A combination of “environmental factors” in the U.S. has led to an increased demand for health care professionals. However, there has been a significant decrease in the number of U.S. medical graduates selecting careers in family medicine and general internal medicine, thus driving demand for international medical graduates. At the heart of our national workforce policy needs to be good domestic and foreign policies, such as self-sufficiency approaches that include strategies to incentivize rural and underserved practice for U.S. medical graduates.

Health care depends on people. It is the health workforce — doctors, nurses, pharmacists, lab technicians, and nursing assistants, to mention a few — that, in large measure, determine the quality and effectiveness of any health enterprise. The nature of the health workforce was integral to the health care reform debates of the early 1990s and will surely be central in proposals to improve the quality, accessibility, and cost of U.S. health care in the future. Therefore, as we enter a (...) new period of health reform deliberations and as we face the inevitability of an aging population, it is important to consider the problems and potential remediation necessary for the health workforce of the future. This article focuses particularly on physicians and nurses while recognizing the importance and frequently parallel concerns that arise across all health care disciplines. Understanding how the composition, capacity, and activities of a health care workforce must change as part of health reform requires an understanding of the context in which health professionals practice. What are the factors that govern health care today, and what are their impact on the health workforce? (shrink)

The following text is the first ever translation into English of a writing by German phenomenologist Hermann Schmitz (*1928). In it, Schmitz outlines and defends a non-mentalistic view of emotions as phenomena in interpersonal space in conjunction with a theory of the felt body’s constitutive involvement in human experience. In the first part of the text, Schmitz gives an overview covering some central pieces of his theory as developed, for the most part, in his massive System of Philosophy, published in (...) German in a series of volumes between 1964 and 1980. Schmitz’s System is centred on the claim that the contemporary view of the human subject is the result of a consequential historical process: A reductionist and ‘introjectionist’ objectification of lived experience culminating in the ‘invention’ of the mind (or ‘soul’) as a private, inner realm of subjective experience and in a corresponding ‘grinding down’ of the world of lived experienced to a meagre, value-neutral ‘objective reality’. To counter this intellectualist trend, Schmitz puts to use his approach to phenomenology with the aim of regaining a sensibility for the nuanced realities of lived experience—hoping to make up for what was lost during the development of Western intellectual culture. Since both this text and the overall style of Schmitz’s philosophising are in several ways unusual for a contemporary readership, a brief introduction is provided by philosophers Jan Slaby and Rudolf Owen Müllan, the latter of whom translated Schmitz’s text into English. The introduction emphasises aspects of Schmitz’s philosophy that are likely to be of relevance to contemporary scholars of phenomenological philosophy and to its potential applications in science and society. (shrink)

The question of whether or not to partition data for the purposes of inferring phylogenetic hypotheses remains controversial. Opinions have been especially divided since Kluge's (1989, Systematic Zoology 38, 7–25) claim that data partitioning violates the requirement of total evidence (RTE). Unfortunately, advocacy for or against the RTE has not been based on accurate portrayals of the requirement. The RTE is a basic maxim for non-deductive inference, stipulating that evidence must be considered if it has relevance to an inference. Evidence (...) is relevant if it has a positive or negative effect on a given conclusion. In the case of ℈partitioned’ phylogenetic inferences, the RTE is violated, and the basis for rational belief in any conclusion is compromised, unless it is shown that the partitions are evidentially irrelevant to one another. The goal of phylogenetic systematics is to hypothesize past causal conditions to account for observed shared similarities among two or more species. Such inferences are non-deductive, necessitating consideration of the RTE. Some phylogeneticists claim the parsimony criterion as justification for the RTE. There is no relation between the two – parsimony is a relation between a hypothesis and causal question(s). Parsimony does not dictate the content of premises prior to an inference. ℈Taxonomic congruence,’ ℈supertrees,’ and ℈conditional combination’ methods violate the RTE. Taxonomic congruence and supertree methods also fail to achieve the intended goal of phylogenetic inference, such that ℈consensus trees’ and ℈supertrees’ lack an empirical basis. ℈Conditional combination’ is problematic because hypotheses derived from partitioned data cannot be compared – a causal hypothesis inferred to account for a set of effects only has relevance to those effects, not any comparative relevance to other causal hypotheses. A similar problem arises in the comparisons of hypotheses derived from different causal theories. (shrink)

