ObjectiveCo-morbid insomnia and sleep apnea is a common and debilitating condition that is more difficult to treat compared to insomnia or sleep apnea-alone. Emerging evidence suggests that cognitive behavioral therapy for insomnia is effective in patients with COMISA, however, those with more severe sleep apnea and evidence of greater objective sleep disturbance may be less responsive to CBTi. Polysomnographic sleep study data has been used to predict treatment response to CBTi in patients with insomnia-alone, but not in patients with COMISA. (...) We used randomized controlled trial data to investigate polysomnographic predictors of insomnia improvement following CBTi, versus control in participants with COMISA.MethodsOne hundred and forty five participants with insomnia and sleep apnea [apnea-hypopnea index ≥ 15] were randomized to CBTi or no-treatment control. Mixed models were used to investigate the effect of pre-treatment AHI, sleep duration, and other traditional, and novel [quantitative electroencephalography ] polysomnographic predictors of between-group changes in Insomnia Severity Index scores from pre-treatment to post-treatment.ResultsCompared to control, CBTi was associated with greater ISI improvement among participants with; higher AHI, less wake after sleep onset, and less N3 sleep. No quantitative electroencephalographic, or other traditional polysomnographic variables predicted between-group ISI change.DiscussionAmong participants with COMISA, higher OSA severity predicted a greater treatment-response to CBTi, versus control. People with COMISA should be treated with CBTi, which is effective even in the presence of severe OSA and objective sleep disturbance. (shrink)

Human languages vary in terms of which meanings they lexicalize, but this variation is constrained. It has been argued that languages are under two competing pressures: the pressure to be simple (e.g., to have a small lexicon) and to allow for informative (i.e., precise) communication, and that which meanings get lexicalized may be explained by languages finding a good way to trade off between these two pressures. However, in certain semantic domains, languages can reach very high levels of informativeness even (...) if they lexicalize very few meanings in that domain. This is due to productive morphosyntax and compositional semantics, which may allow for construction of meanings which are not lexicalized. Consider the semantic domain of natural numbers: many languages lexicalize few natural number meanings as monomorphemic expressions, but can precisely convey very many natural number meanings using morphosyntactically complex numerals. In such semantic domains, lexicon size is not in direct competition with informativeness. What explains which meanings are lexicalized in such semantic domains? We will propose that in such cases, languages need to solve a different kind of trade‐off problem: the trade‐off between the pressure to lexicalize as few meanings as possible (i.e, to minimize lexicon size) and the pressure to produce as morphosyntactically simple utterances as possible (i.e, to minimize average morphosyntactic complexity of utterances). To support this claim, we will present a case study of 128 natural languages' numeral systems, and show computationally that they achieve a near‐optimal trade‐off between lexicon size and average morphosyntactic complexity of numerals. This study in conjunction with previous work on communicative efficiency suggests that languages' lexicons are shaped by a trade‐off between not two but three pressures: be simple, be informative, and minimize average morphosyntactic complexity of utterances. (shrink)

