Judith Butler's (2006) account of vulnerability, resonant with other accounts offered by feminist theorists of embodiment (such as Margrit Shildrick [2000] and Rosalyn Diprose [2002]), underscores a "conception of the human . . . in which we are, from the start, given over to the other, one in which we are, from the start, even prior to individuation itself and, by virtue of bodily requirements, given over to some set of primary others" (31). She is concerned with how this state (...) of being—"not only constituted by our relations but also dispossessed by them as well" (24)—becomes recognized, or not, in the political production and recognition of vulnerability, and the suffering that occurs in the violent .. (shrink)

KEY POINTS In Canada, commercial data brokers collect deidentified patient data from pharmacies, private drug insurers, the federal government and medical clinics without patient consent. Although pharmaceutical companies are the data brokers’ primary customers, academics and nonprofit and public entities also use commercial data sets, given the absence of a coordinated public approach to collecting these data across Canada. Risks of commercialized patient data include loss of anonymity, surveillance and marketing, discrimination and violation of Indigenous data sovereignty. Coordinated infrastructure for (...) the collection and coordination of health data across Canada and updated privacy legislation would protect individuals and communities and enable appropriate data uses. (shrink)

This paper provides suggestions for educators who have a desire to learn about, or are already committed to, challenging ableism and disablism. As philosophy teachers, we have the opportunity to facilitate student reflection regarding disability, which puts students in a position to make decisions about whether to retain their habitual ways of comporting themselves toward disabled people or to begin the process of forming new perceptual practices. I contend that existential phenomenology, as formulated by Maurice Merleau-Ponty and Linda Martín Alcoff, (...) provides insights regarding the habitual formation of perceptual practices that are useful for thinking about ways that perception may be informed by ableism and disablism. Jessica Cadwallader demonstrates how their insights can be usefully applied to thinking about perceptions of disability. Through analysis of past encounters with people with disabilities, Cadwallader suggests that students change their habitual ways of responding to people with disabilities. While such reflections may be valuable for making habitual perceptual practices explicit, I would suggest that this is only a condition for the possibility of changing ablist perceptual practices rather than the change itself. Students are likely to enter the classroom lacking the insight that they are even engaging in perceptual practices informed by cultural narratives rather than simply perceiving people with impairments as they are. I argue that an approach to teaching on disability that thematizes perceptual practices regarding disability, and takes experiences of disabled people into account, would be more effective than the one Cadwallader describes. Understanding the ways that people with disabilities experience being constructed as a problem through ableist perceptual practices could help students recognize their own potential to impact others in positive and negative ways. (shrink)

Something Aristotle calls ‘right logos’ plays a crucial role in his theory of virtue. But the meaning of ‘logos’ in this context is notoriously contested. I argue against the standard translation ‘reason’, and—drawing on parallels with Plato’s work, especially the Laws—in favor of its being used to denote what transforms an inferior epistemic state into a superior one: an explanatory account. Thus Aristotelian phronēsis, like his and Plato’s technē and epistēmē, is a matter of grasping explanatory accounts: in this case, (...) accounts that identify the right action and say why it is right. Arguably, Aristotelian rationality is a matter of being able to grasp accounts in general. (shrink)

How can mental properties bring about physical effects, as they seem to do, given that the physical realizers of the mental goings-on are already sufficient to cause these effects? This question gives rise to the problem of mental causation (MC) and its associated threats of causal overdetermination, mental causal exclusion, and mental causal irrelevance. Some (e.g., Cynthia and Graham Macdonald, and Stephen Yablo) have suggested that understanding mental-physical realization in terms of the determinable/determinate relation (henceforth, 'determination') provides the key to (...) solving the problem of MC: if mental properties are determinables of their physical realizers, then (since determinables and determinates are distinct, yet don't causally compete) all three threats may be avoided. Not everyone agrees that determination can do this good work, however. Some (e.g., Douglas Ehring, Eric Funkhauser, and Sven Walter) object that mental-physical realization can't be determination, since such realization lacks one or other characteristic feature of determination. I argue that on a proper understanding of the features of determination key to solving the problem of MC these arguments can be resisted. (shrink)

