Despite promising early work into the role of immune cells such as eosinophils in adipose tissue (AT) homeostasis, recent findings revealed that elevating the number of eosinophils in AT alone is insufficient for improving metabolic impairments in obese mice. Eosinophils are primarily recognized for their role in allergic immunity and defence against parasitic worms. They have also been detected in AT and appear to contribute to adipose homeostasis and drive energy expenditure, but the underlying mechanisms remain elusive. It has long (...) been recognized that immune cells such as macrophages respond to external signals to regulate adipose homeostasis and energy balance, however, less is known about the relevance of eosinophil activity in AT. As the authors propose in this review, given recent debate over the relative importance of their tissue‐specific abundance, the stage is now set for exploring the functionality and activation states of AT eosinophils. (shrink)

Postural instability marks a prevalent symptom of Parkinson’s disease. It often manifests in increased body sway, which is commonly assessed by tracking the Center of Pressure. Yet, in terms of postural control, the body’s Center of Mass, and not CoP is what is regulated in a gravitational field. The aim of this study was to explore the effect of early- to mid-stage PD on these measures of postural control in response to unpredictable visual perturbations. We investigated three cohorts: 18 (...) patients with early to mid-stage PD [Hoehn & Yahr stage ; 1.94 ± 0.70]; a group of 15 age-matched controls ; and a group of 12 young healthy adults. Participants stood on a force plate to track their CoP, while the movement of their entire body was recorded with a video-based motion tracking system to monitor their CoM. A moving room paradigm was applied through a head-mounted virtual reality headset. The stimulus consisted of a virtual tunnel that stretched in the anterior-posterior direction which either remained static or moved back and forth in an unpredictable fashion.We found differences in mean sway amplitude and mean velocities of CoP and CoM between the groups under both conditions, with higher MSA of CoP and CoM for PD and higher mean velocities of both variables for PD and ECT when compared with YCT. Visual perturbation increased mean CoP velocity in all groups but did not have effects on mean CoM velocity or MSA. While being significantly lower for the young adults, the net effect of visual perturbation on mean CoP velocity was similar between patients with PD and age-matched controls. There was no effect of the visual perturbation on mean CoM velocity for any of the groups.Our simultaneous assessment of CoP and CoM revealed that postural control is reflected differently in CoM and CoP. As the motion of CoM remained mostly unaffected, all groups successfully counteracted the perturbation and maintained their balance. Higher CoP velocity for PD and ECT revealed increased corrective motion needed to achieve this, which however was similar in both groups. Thus, our results suggest increased effort, expressed in CoP velocity, to be an effect of age rather than disease in earlier stages of PD. (shrink)

Background: Parkinson’s disease is a neurodegenerative disease in which the progressive loss of dopaminergic neurons leads to initially sporadic and eventually widespread damage of the nervous system resulting in significant musculoskeletal and cognitive deterioration. Loss of motor function alongside increasing cognitive impairment is part of the natural disease progression. Gait is often considered an automatic activity; however, walking is the result of a delicate balance of multiple systems which maintain the body’s center of mass over an ever-changing base of support. (...) It is a complex motor behavior that requires components of attention and memory to prevent falls and injury. In addition, evidence points to the critical role of salient visual information to gait adaptability. There is a growing understanding that treatment for PD needs to address movement as it occurs naturally and walking needs to be practiced in more complex environments than traditional therapy has provided.MethodsIn this single-blinded randomized-controlled pilot study, an immersive treadmill training was piloted to determine feasibility and preliminary efficacy on gait and cognition in people with PD. Eighteen participants with Hoehn and Yahr stages I-III PD were randomized to either an intervention or a waitlist control group. Following baseline data collection, the intervention group trained for 30 min, three times/week for 4 weeks on a split belt treadmill combined with a first-person immersive video game targeting visuospatial skills and working memory. Assessment was repeated after 4 weeks of training for the experimental group and 1-month after baseline for the control group. Primary motor outcomes were captured with the APDM Opal sensors during 6 MWT, TUG, and TUG Cognitive. Secondary outcomes of cognition were measured with the Montreal Cognitive Assessment, Verbal Fluency and the Symbol Digit Modality Test. Within subject differences were calculated using the Wilcoxon Signed Ranked Test and between subject comparisons were analyzed using the Mann Whitney U-test.ResultsThis novel treadmill training program was well-tolerated with all participants in the intervention group completing 4 weeks of training three times a week without any adverse effects. After immersive cognitive motor training, the experimental group made clinically relevant improvements in gait speed and walking distance during the 6 MWT while members of the control group showed no change or decreased gait speed and walking distance over the 1-month trial. In addition, the experimental group demonstrated significant improvement for the TUG Cognitive and those changes were greater than the control group. The experimental group also improved scores on MoCA and SDMT cognitive outcome measures while the control group did not.ConclusionThe use of immersive gaming technology to engage specific areas of cognition related to gait is feasible in PD. The treadmill training program paired with a customized interactive video game improved walking velocity in addition to non-significant but consistent improvements in other gait measures and cognitive performance in participants with early to mid-stage PD. (shrink)