The formal definition of species as explanatory hypotheses presented by Fitzhugh is emended. A species is an explanatory account of the occurrences of the same character among gonochoristic or cross-fertilizing hermaphroditic individuals by way of character origin and subsequent fixation during tokogeny. In addition to species, biological systematics also employs hypotheses that are ontogenetic, tokogenetic, intraspecific, and phylogenetic, each of which provides explanatory hypotheses for distinctly different classes of causal questions. It is suggested that species hypotheses can not be (...) applied to organisms with obligate asexual, parthenogenetic, and self-fertilizing modes of reproduction. Hypotheses explaining shared characters among such organisms are, instead, strictly phylogenetic. Several implications of this emended definition are examined, especially the relations between species, intraspecific, and phylogenetic hypotheses, as well as the limitations of species names to be applied to temporally different characters within populations. (shrink)

Advocates of tuition-free four-year public college make the argument for it too easy by asserting that it would be paid for out of taxes on the wealthy. Other uses of the revenues are possible. In this paper, Harry Brighouse and Kailey Mullane establish two criteria for comparing different uses of the revenues: the first criterion is, will the policy increase the overall level of educational goods?, and the second is, will the policy reduce inequalities of educational goods? Here, Brighouse and (...) Mullane compare tuition-free four-year public college with two alternatives: (1) spending the revenues in pre-K and K-12, and (2) spending them on expanding the Pell Grant Program. Both alternatives are superior with respect to reducing inequalities, and spending in pre-K and K-12 is superior with respect to increasing the overall level of educational goods. While on some assumptions tuition-free four-year public college might prove better than expanding Pell Grants at increasing the overall level of educational goods, there are good reasons, nevertheless, to prefer expanding Pell Grants. (shrink)

Framing systematics as a field consistent with scientific inquiry entails that inferences of phylogenetic hypotheses have the goal of producing accounts of past causal events that explain differentially shared characters among organisms. Linking observations of characters to inferences occurs by way of why-questions implied by data matrices. Because of their form, why-questions require the use of common-cause theories. Such theories in phylogenetic inferences include natural selection and genetic drift. Selection or drift can explain ‘morphological’ characters but selection cannot be causally (...) applied to sequences since fitness differences cannot be directly associated with individual nucleotides or amino acids. The relation of selection to sequence data is by way of downward or top-down causation from those phenotypes upon which selection occurs. The application of phylogenetic inference to explain sequence data is thus restricted to instances where drift is the relevant theory; those nucleotides or amino acids that can be explained via downward causation are precluded from inclusion in the data matrix. The restrictions on the inclusion of sequence data in phylogenetic inferences equally apply to species hypotheses, precluding the more restrictive approach known as DNA barcoding. Not being able to discern drift and selection as relevant causal mechanisms can severely constrain the inclusion and explanations of sequence data. Implications of such exclusion are discussed in relation to the requirement of total evidence. (shrink)

Three competing ‘methods’ have been endorsed for inferring phylogenetic hypotheses: parsimony, likelihood, and Bayesianism. The latter two have been claimed superior because they take into account rates of sequence substitution. Can rates of substitution be justified on its own accord in inferences of explanatory hypotheses? Answering this question requires addressing four issues: (1) the aim of scientific inquiry, (2) the nature of why-questions, (3) explanatory hypotheses as answers to why-questions, and (4) acknowledging that neither parsimony, likelihood, nor Bayesianism are inferential (...) actions leading to explanatory hypotheses. The aim of scientific inquiry is to acquire causal understanding of effects. Observation statements of organismal characters lead to implicit or explicit why-questions. Those questions, conveyed in data matrices, assume the truth of observation statements, which is contrary to subsequently invoking substitution rates within inferences to phylogenetic hypotheses. Inferences of explanatory hypotheses are abductive in form, such that some version of an evolutionary theory(ies) is/are included or implied. If rates of sequence evolution are to be considered, it must be done prior to, rather than within abduction, which requires renaming those putatively-shared nucleotides subject to substitution rates. There are, however, no epistemic grounds for renaming characters to accommodate rates, calling into question the legitimacy of causally accounting for sequence data. (shrink)

