Brock Macdonald1, Evi Vakiani2, Rhonda K Yantiss3, Jun Lee4, Robert S Brown Jr5, Samuel H Sigal61Division of Gastroenterology, Department of Medicine, University of California-San Francisco, San Francisco, CA, 2Department of Pathology, Memorial Sloan–Kettering Cancer Center, New York, NY, 3Department of Pathology and Laboratory Medicine, New York Weill Cornell Medical College, New York, NY, 4Division of Nephrology, Department of Medicine, Weill Cornell Medical College, New York, NY, 5Division of Gastroenterology, Department of Medicine, Columbia University College of Physicians and Surgeons, New (...) York, NY, 6Division of Gastroenterology and Hepatology, Department of Medicine, New York University, New York, NY, USA: The use of sirolimus as an alternative to calcineurin inhibitors for posttransplant immunosuppression is associated with a variety of inflammatory conditions. In this report, we describe the case of a 34-year-old man who developed abnormal liver tests 6 years after live-donor kidney transplantation and 5 years after initiation of sirolimus-based immunosuppression. Elevated aminotransferase levels persisted after withdrawal of potentially hepatotoxic medications, and serologic evaluation for viral hepatitis, autoimmune disease, and genetic disorders was unrevealing. Liver biopsy revealed prominent hepatocellular injury associated with a mixed inflammatory infiltrate and liver tests normalized within 2 weeks of discontinuation of sirolimus. In this report, we review previous reports of sirolimus hepatotoxicity and propose a unifying hypothesis for the various inflammatory conditions that have been attributed to sirolimus.Keywords: sirolimus, immunosuppression, transplant, inflammatory conditions, hepatotoxicity. (shrink)

In this study, we comprehensively examine the relationships between ethical leadership, social exchange, and employee commitment. We find that organizational and supervisory ethical leadership are positively related to employee commitment to the organization and supervisor, respectively. We also find that different types of social exchange relationships mediate these relationships. Our results suggest that the application of a multifoci social exchange perspective to the context of ethical leadership is indeed useful: As hypothesized, within-foci effects (e.g., the relationship between organizational ethical leadership (...) and commitment to the organization) are stronger than cross-foci effects (e.g., the relationship between supervisory ethical leadership and commitment to the organization). In addition, in contrast to the “trickle down” model of ethical leadership (Mayer et al. in Org Behav Hum Decis Process 108:1–13, 2009), our results suggest that organizational ethical leadership is both directly and indirectly related to employee outcomes. (shrink)

Applied Christian Ethics addresses selected themes in Christian social ethics. Part one shows the roots of contributors in the realist school; part two focuses on different levels of the significance of economics for social justice; and part three deals with both existential experience and government policy in war and peace issues.

Written memoranda of conversations, or memcons, provide a near‐contemporaneous record of what was said in conversation, and offer important insights into the activities of high‐profile individuals. We assess the impact of writing a memcon on memory for conversation. Pairs of participants engaged in conversation and were asked to recall the contents of that conversation 1 week later. One participant in each pair memorialized the content of the interaction in a memcon shortly after the conversation. Participants who generated memcons recalled more (...) details of the conversations than participants who did not, but the content of recall was equally and largely accurate for both participants. Remarkably, only 4.7% of the details of the conversation were recalled by both of the partners after a week delay. Contemporaneous note‐taking appears to enhance memory for conversation by increasing the amount of information remembered but not the accuracy of that information. These findings have implications for evaluating the testimony of participants on conversations with major political or legal ramifications. (shrink)

Legally blind participants were able to identify a visual stimulus attribute in the absence of consciously identifying its presence. Specifically, participants—with their corrective lenses removed—correctly guessed the hour-hand position above chance on a clockface shown on a computer screen. This occurred both when presented in a 1-clockface display , as well as when shown a display containing 4 clockfaces , in which only 1 face contained a hand. Even more striking, hand identification accuracy in the 4-clockface condition was comparable whether (...) the clockface containing the hand was or was not correctly identified. That legally blind individuals are capable of identifying stimulus attributes without conscious awareness provides an additional vehicle for exploring implicit perception. Consistent with previous research, the visualsystem can apparently cope with degraded visual input through information available through a secondary pathway via the superior colliculi. (shrink)