The philosophically rich David Bowie is an artist of wide and continuing influence. The theatrical antics of Bowie ushered in a new rock aesthetic, but there is much more to Bowie than mere spectacle. The visual belies the increasing depths of his concerns, even at his lowest personal moments. We never know what lies in store in a Bowie song, for there is no point in his nearly 30 albums at which one can say, "That's typical Bowie!" Who else has (...) combined techno and hard rock, switched to R&B love songs (with accompanying gospel) to funk to jazz-rock fusion and back again? Among the topics explored inDavid Bowie and Philosophy are the nature of Bowie as an institution and a cult; Bowie's work in many platforms, including movies and TV; Bowie's spanning of low and high art; his relation to Andy Warhol; the influence of Buddhism and Kabuki theater; the recurring theme of Bowie as a space alien; the dystopian element in Bowie's thinking; the role of fashion in Bowie's creativity; the aesthetics of theatrical rock and glam rock; and Bowie's public identification with bisexuality and hisinfluence within the LGBTQ community. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Operating Through HatredAndrew G. Shuman“You’re not cutting my ***ing neck. The cancer is in my ***ing mouth.”While many patient encounters are memorable, Mr. K’s introduction to the head and [End Page 20] neck surgical oncology clinic is indelibly imprinted into the minds of all of the clinicians present on that certain autumn morning. This was, quite simply, a man who resonated hate. He was rude and disruptive. He insisted (...) on an expedited workup “without any waiting.” He questioned the ethnicity and nationality of his care providers. He told me, in no uncertain terms, that he did not appreciate my Jewish heritage—the swastika tattooed on his bicep underscored the point. He bragged about his recent incarceration for armed robbery. While my colleagues and I were tempted to simply refuse to assume his care, Mr. K had a bad problem—his recurrent tongue cancer required a major operation in order to offer him any hope for cure.Mr. K initially received an abbreviated course of radiation at an outside institution, which was limited by his non–compliance. While one might debate the wisdom of this decision in retrospect—in general, surgery is preferred for his type of tumor—the die was already cast. A heroic attempt at surgical salvage was now his only curative option. He previously sought care elsewhere... only to be fired by this original surgeon when Mr. K physically threatened him in the outpatient office during preoperative consultation. [It was the doctor’s fault for insulting him in the first place, Mr. K maintained... and no charges were filed.] We were, indeed, his last resort. Other than his recurrent cancer, Mr. K was robust; he was in his sixth decade, physically fit, and on the whole, fairly healthy. In the classic surgical lexicon, he was a reasonable surgical candidate. But was it reasonable to operate on such a person?I remember thinking, at the time, about our obligation to care for such an individual. Of course, being a medical professional carries with it many obligations, including a judicious assumption of personal risk. And, working in a tertiary care center begets the responsibility to assist referring clinicians in the management of difficult cases. Although professional obligations certainly have their limits, defining their bounds is decidedly more difficult. Paramount is creating an atmosphere of mutual trust and acceptance. Naturally, this was easier said than done in regard to Mr. K.Perhaps against our better judgment, we agreed to operate under the condition that he abide by strict behavioral ground rules, on our terms. We agreed upon the extent of the necessary operation (which indeed involved cutting his ***ing neck, much to his chagrin and reluctant acceptance). Mr. K promised to follow instructions for postoperative care. He assured us that he would not swear or yell (again). And, in the presence of hospital security, who reinforced our institutional policies regarding patient behavior, he guaranteed that he would not be verbally or physically violent or inappropriate, and would not make disparaging comments to other patients or staff. It seemed, at least, that we had an understanding.Needless to say, these rules were broken shortly after he awoke from surgery. I vividly remember being summoned from the OR when he threatened to murder his impressionable and terrified nurse a few days later, who would not acquiesce to his unreasonable demands. From that point onward, hospital security was deployed to his room regularly, and anything resembling a potential weapon was safeguarded. Any semblance of a mutual doctor–patient bond was shattered. At this point, everyone’s goal was simply to get Mr. K home.My visceral reactions to his behavior, while intense, were not unexpected, and fell in line with those of the entire team of clinicians caring for him. His antics brought his healthcare team together in collective unity (and condemnation). However, my surgical colleagues and I also felt somewhat guilty and responsible. While surgeons can choose to assume some degree of inherent personal danger in caring for a violent and angry patient, we also put the safety and soundness of the entire perioperative team in jeopardy, without necessarily seeking their input. But once we had decided to... (shrink)

Cognitive Science, Volume 46, Issue 5, May 2022.