Research is increasingly recognised as a key component of medical curricula, offering a range of benefits including development of skills in evidence-based medicine. The literature indicates that experienced academic supervision or mentoring is important in any research activity and positively influences research output. The aim of this project was to investigate the human research ethics experiences and knowledge of three groups: medical students, and university academic staff and clinicians eligible to supervise medical student research projects; at two Australian universities. Training (...) in research ethics was low amongst academic staff and clinicians eligible to supervise medical student research. Only two-thirds of academic staff and students and less than half of clinicians surveyed indicated that specific patient consent was required for a doctor to include patient medical records within a research publication. There was limited awareness of requirements for participant information and consent forms amongst all groups. In the case of clinical trials, fewer clinicians and students than academics indicated there was a requirement to obtain consent. Awareness of the ethics committee focus on respect was low across all groups. This project has identified significant gaps in human research ethics understanding among medical students, and university academic staff and clinicians. The incorporation of research within medical curricula provides the impetus for medical schools and their institutions to ensure that academic staff and clinicians who are eligible and qualified to supervise students’ research projects are appropriately trained in human research ethics. (shrink)

In this article, we explore the act of resistance by nurses and midwives at the nexus of abortion care and gender-based violence. We commence with a brief overview of a multiphased extended grounded theory doctoral project that analysed the individual, situational and socio-political experiences of Australian nurses and midwives who provide abortion care to people victimised by gender-based violence. We then turn to Essex's conceptualisation of resistance in health and healthcare and draw upon these concepts to tell a unifying and (...) cohesive story about how nurses and midwives exercise their politics. Vignettes taken from the three study phases are provided for demonstrative purposes. Finally, we discuss the potential of resistance in health and healthcare as a postmodern feminist research tool to analyse acts by nurses and midwives that could be categorised as political. (shrink)

In this article, we explore the act of resistance by nurses and midwives at the nexus of abortion care and gender-based violence. We commence with a brief overview of a multiphased extended grounded theory doctoral project that analysed the individual, situational and socio-political experiences of Australian nurses and midwives who provide abortion care to people victimised by gender-based violence. We then turn to Essex's conceptualisation of resistance in health and healthcare and draw upon these concepts to tell a unifying and (...) cohesive story about how nurses and midwives exercise their politics. Vignettes taken from the three study phases are provided for demonstrative purposes. Finally, we discuss the potential of resistance in health and healthcare as a postmodern feminist research tool to analyse acts by nurses and midwives that could be categorised as political. (shrink)

If someone reports that he had been thinking that he would very much like to seduce his sister, an appropriate comment might be: “Shame on you for having such a nasty idea.” But if one reports that he dreamt he seduced his sister the situation appears quite different, for while we might be repulsed by the dream shaming seems, to say the least, far less appropriate.We do not ordinarily, if ever, say things like, “It was bad of you to dream (...) that.” A child may be sent to bed without supper for saying that he hates his father, but not for reporting a dream which clearly expresses hate for his father. (shrink)

In comments on my “Moral Responsibility for Dreams,” J. F. M. Hunter claims that I fail to see that “‘Dreaming is not an action’ is a grammatical remark, [not an “empirical” one] and as such makes no assertion as to what is or may be the case in our souls, but only about how we may talk about certain psychological goings-on.” Hunter argues that ‘Dreaming is not an action’ is a logical remark in the way that ‘Bachelors are unmarried’ is (...) a logical remark. “It is not something that we notice about dreams, that they happen, as it is not something we notice about bachelors that they have no wives. It is part of the concept of a dream; and no matter what characteristics a phenomenon shares with a dream, such as being experienced while asleep, if it does not happen it is for that reason alone not a dream.”. (shrink)

Are some mental activities rational but unconscious? Psychopathological symptoms, it is said, have a sense — they are seen as compromise-formations which express the intentions of agents even though the agents are totally unaware of bringing about such symptoms. Philosophers, who often claim that such a conception is simply contradictory or incoherent, have shed little light on the puzzles and apparent paradoxes that surround the issue. It is argued here that Freud's two models of explanation — the mechanistic and the (...) intentionalistic — each fail to provide a basis for an explanatory account of the phenomenon of unconscious defense. An examination of the problem of dream composition helps explain why Freud's dependence upon rational homunculi is inappropriate and misleading. Finally, an alternative model which depends neither upon Freud's version of mechanism nor upon his lavish anthropormorphism is suggested.Ladies and Gentlemen, — It was discovered one day that the pathological symptoms of certain neurotic patients have a sense. On this discovery the psychoanalytic method of treatment was founded. It happened in the course of the treament that patients, instead of bringing forward their symptoms, brought forward dreams. A suspicion thus arose that the dreams too had a sense. (shrink)

This book explores society’s problems with interpersonal communication amid increasingly technological environments. The author argues that the work of Gabriel Marcel reveals the root of our issues with communication to be issues with being with others, ultimately suggesting that seeking communion is a way to bridge our disconnections.

