A 35-year-old woman presents to the hospital after a fall at home. A routine medical history and physical examination reveal that the patient identifies as intersex, and an X-ray of the left hip demonstrates profound osteopenia. The patient is admitted to the hospitalist service for further evaluation. What does it mean to identify as intersex? In the medical world, “intersex” is usually referred to as DSD, or “disorders of sex development.” Until the 1990s, physicians referred to this condition as hermaphroditism, (...) but this label is no longer used because it evokes mythical creatures rather than real human beings. Even the DSD label is controversial, and the patient in our case study does not think... (shrink)

Rare copy number variants have a prominent role in the aetiology of schizophrenia and other neuropsychiatric disorders. Substantial risk for schizophrenia is conferred by large CNVs at several loci, including microdeletions at 1q21.1, 3q29, 15q13.3 and 22q11.2 and microduplication at 16p11.2. However, these CNVs collectively account for a small fraction of cases, and the relevant genes and neurobiological mechanisms are not well understood. Here we performed a large two-stage genome-wide scan of rare CNVs and report the significant association of copy (...) number gains at chromosome 7q36.3 with schizophrenia. Microduplications with variable breakpoints occurred within a 362-kilobase region and were detected in 29 of 8,290 patients versus 2 of 7,431 controls in the combined sample. All duplications overlapped or were located within 89 kilobases upstream of the vasoactive intestinal peptide receptor gene VIPR2. VIPR2 transcription and cyclic-AMP signalling were significantly increased in cultured lymphocytes from patients with microduplications of 7q36.3. These findings implicate altered vasoactive intestinal peptide signalling in the pathogenesis of schizophrenia and indicate the VPAC2 receptor as a potential target for the development of new antipsychotic drugs. © 2011 Macmillan Publishers Limited. All rights reserved. (shrink)

Once there were brook trout in the streams in the mountains. You could see them standing in the amber current where the white edges of their fins wimpled softly in the flow. They smelled of moss in your hand. Polished and muscular and torsional. On their backs were vermiculate patterns that were maps of the world in its becoming. Maps and mazes. Of a thing which could not be put back. Not be made right again. In the deep glens where (...) they lived all things were older than man and they hummed of mystery.Cormac McCarthy, The Road. (shrink)

A 28-year-old female-to-male transgender patient presents to the emergency room with one day of pleuritic chest pain and shortness of breath. The patient is found to have an acute pulmonary embolus and is admitted is to the academic hospitalist teaching service for further management.The transgender population is diverse in gender identity, expression, and sexual orientation. Although estimates vary, one study suggests that 0.3% of adults identify as transgender. The U.S. National Transgender Discrimination Survey revealed that 28% of transgender adults have (...) experienced harassment in medical settings, 19% reported being refused care, and 28% postponed care because of discrimination... (shrink)

Preparing the Next Generation of Oral Historians is an invaluable resource to educators seeking to bring history alive for students at all levels. Filled with insightful reflections on teaching oral history, it offers practical suggestions for educators seeking to create curricula, engage students, gather community support, and meet educational standards. By the close of the book, readers will be able to successfully incorporate oral history projects in their own classrooms.

Translating ethical theories into clinical practice presents a perennial challenge to educators. While many suggestions have been put forth to bridge the theory-practice gap, none have sufficiently remedied the problem. We believe the ascendance of hospital medicine, as a dominant new force in medical education and patient care, presents a unique opportunity that could redefine the way clinical ethics is taught. The field of hospital medicine in the United States is comprised of more than 50,000 hospitalists—specialists in inpatient medicine—representing the (...) fastest growing subspecialty in the history of medicine, and its members have emerged as a dominant new force around which medical education and patient care pivot. This evolution in medical education presents a unique opportunity for the clinical ethics community. Through their proximity to patients and trainees, hospitalists have the potential to teach medical ethics in real time on the wards, but most hospitalists have not received formal training in clinical ethics. We believe it is time to strengthen the ties between hospital medicine and medical ethics, and in this article we outline how clinical ethicists might collaborate with hospitalists to identify routine issues that do not rise to the level of an “ethics consult,” but nonetheless require an intellectual grounding in normative reasoning. We use a clinical vignette to explore how this approach might enhance and broaden the scope of medical education that occurs in the inpatient setting: A patient with an intra-abdominal abscess is admitted to the academic hospitalist teaching service for drainage of the fluid, hemodynamic support, and antimicrobial therapy. During the initial encounter with the hospitalist and his team of medical students and residents, the patient reports night sweats and asks if this symptom could be due to the abscess. How should the hospitalist approach this question? (shrink)

