Disparities exist in the health, livelihood, and opportunities for the 46-60 million people living in America’s rural communities. Rural communities across the United States need a new energy and focus concentrated around health and health care that allows for the designing capturing, and spreading of existing and new innovations. This paper aims to provide a framework for policy solutions to build a healthier rural America describing both the current state of rural health policy and the policies and practices in states (...) that could be used as a national model for positive change. (shrink)

Background Clinical ethics consultants are expected to “reduce disparities, discrimination, and inequities when providing consultations,” but few studies about inequities in ethics consultation exist.1 The objectives of this study were (1) to determine if there were racial or gender differences in the timing of requests for ethics consultations related to limiting treatment, and (2) if such differences were found, to identify factors associated with that difference and the role, if any, of ethics consultants in mitigating them. Methods The study was (...) a mixed methods retrospective study of consultation summaries and hospital and ethics center data on 56 age-and gender-matched Caucasian and African American Medicare patients who received ethics consultations related to issues around limiting medical treatment in the period 2011 to 2014. The average age of patients was 70.9. Results Consultation requests for females were made significantly earlier in their stays in the hospital (6.57 days) than were consultation requests made for males (16.07 days). For African American patients, the differences in admission-to-request intervals for female patients (5.93 days) and male patients (18.64 days) were greater than for Caucasian male and female patients. Differences in the timing of a consultation were not significantly correlated with the presence of an advance directive, the specialty of the attending physician, or the reasons for the consult request. Ethics consultants may have mitigated problems that developed during the lag in request times for African American males by spending more time, on average, on those consultations (316 minutes), especially more time, on average, than on consultations with Caucasian females (195 minutes). Most consultations (40 of 56) did result in movement toward limiting treatment, but no statistically significant differences were found among the groups studied in the movement toward limiting treatment. The average number of days from consult to discharge or death were strongly correlated with the intervals between admission to the hospital and request for an ethics consultation. Conclusion Our findings suggest race and gender disparities in the timing of ethics consultations that consultants may have partially mitigated. (shrink)

The Patient Protection and Affordable Care Act, passed in 2010, is considered by many to be the most significant healthcare overhaul since the 1960s, but part of its promise — improvement of population health through requirements for non-profit hospitals to provide “community benefit” — has not been met. This paper examines the history of community benefit legislation, how community benefit dollars are allocated, and innovative practices by a few hospitals and communities that are addressing primarily non-medical factors that influence health (...) such as social disadvantage, attitudes, beliefs, risk exposure, and social inequalities. (shrink)

_ Source: _Volume 94, Issue 3, pp 381 - 390 Reference can fail in a way that intentionality cannot. Though the stream of phenomenal experience typically does not fail to target objects outside, it may do. How does the mind go about targeting objects beyond itself? The speculative conjecture of this paper is that it does so by a type of process which can be called _pointing_, and that the acts or act-aspects of pointing can be called _pointers_. The notion (...) of a pointer has several suggestive roots. One is the familiar physical gesture of pointing. Another is the existence of directional signs such as on roads. The third is the software data types making direct reference to memory locations in computers, also called ‘pointers’. A final source is demonstrative pronouns and other deictic expressions in language, of which Peter Geach wrote, “a demonstrative pronoun … works like a pointer, not like a label”. I suggest that there is in the mental cognitive repertoire a structurally and semantically analogous type of act which pierces the passivity of perception, directs us outside the machine, and prepares the way for drawing others’ minds to the same thing. (shrink)

If we try to evaluate the sentence on line 1 we ¯nd ourselves going in an unending cycle. For this reason alone we may conclude that the sentence is not true. Moreover we are driven to this conclusion by an elementary argument: If the sentence is true then what it asserts is true, but what it asserts is that the sentence on line 1 is not true. Consequently the sentence on line 1 is not true. But when we write this (...) true conclusion on line 2 we ¯nd ourselves repeating the very same sentence. It seems that we are unable to deny the truth of the sentence on line 1 without asserting it at the same time. (shrink)

The semantic paradoxes, whose paradigm is the Liar, played a crucial role at a crucial juncture in the development of modern logic. In his 1908 seminal paper, Russell outlined a system, soon to become that of the Principia Mathematicae, whose main goal was the solution of the logical paradoxes, both semantic and settheoretic. Russell did not distinguish between the two and his theory of types was designed to solve both kinds in the same uniform way. Set theoreticians, however, were content (...) to treat only the set-theoretic paradoxes, putting aside the semantic ones as a non-mathematical concern. This separation was explicitly proposed, eighteen years after Russell’s paper, by Ramsey, though he, like Russell, advocated a system that addresses both kinds. Since then, the semantic paradoxes have been viewed within the perspective of the theory of truth, where they have occupied a respectable niche, but one of rather specialized interest. (shrink)

This commentary raises three questions about the target article: What are pointers or deictic devices? Why insist on deictic codes for cognition rather than deixis simpliciter? And in what sense is cognition embodied, on this view?

