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)

Continuing the dialogue: postcolonial feminist scholarship and Bourdieu — discourses of culture and points of connection Postcolonial feminist theories provide the analytic tools to address issues of structural inequities in groups that historically have been socially and economically disadvantaged. In this paper we question what value might be added to postcolonial feminist theories on culture by drawing on Bourdieu. Are there points of connection? Like postcolonial feminists, he puts forward a position that aims to unmask oppressive structures. We argue that, (...) while there are points of connection, there are also epistemologic and methodologic differences between postcolonial feminist perspectives and Bourdieu's work. Nonetheless, engagement with different theoretical perspectives carries the promise of new insights — new ways of ‘seeing’ and ‘understanding’ that might enhance a praxis‐oriented theoretical perspective in healthcare delivery. (shrink)

This editorial introduces the Journal of Consciousness Studies special issue on "Animal Consciousness". The 15 contributors and co-editors answer the question "How should we study animal consciousness scientifically?" in 500 words or fewer.

Next SectionIn an online study conducted separately in the UK and the US, participants rated the acceptability and fairness of four interventions: two types of financial incentives and two types of medical interventions. These were stated to be equally effective in improving outcomes in five contexts: weight loss and smoking cessation programmes, and adherence in treatment programmes for drug addiction, serious mental illness and physiotherapy after surgery. Financial incentives were judged less acceptable and to be less fair than medical interventions (...) across all five contexts. Context moderated the relative preference between rewards and penalties: participants from both countries favoured rewards over penalties in weight loss and treatment for serious mental illness. Only among US participants was this relative preference moderated by perceived responsibility of the target group. Overall, participants supported funding more strongly for interventions when they judged members of the target group to be less responsible for their condition, and vice versa. These results reveal a striking similarity in negative attitudes towards the use of financial incentives, rewards as well as penalties, in improving outcomes across a range of contexts, in the UK and the USA. The basis for such negative attitudes awaits further study. (shrink)

