Surgeons have an ethical obligation to ensure all patients, regardless of their personal characteristics, receive the same quality of care. Established surgeons also have an obligation to ensure equal treatment for their peers and for those who would like to join the field. The commitment to ethical hiring and working standards entails making certain all individuals have the same opportunities free from discriminatory practices. The world of business has long realized the positive implications of having a diverse and inclusive workforce. (...) Studies have shown a positive correlation between increased racial and gender diversity and company performance. Diversity can lead to an increase in knowledge by sharing ideas with individuals who come from different life experiences and breakdown cultural barriers. We have already begun to see the impact of ignoring the importance of diversity within healthcare, including surgery. Healthcare disparities are defined by the NIH as “differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups.” Healthcare disparities persist despite decades acknowledging their existence, and they are pernicious and prevalent in surgery. One proposed method to help reduce or eliminate healthcare disparities is to increase the diversity of the workforce treating the patients, which would in turn reduce potential bias the patients face in the healthcare setting. Implicit bias can play a key role in interactions with patients and colleagues and needs to be explored on an individual basis. Cultural competence training can also provide surgeons the ability to effectively communicate with not only a diverse population of patients but also a diverse surgical workforce. All surgeons regardless of their role can have a positive impact on diversity as it relates to patient care and the surgical workforce. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Neuroscientists are searching for the engram within the conceptual framework established by John Locke's theory of mind. This framework was elaborated before the development of information theory, before the development of information processing machines and the science of computation, before the discovery that molecules carry hereditary information, before the discovery of the codon code and the molecular machinery for editing the messages written in this code and translating it into transcription factors that mark abstract features of organic structure such as (...) anterior and distal. The search for the engram needs to abandon Locke's conceptual framework and work within a framework informed by these developments. The engram is the medium by which information extracted from past experience is transmitted to the computations that inform future behavior. The information-conveying symbols in the engram are rapidly generated in the course of computations, which implies that they are molecules. (shrink)

In this rich and resonant work, Soren Kierkegaard reflects poetically and philosophically on the biblical story of God's command to Abraham, that he sacrifice his son Isaac as a test of faith. Was Abraham's proposed action morally and religiously justified or murder? Is there an absolute duty to God? Was Abraham justified in remaining silent? In pondering these questions, Kierkegaard presents faith as a paradox that cannot be understood by reason and conventional morality, and he challenges the universalist ethics and (...) immanental philosophy of modern German idealism, especially as represented by Kant and Hegel. This volume, first published in 2006, presents the first new English translation for twenty years, by Sylvia Walsh, together with an introduction by C. Stephen Evans which examines the ethical and religious issues raised by the text. (shrink)

A robust result in research on the production of grammatical agreement is that speakers are more likely to produce an erroneous verb with phrases such as the key to the cabinets, with a singular noun followed by a plural one, than with phrases such as the keys to the cabinet, where a plural noun is followed by a singular. These asymmetries are thought to reflect core language production processes. Previous accounts have attributed error patterns to a syntactic number feature present (...) on plurals but not singulars. An alternative approach is presented in which a process similar to structural priming contributes to the error asymmetry via speakers' past experiences with related agreement constructions. A corpus analysis and two agreement production studies test this account. The results suggest that agreement production is shaped by statistical learning from past language experience. Implications for accounts of agreement are discussed. (shrink)

Error is protean, ubiquitous and crucial in scientific process. In this paper it is argued that understanding scientific process requires what is currently absent: an adaptable, context-sensitive functional role for error in science that naturally harnesses error identification and avoidance to positive, success-driven, science. This paper develops a new account of scientific process of this sort, error and success driving Self-Directed Anticipative Learning (SDAL) cycling, using a recent re-analysis of ape-language research as test example. The example shows the limitations of (...) other accounts of error, in particular Mayo’s (Error and the growth of experimental knowledge, 1996) error-statistical approach, and SDAL cycling shows how they can be fruitfully contextualised. (shrink)

