The purpose of medical humanities is to improve the delivery of effective health care through a better understanding of disease in society, and in the individual. The interfaces between the science of medicine and the arts, philosophy, sociology and law interpret causes and effects of disease. The field of medical ethics is the most prominent offspring of this wider debate, yet the context of disease in the life of the individual and of society is profound and far-reaching. The influences of (...) medicine on the humanities and vice versa are all around, yet only recently have they been recognised in the wider world of health care. How can you encapsulate the essence of medical humanities and teach it to health professionals? Medical Humanities is designed to fill the need for a clear, well illustrated text that both provides the principles for the individual reader, and encourages discussion. The issues are explored in four main sections. Based on a highly successful seminar, and with contributions from leading writers, thinkers, and teachers, this book provides a comprehensive and authoritative reference for what is becoming a professional requirement in medicine. It will be invaluable for clinicians and students alike. (shrink)

In this book the author argues that human musical understanding is rooted in the traditions of culture and that experience of music depends crucially on what the individual brings to it.

Recent theoretical and philosophical movements within the study of material culture are more carefully attending to the variety of ways in which human artefacts, institutions, and cultural developments extend, shape and alter human cognition over time. Material Engagement Theory in particular has set out to map, explore and understand the relational nature of mind and material world as can be read through cultural artefacts. Within the context of MET, the neurological concept of metaplasticity has been expanded to include the affective (...) domains of technology, materials, and things in the neurological development and architecture of the plastic human mind; a ‘transactional’ relationship between a plastic mind and a plastic material world that are correlated at the ontological level. The challenges of mapping this metaplasticity of mind lie in understanding how the mind and material culture should be understood in relation to the constantly changing lifeworlds of humans over time; the ecological, social, technological and environmental contexts that form the historical specificity of cognitive development. This paper explores how the historical specificity of metaplasticity can be made tangible through the study of material culture, focusing upon the particular activity of oil painting. It will be argued that paintings can provide clues to the historical specificity of the mind that crosses the lifeworld of human action; the technological, phenomenological, philosophical, material, and social conditions underpinning the creation of a painted mark. Drawing from a range of sources that have a root within a Deleuzian process philosophy, the paper builds an account of painting that can be read as expressing the encultured and historical manipulation of paint as an expressive material in itself; an action rendered visible that express the historical emergence of mind. (shrink)

Qu’elle soit ingrate ou réussie, la vieillesse soulève des questions incontournables : celles de la mort et de la souffrance, de la responsabilité et de la vulnérabilité. Du silence et de la parole aussi. Être vulnérable, c’est être fragile, friable ; c’est avoir besoin de son prochain. La vulnérabilité est liée, notamment, à la maladie, au grand âge, à la dépendance ou au fardeau de l’aide. Or, les personnes aidées et aidantes sont surtout des femmes. Il y a les femmes (...) du grand âge et les femmes de tous les âges, qui exécutent à leurs côtés, bénévolement, un travail domestique de santé. Faisons apparaître les obstacles au respect des droits et au pouvoir d’agir de ce « couple vulnérable » aidant-aidé, dans une perspective critique et féministe du droit et de l’éthique. Brisons le silence. (shrink)

Theories of affective influences on cognition posit that negative mood may increase cognitive load, causing a decrement in task performance (Seibert & Ellis, [1991]. Irrelevant thoughts, emotional mood states, and cognitive task performance. Memory & Cognition, 19(5), 507–513), or cause a shift to more analytic thinking, which benefits tasks requiring attention to detail (Schwarz & Clore, [1983]. Mood, misattribution, and judgments of well-being: Informative and directive functions of affective states. Journal of Personality and Social Psychology, 45(3), 513–523). We previously reported (...) that individuals who are higher in the trait of emotional reactivity performed better on an inhibitory task with increasing negative mood whereas low-reactive individuals showed the converse pattern (Gabel & McAuley, [2018]. Does mood help or hinder executive functions? Reactivity may be the key. Personality and Individual Differences, 128, 94–99; [2020]. React to act: Negative mood, response inhibition, and the moderating role of emotional reactivity. Motivation and Emotion, 44(6), 862–869). Because high-reactive individuals are more accustomed to negative affect (Nock et al., [2008]. The emotion reactivity scale: Development, evaluation, and relation to self-injurious thoughts and behaviors. Behavior Therapy, 39(2), 107–116), we speculated that negative mood engendered analytic thinking but without a task-incongruent increase in cognitive load – thereby facilitating performance. Here, we induced a heuristic or analytic approach to information processing prior to performance of an inhibitory task and expected different results pending the thinking style induced. In the heuristic condition, increasing negative mood was associated with better performance for high-reactive participants but not their low-reactive counterparts. In the analytic condition, increasing negative mood was associated with better performance irrespective of emotional reactivity. Our results are consistent with the notion that negative mood engenders analytic thinking which may benefit response inhibition provided it does not increase task-incongruent cognitive load. (shrink)

