Immunological mechanisms and therapy approaches in psychotic syndromes were recently supported by the discovery of autoantibody-associated limbic and non-limbic encephalitis. However, how clinical diagnostic procedures in psychiatry should be adapted to these new insights is still unclear. In this study, we analyzed the cerebrospinal fluid (CSF) and neuroimmunological alterations and their association with cerebral MRI (cMRI) and electroencephalographic (EEG) findings. From 2006 until 2013, we acquired 180 CSF samples from psychotic patients. Between 2006 and 2009, CSF examinations were only performed (...) in cases in which organic brain disease was suspected. Since then, this procedure has been integrated into our routine diagnostic workup. CSF basic diagnostics were supplemented by measuring antineuronal antibodies against intracellular synaptic antigens, antibodies against intracellular onconeural antigens, antibodies against neuronal cell surface antigens and thyroid antibodies. In addition, cMRIs and EEGs were conducted. We found white cell counts elevated in 3.4% of the cases, albumin quotient elevated in 21.8%, and protein concentration elevated in 42.2%. Evidence of intrathecal immunoglobulin synthesis was found in 7.2% of the cases. Antibodies measured against neuronal cell surface antigens were positive in 3.2%. Reactivity on antibodies against intracellular onconeural antigens were detected in 3.5%. Serum thyroid antibodies were elevated in 24.7%. Abnormalities were found in 39.5% of cMRIs and in 34.3% of EEGs. The main finding of our study was the high prevalence of CSF and autoantibody abnormalities in 54.4% of psychotic patients. In combination with cMRIs and EEGs, 75.6% showed abnormal findings. Our results are discussed with regard to the concept of immunological encephalopathy. Future studies should analyze the efficacy of immunomodulatory therapies. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

Adults’ intentionality judgments regarding an action are influenced by their moral evaluation of this action. This is clearly indicated in the so-called side-effect effect: when told about an action (e.g. implementing a business plan) with an intended primary effect (e.g. raise profits) and a foreseen side effect (e.g. harming/helping the environment), subjects tend to interpret the bringing about of the side effect more often as intentional when it is negative (harming the environment) than when it is positive (helping the environment). (...) From a cognitive point of view, it is unclear whether the side-effect effect is driven by the moral status of the side effects specifically, or rather more generally by its normative status. And from a developmental point of view, little is known about the ontogenetic origins of the effect. The present study therefore explored the cognitive foundations and the ontogenetic origins of the side-effect effect by testing 4-to 5-year-old children with scenarios in which a side effect was in accordance with/violated a norm. Crucially, the status of the norm was varied to be conventional or moral. Children rated the bringing about of side-effects as more intentional when it broke a norm than when it accorded with a norm irrespective of the type of norm. The side-effect effect is thus an early-developing, more general and pervasive phenomenon, not restricted to morally relevant side effects. (shrink)

Background Outbreaks of infectious disease cause serious and costly health and social problems. Two new technologies – pathogen whole genome sequencing and Big Data analytics – promise to improve our capacity to detect and control outbreaks earlier, saving lives and resources. However, routinely using these technologies to capture more detailed and specific personal information could be perceived as intrusive and a threat to privacy. Method Four community juries were convened in two demographically different Sydney municipalities and two regional cities in (...) New South Wales, Australia to elicit the views of well-informed community members on the acceptability and legitimacy of: making pathogen WGS and linked administrative data available for public health researchusing this information in concert with data linkage and machine learning to enhance communicable disease surveillance systems Fifty participants of diverse backgrounds, mixed genders and ages were recruited by random-digit-dialling and topic-blinded social-media advertising. Each jury was presented with balanced factual evidence supporting different expert perspectives on the potential benefits and costs of technologically enhanced public health research and communicable disease surveillance and given the opportunity to question experts. Results Almost all jurors supported data linkage and WGS on routinely collected patient isolates for the purposes of public health research, provided standard de-identification practices were applied. However, allowing this information to be operationalised as a syndromic surveillance system was highly contentious with three juries voting in favour, and one against by narrow margins. For those in favour, support depended on several conditions related to system oversight and security being met. Those against were concerned about loss of privacy and did not trust Australian governments to run secure and effective systems. Conclusions Participants across all four events strongly supported the introduction of data linkage and pathogenomics to public health research under current research governance structures. Combining pathogen WGS with event-based data surveillance systems, however, is likely to be controversial because of a lack of public trust, even when the potential public health benefits are clear. Any suggestion of private sector involvement or commercialisation of WGS or surveillance data was unanimously rejected. (shrink)