IntroductionDeep brain stimulation is an effective treatment for advanced Parkinson’s disease with the targeting bilateral subthalamic nucleus or globus pallidus internus. So far, detailed studies on the efficacy of unilateral STN-DBS for motor symptoms have been reported, but few studies have been conducted on unilateral GPi-DBS.Materials and MethodsSeventeen patients with Parkinson’s disease who underwent unilateral GPi-DBS were selected. We conducted comparison analyses between scores obtained 6–42 months pre- and postoperatively using the following measurement tools: the Movement Disorder Society Unified Parkinson’s (...) Disease Rating Scale part III, the Hoehn and Yahr stage, the presence/absence of dyskinesia, Mini-Mental State Examination, Frontal Assessment Battery, Geriatric Depression Scale, levodopa equivalent dose, and cerebral blood flow by single photon emission computed tomography. Patient backgrounds were compared between four cohorts with favorable and unfavorable postoperative outcome.ResultsSignificant improvement was observed postoperatively in the following: total MDS-UPDRS Part III scores during the off period, contralateral scores, ipsilateral scores, and axial scores. Similarly, the Hoehn and Yahr stages during the off period, and GDS also showed significant decrease. In contrast, LED, MMSE, and FAB remained unchanged while the number of patients who scored positive for dyskinesia decreased by 40%. Abnormal cerebral blood flow preoperatively seen in the cerebral cortex had normalized in the total score-based good responder cohort. In the ipsilateral score-based good responder cohort, cerebral blood flow increased in the contralateral frontal lobe including in the premotor cortex, contralateral to the DBS. Compared to the poor responders, postoperative good responders demonstrated significantly higher preoperative MMSE scores.DiscussionUnilateral GPi-DBS therapy was effective in improving contralateral, ipsilateral, and axial motor symptoms of patients with advanced PD; in particular, it was found to be especially beneficial in PwPD whose cognitive function was unimpaired; the treatment efficacy rivaled that of bilateral counterparts up till at least 6 months postoperatively. Finally, normalization of preoperative abnormalities in cerebral blood flow and increased cerebral blood flow in the contralateral frontal lobe indicated the beneficial potential of this therapy on ipsilateral motor symptoms. (shrink)

The ethics of adolescent decision making is a complicated mine­field with laws that vary from state to state. The case of a fourteen-year-old girl, who simultaneously was diagnosed with cancer and discovered she was pregnant, highlights several weaknesses in our current approach to adolescent decision making in the context of pregnancy. In addition, adolescents with life-limiting conditions face similar challenges that can be examined through the framework of Catholic doctrine.