Purpose– The medical advances and historical fluctuations in the demographics are contributing to the rise of the average age. These changes are increasing the pressure to organize adequate care to a growing number of individuals. As a way to provide efficient and cost-effective care, eHealth systems are gaining importance. However, this trend is creating new ethical concerns. Major issues are privacy and patients’ control over their data. To deploy these systems on a large scale, they need to offer strict privacy (...) protection. Even though many research proposals focus on eHealth systems and related ethical requirements, there is an evident lack of practical solutions for protecting users’ personal information. The purpose of this study is to explore the ethical considerations related to these systems and extract the privacy requirements. This paper also aims to put forth a system design which ensures appropriate privacy protection.Design/methodology/approach– This paper investigates the existing work in the area of eHealth systems and the related ethical considerations, which establish privacy as one of the main requirements. It lists the ethical requirements and data protection standards that a system needs to fulfil and uses them as a guideline for creating the proposed design.Findings– Even though privacy is considered to be a paramount aspect of the eHealth systems, the existing proposals do not tackle this issue from the outset of the design. Consequently, introducing privacy at the final stages of the system deployment imposes significant limitations and the provided data protection is not always to the standards expected by the users.Originality/value– This paper motivates the need for addressing ethical concerns in the eHealth domain with special focus on establishing strict privacy protection. It lists the privacy requirements and offers practical solutions for developing a privacy-friendly system and takes the approach of privacy-by-design. Additionally, the proposed design is evaluated against ethical principles as proposed in the existing literature. The aim is to show that technological advances can be used to improve quality and efficiency of care, while the usually raised concerns can be avoided. (shrink)

Political discourse is primarily identified as political action, the discourse of deliberating which course of action to follow in accordance with specific political goals. A pragmatic analysis of various sub-genres of political discourse can identify the preference for particular speech acts. The first aim of this paper is to analyze commissive and expressive illocutionary acts in political speeches, as indicators of personal involvement of political speakers, notorious for vagueness and avoiding commitment. A corpus of Serbian, American and British political speeches (...) that address the issue of economic standard of living has been examined to identify commissive illocutionary acts as indicators of politicians’ explicit commitment to a chosen course of action, and expressive illocutionary acts as indicators of politicians’ explicit attitudes to their own or other politicians’ chosen practices. The analysis classifies subtypes of commissives and expressives in the corpus and identifies illocutionary force indicating devices that constitute them in English and in Serbian, after which the resulting classifications are compared and contrasted. The research results are aimed at explaining the hypothesis that a specific use/lack of commissives and expressives can be the politician’s strategy for adding credibility to their speeches, and in that way, swaying public opinion to serve the politician’s interest; conversely, establishing the relation between the use/lack of these illocutionary acts and the politician’s commitment to actions can be a method for exposing the politician’s lack of credibility and accountability. (shrink)

Clanak se bavi konceptualnim razjasnjenjem razlike izmedju idealne i neidealne teorije. Analiza je radjena na osnovu teorije koju je Rols prezentovao u svojim knjigama?Teorija pravde? i?Pravo naroda?. Clanak ukazuje na znacaj idealne teorije, ali istovremeno i na to da je u razliku izmedju idealne i neidealne potrebno uneti dalja odredjenja. Clanak uvodi distinkciju na normativno i deskriptivno u idealnu, tj. neidealnu teoriju. Kroz ovu cetvorostruku distinkciju lakse je utvrditi funkciju svake od teorija i razdeliti polja delovanja izmedju filozofa, pravnika i (...) politicara. (shrink)

In contemporary debates on euthanasia, physician assisted suicide and withholding and withdrawing life prolonging treatments, besides commonly used reasons, which are based on presumption of freedom and avoidance of pain, there is also an idea of a duty to die. Given that individuals are also members of society, and that they have families and loved ones, it is necessary to discuss cases when illness causes severe burdens for lives of loved ones. We consider that patient’s just assessment of duty to (...) die can be legitimate candidate for justification of procedure of acceleration of death, taken care of necessary conditions of justified social support for patients and necessary aliment from family and society. In this paper we examine main features of duty to die thesis, extract objections, and offer guidelines for continued discussion. We also want to express the importance of establishing social circumstances and preconditions for protecting the individuals.U suvremenim raspravama o eutanaziji i liječnički potpomognutom samoubojstvu, te odustajanju od tretmana, osim uobičajenih razloga koji se temelje na slobodi i izbjegavanju patnje osobe koja traži ubrzavanje smrti, postoji i teza o dužnosti umiranja. S obzirom na to da je pojedinac ujedno i član zajednice, odnosno da ima obitelj i voljene, nužno je raspraviti o slučajevima kada bolest izaziva značajne teškoće za život njegovih bližnjih. Smatramo kako i pacijentova pravedna prosudba o dužnosti umiranja može biti legitiman kandidat za opravdanje postupaka ubrzavanja smrti, uz nužne preduvjete pravedne društvene podrške pacijentu i dužne skrbi od strane obitelji i društva. U ovom tekstu razlažemo osnovne značajke teze o dužnosti umiranja, izdvajamo prigovore i dajemo smjernice za nastavak rasprave te izražavamo važnost ustanovljavanja društvenih okolnosti i preduvjete za zaštitu pojedinaca. (shrink)