Precision medicine is an emerging approach to treatment and disease prevention that relies on linkages between very large datasets of health information that is shared amongst researchers and health professionals. While studies suggest broad support for sharing precision medicine data with researchers at publicly funded institutions, there is reluctance to share health information with private industry for research and development. As the private sector is likely to play an important role in generating public benefits from precision medicine initiatives, it is (...) important to understand what the concerns are and how they might be mitigated. This study reports outcomes of a deliberative method of citizen engagement in Singapore that asked whether sharing precision medicine data with private industry would be permissible, and if so, under what circumstances. Findings from this citizens’ jury suggest sharing with industry would be permissible under certain conditions that are set out in nine recommendations. Implications of the recommendations and their underlying assumptions for policy decision makers are discussed. This study aligns with prior international studies which found conditional acceptance for data sharing with private industry, a public benefit requirement, specific reluctance to share with insurance companies and an emphasis on accountability and transparency to demonstrate trustworthiness. However, our results differ from prior studies in that opt-in consent did not dominate the deliberations as jurors were able to set it aside as an assumed prerequisite for participation in a precision medicine programme. (shrink)

Ethics review processes are frequently perceived as extending from codes and protocols rooted in biomedical disciplines. As a result, many researchers in the humanities and social sciences (HASS) find these processes to be misaligned, if not outrightly obstructive to their research. This leads some scholars to advocate against HASS participation in institutional review processes as they currently stand, or in their entirety. While ethics review processes can present a challenge to HASS researchers, these are not insurmountable and, in fact, present (...) opportunities for ethics review boards (ERBs) to mediate their practices to better attend to the concerns of the HASS disciplines. By highlighting the potential value of the ethics review process in recognising the nuances and specificity across different forms of research, this article explores the generative possibilities of greater collaboration between HASS researchers and ERBs. Remaining cognisant of the epistemic and methodological differences that mark different disciplinary formations in turn will benefit the ethical conduct of all researchers. (shrink)

Food security is becoming an increasingly relevant topic in the Global North, especially in urban areas. Because such areas do not always have good access to nutritionally adequate food, the question of how to supply them is an urgent priority in order to maintain a healthy population. Urban and peri-urban agriculture, as sources of local fresh food, could play an important role. Whereas some scholars do not differentiate between peri-urban and urban agriculture, seeing them as a single entity, our hypothesis (...) is that they are distinct, and that this has important consequences for food security and other issues. This has knock-on effects for food system planning and has not yet been appropriately analysed. The objectives of this study are to provide a systematic understanding of urban and peri-urban agriculture in the Global North, showing their similarities and differences, and to analyse their impact on urban food security. To this end, an extensive literature review was conducted, resulting in the identification and comparison of their spatial, ecological and socio-economic characteristics. The findings are discussed in terms of their impact on food security in relation to the four levels of the food system: food production, processing, distribution and consumption. The results show that urban and peri-urban agriculture in the Global North indeed differ in most of their characteristics and consequently also in their ability to meet the food needs of urban inhabitants. While urban agriculture still meets food needs mainly at the household level, peri-urban agriculture can provide larger quantities and has broader distribution pathways, giving it a separate status in terms of food security. Nevertheless, both possess (unused) potential, making them valuable for urban food planning, and both face similar threats regarding urbanisation pressures, necessitating adequate planning measures. (shrink)

The Sustained Attention to Response Task is a Go–No-Go signal detection task developed to measure lapses of sustained conscious attention. In this study, we examined the impact global interference and spatial uncertainty has on SART performance. Ten participants performed either a SART or a traditionally formatted version of a global–local stimuli detection task with spatially certain and uncertain signals. Reaction time in the SART was insensitive to global interference and spatial uncertainty, whereas reaction time in the low-Go task was sensitive. (...) Spatial uncertainty increased errors of omission in the SART, which was not expected if the SART measures mindlessness. There was a high correlation between participants’ errors of commission rate and their reaction time in the SART. The results, overall, support the view that the SART is a better measure of response strategy than lapses in sustained attention or mindlessness. (shrink)