Pediatric palliative care is specialized medical care for children who live with serious and life-limiting illnesses, with the central goal to improve quality of life for both children and their families. Presently, a majority of pediatric palliative care referrals are based on the traditional consultative model, in which primary providers serve as the gatekeepers to palliative care access. It is well-known that racial and ethnic healthcare disparities exist across the continuum of care, fraught with healthcare providers’ biases that impact the (...) care delivered. This includes the referral practices, allocation and utilization of palliative care services, and leaving vulnerable children and families with potentially unmet palliative care needs. We make the moral argument that the establishment of standard referral criteria for pediatric palliative care services is one simple step that must be taken to begin to address and hopefully ameliorate the impact of providers’ biases and disparities that exist within pediatric palliative care. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Justice Not GreedRichard A. HoehnJustice Not Greed Edited by Pamela Brubaker and Rogate Mshana Geneva: WCC Publications, 2010. 224 pp. $14.00The World Council of Churches (WCC) Advisory Group on Economic Matters (AGEM) advises the WCC and congregations on global economic issues. AGEM members from diverse backgrounds produced the papers in this volume. The introduction is by Rogate Mshana, WCC director for Peace, Justice, and Creation. Samuel Kobia, general (...) secretary of the WCC from 2004–9, introduces the rationale and role of AGEM in the global financial crisis. The book ends with a statement on just finance and the economy of life, adopted by the WCC Central Committee in September 2009. Justice Not Greed will be most useful in settings where there is interest in the intersection of ethics, the economic crisis, and Christianity in relation to the global economy, as well as among those who wish to follow the WCC. As expected [End Page 208] of conference papers, there is not a systematic development of an argument but overlapping ethical and economic analyses. All, however, are opposed to the status quo because of its manifest injustice, especially the impact on poor people.If one were to impose a thematic development, it might go something like this, allowing for individual differences among the authors. Decolonization has resulted in a lopsided, Western, capitalist economic system predicated on greed (Jan Pronk), described by other authors as a beast or a cancer (vivid but unhelpful metaphors since the crisis was caused by humans, not nature). The world lacks appropriate international structures. We need new global institutions, a new global financial architecture that is predicated on, or at least takes into account, justice. Congregations, the ecumenical movement, and the WCC could play a significant role in helping the United Nations move toward such a system.Several authors hope that the global crisis will provide a moment when such a change might become possible (e.g., Alexander Cobham’s “Blood-Stained Silver Lining”). Pamela K. Brubaker, Kim Yong-Bock, Roel Aalbersberg, Rienzie Perera, and Geevarghese Mor Coorilos examine questions related to the Bible, ethics, theology, a culture of “enough for all” (Musa Panti Filibus), the church as moral community, the ecumenical movement, and principles for an alternative economic system. Mariana Issa Zureikat argues for “econo-morals,” applying moral values to economic analyses. Thomas H. Kang advocates the capabilities approach of Amartya Sen and Martha Nussbaum. Marcos Arruda suggests an economy of world solidarity with the “gross happiness index” as a standard for measuring progress. While most chapters include economic analysis, John Dillon wades into some nitty-gritty causes of the current financial crisis, with a positive nod toward the (never adopted) Keynes plan for the Bretton Woods system of monetary management. Marie-Aimee Tourres lays out impacts on the developing world, as does Xiao Lian from a Chinese perspective. Most of these authors argue for such global solutions as a global reserve system and a global tax system.Justice Not Greed presents thoughtful, sometimes passionate papers that could form a basis for lively discussion. Yet real-world solutions often come down to the practice of democracy and political will. Unfortunately, it is not clear that the ecumenical movement possesses the will or the means to effect change because local organizing for political change is not a high priority at any level. [End Page 209]Richard A. HoehnChrist the Servant Lutheran ChurchCopyright © 2012 The Society of Christian Ethics... (shrink)

Objective To assess parental permission for a neonate's research participation using the MacArthur competence assessment tool for clinical research (MacCAT-CR), specifically testing the components of understanding, appreciation, reasoning and choice. Study Design Quantitative interviews using study-specific MacCAT-CR tools. Hypothesis Parents of critically ill newborns would produce comparable MacCAT-CR scores to healthy adult controls despite the emotional stress of an infant with critical heart disease or the urgency of surgery. Parents of infants diagnosed prenatally would have higher MacCAT-CR scores than parents (...) of infants diagnosed postnatally. There would be no difference in MacCAT-CR scores between parents with respect to gender or whether they did or did not permit research participation. Participants Parents of neonates undergoing cardiac surgery who had made decisions about research participation before their neonate's surgery. Methods The MacCAT-CR. Results 35 parents (18 mothers; 17 fathers) of 24 neonates completed 55 interviews for one or more of three studies. Total scores: magnetic resonance imaging (mean 36.6, SD 7.71), genetics (mean 38.8, SD 3.44), heart rate variability (mean 37.7, SD 3.30). Parents generally scored higher than published subject populations and were comparable to published control populations with some exceptions. Conclusions The MacCAT-CR can be used to assess parental permission for neonatal research participation. Despite the stress of a critically ill neonate requiring surgery, parents were able to understand study-specific information and make informed decisions to permit their neonate's participation. (shrink)

The analysis distinguishes two types of standards for defining organic produce; process standards and product standards. Process standards define organic products by the method and means of production. Product standards define organic by the physical quality of the end product. The National Organic Program (NOP) uses process standards as the basis for defining organic. However, the situation is complicated by agricultural production practices, which sometimes result in the migration of NOP prohibited substances from conventional to organic fields. When this interaction (...) alters the value of the product or the costs of production, a production externality is said to exist. Defining organic using process, rather than product standards, influences the burden and character of production externalities. The NOP’s emphasis on process standards reduces the likelihood that production externalities will emerge. (shrink)

The article explores the complex roles shame plays in the lives of people with one or more chronic conditions. This is achieved through a participatory research process in which people with chronic conditions were invited to share stories of shame on the public social media profiles of a peer-led patient community called ‘Chronic Influencers’. The crowdsourced material shows that 7 out of 10 experience shame in relation to their illness on a daily or weekly basis. Other findings are that shame (...) seems to stick to ‘energetic failures’ of the slow or tired body in various social situations; shame is predominantly produced or anticipated in the intimate sphere; and shame can be ‘rescripted’ as culturally produced and politically contestable – and thus counter the pressure to individualise health as a project of personal improvement and self-inspection – when it is shared through voluntary storytelling among peers on social media. (shrink)