This interdisciplinary collection of essays highlights the relevance of Buddhist doctrine and practice to issues of globalization. From philosophical, religious, historical, and political perspectives, the authors show that Buddhism—arguably the world’s first transnational religion—is a rich resource for navigating todays interconnected world.

Summary In this article the authors seek to broaden the scope of the methodological debates now underway in Germany between proponents of a critical theory of society — principally the late T. W. Adorno and J. Habermas — on the one side and proponents of an analytical theory of social science — principally Karl Popper and Hans Albert — on the other. An attempt is made to formulate and systematize some of the fundamental epistemological and methodological principles which are basic (...) to Habermas' philosophy of social science and to bring them into a critical confrontation with some of the relevant counter-positions which have today a wide currency in analytic circles. (shrink)

Via a reading of Cormac McCarthy’s Blood Meridian and a critical appraisal of Foucault’s break with historical materialism, W. Oliver Baker finds, at the limits of the new materialisms, space for a new post-humanist critical materialism that sees utopia not in post-human assemblages, but in the abolition of colonial and capitalist structures that condition those assemblages in the first place.

"I'll furnish the war": the making of a media myth -- Fright beyond measure? the myth of the war of the worlds -- Murrow vs. McCarthy: timing makes the myth -- The Bay of Pigs/New York Times suppression myth -- Debunking the "Cronkite moment" -- The nuanced myth: bra burning at Atlantic City -- It's all about the media: Watergate's heroic-journalist myth -- The "fantasy panic": the news media and the crack-baby myth -- "She was fighting to the death": (...) mythmaking in Iraq -- Hurricane Katrina and the myth of superlative reporting -- Conclusion. (shrink)

"I'll furnish the war" : the making of a media myth -- Fright beyond measure? : the myth of the war of the worlds -- Murrow vs. McCarthy : timing makes the myth -- TV viewers, radio listeners, and the myth of the first Kennedy-Nixon debate -- The Bay of Pigs-New York Times suppression myth -- Debunking the "Cronkite moment" -- The nuanced myth : bra burning at Atlantic City -- Picture power? : confronting the myths of the "napalm (...) girl" photograph -- It's all about the media : Watergate's heroic-journalist myth -- The "fantasy panic" : the news media and the "crack-baby" myth -- "She was fighting to the death" : mythmaking in Iraq -- Hurricane Katrina and the myth of superlative reporting -- Counterfeit quotations : swelling with a digital tide. (shrink)

Beginning with an overview of the knowledge claims proposed by John Locke and David Hume, this essay first explores the respective responses of Newman and W. G. Ward and then updates the discussion by bringing Newman into dialogue with the thoughtof Alasdair MacIntyre.

Book Information The origins of complex language. By Carstairs-McCarthy Andrew. Oxford University Press. Oxford. 1999. Pp. vi + 260.