Background Sharing anonymized/de-identified clinical trial data and publishing research outcomes in scientific journals, or presenting them at conferences, is key to data-driven scientific exchange. However, when data from scientific publications are linked to other publicly available personal information, the risk of reidentification of trial participants increases, raising privacy concerns. Therefore, we defined a set of criteria allowing us to determine and minimize the risk of data reidentification. We also implemented a review process at Takeda for clinical publications prior to submission (...) for publication in journals or presentation at medical conferences. Methods Abstracts, manuscripts, posters, and oral presentations containing study participant information were reviewed and the potential impact on study participant privacy was assessed. Our focus was on direct and indirect identifiers, such as sex, age or geographical indicators in rare disease studies or studies with small sample size treatment groups. Risk minimization was sought using a generalized presentation of identifier-relevant information and decision-making on data sharing for further research. Additional risk identification was performed based on study participant/personnel parameters present in materials destined for the public domain. The potential for participant/personnel identification was then calculated to facilitate presentation of meaningful but de-identified information. Results The potential for reidentification was calculated using a risk ratio of the exposed versus available individuals, with a value above the threshold of 0.09 deemed an unacceptable level of reidentification risk. We found that in 13% of Takeda clinical trial publications reviewed, either individuals could potentially be reidentified or inappropriate data sharing plans could pose a data privacy risk to study participants. In 1/110 abstracts, 58/275 manuscripts, 5/87 posters and 3/58 presentations, changes were necessary due to data privacy concerns/rules. Despite the implementation of risk-minimization measures prior to release, direct and indirect identifiers were found in 11% and 34% of the analysed documents, respectively. Conclusions Risk minimization using de-identification of clinical trial data presented in scientific publications and controlled data sharing conditions improved privacy protection for study participants. Our results also suggest that additional safeguards should be implemented to ensure that higher data privacy standards are met. (shrink)

In controlled human infection studies (CHIs), participants are deliberately exposed to infectious agents in order to better understand the mechanism of infection or disease and test therapies or vaccines. While most CHIs have been conducted in high‐income countries, CHIs have recently been expanding into low‐ and middle‐income countries (LMICs). One potential ethical concern about this expansion is the challenge of obtaining the voluntary informed consent of participants, especially those who may not be literate or have limited education. In some CHIs (...) in LMICs, researchers have attempted to address this potential concern by limiting access to literate or educated populations. In this paper, we argue that this practice is unjustified, as it does not increase the chances of obtaining valid informed consent and therefore unfairly excludes illiterate populations and populations with lower education. Instead, we recommend that investigators improve the informed consent process by drawing on existing data on obtaining informed consent in these populations and interventions aimed at improving their understanding. Based on a literature review, we provide concrete suggestions for how to follow this recommendation and ensure that populations with lower literacy or education are given a fair opportunity to protect their rights and interests in the informed consent process. (shrink)

Smell perception plays an important role in eating behavior and might be involved in body weight gain. Since a body of literature implies that olfactory perception and function is hampered in obesity, we here investigate neuroanatomical correlates of this phenomenon. We assessed olfactory bulb volume with magnetic resonance imaging in 67 healthy participants with a body mass index from 18.9 to 45.4 kg/m2. Moreover, we obtained psychophysiological data on olfactory ability and self-report measurements on eating behavior. Additionally, we collected parameters (...) associated with metabolic health in obesity to investigate recently proposed mechanistic explanatory models of why olfaction may be altered in obesity. We showed that OB volume was significantly lower in participants with obesity when compared to those of normal weight. Moreover, we found weak to moderate negative correlations between OB volume and BMI and related measures of metabolic health, especially leptin, body fat percentage, waist-height ratio and insulin resistance. However, neither OB volume nor BMI were related to olfactory function in our young and healthy sample. Nevertheless, our results provide first indications that obesity is associated with brain anatomical changes in the OBs. (shrink)

Die Kategorie des Werks wurde in den Literaturwissenschaften in den letzten 50 Jahren massiv kritisiert. Im Laufe der letzten Jahre lässt sich allerdings beobachten, dass der einstmals verpönte Werkbegriff schrittweise wieder zu einer zentralen und produktiven Analysekategorie avanciert ist. Der vorliegende Band untersucht, welche Formen und Funktionen der Werkbegriff in den Geisteswissenschaften des 21. Jahrhunderts annehmen kann.