The years from 1918 to 1945 remain central to European History. It was a breath-taking time during which the very best and very worst attributes of Mankind were on display. In the euphoria of peace which followed the end of the First World War, the Baltic States emerged as independent forces on the world stage, participating in thrilling experiments in national and transnational governance. Later, following economic collapse and in the face of rising totalitarianism among even Europe’s most cultured nations, (...) Baltic communities succumbed to nationalism too. During wartime, Baltic peoples became both victims and, sometimes, victimisers. Ultimately their victimhood lasted until the end of the Cold War, yielding consequences still discernible at the start of the twenty first century. Taking the period 1918 to 1945 as pivotal, this collection of essays examines some of the key themes in Baltic History as they are emerging today. These include appreciations of identity, autonomy and the rights of national minorities; the everyday and social foundations of international security; and the importance of historical memory to popular and political identities. (shrink)

The concept of “ethical research” holds considerable sway over the ways in which contemporary biomedical, natural, and social science investigations are funded, regulated, and practiced within a variety of countries. Some commentators have viewed this “new” means of governance positively; others, however, have been resoundingly critical, regarding it as restrictive and ethics bodies and regulations unfit for the task they have been set. Regardless, it is clear that science today is an “ethical” business. The ways in which formal and informal (...) ethical discourses and practices—what might be called “regimes of normativity”—structure scientific work and the meanings it is ascribed with have, however, been underexplored. This article attends to how science and ethics articulate; how they are, in many ways, co-produced. Exploring these processes of co-production casts into sharp relief the essential emotionality of science; the relationships investigators have with their colleagues, work, and research participants pulse with emotion, potentially shaping in important ways the very kinds of knowledge that laboratories produce. (shrink)

The development of the fifth edition of the American Psychiatric Association9s _Diagnostic and Statistical Manual of Mental Disorders_—the DSM-5—has reenergised and driven further forward critical discourse about the place and role of diagnosis in mental health. The DSM-5 has attracted considerable criticism, not least about its role in processes of medicalisation. This paper suggests the need for a sociology of psychiatric critique. Sociological analysis can help map fields of contention, and cast fresh light on the assumptions and nuances of debate (...) around the DSM-5; it underscores the importance of diagnosis to the governance of social and clinical life, as well as the wider discourses critical commentaries connect with and are activated by. More normatively, a sociology of critique can indicate which interests and values are structuring the dialogues being articulated, and just how diverse clinical opinion regarding the DSM can actually be. This has implications for the considerations of health services and policy decision-makers who might look to such debates for guidance. (shrink)

Regulated secretory proteins are stored within specialized vesicles known as secretory granules. It is not known how proteins are sorted into these organelles. Regulated proteins may possess targeting signals which interact with specific sorting receptors in the lumen of the trans‐Golgi network (TGN) prior to their aggregation to form the characteristic dense‐core of the granule. Alternatively, sorting may occur as the result of specific aggregation of regulated proteins in the TGN. Aggregates may be directed to secretory granules by interaction of (...) a targeting signal on the surface with a sorting receptor. Novel targeting signals which confer on regulated proteins a tendency to aggregate under certain conditions, and in so doing cause them to be incorporated into secretory granules, have been implicated. Specific targeting signals may also play a role in directing membrane proteins to secretory granules. (shrink)