How are the teachings of a thirteenth-century master relevant today? Twenty contemporary writers unpack Dogen's words and show how we can still find meaning in his teachings. Engaging Dogen's Zen is a practice oriented study of Shushogi (a canonical distillation of Dogen's thought used as a primer in the Soto School of Zen) and Fukanzazengi (Dogen's essential text on the practice of "just sitting," a text recited daily in the Soto School of Zen). It is also a study of the (...) entire self. Here, the principles of Soto Zen practice are unpacked and explained by leading contemporary Buddhists from the living tradition--monks, priests, academics, and community teachers. Tackling Dogen's approach to key issues, such as the preeminence of shikantaza, universal buddha nature, and what it means to be a Mahayana Buddhist, the contributors to the volume help Zen practitioners and any who are trying to deepen their lives to appreciate better the teachings of Soto Zen and make these teachings part of their lives. By revisiting what remains precious in Shushogi and Fukanzazengi, we let them breathe just as we learn to breathe in zazen. We find that Soto practice not only engages Dogen and Sakyamuni, but all of our sisters and brothers, and indeed the great earth itself. Includes essays from Kosho Itagaki, Taigen Dan Leighton, Tenshin Charles Fletcher, Shudo Brian Schroeder, Glen A. Mazis, David Loy, Drew Leder, Steven DeCaroli, Steve Bein, John Maraldo, Michael Schwartz, Tetsuzen Jason M. Wirth, Leah Kalmanson, Erin Jien McCarthy, Dainen David Putney, Steven Heine, Graham Parkes, Mark Unno, Shudo Brian Schroeder, and Kanpu Bret W. Davis. (shrink)

The moth snowstorm, a phenomenon Michael McCarthy remembers from his boyhood when moths 'would pack a car's headlight beams like snowflakes in a blizzard,' is a distant memory. Wildlife is being lost, not only in the wholesale extinctions of species but also in the dwindling of those species that still exist. The Moth Snowstorm records in painful detail this rapid dissolution of nature's abundance and proposes a radical solution: that we recognize our capacity to love the natural world. Arguing (...) that neither sustainable development nor ecosystem services have proven adequate as defenses against pollution, habitat destruction, species degradation, and climate change, McCarthy asks us to consider nature as an intrinsic good and an emotional and spiritual resource, capable of inspiring joy, wonder, and even love. An award-winning environmental journalist, McCarthy presents a clear, well-documented picture of what he calls 'the great thinning' around the world, while interweaving the story of his own early discovery of wilderness and a childhood saved by nature. Drawing on the truths of poets, the studies of scientists, and the author's long experience in the field, The Moth Snowstorm is part elegy, part ode, and part argument, resulting in a passionate call to action. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

In this new textbook two Catholic ethicists with extensive teaching experience present a moral theology based on vision. David Matzko McCarthy and James M. Donohue draw widely from the Western philosophical tradition while integrating biblical and theological themes in order to explore such fundamental questions as What is good? The fourteen chapters in Moral Vision are short and thematic. Substantive study questions engage with primary texts and encourage students to apply theory to everyday life and common human experiences. The (...) book is accessibly written and flexible enough to fit into any undergraduate or seminary course on ethics. (shrink)

Philosophers often assume that we can somehow quantitatively measure how good things are for people. But what does such talk mean? And what are the measures? In *Weighing Goods* John Broome offers one treatment of these questions. In his later *Weighing Lives* he offers a different treatment. This article discusses both positions but advocates a third. But while the three positions disagree about matters of meaning, they agree about the form of the measures. Roughly speaking, they are such that the (...) goodness of a lottery for an individual is equal to its expected goodness for her. (shrink)

This book proposes a new theory of the origins of human language ability and presents an original account of the early evolution of language. It explains why humans are the only language-using animals, challenges the assumption that language is a consequence of intelligence, and offers a new perspective on human uniqueness. The author draws on evidence from archaeology, linguistics, cognitive science, and evolutionary biology. Making no assumptions about the reader's prior knowledge he first provides an introductory but critical survey of (...) all sources of evidence for language evolution. He then considers what language itself reveals about its own and human origins and evolution. He shows that certain central aspects of language do not, unexpectedly, reflect what they are used for, are maladapted for their function. He considers why this should be, and argues that these odd aspects of language reveal important clues about its evolutionary origin. The Origins of Complex Language fulfils the promise of its title. In doing so it turns upside down conventional theories about the relation between cognition and expression, truth and reference, and the co-evolution of mind and body. Original in conception, brilliantly executed, stylishly written, this book will attract a wide range of readers interested in the evolution and origins of language. (shrink)