Moving from viruses, vaccines, and copycat murder to gay panics, xenophobia, and psychopaths, _Transforming Contagion_ energetically fuses critical humanities and social science perspectives into a boundary-smashing interdisciplinary collection on contagion. The contributors provocatively suggest contagion to be as full of possibilities for revolution and resistance as it is for the descent into madness, malice, and extensive state control. The infectious practices rooted in politics, film, psychological exchanges, social movements, the classroom, and the circulation of a literary text or meme on (...) social media compellingly reveal patterns that emerge in those attempts to re-route, quarantine, define, or even exacerbate various contagions. (shrink)

I propose a `stage theory’ of groups: a group is a fusion of group-stages, where a group-stage is a plurality of individuals at a world and a time. The stage theory consists of existence conditions, identity conditions, and parthood conditions for groups.

Psychiatry has witnessed a new wave of approaches to clinical phenotyping and the study of psychopathology, including the National Institute of Mental Health’s Research Domain Criteria, clinical staging, network approaches, the Hierarchical Taxonomy of Psychopathology, and the general psychopathology factor, as well as a revival of interest in phenomenological psychopathology. The question naturally emerges as to what the relationship between these new approaches is – are they mutually exclusive, competing approaches, or can they be integrated in some way and used (...) to enrich each other? In this opinion piece, we propose a possible integration between clinical staging and phenomenological psychopathology. Domains identified in phenomenological psychopathology, such as selfhood, embodiment, affectivity, etc., can be overlaid on clinical stages in order to enrich and deepen the phenotypes captured in clinical staging (‘high resolution’ clinical phenotypes). This approach may be useful both ideographically and nomothetically, in that it could complement diagnosis, enrich clinical formulation, and inform treatment of individual patients, as well as help guide aetiological, prediction, and treatment research. The overlaying of phenomenological domains on clinical stages may require that these domains are reformulated in dimensional rather than categorial terms. This integrative project requires assessment tools, some of which are already available, that are sensitive and thorough enough to pick up on the range of relevant psychopathology. The proposed approach offers opportunities for mutual enrichment: clinical staging may be enriched by introducing greater depth to phenotypes; phenomenological psychopathology may be enriched by introducing stages of severity and disorder progression to phenomenological analysis. (shrink)

According to four dimensionalism, the material world is divided into momentary stages. In a four-dimensional world, which objects are the ordinary things, the things we normally name and quantify over? Aggregates of stages, according to most four-dimensionalists, but according to stage theorists (or exdurantists), ordinary objects are instead to be identified with the stages themselves. (A temporal counterpart theoretic account of de re temporal predication is then given.) This paper argues that a stage theorist is best positioned to (...) accept David Lewis's argument from temporary intrinsics for four-dimensionalism, since stage theorists are the only four-dimensionalists who attribute monadic temporary intrinsic properties to ordinary things. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 55-59 [Access article in PDF] One Stage Is Not Enough Andrew W. Young and Karel W. de Pauw Keywords: delusions, Cotard delusion, Capgras delusion, cognitive neuropsychiatry. WE WELCOME THE OPPORTUNITY to offer our reflections on Philip Gerrans' interesting paper. Our opinion is that on fundamental issues we agree quite a bit—but there are clear differences when it comes to details.The most basic (...) issue concerns the nature of the enterprise. Like Gerrans, we think that it is possible to create testable accounts of the formation and maintenance of what would otherwise seem bizarre and inexplicable delusions, and that these accounts should be grounded in theoretical models of factors that underpin our everyday perception and reasoning. This general approach certainly forms part of what has been called cognitive neuropsychiatry. However, we disagree with Gerrans in that we see cognitive neuropsychiatry as an attempt to draw on the underlying logic of cognitive neuropsychology, rather than (as Gerrans implies) its current methods. The underlying logic of cognitive neuropsychological approaches has been to try to understand the effects of brain injury in terms of disruption of different components of theoretical models of normal abilities. In this approach, a model of normal performance is tested by its ability to account for the effects of brain injury. Where the model of normal performance also provides a convincing account of brain injury it is retained, and when it fails to account for effects of brain injury, it is revised or abandoned. In cognitive neuropsychiatry, the key theoretical move has been to argue that an adequate model of normal performance should be able to account for any disordered pattern (Ellis and Young 1990). The same logic of seeking to explain disordered performance by reference to models of normal function is then attempted, but for disorders that would usually fall within the province of psychiatry.In our opinion, however, cognitive neuropsychiatry will not simply involve importing the methods of cognitive neuropsychology into the new domain; they will need to be developed and adapted to fit the new agenda (Young 2000).In cognitive neuropsychology, progress has often come from the careful investigation of people with stable, selective deficits of fundamental cognitive functions involved in sensory analysis, memory, and verbal or motor output. In contrast, delusional beliefs can be relatively unstable; often they are only held for a few weeks or even days. When the delusions change, patients may modify or abandon them as suddenly as they seemed to form them, or they may give them up much more slowly and reluctantly. At the very least, this creates difficulties in the timing of investigations and in interpreting the relation of deficits and symptoms, which may be recorded on separate dates. These methodological problems [End Page 55] are exacerbated by the fact that deficits linked to complex abnormal experiences such as delusions may be multifaceted and diffuse, even when the delusions themselves have a specific content or theme. Such complications do not invalidate cognitive neuropsychiatry, but they do mean it will need to develop its own methods for dealing with them and making appropriate inferences.One of the key complexities that has surfaced already involves the idea that delusional beliefs might reflect the interaction of two or more contributory factors. Gerrans discusses a particular variant of this idea, which had been suggested by Young and Leafhead (1996) as an approach to understanding the Cotard delusion: The Cotard delusion represents a depressed person's attempt to account for abnormal perceptual experiences. It follows that the delusion is based on an unfortunate interaction between different contributory factors. One set of factors creates the abnormal perceptual experiences, which are characterised by lack of emotional responses and feelings of emptiness, depersonalisation and derealisation. The other factors result in a misinterpretation of these perceptual changes, in which the patients' depressed moods lead them correctly to attribute the changes to themselves, but to exaggerate their consequences. (Young and Leafhead, 1996, 166) Gerrans describes this as a two-stage account, but argues that a one-stage account based only on abnormal perceptual... (shrink)