There is much law and many guidelines surrounding the whole issue of the indemnity for human volunteers when it comes to clinical trials. The system that had been put in place to protect individual volunteer drug trialists seems largely to have worked by the fact that there are so few examples of legal cases being issued. However, recent events have shown that when the system fails it fails somewhat spectacularly. The difficulty for groups such as the ethics committee is that (...) lawyers look for targets to try and meet the difference between the claims and the monies available and it might therefore always be possible that the ethics committee becomes centre stage in terms of the pursuit of the action. (shrink)

The current state of British sociology of education is reviewed; noting its decline, but suggesting that its influence has been dispersed throughout educational research in Britain. It is argued that its fate is not simply a product of external attack but also derives from internal problems. Against this background, it is suggested that postmodernism can be treated as a stimulus for a fundamental reconsideration of the proper nature and role of academic research on education.

This article challenges the assumption inherent in many ethics codes that duties only arise when the project is sufficiently advanced that a formal research proposal can be put before an ethics committee for approval. Certain social science methodologies do not lend themselves to a simple demarcation between the preparation and the implementation of the research. It is therefore imperative that consideration is given to researchers' ethical duties prior to formal review. The problem of demarcation and of defining a duty are (...) explored in the particular context of a potential research project involving research on taxi-drivers' experiences of crime and the strategies that they employ to avoid victimisation. Two key issues emerge. First, in what circumstances, if any, can information supplied during this gestation period be used as ‘research data’? Secondly, there are concerns about the researcher's identity and role at this stage. These issues, and others, need to be the subject of further consideration by the relevant bodies so that researchers receive meaningful guidance on the duty prior to ethics review. (shrink)

Anthony Everett gives a philosophical defence of the common-sense view that there are no such things as fictional people, places, and things. He argues that our talk and thought about such fictional objects takes place within the scope of a pretense, and that we gain little but lose much by accepting fictional realism.

Recent research has begun treating the perennial philosophical question, “what makes a person the same over time?” as an empirical question. A long tradition in philosophy holds that psychological continuity and connectedness of memories are at the heart of personal identity. More recent experimental work, following Strohminger & Nichols (2014), has suggested that persistence of moral character, more than memories, is perceived as essential for personal identity. While there is a growing body of evidence supporting these findings, a critique by (...) Starmans & Bloom (2018) suggests that this research program conflates personal identity with mere similarity. To address this criticism, we explore how loss of someone’s morality or memories influence perceptions of identity change, and perceptions of moral duties towards the target of the change. We present participants with a classic ‘body switch’ thought experiment and after assessing perceptions of identity persistence, we present a moral dilemma, asking participants to imagine that one of the patients must die (Study 1) or be left alone in a care home for the rest of their life (Study 2). Our results highlight the importance of the continuity of moral character, suggesting lay intuitions are tracking (something like) personal identity, not just mere similarity. (shrink)

This book questions the generally accepted view that mechanics’ institutes made little contribution to adult working-class education from their foundation in the 1820s to 1890. The book traces the historical development of several mechanics’ institutes across Britain, establishing that many supported both male and female working-class membership before state intervention at the end of the nineteenth century resulted in the development of further education for all. Chapters of the book draw on historical accounts in supporting the claim that the movement, (...) until now seen as of little national significance, was a success, and particularly for the working classes for whom they were established. (shrink)

ArgumentResearch into the biological markers of pathology has long been a feature of British psychiatry. Such somatic indicators and associated features of mental disorder often intertwine with discourse on psychological and behavioral correlates and causes of mental ill-health. Disorders of sociality – particularly psychopathy and antisocial personality disorder – are important instances where the search for markers of pathology has a long history; research in this area has played an important role in shaping how mental health professionals understand the conditions. (...) Here, I characterize the multiplicity of psychiatric praxis that has sought to define the mark of antisociality as a form of “ontological anarchy.” I regard this as an essential feature of the search for biological and other markers of an unstable referent, positing that uncertainties endure – in part – precisely because of attempts to build consensus regarding the ontology of antisociality through biomedical means. Such an account is suggestive of the co-production of biomarkers, mental disorder, and psychiatric institutions. (shrink)