This unique textbook utilizes an integrated, case-based approach to explore how the domains of bioethics, public health and the social sciences impact individual patients and populations. It provides a structured framework suitable for both educators (including course directors and others engaged in curricular design) and for medical and health professions students to use in classroom settings across a range of clinical areas and allied health professions and for independent study. The textbook opens with an introduction, describing the intersection of ethics (...) and public health in clinical practice and the six key themes that inform the book's core learning objectives, followed by a guide to using the book. It then presents 22 case studies that address a broad spectrum of patient populations, clinical settings, and disease pathologies. Each pair of cases shares a core concept in bioethics or public health, from community perspectives and end-of-life care to medical mistakes and stigma and marginalization. They engage learners in rigorous clinical and ethical reasoning by prompting readers to make choices based on available information and then providing additional information to challenge assumptions, simulating clinical decision-making. In addition to providing a unique, detailed clinical scenario, each case is presented in a consistent format, which includes learning objectives, questions and responses for self-directed learning, questions and responses for group discussion, references, and suggested further reading. All cases integrate the six themes of patient- and family-centered care; evidence-based practice; structural competency; biases in decision-making; cultural humility and awareness of the culture of medicine; and justice, social responsibility and advocacy. The final section discusses some challenges to evaluating courses and learning encounters that adopt the cases and includes a model framework for learner assessment. (shrink)

1 Evidence-based policy requires researchers to provide the answers to ecological questions that are of interest to policy makers. To find out what those questions are in the UK, representatives from 28 organizations involved in policy, together with scientists from 10 academic institutions, were asked to generate a list of questions from their organizations. 2 During a 2-day workshop the initial list of 1003 questions generated from consulting at least 654 policy makers and academics was used as a basis for (...) generating a short list of 100 questions of significant policy relevance. Short-listing was decided on the basis of the preferences of the representatives from the policy-led organizations. 3 The areas covered included most major issues of environmental concern in the UK, including agriculture, marine fisheries, climate change, ecosystem function and land management. 4 The most striking outcome was the preference for general questions rather than narrow ones. The reason is that policy is driven by broad issues rather than specific ones. In contrast, scientists are frequently best equipped to answer specific questions. This means that it may be necessary to extract the underpinning specific question before researchers can proceed. 5 Synthesis and applications. Greater communication between policy makers and scientists is required in order to ensure that applied ecologists are dealing with issues in a way that can feed into policy. It is particularly important that applied ecologists emphasize the generic value of their work wherever possible. (shrink)

Although activated spinal cord glia contribute importantly to neuropathic pain, how nerve injury activates glia remains controversial. It has recently been proposed, on the basis of genetic approaches, that toll-like receptor 4 may be a key receptor for initiating microglial activation following L5 spinal nerve injury. The present studies extend this idea pharmacologically by showing that TLR4 is key for maintaining neuropathic pain following sciatic nerve chronic constriction injury. Established neuropathic pain was reversed by intrathecally delivered TLR4 receptor antagonists derived (...) from lipopolysaccharide. Additionally, -naltrexone, -naloxone, and -naloxone, which we show here to be TLR4 antagonists in vitro on both stably transfected HEK293-TLR4 and microglial cell lines, suppressed neuropathic pain with complete reversal upon chronic infusion. Immunohistochemical analyses of spinal cords following chronic infusion revealed suppression of CCI-induced microglial activation by -naloxone and -naloxone, paralleling reversal of neuropathic pain. Together, these CCI data support the conclusion that neuron-to-glia signaling through TLR4 is important not only for initiating neuropathic pain, as suggested previously, but also for maintaining established neuropathic pain. Furthermore, these studies suggest that the novel TLR4 antagonists -naloxone and -naloxone can each fully reverse established neuropathic pain upon multi-day administration. This finding with -naloxone is of potential clinical relevance. This is because -naloxone is an antagonist that is inactive at the -opioid selective receptors on neurons that produce analgesia. Thus, these data suggest that -opioid antagonists such as -naloxone may be useful clinically to suppress glial activation, yet -opioid agonists suppress pain. (shrink)