The reconciliation of theories of concepts based on prototypes, exemplars, and theory-like structures is a longstanding problem in cognitive science. In response to this problem, researchers have recently tended to adopt either hybrid theories that combine various kinds of representational structure, or eliminative theories that replace concepts with a more finely grained taxonomy of mental representations. In this paper, we describe an alternative approach involving a single class of mental representations called “semantic pointers.” Semantic pointers are symbol-like representations (...) that result from the compression and recursive binding of perceptual, lexical, and motor representations, effectively integrating traditional connectionist and symbolic approaches. We present a computational model using semantic pointers that replicates experimental data from categorization studies involving each prior paradigm. We argue that a framework involving semantic pointers can provide a unified account of conceptual phenomena, and we compare our framework to existing alternatives in accounting for the scope, content, recursive combination, and neural implementation of concepts. (shrink)

ABSTRACT A complete axiomatic system CTLrp is introduced for a temporal logic for finitely branching ω+ -trees in a language extended with so called reference pointers. Syntactic and semantic interpretations are constructed for the branching time computation tree logic CTL* into CTLrp. In particular, that yields a complete axiomatization for the translations of all valid CTL*-formulae. Thus, the temporal logic with reference pointers is brought forward as a simpler (with no path quantifiers), but in a way more expressive (...) medium for reasoning about branching time. (shrink)

A complete axiomatic system CTL$_{rp}$ is introduced for a temporal logic for finitely branching $\omega^+$-trees in a temporal language extended with so called reference pointers. Syntactic and semantic interpretations are constructed for the branching time computation tree logic CTL$^{*}$ into CTL$_{rp}$. In particular, that yields a complete axiomatization for the translations of all valid CTL$^{*}$-formulae. Thus, the temporal logic with reference pointers is brought forward as a simpler (with no path quantifiers), but in a way more expressive medium (...) for reasoning about branching time. (shrink)

In attempting to derive irreversible macroscopic thermodynamics from reversible microscopic dynamics, Boltzmann inadvertently smuggled in a premise that assumed the very irreversibility he was trying to prove: ‘molecular chaos.’ The program of ‘Einselection’ within Everettian approaches faces a similar ‘Loschmidt’s Paradox’: the universe, according to the Everettian picture, is a closed system obeying only unitary dynamics, and it therefore contains no distinguishable environmental subsystems with the necessary ‘phase randomness’ to effect einselection of a pointer observable. The theoretically unjustified assumption of (...) distinguishable environmental subsystems is the hidden premise that makes the derivation of einselection circular. In effect, it presupposes the ‘emergent’ structures from the beginning. Thus the problem of basis ambiguity remains unsolved in Everettian interpretations. (shrink)

Herein is reproduced the text of the address of Jean-Marie Muller during the General Assembly of Iraqi groups dedicated to non-violence which took place in Erbil on 9 and 10 November 2009. Jean-Marie Muller defines six prospective forms of action for the non-violent movement in Iraq: training, information, sensitization, education, protest, and non-violent direct action.

In the iconic measurements of atomic spin-1/2 or photon polarization, one employs two separate noninteracting detectors. Each detector is binary, registering the presence or absence of the atom or the photon. For measurements on a d-state particle, we recast the standard von Neumann measurement formalism by replacing the familiar pointer variable with an array of such detectors, one for each of the d possible outcomes. We show that the unitary dynamics of the pre-measurement process restricts the detector outputs to the (...) subspace of single outcomes, so that the pointer emerges from the apparatus. We propose a physical extension of this apparatus which replaces each detector with an ancilla qubit coupled to a readout device. This explicitly separates the pointer into distinct quantum and (effectively) classical parts, and delays the quantum to classical transition. As a result, one not only recovers the collapse scenario of an ordinary apparatus, but one can also observe a superposition of the quantum pointer states. (shrink)

This paper gives an implicit characterization of the class of functions computable in polynomial space by deterministic Turing machines – PSPACE. It gives an inductive characterization of PSPACE with no ad-hoc initial functions and with only one recursion scheme. The main novelty of this characterization is the use of pointers to reach PSPACE. The presence of the pointers in the recursion on notation scheme is the main difference between this characterization of PSPACE and the well-known Bellantoni-Cook characterization of (...) the polytime functions – PTIME. (shrink)

