Patterns resulting from the sole interplay between reaction and diffusion are probably involved in certain stages of morphogenesis in biological systems, as initially proposed by Alan Turing. Self-organization phenomena of this type can only develop in nonlinear systems (i.e. involving positive and negative feedback loops) maintained far from equilibrium. We present Turing patterns experimentally observed in a chemical system. An oscillating chemical reaction, the CIMA reaction, is operated in an open spatial reactor designed in order to obtain a pure (...) reaction-diffusion system. The two types of Turing patterns observed, hexagonal arrays of spots and parallel stripes, are characterized by an intrinsic wavelength. We identify the origin of the necessary difference of diffusivity between activator and inhibitor. We also describe a pattern growth mechanism by spot splitting that recalls cell division. (shrink)

A pesquisa quantitativa tem sido predominante nos estudos sobre oração. A partir de uma abordagem qualitativa baseada na análise de conteúdo, este estudo examina as relações entre oração e saúde. Os dados são provenientes de 104 vídeos com entrevistas gravadas com participantes de igrejas Católicas, Protestantes e Pentecostais. A análise levantou quatro categorias descritivas do uso da oração: 1. Como estratégia de coping (enfrentamento) (62,5%); 2. Para manter viva a espiritualidade (15,3%); 3. Como técnica de empoderamento mútuo (8,6%); 4. Como (...) ponto de mudança no processo existencial (13,4%). Correspondem a estas categorias, respectivamente, os tipos de oração: 1. Petição, Lamentação; 2. Descanso, Sacramental, 3. Intercessão; 4. Conversão, Chamado; Movimento do Espírito. De acordo com a literatura corrente, a oração proporciona formas de conexão orientadas “para dentro/si mesmo” ; “para cima/divino” e “ para fora/outro” . Os resultados sugerem uma modalidade de conexão ainda não estudada: a conectividade epifânica – que se origina no sagrado, vem ao encontro do humano, e marca um ponto de mudança no processo existencial. Os achados indicam estreita relação entre oração e saúde mental e espiritual, como diminuição da ansiedade, direção e propósito na vida, e apontam a importância de maiores estudos na interface entre teologia e psicologia da religião. Palavras-chave: Oração. Coping religioso espiritual. Saúde mental e espiritual. Psicologia da religião. Subjetividade.Quantitative research has been prevalent in the studies on prayer. Using a qualitative approach based on content analysis, this study examines the relationship between prayer and health. Data come from 104 recorded interviews of participants from Catholic, Protestant and Pentecostal traditions. The analysis found four categories that describe the use of prayer: 1. Prayer as a religious coping strategy (62,5%); 2. Prayer as a discipline to keep spirituality alive (15,3%); 3. Prayer as a technique of mutual empowerment (8,6%); 4. Prayer as a turning point in the existential process (13,4%). The types of prayer corresponding to these categories are: 1. Petitionary and Lamentation; 2. Rest and Sacramental; 3. Intercessory prayer; 4. Conversion; Calling; Movement of the Spirit. According to the current literature, prayer provides inward, outward and upward connectivity. The results indicate an additional connectivity not yet studied: the Epiphanic connectivity, which comes from sacred to human and marks a turning point in the existential process. The outcomes suggest a close relationship between prayer and spiritual and mental health by decreasing anxiety, making meaning and purpose in life, and point out the relevance and need for further studies on the interface between theology and psychology of religion. Key words : Prayer. Spiritual religious coping. Mental and spiritual health. Psychology of religion. Subjectivity. (shrink)

En este trabajo se intenta localizar el lugar en el que pudo asentarse el castillo de Penna Cadiella mencionado en el Poema de Mio Cid. Para ello, se retoma la hipótesis que en su día planteara P. Guichard sobre su ubicación en la cima de la Sierra de Benicadell (Valencia-Alicante) y se aportan nuevos datos documentales y arqueológicos. Asimismo, se analiza el capítulo 371 de la Crónica de Jaime I en el cual se relata la batalla que, por su (...) posesión, libraron las tropas del rey aragonés contra al-Azraq a mediados del siglo XIII. (shrink)

In their article, Crutchfield and Redinger (2024) outline the conditions that they have identified as situations in which it is ethically permissible to use chemical restraints, defined as medicati...