The ACA shifted U.S. health policy from centering on principles of actuarial fairness toward social solidarity. Yet four legal fixtures of the health care system have prevented the achievement of social solidarity: federalism, fiscal pluralism, privatization, and individualism. Future reforms must confront these fixtures to realize social solidarity in health care, American-style.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 26.1 (2002) 157-172 [Access article in PDF] Symposium: On Ken Burns's "Jazz" Jazz: America's Classical Music? 1 Lee B. Brown I VIEWERS OF KEN BURNS'S third cultural epic "Jazz" probably fell into one of three categories. 2 Some found it gripping. Some found it grating. Some found it both at once.The series has unforgettable moments: spectacular jitterbug sequences; Jimmy Lunceford's horn men fanning their trumpet (...) bells with hat mutes in sync; the close-up of the whirring cross-hand drumming of Art Blakey; the bitter-sweet glance Billie Holiday and Lester Young exchange in their last filmed appearance together; the occasional marriage of visuals to music. One riveting three minutes comes when the talking heads tune out, a 78-rpm disk of Louis Armstrong's "West End Blues" is set spinning, and the thrilling notes pour out on a carousel of visual imagery—finally freeze-framing on the face of the young genius himself.On the downside, the series is massively repetitious. As a result of Burns's decision to track two major figures—Louis Armstrong and Duke Ellington—from cradle to grave, the same cuts of Armstrong appear again and again, no matter what the time frame. Some of the series' commentators are particularly annoying—the fiddler of Burns's Civil War series, Matt Glaser, for instance, with his fatuous theories [End Page 157] about Louis Armstrong and Albert Einstein. And the documentary's heavy load of social freight—by Wynton Marsalis, and his mentors Albert Murray and Stanley Crouch 3 —threatens to flatten the music.The series is designed as informative entertainment, not Jazz 101. But Burns pays a price here, as he did in his documentary about baseball, in which not even the basics of the game, let alone any of the subtleties, were explained. In "Jazz" we get no explanation of what Jelly Roll Morton did to transform ragtime into jazz. (The series could easily have pressed Morton himself into service. With no sacrifice of his considerable charm, Morton did explain it, beautifully, in his recorded Library of Congress interviews. 4) Although the swing era gets big billing, no attempt is made to explain how swing rhythm actually works, as contrasted with earlier practices. (I have watched swing drummer Panama Francis entertain a packed hall with a brief but riveting illustration of how it works.)As jazz history, the film also has problems. Some legendary figures are resurrected unconvincingly. When Marsalis tells us what the legendary trumpet player Buddy Bolden sounded like, the illustrative off-camera trumpet is Marsalis's, not Bolden's, who embedded not one note in a record groove. Further, we face the tiresomely obvious problem of omissions. We hear nothing of Albert Ayler, Keith Jarrett, Sun Ra, Mildred Bailey, Benny Carter, Lennie Tristano, Erroll Garner, Eric Dolphy, Art Pepper, or Woody Herman. All we learn about Bill Evans—whose influence on jazz piano was huge—is that Miles Davis hired him even though he was white. Omissions are inevitable, of course. But there is a muted pattern to the exclusions. It was impossible for the series to avoid Benny Goodman, given his central role in the swing era. But white figures are too often either ignored or treated as alienated outsiders. We hear New York Times columnist Margo Jefferson opine that Bix Beiderbecke drank himself to death because he wasn't allowed to play with black musicians. In fact, many of the greatest players—white and black—never played with musicians of their own caliber.Most figures covered in the film are treated either with respect or with reverence. But things get nasty when matters turn to avant-gardists. Thus, Branford Marsalis—Wynton's talented brother—singles out the volcanic pianist Cecil Taylor for a particularly hostile attack. 5 Instead of explaining what Ornette Coleman meant by "free jazz," Albert Murray tells us that jazz is, by definition, free music—and by implication, that Coleman's concept must be fatuous. And Wynton has complained [End Page 158] elsewhere about a jazz avant-garde retreat into what he calls "a... (shrink)