RATIONALE: The concept of evidence-based medicine is important in providing efficient health care. The process uses research findings as the basis for clinical decision making. Evidence-based practice helps optimize current health care and enables the practitioners to be suitably accountable for the interventions they provide. Little work has been undertaken to examine how allied health professionals change their clinical practice in light of the latest evidence. The use of opinion leaders to disseminate new evidence around the management of low back (...) pain into practice has been proposed. AIMS: The aim of this study was to investigate if physiotherapists' clinical management of patients with low back pain would change following an evidence-based education package, which utilized local opinion leaders and delivered the best evidence. METHOD: Thirty musculoskeletal physiotherapists from a Community Trust in North Staffordshire were cluster randomized by location of work, to two groups. The intervention group received an evidence-based programme on the management of low back pain, including advice regarding increasing activity levels and return to normal activity and challenging patients' fears and beliefs about their pain. The control group received a standard in-service training package on the management of common knee pathologies. The physiotherapists' clinical management of patients with low back pain was measured prior to training and 6 months post training. Outcome measures were based on physiotherapists completing 'discharge summary' questionnaires, which included information relating to the use and importance of therapies for treating their low back pain patients. RESULTS: There were few significant differences in treatment options between the intervention and control groups post training. Whilst there was some indication that physiotherapists were already utilizing aspects of psychosocial management for patients with low back pain, there was little change in what physiotherapists perceived to be important to patient recovery and actual clinical practice following the intervention. CONCLUSIONS: Psychosocial factors have been identified as an important factor in the recovery of patients with low back pain. This project incorporated the latest evidence on the management of low back pain and utilized the theory of opinion leaders to disseminate this evidence into clinical practice. Whilst there were some limitations in the overall size of the study, the results help to give an insight into the challenges faced by the health care system and researchers alike to ensure quality evidence is actually utilized by practitioners for the benefits of patient care. (shrink)

Philosophy of the Social Sciences, Volume 52, Issue 3, Page 132-149, June 2022. An influential strand within Science and Technology Studies rejects the idea that science produces representations referring to objects or processes that exist independently of it. This radical ‘turn’ has been framed as ‘constructionist’, ‘nominalist’, and more recently as ‘ontological’. Its central argument is that science constructs or enacts rather than represents. Since most practitioners of science believe that it involves representation, an implication of the radical turn must (...) be that ‘representation’ is a folk concept; perhaps even a myth or an ideology. This paper explores this anti-representationalism and its implications for the relationship between STS and mainstream social science, in part through drawing parallels with ethnomethodology. (shrink)

Michel Foucault’s formative years included the study not only of history and philosophy but also of psychology: two years after he took license in philosophy at the Sorbonne in 1948, he took another in psychology, and then obtained, in 1952, a Diplôme de Psycho Pathologie . From his earliest years at the Ecole Normale Superieur he had taken courses on general and social psychology with one of most influential psychologists of the time, Daniel Lagache, who was attempting to integrate psychoanalysis (...) with clinical methods.(Eribon 1991, 42) Foucault’s studies included experimentation and clinical instruction in which patients were presented in an amphitheatre just as in the days of Charcot. For several years after he had received his Diplôme, Foucault continued research in psychopathology, observing practices in mental hospitals, reportedly sometimes volunteering in experiments himself. He purchased the material required to administer Roschach tests, subjecting numerous friends to the inkblots, and became, when it was founded, the honorary president of the French Rorschach organization. Foucault’s first books were on the topic of the psychological characterization of madness and the development of clinical medicine, and his last books addressed the development of psychological norms within the establishment of modern prisons as well as within an increasingly scientific approach to sex. Thus, he worked at the intersections of philosophy and psychology throughout his life. Nonetheless, Foucault reported feeling an intense aversion to psychology no less than to philosophy.(Sheridan 1980, 5) Foucault’s oeuvre is almost exclusively focused on particular knowledges in the human sciences, especially those aspects which pertained to psychological theories of human behavior, capacity, and normative functioning. His historical approach to these, and his emphasis on the role of discourse, is readily reminiscent of Thomas Kuhn’s similarly historical approach to scientific method with its emphasis on the role of paradigms and the untranslatability of paradigm dependent objects.. (shrink)