When K. Grue-Sørensen became a professor of pedagogy at the University of Copenhagen in 1955, he was inline with the dominant historical-hermeneutical approach to humanities. From the late 1960s until retirementin 1974, his approach was challenged by both technical and critical alternatives. Both these alternative havesince grown steadily, while the historical-hermeneutical view has been in the defensive. But Grue-Sørensenand the tradition he represented have three signifi cant points for today’s pedagogy, whether it is technicalor critical: pedagogy can and should not (...) deliver effi ciency technology, pedagogy should as far as possible useeveryday language, and fi nally that the educational history can make us wiser. (shrink)

We introduce and study hierarchies of extensions of the propositional modal and temporal languages with pairs of new syntactic devices: point of reference-reference pointer which enable semantic references to be made within a formula. We propose three different but equivalent semantics for the extended languages, discuss and compare their expressiveness. The languages with reference pointers are shown to have great expressive power (especially when their frugal syntax is taken into account), perspicuous semantics, and simple deductive systems. For instance, Kamp's (...) and Stavi's temporal operators, as well as nominals (names, clock variables), are definable in them. Universal validity in these languages is proved undecidable. The basic modal and temporal logics with reference pointers are uniformly axiomatized and a strong completeness theorem is proved for them and extended to some classes of their extensions. (shrink)

This paper is a commentary on the target article by Lokendra Shastri & Venkat Ajjanagadde [S&A]: “From simple associations to systematic reasoning: A connectionist representation of rules, variables and dynamic bindings using temporal synchrony” in same issue of the journal, pp.417–451. -/- It puts S&A's temporal-synchrony binding method in a broader context, comments on notions of pointing and other ways of associating information - in both computers and connectionist systems - and mentions types of reasoning that are a challenge to (...) S&A's system (amongst many other connectionist systems, recognizing that S&A's is much more capable as regards reasoning than most other contemporary systems). (shrink)

In Science of the Soul in Ibn Sina's Pointers and Reminders, Michael A. Rapoport provides a philological and interpretive guide for critically reading and interpreting Ibn Sina's (Avicenna, d. 1037) most challenging and influential text. Rapoport argues that chapters VII-X of the Pointers present scientific explanations for phenomena related to the human soul - from intellection to divination, magic, and marvels - within the framework of Ibn Sina's Metaphysics of the Rational Soul. This book dispels widespread notions that (...) the Pointers represents Ibn Sina's mystical or Sufi philosophy and therefore stands apart from the rest of his corpus. (shrink)

We propose a unified theory of intentions as neural processes that integrate representations of states of affairs, actions, and emotional evaluation. We show how this theory provides answers to philosophical questions about the concept of intention, psychological questions about human behavior, computational questions about the relations between belief and action, and neuroscientific questions about how the brain produces actions. Our theory of intention ties together biologically plausible mechanisms for belief, planning, and motor control. The computational feasibility of these mechanisms is (...) shown by a model that simulates psychologically important cases of intention. (shrink)

Describes 100 real-life ethical dilemmas faced by school administrators.

The current model, based on event-related potential (ERP) studies, posits that the working-memory system is a state of activated long-term memory; this appears comprehensive, but it needs further detailed analysis of functional neural connectivity analysis within the prefrontal cortex (PFC) and between the posterior and prefrontal cortex. Specifically, the role of dorsolateral PFC and anterior cingulate cortex (ACC) is probably critical for PFC's attentional controller. Neural implementation of the executive function in working memory appears critical to build a firm model.

A two-sorted term system characterizing NC implicitly is described. The term system is defined over the tree algebra [MATHEMATICAL DOUBLE-STRUCK CAPITAL T], the free algebra generated by 0, 1 and ∗, and the recursion scheme uses pointers over tier 0. This differs from previous characterizations of NC, where tier 1 pointers were used or full parameter substitution over tier 0 was allowed.

This article engages the considerations of imagination in Kierkegaard and Ricoeur to argue for a moral dimension of the imagination and its objects. Imaginary objects are taken to be mental representations in images and narratives of people or courses of action that are not real in the sense that they are not actual, or have not yet happened. Three claims are made in the article. First, by drawing on the category of possibility, a conceptual distinction is established between imagination and (...) fantasy, (1) I claim that imagination has a moral dimension because it is engaged in considering real-life possibilities. Second, (2) drawing on Kierkegaard and Ricoeur, it is argued that mental representations of selfhood in imagination have a moral dimension because they essentially allow people to understand the development of agency in human selfhood by means of representations of would-be selves and narrative figurations of the self. Third, (3) mental representations of human selves have a moral dimension because they form important points of reference for moral orientations in the field of human praxis (moral pointers). (shrink)

The Evolving Social Responsibilities of Internet Corporate Actors: Pointers Past and Present Content Type Journal Article Category Commentary Pages 455-461 DOI 10.1007/s13347-011-0049-0 Authors Robert Madelin, Directorate General Information Society and Media, European Commission, BU25 06/183, 1049 Brussels, Belgium Journal Philosophy & Technology Online ISSN 2210-5441 Print ISSN 2210-5433 Journal Volume Volume 24 Journal Issue Volume 24, Number 4.

