In step with rapid advancements in computer vision, vehicle classification demonstrates a considerable potential to reshape intelligent transportation systems. In the last couple of decades, image processing and pattern recognition-based vehicle classification systems have been used to improve the effectiveness of automated highway toll collection and traffic monitoring systems. However, these methods are trained on limited handcrafted features extracted from small datasets, which do not cater the real-time road traffic conditions. Deep learning-based classification systems have been proposed to incorporate the (...) above-mentioned issues in traditional methods. However, convolutional neural networks require piles of data including noise, weather, and illumination factors to ensure robustness in real-time applications. Moreover, there is no generalized dataset available to validate the efficacy of vehicle classification systems. To overcome these issues, we propose a convolutional neural network-based vehicle classification system to improve robustness of vehicle classification in real-time applications. We present a vehicle dataset comprising of 10,000 images categorized into six-common vehicle classes considering adverse illuminous conditions to achieve robustness in real-time vehicle classification systems. Initially, pretrained AlexNet, GoogleNet, Inception-v3, VGG, and ResNet are fine-tuned on self-constructed vehicle dataset to evaluate their performance in terms of accuracy and convergence. Based on better performance, ResNet architecture is further improved by adding a new classification block in the network. To ensure generalization, we fine-tuned the network on the public VeRi dataset containing 50,000 images, which have been categorized into six vehicle classes. Finally, a comparison study has been carried out between the proposed and existing vehicle classification methods to evaluate the effectiveness of the proposed vehicle classification system. Consequently, our proposed system achieved 99.68%, 99.65%, and 99.56% accuracy, precision, and F1-score on our self-constructed dataset. (shrink)

Refusing consent to organ donation remains unacceptably high, and improving consent rates from family or next-of-kin is an important step to procuring more organs for solid organ transplantation in countries where this approval is sought. We have thus far failed to translate fully our limited understanding of why families refuse permission into successful strategies targeting consent in the setting of deceased organ donation, primarily because our interventions fail to target underlying cognitive obstacles. Novel interventions to overcome these hurdles, incorporating an (...) understanding of cognitive psychology and behavioral change therapy, may be beneficial. One potential intervention is to use the concept of nudge theory, where decision-making is influenced by encouraging positive reinforcement and indirect suggestion. Purposefully nudging families to given consent for organ donation by understanding, and then overcoming, their inherent cognitive biases is novel but also controversial. This article explores the roles of relatives in decisions about organ donation, how nudge theory translates to organ donation and discusses the arguments for and against its application. (shrink)

We show in this paper that the AGM postulates are too weak to ensure the rational preservation of conditional beliefs during belief revision, thus permitting improper responses to sequences of observations. We remedy this weakness by proposing four additional postulates, which are sound relative to a qualitative version of probabilistic conditioning. Contrary to the AGM framework, the proposed postulates characterize belief revision as a process which may depend on elements of an epistemic state that are not necessarily captured by a (...) belief set. We also show that a simple modification to the AGM framework can allow belief revision to be a function of epistemic states. We establish a model-based representation theorem which characterizes the proposed postulates and constrains, in turn, the way in which entrenchment orderings may be transformed under iterated belief revision. (shrink)

Big data technologies are entering the world of ageing computer systems running critical infrastructures. These innovations promise to afford rapid Internet connectivity, remote operations or predictive maintenance. As legacy critical infrastructures were traditionally disconnected from the Internet, the prospect of their modernisation necessitates an inquiry into cyber security and how it intersects with traditional engineering requirements like safety, reliability or resilience. Looking at how the adoption of big data technologies in critical infrastructures shapes understandings of risk management, we focus on (...) a specific case study from the cyber security governance: the EU Network and Information Systems Security Directive. We argue that the implementation of Network and Information Systems Security Directive is the first step in the integration of safety and security through novel risk management practices. Therefore, it is the move towards legitimising the modernisation of critical infrastructures. But we also show that security risk management practices cannot be directly transplanted from the safety realm, as cyber security is grounded in anticipation of the future adversarial behaviours rather than the history of equipment failure rates. Our analysis offers several postulates for the emerging research agenda on big data in complex engineering systems. Building on the conceptualisations of safety and security grounded in the materialist literature across Science and Technology Studies and Organisational Sociology, we call for a better understanding of the ‘making of’ technologies, standardisation processes and engineering knowledge in a quest to build safe and secure critical infrastructures. (shrink)