Originally published in 1936, this book presents the ancient Greek text of the paraphrases and quotations of Zeno's philosophical arguments, together with a facing-page English translation and editorial commentary. Detailed notes are incorporated throughout and a bibliography is also included. This book will be of value to anyone with an interest in Zeno and ancient philosophy.

Explores mind-body philosophy from an Asian perspective.

The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD. This extension, suggested by the equivalence of PAS/E and CSD, is designed to promote additional patient autonomy at the end-of-life. Samuel LiPuma, in his article, “Continuous Sedation Until Death as Physician-Assisted Suicide/Euthanasia: A Conceptual Analysis” claims equivalence between CSD and death; his paper is seminal in the equivalency debate. Critics contend that sedation follows (...) proportionality protocols for which LiPuma’s thesis does not adequately account. Furthermore, sedation may not eliminate consciousness, and as such LiPuma’s contention that CSD is equivalent to neocortical death is suspect. We not only defend the equivalence thesis, but also expand it to include additional moral considerations. First, we explain the equivalence thesis. This is followed by a defense of the thesis against five criticisms. The third section critiques the current use of CSD. Finally, we offer two proposals that, if adopted, would broaden the use of PAS/E and CSD and thereby expand options at the end-of-life. (shrink)

The problem of underdetermination is thought to hold important lessons for philosophy of science. Yet, as Kyle Stanford has recently argued, typical treatments of it offer only restatements of familiar philosophical problems. Following suggestions in Duhem and Sklar, Stanford calls for a New Induction from the history of science. It will provide proof, he thinks, of “the kind of underdetermination that the history of science reveals to be a distinctive and genuine threat to even our best scientific theories” (Stanford 2001, (...) p. S12). This paper examines Stanford’s New Induction and argues that it – like the other forms of underdetermination that he criticizes – merely recapitulates familiar philosophical conundra. (shrink)

The ontic structural realist stance is motivated by a desire to do philosophical justice to the success of science, whilst withstanding the metaphysical undermining generated by the various species of ontological underdetermination. We are, however, as yet in want of general principles to provide a scaffold for the explicit construction of structural ontologies. Here we will attempt to bridge this gap by utilizing the formal procedure of quantization as a guide to ontic structure of modern physical theory. The example of (...) non-relativistic particle mechanics will be considered and, for that case, it will be shown that a viable candidate for an ontic structural realism framework can be constituted in terms of the combination of a state-space with Poisson bracket structure, and a set of observables, with Lie algebra structure. 1 Introduction2 Formulation Underdetermination and Structural Ontologies3 Quantization and Structural Ontologies4 The Case of Non-relativistic Particle Mechanics4.1 Formulation underdetermination4.2 The classical ontology4.3 Quantum theory and the generalized structural ontology4.4 Interpretation of results5 Conclusion and Prospects. (shrink)

Cheating is a serious issue among business students worldwide. However, research investigating the social factors that may help prevent cheating in Chinese higher education is rare. The present study examined two key social relationship factors of perceived teacher-student relationships and peer relationships by the students. It attempted to build a model which addressed the effects of two variables on Chinese business students’ cheating behaviour: the teacher’s approachability and the relationship goal of the students. Two important social influence factors were also (...) tested as mediators: neutralizing attitudes and perceived cheating norms of the students. A student survey was conducted with 1329 questionnaires collected. The results showed the negative effects of both social relationship variables on cheating, and that their effects were fully mediated by neutralizing attitudes. Moreover, perceived cheating norms fully mediated the effect of the teacher’s approachability, but not so for the relationship goal of the students. This study provided novel insights and recommendations for promoting academic integrity in Chinese business schools and universities. (shrink)