In the contemporary debate about the nature of persistence, stage theory is the view that ordinary objects (artefacts, animals, persons, etc.) are instantaneous and persist by being suitably related to other instantaneous objects. In this paper I focus on the issue of what stage theorists should say about the semantics of ordinary proper names, like ‘Socrates’ or ‘London’. I consider the remarks that stage theorists actually make about this issue, present some problems they face, and finally offer (...) what I take to be the best alternative available for them. (shrink)

Most four-dimensionalists, including both worm and stage theorists, endorse mereological universalism, the thesis that any class of objects has a fusion. But the marriage of fourdimensionalism and universalism is unfortunate and unprofitable: it creates a recalcitrant problem for stage theory’s account of lingering properties, such as writing ‘War and Piece’ and traveling across the tennis court, which take time to be instantiated. This makes it necessary to impose a natural restriction on diachronic composition.

Four-dimensionalism, or perdurantism, the view that temporally extended objects persist through time by having (spatio-)temporal parts or stages, includes two varieties, the worm theory and the stage theory. According to the worm theory, perduring objects are four-dimensional wholes occupying determinate regions of spacetime and having temporal parts, or stages, each of them confined to a particular time. The stage theorist, however, claims, not that perduring objects have stages, but that the fundamental entities of the perdurantist ontology are stages. (...) I argue that considerations of special relativity favor the worm theory over the stage theory. (shrink)

Feser (2017) presents and defends five proofs of the existence of God. Each proof is in two stages: the first stage proves the existence of something which, in the second stage, is shown to possess an appropriate range of divine attributes. Each proof is given two presentations, one informal and one formal. In this paper, I critically examine two premises from one of Feser's five first stage proofs. I provide reasons for thinking that naturalists reject both of (...) these premises. In my view, this enough to show that the proof fails: it fails to advance considerations that decide between theism and important competing positions. (shrink)

The acquisition of a new skill usually proceeds through five stages, from novice to expert, with a sixth stage of mastery available for highly motivated performers. In this chapter, we re-state the six stages of the Dreyfus Skill Model, paying new attention to the transitions and interrelations between them. While discussing the fifth stage, expertise, we unpack the claim that, “when things are proceeding normally, experts don’t solve problems and don’t make decisions; they do what normally works” (Dreyfus (...) & Dreyfus, 1988, pp. 30 – 31). This leads us to offer an account of the “perspectival deliberation” that arises for experts and masters and that is distinct from the calculative deliberation characteristic of the lower stages of skillfulness. (shrink)

This paper defends stage theory against the argument from diachronic counting. It argues that stage theorists can appeal to quantifier domain restriction in order to accommodate intuitions about diachronic counting sentences. Two approaches involving domain restriction are discussed. According to the first, domains of counting are usually restricted to stages at the time of utterance. This approach explains intuitions in many cases, but is theoretically costly and delivers wrong counts if diachronic counting is combined with fission or fusion. (...) On the second approach, domains of counting are usually restricted in an indeterminate way, so as to include at most one member of any maximal class of counterpart-interrelated stages (with respect to a certain utterance). This view can accommodate all the relevant intuitions about counting sentences, and it fits well with a new stage-theoretic view of reference that allows speakers to refer to both present and past stages. (shrink)

Mark Johnston has recently argued that four-dimensionalist theories of persistence are incompatible with some of our most basic ethical and prudential principles. I argue that although Johnston’s arguments succeed on a worm-theoretic account of persistence, they fail on a stage-theoretic account. So much the worse, I conclude, for the worm theory.