Recent work has shown that the input-output behavior of some common machine learning classifiers can be captured in symbolic form, allowing one to reason about the behavior of these classifiers using symbolic techniques. This includes explaining decisions, measuring robustness, and proving formal properties of machine learning classifiers by reasoning about the corresponding symbolic classifiers. In this work, we present a theory for unveiling the _reasons_ behind the decisions made by Boolean classifiers and study some of its theoretical and practical implications. (...) At the core of our theory is the notion of a _complete reason,_ which can be viewed as a necessary and sufficient condition for why a decision was made. We show how the complete reason can be used for computing notions such as sufficient reasons (also known as PI-explanations and abductive explanations), how it can be used for determining decision and classifier bias and how it can be used for evaluating counterfactual statements such as “a decision will stick even if...because....” We present a linear-time algorithm for computing the complete reasoning behind a decision, assuming the classifier is represented by a Boolean circuit of appropriate form. We then show how the computed complete reason can be used to answer many queries about a decision in linear or polynomial time. We finally conclude with a case study that illustrates the various notions and techniques we introduced. (shrink)

History in this age needs to record and analyze the events in the light of modern concept of contemporary world. When the historians narrate the brutal condition of Indo-Pak history, they never forget the work and services of Shaykh Ahmad Sirhindi to transform the society according to the current values. For his services, he is hailed as Mujaddid Alf-I-Thani. The Muslim society had degenerated when Mujaddid Alf-I-Thani appeared on the horizon. A number of Hindu customs and practices had become the (...) part of their creed. The commandments of Shariat and Sunnah were being floated. Moreover, the Mughal emperor Akbar had adopted controversial policies detrimental to the very existence of Muslim society. Mujaddid Alf -Thani made strenuous and constant efforts to turn the tide. When Mujadded-Alf-Thani started his social reform movement, he found that the Muslim society was embracing un-Islamic practices such as widespread belief in Karamat had developed under the influence of Hindu thinking. Moreover, the Islamic teachings had been vitiated by adopting customs and practices of other religions such as inter marriages between Hindus and Muslims and ban on cow slaughter etc. Shaykh Ahmad Sirhindi never entered into any political conflict directly. He endeavored to restore pure doctrine to Islamic thought and to compel the Muslims to follow Shariat and Sunnah in letter and spirit. He was a social reformer, great Alim, Sufi and Mujaddid. He initiated a process of social change, inspired by Islamic Ideal, in an age, which was becoming secular. This research paper is an attempt to mention the role of Shaykh Ahmad Sirhindi for saving the society from un-Islamic values and customs in the sub-continent and its impact on society. By utilizing the historical method, this paper aims at analyzing the effect of social reforms of Shaykh Ahmed Sirhindi on Muslim society. (shrink)

We address in this paper the problem of counting the models of a propositional theory under incremental changes to its literals. Specifcally, we show that if a propositional theory Δ is in a special form that we call smooth, deterministic, decomposable negation normal form, then for any consistent set of literals S, we can simultaneously count the models of Δ ∪ S and the models of every theory Δ ∪ T where T results from adding, removing or flipping a literal (...) in S. We present two results relating to the time and space complexity of compiling propositional theories into sd-DNNF. First, we show that if a conjunctive normal form has a bounded treewidth, then it can be compiled into an sd-DNNF in time and space which are linear in its size. Second, we show that sd-DNNF is a strictly more space efficient representation than Free Binary Decision Diagrams. Finally, we discuss some applications of the counting results to truth maintenance systems, belief revision, and model-based diagnosis. (shrink)

We address in this paper the problem of counting the models of a propositional theory under incremental changes to its literals. Specifcally, we show that if a propositional theory Δ is in a special form that we call smooth, deterministic, decomposable negation normal form (sd-DNNF), then for any consistent set of literals S, we can simultaneously count (in time linear in the size of Δ) the models of Δ ∪ S and the models of every theory Δ ∪ T where (...) T results from adding, removing or flipping a literal in S. We present two results relating to the time and space complexity of compiling propositional theories into sd-DNNF. First, we show that if a conjunctive normal form (CNF) has a bounded treewidth, then it can be compiled into an sd-DNNF in time and space which are linear in its size. Second, we show that sd-DNNF is a strictly more space efficient representation than Free Binary Decision Diagrams (FBDDs). Finally, we discuss some applications of the counting results to truth maintenance systems, belief revision, and model-based diagnosis. (shrink)