The paper examines the very different insights of theorists into the interpretation of historical meaning of literary reception and Anglo-American theorists of the "new" history of political thought . Among the former, readers create meaning; among the latter, authorial intended meanings are fundamental. Both perspectives are valuable, but one-sided. The differences between them arise from different perspectives on the character of a text. But those perspectives are not as incompatible as has been supposed, especially by reception theorists. By examining the (...) incoherences of literary reception theory when viewed from the perspective of the intentionalists, and by examining the one-sidedness of intentionalist theory in the light of a modified version of the reception perspective, it is shown that an understanding of historical meaning requires both insights. The argument is illustrated by reference to the history of political thought, a history which might more usefully be conceived as the history of political literature. (shrink)

The work of Alfred Schutz was an important early influence on Harold Garfinkel and therefore on the development of ethnomethodology. In this article, I try to clarify what Garfinkel drew from Schutz, as well as what he did not take from him, specifically as regards the task of social inquiry. This is done by focusing in detail on one of Schutz’s key articles: ‘Concept and Theory Formation in the Social Sciences’. The aim is thereby to illuminate the relationship between Schutz’s (...) views on the character of social science and Garfinkel’s radical proposal for a re-specified focus of investigation. This is further pursued by examining an important debate about the link between Schutz and ethnomethodology. (shrink)

In two recent papers, Michael Della Rocca accuses Descartes of reasoning circularly in the Fourth Meditation. This alleged new circle is distinct from, and more vicious than, the traditional Cartesian Circle arising in the Third Meditation. We explain Della Rocca’s reasons for this accusation, showing that his argument is invalid.

Through an example of the prohibition against dating in a technical school in southwest China in 1978, this article analyzes how three intersecting forces - the ideology of socialist collectivism, the structure of the work unit system and the socialist sovereign ownership of the body - account for sexual repression in the Maoist period in China. Rather than being an ahistorical, essential component of Maoist socialism, sexual repression (psychic and social) was a historically specific and complex phenomenon. The transformation of (...) sexual repression at a historical moment took the form of an assemblage of the return of love discourse and an emergent desire-centered subjectivity in the great transformation from Maoist socialism to the post-Mao reform period. (shrink)

In the United States, the National Institute of Mental Health is seeking to encourage researchers to move away from diagnostic tools like the Diagnostic and Statistical Manual of Mental Disorders. A key mechanism for this is the “Research Domain Criteria” initiative, closely associated with former NIMH Director Thomas Insel. This article examines how key figures in US psychiatry construct the purpose, nature, and implications of the ambiguous RDoC project; that is, how its novelty is constituted through discourse. In this paper, (...) I explore and analyze these actors’ accounts of what is new, important, or desirable about RDoC, demonstrating how they are constituted through institutional context and personal affects. In my interviews with mental health opinion leaders, RDoC is presented as overly reliant on neurobiological epistemologies, distant from clinical imaginaries and imperatives, and introduced in a top-down manner inconsistent with the professional norms of scientific research. Ultimately, the article aims to add empirical depth to current understandings about the epistemological and ontological politics of contemporary psychiatry and to contribute to science and technology studies debates about “the new” in technoscience. Accordingly, I use discussions about RDoC as a case study in the sociology of novelty. (shrink)

Medicine, as Byron Good argues, reconstitutes thehuman body of our daily experience as a medical body,unfamiliar outside medicine. This reconstitution can be seen intwo ways: as a salutary reminder of the extent to which thereality even of the human body is constructed; and as anarena for what Stephen Toulmin distinguishes as theintersection of natural science and history, in which many ofphilosophy''s traditional questionsare given concrete and urgent form.This paper begins by examining a number of dualities between themedical body and the (...) body familiar in daily experience. Toulmin''s epistemological analysis of clinical medicine ascombining both universal and existential knowledge is thenconsidered. Their expression, in terms of attention,respectively, to natural science and to personal history, isexplored through the epistemological contrasts between themedical body and the familiar body, noting the traditionalphilosophical questions which they in turn illustrate. (shrink)

