The thesis is defended that the theories of causation, time and space, and levels of reality are mutually interrelated in such a way that the difficulties internal to theories of causation and to theories of space and time can be understood better, and perhaps dealt with, in the categorial context furnished by the theory of the levels of reality. The structural condition for this development to be possible is that the first two theories be opportunely generalized.

Epistemological investigation belonged to the core topics in Indian philosophical traditions, too. Right cognition had generally been regarded as one of the important means to emancipation (niḥśreyasa) since ancient times. To reach this religious goal, they keenly discussed the problems of what kinds of cognition we should accept as right or what kinds of objects a right cognition refers to. Specifically it is about the number and the nature of the means of right cognition that opinions differ from school to (...) school. The number ranges from one (perception) to six or even ten (perception, inference, comparison, testimony, implication, non-perception, equivalence, tradition, gesture, and intuition). The concept of each means of right cognition, too, varies greatly among schools. In this paper I take up the Nyāya System, a rationalistic school of Brahmanic philosophy. In Nyāya the inference is regarded as particularly important, but it never means that logical thinking dominates testimony or the authority of religious scriptures in the Nyāya System. On the contrary we find such cases as the religious authority seems to delimit the validity of inference. Some inferences are obstructed by an axiom established in the school, whereas others by a ristriction of Brahmanic tradition. In this manner they seemed to protect their whole system from followers of other Schools. By examining this topic I would like to throw a tiny light on the characteristic affinity between philosophy and religion in Indian thought. (shrink)

(2011). An Obscure Rider Obstructing Science: The Conflation of Parthenotes with Embryos in the Dickey–Wicker Amendment. The American Journal of Bioethics: Vol. 11, No. 3, pp. 20-28.

ObjectivesTo investigate the views of Human Research Ethics Committee (HREC) members and of researchers concerning the human research ethics review process in Australia.To examine whether there are differences between views of researchers and HREC members.Design and settingRegistrants at the NHMRC Ethics in Human Research Conference held in Canberra in May 2005 were surveyed by anonymous questionnaire comprising 14 questionnaire items and background demographic questions.ResultsOf the 407 registrants, 252 completed the questionnaire (62% response rate). Respondents comprised 219 (87%) HREC members or (...) administrators, and 33 (13%) researchers who were not HREC members. Researchers generally had a less positive attitude to the HREC process than did HREC members. Researchers were less likely to believe that HRECs: make clear and reasonable decisions in an acceptable timeframe; provide informal guidance to researchers; and have the necessary expertise to make appropriate decisions. The largest difference related to relations between researchers and HRECs: 82.5% of HREC members thought relations were good, but only 59.3% of researchers held this view. Despite these differences, both HREC members and researchers held the view that the ethics review process in Australia is working well.ConclusionAlthough our study suggests that both HREC members and researchers are satisfied with the process of human research ethics review in Australia, there are areas of concern that merit further investigation. These include the timeliness and clarity of HREC decisions, the methodological expertise available to HRECs and the basis for HREC decisions. (shrink)

The dilemma of whether or not a doctor should tell a patient dying of cancer the truth remains a difficult one, as the disagreement between the two previous writers shows. One favours giving priority to patient autonomy, the other feels the doctor's duty of beneficence should be the overriding principle governing such decisions. To this contributor it seems both approaches have something to offer. By being sensitive to what and how much the patient wishes to know and by learning from (...) the insights provided by the study of medical ethics, doctors can learn how to make better moral decisions in this and in other areas. Both lying and truth-telling carry risks of harm to the patient. Learning to work with and balance these risks is part of clinical practice. So is minimising risks by clear thinking. (shrink)

