Awareness is a personal experience, which is only accessible to the rest of world through interpretation. We set out to identify a neural correlate of visual awareness, using brief subliminal and supraliminal verbal stimuli while measuring cerebral blood flow distribution with H215O PET. Awareness of visual verbal stimuli differentially activated medial parietal association cortex (precuneus), which is a polymodal sensory cortex, and dorsolateral prefrontal cortex, which is thought to be primarily executive. Our results suggest participation of these higher order perceptual (...) and executive cortical structures in visual verbal awareness. (shrink)

This article discusses the role of moment-to-moment affect dynamics in mental disorder and aims to integrate recent literature on this topic in the context of complex dynamical system theory. First, we will review the relevance of temporal and contextual aspects of affect dynamics in relation to psychopathology. Related to this, we will discuss recent insights resulting from a network view on affect dynamics in psychopathology. Next, we explore how we can reconcile literature findings from a perspective of complex dynamical system (...) theory. Finally, future directions with regard to personalized assessment of risk and diagnostic use are discussed. (shrink)

OBJECTIVE: To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN: Retrospective descriptive study. SETTING: A cancer clinical trials unit in a large teaching hospital. PATIENTS: From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT: Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. RESULTS: (...) DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS: DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom. (shrink)

We show that the divergence between the predictions of quantum optics and the local realist theory known as stochastic optics, for the extended type of photon-coincidence experiment described recently by de Caro, is of the same order of magnitude as for Aspect-type experiments. This means that, in such new experiments, as in those so far performed, counting statistics will have to be greatly improved before a discrimination between the two theories becomes possible.We also show that the outstanding difference between the (...) two theories is that, while stochastic optics uses a genuine, that is, positive, detection probability, the corresponding quantum formalism leads to a pseudoprobability. Nevertheless, there is a striking parallel, in that both theories recognize the phenomenon known as enhancement, and both describe it as having its origin in a mixing of the signal field with the zero-point field by a polarizing device. (shrink)

In this article, an ethical analysis of an educational programme on renal replacement therapy options for patients and their social network is presented. The two main spearheads of this approach are: (1) offering an educational programme on all renal replacement therapy options ahead of treatment requirement and (2) a home-based approach involving the family and friends of the patient. Arguments are offered for the ethical justification of this approach by considering the viewpoint of the various stakeholders involved. Finally, reflecting on (...) these ethical considerations, essential conditions for carrying out such a programme are outlined. The goal is to develop an ethically justified and responsible educational programme. (shrink)

The world I grew up in believed that change and development in life are part of a continuous process of cause and effect, minutely and patiently sustained throughout the millenniums. With the exception of the initial act of creation ..., the evolution of life on earth was considered to be a slow, steady and ultimately demonstrable process. No sooner did I begin to read history, however, than I began to have my doubts. Human society and living beings, it seemed to (...) me, ought to be excluded from so calm and rational a view. The whole of human development, far from having been a product of steady evolution, seemed subject to only partially explicable and almost invariably violent mutations. Entire cultures and groups of individuals appeared imprisoned for centuries in a static shape which they endured with long-suffering indifference, and then suddenly, for no demonstrable cause, became susceptible to drastic changes and wild surges of development. It was as if the movement of life throughout the ages was not a Darwinian caterpillar but a startled kangaroo, going out towards the future in a series of unpredictable hops, stops, skips and bounds. Indeed, when I came to study physics I had a feeling that the modern concept of energy could perhaps throw more light on the process than any of the more conventional approaches to the subject. It seemed that species, society and individuals behaved more like thunder-clouds than scrubbed, neatly clothed and well-behaved children of reason. Throughout the ages life appeared to build up great invisible charges, like clouds and earth of electricity, until suddenly in a sultry hour the spirit moved, the wind rose, a drop of rain fell acid in the dust, fire flared in the nerve, and drums rolled to produce what we call thunder and lightening in the heavens and chance and change in human society and personality.LAURENS VAN DER POST, The Lost World of the Kalahari. (shrink)