Through an example of the prohibition against dating in a technical school in southwest China in 1978, this article analyzes how three intersecting forces - the ideology of socialist collectivism, the structure of the work unit system and the socialist sovereign ownership of the body - account for sexual repression in the Maoist period in China. Rather than being an ahistorical, essential component of Maoist socialism, sexual repression (psychic and social) was a historically specific and complex phenomenon. The transformation of (...) sexual repression at a historical moment took the form of an assemblage of the return of love discourse and an emergent desire-centered subjectivity in the great transformation from Maoist socialism to the post-Mao reform period. (shrink)

Clonal expansion of T‐lymphocyte populations results from interactions of antigenic structures presented in combination with accessory cells (macrophages) and antibody recognition sites on the surface of T cells. The resulting activation of a membrane phospholipase C plays a crucial role in lymphocyte responses by releasing diglyceride and PIP3. The released diglyceride activates a cellular protein kinase C while PIP3 stimulates Ca2+ influx. Arachidonic acid released by the action of diglyceride lipase serves as substrate for the synthesis of bioactive eicosanoids (prostaglandins (...) and leukotrienes) which in turn modulate cellular adenyl and guanyl cyclases. The eicosanoids serve as both intra‐ and extra‐cellular signals for lymphocytes, regulating the production and expression of lymphokines and mediating the complex interactions between the monocyte‐macrophage components and helper and suppressor T cells.Aspirin and other anti‐inflammatory drugs stimulate mitogenesis by inhibiting production of the negative modulator prostaglandin E2 in accessory cells and by enhancing the production of the lymphokine 1L‐2 by producer T‐cells. (shrink)

This volume surveys 150 law books of fundamental importance in the history of Western legal literature and culture. The entries are organized in three sections: the first dealing with the transitional period of fifteenth-century editions of medieval authorities, the second spanning the early modern period from the sixteenth to the eighteenth century, and the third focusing on the nineteenth and twentieth centuries. The contributors are scholars from all over the world. Each 'old book' is analyzed by a recognized specialist in (...) the specific field of interest. Individual entries give a short biography of the author and discuss the significance of the works in the time and setting of their publication, and in their broader influence on the development of law worldwide. Introductory essays explore the development of Western legal traditions, especially the influence of the English common law, and of Roman and canon law on legal writers, and the borrowings and interaction between them. The book goes beyond the study of institutions and traditions of individual countries to chart a broader perspective on the transmission of legal concepts across legal, political, and geographical boundaries. Examining the branches of this genealogical tree of books makes clear their pervasive influence on modern legal systems, including attempts at rationalizing custom or creating new hybrid systems by transplanting Western legal concepts into other jurisdictions. (shrink)

In a chronically migrant world, the academy is no exception. Academic migrants, who shift to another space and another world view, feature in the educational landscape of every continent. However, a global lens may not be useful in understanding their experiences, nor in seeking to support them in their endeavours. This dispatch discusses ways of understanding the intersections of space, movement and world view derived from Pacific thinking of various sources. The discussion is grounded in the activities of Leadership Pacific (...) (LP). This is not a program but a cause-based movement. It provides a safe space for storying as learning and leadership. LP has grown from a single group to become a fluid, welcoming and ever-morphing network of inter-locking clusters across the region. Responding to the need for a village-like web of caring and reciprocal relationships, LP fills the gap experienced by many Pacific-origin academic migrants when faced with academic practices and relationships. Through its people-centred storying pedagogy, LP provides an alternative space in which indigenous ways of knowing and being can be at home and the racism inherent in a mono-cultural understanding of academia is challenged. It welcomes both Pacific-origin academic migrants and those academics who seek alignment with a village-like people-centred approach to relationships. The LP experience, which now includes an international conference, provides a model of contextualised action that may be helpful in supporting academic migrants from other regions. Long-term, the influence of movements such as LP has the potential to shift deep-seated universal assumptions of what movement and space might mean for the academy, and of ethical forms of response to the needs and potentials of the academically migrant. (shrink)