In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited from (...) KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)

The author laudably attempts to integrate Cassirer's approach to symbolism with current work being done by sociologists, anthropologists and psychologists. The thesis that symbols are the creative link between personality and culture is defended in a variety of ways. The discussion is repetitious and disorganized. Still, the rich array of content deserves attention.--D. C. B.

A sequel to his New Apologists, this latest work sees the "tragic vision" as the Dionysian component of tragedy, in an irreducible tension with the ethical or Apollonian: a conflict characterizing the modern "crisis-mentality" of literature and existentialism. Gide, Kafka, and Melville, are contrasted with D. H. Lawrence, Camus, Dostoevsky, and others in a very illuminating manner.--D. C. B.

Raising a child with an autism spectrum disorder (ASD) is a stressful experience and has been associated with poor maternal mental health and increased maternal emotional distress. However, the experiences of fathers of children with ASD are largely unexplored and the coping strategies these men employ to cope with the challenges they face have received little research attention. This research aimed to explore the phenomenological experiences of fathers of preschool children with ASD by gaining a better understanding of the manner (...) in which these individuals attempted to cope with their situation. A multiple, single-case study design was employed and five participants were recruited via two local paediatric practices. Semi-structured interviews were conducted with the participants and data were analysed making use of Interpretative Phenomenological Analysis (IPA). This analysis yielded three superordinate themes, which were labelled as follows: (a) the experience of fathering a child with ASD, (b) challenges of fathering a child with ASD, and (c) coping with fathering a child with ASD. The results suggest that the fathers of children with ASD experience their parental role as stressful. The participants in the current study related the stress they experienced to a number of challenges associated directly with their children’s behaviour, as well as to the effects that parenting a child with ASD had on their own wellbeing and functioning. The participants reported making use of a number of coping strategies in order to deal with the challenges they faced. The participants used both problem-focussed and avoidant coping strategies. The results are discussed and recommendations made with regard to future research. (shrink)

This work provides an interesting, though sometimes rather sweeping, demonstration that the metaphysical problem of the same and the other is also the central problem of literature and literary criticism. The author defends the analogical imagination as the symbolic counterpart of participation in Platonic metaphysics.--D. C. B.

Through discourse with international groups of physicians, we conducted a cross-cultural analysis of the types of ethical dilemmas physicians face. Qualitative analysis was used to categorise the dilemmas into seven themes, which we compared among the physicians by country of practice. These themes were a-theoretically-driven and grounded heavily within the text. We then subjected the dilemmas to an analysis of moral intensity, which represents an important theoretical perspective of ethical decision making. These constructs represent salient determinants of ethical behaviour and (...) our cross-cultural sample afforded us the opportunity to consider both the pragmatic aspects of culture, as they are perceived by physicians, as well as the theory-driven concept of moral intensity. By examining both culture and moral intensity, we hope to better elucidate the complexities of ethical decision-making determinants among physicians in their daily practice. Doing so may potentially have practical implications for ethics training of medical students and foreign physicians. (shrink)

'Why did the window break when it was hit by the stone? Because the window is brittle and the stone is hard; hardness and brittleness are powers, dispositional properties or dispositions.' Dispositions are essential to our understanding of the world. This book is a record of the debate on the nature of dispositions between three distinguished philosophers - D. M. Armstrong, C. B. Martin and U. T. Place - who have been thinking about dispositions all their working lives. Their distinctive (...) accounts cover many of the issues surrounding dispositions such as the nature of mind, matter, universals, existence, laws of nature and causation. Dispositions illuminates this central topic in analytic philosophy and at the same time highlights deeper concerns of metaphysics. (shrink)

This study explored drug users’ attitudes toward and understanding of randomized controlled trials testing addiction therapies. A video portraying a fictional consent conference for a randomized controlled trial with placebo arm was shown to poor male and female drug users of diverse ethnic status and sexual orientation. The video stimulated focus group discussion in which participants’ comments often reflected “experimental realism”—a realistic view of the trial—and adequate understanding of the uncertain efficacy of the treatment being tested, as well as the (...) concepts of randomization and placebo control. However, participants’ comprehension of the nature of placebos was compromised by the widespread view that placebos are a way of testing a subject’s willpower and personal control over his or her addiction. Comments also showed a mistrust of the video investigator’s integrity and competence and signs of therapeutic misconception and misestimation. The study’s findings underscore the importance of tailoring informed consent encounters to the personal and sociohistorical context of participants’ lived experiences. (shrink)

A new criterion is introduced for judging the suitability of various fuzzy logics for practical uncertain reasoning in a probabilistic world and the relationship of this criterion to several established criteria, and its consequences for truth functional belief, are investigated.

