Functional imaging techniques, such as positron emission tomography and functional magnetic resonance imaging, present a unique opportunity to examine, in humans, the cerebral representation of space in vivo. Space is ubiquitous and not a unitary phenomenon, and the brain uses visual, vestibular and proprioceptive inputs to produce multiple representations of space subserving spatial cognition, ranging from gaze control to remembering multiple complex large-scale environments. Functional imaging studies have shown the importance of the parietal cortex in perceptual, motor, attention and working (...) memory aspects of body-centred human spatial cognition. Functional imaging has also revealed pathways in humans homologous to those found in monkeys for the separate processing of spatial location and object identity. There are further suggestions of similar differentiation in working memory. The importance of the medial temporal region in the recall of spatial location has been confirmed also and novel virtual reality paradigms are now providing insights into the cerebral representation of spatially-extended large-scale environments. We still have much to learn about the cerebral representation of space in the human brain and functional brain imaging, in concert with patient studies and animal models, will allow us to continue investigating. (shrink)

Various claims have been made concerning the role of narrative in grief. In this paper, we emphasize the need for a discerning approach, which acknowledges that narratives of different kinds relate to grief in different ways. We focus specifically on the positive contributions that narrative can make to sustaining, restoring and revising a sense of who one is. We argue that, although it is right to suggest that narratives provide structure and coherence, they also play a complementary role in disrupting (...) established structure and opening up new possibilities. We add that both of these roles point to the importance of interpersonal, social and cultural factors in shaping the trajectory of grief. We conclude by briefly considering the implications for distinguishing between typical and pathological forms of grief. (shrink)

Research in various disciplines has highlighted that humans are uniquely able to solve the problem of cooperation through the informal mechanisms of reputation and gossip. Reputation coordinates the evaluative judgments of individuals about one another. Direct observation of actions and communication are the essential routes that are used to establish and update reputations. In large groups, where opportunities for direct observation are limited, gossip becomes an important channel to share individual perceptions and evaluations of others that can be used to (...) condition cooperative action. Although reputation and gossip might consequently support large-scale human cooperation, four puzzles need to be resolved to understand the operation of reputation-based mechanisms. First, we need empirical evidence of the processes and content that form reputations and how this may vary cross-culturally. Second, we lack an understanding of how reputation is determined from the muddle of imperfect, biased inputs people receive. Third, coordination between individuals is only possible if reputation sharing and signaling is to a large extent reliable and valid. Communication, however, is not necessarily honest and reliable, so theoretical and empirical work is needed to understand how gossip and reputation can effectively promote cooperation despite the circulation of dishonest gossip. Fourth, reputation is not constructed in a social vacuum; hence we need a better understanding of the way in which the structure of interactions affects the efficiency of gossip for establishing reputations and fostering cooperation. (shrink)

There is growing interest in clinical ethics. However, we still have sparse knowledge about what is actually going on in the everyday practice of clinical ethics consultations. This paper introduces a descriptive evaluation tool to present, discuss and compare how clinical ethics case consultations are actually carried out. The tool does not aim to define ‘best practice’. Rather, it facilitates concrete comparisons and evaluative discussions of the role, function, procedures and ideals inherent in clinical ethics case consultation practices. The tool (...) was developed during meetings of the European Clinical Ethics Network. Based on written reports and participation in the network meetings, the development and the content of the tool and the results of its application in presenting and discussing 10 case consultations are summarized. The tool facilitated understanding of the details of clinical ethics case consultations across individuals and institutions with various experiences and cultures, and comparison between various practices. (shrink)

Having a serious illness like breast cancer is a calamity for individuals and families. Along with the pain, discomfort, and dislocation comes the issue of how to pay the medical expenses for the care and treatment of the disease. If the seriously ill person has inadequate or no insurance, these problems are aggravated.Stories abound about seriously ill people losing private health insurance following diagnosis with a catastrophic disease, remaining in jobs just to maintain health insurance, or facing financial hardship because (...) of gaps in coverage. Yet surprisingly little research has focused on the problems that people with serious illness face with health coverage and, in particular, how concerns about access to health insurance coverage shape their lives.Further, despite profoundly moving anecdotes of cancer victims and other seriously ill people about their problems with health insurance and despite recent federal and state efforts to reform the private health insurance market in ways discussed below, neither the federal government, states, nor the private sector has crafted comprehensive strategies to enhance health coverage for the seriously ill. (shrink)