In Regina v. Murray, (2000, Ont S.Ct.J.) the learned trial judge, Justice Gravely, errs in his interpretation and application of the law of mens rea in the offense of willfully attempting to obstruct justice under section 139(2) of the Criminal Code of Canada. In view of his findings of fact and law, including the determination that the accused knowingly and intentionally committed the actus reus of the offense and the absence of any suggestion that he lacked awareness of any relevant (...) facts, there is no question in law but that Kenneth Murray was liable to be, and actually should have been, convicted. Nonetheless, the trial judge concluded that Murray’s alleged belief, that his actions were required by his duty to his client, raised a reasonable doubt about his intention to obstruct justice and entitled him to be acquitted. -/- In his reasons for judgment, the trial judge analyzes mens rea as if there is a “color of right” defense to the offense of obstruction of justice. In law, however, no such defense exists to this offense. Consequently, even if Mr. Murray did “honestly believe” that he had a duty to his client not to disclose the existence of the video tapes, that belief could not provide him with an exculpatory defence. In Canada, pursuant to common law and section 19 of the Criminal Code, mistakes of law do not excuse accused persons from responsibility for criminal conduct in the absence of a statutory exception. No exception exists for the offense of obstruction of justice. Yet the Crown did not choose to appeal and thereby signaled its acceptance of the legal analysis adopted by the trial judge. By contrast, if the analysis proposed in this piece had been adopted, the Crown should have prevailed at trial and, if unsuccessful at trial, would have had a right of appeal on a question of law. -/- At least two tendencies converge as significant influences shaping the outcome in the Murray case. The central tendency, discussed in Part I of this article, is the trial judge’s treatment of the accused’s alleged mistake about his legal duty as if it were a mistake about a question of fact which therefore could give rise to a reasonable doubt about intention or culpable awareness. This approach to mistaken beliefs ignores the distinction between mistakes of law and mistakes of fact, and then characterizes all mistakes as mistakes of fact. Unfortunately, this is not uncommon in the case law. In recent years however, as explained below, the judiciary has rejected that approach in a number of leading cases and ruled that mistakes which are actually mistakes about the meaning, scope, or application of the law are subject to the general rule and do not provide an accused with an exculpatory defense. The relationship between mistake of law and mens rea in Canadian criminal law has also been the subject of critical scholarly comment in Canada in recent years. The Murray decision provides evidence that, despite clarification by the Supreme Court, in some lower courts the unrefined approach to mistaken belief continues to shape the legal analysis of criminal culpability, even when the mistaken belief is overtly a belief about the law. This will not change until the proper characterization of mistaken beliefs as legal or factual becomes a deliberate and common-place aspect of case analysis at the trial court level. -/- The other tendency, discussed in Part III of this article, is one that often appears as a companion to the first - the judicial tendency to perceive and invoke analytical legal ambiguity in favour of accuseds more readily in cases in which the impugned conduct involves the discretionary exercise of authority which, when used appropriately, is fully legitimate and essential to the normal functioning of the existing socio-legal order. Of course, courts are strongly influenced by the arguments put to them by counsel. And counsel, acting on behalf of client groups with particular group interests may, consciously or unconsciously, favour the development of those lines of analysis which are protective of that interest or associated institutional interests. One of the reasons for scrutinizing the Murray case is that it provides a concrete context for discussion of those issues in relation to an actual decision made by Crown prosecutors. The case provides an occasion to examine a specific example of the exercise of prosecutorial discretion, its implications for the administration of criminal justice, and its broader potential impact on the public interest. [See also errata in UNBLJ 2002 volume 52 at pp 309-310.]. (shrink)

Obstructive sleep apnea syndrome severely affects psychological well-being. This syndrome frequently occurs in obesity; however, no previous study has investigated the level of psychological well-being in the case of OSA syndrome associated with obesity. In this work, we assessed the level of psychological well-being in fifty-two individuals affected by OSA syndrome and obesity through the Psychological General Well-Being Index. Moreover, we investigated the role of personality, cognitive functioning and attentional capabilities, subjective perception and objective measurement about sleeping, on the subjective (...) perception of psychological well-being. Our sample reported a lower level of psychological well-being; the participants’ scores were below the normative cut-off in all components, except for depression symptoms. A lower expression of harm avoidance temperament and a lower level of daily sleepiness predicted a higher level of psychological well-being. Psychological well-being seemed to be severely affected in individuals affected by OSA syndrome and obesity. The temperament and subjective perception of daily alertness and sleepiness, rather than the syndrome severity, seemed to play a crucial role in the individual perception of the psychological well-being. (shrink)