According to the naïve, pre-theoretic conception, lying seems to be characterized by the intent to deceive. However, certain kinds of bald-faced lies appear to be counterexamples to this view, and many philosophers have abandoned it as a result. I argue that this criticism of the naïve view is misplaced; bald-faced lies are not genuine instances of lying because they are not genuine instances of assertion. I present an additional consideration in favor of the naïve view, which is that abandoning it (...) comes at an extremely high price; alternative accounts which eschew the intent-to-deceive condition on lying have difficulty distinguishing lies from non-literal speech. (shrink)

Derek Parfit's “reductionist” account of personal identity (including the rejection of anything like a soul) is coupled with the rejection of a commonsensical intuition of essential self-unity, as in his defense of the counter-intuitive claim that “identity does not matter.” His argument for this claim is based on reflection on the possibility of personal fission. To the contrary, Simon Blackburn claims that the “unity reaction” to fission has an absolute grip on practical reasoning. Now David Lewis denied Parfit's claim that (...) reductionism contravenes common sense, so I revisit the debate between Parfit and Lewis, showing why Parfit wins it. Is reductionism about persons then inherently at odds with the unity reaction? Not necessarily; David Velleman presents a reductionist theory according to which fission does not conflict with the unity reaction. Nonetheless, relying on the distinction between person level descriptions of first-person states and the first-person perspective itself, I argue that Velleman's theory does not eliminate fission-based conflict with the unity reaction. Footnotesa * Earlier versions of this paper were presented at the philosophy departments at Rutgers University and Bowling Green State University. I am indebted to many members of these audiences, and to the other contributors to this volume, for their comments—especially Frank Arntzenius, Michael Bradie, David Copp, John Finnis, Jerry Fodor, Brian Loar, Barry Loewer, Colin McGinn, Fred Miller, Mark Moyer, David Oderberg, Marya Schechtman, David Schmidtz, David Sobel, and Sara Worley. Special thanks to David Sanford. I am also grateful to graduate students in my seminar at Bowling Green during the spring of 2003, for urging me to take seriously the grip of the unity reaction; I am especially grateful for the comments of Nico Maloberti, Jonathan Miller, John Milliken, Robyn Peabody, Jennifer Sproul, Jessica Teaman, and Sherisse Webb. (shrink)

Here I compare two accounts of metaphysical indeterminacy (MI): first, the 'meta-level' approach described by Elizabeth Barnes and Ross Cameron in the companion to this paper, on which every state of affairs (SOA) is itself precise/determinate, and MI is a matter of its being indeterminate which determinate SOA obtains; second, my preferred 'object-level' determinable-based approach, on which MI is a matter of its being determinate---or just plain true---that an indeterminate SOA obtains, where an indeterminate SOA is one whose constitutive object (...) has a determinable property, but no unique determinate of that determinable. In S1, I first note an important difference between our accounts, concerning whether MI is taken to induce propositional indeterminacy; in S2, I highlight and defend certain advantages of my account; in S3, I address certain of Barnes and Cameron's objections to my account. (shrink)

Some claim that Non-reductive Physicalism is an unstable position, on grounds that NRP either collapses into reductive physicalism, or expands into emergentism of a robust or ‘strong’ variety. I argue that this claim is unfounded, by attention to the notion of a degree of freedom—roughly, an independent parameter needed to characterize an entity as being in a state functionally relevant to its law-governed properties and behavior. I start by distinguishing three relations that may hold between the degrees of freedom needed (...) to characterize certain special science entities, and those needed to characterize their composing physical entities; these correspond to what I call ‘reductions’, ‘restrictions’, and ‘eliminations’ in degrees of freedom. I then argue that eliminations in degrees of freedom, in particular—when strictly fewer degrees of freedom are required to characterize certain special science entities than are required to characterize their composing physical entities—provide a basis for making sense of how certain special science entities can be both physically acceptable and ontologically irreducible to physical entities. (shrink)

The interpretation of metaphorical utterances often results in the attribution of emergent properties, which are neither standardly associated with the individual constituents in isolation nor derivable by standard rules of semantic composition. An adequate pragmatic account of metaphor interpretation must explain how these properties are derived. Using the framework of relevance theory, we propose a wholly inferential account, and argue that the derivation of emergent properties involves no special interpretive mechanisms not required for the interpretation of ordinary, literal utterances.

