Experiential evidence shows that pain is associated with common meanings. These include a meaning of threat or danger, which is experienced as immediately distressing or unpleasant; cognitive meanings, which are focused on the long-term consequences of having chronic pain; and existential meanings such as hopelessness, which are more about the person with chronic pain than the pain itself. This interdisciplinary book - the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk - aims to better (...) understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them. The lived experiences of pain described here involve various types of chronic pain, including spinal pain, labour pain, rheumatic pain, diabetic peripheral neuropathic pain, fibromyalgia, complex regional pain syndrome, endometriosis-associated pain, and cancer-related pain. Two chapters provide narrative descriptions of pain, recounted and interpreted by people with pain. Language is important to understanding the meaning of pain since it is the primary tool human beings use to manipulate meaning. As discussed in the book, linguistic meaning may hold clues to understanding some pain-related experiences, including the stigmatisation of people with pain, the dynamics of patient-clinician communication, and other issues, such as relationships between pain, public policy and the law, and attempts to develop a taxonomy of pain that is meaningful for patients. Clinical implications are described in each chapter. This book is intended for people with pain, their family members or caregivers, clinicians, researchers, advocates, and policy makers. (shrink)

One of the contemporary results of Germany’s memorial conundrum is the rise of its “counter-monuments”: brazen, painfully self-conscious memorial spaces conceived to challenge the very premises of their being. On the former site of Hamburg’s greatest synagogue, at Bornplatz, Margrit Kahl has assembled an intricate mosaic tracing the complex lines of the synagogue’s roof construction: a palimpsest for a building and community that no longer exist. Norbert Radermacher bathes a guilty landscape in Berlin’s Neukölln neighborhood with the inscribed light of (...) its past. Alfred Hrdlicka began a monument in Hamburg to counter—and thereby neutralize—an indestructible Nazi monument nearby. In a suburb of Hamburg, Jochen Gerz and Esther Shalev-Gerz have erected a black pillar against fascism and for peace designed to disappear altogether over time. The very heart of Berlin, former site of the gestapo headquarters, remains a great, gaping wound as politicians, artists, and various committees forever debate the most appropriate memorial for this site.4 4. The long-burning debate surrounding projected memorials, to the Gestapo-Gelände in particular, continues to exemplify both the German memorial conundrum and the state’s painstaking attempts to articulate it. For an excellent documentation of the process, see Topographie des Terrors: Gestapo, SS und Reichssicherheitshauptamt auf dem “Prinz-Albrecht-Gelände,” ed. Reinhard Rürup . For a shorter account, see James E. Young, “The Topography of German Memory,” The Journal of Art 1 : 30. James E. Young is assistant professor of English and Judaic studies at the University of Massachusetts, Amherst. He is the author of Writing and Rewriting the Holocaust: Narrative and the Consequences of Interpretation and The Texture of Memory: Holocaust Memorials and Meaning in Europe, Israel, and America , from which this essay is drawn. He is also the curator of “The Art of Memory,” an exhibition at the Jewish Museum of New York. (shrink)

The contribution of this work is a classification of corporate social action underlying the Social Ratings Data compiled by Kinder Lydenburg Domini Analytics, Inc. We compare extant typologies of corporate social action to the results of our exploratory factor analysis. Our findings indicate four distinct latent constructs that bear resemblance to concepts discussed in prior literature. Akey finding of our research is that positive and negative social action are both empirically and conceptually distinct constructs and should not be combined in (...) future research. Additionally, we recommend that some prior research results be reconsidered to determine whether these newly derived measures might clarify some previous findings. (shrink)

The Alexandrian emphasis on smallness, elegance, and slightness at the expense of grand themes in major poetic genres was not preciosity for its own sake: although the poetry was written by and for scholars, it had much larger sources than the bibliothecal context in which it was composed. Since the time of the classical poets, much had changed. Earlier Greek poetry was an intimate part of the life of the city-state, written for its religious occasions and performed by its citizens. (...) But eh conquests of Alexander had altered the structure and the boundaries of the Greek world to an astonishing degree. Alexandria, the center of the poetic culture of the new age, was a city that had not even existed at the time of Euripides; it was in Egypt, not in Greece, and was a huge, polyglot community. As immigrants immersed in a new, impersonal, and bureaucratic society, the poets not unreasonably sought out what was small, intimate, and personal in their verses. The heroes of early Greek poetry are larger than life; those of Alexandrian poetry are life-size. They are human, like us; they have a childhood and an old age; they are afraid or in love or caught in a rainstorm. It was simply one way of reducing the world to more manageable dimensions. At the same time, the new world of Alexandria needed a new poetry. To continue writing epics about a mythology that seemed very far away was senseless; it was impossible to recapture either the style or the immediacy of Homer, lyric poetry, or Attic tragedy. The scholar-poets of Alexandria admired the literature of classical Greece; for them Homer was incomparable and inimitable, to be studied—but not to be copied. Far better, then, to find a new voice on a more manageable scale: instead of oral epic, erudite epyllion; instead of lyric, epigram; instead of tragedy, mime. The poets of an urban and unheroic world might long for but could never re-create the grandeur of the past. James E. G. Zetzel is associate professor of classics at Princeton University and editor of the Transactions of the American Philological Association. He is the author of Latin Textual Criticism in Antiquity and, with Anthony T. Grafton and Glenn W. Most, has translated Friedrich August Wolf’s Prolegomena ad Homerum. (shrink)