Having a serious illness like breast cancer is a calamity for individuals and families. Along with the pain, discomfort, and dislocation comes the issue of how to pay the medical expenses for the care and treatment of the disease. If the seriously ill person has inadequate or no insurance, these problems are aggravated.Stories abound about seriously ill people losing private health insurance following diagnosis with a catastrophic disease, remaining in jobs just to maintain health insurance, or facing financial hardship because (...) of gaps in coverage. Yet surprisingly little research has focused on the problems that people with serious illness face with health coverage and, in particular, how concerns about access to health insurance coverage shape their lives.Further, despite profoundly moving anecdotes of cancer victims and other seriously ill people about their problems with health insurance and despite recent federal and state efforts to reform the private health insurance market in ways discussed below, neither the federal government, states, nor the private sector has crafted comprehensive strategies to enhance health coverage for the seriously ill. (shrink)

Knowledge of eukaryotic life cycles and associated genome dynamics stems largely from research on animals, plants, and a small number of “model” (i.e., easily cultivable) lineages. This skewed sampling results in an underappreciation of the variability among the many microeukaryotic lineages, which represent the bulk of eukaryotic biodiversity. The range of complex nuclear transformations that exists within lineages of microbial eukaryotes challenges the textbook understanding of genome and nuclear cycles. Here, we look in‐depth at Foraminifera, an ancient (∼600 million‐year‐old) lineage (...) widely studied as proxies in paleoceanography and environmental biomonitoring. We demonstrate that Foraminifera challenge the “rules” of life cycles developed largely from studies of plants and animals. To this end, we synthesize data on foraminiferal life cycles, focusing on extensive endoreplication within individuals (i.e., single cells), the unusual nuclear process calledZerfall, and the separation of germline and somatic function into distinct nuclei (i.e., heterokaryosis). These processes highlight complexities within lineages and expand our understanding of the dynamics of eukaryotic genomes. (shrink)

Summary Descartes' two treatises of corpuscular-mechanical natural philosophy—Le Monde (1633) and the Principia philosophiae (1644/1647)—differ in many respects. Some historians of science have studied their significantly different theories of matter and elements. Others have routinely noted that the Principia cites much evidence regarding magnetism, sunspots, novae and variable stars which is absent from Le Monde. We argue that far from being unrelated or even opposed intellectual practices inside the Principles, Descartes' moves in matter and element theory and his adoption of (...) wide swathes of novel matters of fact, were two sides of the same coin—that coin being his strategies for improving the systematic power, scope and consistency of the natural philosophy presented in the Principia. We find that Descartes' systematising strategy centred upon weaving ranges of novel matters of fact into explanatory and descriptive narratives with cosmic sweep and radical realist Copernican intent. Gambits of this type have recently been labelled as ‘cosmographical’ (the natural philosophical relating of heavens and earth in contemporary usage). Realist Copernican natural philosophers, from Copernicus himself, through Bruno, Gilbert and Galileo did this to varying degrees; but, we suggest, Descartes presented in Books III and IV of the Principia the most elaborate and strategically planned version of it, underneath the ostensible textbook style of the work. (shrink)

One of the chief concerns of the young Descartes was with what he, and others, termed “physico-mathematics”. This signalled a questioning of the Scholastic Aristotelian view of the mixed mathematical sciences as subordinate to natural philosophy, non explanatory, and merely instrumental. Somehow, the mixed mathematical disciplines were now to become intimately related to natural philosophical issues of matter and cause. That is, they were to become more ’physicalised’, more closely intertwined with natural philosophising, regardless of which species of natural philosophy (...) one advocated. A curious, short-lived yet portentous epistemological conceit lay at the core of Descartes’ physico-mathematics—the belief that solid geometrical results in the mixed mathematical sciences literally offered windows into the realm of natural philosophical causation—that in such cases one could literally “see the causes”. Optics took pride of place within Descartes’ physico-mathematics project, because he believed it offered unique possibilities for the successful vision of causes. This paper traces Descartes’ early physico-mathematical program in optics, its origins, pitfalls and its successes, which were crucial in providing Descartes resources for his later work in systematic natural philosophy. It explores how Descartes exploited his discovery of the law of refraction of light—an achievement well within the bounds of traditional mixed mathematical optics—in order to derive—in the manner of physico-mathematics—causal knowledge about light, and indeed insight about the principles of a “dynamics” that would provide the laws of corpuscular motion and tendency to motion in his natural philosophical system. (shrink)