Few fields in philosophy are so seemingly distant from ordinary human experience as theories of knowledge. How much information do we draw in from bodies outside of us? And to what degree do our perceptual and mental processes subjectify that information to the point of becoming non-objective? The Heart of Matter: Bridging the Kantian Gap in How we Know Things presents both a back history of current theories of perception, and a plausible theory to span the gap between subject and (...) object. This book begins with K. Popper's theory of falsifiability, as a twentieth-century version of Kantian subjectivism. Before considering eighteenth-century transcendental philosophy, a look at both the empirical and rational theories that inspired Kant helps place his Critique of Pure Reason in context. This book highlights the developments in Kant's thought, as he struggled to solve important problems within his Copernican revolution. How far does Kant's theory coincide with our actual perceptual experience? Twentieth-century experimentation in perception sheds important light on human knowing. The Heart of Matter follows C. Fabro's study of those psychological findings, and especially his ability to incorporate those findings into a coherent description and explanation. Many current theories of knowledge dismiss any possibility of our objectively knowing bodies outside of us; this book takes a candid look at both the major dilemmas implied in such a dismissal, as well as our actual perception of things. On this account, a fruitful exchange does appear to take place between the mind and reality in perception. (shrink)

This paper examines the outcomes of Preserving the Past Together, a workshop series designed to build the capacity of local heritage managers to engage in collaborative and community-based approaches to archaeology and historic preservation. Over the past two decades practitioners of these approaches have demonstrated the interpretive, methodological, and ethical value of integrating Indigenous perspectives and methods into the process and practice of heritage management and archaeology. Despite these benefits, few professional resources exist to support the development of collaborative relationships (...) between local heritage managers and Tribal nations. Filling this need, Preserving the Past Together’s interactive workshops and keynote lectures involved participants in a discussion of the central themes in collaborative and Indigenous approaches to archaeology today, highlighting the local challenges and opportunities that exist for archaeologists, heritage managers, and Tribal nations to work together to care for the past. This paper presents an overview of the event series’ goals, the strategies it used to foster collaboration among the diverse stakeholders of the Salish Sea, and the next steps the project’s co-directors are taking to further support communication and collaboration between stewards and stakeholders in the Pacific Northwest. (shrink)

In “Moral Responsibility for Dreams,” Harvey Mullane maintains that although there is something inappropriate about blaming people for their dreams, this is because we do not have very direct control over our dreams: but although this is the case, it is not the case that we have no control over them. We can work at having the right dreams, or not having the wrong ones, as we can work at blushing and not blushing and at loving our neighbour: and therefore (...) presumably there must be a sense in which or a degree to which we can be responsible for what we dream. There are a number of aspects of this question, and of Mullane's treatment of it, which I would like to explore further. (shrink)

A reaction diffusion system is used to study the interaction between species in a population dynamic system. It is not only used in a population dynamic system with the diffusion phenomenon but also used in physical chemistry, medicine, and animal and plant protection. It has been studied by more and more scholars in recent years. The FitzHugh–Nagumo model is one of the most famous reaction-diffusion models. This article takes a deeper look at a FitzHugh–Nagumo model in a network (...) with time delay. Firstly, we studied the linear stability of the equilibrium, then the existence of Hopf bifurcation is given, and finally, the stability of the Hopf bifurcation is introduced. (shrink)

The poor denoising effect for noisy grayscale images with traditional processing methods would be obtained under strong noise condition, and some image details would be lost. In this paper, a parallel array model of Fitzhugh–Nagumo neurons was proposed, which can restore noisy grayscale images well with low peak signal-to-noise ratio conditions and the image details are better preserved. Firstly, the row-column scanning method was used to convert the 2D grayscale image into a 1D signal, and then the 1D signal (...) was converted into a binary pulse amplitude modulation signal by signal modulation. The modulated signal was input to an FHN parallel array for stochastic resonance. Finally, the array output signal was restored to a 2D gray image, and the image restoration effect was analyzed based on the PSNR and Structural SIMilarity index. It is shown that the SR effect can be exhibited in an array of FHN neuron nonlinearities by increasing the array size, and the image restoration effect is significantly better than the traditional image restoration method, and larger PSNR and SSIM can be obtained. It provides a new idea for grayscale image restoration in a low PSNR environment. (shrink)