In much of modern scholarship, the notion of datong 大通 in Zhuangzi’s famous zuowang 坐忘 (sitting in disregard) passage is often interpreted as either Dao or a mental/spiritual state of an ideal person, a person who has obtained Dao. In either case, however, the association between datong and such interpretation lacks detailed justification resulting from an insufficiently understood relation between datong and its immediately preceding statements. Different from the more common readings, I propose a cognitive approach based on an image (...) schema related to non-obstruction. In order to demonstrate the philosophical importance of this schema, I will first briefly point out the problems of previous scholarship regarding the zuowang passage. Second, I will introduce the image schema related to non-obstruction based on a number of examples taken from the Zhuangzi. Finally, I will apply this methodology and introduce a cognitive experience-based interpretation of the zuowang passage. (shrink)

While many neuroscientists and philosophers share an interest in integrating neuroscience, both camps suggest that this integration is challenging. Why is this the case? In this paper, I account for why tools, or the materials and technologies that researchers use to study brain structure and activity, are obstructions to integrating neuroscience. The constraints of tools and their productivity create neuroscience practices that can be in tension with methodological, data, and explanatory integration. My account explains why integration in neuroscience likely will (...) not occur unless new tools are developed. At the same time, my account explains why new tools can facilitate local integration between neuroscience subfields for the same reasons why they can obstruct it. (shrink)

The Bell–Kochen–Specker theorem shows that, in any Hilbert space of dimension of at least 3, it is impossible to assign noncontextual definite values to all observables in such a way that the quantum-mechanical predictions are reproduced. This leaves open the issue of what subsets of observables may be assigned definite values. Clifton has shown that, for a system of at least two continuous degrees of freedom, it is not possible to assign simultaneous noncontextual values to two coordinates and their conjugate (...) momenta. In this Letter, it is shown that, for a system of a single continuous degree of freedom, it is not possible to assign noncontextual values to the coordinate and its conjugate momenta that satisfy a continuity assumption herein called the ‘ ε -Product Rule’. (shrink)

ObjectiveThis study aims to evaluate the effectiveness of the MotivAir program—a phone-based intervention based on Motivational Interviewing principles and techniques—in enhancing adherence to Continuous Positive Airway Pressure therapy among patients with Obstructive Sleep Apnea Syndrome.MethodsA multicenter randomized controlled trial design with random allocation at the level of the individual will be conducted to compare the impact of the experimental program with a control group receiving usual care only in improving selected clinical and psychological parameters in the patients. A minimum sample (...) of 80 participants will be recruited in each center according to the inclusion criteria. After the initial screening, participants will be randomly assigned to either the experimental group or the control condition. The program will last 180 days and will be delivered by a trained nurse. The impact of the MotivAir program on selected primary and secondary outcomes will be measured at baseline, and after 1-, 3-, and 6-month from CPAP initiation.DiscussionParticipants are expected to show an increased level of adherence to CPAP and to acquire the skills and self-confidence necessary to deal with the psychological consequences of their chronic condition. (shrink)

Traditional methods of evaluating and solving world problems are insufficient to deal with today's issues, which are complex and interconnected, and therefore cannot be understood, or solved, in isolation. The author's study aimed to better understand behaviors that impact systemic problems in the capacity-building community. The resultant theory of simulating benevolence conceptualizes a collection of behaviors where change agents undertake activities that are not in the best interest of community members. Instead, activities satisfy the need for activity, involvement, and excitement. (...) This theory has real-world implications in the pursuit of systemic social change. In any social context, a change agent cannot merely go through the motions of change, seemingly behaving active and engaged, at the expense of those that he or she claims to help. (shrink)

The severe hereditary progeroid disorder Cockayne syndrome is a consequence of a defective transcription‐coupled repair (TCR) pathway. This special mode of DNA repair aids a RNA polymerase that is stalled by a DNA lesion in the template and ensures efficient DNA repair to permit resumption of transcription and prevent cell death. Although some key players in TCR, such as the Cockayne syndrome A (CSA) and B (CSB) proteins have been identified, the exact molecular mechanism still remains illusive. A recent report (...) provides new unexpected insights into TCR in yeast.1 The identification and characterisation of a novel protein co‐purifying with the yeast homologue of CSB (Rad26) imposes reassessment of our current understanding of TCR in yeast. What about humans? BioEssays 24:780–784, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