This paper looks at the relationship between spacetime functionalism and Harvey Brown’s dynamical relativity. One popular way of reading and extending Brown’s programme in the literature rests on viewing his position as a version of relationism. But a kind of spacetime functionalism extends the project in a different way, by focussing on the account Brown gives of the role of spacetime in relativistic theories. It is then possible to see this as giving a functional account of the concept of spacetime (...) which may be applied to theories that go beyond relativity. This paper explores the way in which both the relationist project and the functionalist project relate to Brown’s work, despite being incompatible. Ultimately, these should not be seen as two conflicting readings of Brown, but two different directions in which to take his project. (shrink)

Prelinguistic infants must find a way to isolate meaningful chunks from the continuous streams of speech that they hear. BootLex, a new model which uses distributional cues to build a lexicon, demonstrates how much can be accomplished using this single source of information. This conceptually simple probabilistic algorithm achieves significant segmentation results on various kinds of language corpora - English, Japanese, and Spanish; child- and adult-directed speech, and written texts; and several variations in coding structure - and reveals which statistical (...) characteristics of the input have an influence on segmentation performance. BootLex is then compared, quantitatively and qualitatively, with three other groups of computational models of the same infant segmentation process, paying particular attention to functional characteristics of the models and their similarity to human cognition. Commonalities and contrasts among the models are discussed, as well as their implications both for theories of the cognitive problem of segmentation itself, and for the general enterprise of computational cognitive modeling. (shrink)

Objective: Even when critically ill patients are almost certain to die from their illnesses, there is generally an element of prognostic uncertainty. Little is known about how physicians handle this uncertainty in conversations with surrogate decision makers. We sought to evaluate whether and how physicians discuss prognostic uncertainty with surrogate decision makers of patients who are highly likely, but not certain, to die. Design: We audiotaped and transcribed discussions between clinicians and surrogate decision makers at two major California teaching hospitals (...) from 2006 through 2008. Physicians completed a questionnaire addressing their prognostic estimates for patients' survival to hospital discharge. Participants: We included physicians and surrogates of 12 incapacitated, critically ill patients. Measurements: We analyzed transcripts of discussions in which physicians' estimates of patients' chances of hospital survival were 1% to 5%; we coded whether physicians disclosed the prognostic uncertainty and, if so, how they conveyed that death was highly likely but not certain. Results: Physicians' estimates of short-term survival were 1% to 5% for 12 of the 70 patients enrolled in the original study. In 8 of 12 cases, physicians conveyed prognostic uncertainty by using probabilistic language or by an explicit mention of uncertainty. In four cases, physicians made at least one statement that either implied or was ambiguous about whether death was certain. Conclusion: We observed variability in how physicians handle prognostic uncertainty in their discussions with surrogates of patients who are highly likely, but not certain, to die, including some circumstances in which physicians stated or implied that death was certain. (shrink)

Background People who are at elevated risk of suicide stand to benefit from internet-based interventions; however, research in this area is likely impacted by a range of ethical and practical challenges. The aim of this study was to examine the ethical issues and practical barriers associated with clinical studies of internet-based interventions for suicide prevention. Method This was a mixed-methods study involving two phases. First, a systematic search was conducted to identify studies evaluating internet-based interventions for people at risk of (...) suicide, and information pertaining to safety protocols and exclusion criteria was extracted. Second, investigators on the included studies were invited to complete an online survey comprising open-ended and forced-choice responses. Quantitative and qualitative methods were used to analyse the data. Results The literature search identified 18 eligible studies, of which three excluded participants based on severity of suicide risk. Half of the 15 suicide researchers who participated in the survey had experienced problems obtaining ethics approval, and none had encountered adverse events attributed to their intervention. Survey respondents noted the difficulty of managing risk in online environments and the limitations associated with implementing safety protocols, although some also reported increased confidence resulting from the ethical review process. Respondents recommended researchers pursue a collaborative relationship with their research ethics committees. Conclusion There is a balance to be achieved between the need to minimise the risk of adverse events whilst also ensuring interventions are being validated on populations who may be most likely to use and benefit from them. Further research is required to obtain the views of research ethics committees and research participants on these issues. Dialogue between researchers and ethics committees is necessary to address the need to ensure safety while also advancing the timely development of effective interventions in this critical area. (shrink)