Mādhyamikas argue that ultimate reality, which is without any delimitation and hence cannot be verbalized in itself, can be expressed in words on the basis of the attribution or superimposition of the basis for the application of the word. The denotation theory of ultimate reality Bhartṛhari advances in the Dravyasamuddeśa of his Vākyapadīya convincingly explains that, insofar as ultimate reality is spoken of, we must say that it is denoted by the word; ultimate reality is said to be ineffable only (...) in the sense that it is far from what is conveyed as something by the word; language is a pointer to the ultimate reality. The point that the application of a word to ultimate reality depends on the attribution of the basis for the application of the word to it naturally leads to an idea that one should not hypostatize the basis, although without resorting to it any word cannot be used to convey the ultimate reality; otherwise, it would have to be said that the ultimate reality to which the word is applied has in essence the property which serves as the basis. Such a property is precisely what the Mādhyamikas consider to be the svabhāva ‘intrinsic nature’. What they understand by the term śūnyatā is precisely that everything has no real basis for the application of the word to it. (shrink)

BackgroundWhenever South African research institutions share human biological material and associated data for health research or clinical trials they are legally compelled to have a material transfer agreement in place that uses as framework the standard MTA newly gazetted by the South African Minister of Health.Main bodyThe article offers a legal analysis of the SA MTA and focuses on its substantive fit with the broader legal environment in South Africa, and the clarity and practicality of its terms. The following problematic (...) aspects of the SA MTA are highlighted: Where only data and no human biological material are transferred, the SA MTA does not apply, leaving a lacuna; Health Research Ethics Committees are required to be parties to a MTA despite it being outside their legal mandate and undermining their oversight function; the SA MTA’s consent provisions are not aligned with extant law; and, similarly, its provision on donor ownership is misaligned with extant law; its creation of fictitious performance can only cause frustration on the part of an injured party; its benefit-sharing provision is vague and will have little practical effect; its dispute-resolution provisions fail to adequately protect South African research institutions and research participants; it fails to provide substantive guidance regarding intellectual property as its provisions relating to intellectual property may cause practical problems; and, finally, its data privacy provision is insufficiently specific, is overbroad, and fails to provide terms that in general would facilitate the international sharing of human biological material and associated data in terms of existing privacy law.ConclusionsWhile some of the problematic aspects of the SA MTA are intricate and require consultative processes with stakeholders and others, to develop comprehensive solutions, most of the problematic aspects can be resolved immediately through amendments by the South African Minister of Health. The formulation of such amendments is proposed and, where possible, interim measures are suggested that may ameliorate the problems presented by the SA MTA. (shrink)

This article seeks to provide a set of pointers for methodological reflections on Foucauldian-inspired analyses of the exercise of power. Michel Foucault deliberately eschewed methodological schemata, which may be why so little has been written on the methodological implications of his analyses. While this article shares the premise that we should refrain from a standardized methodology, it argues that providing broad pointers for analyses informed by the critical ambition and conceptual framework offered by Foucault is both desirable and (...) possible. The article then offers some reflections and general guidelines on how to strengthen the methodological quality of Foucauldian analyses. We argue that the quality of Foucauldian-inspired analysis of modern power may gain from methodological reflections around four pointers: curiosity, nominalism, conceptual grounding and exemplarity. (shrink)

Defining actions in contradistinction to mere happenings runs into the problem of specifying the role of the agent and separating what the agent does from what they exploit or suffer. Traditionally these problems have been approached by starting with a simple act, such as an incidental movement, and considering causality, or by seeking to elucidate the connection between the act and the agent's intentions or reasons. It is suggested here that a promising approach is to shift attention from 'simple' movements (...) and start instead by exploring the general character of acquired skills. Balancing the body is one such skill and serves here as an exemplar. Some remarks made by Reid on balance are used in a Peircean framework for perception to suggest that, at least for humans, an action is always the performance of an acquired skill. Also, while action is constitutive of perception, bodily perception is the basis of action, providing in a feeling of ownership direct knowledge of an asymmetric opposition between the agent and the world. (shrink)