The Bell–Kochen–Specker theorem shows that, in any Hilbert space of dimension of at least 3, it is impossible to assign noncontextual definite values to all observables in such a way that the quantum-mechanical predictions are reproduced. This leaves open the issue of what subsets of observables may be assigned definite values. Clifton has shown that, for a system of at least two continuous degrees of freedom, it is not possible to assign simultaneous noncontextual values to two coordinates and their conjugate (...) momenta. In this Letter, it is shown that, for a system of a single continuous degree of freedom, it is not possible to assign noncontextual values to the coordinate and its conjugate momenta that satisfy a continuity assumption herein called the ‘ -Product Rule’.  2002 Elsevier Science B.V. All rights reserved. (shrink)

In placing education at the centre, as The Main Enterprise of the World, Philip Kitcher has undertaken a monumental task. He has come to the field of philosophy of education captivated by the importance of its substantive preoccupations for the advancement of democratic aims. Accordingly, his book argues that the most salient obstruction to preparing citizens who will contribute to society is the seeming irreconcilability of the demands of industry, on the one hand, and of students’ personal growth, on (...) the other. In spite of his desire to accommodate diverse accounts of the human good, and his recognition of the formative role of culture, broadly conceived, there are strains in his account of human fulfilment deriving from the disjunction of the self and others. It is not evident, on his Deweyan onto-epistemology, that there is adequate attention to the imprint on an individual, and on the beliefs they come to form, of proximal social groups. The nature of the balance between ‘in-group’ and ‘out-group’ influences, between those that are near and those that are far, can profoundly affect the plausibility of Kitcher's account of a socially based sense of fulfilment. (shrink)

Researchers display confirmation bias when they persevere by revising procedures until obtaining a theory-predicted result. This strategy produces findings that are overgeneralized in avoidable ways, and this in turn binders successful applications. (The 40-year history of an attitude-change phenomenon.

Obstructive sleep apnea (OSA) severely impacts sleep and has long-term health consequences. Treating sleep apnea with continuous positive airway pressure (CPAP) not only relieves obstructed breathing, but also improves sleep. CPAP improves sleep by reducing apnea-induced awakenings. CPAP may also improve sleep by enhancing features of sleep architecture assessed with electroencephalography (EEG) that maximize sleep depth and neuronal homeostasis, such as the slow oscillation and spindle EEG activity, and by reducing neurophysiological arousal during sleep (i.e., beta EEG activity). We examined (...) cross-sectional differences in quantitative EEG characteristics of sleep, assessed with power spectral analysis, in 29 adults with type 2 diabetes treated with CPAP and 24 adults undergoing SHAM CPAP treatment (total n = 53). We then examined changes in spectral characteristics of sleep as the SHAM group crossed over to active CPAP treatment (n = 19). Polysomnography (PSG) from the CPAP titration night was used for the current analyses. Analyses focused on EEG frequencies associated with sleep maintenance and arousal. These included the slow oscillation (0.5–1 Hz), sigma activity (12–16 Hz, spindle activity), and beta activity (16–20 Hz) in F3, F4, C3, and C4 EEG channels. Whole night non-rapid eye movement (NREM) sleep and the first period of NREM spectral activity were examined. Age and sex were included as covariates. There were no group differences between CPAP and SHAM in spectral characteristics of sleep architecture. However, SHAM cross-over to active CPAP was associated with an increase in relative 12–16 Hz sigma activity across the whole night and a decrease in average beta activity across the whole night. Relative slow oscillation power within the first NREM period decreased with CPAP, particularly for frontal channels. Sigma and beta activity effects did not differ by channel. These findings suggest that CPAP may preferentially enhance spindle activity and mitigate neurophysiological arousal. These findings inform the neurophysiological mechanisms of improved sleep with CPAP and the utility of quantitative EEG measures of sleep as a treatment probe of improvements in neurological and physical health with CPAP. (shrink)