Im Topologischen Manifest sind die Ergebnisse des Forschungsprojekts „Topologie der Technik“ auf prägnante Weise dargelegt. Der spatial turn analysierte die Produktion des Raumes durch soziale Praktiken, jedoch ohne die Einbettung jener Praktiken in technische Systeme zu berücksichtigen. Angesichts der Bedeutung technisierter Räume für das heutige Leben ist dieser Mangel akut. In diesem Band sind neben dem Manifest Beiträge aus verschiedenen Disziplinen versammelt, um Möglichkeiten und Grenzen einer Topologie der Technik auszuloten. Ausgehend von einem modalen Machtbegriff wird nach technogener Formation und (...) Transformation von Räumen gefragt, nach der Konzeptionalisierung relationaler Räume als Struktur- oder Netzphänomenen und der Rolle von Imagination für raumbildende Prozesse. Der InhaltDie interdisziplinären Beiträge gruppieren und positionieren sich um und auf unterschiedliche Weise zum Topologischen Manifest sowie den darin niedergelegten Raumthesen und -typen. Sie reichen von raumtheoretischen Überlegungen und den Besonderheiten relationaler Räume über historische und praxeologische Abhandlungen zur Performanz von Orten bis hin zur Analyse spezifischer Räume wie virtuellen und textuellen Räumen, Sicherheits- und Möglichkeitsräumen oder der Kryosphäre. Die Autorinnen und Autoren erforschen Praktiken, Dynamiken und Zustandsbedingungen im Beziehungsgefüge zwischen Technik, Macht und Raum. Die ZielgruppenForschende auf den Gebieten der Raum- und Technikphilosophie, -soziologie, -geschichte sowie alle interessierten Wissenschaftlerinnen und Wissenschaftler Die HerausgeberDie Herausgeberinnen und Herausgeber sind Doktorandinnen und Doktoranden im Forschungsprojekt „Topologie der Technik“ in Darmstadt. (shrink)

Background:Homeless persons in the United States have disproportionately high rates of illness, injury, and mortality and tend to believe that the quality of their end-of-life care will be poor. No studies were found as to whether nurses or nursing students require moral courage to help homeless persons or members of any other demographic complete advance directives.Research hypothesis:We hypothesized that baccalaureate nursing students require moral courage to help homeless persons complete advance directives. Moral courage was defined as a trait of a (...) person or an action that overcomes fears or other challenges to achieve something of great moral worth.Research design:The hypothesis was investigated through a qualitative descriptive study. Aside from the pre-selection of a single variable to study (i.e. moral courage), our investigation was a naturalistic inquiry with narrative hues insofar as it attended to specific words and phrases in the data that were associated with that variable.Participants and research context:A total of 15 baccalaureate nursing students at a public university in the United States responded to questionnaires that sought to elicit fears and other challenges that they both expected to experience and actually experienced while helping homeless persons complete advance directives at a local, non-profit service agency.Ethical considerations:The study was approved by the Internal Review Board of the authors’ university, and each participant signed an informed consent form, which stated that the study involved no reasonably foreseeable risks and that participation was voluntary.Findings:Before meeting with homeless persons, participants reported that they expected to experience two fears and a challenge: fear of behaving in ways that a homeless person would deem inappropriate, fear of discussing a homeless person’s dying and death, and the challenge of adequately conveying the advance directive’s meaning and accurately recording a homeless person’s end-of-life wishes. In contrast, after their meetings with homeless persons, relatively few participants reported having encountered those obstacles. So, while participants required moral courage to assist homeless persons with advance directives, they required greater moral courage as they anticipated their meetings than during those meetings.Discussion:Our study breaks new ground at the intersection of nursing, moral courage, and advance directives. It might also have important implications for how to improve the training that US nursing students receive before they provide this service.Conclusion:Our results cannot be generalized, but portions of our approach are likely to be transferable to similar social contexts. For example, because homeless persons are misunderstood and marginalized throughout the United States, our design for training nursing students to provide this service is also likely to be useful across the United States. Internationally, however, it is not yet known whether our participants’ fears and the challenge they faced are also experienced by those who assist homeless persons or members of other vulnerable populations in documenting healthcare wishes. (shrink)