HOME . ABOUT US . CONTACT US HELP . PUBLISH WITH US . LIBRARIANS Search in or Explore Browse Publications A-Z Browse Subjects A-Z Advanced Search University of Cambridge SIGN IN Register | Why Register? | Sign Out | Got a Voucher? prev abstract next Two Approaches to Reading the Historical Descartes A Devout Catholic? Knowledge of The Mental Thought and Language Descartes as A Natural Philosopher Substance Dualism Notes Two Approaches to Reading the Historical Descartes Author: Desmond M. Clarke (...) DOI: 10.1080/09608780902986680 Publication Frequency: 5 issues per year Published in: British Journal for the History of Philosophy, Volume 17, Issue 3 June 2009 , pages 601 - 616 John Cottingham: Cartesian Reflections: Essays on Descartes's Philosophy (Oxford: Oxford University Press, 2008) 40.00 (hb.). ISBN 978-0-19-922697-9 John Cottingham, in a new collection of essays, asks the question: 'what exactly did Descartes himself chiefly take himself to be doing?' (254). 1 While the question is relatively clear, and while it acknowledges implicitly that Descartes was probably doing a range of different things, the answer that is apparently proposed here emerges only on reading the whole collection. Cottingham distinguishes in Chapter 1 - which is a new, synoptic overview of what is discussed in the other chapters, all of which were previously published - between two approaches to reading Descartes. One is to see him as 'a dummy on which to drape various suspect doctrines (such as “Cartesian dualism”)' (3), which contemporary analytic philosophers have shown to be radically mistaken. Another approach is adopted by historians of ideas 'who make it their life's work to pay meticulous scholarly attention to the philosophical works of past ages' (3). Cottingham does not explicitly criticize either of these approaches, but he hints at situating his own as some kind of Aristotelian middle course between the two. Since the two reference points are dangerously close to straw men or what Cottingham calls 'extreme positions', the proposed middle way may simply combine elements of two approaches, each of which is entirely legitimate. I return to this question at the conclusion. In fact, many of these essays were intended to show (rightly!) that Descartes never held the philosophical positions that are often attributed to him. The interpretation of Karol Wojtyla, later Pope John Paul II, provides a good example of how mistaken one can be: The Cogito ergo sum radically changed the way of doing philosophy … After Descartes, philosophy became a science of pure thought: all that is being- the created world, and even the Creator, is situated within the ambit of the Cogito, as contents of human consciousness. Philosophy is concerned with beings as contained in consciousness, and not as existing independently of it. (257) The only way to address such a caricature is to refer back to what Descartes actually wrote. Cottingham does precisely that, often quoting the original Latin or French texts. However, having shown successfully, by a close reading of the texts, that Descartes did not hold many of the views that are attributed to him, it still remains to say what Descartes did hold or teach about various philosophical problems that retain their perennial interest for us. This is how the question arises, intermittently, about what Descartes thought he was 'chiefly' doing, or what was his primary objective, in the course of an intellectual career that spanned three decades. However, the apparently legitimate desire to bring Descartes' intellectual endeavours into sharp focus may be frustrated by the evidence. His life and work manifestly lack the coherence or unity of purpose that one finds, for example, among many of his French or Dutch contemporaries. It is comparatively easy to 'read' the life of Gisbertus Voetius as that of an unwavering Calvinist theologian, to see Antoine Arnauld as a staunch and consistent theological defender of Port Royal, and even to interpret the obviously fragmentary contents of Pascal's unpublished notebooks (subsequently, the Penses) as an extended search for authentic religious faith, in opposition to what he perceived as the corruption of ecclesial structures. In contrast, Descartes' life reveals features that are difficult to integrate into a coherent pattern. He lived and published during a critical juncture in the Scientific Revolution of the seventeenth century. Although baptized into the Catholic Church soon after his birth in the Loire district of France, he chose to live most of his life in the aggressively Calvinist United Provinces, in which other religious practices were officially (though often ineffectively) banned. Descartes may have adopted the motto from Ovid, at least early in his career: 'bene vixit qui bene latuit' (he lives well who conceals himself well), and he seems genuinely to have wished to avoid theological controversies. However, he engaged in very public controversies with so many of his contemporaries - including Hobbes, Gassendi, the French Jesuits (collectively) and Father Dinet (in particular), Voetius and the University of Utrecht, Regius, Fermat, Roberval, Revius and other theologians at Leiden - that one might conclude that his claimed preference for a quiet life was a disingenuous mask. 2 Descartes published four books during his lifetime, and wrote at least one other that he had intended to publish. The latter was his first major composition, Le Monde, which he suppressed when he heard about Galileo's condemnation by Rome in 1633. This was followed, in 1637, by Descartes' first book (also written in French), which he tried to publish anonymously by withholding his name from the title page: the Discours de la methode pour bien conduire sa raison, & chercher la verit dans les sciences. Plus la dioptrique, les meteors, et la geometrie, qui sont des essais de cete methode. Four years later Descartes published the first edition (in Latin) of Meditationes de prima philosophia, in quibus Dei existentia et animae immortalitas demonstrator, which also included six sets of objections and replies. The Principia philosophiae appeared (in Latin) in Amsterdam in 1644, and was followed five years later by Les Passions de l'Ame (in French). 3 In parallel with these publications, Descartes carried on a very extensive correspondence over a thirty-year period (in both Latin and French), and preserved copies or drafts of his letters with a view to future publication. Given the range and variety of his interests, and the sheer volume of writings, published or otherwise, that have survived from his pen, one may be tempted to engage in a comparative evaluation, as Cottingham does, by selecting one of Descartes' books as his primary contribution to philosophy. Cottingham claims that the Meditations was Descartes''masterpiece' (44), 'the definitive statement of Descartes's philosophy' (45) and the 'definitive statement of his metaphysics' (68). He also describes the Meditations more narrowly as 'his metaphysical masterpiece' (259, 303) and, more broadly, as 'his philosophical masterpiece' (289), and he lists it with the Discours as one of Descartes' two 'masterworks' (280). The Principia offers some competition in this comparative judgement when it is described as 'the canonical presentation of his metaphysical views' (114), while 'the construction of a moral system … was the crowning aim of his philosophy' (231). Having pitched repeatedly for the Meditations as Descartes' primary text, Cottingham claims that its author was 'a devout Catholic' (215), that he was 'a devoutly religious philosopher' (256), and that he could not free himself 'from the influence of the long years of theological study he had dutifully completed at La Flche' (62). Accordingly, the Meditations should be read as 'in essence a work of theodicy' (220); 'what has pride of place in the construction of his philosophical system is … an appeal to God … the nature and existence of the Deity is something that lies at the very heart of his entire philosophical system' (255). Without quite saying so, there are hints here that Descartes was a devout Christian whose primary intellectual contribution was to write a work of metaphysics, in which God is central and in the course of which the author alternates between proving God's existence and contemplating God - the latter a seventeenth-century version of Bonaventure's Journey of the Soul to God. 'Descartes's attraction to a contemplative mode of philosophizing' (305) is reflected, in the Meditations, in 'the language of the soul's coming to rest in adoring contemplation of the light' (306). Cottingham also accepts the overwhelming evidence from Descartes' correspondence that he 'devoted most of his career not to metaphysics but to science' (108), although he quibbles elsewhere with those who adopt the shorthand term 'science' to describe part of what was called 'natural philosophy' in the seventeenth century (282). He also refers to the '(notoriously lame) argument for the essential incorporeality of the thinking self' in one of Descartes' masterworks (60), and he describes the 'strange, seemingly isolated world of his metaphysical meditations' (139), with its 'creaking ontology' (147), when read in isolation from the rest of his work as a natural philosopher. How should we read him, then, in the twenty-first century? A Devout Catholic? That Descartes was a devout Catholic is possible, unlikely and undecidable. He seems not to have studied theology at all while at school at La Flche, although he completed the pre-theology college cycle in the company of Jesuit students who then continued their studies in theology. Descartes consistently attempted to avoid public entanglement with religious and theological controversies, and said so frequently. 4 Given the alignments that prevailed at the time, both in France. (shrink)