Philip Kitcher is a leading figure in the philosophy of science, and he is part of a growing community of scholars who have turned their attention from the field’s long-time focus on questions of logic and epistemology to the relation between science and society. Kitcher’s book Science, Truth, and Democracy (2001) charted a course between relativism and realism, arguing that the aims of science emerge from not only scientific curiosity but also practical and public concerns. The book also drew on (...) John Rawls’s A Theory of Justice (1999) to develop an ideal of “well-ordered science,” and then applied the ideal to various aspects of the scientific research agenda. Ten years later, complex public issues like climate change have grown more urgent, and with many people questioning mainstream science on climate change, evolutionary biology, vaccines, stem cell research, and other topics, the tensions between science and democracy seem more pronounced than ever. Kitcher’s Science in a Democrat. (shrink)

Co-authored by three prominent philosophers of art, Jazz and the Philosophy of Art is the first book in English to be exclusively devoted to philosophical issues in jazz. It covers such diverse topics as minstrelsy, bebop, Voodoo, social and tap dancing, parades, phonography, musical forgeries, and jazz singing, as well as Goodman's allographic/autographic distinction, Adorno's critique of popular music, and what improvisation is and is not. The book is organized into three parts. Drawing on innovative strategies adopted to address challenges (...) that arise for the project of defining art, Part I shows how historical definitions of art provide a blueprint for a historical definition of jazz. Part II extends the book's commitment to social-historical contextualism by exploring distinctive ways that jazz has shaped, and been shaped by, American culture. Chapters 4 and 5 use the lens of jazz vocals to provide perspective on racial issues previously unaddressed in the work, after which chapter 6 examines the broader premise that jazz was a socially progressive force in American popular culture. Part III concentrates on a topic that has entered into the arguments of each of the previous chapters: what is jazz improvisation? It outlines a pluralistic framework in which distinctive performance intentions distinguish distinctive kinds of jazz improvisation. This book is a comprehensive and valuable resource for any reader interested in the intersections between jazz and philosophy. (shrink)

Efforts to develop a coherent role for white people in racial justice initiatives in the USA are often stymied by the defensiveness, paternalism, and guilt of many white liberals. Such efforts are also undermined by critiques of whiteness that conflate white identity and white supremacy. I address this dilemma by developing an account of antiracist white identity politics, conceived of here as taking responsibility for the effects of being socially defined as white. I locate conceptual resources for this project in (...) James Baldwin’s reflections on tragedy, love, and identity. In contrast to those who invoke Baldwin to argue for abolishing white identity, I make a case for politicizing it. I draw on Baldwin’s articulation of a tragic sensibility to argue that white antiracism requires accepting a morally compromised identity one has not chosen. It also requires accepting that serious efforts to end white supremacy inevitably lead to mistakes, misunderstandings, and counterproductive outcomes. By adopting a tragic perspective on these aspects of white antiracism, white people would become more capable of forging antiracist white identities through robust engagement in struggles for racial justice. (shrink)

