Personality disorder symptomatology (PD-Sx) can result in personal distress and impaired interpersonal functioning, even in the absence of a clinical diagnosis, and is frequently comorbid with psychiatric disorders such as substance use, mood, and anxiety disorders; however, they often remain untreated, and are not taken into account in clinical studies. To investigate brain morphological correlates of PD-Sx, we measured subcortical volume and shape, and cortical thickness/surface area, based on structural magnetic resonance images. We investigated 37 subjects who reported PD-Sx exceeding (...) DSM-IV Axis-II screening thresholds, and 35 age, sex, and smoking status-matched control subjects. Subjects reporting PD-Sx were then grouped into symptom-based clusters: N = 20 into Cluster B (reporting Antisocial, Borderline, Histrionic, or Narcissistic PD-Sx) and N = 28 into Cluster C (reporting Obsessive–Compulsive, Avoidant, or Dependent PD-Sx); N = 11 subjects reported PD-Sx from both clusters, and none reported Cluster A (Paranoid, Schizoid, or Schizotypal) PD-Sx. Compared to control, Cluster C PD-Sx was associated with greater striatal surface area localized to the caudate tail, smaller ventral striatum volumes, and greater cortical thickness in right prefrontal cortex. Both Cluster B and C PD-Sx groups also showed trends toward greater posterior caudate volumes and orbitofrontal surface area anomalies, but these findings did not survive correction for multiple comparisons. The results point to morphological abnormalities that could contribute to Cluster C PD-Sx. In addition, the observations parallel those in substance use disorders, pointing to the importance of considering PD-Sx when interpreting findings in often-comorbid psychiatric disorders. (shrink)

Background Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap (...) by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. Discussion Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs – equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care – and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. Summary This paper aims to bridge an important gap in the literature by examining the ethics of a new regionalisation strategy with a focus on the implications for people with disabilities and chronic illnesses across multiple sites of care. While Ontario is used as a case study to contextualize our discussion, the issues we identify, the ethical principles we apply, and the critical success factors we provide have broader applicability for guiding and evaluating the development of – or revisions to – a regionalised health care strategy. (shrink)

We apply the Galilean covariant formulation of quantum dynamics to derive the phase-space representation of the Pauli–Schrödinger equation for the density matrix of spin-1/2 particles in the presence of an electromagnetic field. The Liouville operator for the particle with spin follows from using the Wigner–Moyal transformation and a suitable Clifford algebra constructed on the phase space of a (4 + 1)-dimensional space–time with Galilean geometry. Connections with the algebraic formalism of thermofield dynamics are also investigated.

In this paper we show how the dynamics of the Schrödinger, Pauli and Dirac particles can be described in a hierarchy of Clifford algebras, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}${\mathcal{C}}_{1,3}, {\mathcal{C}}_{3,0}$\end{document}, and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}${\mathcal{C}}_{0,1}$\end{document}. Information normally carried by the wave function is encoded in elements of a minimal left ideal, so that all the physical information appears within the algebra itself. The state of the quantum process can (...) be completely characterised by algebraic invariants of the first and second kind. The latter enables us to show that the Bohm energy and momentum emerge from the energy-momentum tensor of standard quantum field theory. Our approach provides a new mathematical setting for quantum mechanics that enables us to obtain a complete relativistic version of the Bohm model for the Dirac particle, deriving expressions for the Bohm energy-momentum, the quantum potential and the relativistic time evolution of its spin for the first time. (shrink)

In The Art Instinct, Denis Dutton promoted a theoretical framework that “has more validity, more power, and more possibilities than the hermetic discourse that deadens so much of the humanities.”1 This framework is Charles Darwin’s theory of evolution by natural and sexual selection. Dutton proposed to seek “human universals that underlie the vast cacophony of cultural differences and across the globe” (AI, p. 39), based on a shared, evolved human nature.This contrasts with the relativistic presumptions of those falling under the (...) shadow of Margaret Mead and Clifford Geertz, or “the dogmas of Freud, the speculations of Jung, the sterile formulations of behaviorism, all variously empty or misleading” (p. 37). Also .. (shrink)

Within any organization (e.g. a hospital or clinic) the perception of the way things operate may vary dramatically as a function of one’s location in the organizational hierarchy as well as one’s professional discipline. Interorganizational variability depends on organizational coherence, safety, and stability. In this four-nation (Canada, Ireland, Australia, and Korea) qualitative study of 42 nurses, we explored their perception of how ethical decisions are made, the nurses’ hospital role, and the extent to which their voices were heard. These nurses (...) suggested that their voices were silenced (often voluntarily) or were not expressed in terms of ethical decision making. Finally, they perceived that their approach to ethical decision making differed from physicians. (shrink)

'To think often, and never to retain it so much as one moment, is a very useless sort of thinking' In An Essay concerning Human Understanding, John Locke sets out his theory of knowledge and how we acquire it. Eschewing doctrines of innate principles and ideas, Locke shows how all our ideas, even the most abstract and complex, are grounded in human experience and attained by sensation of external things or reflection upon our own mental activities. A thorough examination of (...) the communication of ideas through language and the conventions of taking words as signs of ideas paves the way for his penetrating critique of the limitations of ideas and the extent of our knowledge of ourselves, the world, God, and morals. Locke's masterpiece laid the foundation of British empiricism and is of enduring interest to anyone exploring the development of philosophical thought. This sensitive abridgement uses P. H. Nidditch's authoritative text, and together with an illuminating introduction and other features, makes Locke's arguments more accessible. (shrink)

Limits to Action: The Allocation of Individual Behavior presents the ideas and methods in the study of how individual organisms allocate their limited time and energy and the consequences of such allocation. The book is a survey of individual resource allocation, emphasizing the relationships of the concepts of utility, reinforcement, and Darwinian fitness. The chapters are arranged beginning with plants and general evolutionary considerations, through animal behavior in nature and laboratory, and ending with human behavior in suburb and institution. Topics (...) discussed include operant conditioning; the principle of diminishing returns; and issues in relation to mating strategies. Biologists, sociologists, economists, and psychologists will find the book interesting. (shrink)

Changes in pupil size can reflect social interest or affect, and tend to get mimicked by observers during eye contact. Pupil mimicry has recently been observed in young infants, whereas it is unkno...