Beliefs are freely attributed to God nowadays in Anglo–American philosophical theology. This practice undoubtedly reflects the twentieth–century popularity of the view that knowledge consists of true justified belief . The connection is frequently made explicit. If knowledge is true justified belief then whatever God knows He believes. It would seem that much recent talk of divine beliefs stems from Nelson Pike's widely discussed article, ‘Divine Omniscience and Voluntary Action’. In this essay Pike develops a version of the classic argument for (...) the incompatibility of divine foreknowledge and free will in terms of divine forebelief. He introduces this shift by premising that ‘ A knows X ’ entails ‘A believes X ’. As a result of all this, philosophers have increasingly been using the concept of belief in defining ‘omniscience’. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Sacramental Wisdom:Humilitatio, Eruditio, Exercitatio in the Scholastics and TodaySr. Albert Marie Surmanski O.P.IntroductionThe relationship between human nature and the sacraments is often characterized in a way that takes away from the beauty and power of the sacraments. Sacraments are sometimes viewed today as something basically irrelevant to human life, an interesting spiritual "option" for those who find comfort in ritual. This view leads to a sacramental practice that is (...) occasional, irregular, or nonexistent. Many young people who fail to grasp religion as important to their reality implicitly embrace this perspective. The difficulty parishes have had in the past few years in convincing parishioners to return to liturgical prayer after each wave of the coronavirus pandemic demonstrates this viewpoint.In another perspective, the sacraments might be viewed precisely as expressions of what it means to be human, or one might say, to be human in a world in which God reveals himself at all times.1 In this view, the sacraments [End Page 1391] are our own graced self-expression as a community. They merely make thematic what already happens each moment. Alternatively, they celebrate who we are, and perhaps can be radically updated to reflect changing categories of social identity. 2Both of these viewpoints overlook the fallen state of human nature that cries out for healing from God. The first view does not preclude knowledge of human violence and fragility, but fails to recognize the sacraments as a medicine needed for the remedy of human ills. The second viewpoint, while professing a need for Christ, looks to the human person or community for healing rituals. This approach risks being enmeshed with human nature in a disordered state in such a way that it celebrates human disorder instead of healing it. Alternatively, the viewpoint may lead to the abandonment eschatological hope and wither into inanity.There are profound metaphysical and anthropological issues that play out in these two opposite but strangely united viewpoints. Rather than directly analyze these errors, this paper would like to propose the recovery of a medieval viewpoint that offers another perspective. This is Hugh of St. Victor's explanation that the sacraments fit and heal human nature through offering humanity humility, instruction, and exercise. 3 This paper will briefly survey Hugh's contribution, analyze its reception by several of the thirteenth-century Scholastics, shows its deep rootedness in biblical wisdom, and then show how it fruitfully opposes current-day challenges.Hugh of St. VictorHugh of St. Victor was a twelfth-century canon of the Parisian Abbey of St. Victor. The most influential writer of the Victorine school, his work is characterized by an Augustinian concern for the re-formation of the image of God in man, a sense of the wise ordering of salvation history, and an emphasis on both virtue and liturgical practice. In his masterwork, De Sacramentis Christianae Fidei, Hugh of St. Victor divides the works of God into two main periods: the work of creation and the work of restoration. Within the [End Page 1392] work of restoration, there are three periods: the period of the natural law, that of the Mosaic or written law, and that of grace, inaugurated by Christ.4 His book's division into two parts cuts across these distinctions: Part 1 of Hugh's text covers creation, the restoration in general, faith, sacraments in general, as well as particulars of the sacraments of the periods of the natural and written law. Part 2 includes the Incarnation, the Church, various Christian rituals, and the final restoration of Christ's return.Hugh is writing around the time when theologians began to list the number of the sacraments of the Church as seven. Emerging from the wider use of the term, Hugh uses the word "sacrament" in a wide sense, but distinguishes several categories of sacraments. Following Dominique Poirel, scholars recognize that Hugh uses the word sacramentum in five main ways.5 The first is a general definition: (1) any sign of anything sacred. The second through fourth are more specific usages, to which we do not commonly give the term "sacrament" today: (2) Scripture, which signifies sacred realities both through its text and the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Full Collection of Personal NarrativesZohar Lederman, Ola Ziara, Rachel Coghlan, Oksana Sulaieva, Anna Shcherbakova, Oleksandr Dudin, Vladyslava Kachkovska, Iryna Dudchenko, Anna Kovchun, Lyudmyla Prystupa, Yuliya Nogovitsyna, Ghaiath Hussein, Kathryn Fausch, P. P. Kyaw, Ayesha Ahmad, Richard W Sams II, Handreen Mohammed Saeed, Artem Riga, Ryan C. Maves, Elizabeth Dotsenko, Irina Deyneka, Eva V. Regel, and Vita Voloshchuk• An Unsettling Affair• How We Keep Caring While Walking Through Our Pain• (...) Adjusting Laboratory Practices to the Challenges of Wartime• Why We Stay• A Semi-Personal Story from a Ukrainian NGO Professional (or a Semi-Professional Story from a Ukrainian Person) Living through the War• When Ethics Survives Where People Do Not: A Story From Darfur• Burma’s Healthcare Under Fire: My Experience as an Exiled Medical Professional• When a Conflict Collapses on a Child: An (Aborted) Medical Evacuation of a Hazara Toddler During the Kabul Airport Blast and the Taliban Takeover• The Vagaries and Vicissitudes of War• Providing Care to a Potential Aggressor: An Ethical Dilemma• One Surgeon’s Experience During Armed Conflict in Ukraine• The Limits of Our Obligations• A Liberating Breath• Soldiers of the Invisible Front: How Ukrainian Therapists Are Fighting for the Mental Health of the Nation Under Fire• Stories of Families with Chronically Ill Pediatric Patients during the War in UkraineCopyright © 2023 Johns Hopkins University Press... (shrink)