BARBARA HERMAN, MORALITY AS RATIONALITY: A STUDY OF KANT’SETHICS, ROUTLEDGE, ABINGDON AND NEW YORK, 2016.Milica Smajević.

Kant’s critique/doctrine distinction tracks the difference between a canon for the understanding’s proper use and an organon for its dialectical misuse. The latter reflects the dogmatic use of reason to attain a doctrine of knowledge with no antecedent critique. In the 1790s, Fichte collapses Kant’s distinction and redefines dogmatism. He argues that deriving a canon is essentially dialectical and thus yields an organon: critical idealism is properly a doctrine of science or Wissenschaftslehre. Criticism is furthermore said to refute dogmatism, by (...) which Fichte means Spinozism. Schelling repudiates Fichte’s position in his Philosophical Letters by reviving Kant’s distinction. First, ‘critique’ for Schelling names a canon that is valid for all systems—including Spinozism—and thus favours none—not even the Wissenschaftslehre. Second, Schelling coins ‘dogmaticism’ to refer to what Kant calls ‘dogmatism’: reason’s uncritical claim to doctrine. Hence, he says all systems—even Fichte’s—are susceptible to the ‘enthusiasm’ of mistaking themselves for doctrines or ‘objects of knowledge’, instead of subjectively valid ‘objects of freedom’. I reconstruct Schelling’s argument for reviving Kant’s distinction, while noting two consequences for German idealism. First, if criticism favours no system, a system’s origin cannot be an act of knowledge, e.g., intellectual intuition, but only an act of endorsement. Second, if dogmaticism entails enthusiasm, a system’s goal cannot be absolute knowledge, but only infinite striving. Hence, by retrieving Schelling’s notion of dogmaticism, we can both gain a better understanding of the Letters and register the impact of a core Kantian distinction on the German idealist project. (shrink)

This review essay explores recent historical and anthropological literature on the emergence and development of transcultural psychiatry in the second half of the twentieth century. It examines how postcolonial psychiatry attempted to remove itself from its erstwhile colonial frameworks and strove to introduce new concepts and paradigms to make itself relevant in the context of decolonization and postwar reconstruction. The essay looks at both continuities and discontinuities between colonial and post-colonial transcultural psychiatry, asking how the recent surge of scholarly literature (...) in this field engaged with these issues. It also aims to identify the most important avenues for future research. (shrink)

Meillassoux seeks knowledge of transcendental reality, blaming Kant for the ‘correlationist’ proscription of independent access to either thought or being. For Meillassoux, correlationism blocks an account of the meaning of ‘ancestral statements’ regarding reality prior to humans. I examine three charges on which Meillassoux’s argument depends: (1) Kant distorts ancestral statements’ meaning; (2) Kant fallaciously infers causality’s necessity; (3) Kant’s transcendental idealism cannot grasp ‘the great outdoors’. I reject these charges: (1) imposes a Cartesian misreading, hence Meillassoux’s false assumption that, (...) for Kant, objects don’t exist without subjects; (2) misreads Kant, who infers causality’s necessity from the possibility of experience; (3) casts Kant’s idealism as subjective, ignoring his perspectival portrayal of it. (shrink)

This paper is about the notions of the artistic, aesthetic, cognitive and moral value of art and their interconnectedness. The main concern is to try to advocate the cognitivist claim about the artistic value of artworks’ contribution to the advance of knowledge, as well as for the relevance of the moral dimension for artistic value. This is a discussion of the intersection of the debate about moral and aesthetic value. The central part of the paper is focused on a debate (...) with Peter Lamarque. The problem of immoral art-works and their cognitive value is discussed at the end of this paper in order to show that they are counterexamples of the thesis of artistic relevance of the moral dimension. (shrink)

Despite downsides, it must, on balance, be good to reduce prejudice. Despite upsides, collective action can also have destructive outcomes. Improving intergroup relations requires multiple levels of analysis involving a broader approach to prejudice reduction, awareness of potential conflict escalation, development of intergroup understanding, and promotion of a wider human rights perspective.