Are the employees working in different countries and enjoying healthy compensation truly loyal to their organization? Our study attempts to answer this question by examining the role of perception of politics on the affective commitment of expatriates in the Sultanate of Oman. Following the axiom of equity theory, the relationships between the perception of politics (POP) to affective commitment (AC) and Islamic work ethics (IWE) to affective commitment (AC) was tested. The moderating role of Islamic work ethics was also examined (...) in the POP-AC relationship. Responses from 146 employees were collected following a simple random sampling technique. Employees working in different organizations at various managerial levels were approached for data collection. Descriptive statistics, correlation, and regression tests were applied to test hypotheses using SPSS-22.0 and SmartPLS-4. Results confirmed the positive relationship between Islamic work ethics to affective commitment and the negative relationship between perception of politics to affective commitment. Moreover, the negative relationship between the perception of politics with affective commitment was weaker when Islamic work ethics were high. Practical implications of the study are presented based on the results. (shrink)

Given that health systems research involves different aims, approaches, and methodologies as compared to more traditional clinical trials, the ethical issues present in HSR may be unique or particularly nuanced. This article outlines eight pertinent ethical issues that are particularly salient in HSR and argues that the ethical review process should be better tailored to ensure more efficient and appropriate oversight of HSR with adequate human protections, especially in low- and middle-income countries. The eight ethical areas we discuss include the (...) nature of intervention, types of research subjects, units of intervention and observation, informed consent, controls and comparisons, risk assessment, inclusion of vulnerable groups, and benefits of research. HSR involving human participants is necessary to ensure health systems strengthening and quality of care and to guide public policy intelligently. Health systems researchers must carefully define their intent and goals and openly clarify the values that may influence the premises and design of protocols. As new types of population-level research activities become more commonplace, it is critical that institutional review board and research ethics committee review processes evolve to evaluate these research protocols in ways that address the nuanced features of these studies. (shrink)

One of the main features that distinguish modern novel from traditional one is the use of new narrative techniques such as monologue, flow of consciousness, leitmotiv and intertextuality. These techniques relate to new approaches that take shape in formal elements such as time, characters and event patterns that make up the modern novel. Which expression technique is used in the work is often related to the form and content of the novel. This research examines the Kevâbîsu Beyrût, which uses modern (...) and post modern expression techniques in the Arab novels of the last century, in the context of the content of the work and reveals the appropriateness of the techniques used for the purpose of the work. The authors of the novel, autobiographical, tried to convey the feelings of a civil war in many ways, and remained in the midst of conflicts. The techniques that came to the forefront in his narration have added aesthetic value to the composition of the narration and it has become one of the famous Arab novels. The introduction part of the work consists of the factors that prepared the ground for the civil war that took place in Lebanon between 1975 and 1990, the first chapter, the work of writer Gâde es-Semman, the third chapter; Kevâbîsu will investigate the relation between the narrative techniques of the novel Beirut and the factors leading to the writing of the work. (shrink)

Ways of Being Free: Introduction -- War Is Everything's Father: History and Death as Causes of Existential Angst -- Introduction: Causes of Existential Angst -- Change and Changelessness in Midnight's Children -- The Road of Existential Struggle in The Famished Road -- History and the "Nervous Condition" in The English Patient -- Death as a Drive to Meaningful Existence in Midnight's Children -- Becoming Dead-to-the-World in The English Patient -- Ideological Re-appropriation through Death in The Famished Road -- Authenticity -- (...) Authenticity: Introduction -- From Self-Sufficiency to Inoperative Community in The English Patient -- Revolution Revisited in The Famished Road -- From Communalism to the Comic Absurd in Midnight's Children. (shrink)

This article draws attention to the limited amount of scholarship on what constitutes fairness and equity in resource allocation to health research by individual funders. It identifies three key decisions of ethical significance about resource allocation that research funders make regularly and calls for prioritizing scholarship on those topics – namely, how health resources should be fairly apportioned amongst public health and health care delivery versus health research, how health research resources should be fairly allocated between health problems experienced domestically (...) versus other health problems typically experienced by disadvantaged populations outside the funder's country, and how domestic and non-domestic health research funding should be further apportioned to different areas, e.g. types of research and recipients. These three topics should be priorities for bioethics research because their outcomes have a substantial bearing on the achievement of health justice. The proposed agenda aims to move discussion on the ethics of health research funding beyond its current focus on the mismatch between worldwide basic and clinical research investment and the global burden of disease. Individual funders’ decision-making on whether and to what extent to allocate resources to non-domestic health research, health systems research, research on the social determinants of health, capacity development, and recipients in certain countries should also be the focus of ethical scrutiny. (shrink)

203 surveys were considered complete and were included in the analysis. Written consent was not used by nearly 40% of the researchers.