This book directs discussions of critical theory to the Caribbean as a key source in the theory and practice of freedom, liberation, and justice. In dialogue with Frankfurt School Critical Theory, while highlighting contributions of Caribbean theorists, the volume offers a wider archive of Marxism as well as of social critique and construction.

In lieu of an abstract, here is a brief excerpt of the content:The Adoro Te Devote of St. Thomas AquinasSr. Lucia Marie of the Visitation Langford O.P.The Adoro te devote is perhaps the most well-beloved Eucharistic hymn of our time, popularly attributed to St. Thomas Aquinas, the medieval Dominican friar known for his theological treatises as well as his Eucharistic hymnography. Unlike most of Aquinas's work, the poem reveals the intensely personal side of his faith. Rich in theological content and (...) inspiring deep Eucharistic devotion, this poem amply repays a closer investigation. We will look first at the questions of authorship, background, and structure before moving on to a discussion of the text itself.The "Disputed Question" of AuthorshipWhile the Adoro te has traditionally been attributed to St. Thomas Aquinas, the Thomistic authorship of the text was contested in the twentieth century, with two main objections being raised. The first claims that the content of the poem contradicts Thomas's own teachings and cannot have flowed from the same pen. The second objection is historical, claiming that a lack of evidence makes Thomistic authorship improbable.The first objection, claiming that the content of the poem is irreconcilable with Thomistic authorship, takes objection to a line in the poem which seems to claim that sense perception is unreliable and inaccurate, at least with regard to the Eucharist. The text of the Adoro te uses the word fallitur (deceived) with reference to the senses: "Visus, tactus, gustus in te fallitur"—"Sight, touch, taste in you are deceived." Some scholars have claimed that this line contradicts the teaching of Aquinas that the senses are [End Page 365] infallible in regard to their proper sensibles.1 Robert Wielockx addresses this charge in his study of the Adoro te, arguing that "the text does not contradict the continuous teaching of Thomas according to which the senses are not wrong when they judge their proper object, which as far as the Eucharist is concerned, is only the sacramental species."2 The substantial presence of Christ in the Eucharist is a mystery which is not knowable by the senses, and as Paul Murray, O.P., observes: "That's surely the point St. Thomas is making."3 However, the Thomistic insistence that all knowledge comes through our senses is not missing even here. While sight, touch, and taste fall short of comprehending the truth before them, the Adoro te itself proclaims that it is another sense—hearing—which reveals the mystery: "sed auditu solo tute creditur"—"but by hearing alone it is safely believed."4Thus there is no solid objection to Thomistic authorship based on the poem's content. But what about the historical evidence? Dom André Wilmart published a comprehensive study of the manuscript tradition in 1929. Noting that there were no extant copies of the text dating to Aquinas's lifetime and that the biography of Aquinas written by his own Dominican confrere and contemporary, William of Tocco, made no mention of the Adoro te, he considered it most probable that the poem was authored at a later date and ascribed to Aquinas.5However, Dom Wilmart did not know that he was not working with William of Tocco's final version of his work. The publication of a critical edition of William of Tocco's Ystoria Sancti Thome de Aquino in 1996 demonstrated that Tocco published his work in four successive redactions. The fourth and final version of his text (unknown to Dom Wilmart) was finished just before his death in 1323, and in this final version, Tocco includes the text of the Adoro te, attributing its authorship to St. Thomas.6 [End Page 366] Furthermore, Wielockx published a study of the Adoro te in 1998; his investigation of the manuscript tradition found that, of fifty-one sources, forty-four explicitly cite St. Thomas as their author. The remaining sources simply lacked any attribution. We may thus conclude with Wielockx: "External evidence, which must be given priority in sound criticism, wholly favors Thomas Aquinas's authorship of the poem."7BackgroundWith the attribution of the poem to St. Thomas Aquinas on secure footing, we now move to the background of the poem. Unlike Aquinas's Eucharistic hymns such as... (shrink)