Many commentators fear that climate engineering research might lead policy-makers to reduce mitigation efforts. Most of the literature on this so-called ‘moral hazard’ problem focuses on the prediction that climate engineering research would reduce mitigation efforts. This paper focuses on a related ethical question: Why would it be a bad thing if climate engineering research obstructed mitigation? If climate engineering promises to be effective enough, it might justify some reduction in mitigation. Climate policy portfolios involving sufficiently large or poorly planned (...) reductions in mitigation, however, could lead to an outcome that would be worse than the portfolio that would be chosen in the absence of further climate engineering research. This paper applies three ethical perspectives to describe the kinds of portfolios that would be worse than that ‘baseline portfolio’. The literature on climate engineering identifies various mechanisms that might cause policy-makers to choose these inferior portfolios, but it is difficult to know in advance whether the existence of these mechanisms means that climate engineering research really would lead to a worse outcome. In the light of that uncertainty, a precautionary approach suggests that researchers should take measures to reduce the risk of mitigation obstruction. Several such measures are suggested. (shrink)

This study investigated the effect of obstructive sleep apnea on the neural mechanism of visual perception. A preliminary case-control study was conducted. Seventeen patients with moderate to severe OSA in the sleep center of Civil Aviation General Hospital and 20 healthy controls matched for age, sex, and education were recruited. The participants accepted the perceptual contour integration task, compared the differences in behavioral indicators between the two groups, and compared the differences in electroencephalography data between the two groups through event-related (...) potential technology. The groups did not differ significantly in age and gender, but they differed significantly in body mass index. The groups were not statistically different in terms of sleep structure and total sleep time. AHI, sleep efficiency, and minimal SaO2 value in the OSA group were significantly different from those of the control group. The results showed that the average reaction time of the OSA group was significantly longer than that of the healthy control group in the contour integration task. There was no significant difference in the accuracy rate. The results of EEG showed that the amplitudes of N100 of the OSA group were significantly higher than those of the control group at O1, Oz, and O2 electrodes. There was no significant difference in latency between the two groups. At the FCz electrode, the amplitudes of N200 of the OSA group were significantly higher than those of the control group. Therefore, we concluded that in the early stage of the perceptual integration task, although the neural response activity of patients with moderate and severe OSA was not accelerated, they need to call on more psychological resources, activate more neurons in the contour global recognition processing stage, and the compensatory effect of frontal lobe appeared in the stage of visual perception. (shrink)

ObjectiveThis study aims to investigate the lived experience in patients with obstructive sleep apnea syndrome and comorbid obesity following after continuous positive airway pressure therapy made with the disease the device, and to identify barriers and facilitators to the use of CPAP to improve rehabilitation provision and aid in disease self-management.MethodsQualitative research was conducted using three focus groups with a representative sample of 32 inpatients undergoing a 1-month pulmonary rehabilitation program at the IRCSS Istituto Auxologico Italiano San Giuseppe Hospital, Verbania, (...) Italy. The focus groups were recorded on tape, and contemporaneous notes were made. The tapes were transcribed verbatim, and Interpretative Phenomenological Analysis was used to develop themes.ResultsSix main themes were extracted: Living the diagnosis as a shock; You should not sleep on it: the importance of prevention; The adjustment to CPAP; Barriers and facilitators to the use of CPAP; Three in a bed; and The relationship with the healthcare system.ConclusionResults of this study suggest potential avenues for interventions to increase adherence to CPAP, including the provision of information and continued support. Individual counseling providing strategies aimed at helping the person to cope with the emotional problem and relational difficulties associated with the use of CPAP, and at strengthening self-efficacy and self-management skills are also encouraged for optimal care during the rehabilitation program. (shrink)

The paper comments on Scott Dunbar's "An obstructed death and medical ethics," arguing contra Dunbar that we should not view truth-telling to the terminally ill as primarily governed by principles of veracity and respect for autonomy. All such rules are of limited value in medical ethics. We should instead turn to an ethics deriving from the centrality of moral relationships and virtues. A brief analysis of the connections between moral relationships and moral rules is offered. Such an ethics would lower (...) the value that philosophical fashion places on truth-telling and autonomy and leave decisions about truth-telling and the terminally ill more dependent on the circumstances of particular cases. (shrink)