Several protective cellular mechanisms protect against the accumulation of reactive oxygen species (ROS) and the concomitant oxidative stress. Therefore, any reduction in glucose or fatty acid flux into cells leading to a decrease in the production of reducing equivalents would also lead to a decreased ROS production and protect cells against oxidative stress. In the presence of insulin, FOXO proteins are localized from the nucleus to the cytoplasm and degraded. An increase in cellular glucose uptake will lead to increased production (...) of ROS. This in turn activates the stress‐responsive Jun‐N‐terminal kinase (JNK), which promotes nuclear translocation of FOXO proteins, upregulating some important target genes including stress resistance. Consequently, insulin resistance should result in decreased cellular ROS production. For this reason, insulin resistance could be a physiological mechanism activated at the cellular level in response to conditions stimulating ROS production and leading to the prevention of oxidative stress, and extension of life. Concerning the whole organism, however, IR is a maladaptive process in the long term causing a diabetic state. BioEssays 29:811–818, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Despite the fact that in order to become a liveable space for humankind the world owes many things to the scientific point of view, to fill that space with meaning so that it can be our home, is only possible due to the aesthetic relation which man establishes with life. The meaning which is required so that man could make sense of this space can only be brought into this world through the fictional strength of language. Existence which in itself (...) alone is meaningless, indifferent and neutral can only become a stage where humanity dares to appear, thanks to the attributes that it gains through the act of making sense. By overlooking that point the theoretical approach which is symbolized by the Enlightenment destroys according to Nietzsche the basics of the relation between man and life. Today the scientific and technological Perspective which have become the forces of our culture and civilization have already withdrawn themselves from the question of the meaning of life to the point of ignoring its importance. On the other side, due to its natural mechanism, the advantage which the artistic approach possesses comes from the capacity to transform the reality through fiction. Hence, art is maybe one of the most important accomplishments which contributes to the creation of meaning so that man won't perish against this essential indifference of existence. (shrink)

Özgür istemeyi bir illüzyona dönüştüren deterministik öğelere sahip olan bir ideoloji içerisinde insan varoluşunun anlamsız ve saçma bir nitelik arz edeceğini düşünen Dostoyevski, Yeraltından Notlar’da kurguladığı yeraltı adamı karakteri aracılığıyla, doğa yasalarını temel alan ve Çernişevski gibi materyalist düşünürler tarafından savunulan toplumsal mühendislik fikrinin hiçbir şekilde uygulamaya konulmayacağını göstermek ister. Bunu gerçekleştirmek için dolaylı bir yol izleyen ve yeraltı adamı aracılığıyla determinist bir ideolojinin penceresinden dünyaya bakan bir karakter yaratan Dostoyevski, bu karakterin bakışından hareketle tüm insani edimlerin zorunlu bir nedensellik (...) tarafından belirlendiğini idrak eden bilincin verdiği irrasyonel, çelişkili ve bir anlamda saçma tepkileri gün yüzüne çıkarır. Karşıt olduğu öğretinin perspektifinden bir anlatı ortaya koyan Dostoyevski böylece materyalist bir determinizm ileri süren ideolojiyi adeta içeriden çürütmeye çalışır. Bu makalenin amacı Dostoyevski’nin Yeraltından Notlar’ını takip ederek, istemelerini, arzularını ve seçimlerini özgürce hayata geçiremeyeceğinin bilincine varan yeraltı adamının düştüğü çelişkili varoluşu irdelemek ve böylece determinist öğretilerin kabul edilmesi güç olan pratik sonuçlarını anlaşılır kılmaktır. (shrink)

Alzheimer’s disease is the most common form of dementia which is estimated to impact 350,000 people over 65 years of age in Canada. The lack of effective treatment and the growing number of people who are expected to be diagnosed with Alzheimer’s disease in the near future are compelling reasons why continued research is in this area is necessary. With additional research, there needs to be greater recognition of the complexity of seeking ongoing informed consent from those with Alzheimer’s disease. (...) This complexity is because the impairment of memory and cognitive ability does not diminish in a linear manner, but rather fluctuates between periods of impairment and relatively normal cognitive lucidness. There is limited discussion in the guidelines of those progressing from early stages of Alzheimer’s disease who have intermittent cognitive function. Guidelines to research and Research Ethics Boards require further development to facilitate researcher including those with Alzheimer’s disease while protecting this growing pool of potential participants. (shrink)