The decision whether to have a realist or an anti-realist attitude towards scientific hypotheses is interpreted in this paper as a choice that scientists themselves have to face in their work as scientists, rather than as a ‘philosophical’ problem. Scientists’ choices between realism and instrumentalism (or other types of anti-realism) are interpreted in this paper with the help of two different conceptual tools: a deflationary semantics grounded in the inferentialist approach to linguistic practices developed by some authors (e.g., Sellars, Brandom), (...) and an epistemic utility function that tries to represent the cognitive preferences of scientists. The first tool is applied to two different questions traditionally related to the problem of scientific realism: the non-miracle argument, and the continuity of reference. The second one is applied to the problem of unconceived alternatives, and to the distinction between realist and instrumentalist attitudes towards scientific hypotheses. (shrink)

This paper discusses the utilization of pilots' physiological indications such as electroencephalographic signals, ocular parameters, and pilot performance-based quantitative metrics to estimate cognitive workload. The study aims to derive a non-invasive technique to estimate pilot's cognitive workload and study their correlation with standard physiological parameters. Initially, we conducted a set of user trials using well-established psychometric tests for evaluating the effectiveness of pupil and gaze-based ocular metrics for estimating cognitive workload at different levels of task difficulty and lighting conditions. Later, (...) we conducted user trials with the NALSim flight simulator using a business class Learjet aircraft model. We analyzed participants' ocular parameters, power levels of different EEG frequency bands, and flight parameters for estimating variations in cognitive workload. Results indicate that introduction of secondary task increases pilot's cognitive workload significantly. The beta frequency band of EEG, nearest neighborhood index specifying distribution of gaze fixation, L1 Norm of power spectral density of pupil diameter, and the duty cycle metric indicated variations in cognitive workload. (shrink)

Glowacki defines peace as harmonious relationships between groups maintained without the threat of violence, where groups can be anything from families to nation states. However, defining such contentious concepts like “peace” and “groups” is a difficult task, and we discuss the implications of Glowacki's definitions for understanding intergroup relationships and their evolutionary history.

The scientist’s decision of accepting a given proposition is assumed to be dependent on two factors: the scientist’s ‘private’ information about the value of that statement and the proportion of colleagues who also accept it. This interdependence is modelled in an economic fashion, and it is shown that it may lead to multiple equilibria. The main conclusions are that the evolution of scientific knowledge can be path-dependent, that scientific revolutions can be due to very small changes in the empirical evidence, (...) and that not all possible equilibria are necessarily efficient, neither in the economic nor in the epistemic sense. These inefficiencies, however, can be eliminated if scientists can form coalitions. (shrink)

The study relevance lies in understanding strategic objectives' content concerning intelligent technologies’ application. The development and application of artificial intelligence in various branches of human activity carry the potential for global changes in society, which, in methodological terms, increases the relevance of considering these problems. The study of ethical problems of artificial intelligence in the concept of sustainable development of society is connected with the dynamic development of innovative artificial intelligence (AI) technologies, which are considered a process of becoming a (...) new technosubject in the context of neuroscience development. The article emphasizes that the development of artificial intelligence acts as an innovative form of technology development when a new kind of human-machine technosubject is formed. The authors identify social problems of artificial intelligence application as the digitalization of life becomes a global anthropological challenge. Innovations of artificial intelligence are directly related to a number of ethical problems, as they contribute not only to the sustainable development of society but also cause dehumanization of relations between people and society. Based on the analysis of qualitative changes in scientific and technological research, using human-machine devices is becoming inevitable. Humankind must develop ethical guidelines for the application of AI systems. (shrink)