During the past two decades, several reports have documented substantial support from clinicians, policy-makers, and the general public for the use of advance directives, yet studies continue to find that only a minority of individuals have completed these legal documents. Advance directives are written instructions, such as living wills or durable powers of attorney for health care, which describe an individual's medical treatment wishes in the event that individual becomes incapacitated in the future. The completion and use of advance directives (...) is one of several components of the broader activity of advance care planning, that is, the overall planning and communication of personal wishes concerning future medical care.In December 1991, the federal Patient Self-Determination Act became effective. Promoted as a federal initiative to enhance an individual's control over medical treatment decision making and, therefore, patient autonomy and self-determination, PSDA placed several new requirements on health care organizations receiving Medicare or Medicaid payments. (shrink)

During the past two decades, several reports have documented substantial support from clinicians, policy-makers, and the general public for the use of advance directives, yet studies continue to find that only a minority of individuals have completed these legal documents. Advance directives are written instructions, such as living wills or durable powers of attorney for health care, which describe an individual's medical treatment wishes in the event that individual becomes incapacitated in the future. The completion and use of advance directives (...) is one of several components of the broader activity of advance care planning, that is, the overall planning and communication of personal wishes concerning future medical care.In December 1991, the federal Patient Self-Determination Act became effective. Promoted as a federal initiative to enhance an individual's control over medical treatment decision making and, therefore, patient autonomy and self-determination, PSDA placed several new requirements on health care organizations receiving Medicare or Medicaid payments. (shrink)

We present a general derivation of the Duffin-Kemmer-Petiau (D.K.P) equation on the relativistic phase space proposed by Bohm and Hiley. We consider geometric algebras and the idea of algebraic spinors due to Riesz and Cartan. The generators βμ (p) of the D.K.P algebras are constructed in the standard fashion used to construct Clifford algebras out of bilinear forms. Free D.K.P particles and D.K.P particles in a prescribed external electromagnetic field are analized and general Liouville type equations for these cases are (...) obtained. Choosing particular values for the label p we classify the different types of the D.K.P Liouville operators. (shrink)

Dispositions are essential to our understanding of the world. Dispositions: A Debate is an extended dialogue between three distinguished philosophers - D.M. Armstrong, C.B. Martin and U.T. Place - on the many problems associated with dispositions, which reveals their own distinctive accounts of the nature of dispositions. These are then linked to other issues such as the nature of mind, matter, universals, existence, laws of nature and causation.

Studies have shown that as MRI T2 relaxation time lengthens there is a shift toward more unbound or “free-water” and less partitioning of the protein/lipid molecules per unit volume. A shift toward less water partitioning or lengthened MRI T2 relaxation time is linearly related to reduced high frequency EEG amplitude, reduced short distance EEG coherence, increased long distance EEG coherence, and reduced cognitive functioning (Thatcher et al. 1998a; 1998b).

Mencius, who lived in the 4th century B.C., is second only to Confucius in importance in the Confucian tradition. The _Mencius_ consists of sayings of Mencius and conversations he had with his contemporaries. When read side by side with the _Analects_, the _Mencius_ throws a great deal of light on the teachings of ConfuciusMencius developed many of the ideas of Confucius and at the same time discussed problems not touched upon by Confucius. He drew out the implications of Confucius' moral (...) principles and reinterpreted them for the conditions of his time. As the fullest of the four great Confucian texts, the _Mencius_ has been the required reading amongst Chinese scholars for two thousand years, and it still throws considerable light on the character of the Chinese people. (shrink)