hroughout medieval Christianity, religious works of art emerged to illustrate the teachings of the Bible for the largely illiterate population. What, then, is the significance of the psychoactive mushrooms hiding in plain sight in the artwork and icons of many European and Middle-Eastern churches? Does Christianity have a psychedelic history? -/- Providing stunning visual evidence from their anthropological journey throughout Europe and the Middle East, including visits to Roslyn Chapel and Chartres Cathedral, authors Julie and Jerry Brown document the (...) role of visionary plants in Christianity. They retrace the pioneering research of R. Gordon Wasson, the famous “sacred mushroom seeker,” on psychedelics in ancient Greece and India, and among the present-day reindeer herders of Siberia and the Mazatecs of Mexico. Challenging Wasson’s legacy, the authors reveal his secret relationship with the Vatican that led to Wasson’s refusal to pursue his hallucinogen theory into the hallowed halls of Christianity. -/- Examining the Bible and the Gnostic Gospels, the authors provide scriptural support to show that sacred mushrooms were the inspiration for Jesus’ revelation of the Kingdom of Heaven and that he was initiated into these mystical practices in Egypt during the Missing Years. They contend that the Trees of Knowledge and of Immortality in Eden were sacred mushrooms. -/- Uncovering the role played by visionary plants in the origins of Judeo-Christianity, the authors invite us to rethink what we know about the life of Jesus and to consider a controversial theory that challenges us to explore these sacred pathways to the divine. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 26.1 (2002) 157-172 [Access article in PDF] Symposium: On Ken Burns's "Jazz" Jazz: America's Classical Music? 1 Lee B. Brown I VIEWERS OF KEN BURNS'S third cultural epic "Jazz" probably fell into one of three categories. 2 Some found it gripping. Some found it grating. Some found it both at once.The series has unforgettable moments: spectacular jitterbug sequences; Jimmy Lunceford's horn men fanning their trumpet (...) bells with hat mutes in sync; the close-up of the whirring cross-hand drumming of Art Blakey; the bitter-sweet glance Billie Holiday and Lester Young exchange in their last filmed appearance together; the occasional marriage of visuals to music. One riveting three minutes comes when the talking heads tune out, a 78-rpm disk of Louis Armstrong's "West End Blues" is set spinning, and the thrilling notes pour out on a carousel of visual imagery—finally freeze-framing on the face of the young genius himself.On the downside, the series is massively repetitious. As a result of Burns's decision to track two major figures—Louis Armstrong and Duke Ellington—from cradle to grave, the same cuts of Armstrong appear again and again, no matter what the time frame. Some of the series' commentators are particularly annoying—the fiddler of Burns's Civil War series, Matt Glaser, for instance, with his fatuous theories [End Page 157] about Louis Armstrong and Albert Einstein. And the documentary's heavy load of social freight—by Wynton Marsalis, and his mentors Albert Murray and Stanley Crouch 3 —threatens to flatten the music.The series is designed as informative entertainment, not Jazz 101. But Burns pays a price here, as he did in his documentary about baseball, in which not even the basics of the game, let alone any of the subtleties, were explained. In "Jazz" we get no explanation of what Jelly Roll Morton did to transform ragtime into jazz. (The series could easily have pressed Morton himself into service. With no sacrifice of his considerable charm, Morton did explain it, beautifully, in his recorded Library of Congress interviews. 4) Although the swing era gets big billing, no attempt is made to explain how swing rhythm actually works, as contrasted with earlier practices. (I have watched swing drummer Panama Francis entertain a packed hall with a brief but riveting illustration of how it works.)As jazz history, the film also has problems. Some legendary figures are resurrected unconvincingly. When Marsalis tells us what the legendary trumpet player Buddy Bolden sounded like, the illustrative off-camera trumpet is Marsalis's, not Bolden's, who embedded not one note in a record groove. Further, we face the tiresomely obvious problem of omissions. We hear nothing of Albert Ayler, Keith Jarrett, Sun Ra, Mildred Bailey, Benny Carter, Lennie Tristano, Erroll Garner, Eric Dolphy, Art Pepper, or Woody Herman. All we learn about Bill Evans—whose influence on jazz piano was huge—is that Miles Davis hired him even though he was white. Omissions are inevitable, of course. But there is a muted pattern to the exclusions. It was impossible for the series to avoid Benny Goodman, given his central role in the swing era. But white figures are too often either ignored or treated as alienated outsiders. We hear New York Times columnist Margo Jefferson opine that Bix Beiderbecke drank himself to death because he wasn't allowed to play with black musicians. In fact, many of the greatest players—white and black—never played with musicians of their own caliber.Most figures covered in the film are treated either with respect or with reverence. But things get nasty when matters turn to avant-gardists. Thus, Branford Marsalis—Wynton's talented brother—singles out the volcanic pianist Cecil Taylor for a particularly hostile attack. 5 Instead of explaining what Ornette Coleman meant by "free jazz," Albert Murray tells us that jazz is, by definition, free music—and by implication, that Coleman's concept must be fatuous. And Wynton has complained [End Page 158] elsewhere about a jazz avant-garde retreat into what he calls "a... (shrink)

Constructivist technology studies have often cast government as one “social group” among many, reflecting a liberal pluralist view of politics. This article argues, in contrast, that due to the conceptions of citizenship conveyed by policy designs, governments have a special role to play in the shaping of new technologies. This argument is illustrated in the case of the controversial 1996 decision by the California Air Resources Board to significantly revise its electric vehicle program. The article shows that the board’s decision (...) changed the image of citizenship conveyed by its policy design, thus influencing the civic values embedded within electric vehicle technology. (shrink)

Clarke and Beck assume that approximate number system representations should be assigned referents from our scientific ontology. However, many representations, both in perception and cognition, do not straightforwardly refer to such entities. If we reject Clarke and Beck's assumption, many possible contents for ANS representations besides number are compatible with the evidence Clarke and Beck cite.