How is language acquired when infants are exposed to multiple language input from birth and when adults are required to learn a second language after early childhood? How do adult bilinguals comprehend and produce words and sentences when their two languages are potentially always active and in competition with one another? What are the neural mechanisms that underlie proficient bilingualism? What are the general consequences of bilingualism for cognition and for language and thought? This handbook will be essential reading for (...) cognitive psychologists, linguists, applied linguists, and educators who wish to better understand the cognitive basis of bilingualism and the logic of experimental and formal approaches to language science. (shrink)

BackgroundPrognostic uncertainty is a challenge for physicians in the neuro intensive care field. Questions about whether continued life-sustaining treatment is in a patient’s best interests arise in different phases after a severe traumatic brain injury. In-depth information about how physicians deal with ethical issues in different contexts is lacking. The purpose of this study was to seek insight into clinicians’ strategies concerning unresolved prognostic uncertainty and their ethical reasoning on the issue of limitation of life-sustaining treatment in patients with minimal (...) or no signs of neurological improvement after severe traumatic brain injury in the later trauma hospital phase.MethodsInterviews with 18 physicians working in a neurointensive care unit in a large Norwegian trauma hospital, followed by a qualitative thematic analysis focused on physicians’ strategies related to treatment-limiting decision-making.ResultsA divide between proactive and wait-and-see strategies emerged. Notwithstanding the hospital’s strong team culture, inter-physician variability with regard to ethical reasoning and preferred strategies was exposed. All the physicians emphasized the importance of team—family interactions. Nevertheless, their strategies differed: (1) The proactive physicians were open to consider limitations of life-sustaining treatment when the prognosis was grim. They initiated ethical discussions, took leadership in clarification and deliberation processes regarding goals and options, saw themselves as guides for the families and believed in the necessity to prepare families for both best-case and worst-case scenarios. (2) The “wait-and-see” physicians preferred open-ended treatment (no limitations). Neurologically injured patients need time to uncover their true recovery potential, they argued. They often avoided talking to the family about dying or other worst-case scenarios during this phase.ConclusionsDepending on the individual physician in charge, ethical issues may rest unresolved or not addressed in the later trauma hospital phase. Nevertheless, team collaboration serves to mitigate inter-physician variability. There are problems and pitfalls to be aware of related to both proactive and wait-and-see approaches. The timing of best-interest discussions and treatment-limiting decisions remain challenging after severe traumatic brain injury. Routines for timely and open discussions with families about the range of ethically reasonable options need to be strengthened. (shrink)

Queen pheromones, which signal the presence of a fertile queen and induce daughter workers to remain sterile, are considered to play a key role in regulating the reproductive division of labor of insect societies. Although queen pheromones were long thought to be highly taxon‐specific, recent studies have shown that structurally related long‐chain hydrocarbons act as conserved queen signals across several independently evolved lineages of social insects. These results imply that social insect queen pheromones are very ancient and likely derived from (...) an ancestral signalling system that was already present in their common solitary ancestors. Based on these new insights, we here review the literature and speculate on what signal precursors social insect queen pheromones may have evolved from. Furthermore, we provide compelling evidence that these pheromones should best be seen as honest signals of fertility as opposed to suppressive agents that chemically sterilize the workers against their own best interests. (shrink)

This commentary questions the applicability of the Newell Test for evaluating the utility of connectionism. Rather than being a specific theory of cognition (because connectionism can be used to model nativist, behaviorist, or constructivist theories), connectionism, we argue, offers researchers a collection of computational and conceptual tools that are particularly useful for investigating and rendering specific fundamental issues of human development. These benefits of connectionism are not well captured by evaluating it against Newell's criteria for a unified theory of cognition.

Across the world, pain is under-treated in emergency departments. We canvass the literature testifying to this problem, the reasons why this problem is so important, and then some of the main hypotheses that have been advanced in explanation of the problem. We then argue for the plausibility of two new hypotheses: pain's under-treatment in the ED is due partly to an epistemic preference for signs over symptoms on the part of some practitioners, and some ED practices that themselves worsen pain (...) by increasing patients' anxiety and fear. Our argument includes the following logic. Some ED practitioners depart from formal guidance in basing their acute pain assessments on observable features rather than on patient reports of pain. This is potentially due to an epistemic preference for signs over symptoms which aims to circumvent intentional and/or unintentional misrepresentation on the part of patients. However, conducting pain assessments in line with this epistemic preference contributes to the under-treatment of pain in at least three respects, which we detail. Moreover, it may do little to help the practitioner circumvent any intentional misrepresentation on the part of the patient, as we explain. Second, we examine at least four ED practices that may be contributing to the under-treatment of pain by increasing patient anxiety and fear, which can worsen pain. These practices include failing to provide orienting information and partially objectifying patients so as to problem-solve along lines pre-established by modern medical science. We conclude by touching on some potential solutions for ED practice. (shrink)