The early period Ismaili jurist Al-Qādî al-Nu'mān appears as an important figure in the formation of Ismaili jurisprudence. There is very little information about Kadı Nu'mân's family, childhood, education and intellectual environment. His full name is Abû Hanîfah Nu'man b. Muhammad b. Mansûr al-Qādî at-Tamîmî Al Qayrawānî. He was born around 290/903 (late 3rd (9th) century) into an educated family in Qayravan in North Africa. There are different opinions about the sect he belonged to when he was growing up. On (...) the other hand, it is difficult to say for certain whether Nu’mān received education in the Ismaili sect due to the understanding of taqiyya in the madhhab. However, it is understood from the basic jurisprudence texts Nu’mān wrote that he most likely did not receive a Sunni education. Historians refer to him as 'Qadi Nu’mān or Abu Hanifah al-Shi'i' in order not to confuse him with the imam of the Hanafi school. Qādî Nu’mān served at different levels of the Fatimid State. Around 313/925, he entered the service of the first Fatimid caliph, Mahdi (r. 909-934 CE/297-322 AH), as a copyist and secretary. During the reigns of the third caliph Mansur and the fourth Fatimid caliph Mu’izz (d. 365/975), Qādî Nu’mān first served as a judge in Tripoli and then in Mansouriya, the Fatimid capital. After the Fatimids conquered Egypt and the center of government was moved to Cairo, Qādî Nu’mān was appointed by the fourth caliph Mu’izz as the head of the appellate courts (maẓālim). Qadi Numans career was at the peak in the period of Caliph Muiz. Qādî Nu’mān worked as a judge in the Fatimid State for about twenty-six years and continued this duty until his death in 363 (973). After the fall of the Fatimid caliphate, there haven’t been any other Fatimid or Ismaili jurists. Qādî Nu’mān is considered by contemporary Ismaili writers as a figure who systematically transformed Ismaili fiqh into an independent sect of fiqh. It can be said that Ismaili fiqh was developed through his works in the Fatimid period. His works continued as the main references in the fiqh studies and after the Fatimid period. With the death of Qādî Nu’mān, the period of ijtihad in Ismaili fiqh and its the establishment phase of Ismaili fiqh came to an end; The sect, in which esoteric interpretations were at the forefront, emerged as a distinctive school of fiqh by discarding ambiguity. Qādî Nu’mān was a very productive writer. He wrote important works related to the field of furu al-fiqh and usûl al-fiqh. Among his works, Ikhtilāf uṣūl al-madhāhib is undoubtedly one of the most important works in the early history of fiqh methodology. The work in question, which was originally written with the aim of rejecting the Sunni fiqh method, discusses the approaches of the Sunni schools of fiqh on ikhtilāf, taqlid, ijma, nazar, qiyas, istihsan, ijtihad and ra’y in a polemical manner. It reveals the differences of the Ismaili method from the Sunni method in terms of the sources on which the fiqh is based, the authority to make ijtihad and the theory of interpretation of the texts. Qādî Nu’mān examined the relationship between reason and revelation in general and the role of religious authority in comprehending and interpreting the texts while criticizing Sunni methods. Ikhtilāf uṣūl al-madhāhib has the characteristics of the works of development period as a form. It is possible to observe the question-answer and dialectic form which can be seen in the works of the development period throughout the work in question. Qādî Nu’mān endeavoured to persuade his opponents with a dialectical and argumentative style. Again, he replied to the Sunnis, who were his interlocutors, with their own proofs. In addition to these, Ikhtilāf uṣūl al-madhāhib has a unique feature in the matter of content. Because it is not very familiar to any Sunni handbook of usûl al-fiqh. It does not mention the hâss, âmm, ijma, qiyas, amir, nahy, alfaz bets, etc. The text is very similar to the Ahbari movement of the Jafari sect for it rejects all forms of ijtihad. It was written at a time when fiqh was not yet stable. Ikhtilāf uṣūl al-madhāhib gives us crucial information about the development of different usûl and fiqh sources in the middle of the fourth century. However, what is interesting here is that the information he gives about Ismaili method and fiqh is very little compared to the one about Sunni method and fiqh. Much of it centered on Sunni thought and its rejection. However, his ultimate goal was to defend the Ismaili doctrine. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:On the Importance of Conceptual ContrastsMadness, Reason, and Mad PrideAwais Aftab, MD (bio)Garson (2023) offers an engaging historical and philosophical discussion around the importance Late Modern thinkers assigned to the task of differentiating madness from idiocy (or more specifically, to the tripartite distinction of sanity, madness, and idiocy). Based on this analysis, Garson’s identifies the need to offer a positive account of mental illness—one that does not define the (...) essence of mental illness exclusively as the absence, lack, or failure of the power of reasoning. Following the Late Modern thinkers (Locke, Kant, Wigan, and Heinroth), Garson concludes that madness is infused with reason, and what characterizes madness is the presence of reason in an altered and mutated form. This is all worth taking seriously. My own assessment of this historical and philosophical material nonetheless differs from that of Garson. To recognize madness as possessing reason within it in an altered form may be of less profound significance than he thinks it is. Garson’s discussion commendably highlights the importance of making conceptual contrasts explicit in definitional debates, and this should indeed lead us to search for contrasts that are more philosophically illuminating (what is better will depend on the context of inquiry). However, in my view, the recognition of madness as altered reason neither reframes the project of defining “mental disorder” nor does it provide an intellectual scaffolding for mad activism.The significance of “madness contains reason within in but in an altered or perverse form” is difficult to translate into contemporary scientific terms, and the fuzziness and historical baggage around the terms “madness,” “reason,” and “perversion” does not make it easy. “Mental disorder” or “psychopathology” means to us something quite different than what madness meant to Late Modern thinkers, and while “madness” remains a popular term in philosophical literature, there is no clarity on the nature of overlap between the domain of madness and the domain of conditions currently classified by the diagnostic manuals. Mental disorders, as currently conceptualized, include a motley of conditions that were previously characterized using terms such as idiocy, madness, neuroses, and psychopathic personalities. [End Page 297]From our contemporary vantage point, to compare idiocy and madness is to make a distinction within the domain of psychopathology. We are comparing two groups of psychiatric conditions. The lessons we derive from this comparison do not necessarily extrapolate well to a comparison of mental disorders with something outside the domain of psychopathology. To the extent that psychopathology is inclusive of both idiocy and madness, psychiatric disorders both contain and do not contain “reason” within them. The domain is heterogenous in this regard, and broad generalizations about the nature of reason in the mental disorders would be simplistic at best and inaccurate at worst. Other distinctions that we have made within the domain of psychopathology have included organic versus functional, neurosis versus psychosis, categories versus continua, and distinctions used within nosology have included operationalized criteria versus phenomenology, idiographic versus nomothetic, medical versus non-medical, description versus explanation, and so on (Aftab & Ryznar, 2021; Zachar, Banicki, & Aftab, 2023), all of which have the potential to offer a positive account of some aspect of psychopathology.It is worth nothing that the distinction between “absence of reason” versus “perversion of reason” is analogous to the common distinction between absence of function and altered function in patho-physiology. Such a distinction exists for almost every function that exists. Consider vision: absence of vision (blindness) and altered vision (illusions, distortions, hallucinations). Consider hypoesthesia (reduced sense of touch) and paraesthesia (altered sense of touch—tingling, pricking, burning, etc.). Garson alludes to diminished sexual capacity versus paraphilia as an analogy, but he does not seem to appreciate that the analogy applies much more broadly. Is the distinction between absence of reason versus perversion of reason of any greater significance than the distinction between blindness and hallucination? If we were to say, “What distinguishes hallucination from blindness is not the failure, absence, or lack of sight, but its presence—albeit in a perverse and mutated form,” how profound would it really be for our notions of disorder? Or imagine some Late Modern physician saying that a disturbance of speech and... (shrink)