Undercover filming is a method commonly used by animal activist groups to expose animal cruelty and it is important to consider the effects of publically releasing video footage of cruel practices on the viewers’ mental health. Previously, we reported that members of the Australian public were emotionally distressed soon after viewing media broadcasts of cruelty to Australian cattle exported for slaughter in Indonesia in 2011. To explore if there were any long term impacts from exposure to media on this issue, (...) a self-selecting group of 15 people who were exposed to a documentary exposé of the cruelty were re-interviewed 12 months later. Nearly all recalled their strong initial reaction to the footage. Approximately one half of the respondents who initially had had a strong emotional reaction to the footage reported negative reactions that were still strong even after this period of time. They reported potential triggers for these feelings. Of the rest, some managed to internalise their feelings. Approximately one half of respondents were unaware of continued live export exposés, suggesting less prominent media coverage. Despite the aversion and repulsion reported after viewing the initial coverage, most respondents said they would choose to watch another broadcast of animal cruelty and nearly all supported undercover investigations as a means of revealing cruelty to animals. We conclude that many people viewing footage of cruelty to animals will have long term memory of this, but that they would prefer to be informed about the issues and not be protected from them. (shrink)

Alchemy is central to Jung's hypothesis of the collective unconscious. In this volume he begins with an outline of the process and aims of psychotherapy, and then moves on to work out the analogies between alchemy, Christian dogma and symbolism and his own understanding of the analytic process. Introducing the basic concepts of alchemy, Jung reminds us of the dual nature of alchemy, comprising both the chemical process and a parallel mystical component. He also discusses the seemingly deliberate mystification of (...) the alchemists. Finally, in using the alchemical process as providing insights into individuation, Jung emphasises the importance of alchemy in relating to us the transcendent nature of the psyche. (shrink)

A comparison is made between the Bohm trajectory and Feynman path approaches to the long-standing problem of determining the average lime taken for a particle described by the Schrödinger wave function ψ to tunnel through a potential barrier. The former approach follows simply and uniquely from the basic postulates of Bohm's causal interpretation of quantum mechanics; the latter is intimately related to the most frequently cited approaches based on conventional interpretations. Emphasis is given to the fact that fundamentally different transmission (...) (T)-reflection (R) decompositions, particlelike and wavelike respectively, are central to the two methods: ¦ψ¦2=[¦ψ¦2]T+[¦ψ¦2]R (Bohm trajectory approach); ψ=ψT+ψR (Feynman path approach). (shrink)

Description: This book proposes to examine the central doctrines of Wittgenstein's Tractatus from a transcendental point of view. The book brings Wittgenstein's thought closer to that of the Vedanta by showing that Wittgenstein echoes the Vedantic idea that the ultimate reality is beyond language and intellect.

Objective: To evaluate feasibility of the guidelines of the Groupe Francophone de Réanimation et Urgence Pédiatriques for limitation of treatments in the paediatric intensive care unit .Design: A 2-year prospective survey.Setting: A 12-bed PICU at the Hôpital Jeanne de Flandre, Lille, France.Patients: Were included when limitation of treatments was expected.Results: Of 967 children admitted, 55 were included with a 2-day median delay. They were younger than others , had a higher paediatric risk of mortality score , and a higher paediatric (...) overall performance category score at admission ; all p<0.002. 34 children died. A limitation decision was made without meeting for 7 children who died: 6 received do-not-resuscitate orders and 1 received withholding decision. Decision-making meetings were organised for 31 children, and the following decisions were made: 12 DNROs , 4 withholding , with 14 withdrawing and 1 continuing treatment . After limitation, 21 children died and 10 survived . 13 procedures were interrupted because of death and 11 because of clinical improvement . Parents’ opinions were obtained after 4 family conferences , 3 days after inclusion. The first meeting was planned for 6 days after inclusion and held on the 7th day after inclusion; 80% of parents were immediately informed of the decision, which was implemented after half a day.Conclusions: GFRUPs procedure was applicable in most cases. The main difficulties were anticipating the correct date for the meeting and involving nurses in the procedure. Children for whom the procedure was interrupted because of clinical improvement and who survived in poor condition without a formal decision pointed out the need for medical criteria for questioning, which should systematically lead to a formal decision-making process. (shrink)

This paper discusses the debate over whether emotional expressions are spontaneous or intentional actions. We describe a variety of empirical evidence supporting these two possibilities. But we argue that the spontaneous-intentional distinction fails to explain the psychological dynamics of emotional expressions. We claim that a complex systems perspective on intentions, as self-organized critical states, may yield a unified view of emotional expressions as a consequence of situated action. This account simultaneously acknowledges the embodied status of environment, evolution, culture and mind (...) in theories of emotion. (shrink)

Professor Geoffrey Lewis Lewis was a pioneer in Turkish Studies in Britain and an internationally admired scholar in the field. In considering the body of his work as a whole, two consistent themes emerge, two driving forces behind it: first, a deep, continuing fascination with language, and now especially with Turkish; and second, a rooted and constantly developing love of Turkey and its people and a concomitant desire to bring its language, history, and culture to the attention of the English-speaking (...) world by a variety of means, all of them grounded in a thorough scholarly engagement with his subject. (shrink)