Numerous studies have found that many people believe that a provocatively dressed woman is at greater risk for sexual assault and bears some responsibility for her assault if she is attacked. Furthermore, in legal, academic, and public debates about sexual assault the appropriateness of the term ‘provocative’ as a descriptor of certain kinds of women’s clothing is rarely questioned. Thus, there is a widespread but largely unquestioned belief that it is appropriate to describe revealing or suggestive women’s clothing as ‘provocative’ (...) and that women who wear such clothing could provoke sexual assault and harassment from men. Yet it is rarely noted that only women’s clothing is described as sexually provocative. Men’s clothing, no matter how revealing, is never described as provocative. Why is this the case? This Article challenges the assumption that it is appropriate to describe women’s clothing as provocative. Drawing on on models of the legal defense of provocation and research on objectification and responsibility, this Article demonstrates that continued use of ‘provocative’ term normalizes and entrenches deeply problematic attitudes about women’s responsibility for men’s sexual behavior. The social interpretation of women’s clothing as provocative arises from the privileged social and legal status of men’s sexual arousal and the objectification of women’s bodies. Describing women’s clothing as provocative thus reinforces a problematic conception of women’s bodies and sexuality that is connected to women’s experiences of their bodies, their clothes, and shapes their vulnerability to sexual assault and social and legal attitudes to such attacks. (shrink)

Every paper in this collection is worth reading, for one reason or another. Still, due to certain problematic metametaphysical presuppositions most of these discussions miss the deeper mark, on the pessimist as well as the optimist side. My reasons for thinking this come from considering how best to answer three metametaphysical questions. First, why be pessimistic about metaphysics – why be Carnapian in a post-positivist age? There is, I’ll suggest, a post-positivist strategy for reviving Carnapian pessimism, but it is almost (...) entirely neglected here; and the motivations that pessimists offer instead are not compelling. Second, why think that the best way to approach metametaphysical questions is by attention to features of language, and in particular to quantifier semantics, in ordinary or ontological language(s)? Here again we are offered little motivation for this supposition, which, notwithstanding its acceptance by nearly all contributors, faces clear difficulties. Third, granting that quantification is somehow bound up with first-order questions about what exists, what is the nature of this connection, and what are the associated implications for metametaphysics? Here I find the accounts of the connection on offer implausible, especially as compared to an alternative that makes better sense of metaphysical practice and disagreement. The moral following consideration of these questions is that real progress in metametaphysics is likely to occur less by attention to semantic issues pertaining to representation, translation and quantification and more to non-semantic issues pertaining to epistemology and metaphysical determinacy. (shrink)

ABSTRACT:We discuss workers’ dignity in hierarchical organizations. First, we explain why a conflict exists between high-ranking individuals’ authority and low-ranking individuals’ dignity. Then, we ask whether there is any justification that reconciles hierarchical authority with the dignity of workers. We advance a communitarian justification for hierarchical authority, drawing upon Confucianism, which provides that workers can justifiably accept hierarchical authority when it enables a certain type of social functioning critical for the good life of workers and other involved parties. The Confucian (...) communitarian perspective shows that promoting workers’ good life or well-being is an important condition for protecting their dignity. (shrink)

Ethical questions posed by emerging technologies call for greater understanding of their societal, economic, and environmental aspects by policymakers, citizens, and the engineers and applied scientists at the heart of their development and application. This article reports on the efforts of one research project that assessed the growth of critical thinking and awareness of these multiple aspects in undergraduate engineering and applied science students, with specific regard to nanotechnology. Students in two required courses, a first-year writing and engineering ethics course (...) and a second-year social science course, went through nanotechnology modules as a part of their regular coursework. In the first-year humanities course, we observed self-reported increases in risk awareness, significant educational impact of the module, and a greater awareness of nanotechnology’s applications and social context. In the second-year social science course, we noted changes in risk/benefit analysis as well as in the character and depth of students’ historical analysis, but no change in comparative awareness of other topics, including labor issues and corporate motivations. (shrink)