Bioethics and the stages on life's way -- Bioethical challenges in the new millennium -- The covenantal aspect of Christian marriage -- The use and abuse of human embryos -- The sacredness of newborn life -- On addictions and family systems -- The hope of glory : from a physical to a spiritual body -- Care in the final stage of life.

We present a model for several early stages of the sensorimotor transformations involved in targeted arm movement. In psychophysical experiments, human subjects pointed to the remembered locations of randomly placed targets in three-dimensional space. They made consistent errors in distance, and from these errors stages in the sensorimotor transformation were deduced. When subjects attempted to move the right index finger to a virtual target they consistently undershot the distance of the more distal targets. Other experiments indicated that the error was (...) in the sensorimotor transformation rather than in the perception of distance. The error was most consistent when evaluated using a spherical coordinate system based at the right shoulder, indicating that the neural representation of target parameters is transformed from a retinocentric representation to a shoulder-centered representation. According to the model, the error in distance results from the neural implementation of a linear approximation in the algorithm to transform shoulder-centered target parameters into a set of arm orientations appropriate for placing the finger on the target. The transformation to final arm orientations places visually derived information into a frame of reference where it can readily be combined with kinesthetically derived information about initial arm orientations. The combination of these representations of initial and final arm orientations could give rise to the representation of movement direction recorded in the motor cortex by Georgopoulos and his colleagues. Later stages, such as the transformation from kinematic to dynamic parameters, or to levels of muscle activation, are beyond the scope of the present model. (shrink)

The negative consequences of physicians' failure to establish and maintain personal relationships with patients are at the heart of the humanistic crisis in medicine. To resolve this crisis, a new model of doctor-patient interaction is proposed, based on the ideas of Martin Buber's philosophy of dialogue. This model shows how the physican may successfully combine the personal (I-Thou) and impersonal (I-It) aspects of medicine in three stages. These Three Stages of Medical Dialogue include:1. An Initial Personal Meeting stage, which (...) initiates the doctor-patient relationship and involves mutual confirmation; 2. An Examination stage, which requires a shift from a personal to an impersonal style of interaction; 3. An Integration Through Dialogue or Healing Through Meeting Stage, which involves the integration of the impersonal medical data into the ongoing dialogue between doctor and patient, as a basis for shared decision-making. The use of the model, as well as common failures of doctor-patient dialogue are discussed. (shrink)

Stages on Life's Way, the sequel to Either/Or, is an intensely poetic example of Kierkegaard's vision of the three stages, or spheres, of existence: the esthetic, the ethical, and the religious. With characteristic love for mystification, he presents the work as a bundle of documents fallen by chance into the hands of "Hilarius Bookbinder," who prepared them for printing. The book begins with a banquet scene patterned on Plato's Symposium. (George Brandes maintained that "one must recognize with amazement that it (...) holds its own in this comparison.") Next is a discourse by "Judge William" in praise of marriage "in answer to objections." The remainder of the volume, almost two-thirds of the whole, is the diary of a young man, discovered by "Frater Taciturnus," who was deeply in love but felt compelled to break his engagement. The work closes with a letter to the reader from Taciturnus on the three "existence-spheres" represented by the three parts of the book. Stages on Life's Way not only repeats themes, characters, and pseudonymous authors of the earlier works but also goes beyond them and points to further development of central ideas in Concluding Unscientific Postscript. (shrink)

Theater requires artifice, justice demands truth. Are these demands as irreconcilable as the pejorative term “show trials” suggests? After the Second World War, canonical directors and playwrights sought to claim a new public role for theater by restaging the era’s great trials as shows. The Nuremberg trials, the Eichmann trial, and the Auschwitz trials were all performed multiple times, first in courts and then in theaters. Does justice require both courtrooms and stages? In Staged, Minou Arjomand draws on a rich (...) archive of postwar German and American rehearsals and performances to reveal how theater can become a place for forms of storytelling and judgment that are inadmissible in a court of law but indispensable for public life. She unveils the affinities between dramatists like Bertolt Brecht, Erwin Piscator, and Peter Weiss and philosophers such as Hannah Arendt and Walter Benjamin, showing how they responded to the rise of fascism with a new politics of performance. Linking performance with theories of aesthetics, history, and politics, Arjomand argues that it is not subject matter that makes theater political but rather the act of judging a performance in the company of others. Staged weaves together theater history and political philosophy into a powerful and timely case for the importance of theaters as public institutions. (shrink)