In this paper, I identify a theoretical and political role for ‘white ignorance’, present three alternative accounts of white ignorance, and assess how well each fulfils this role. On the Willful Ignorance View, white ignorance refers to white individuals’ willful ignorance about racial injustice. On the Cognitivist View, white ignorance refers to ignorance resulting from social practices that distribute faulty cognitive resources. On the Structuralist View, white ignorance refers to ignorance that (1) results as part of a social process that (...) systematically gives rise to racial injustice, and (2) is an active player in the process. I argue that, because of its greater power and flexibility, the Structuralist View better explains the patterns of ignorance that we observe, better illuminates the connection to white racial domination, and is overall better suited to the project of ameliorating racial injustice. As such, the Structuralist View should be preferred. (shrink)

The first part of this paper finds Craver’s (2007) mutual manipulability theory (MM) of constitution inadequate, as it definitionally ties constitution to the feasibility of idealized experiments, which, however, are unrealizable in principle. As an alternative, the second part develops an abductive theory of constitution (NDC), which exploits the fact that phenomena and their constituents are unbreakably coupled via common causes. The best explanation for this common-cause coupling is the existence of an additional dependence relation, viz. constitution. Apart from adequately (...) capturing the essential characteristics of constitution missed by MM, NDC has important ramifications for constitutional discovery—most notably, that there is no experimentum crucis for constitution, not even under ideal discovery circumstances. (shrink)

" By the end, we can see the cause to which Hume has been true throughout the work.

The term ‘environment’ is not uniformly defined in the public health sciences, which causes crucial inconsistencies in research, health policy, and practice. As we shall indicate, this is somewhat entangled with diverging pathogenic and salutogenic perspectives (research and policy priorities) concerning environmental health. We emphasise two distinct concepts of environment in use by the World Health Organisation. One significant way these concepts differ concerns whether the social environment is included. Divergence on this matter has profound consequences for the understanding of (...) health and disease, for measures derived from that understanding targeting health promotion and disease prevention, and consequently, for epistemic structures and concept development in scientific practice. We hope to improve the given situation in public health by uncovering these differences and by developing a fruitful way of thinking about environment. Firstly, we side with the salutogenic conception of environment as a _health resource_ (as well as a source of health risks). Secondly, we subdivide the concept of environment into four _health-oriented environmental categories_ (viz., natural, built-material, socio-cultural, and psychosocial) and we link these with other theoretical notions proposed in the health sciences literature. Thirdly, we propose that in public health ‘environment’ should be understood as consisting of all extrinsic factors that influence or are influenced by the health, well-being, and development of an individual. Consequently, none of the four categories should be excluded from the concept of environment. We point out the practical relevance and fruitfulness of the conception of environment as a health source and frame this in causal terms, representing _individual health environments_ as causal networks. Throughout, we side with the view that for the design of human health-promoting settings, increased attention and consideration of environmental resources of salutogenic potential is particularly pressing. (shrink)

In this paper, I identify a theoretical and political role for ‘white ignorance’, present three alternative accounts of white ignorance, and assess how well each fulfils this role. On the Willful Ignorance View, white ignorance refers to white individuals’ willful ignorance about racial injustice. On the Cognitivist View, white ignorance refers to ignorance resulting from social practices that distribute faulty cognitive resources. On the Structuralist View, white ignorance refers to ignorance that results as part of a social process that systematically (...) gives rise to racial injustice, and is an active player in the process. I argue that, because of its greater power and flexibility, the Structuralist View better explains the patterns of ignorance that we observe, better illuminates the connection to white racial domination, and is overall better suited to the project of ameliorating racial injustice. As such, the Structuralist View should be preferred. (shrink)