Harmful algal blooms in Lake Erie’s western basin are caused in large part by nutrient loss from agricultural production. While use of nutrient management practices is encouraged to reduce agricultural nutrient loss and its consequent environmental impacts, such practices are not universally adopted. This study aims to better understand the factors that influence western Lake Erie basin farmers’ risk perceptions associated with agricultural nutrient loss, and thus further our knowledge of how adoption of nutrient management practices may be increased. We (...) propose a conceptual model to explain the relationships that we hypothesize to influence farmers’ risk perceptions associated with agricultural nutrient loss. Specifically, we consider the roles that farmer conservation identity, farmers’ perceived sufficiency of their nutrient management practices, and land vulnerability to nutrient loss play in influencing risk perceptions. We find that many of the hypothesized relationships are not statistically significant, and that risk perception associated with nutrient loss is primarily driven by farmers’ conservation identities. While farmers’ perceived sufficiency of their nutrient management practices plays some role in governing risk perceptions, we do not observe the hypothesized relationship between land vulnerability to nutrient loss and perceived sufficiency of nutrient management practices. (shrink)

This article explores notions about Nietzsche’s career as a philologist and his fascination with the Greeks. It considers his interest in Homer and the Greek philosophers—in particular, Heraclitus and Pyrrho. For Nietzsche, ancient Greeks such as Heraclitus and Homer were interesting not because of their doctrines, but because of the example they themselves provided of certain psychological types. Like the ancient skeptics following Pyrrho, Nietzsche was generally more interested in the psychological consequences of philosophical doctrines than in their content, and (...) like those skeptics he often rejected any ambitions to limn the true nature of reality. (shrink)

I first discuss Kit Fine's distinctive 'schema-based' approach to metaphysical theorizing, which aims to identify general principles accommodating any intelligible application of the notion, by attention to his accounts of essence and dependence. I then raise some specific concerns about the general principles Fine takes to schematically characterize these notions. In particular, I present various counterexamples to Fine's essence -based account of ontological dependence. The problem, roughly speaking, is that Fine supposes that an object's essence makes reference to just what (...) it ontologically depends on, but various cases suggest that an object's essence can also make reference to what ontologically depends on it, either by way of composition or causation. As such, Fine's account of ontological dependence is subject to the same objection he raises against modal accounts of essence and dependence---that is, of being insufficiently ecumenical. (shrink)

The capability approach was developed as a response to the ‘equality of what?’ question, which asks what the metric of equality should be. The alternative answers are, broadly, welfare, resources or capabilities. G.A. Cohen has raised influential criticisms of this last response. He suggests that the capability approach’s focus on individuals’ freedom – their capability to control their own lives – renders its view of well-being excessively ‘athletic’, ignoring benefits achieved passively, without the active involvement of the benefitted individual. However, (...) positing ‘capabilities’ as the appropriate metric of distributive justice need not commit capability theorists to a comprehensive account of well-being, and so not to the athletic conception Cohen ascribes to them. Their aim can, instead, be to delineate legitimate government action and guide egalitarian public policy. Capabilities, in this context, are not just components of individual well-being; they must also be the appropriate goal of just distributive policies. When understood in this way, as a guide to policy, I will argue that the capability approach’s focus on ‘athletic’ individual freedom and control is justified: in the public domain, it is important not just that individuals receive ‘benefits’, but that they participate in their achievement. (shrink)

The proportion of the world’s population living in urban areas is increasing rapidly, with the vast majority of this growth in developing countries. As growing populations in urban areas demand greater food supplies, coupled with a rise in rural to urban migration and the need to create livelihood options, there has been an increase in urban agriculture worldwide. Urban agriculture is commonly discussed as a sustainable solution for dealing with gaps in the local food system, and proponents often highlight the (...) many social, environmental, and economic benefits. We argue that the sustainability of urban agriculture should not be assumed. There is a need for research to take a bottom-up approach, exploring the influence that city-level conditions have on livelihood decisions by farmers and how this shapes the practice of urban agriculture. This paper uses a case study for an in-depth look at urban agriculture in Delhi, India to understand from the farmers’ perspective how urban agriculture is practiced and what factors influence farmers’ livelihood decisions. Using a team-based, multi-method Rapid Assessment Process, data were collected through preliminary key informant interviews, field observations, semi-structured interviews with urban farmers, and geographic information systems mapping. This research provides an in-depth description of market-oriented urban agriculture in a developing country, explores how farmers’ livelihood decisions are embedded in the urban context, and discusses the potential of urban agriculture as a sustainable city-system. (shrink)