Perdurantists hold that we persons—just like other ordinary objects—persist by perduring, by having temporal parts, or stages, located over time. Perdurantists also standardly endorse the B-theory of time. And, in light of this endorsement, they typically characterize our tensed beliefs as self-ascriptions of properties, made not by us but by our stages. For instance, for me to believe that Angela Merkel is currently the chancellor of Germany is for my now-located stage to self-ascribe the property of being simultaneous with (...) Merkel’s chancellorship. The problem with this way of understanding tensed belief is that it undermines—if not outright contradicts—the perdurantist’s best options for resisting the Too Many Thinkers objection. In what follows, I show why this is. I then consider what I take to be the perdurantist’s most promising alternative account of tensed belief. I argue that this alternative either leaves perdurantists no better off with respect to the Too Many Thinkers objection or, instead, leaves them vulnerable to another objection, one that they would otherwise have no problem resisting. (shrink)

Metastasis is one of the clinical parameters that has a strong negative influence on the prognosis of cancer patients. In recent years, significant advances have furthered our understanding of this process at the molecular and biological levels. This paper will discuss recent discoveries relating to the earliest, intra‐tumoral stages of metastasis in cancer cells, specifically focusing on: (i) the development of metastatic traits during primary tumorigenesis; (ii) intrinsic and extrinsic cancer cell programs associated with malignant traits; (iii) the intra‐tumoral migration (...) patterns of cancer cells and the dynamic roles played by the Rho/Rac GTPases and epithelial‐mesenchymal transitions in this process; and (iv) the genetic strategies used by metastatic cancer cells to promote intra‐tumoral cell migration and their subsequent escape to peripheral tissues. Finally, the therapeutic and diagnostic relevance of this information will be discussed, as well as potential future developments. (shrink)

The founding of the Carnegie Institute’s Department of Embryology in 1913, alongside its systematization of embryo staging, contributed to the mechanization of developmental stages of embryo growth in the early 20th century. For a brief period in the middle of the century, attention to the detailed interrelation between embryo development and time made pre-existing ideas about pregnancy ends less determinative of ideas about that developmental course. However, the turn to the genetic scale led to the disappearance of this attention, replaced (...) by a sense of biological life as seamlessly scripted. This study examines the history of what I refer to as temporal attention: attention to the live, unfolding potentialities within vital matter. The reintroduction of temporal attention to discussions of development allows us to more fully consider non-human vitality and the experiences of beings that house or otherwise intimately intersect with that vital tissue, regardless of outcomes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 39.4 (2005) 119-131 [Access article in PDF] New Stages: Challenges for Teaching the Aesthetics of Drama Online Michael Anderson Introduction The history of drama education can be read as a series of arguments over dichotomies: process and product, theatre and classroom, artist and teacher, and so forth.1 One of the more recent discussions has focused on technology versus live classroom drama.2 At the heart (...) of these discussions is an attempt to define the aesthetic dimensions of the subject. In one sense, these are fruitful discussions to have as they reflect the dynamism of a live art form in schools. There seems, however, to be a tendency for these debates to entrench themselves into ideological positions. In this paper, I would like to promote the idea that we do not have to develop oppositions or dichotomies before finding that the middle ground provides the richest experiences for drama students. I would like to propose that we see these emerging technologies as providing yet other (albeit different) stages upon which the drama aesthetic can be played.3 Aesthetics and Drama Education Drama education has had an uneasy and often contentious relationship with discussions around aesthetics. Often the drama education community has split along two lines—those who value process and those who value product.4 Work by drama educators such as Judith McLean has demonstrated the centrality of the understanding of the aesthetic and the importance of putting an aesthetic understanding at the center of teaching and learning in drama.5 Her development of an Aesthetic Framework provides teachers with an approach for understanding the position of aesthetics within drama teaching and learning that bypasses the fruitless dichotomies [End Page 119] of process versus product. As most now agree, the drama classroom has a place for both process and product.6 In both, we can find important aesthetic features of drama education. The Challenge of Emerging Technologies and Drama Education Having weathered the dichotomies of the past, there are now fresh challenges to the understanding of drama and aesthetics. The prevalence of and pressure for integration of new technologies in the drama classroom are also challenging drama educators to incorporate technology within the drama aesthetic. The ubiquity of technology that relates to drama education is facing teachers with serious challenges to engage with a dramatic aesthetic in classrooms. Perhaps the most stunning challenge is the exposure and experience twenty-first-century children have to rapidly changing technologies. As Morris explains, students are exposed to more drama in settings other than classrooms and theatres: For most Australian children, experience of drama is less likely to be through live performance than through screen-based media such as television, film, videos, video games, CD-ROM, DVD-ROM and interactive web-based games. And their experience of live performance is most likely to be shaped by the use of technology for design elements such as set, lighting and sound.7This is a compelling and imminent challenge. If drama educators cannot or will not find ways to work with technology, students will find other places to express their creativity outside the drama classroom. Added to the pressure from students who have grown up with these technologies, there is increasing pressure from curriculum developers and school systems to integrate technology into teaching. Aesthetics, Technology, and Curriculum: An Evolving Relationship All authorities and educational policy bodies in Australia are mandating integration of Information and Communications Technology (ICT) into drama curriculum. Recently, the New South Wales (NSW) Board of Studies mandated ICT as an area of "cross curriculum content," necessitating its inclusion in all Years 7-10 syllabi (which include all of the arts).8 For instance, the Year 7-10 drama syllabus states "... teachers should allow students the opportunity to explore different information communication technologies in their class work."9Recent studies have demonstrated mixed rates of participation and enthusiasm for the introduction of ICT in Australia and internationally. In the Australian study, half the respondents surveyed were not using ICT of any kind in their drama education.10 A... (shrink)

