In footnotes and parenthetical references throughout the book, Osborn argues against the approaches to Clement in doxography and Discourse Power theory, precisely because they are unable to treat him as a philosopher (79). The doxographer can show Clement's dependence on earlier philosophers, but is unable to see how he differs from them (xii). The Discourse Power theorist can see that Clement's system differs from the Gnostic system, but is able to explain the difference only as a competition between two social structures, without seeing that only one of them aspires to logical coherence (215).This dismissal of doxography and Discourse Power theory may strike the reader as too thoroughgoing, especially if we distinguish, as Osborn himself does in his book on Tertullian, philosophy as "a matter of system and speculation" from philosophy as "a matter of argument" (198). Clement's optimism depends on his confidence in system and speculation, in so far as they can be defended by argument. But if argument can defend two different systems equally well, then we may wonder why Clement chooses the system he does. Here the doxographer, who can show the provenance of his thought, becomes essential, as does the Discourse Power theorist, who can set Clement's choice of system in the context of the contemporary social fabric that inevitably affects even the... (shrink)

However, other leading philosophers of the era--such as David Hume, Adam Smith, and J.G. Herder--placed greater emphasis on feeling, seeing moral and political ...

This article is concerned with developing a philosophical approach to a number of significant changes to academic publishing, and specifically the global journal knowledge system wrought by a range of new digital technologies that herald the third age of the journal as an electronic, interactive and mixed-media form of scientific communication. The paper emerges from an Editors' Collective, a small New Zealand-based organisation comprised of editors and reviewers of academic journals mostly in the fields of education and philosophy. The paper (...) is the result of a collective writing process. (shrink)

This book is a translation of a key commentary on the Book of Changes, or Yijing, perhaps the most broadly influential text of classical China. The Yijing first appeared as a divination text in Zhou-dynasty China and later became a work of cosmology, philosophy, and political theory as commentators supplied it with new meanings. While many English translations of the Yijing itself exist, none are paired with a historical commentary as thorough and methodical as that written by the Confucian scholar (...) Cheng Yi, who turned the original text into a coherent work of political theory. (shrink)

This publication features the stories and experiences of pharmacy professionals who identify as members of historically underrepresented groups. This collection of personal essays presents significant events in the lives of those in the pharmacy community whose experiences have been shaped by their race, ethnicity, gender or gender presentation, sexual orientation, ability, language, mental health, or other factors. The perspectives from the narratives highlight the importance of diversity, equity, and inclusion in the healthcare sector. The authors of the narratives also reflect (...) on their experience to consider what they wish would have happened in the experience, to offer advice for others that may be faced with similar situations. Access to these stories will deepen the collective understanding among pharmacy colleagues, patients, and society of the experiences that individuals from historically underrepresented groups within pharmacy have experienced. (shrink)

Michael L. Morgan is Emeritus Chancellor Professor at Indiana University and the Grafstein Visiting Chair in Jewish Philosophy at the University of Toronto. He has written extensively on ancient Greek philosophy, modern Jewish philosophy, and post-Holocaust theology and ethics.

This book provides a clear and helpful overview of the philosophical core of the thought of Emmanuel Levinas, one of the most significant and interesting philosophers of the late twentieth century.