In this article we take off from critiques of psychological and school bullying typologies as creating problematic binary categories of bully and victim and neglecting sociocultural aspects of gender and sexuality. We review bullying research informed by Judith Butler’s theories of discursive performativity, which help us to understand how subjectification works through performative repetitions of heterosexual gender norms. We then build on these insights drawing on the feminist new materialist approach of Karen Barad’s posthuman performativity, which we argue enlarges our (...) scope of inquiry in profound ways. Barad’s theories suggest we move from psychological models of the inter-personal, and from Butlerian notions of discursive subjectification, to ideas of discursive-material intra-action to consider the more-thanhuman relationalities of bullying. Throughout the article, we demonstrate the approach using examples from qualitative research with teens in the UK and Australia, exploring nonhuman agentic matter such as space, objects and time as shaping the constitution of gender and sexual bullying events. Specifically we examine the discursive-material agential intraactions of skirts and hair through which ‘girl’ and ‘boy’ and ‘slut’ and ‘gay’ materialise in school spacetimematterings. In our conclusion we briefly suggest how the new materialism helps to shift the frame of attention and responses informing gendered intraactions in schools. (shrink)

As neuroscience has gained an increased ability to enchant the general public, it has become more and more common to appeal to it as an authority on a wide variety of questions about how humans do and should act. This is especially apparent with the question of gender roles. The term ‘neurosexism’ has been coined to describe the phenomenon of using neuroscientific practices and results to promote sexist conclusions; its feminist response is called ‘neurofeminism’. Here, our aim is to survey (...) the phenomena of neurosexism and neurofeminism using a largely philosophical approach, incorporating concepts from the philosophy of mind, the philosophy of science, ethics, and feminist philosophy. First, we delineate how neuroscientific studies purporting to show sex brain differences may be prone to bias at a number of methodological levels – including the choice of categories to be studied, and the choice of tools for data gathering, analysis, and presentation. Then, we show how interpretations of such studies may wrongly assume the notion of ‘hard-wiring’. Furthermore, lack of attention to distinctions within philosophy of mind may result in a mistaken supposition that brain differences lead to mental and/or psychological and/or behavioral ones. It is not difficult to see how these forms of neurosexism, leading to claims of ‘hard-wired’ gender differences that map onto traditional and harmful gender stereotypes, raise ethical questions. We conclude by briefly considering one: are the harms caused by neurosexist studies and their interpretations outweighed by their potential benefits? (shrink)

In liberal moral theory, interfering with someone’s deliberate engagement in a self-harming practice in order to promote their own good is often considered wrongfully paternalistic. But what if self-harming decisions are the product of an oppressive social context that imposes harmful norms on certain individuals, such as, arguably, in the case of cosmetic breast surgery? Clare Chambers suggests that such scenarios can mandate state interference in the form of prohibition. I argue that, unlike conventional measures, Chambers’ proposal recognises that harmful, (...) discriminatory norms entail a twofold collective moral obligation: to eliminate the harmful norm in the long run, but also to address unjust harm that is inflicted in the meantime. I show that these two obligations tend to pull in opposite directions, thus generating a serious tension in Chambers’ proposal which eventually leads to an undue compromising of the second obligation in favour of the first. Based on this discussion, I develop an alternative proposal which, instead of prohibiting breast implant surgery, offers compensation for the disadvantages suffered by individuals who decide not to have surgery. (shrink)