In this commentary on Anneli Jefferson’s book “Are Mental Disorders Brain Disorders?,” I offer an overview of her central thesis, and then propose my own modified account of when we are justified in calling mental disorders as “brain disorders.” In doing so, I draw on recent work in neuroscience that understands the relationship between brain and behavior in complex, dynamic, and computational terms. In particular, I disagree with Jefferson’s criterion of sufficiency, that a particular brain process should always realize a (...) psychological dysfunction. I propose that a psychiatric disorder can be said to be a brain disorder if there are empirically identifiable systematic brain differences associated with it and if these associations are contextualized within a scientifically robust theoretical understanding of the relationship between brain and behavior. I conclude by preliminary reflections on whether the issue of “mental disorder” versus “brain disorder” comes down to “the language of psychology” versus “the language of neuroscience,” and the degree to which the former can be expressed in the latter. (shrink)

With developed country governments and high resource institutions engaging in research in low- and middle-income countries, we argue that these entities have a moral obligation to help build and strengthen research infrastructure and capacity so local scientists and institutions can adequately conduct studies to understand and resolve the health burdens in low and middle income countries. We explore the moral justifications and motivations behind engaging in research capacity strengthening in the health sector in LMIC at multiple levels. In highlighting these (...) issues, this paper aims to initiate a global discourse around why capacity development in LMIC has a moral basis at the individual, institutional and system levels. (shrink)