This essay first examines a few key aspects of the erosion of public university funding in the United States, showing how the ideal of value-free science has undermined efforts to defend a conception of universities as public goods. Then it considers how advocates of California's Proposition 30, a ballot initiative that restored some public university funding, frequently adopted the same logic of privatization they sought to counteract.

Popular interest in the progress of physical science has increased very rapidly in the last few years. Perhaps the spectacular ‘mysteries’ of wireless and the intriguing paradoxes of the theory of relativity are the chief causes. For every home now has its Magic Box—a piece of pure physics; there is not a familiar thing in it, not even that sine qua non of all things that ‘work’—a wheel, only mysterious parts called condensers, grid-leaks, inductances, and thermionic valves. And surely, when (...) a Sunday newspaper produces a facsimile page of Einstein’s recent paper in German containing abstruse tensor equations, reverence for the mathematical physicist is nearing its zenith. (shrink)

Compassionate and Practical Advice Helps Readers Move through Hard Times There are things in life that knock us to the ground. The death of a loved one, the loss of a job, the betrayal of a friend, the turmoil of complex family issues. Sometimes it feels as though life is falling down around us. In those world-rocking times, we can hang on to hurts or we can surrender our pain to the One who promises us abundant life. In this practical (...) and encouraging book, trusted author Elizabeth B. Brown shows weary readers not only how to survive life's difficulties but how to move beyond them to a place of strength and confidence. She shows them that they are not alone and are not destined for a life defined by the chaos of crises. Then she shows readers how to understand and accept their situation, surround themselves with people who can guide and encourage them, and grow through the process. (shrink)

Animal health is key to successful livestock production in developing countries. The development and delivery of vaccines against major epidemic diseases is one component of improving animal health. This paper presents a case study from Kenya on the production and delivery of a vaccine against Contagious Caprine Pleuropneumonia (CCPP), a major disease of goats. The vaccine, while technically a viable preventative measure against CCPP, has not been well integrated into Kenya's animal health care system. From February through November, 1992, the (...) authors explored the organizational and policy constraints to vaccine production and distribution. Data were obtained through interviews, field visits, and available documents. Results suggest an animal health system that 1) does not have a well developed infrastructure to track, identify, and control animal diseases; 2) tends to place greater emphasis on cattle, rather than small ruminant health care; and 3) is not well linked in terms of research, development, and extension services. (shrink)

Emerging adult newlywed couples often experience many demands on their time, and three common problems may surface as couples try to balance these demands—problems related to finances, sleep, and sex. We used two waves of dyadic data from 1,001 emerging adult newlywed couples to identify four dyadic latent profiles from husbands’ and wives’ financial management behaviors, sexual satisfaction, and sleep quality: Flounderers, Financially Challenged Lovers, Drowsy Budgeters, and Flourishers. We then examined how husbands’ and wives’ marital satisfaction, in relation to (...) profile membership, varied at a later wave. We found that Financially Challenged Lovers and Flourishers had significantly higher marital satisfaction than Drowsy Budgeters and Flounderers. Whereas, Financially Challenged Lovers and Flourishers did not differ in terms of marital satisfaction, Drowsy Budgeters seemed to have slightly higher marital satisfaction than Flounderers for wives only. However, we did not find evidence that these connections meaningfully differed by sex. Implications for the efforts of clinicians and educators are discussed. (shrink)