This excerpt from our collective biography emerges from a dialogue that commenced when Noel interjected the concept of ‘becoming-cyborg’ into our conversations about Annette’s experiences of breast cancer, which initially prompted her to interpret her experiences as a ‘chaos narrative’ of cyborgian and environmental embodiment in education contexts. The materialisation of Donna Haraway’s figuration of the cyborg in Annette’s changing body enabled new appreciations of its interpretive power, and functioned in some ways as a successor project to Noel’s (...) earlier deployment of cyborgs in what he now recognises as a ‘posthumanising’ of curriculum inquiry. Noel’s subsequent experiences with throat cancer drew us towards exploring the possibilities that concepts such as Deleuze and Guattari’s machinic assemblage and Karen Barad’s ontoepistemology offer as a mean of thinking the meetings of bodies and technologies in educational inquiry beyond Haraway’s hybrid cyborg. Through both collective biography and playfully scripted conversations with other theorists we explore what it means to perform diffractive interpretations and analyses in posthumanist educational inquiry. Our essay also contributes to contemporary conversations about the uses of collaborative biographical writing as a method of inquiry in educational research. (shrink)

We discuss the variety of sorts of sympathy Hume recognizes, the extent to which he thinks our sympathy with others’ feelings depends on inferences from the other’s expression, and from her perceived situation, and consider also whether he later changed his views about the nature and role of sympathy, in particular its role in morals.

Definition of the problem Death and suicide wishes of older people represent a relevant and morally challenging issue for nurses. Especially in the context of wishes for assisted suicide, the risk for the development of moral uncertainty or even moral distress grows. As suicide rates and requests for assisted suicide are particularly high among people 65 years of age or older, the topic proves to be particularly relevant to the settings of long-term community and nursing home care. At the same (...) time, this fact underlines the importance of suicide prevention, which has recently been strengthened by the federal government, with the intention of launching a national strategy and a corresponding law. Arguments According to our hypothesis, the situational confrontation of nursing professionals with death and suicide wishes may cause an ethical field of tension between an unprejudiced, open, empathetic and respectful acceptance of death and suicide wishes on the one hand and the goal of suicide prevention on the other. The legal uncertainties in regards to the practice of assisted suicide, which currently prevails in practice, may intensify this risk. International studies point to the potential of moral distress of nurses when confronted with death and suicide wishes. Conclusion These findings and the reference to the current legal uncertainties and framework conditions in the national (German) context underpin the importance of the professional discussion about the topic, the need to sensitise (future) nursing professionals to potential ethical tensions and to enable them to deal with the accompanying moral uncertainty in a professional and competent manner. (shrink)

We study the I-ultrafilters on ω, where I is a collection of subsets of a set X, usually R or ω 1 . The I-ultrafilters usually contain the P-points, often as a small proper subset. We study relations between I-ultrafilters for various I, and closure of I-ultrafilters under ultrafilter sums. We consider, but do not settle, the question whether I-ultrafilters always exist.

We study the $I$-ultrafilters on $\omega$, where $I$ is a collection of subsets of a set $X$, usually $\mathbb{R}$ or $\omega_1$. The $I$-ultrafilters usually contain the $P$-points, often as a small proper subset. We study relations between $I$-ultrafilters for various $I$, and closure of $I$-ultrafilters under ultrafilter sums. We consider, but do not settle, the question whether $I$-ultrafilters always exist.

A regularity theory of causation analyses type-level causation in terms of Boolean difference-making. The essential ingredient that helps this theoretical framework overcome the problems of Hume’s and Mill’s classical accounts is a principle of non-redundancy: only Boolean dependency structures from which no elements can be eliminated track causation. The first part of this article argues that the recent regularity-theoretic literature has not consistently implemented this principle, for it disregarded an important type of redundancies: structural redundancies. Moreover, it is shown that (...) a regularity theory needs to be underwritten by a hitherto neglected metaphysical background assumption stipulating that the world’s causal makeup is not ambiguous. Against that background, the second part then develops a new regularity theory that does justice to all types of redundancies and, thereby, provides the first all-inclusive notion of Boolean difference-making. (shrink)

This article identifies problems with regard to providing criteria that regulate the matching of logical formulae and natural language. We then take on to solve these problems by defining a necessary and sufficient criterion of adequate formalization. On the basis of this criterion we argue that logic should not be seen as an ars iudicandi capable of evaluating the validity or invalidity of informal arguments, but as an ars explicandi that renders transparent the formal structure of informal reasoning.