In the current debate on how ordinary objects persist through time, more than one philosopher has endorsed the following two theses: stage theory and diachronic universalism. In this paper, I would like to offer a so-lution to the problem (related to lingering properties) that Balashov poses to the joint acceptance of these theses. I will also offer a number of rea-sons why, even if it is not necessary to undermine Balashov�s counterex-amples, stage theorists can, without making their theory (...) less appealing, reject Balashov�s understanding of sorts, which plays a crucial role in his criticisms of stage universalism. (shrink)

Diachronic identity is understood as an identity holding between something existing at one time and something existing at another time. On the stage view, however, ordinary objects are instantaneous stages that do not exist at other times so diachronic identity is, at best, problematic. On account proposed here a name does not, as Sider and others suggest, denote a stage concurrent with its utterance. Rather, at any time, t, a name of an ordinary object designates a stage-at-t (...) as its primary referent and refers indeterminately over it and all and only those stages counterpart-related to it—its reference class at t. At any time, t, a at t1 is the same object as b at t2 iff for every stage x counterpart-related to a’s stage-at t and every stage y counterpart-related to b’s stage-at-t, x=y. Diachronic identity statements, therefore, assert strict identities—between concurrent stages. Ordinarily names select the same reference classes at every time so, in ordinary cases, identity statements are not ‘occasional’. In fission cases names select different reference classes at different times. Where a becomes b and c, at any pre-fission time ‘a’, ‘b’, and ‘c’ have same the primary referent and so select the same reference class—therefore, before fission b is the same object as c. At any post-fission time ‘b’ and ‘c’ select different reference classes—so after fission b is not the same object as c. Identity is not occasional but, in extraordinary cases, identity statements are—because reference is. (shrink)

In the current debate on how ordinary objects persist through time, more than one philosopher has endorsed the following two theses: stage theory and diachronic universalism. In this paper, I would like to offer a solution to the problem that Balashov poses to the joint acceptance of these theses. I will also offer a number of reasons why, even if it is not necessary to undermine Balashov’s counterexamples, stage theorists can, without making their theory less appealing, reject Balashov’s (...) understanding of sorts, which plays a crucial role in his criticisms of stage universalism. (shrink)

The ideas I suggest and will attempt to explore can be expressed and conceptualized in many ways. -/- Wittgenstein suggested that there are things that cannot be talked about. -/- I suggest that we most likely have ideas, attitudes, words, conceptions, notions, values, standards, opinions, etc when we approach any work of art or perceive anything as art or aesthetic. Just as we have notions, ideas etc concerning spirituality and spiritual phenomena. -/- But during the interaction with those things, when (...) having a direct experience or consciousness, an awareness of them we do not employ words, ideas or concepts. -/- Of course we can and most likely will reflect on those experiences and the things we have or had experiences of. At that stage we will use concepts in those contexts we will use notions and verbalize things - after the experiences, after the event. We will also, most likely, reflect on those phenomena and experiences. -/- I then continue to place this state or stage of pre- or non- or not yet conceptual/ity in the larger contexts of consciousness, anthropocentered socio-cultural practices and the universe or multiverse. (shrink)