' a welcome guide for researchers to the merging fields of neuroscience, linguistics and psycholinguistics.' BRAIN'... an important and captivating book, one that has been long awaited by all researchers interested in language and the brain.' Trends in Cognitive Sciences, 1999. The Neurocognition of Language brings together experts on human language and the brain to present the first critical overview of the cognitive neuroscience of language, one of the fastest-moving and most exciting areas today. In-depth discussion of the representations and (...) structures of language, as well as of the cognitive architectures which underlie speaking, listening, and reading, will provide a basis for future brain imaging research. In addition, the existing brain imaging literature on word and sentence processing is critically reviewed, as well as contributions from brain lesion data. Finally, the book discusses the prospects and problems of brain imaging techniques for the study of language, presents some of the most recent and promising analytic procedures for relating brain imaging data to the higher cognitive functions, and contains a review of the neuroanatomical structure of Broca's language area. Uniquely interdisciplinary, this book will provide researchers and students in cognitive neuroscience with state-of-the-art reviews of the major language functions, while being of equal interest to researchers in linguistics and language who want to learn about the neural bases of language. It will be an essential purchase for anyone requiring an overview of our current understanding of the relation between language and the brain. (shrink)

The number of children with chronic critical illness (CCI) is a growing population in the United States. A defining characteristic of this population is a prolonged hospital stay. Our study assessed the proportion of pediatric patients with chronic critical illness in U.S. hospitals at a specific point in time, and identified a subset of children whose hospital stay lasted for months to years. The potential harms of a prolonged hospitalization for children with CCI, which include over treatment, infection, disruption of (...) family life, and the intensive utilization of resources—combined with the moral distress experienced by the clinicians who care for the children, suggest the need for ethical analysis of this growing issue to identify actions that could be taken at the clinical and health systems levels to reduce the harms associated with prolonged hospital stay.In this article we present three real cases from our study that involved a very long hospital stay. We applied a framework developed by Mackenzie, Rogers, and Dodds to analyze inherent, situational, and pathogenic vulnerabilities to examine the ways that interventions intended to remedy one source of harm for the children in our cohort inadvertently created other harms. We examined the complex ways that children with protracted hospitalization are vulnerable to the choices made by their family and clinicians, as well as by healthcare systems and communities. Finally, we used this analysis to summarize actions and ethical responses to this growing patient population. Such an understanding is essential to making clinical and ethical decisions that arise for children who are at risk for a very long stay in the hospital. (shrink)

There has been much philosophical interest regarding the ‘hierarchy of evidence’ used to determine which study designs are of most value for reporting on questions of effectiveness, prognosis, and so on. There has been much less philosophical interest in the choice of outcome measures with which the results of, say, an RCT or a cohort study are presented. In this paper, we examine the FDA’s recently published guidelines for assessing the psychometric adequacy of patient-reported outcome measures. We focus on their (...) recommendations for demonstrating content validity and also for how researchers should weigh up the sum of psychometric evidence when choosing these measures. We argue that questions regarding judgment and understanding meaning of these measures should play a more central role in determining their adequacy. (shrink)