In this article, I examine both the problem of so-called postmodern history as it relates to the Holocaust and suggest the ways that Saul Friedlander's recent work successfully mediates between the somewhat overly polemicized positions of "relativist" and "positivist" history. In this context, I find that in his search for an adequately self-reflexive historical narrative for the Holocaust, Hayden White's proposed notion of "middle-voicedness" may recommend itself more as a process for eyewitness writers than as a style for historians after (...) the fact. From here, I look at the ways Saul Friedlander's reflections on the historian's voice not only mediate between White's notions of the ironic mode and middle-voicedness, but also suggest the basis for an uncanny history in its own right: an anti-redemptory narrative that works through, yet never actually bridges, the gap between a survivor's "deep memory" and historical narrative.For finally, it may be the very idea of "deep memory" and its incompatibility to narrative that constitutes one of the central challenges to Holocaust historiography. What can be done with what Friedlander has termed "deep memory" of the survivor, that which remains essentially unrepresentable? Is it possible to write a history that includes some oblique reference to such deep memory, but which leaves it essentially intact, untouched and thereby deep? In this section, I suggest, after Patrick Hutton, that "What is at issue here is not how history can recover memory, but, rather, what memory will bequeath to history." That is, what shall we do with the living memory of survivors? How will it enter the historical record? Or to paraphrase Hutton again, "How will the past be remembered as it passes from living memory to history?" Will it always be regarded as so overly laden with pathos as to make it unreliable as documentary evidence? Or is there a place for the understanding of the witness, as subjective and skewed as it may be, for our larger historical understanding of events?In partial answer to these questions, I attempt to extend Friedlander's insights toward a narrow kind of history-telling I call "received history"-a double-stranded narrative that tells a survivor-historian's story and my own relationship to it. Such a narrative would chart not just the life of the survivor-historian itself but also the measurable effect of the tellings-both his telling and mine-on my own life's story. Together, they would compose a received history of the Holocaust and its afterlife in the author's mind-my "vicarious past.". (shrink)

This commentary raises a number of questions in connection with Colin Koopman's paper “Conceptual Analysis for Genealogical Philosophy: How to Study the History of Practices after Foucault and Wittgenstein.” Specifically, this commentary asks about the precise relationship between concepts and practices in Koopman's account and the possibility of resisting certain practices of subjectivation.

If dominating functions in ω ω are adjoined repeatedly over a model of GCH via a finite-support c.c.c. iteration, then in the resulting generic extension there are no long towers, every well-ordered unbounded family of increasing functions is a scale, and the splitting number s (and hence the distributivity number h) remains at ω 1.

Let κ denote a regular uncountable cardinal and NS the normal ideal of nonstationary subsets of κ. Our results concern the well-known open question whether NS fails to be κ + -saturated, i.e., are there κ + stationary subsets of κ with pairwise intersections nonstationary? Our first observation is: Theorem. NS is κ + -saturated iff for every normal ideal J on κ there is a stationary set $A \subseteq \kappa$ such that $J = NS \mid A = \{X \subseteq (...) \kappa:X \cap A \in NS\}$ . Turning our attention to large cardinals, we extend the usual (weak) Mahlo hierarchy to define "greatly Mahlo" cardinals and obtain the following: Theorem. If κ is greatly Mahlo then NS is not κ + -saturated. Theorem. If κ is ordinal Π 1 1 -indescribable (e.g., weakly compact), ethereal (e.g., subtle), or carries a κ-saturated ideal, then κ is greatly Mahlo. Moreover, there is a stationary set of greatly Mahlo cardinals below any ordinal Π 1 1 -indescribable cardinal. These methods apply to other normal ideals as well; e.g., the subtle ideal on an ineffable cardinal κ is not κ + -saturated. (shrink)

Should mental health insurance cover only disorders found in DSM‐IV, or should it be extended to treatment for ordinary shyness, unhappiness, and other responses to life's hard knocks?