ABSTRACTPrevious studies have identified two powerful ways to regulate emotional responses to a stressor: experiencing incidental positive emotions and using cognitive reappraisal to reframe the stressor. Several cognitive and motivational theories of positive emotion support the formulation that incidental positive emotions may facilitate cognitive reappraisal. To test the separate and interacting effects of positive emotions and cognitive reappraisal, we first adapted an established picture-based reappraisal paradigm by interspersing blocks of positive emotion inducing and neutral pictures. Across two pre-registered studies, reappraisal (...) effectively decreased self-reported negative emotions and increased self-reported positive emotions; however, experiencing incidental positive emotions did not facilitate reappraisal success. In another preregistered study, we employed a more powerful positive emotion induction via virtual reality, used a social stress anticipation task, and... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Learning from Examples of Civic Responsibility:What Community-Based Art Centers Teach Us about Arts EducationJessica Hoffmann Davis (bio)Introduction/QuestionThroughout the United States, beyond school walls, there struggles and soars a sprawling field of community art centers dedicated to education.1 Most frequently clustered on either coast in bustling urban communities, these centers provide arts training that enriches or exceeds what is offered in schools. They serve artists who need space for work (...) or performance, students who crave instruction and direction, and the broader community that enjoys attendant cultural enrichment. At the core, they create safe havens for arts learning that has been marginalized elsewhere.Unfettered by the demands and constraints of school administrations, these self-designed centers have been of considerable interest to arts education researchers over the last twenty years.2 Largely conceived and staffed by artists, they demonstrate artful alternatives to mainstream education: creative visions of teaching, learning, and assessment. Moreover, the positive impact these centers have had on students considered at risk across a number of variables has caught the attention of researchers looking for better ways to serve our youth.3The location of these centers beyond school walls, like their operation beyond the hours of the school day, would naturally seem to cast them as positive opportunities for extending arts learning that goes on in school. But with school art curricula scarce or in danger of elimination, supplementary options can seem threatening to school arts specialists. Administrators have regarded the opportunities that outside artists and centers provide as sufficient substitutes for a school-based course of sequential instruction in the arts. While vital funding sources encourage and sustain collaboration, a tension persists between the autonomy of outsider arts centers and the integrity [End Page 82] of insider school arts programs. For students disenfranchised from schools, the "otherness" of centers has a certain cachet. For centers unable to afford their own space, school classrooms in after-school hours offer a home base for their offerings and easy access for students. The back and forth across school walls raises opportunities and concerns that have resulted in a range of creative solutions.4 But my interest here is not in the cross-wall meeting of services, but rather in the differences in arts learning on either side of school walls. In the pages that follow, I pose the question, What can schools learn from the arts education provided in the community?In addressing this question, I first mark the differences between arts learning in schools and in the community as a need for justification versus an opportunity for demonstration. I then describe the research from which my thinking and discussion draw and offer a brief overview of the history of community art centers as inspired by and illustrative of civic responsibility. With an eye to what educators and advocates can learn from these community-based efforts, I focus next on three common objections to prioritizing the arts in our schools: value, measurement, and autonomy. Each objection is introduced from a school-based perspective and then reconsidered in light of community-based attitudes and activities.5 In conclusion, I delineate the insights derived from a consideration of community arts education as stimulus for the redirection of educational objectives and advocacy rationales for arts learning in schools.Justification vs. DemonstrationIn its struggle for recognition and place in school settings, arts education has sought justification in terms of its potential to serve the broader educational scene. We ask of classes that provide mounting skills in visual arts, music, or theater, "Yes, but what else does arts learning do? Can it improve student skills in reading, mathematics, or any other subjects that are more traditionally valued?" Such demands may seem unfair. When has math ever been defended for its ability to improve arts performance? Beyond a sense of injustice, claims for arts learning's causal impact on measurable extraneous outcomes (such as improvements in test scores in nonarts academic subjects) are at best most difficult to prove.6In community centers where art is the chosen heart of the matter, students come specifically to study the arts and to benefit from their enhancement of more generalized experience... (shrink)

Radical doubt about the truths that govern life has posed a problem for thinkers in many different cultures and periods. This study uncovers the solutions offered by a postmodern Western thinker, Hans-Georg Gadamer, and an early modern Indian thinker, Rupa Gosvami, each of whom offers a renewed postskeptical vision of a revitalized life that is firmly rooted in the transcendental truths of reality.

Iris Marion Young has written a compelling account of individuals’ normative responsibilities for structural justice. While I agree with much of Young’s account, in this article I argue that there is an underexplored aspect of Young’s account regarding the link between individuals’ shared responsibility for justice and the normative demand that individuals engage in collective action towards just structural reform. I argue that Young has neglected an important aspect of individual responsibility for justice that links the aforementioned responsibilities together—namely, the (...) responsibility to organize. Recognizing this responsibility is crucial for understanding the real work of structural justice efforts in the nonideal world. (shrink)