The Secret Doctrine comprises a virtual encyclopaedia of the "anciently universal wisdom-tradition" -- scarcely an issue of consequence in the broad range of human experience is left untouched. As part of the Secret Doctrine Centenary project, this 441-page Index provides ready access to the vast quantity of material from many cultures set forth in the SD's original two volumes published in 1888. Due to the topics covered, it is as much an index of ideas as it is of subjects, works, (...) persons, and proper names. To aid the reader, major subject entries are cross-referenced; foreign terms are identified by language and, where possible, given in both their 1888 spelling(s) and as modernly transliterated, often with one or two word definitions. Subentries are arranged alphabetically. Cited works and authors, whose titles or names are not given in the SD are placed in brackets for convenient identification. Also included is an Appendix of foreign phrases with translation and source reference -- all helping to make this Index an invaluable reference tool for students of The Secret Doctrine. (shrink)

Software piracy is an instance of unauthorized duplication of information goods where laws and norms are not agreed-upon. This article presents a content analysis of articles from the five highest circulating U.S. newspapers 1989-2004 as evidence of the prevailing social environment surrounding software piracy. The rationales in the news articles are analyzed as evidence of the social and psychological underpinnings of attitudes toward software piracy. An expanded version of Sykes and Matza's (American Sociological Review 22, 664-670, 1957); Zamoon and Curley (...) (Working paper, Kuwait University, Kuwait, 2007) neutralization framework is applied to analyze the content of the articles. We found that rationales condoning piracy showed a more balanced use of neutralization approaches, and less moral intensity toward the behavior. In contrast, rationales condemning piracy mostly promoted the injury aspect of software piracy, and suggested higher moral intensity. The discrepancies have practical implications as a barrier to the ability to connect the two sides of the debate concerning software piracy. (shrink)

The federal government is funding a sea change in health care by investing in interventions targeting social determinants of health, which are significant contributors to illness and health inequity. This funding power has encouraged states, professional and accreditation organizations, health care entities, and providers to focus heavily on social determinants. We examine how this shift in focus affects clinical practice in the fields of oncology and emergency medicine, and highlight potential areas of reform.

This special issue of Cognitive Linguistics reexamines the notions of uniformity and variability within morphological systems from a cognitive linguistic standpoint. It challenges traditional perspectives that regard morphological variability as mere deviations from the norm, suggesting instead that such variability is systematic and shaped by external influences including language acquisition and processing constraints. The contributions in this issue promote a shift from isolated analysis to a holistic view of paradigms, classes, and systems, advocating for a framework where morphological structures are (...) seen as integral to communicative and functional aspects of language. By accounting for the broad adaptive dynamics of language systems, the complex interplay between uniformity and variability is revealed as an inherent aspect of language usage. (shrink)

Suppose COVID-19 is the runaway tram in the famous moral thought experiment, known as the “Bystander at the Switch.” Consider the two differentiated responses of governments around the world to this new threat, namely the option of quarantine/lockdown and herd immunity. Can we contrast the hypothetical with the real scenario? What do the institutional decisions and strategies for dealing with the virus, in the beginning of 2020, signify in a normative moral framework? This paper investigates these possibilities in order to (...) highlight the similarities and, more importantly, the differences that exist between utilitarianism and Kantian ethics. Analysis shows that the hypothetical scenario can never be fully compared to the complex multifactorial nature of the real world. But if a comparison is attempted, the most obvious difference between the two governmental strategies is the concept of duty within the Kantian perspective. Ultimately, it is a matter of comparing freedom and life. Attributing a moral “priority ticket” to one or the other can be analysed through interpersonal aggregation. (shrink)

This paper advocates for the inclusion of patient perspectives in the diagnosis and treatment of eating disorders (EDs) for ethical, epistemological, and pragmatic reasons. We build upon the ideas of a recent editorial published in this journal. Using EDs as their example, the authors argue against dominant DSM-oriented approaches in favor of an increased focus on understanding patients’ subjective experiences. We argue that their analysis stops too soon for the development of practical—and actionable—insights into how to effect the integration of (...) first-person and third-person accounts of EDs. Methods Contextual analysis was used to make the case for patient perspectives. (shrink)