We study various aspects of the size, including the cardinality, of closed unbounded subsets of [λ]<κ, especially when λ = κ+n for n ε ω. The problem is resolved into the study of the size of certain stationary sets. Relative to the existence of an ω1-Erdös cardinal it is shown consistent that ωω3 < ωω13 and every closed unbounded subsetof [ω3]<ω2 has cardinality ωω13. A weakening of the ω1-Erdös property, ω1-remarkability, is defined and shown to be retained under a large (...) class of Easton-like forcings applied to ω1-Erdös cardinals. A class of reverse-Easton forcings preserving α-Erdösness is also described, with special attention to the establishment of □-principles. Article Outline. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

Current discussions of business ethics usually only consider deontological and utilitarian approaches. What is missing is a discussion of traditional teleology, often referred to as virtue ethics. While deontology and teleology are useful, they both suffer insufficiencies. Traditional teleology, while deontological in many respects, does not object to utilitarian style calculations as long as they are contained within a moral framework that is not utilitarian in its origin. It contains the best of both approaches and can be used to focus (...) on the individual''s role within an organization. More work is needed in exposing students and faculty to traditional teleology and its place in business ethic''s discussions. (shrink)

We study the I-ultrafilters on ω, where I is a collection of subsets of a set X, usually R or ω 1 . The I-ultrafilters usually contain the P-points, often as a small proper subset. We study relations between I-ultrafilters for various I, and closure of I-ultrafilters under ultrafilter sums. We consider, but do not settle, the question whether I-ultrafilters always exist.

We study the $I$-ultrafilters on $\omega$, where $I$ is a collection of subsets of a set $X$, usually $\mathbb{R}$ or $\omega_1$. The $I$-ultrafilters usually contain the $P$-points, often as a small proper subset. We study relations between $I$-ultrafilters for various $I$, and closure of $I$-ultrafilters under ultrafilter sums. We consider, but do not settle, the question whether $I$-ultrafilters always exist.

While the prevalence of opioid use disorder among pregnant women has multiplied in the United States in the last decade, buprenorphine treatment for peripartum women with OUD has been administered to reduce risks of repeated cycles of craving and withdrawal. However, the maternal behavior and bonding in mothers with OUD may be altered as the underlying maternal behavior neurocircuit is opioid sensitive. In the regulation of rodent maternal behaviors such as licking and grooming, a series of opioid-sensitive brain regions are (...) functionally connected, including the ventral pallidum. In humans, these brain regions, interact with the supplementary motor area to regulate maternal behaviors and are functionally dysregulated by opioids. It is unclear how these brain regions respond to the emotions of their child for mothers receiving BT. In this functional magnetic resonance imaging pilot study in 22 mothers within the first postpartum year, including six mothers receiving BT and 16 non-OUD mothers as a comparison group, we devised a child face mirroring task in fMRI settings to assess maternal responses to pictures of facial expressions of own child and an unknown child in an empathic mirroring condition and a non-mirroring observation condition. In each condition, faces of neutral, ambiguous, distressed, and joyful expressions of each child were repeatedly displayed in a random order. The response of SMA during empathic mirroring vs. non-mirroring of own child was reduced among BT/OUD vs. CG. Within MBN, the left VP, critical for parental sensitivity, had a similar deficit. This study outlines potential mechanisms for investigating the risks of deficits in the neural responses to actual maternal sensitivity and parenting behavior in mothers with OUD, and potential targets for interventions that reduce stress and augment maternal behavior and child outcome. (shrink)

Moral distress is a major problem for nurses, other clinicians, and the health system itself. But if properly understood and responded to, it is also a promising guide for healthcare improvement. When individuals experience moral distress or burnout, their reports must be seen as crucial data requiring careful attention to the individuals and to the organization. Distress and burnout will often point to important opportunities for system improvements, which may in turn reduce the experience of distress. For this potential virtuous (...) cycle to happen, individuals must be able to articulate their concerns without fear of retribution, and organizational leaders must be able to listen in an undefensive, improvementoriented manner. (shrink)

Unchanging God -- Simple God -- Simple God lost -- Eternal creator -- One God, three persons.

Although leaders in the field of ethics have for many years pointed to the crucial role that organizations play in shaping healthcare ethics, organizational ethics remains a relatively undeveloped area of ethics activity. Clinical ethics committees are an important source of potential expertise, but new skills will be required. Clinical ethics committees seeking to extend their purview to organizational issues will have to respond to three challenges—how to gain sanction and support for addressing controversial and sensitive issues, how to develop (...) an acceptable process, and how to make a difference on the ground. The article presents practical suggestions for how clinical ethics committees meet these challenges. (shrink)