I had heard rumblings of the possibility of consult on this patient. As a pediatric intensivist conducting consults for my institution's clinical bioethics service, I had come to appreciate that many low‐ to moderate‐level ethical dilemmas are present in the pediatric intensive care unit (PICU) every single day. Despite this, or maybe because of it, it takes quite a morally complicated situation to trigger a consult for the service.Sam was a three‐month‐old who had been born full‐term without complications. In the (...) weeks prior to admission, his parents found that he was not feeding well and at times struggled to catch his breath. At our institution's PICU, it was determined that his decline was secondary to dilated cardiomyopathy, for which he would require cardiac transplantation for survival. Sam's parents were unsure if putting him through a heart transplant was the right thing to do, but they were unable to tolerate the thought of losing him. After an extensive consent process, they decided to pursue cardiac transplantation. (shrink)

In book XI from the Confessions—the book that famously examines the nature of time-consciousness—Augustine enacts the very essence of the questions he investigates by turning to the performance of a psalm. What he seeks to understand is how a succession of events in time—events that unfold and vanish—can at once be part of a whole, like the notes of a melody that cohere into an expressive phrase. He says:Suppose I am about to recite a psalm which I know. Before I (...) begin, my expectation is directed towards the whole. But when I have begun, the verses from it which I take into the past become the object of my memory. The life of this act of mine is stretched in two ways, into my memory because of the words I have... (shrink)

Males are often found to outperform females in tests of mathematics achievement and it has been proposed that this may in part be explained by differences in cognitive style. This study investigated the relation between Wholistic-Analytic and Verbal-Imagery cognitive style, gender and mathematics achievement in a sample of 190 Australian primary school students aged between 8?11?years (M?=?9.77, SD?=?1.05). It was hypothesised that males would outperform females in mathematics achievement tests, and that gender would interact with cognitive style on mathematics performance. (...) A significant gender/cognitive style interaction was found. Boys with an Analytic/Imagery style achieved significantly higher results than the girls with an Analytic/Imagery style, supporting the contention that certain cognitive styles affect boys and girls mathematics performance differently. Implications of results and strategies for improving mathematics achievement among girls are discussed. (shrink)

Abstract Context: Established in 1997, Summa Health System’s Medical Ethics Committee (EC) serves as an educational, supportive, and consultative resource to patients/families and providers, and serves to analyze, clarify, and ameliorate dilemmas in clinical care. In 2009 the EC conducted its 100th consult. In 2002 a Palliative Care Consult Service (PCCS) was established to provide supportive services for patients/families facing advanced illness; enhance clinical decision-making during crisis; and improve pain/symptom management. How these services affect one another has thus far been (...) unclear. Objectives: This study describes EC consults: types, reasons, recommendations and utilization, and investigates the impact the PCCS may have on EC consult requests or recommendations. Methods: Retrospective reviews of 100 EC records explored trends and changes in types of consults, reasons for consults, and EC recommendations and utilization. Results: There were 50 EC consults each in the 6 years pre- and post-PCCS. Differences found include: (1) a decrease in number of reasons for consult requests (133–62); (2) changes in top two reasons for EC consult requests from ‘Family opposed to withdrawing life-sustaining treatment (LST)’ and ‘Patient capacity in question’ to ‘Futility’ and ‘Physician opposed to providing LST’; (3) changes in top two recommendations given by the EC from ‘Emotional Support for Patient/Family’ and ‘Initiate DNR Order’ to ‘Comfort Care’ and ‘Withdraw Treatment.’ Overall, 88% of recommendations were followed. Conclusion: PCCS availability and growth throughout the hospital may have influenced EC consult requests. EC consults regarding family opposition to withdrawing LST and EC recommendations for patient/family support declined. Content Type Journal Article Pages 1-16 DOI 10.1007/s10730-011-9170-9 Authors Jessica Richmond Moeller, Department of Psychiatry and Behavioral Sciences, Akron General Medical Center, 400 Wabash Ave, Akron, OH 44307, USA Teresa H. Albanese, Health Services Research and Education Institute, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Kimberly Garchar, Kent State University, 6000 Frank Ave., N.W, North Canton, OH 44720, USA Julie M. Aultman, Department of Family and Community Medicine, Northeast Ohio Medical University, P.O. Box 95, Rootstown, OH 44272, USA Steven Radwany, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Dean Frate, Internal Medicine, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737. (shrink)