ABSTRACTThis article investigates the recurring concepts emerging in a transnational social-media arena focusing on Brexit in the period immediately after the June 2016 referendum. It mainly focuse...

Just as burnout is manifested through changes in behavioural and communication patterns, it is important to examine whether certain aspects of communication can affect student burnout development. Therefore, this study aims to investigate the relationship between communication and academic burnout. To achieve this, the study proposes an integrated model examining the effects of three communication dimensions – support from academic staff, support from colleagues, and participation in decision-making – on four different dimensions of academic burnout, as well as students’ overall (...) burnout. The model is tested using structural equation modelling (SEM) analysis. High coefficients of determination regarding particular burnout dimensions validate the strength of the proposed model. The results show that support from academic staff and support from fellow students significantly and negatively influence academic burnout, and might be instrumental in its reduction. Unexpectedly, participation in decision-making is shown to be positively related to academic burnout. (shrink)

It is often argued that Kant’s understanding of the right to revolution is contradictory. On the one hand, he expresses enthusiasm for the French Revolution and the ideas on which it rests, while on the other, he openly denies the existence of a legal right to revolution. This paper aims to make Kant’s position plausible by showing that he does not deny the right to revolution in all states, but only in those that fulfill the purpose for which they were (...) created, which is to protect the rights and freedoms of all citizens. (shrink)

In post-independence India secularism was almost taken for granted as a defining feature of the women?s movement with its rejection of the public expression of religious and caste identities. However, already by the 1980s, the assumption that gender could be used as a unifying factor was challenged, revealing that women from different social and religious backgrounds understand and sometime use their identities in ways that are not driven necessarily by some ideology, but by more immediate concerns and even opportunism. This (...) realization opened up a debate about new strategies to tackle women?s activism, especially in light of aggressive political activism of some women associated with right-wing parties in India, which has clearly shattered the perception, held by some, of women as inherently peace-loving, whose gender identity would override their caste and religious belonging. (shrink)

Aktuelna pandemija virusa korona navela je mnoge pojedince da preispitaju usvojene obrasce ponašanja. Savremeni čovek, naviknut da najčešće odlučuje i dela u skladu sa sopstvenim interesima i željama, suočava se danas sa zahtevom da svoje postupke podredi opštem dobru. U doba pandemije kada svaki vid neopreznog i nesavesnog delanja može predstavljati opasnost kako po samog delatnika, tako i po njegove bližnje, postavlja se pitanje: kako treba postupati i u skladu sa kojim načelima? Odgovor na ovu važnu nedoumicu možemo pronaći ispitivanjem (...) etičke doktrine Imanuela Kanta. Jedna od glavnih odlika njegove etike jeste eksplicitna zabrana postavljanja pojedinca i njegovih ličnih težnji i ciljeva u prvi plan. Kantov vrhovni moralni princip nije utemeljen u čulima i iskustvu, nego u čovekovoj racionalnoj prirodi i njegovom umu, što mu daje opšte važenje. Ovaj princip važi jednako za sva racionalna bića. Cilj ovog teksta je da pokaže kako Kantov vrhovni moralni princip (izražen u formi kategoričkog imperativa) i čuveni test univerzalizacije mogu da nam posluže kao neka vrsta vodiča za ispravno postupanje. Videćemo da prilikom svakog odlučivanja moramo prvo da se zapitamo šta bi se desilo kada bismo svi postupili na određeni način, odnosno, da li možemo hteti da živimo u svetu koji bi u tom slučaju nastao. Ukoliko je odgovor potrvdan, onda je predloženi postupak moralno ispravan. (shrink)