ABSTRACT In recent years there has been intense debate regarding the level of medical care provided to ‘standard care’ control groups in clinical trials in developing countries, particularly when the research sponsors come from wealthier countries. The debate revolves around the issue of how to define a standard of medical care in a country in which many people are not receiving the best methods of medical care available in other settings. In this paper, we argue that additional dimensions of the (...) standard of care have been hitherto neglected, namely, the structure and efficiency of the national health system. The health system affects locally available medical care in two important ways: first, the system may be structured to provide different levels of care at different sites with referral mechanisms to direct patients to the appropriate level of care. Second, inefficiencies in this system may influence what care is available in a particular locale. As a result of these two factors locally available care cannot be equated with a national ‘standard’. A reasonable approach is to define the national standard of care as the level of care that ought to be delivered under conditions of appropriate and efficient referral in a national system. This standard is the minimum level of care that ought to be provided to a control group. There may be additional moral arguments for higher levels of care in some circumstances. This health system analysis may be helpful to researchers and ethics committees in designing and reviewing research involving standard care control groups in developing country research. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Future Is Political and TransdisciplinaryAwais Aftab (bio)Philosophy, psychiatry, & psychology (PPP) is a transdisciplinary oasis, one of the few journals in mental health care that facilitate a meaningful dialogue between philosophers, psychiatrists, psychologists, and scholars from related disciplines. The fact that PPP successfully provides such a space is of no small importance, especially from my perspective as a psychiatrist. The multidisciplinary nature of the undertaking has been a (...) central aspect of the identity of the journal from the very beginning. PPP has maintained this transdisciplinary inclusive spirit over the years, and its editorial and advisory boards remain richly representative, but the challenge of ensuring continued participation of clinicians is not insubstantial. After all, the point is not token participation, but a robust and transformative interdisciplinary engagement. Clinicians have much to contribute to philosophical debates, however, such capacity for dialogue requires sustained cultivation (Aftab & Waterman, 2021), and forces in medical education have led to a situation where comparatively fewer psychiatrists have the interest or the ability to engage in such rigorous dialogue with philosophers. Philosophy of mental health has grown and specialized exponentially since the mid-90s. Keeping up with this literature is difficult even for philosophers, it is no small feat for full-time clinicians.This means that PPP and its affiliate organizations have a responsibility to take a more active role in supporting educational initiatives to ensure that future generations of psychiatric clinicians are able to contribute to philosophical debates, and that philosophy of psychiatry does not become divorced from clinical and practical concerns. My advice to clinicians based on my experience would be two-fold: first, it is essential to acquire a basic familiarity with the philosophy of psychiatry literature. Aftab and Waterman (2021) offer a sample list of reading recommendations. At the time of this writing, the International Network for Philosophy and Psychiatry is also undertaking efforts to develop curricula aimed at clinicians. Second, it is important to find ways to interact with others in the philosophy of psychiatry community. Formal avenues to do so include the annual meetings of the Association for the Advancement of Philosophy and Psychiatry and the Philosophy Special Interest Group of the Royal College of Psychiatrists, among others. There are also various online communities active on social media that many find helpful.In recent years, we have seen an unprecedented enthusiasm and support for inclusion of lived experience in mental health care. This is a welcome and much needed development, but we are only just beginning to scratch the surface of [End Page 5] how to philosophically navigate this inclusion. Frameworks such as standpoint epistemology and epistemic justice offer us starting points (Knox, 2022), but much remains to be worked out (Aftab, 2022). There are notable philosophical challenges, such as ascertaining the limits of lived experience, and the biases and errors to which it is vulnerable; the application of scientific method and philosophical criticism to lived experience; methods to resolve disagreements when different forms of lived experience contradict each other; handling discrepancies between knowledge from lived experience and knowledge from other sources be handled; and analyzing the intersection of politics of lived experience with other differentials of power. I anticipate that these topics will be of central importance to the field and to the journal in the coming years.It is also vital that philosophy of psychiatry engage with the sociopolitical dimensions of madness (Kalathil & Jones, 2016). The failure of philosophy to do so in a meaningful way has already been articulated powerfully by commentators such as Nev Jones (2022). An important aspect of acknowledging philosophy's failures in this regard comes from the notion of "elite capture," recently popularized by Olúfẹ́mi O. Táíwò (2022). It refers to how progressive philosophical ideas such as standpoint epistemology are co-opted by the "elite" to serve their own ends. Discussions on social media have already begun to point out that concepts in philosophy of psychiatry such as "epistemic injustice" show signs of elite capture by the psychiatric establishment, resulting in token participation but no systemic changes. Philosophy of psychiatry needs to tackle its own vulnerability to co-option. This will require creative forms of philosophizing and engagement with... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Can The Psychopathologized Speak?Notes on Social Objectivity and Psychiatric ScienceAwais Aftab*, MD (bio)In "Exclusion of Psychopathologized Standpoints Due to Hermeneutical Ignorance Undermines Psychiatric Objectivity" (2022), Bennett Knox offers a compelling argument that failure of psychiatric community to engage with the "psychopathologized" in processes such as the revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) constitutes a form of epistemic injustice and threatens the social objectivity of (...) psychiatric science. I find myself in agreement with the central thesis and I am glad to see it articulated so well by Knox. While it is clear that the exclusion of psychopathologized standpoints in psychiatric science cannot be justified, there are issues that arise that require further clarification, and may generate disagreements, when we consider the complexities of how this inclusion is to take place, what requirements can be imposed on this process of inclusion, and the relationship between the DSM and psychiatric science broadly when it comes to social objectivity.The Methodological Objectivity of the DSM Does Not Exhaust the Methodological Objectivity of Psychiatric ScienceThe DSM is a nosological project within a particular historical context, operating with a certain set of assumptions (Aftab & Ryznar, 2021). The DSM has limitations in terms of what sorts of perspectives it can meaningfully incorporate, but the limitations of the DSM are not the limitations of psychiatric science. This is because psychiatric science is a pluralistic domain and includes many different methodologies and perspectives (Jerotic & Aftab, 2021). As one example, the DSM is poorly equipped to capture the phenomenology of psychiatric conditions. It is not something that it sets out to do. This, however, only becomes a serious problem if we adopt the attitude "if it's not in the DSM then it doesn't really count." Unfortunately, many in the psychiatric community have [End Page 267] adopted this sort of attitude, at least implicitly, resulting in a serious neglect of phenomenology (and various other perspectives, including those of the psychopathologized), leading Nancy Andreasen to bemoan the "death of phenomenology." (Andreasen, 2007) The DSM is methodologically limited by design; there are things that it will fail to do. The appropriate response is to acknowledge these inherent limitations. Other perspectives such as neurodiversity or Hearing Voices Movement also bring their own sets of assumptions and limitations. The DSM is simply one element, one perspective, one methodology in a scientific field that is capable of and ought to adopt a plurality of perspectives and methodologies. This is worth pointing out because Knox appears to assume that if it proves difficult or impossible for the DSM to include radically diverse perspectives, then "all the worse for psychiatry's objectivity." If it is impossible for the DSM, that does not mean that it is also impossible for psychiatric science.1In Determining What Counts as Inappropriate Exclusion, What Is the Role of Scientific Expertise?Longino herself brings up this question: "in determining what counts as inappropriate exclusion of dissenting perspectives, does it matter what kind of issue is involved? Are the duties of inclusion different when the question is, Should we be trying to learn about such and such, for example, atomic fission? than when it is, Is atomic fission a controllable or uncontrollable process?" (Longino, 2002, p. 133) The danger that needs to be averted here is that of trivializing expertise and placing experts on an equal footing with non-experts, a danger that is strikingly illustrated by our social response to the coronavirus disease 2019 pandemic.Take an example from medicine. Individuals with lung cancer have a lot to offer when it comes to the treatment of lung cancer, including their experiences of care, and choice of, say, aggressive chemotherapy vs palliative comfort care, etc. but how much do they have to contribute on the matter of the histopathological classification of lung cancer? Consider the Hierarchical Taxonomy of Psychopathology (HiTOP) (Kotov et al., 2021). This quantitative nosological project has a very specific aim: to determine the patterns of covariation among psychiatric symptoms using statistical techniques such as factor analysis. This... (shrink)

This article comments on the following previously published article: Moncrieff, J., “ It Was the Brain Tumor That Done It!” Szasz and Wittgenstein on the Importance of Distinguishing Disease from Behavior and Implications for the Nature of Mental Disorder. Philosophy, Psychiatry, & Psychology, 27, 169–181.Joanna Moncrieff’s philosophical views on the nature of mental illness represent in many ways the enduring legacy of Thomas Szasz in philosophy of psychiatry. She articulates a defense of Szaszian thinking about disease, with connections to Wittgenstein’s (...) philosophy, that is probably as compelling a defense as a contemporary student of philosophy is likely to find. However, Moncrieff’s... (shrink)