This paper introduces the model of Utilitarian Principlism as a framework for crisis healthcare ethics. In modern Western medicine, during non-crisis times, principlism provides the four guiding principles in biomedical ethics—autonomy, nonmaleficence, beneficence, and justice; autonomy typically emerges as the decisive principle. The physician–patient relationship is a deontological construct in which the physician’s primary duty is to the individual patient and the individual patient is paramount. For this reason, we term the non-crisis ethical framework that guides modern medicine Deontological Principlism. (...) During times of crisis, resources become scarce, standards of care become dynamic, and public health ethics move to the forefront. Healthcare providers are forced to work in non-ideal conditions, and interactions with individual patients must be considered in the context of the crisis. The COVID-19 pandemic has forced healthcare to shift to a more utilitarian framework with a greater focus on promoting the health of communities and populations. This paper puts forth the notion of Utilitarian Principlism as a framework for crisis healthcare ethics. We discuss each of the four principles from a utilitarian perspective and use clinical vignettes, based on real cases from the COVID-19 pandemic, for illustrative purposes. We explore how Deontological Principlism and Utilitarian Principlism are two ends of a spectrum, and the implications to healthcare as we emerge from the pandemic. (shrink)

Déjà vu is the striking sense that the present situation feels familiar, alongside the realization that it has to be new. According to the Gestalt familiarity hypothesis, déjà vu results when the configuration of elements within a scene maps onto a configuration previously seen, but the previous scene fails to come to mind. We examined this using virtual reality technology. When a new immersive VR scene resembled a previously-viewed scene in its configuration but people failed to recall the previously-viewed scene, (...) familiarity ratings and reports of déjà vu were indeed higher than for completely novel scenes. People also exhibited the contrasting sense of newness and of familiarity that is characteristic of déjà vu. Familiarity ratings and déjà vu reports among scenes recognized as new increased with increasing feature-match of a scene to one stored in memory, suggesting that feature-matching can produce familiarity and déjà vu when recall fails. (shrink)

This commentary centres around the system of human visual attention. Although generally supportive of the position advocated in the target article, we suggest that the detailed account overestimates the capacities of active human vision. Limitations of peripheral search and saccadic accuracy are discussed in relation to the division of labour between covert and overt attentional processes.

Until the advent of plastinated cadavers, few outside the medical professions have had firsthand experience with human corpses. Such opportunities are now available at the Body Worlds exhibits of Gunther von Hagens. After an overview of these exhibits, we explore visitor responses as revealed in comment books available upon exiting the exhibit. Cultural, philosophical, and religious issues raised in the comments serve as a microcosm of society at large. The conclusion considers the challenge of such exhibits in introducing the public (...) to science education, notes the image of the body as machine—so prevalent in the West—reflected in visitor comments, and finds hope that the exhibits promote, for many visitors, a sense of community among all humankind. (shrink)

In three studies, factors influencing the incidence of fraudulent financial reporting were assessed. We examined (1) the effects of personal values and (2) codes of corporate conduct, on whether managers misrepresented financial reports. In these studies, executives and controllers were asked to respond to hypothetical situations involving fraudulent financial reporting procedures. The occurrence of fraudulent reporting was found to be high; however, neither personal values, codes of conduct, nor the interaction of the two factors played a significant role in fraudulent (...) financial reporting. (shrink)

In humans over 15% of X‐linked genes have been shown to ‘escape’ from X‐chromosome inactivation (XCI): they continue to be expressed to some extent from the inactive X chromosome. Mono‐allelic expression is anticipated within a cell for genes subject to XCI, but random XCI usually results in expression of both alleles in a cell population. Using a study of allelic expression from cultured lymphoblasts and fibroblasts, many of which showed substantial skewing of XCI, we recently reported that the expression of (...) genes lies on a contiunuum between those that are subject to inactivation, and those that escape. We now review allelic expression studies from mouse, and discuss the variability in escape seen in both humans and mice in genic expression levels, between X chromosomes and between tissues. We also discuss current knowledge of the heterochromatic features, DNA elements and three‐dimensional topology of the inactive X that contribute to the balance of expression from the otherwise inactive X chromosome. (shrink)

Researchers now commonly collect biospecimens for genomic analysis together with information from mobile devices and electronic health records. This rich combination of data creates new opportunities for understanding and addressing important health issues, but also intensifies challenges to privacy and confidentiality. Here, we elucidate the “web” of legal protections for precision medicine research by integrating findings from qualitative interviews with structured legal research and applying them to realistic research scenarios involving various privacy threats.