Background Euthanasia is a topic of intense ethical debate and it is illegal in most countries at present, including Sri Lanka. The aim of this descriptive cross-sectional study of medical students and practicing doctors was to explore the acceptance of euthanasia and physician assisted suicide, and factors influencing this opinion. Methods A customised online questionnaire which explored opinions on euthanasia was administered to first and final year medical undergraduates in University of Colombo and practicing doctors with more than 5 years (...) of work experience at The National Hospital of Sri Lanka. Attitudes on euthanasia and PAS were also assessed with the attitudes towards euthanasia Scale, which is a 10-item questionnaire. Results A total of 425 individuals responded, which included 143 first-year medical undergraduates, 141 final-year medical undergraduates and 141 practicing doctors. More participants favoured legalizing euthanasia than those directly opposing it, but a significant proportion remained undecided. The mean scores of ATE questionnaire from the whole sample were generally unfavourable towards euthanasia/PAS. Accepting euthanasia as an option for oneself was the strongest predictor of favouring euthanasia/PAS or supporting its legalization. Conclusion In this cross-sectional survey, more respondents supported legalisation of euthanasia in Sri Lanka than those openly opposing it. Yet, a significant minority that responded as “undecided” for legalisation, were more likely to have unfavourable ATE. (shrink)

This volume has 41 chapters written to honor the 100th birthday of Mario Bunge. It celebrates the work of this influential Argentine/Canadian physicist and philosopher. Contributions show the value of Bunge’s science-informed philosophy and his systematic approach to philosophical problems. The chapters explore the exceptionally wide spectrum of Bunge’s contributions to: metaphysics, methodology and philosophy of science, philosophy of mathematics, philosophy of physics, philosophy of psychology, philosophy of social science, philosophy of biology, philosophy of technology, moral philosophy, social and political (...) philosophy, medical philosophy, and education. The contributors include scholars from 16 countries. Bunge combines ontological realism with epistemological fallibilism. He believes that science provides the best and most warranted knowledge of the natural and social world, and that such knowledge is the only sound basis for moral decision making and social and political reform. Bunge argues for the unity of knowledge. In his eyes, science and philosophy constitute a fruitful and necessary partnership. Readers will discover the wisdom of this approach and will gain insight into the utility of cross-disciplinary scholarship. This anthology will appeal to researchers, students, and teachers in philosophy of science, social science, and liberal education programmes. 1. Introduction Section I. An Academic Vocation Section II. Philosophy Section III. Physics and Philosophy of Physics Section IV. Cognitive Science and Philosophy of Mind Section V. Sociology and Social Theory Section VI. Ethics and Political Philosophy Section VII. Biology and Philosophy of Biology Section VIII. Mathematics Section IX. Education Section X. Varia Section XI. Bibliography. (shrink)

Many individuals with developmental language disorder (DLD) and individuals who are deaf or hard of hearing (D/HH) have social–emotional problems, such as social difficulties, and show signs of aggression, depression, and anxiety. These problems can be partly associated with their executive functions (EFs) and theory of mind (ToM). The difficulties of both groups in EF and ToM may in turn be related to self-directed speech (i.e., overt or covert speech that is directed at the self). Self-directed speech is thought to (...) allow for the construction of non-sensory representations (i.e., representations that do not coincide with direct observation). Such non-sensory representations allow individuals to overcome the limits set upon them by the senses. This ability is constrained by the development of word meaning structure (i.e., the way words are understood). We argue that the greater ability to construct non-sensory representations may result in more enhanced forms of EF and ToM. We conclude that difficulties in EF, ToM, and social–emotional functioning in those with hearing and language problems may be accounted for in terms of word meaning impairments. We propose that word meaning structure and self-directed speech should be considered in assigning EF and ToM treatments to individuals with DLD and those who are D/HH. (shrink)

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)