De la psychologie sociale aux Théories critiques de J Habermas et A Honneth, en passant par l'interactionnisme symbolique ou la sociologie pragmatiste héritière de l'école de Chicago, l'oeuvre de GH Mead (1863-1931) constitue une source majeure de la théorie sociale. Cet ouvrage invite à la (re)découvrir. Tout en examinant les sources de la pensée de Mead et en discutant ses concepts fondamentaux, il propose de mettre en lumière le potentiel critique et créateur des perspectives qu'elle ouvre pour la théorie sociale. (...) Il montre comment ses développements consacrés au self, à l'Autrui généralisé, à l'interaction, au contrôle social, etc., ainsi que son traitement des problèmes liés, notamment, à la conscience de soi, à la communication, à la reconnaissance ou aux institutions peuvent être mis en dialogue et en confrontation avec les analyses de A Smith, GWF Hegel, W James, G Simmel, J Dewey, RE Park, E Goffman, H Blumer, A Schütz, H Garfinkel, J Habermas, A Honneth, R Collins. Il propose des traductions inédites de textes de GH Mead qui permettent de saisir le processus d'élaboration et la richesse de sa psychologie sociale. A la fois introduction, examen critique et mise en perspective de la pensée de Mead, ce livre s'adresse aux philosophes, sociologues et psychologues, étudiants ou chercheurs, intéressés par l'auteur et, plus généralement, par la théorie sociale d'hier et d'aujourd'hui. (shrink)

The aim of this study is to describe how hermeneutic photography and one application of hermeneutic photography in particular, namely the photo-instrument, can be used as a health care intervention that fosters meaning (re-)construction of mental illness experiences. Studies into the ways how patients construct meaning in illness narratives indicate that aesthetic expressions of experiences may play an important role in meaning making and sharing. The study is part of a larger research project devoted to understanding the photostories that result (...) from groups of psychiatric patients using the photo-instrument. Within a focused ethnography approach we employed a qualitative design of a single case study. Text analysis of photostories was combined with observational data. Data were analyzed using hermeneutic theory. Participant observations were used for triangulation and complementarity. The interaction and collaboration between health care professionals and patients in the context of a photo group emerged as core concept that underlies the photo-instrument. The interaction triggered a reframing of meaning in the patient’s illness narrative that offered new perspectives on positive identity growth. The role of visualizing meaning in images was found to lend a dynamic power to the process and triggered a dialectic between real life circumstances and imagination played out in the context of situated action. The findings suggest that a positive reframing of meaning in illness narratives is facilitated by the photo-instrument. (shrink)

The purpose of this article is to illustrate moral learning in persons with a psychiatric disability who participated in a nursing intervention, called the photo-instrument. This intervention is a form of hermeneutic photography. The findings are based on a multiple case study of 42 patients and additional interviews with eight of them. Photo groups were organized within three settings of psychiatric services: ambulatory as well as clinical, all situated in the Netherlands. Data were analysed according to hermeneutic and semiotic principles. (...) Two cases are presented. Findings show that voice and face are concepts that help to identify elements of moral learning in the rehabilitation process of persons with a psychiatric disability. During the process patients become more aware of their responsibilities towards themselves and others. (shrink)

The subject is in both cases the voyage of the Argo, and therefore the use of the same words is not likely to be coincidental, even though the words themselves are scarcely uncommon. One would hesitate to deny, however, that such reminiscence might be unconscious; that Lucan had famous tags in his head is suggested by another allusion to famous opening lines.

Purpose: Explore public attitudes towards the trade-offs between justice and medical outcome inherent in organ allocation decisions.Background: The US Task Force on Organ Transplantation recommended that considerations of justice, autonomy and medical outcome be part of all organ allocation decisions. Justice in this context may be modeled as a function of three types of need, related to age, clinical urgency, and quality of life.Methods: A web-based survey was conducted in which respondents were asked to choose between two hypothetical patients who (...) differed in clinical urgency , age, pretransplant and post-transplant quality of life, and life expectancy.Results: A pool of 1600 people were notified via email about the survey; 623 responded. Respondents preferred giving organs to younger people up to an age difference of <15.4 years and more clinically urgent people up to a difference in urgency of <2.54 months . Priority varied with the quality of life of the worst-off patient and the relative status of the patients. If both had worse than average quality of life, respondents preferred the better-off patient. When both had better than average quality of life, they preferred the worse-off patient. In analysis according to age versus clinical urgency, the older the patient, the more urgency needed to receive priority. In quality of life versus clinical urgency, the better the control’s quality of life, the more urgency the competing patient required. The worse the patient’s post-transplant outcome, the more urgency needed to receive priority.Conclusions: It appears that clinical urgency is only one of many factors influencing attitudes about allocation decisions and that respondents may invoke different principles of fairness depending the relative clinical status of patients. (shrink)

A brief examination of the self-negating quality of the precautionary principle within the context of environmental ethics, and its consequent failure, as an ethical guide, to justify large-scale regulation of atmospheric cabon dioxide emissions.