In most general terms, my paper is about the mixture of agendas in the recording industry, where documentation, with its apparently educational implications, becomes difficult to distinguish from a range of distinct, even opposed, goals—which I group under the heading "fabrication." After a few historical remarks, I develop the concept of what I call works of phonography —that is, sound-constructs created by the use of recording machinery. I detail their ontological characteristics, as contrasted the features of ordinary musical works. WPs (...) are—I claim—replete. They are autographic. And they are phono-accessible—that is, accessible only through playbacks of authentic instances of their record artifacts, e.g., cassette tapes, CDs, etc. I then turn to Theodore Gracyk's recent study of rock music, arguing that his account is formally similar to my account of WPs. This raises the question of whether there be counter-examples to Gracyk's account—particularly of the sort that show his view to be too broad. I bring this to a focus finally by a comparison of rock recordings with jazz recordings—two classes that Gracyk tries to keep ontologically distinct. I argue that many classic jazz recordings are artifacts of the recording studio, no less than those Gracyk identifies as pure cases of rock music. In the same vein, I argue that, once recorded, the improvisational music of jazz is deformed—indeed, that it acquires features of WPs. This has the further implication that Gracyk cannot preserve his sharp distinction between rock and jazz records that he want's to maintain. (shrink)

Using an ethnographic case study, this research examines three competing hypotheses of how a community acts. The study attempts to reconstruct the events that led various actors in the community to seek the formation of an industrial base as an alternative economic source for the community. The roles of unique events, specific persons and particular strategies in the formation of the industrial base are examined. It was found that unique events play a very important role in the community's concern over (...) economic alternatives to agriculture and their success in securing such alternatives. These events were also important to key individuals within the community, placing them in positions to act in the industrial base formation. Strategies of community action used in the industrial base formation and since that time were found to be consistent with the “centralized weak-tie network” hypothesis of action or ganization. This type of community action organization seems to be very effective at the community level but tends to be very exclusionary of the community population as a whole. (shrink)

What aspects of philosophical style really count? What aspects of philosophical writing count only as matters of style? Some features of philosophical writing and talking do seem to be of merely ornamental significance, worthy subjects only of gossip or banter. We are familiar with the academic sneer with which poor Professor Kluck is charged with having “somehow managed to confuse” one thing with another. A more serious stylistic matter, of course, would be Professor Kluck’s own willingness to use the apparatus (...) of modal logic in his pathetic endeavors. Or is that a matter of style? If so, does the same concept apply to such amusing and affective phenomena as accent and cadence? We have heard Professor Chisholm’s rising terminal voice inflection, if only because it is so widely imitated. One thinks of Professor Earle’s favorite condemnation “boring” pronounced with an “o” which seems to touch base on every vowel sound known to man. We are impressed by Goodman’s pithiness, and we register his penchant for alliterative triples. We compare Bergmann’s Laocöonian baroque prose with Quine’s soothing urbanity. It is an interesting fact that these are the features which come to mind when we begin to consider the whole question of philosophical style. Have we so internalized the parts that really count that they seem “white,” neutral, style-free? There might well be historical factors which encourage such blindness. Varying degrees of lingering transcendentalism about philosophical method would not be easily reconciled with the awful idea that one is merely speaking a local dialect. Of course the transcendentalism itself is rarely owned up to as such, as if it is assumed that it is Reason which speaks but that it is in poor taste to say so. Alternative methods, when confronted, generate distaste, horror, or the head-shaking sort of wonderment of the Eighteenth Century Parisian who wondered how on earth anyone could be a Persian. (shrink)

Background: Since the passage of the Patient Self-Determination Act, numerous policy mandates and institutional measures have been implemented. It is unknown to what extent those measures have affected end-of-life care, particularly with regard to the do-not-resuscitate order.Methods: Retrospective cohort study to assess associations of the frequency and timing of DNR orders with advance directive status, patient demographics, physician’s specialty and extent of documentation of discussion on end-of-life care.Results: DNR orders were more frequent for patients on a medical service than on (...) a surgical service and were made earlier in the hospital stay for medicine than for surgical patients . 22.18% of all patients had some form of an advance directive in their chart, yet this variable had no impact on the frequency or timing of DNR ordering. Documentation of DNR discussion was significantly associated with the frequency of DNR orders and the time from DNR to death .Conclusions: The physician’s specialty continues to have a significant impact on the frequency and timing of DNR orders, while advance directive status still has no measurable impact. Additionally, documentation of end-of-life discussions is significantly associated with varying DNR ordering rates and timing. (shrink)