Description: The book presents a systematic view of the landmark developments in analytic philosophy in the twentieth century. It highlights the development of the concepts such as language, meaning, truth, reference, necessity, analyticity, etc. which have been central to analytic philosophy. The book consists of four parts, namely: Part I The Linguistic Revolution; Part II The Logic of Language; Part III The Primacy of the Semantical and Part IV Language, Mind and Metaphysics. Part I discusses the nature of the linguistic (...) revolution and the analytic method. Part II presents a panoramic view of the fall of formal language philosophy and the rise of the ordinary language philosophy in the west. Part III brings out the semantic issues like the problems of truth, meaning, reference, etc. Part IV attempts to discuss the nature of language-reality relationship, the nature of mental representations and the concept of mind and also the metaphysical issues of realism and anti-realism. Finally, it brings out the metaphysics of freedom, value and reason. The author has attempted to bring out the issues of analytic philosophy in a systematic and coherent fashion. Analytic philosophy, in spite of the appearances to the contrary, is a systematic philosophy with a built-in metaphysics of man and the universe. The book will be of interest to the general students of philosophy as well as the specialists in philosophy working in the areas of philosophy of language and meaning. (shrink)

El artículo aborda los conceptos de multiculturalidad, interculturalidad y educación intercultural, como perspectivas teóricas que permiten explicar la dinámica intercultural de la acción educativa y como desafío epistemológico de los conocimientos indígenas en la escolarización. Para ello se realiza un análisis de los elementos teóricos que sustentan estos conceptos; se problematiza la dificultad epistemológica de la educación intercultural, considerando el contexto en que se lleva a cabo, y en consecuencia, se plantea que la dinámica de estos conceptos permite la posibilidad (...) de considerar la interculturalidad tanto para la formación como para la problematización de situaciones interculturales que están en proceso de investigación. This article addresses the concepts of multiculturalism, interculturalism and intercultural education as theoretical perspectives to explain the intercultural dynamic of educational activities, and as epistemological challenges to indigenous knowledge in the school context. To examine these concepts we analyze the theoretical foundations which underlie them. We then formulate the epistemological problem of intercultural education, considering the context in which it takes place. Consequently, we argue that it is the dynamic of these concepts which makes it possible to consider interculturalism both in education and in the formulation of the questions posed by the intercultural situations under investigation. (shrink)

Mole's (2008 [this issue]) argument that consciousness is a necessary concomitant of attention rests on the question of what is being attended in spatial attention. His answer is space. Some authors, including ourselves, claim that the fact that the processing of unseen objects can be modulated by spatial attention (e.g. Kentridge et al., 1999; 2004; 2008; Marzouki et al., 2007; Sumner et al., 2006) demonstrates that visual attention is not a sufficient precondition for visual awareness. Mole, however, contends that as (...) space, rather than any object that might occupy that space, is what is being attended, these experiments do not constitute evidence for a dissociation between attention and consciousness. We disagree. To understand the source of this disagreement we need to understand the various processes encompassed by the term 'attention' and to consider experimental evidence illustrating how these processes operate. We review evidence that spatial attention can be deployed with the specific goal of determining the properties of objects occupying the attended region of space. One might, for example, attend to a location with the goal of determining the colour of objects occupying that space as efficiently as possible. Mole's assumption that all that is attended in spatial attention is space is not consistent with this evidence. We conclude that attention can be directed at objects by mechanisms of so- called 'spatial attention' without those objects necessarily eliciting conscious visual experience and hence that attention is not a sufficient precondition for visual awareness. (shrink)

There is an undeniable tendency to dismiss women’s sexual assault allegations out of hand. However, this tendency is not monolithic—allegations that black men have raped white women are often met with deadly seriousness. I argue that contemporary rape culture is characterized by the interplay between rape myths that minimize rape, and myths that catastrophize rape. Together, these two sets of rape myths distort the epistemic resources that people use when assessing rape allegations. These distortions result in the unjust exoneration of (...) people we cannot conceive of as monstrous, while making it too easy to believe that some marginalized people could be rapists. I also argue that rape myths enable a novel kind of epistemic injustice. This injustice concerns how our assessments of trustworthiness and our assessments of plausibility interact. I argue that rape myths can result in runaway credibility deflations that can explain both why people fail to believe most women, and also why people may unjustly believe false allegations that white women have been raped by black men. (shrink)