I argue that the best spacetime setting for Newtonian gravitation (NG) is the curved spacetime setting associated with geometrized Newtonian gravitation (GNG). Appreciation of the ‘Newtonian equivalence principle’ leads us to conclude that the gravitational field in NG itself is a gauge quantity, and that the freely falling frames are naturally identified with inertial frames. In this context, the spacetime structure of NG is represented not by the flat neo-Newtonian connection usually made explicit in formulations, but by the sum of (...) the flat connection and the gravitational field. 1 Introduction2 Newtonian Gravity: The Orthodox Approach3 Newtonian Gravity: Additional Symmetries4 Cosmological Considerations5 A Newtonian Equivalence Principle: Inertial Frames in Newtonian Gravitation6 Theory Equivalence?7 Conclusion. (shrink)

I argue that the need to understand spacetime structure as emergent in quantum gravity is less radical and surprising it might appear. A clear understanding of the link between general relativity's geometrical structures and empirical geometry reveals that this empirical geometry is exactly the kind of thing that could be an effective and emergent matter. Furthermore, any theory with torsion will involve an effective geometry, even though these theories look, at first glance, like theories with straightforward spacetime geometry. As it's (...) highly likely that there will be a role for torsion in quantum gravity, it's also highly likely that any theory of quantum gravity will require us to get to grips with emergent spacetime structure. (shrink)

Loneliness is often described as a deadly epidemic sweeping across the population, a silent killer. Loneliness, we are told, is a social disease that must be cured. But what does it mean to think of loneliness as a feminist issue, and what might a specifically feminist theorisation bring to conceptualisations of loneliness? In this paper, I argue that feminism helps us see that loneliness is not just personal but political. I trace how stories of loneliness surface, circulate, shift and compound (...) within the specificity of the present, centring on recent strategies proposed by the UK government in their ‘national mission to end loneliness’. I outline how this policy discourse upholds certain normative attachments as having the promise to alleviate loneliness: coupled love, the family, community. Such framings serve to depoliticise contemporary conditions of loneliness, positioning loneliness as a personal failure, with the cure for loneliness as the responsibility of individuals and communities. Absent in government depictions of the problem of loneliness are the wider mechanisms that condemn people to lonely lives, when infrastructures fail, when people find themselves violently cut off from the world. Finally, I speculate on what might happen if we were to challenge this framing of loneliness as always and only a problem in need of a cure. I seek to uncover some of the political potentials of loneliness, asking what can be learnt through reflecting upon shared experiences of loneliness? For, as feminist politics has shown us, feelings of disaffection and alienation can help us imagine other worlds. (shrink)

Miranda Fricker’s influential concept of epistemic injustice has recently seen application to many areas of interest, with an increasing body of healthcare research using the concept of epistemic injustice in order to develop both general frameworks and accounts of specific medical conditions and patient groups. This paper illuminates tensions that arise between taking steps to protect against committing epistemic injustice in healthcare, and taking steps to understand the complexity of one’s predicament and treat it accordingly. Work on epistemic injustice is (...) therefore at risk of obfuscating legitimate and potentially fruitful inquiry. This paper uses Chronic Fatigue Syndrome/Myalgic Encephalomyelitis as a case study, but I suggest that the key problems identified could apply to other cases within healthcare, such as those classed as Medically Unexplained Illnesses, Functional Neurological Disorders and Psychiatric Disorders. Future work on epistemic injustice in healthcare must recognise and attend to this tension to protect against unsatisfactory attempts to correct epistemic injustice. (shrink)

Several modern accounts of explanation acknowledge the importance of abstraction and idealization for our explanatory practice. However, once we allow a role for abstraction, questions remain. I ask whether the relation between explanations at different theoretical levels should be thought of wholly in terms of abstraction, and argue that changes of the quantities in terms of which we describe a system can lead to novel explanations that are not merely abstractions of some more detailed picture. I use the example of (...) phase transitions as described by statistical mechanics and thermodynamics to illustrate this, and to demonstrate some details of the relationship between abstraction, idealization, and novel explanation. (shrink)