Jean Starobinski, one of Europe's foremost literary critics, examines the life that led Rousseau, who so passionately sought open, transparent communication with others, to accept and even foster obstacles that permitted him to withdraw into himself. First published in France in 1958, Jean-Jacques Rousseau remains Starobinski's most important achievement and, arguably, the most comprehensive book ever written on Rousseau. The text has been extensively revised for this edition and is published here along with seven essays on Rousseau that appeared between (...) 1962 and 1970. (shrink)

BackgroundCommonly applied measures of symptoms of anxiety are not sensitive to disease-specific anxiety in patients with chronic obstructive pulmonary disease. There is a need for validated instruments measuring COPD-specific anxiety. Therefore, we translated the COPD-Anxiety Questionnaire into Danish and performed an initial validation of the psychometric properties in a sample of patients with COPD.Materials and MethodsTranslation procedures followed the World Health Organization guidelines. Participants with COPD completed questionnaires measuring COPD-specific anxiety, general psychological distress as well as variables related to COPD, (...) quality of life, and socio-demography.ResultsA total of 260 patients with COPD completed questionnaires. The Danish version of CAF-R-DK demonstrated acceptable Cronbach’s α values that were comparable with those of the original CAF. As expected, the CAF-R-DK showed positive correlations with convergent constructs and negative correlations with discriminant constructs. However, the results for specific subdomains of the CAF-R-DK indicated inconsistency in the underlying concept of disease-specific anxiety, which was also suggested based on the subsequent confirmatory and exploratory factor analyzes.ConclusionThe CAF could serve as an important supplement to generic psychological distress screening of patients with COPD in somatic health care settings, and the questionnaire is now available in Danish. Translation into other languages is needed with the purpose of obtaining data for further testing the psychometric properties of the questionnaire. (shrink)

Deleuze’s film-philosophy makes much of the notion of virtual images in Bergson’s Matter and Memory ([1896] 1994), but in doing so he transforms a psycho-meta-physical thesis into a (very) unBergsonian ontological one. In this article, we will offer a corrective by exploring Bergson’s own explanation of the image as an ‘attitude of the body’ – something that projects an actual, corporeal and postural approach, not only to cinema, but also to philosophy. Indeed, just as Renoir famously said that ‘a director (...) makes only one movie in his life. Then he breaks it into pieces and makes it again’, so Bergson wrote that each philosopher only makes one ‘single point’ throughout his or her whole career. And this one point, he then declares, is like a ‘vanishing image’, only one best understood as an attitude of the body. It is an embodied image that underlies an alternative Bergsonian cinema of the actual and the body – one that we will examine through what Bergson’s has to say about ‘attitude’ as well as ‘gesture’ and ‘mime’. We will also look at it through a gestural concept enacted by a film, to be precise, the five remakes that comprise Lars von Trier’s and Jørgen Leth’s The Five Obstructions (Lars von Trier and Jørgen Leth, 2003). This will bring us back to the idea of what it is that is being remade, both by directors and philosophers, in Renoir’s ‘one film’ and Bergson’s singular ‘vanishing image’, respectively. Is the ‘one’ being remade an image understood as a representation, or is it a gesture, understood as a bodily movement? It is the latter stance that provides a wholly new and alternative view of Bergson’s philosophy of cinema. (shrink)

Objective: Little has been written in the medical literature concerning the ethics of treatment of the elderly demented patient with bowel obstruction. It is one example of the issues with which we are becoming increasingly involved. We conducted a survey of our colleagues' opinions to determine current practice.Design: A postal questionnaire study . Questions were posed that related to a case scenario of an elderly demented patient presenting with a presumed sigmoid volvulus.Setting: The northern region of England.Participants: Thirty seven (...) surgical members of the Association of Coloproctology of Great Britain and Ireland, Northern Chapter.Results: Sixty five per cent of respondents felt that surgery would be inappropriate, and 26% that any intervention at all upon the subject in the case scenario would be inappropriate. More would operate, however, at the request of relatives. An advance directive not to treat would be respected by 70% despite a relative's wishes.Conclusions: Overall there was a wide variation in the approach of the surgeons to a demented patient with bowel obstruction. In an era of clinical governance, and an increased awareness of the ethics of consent, this study presents one example of the difficult decisions with which we are increasingly faced. The greater use of advance directives may provide one possible solution. (shrink)

ObjectiveThe aim of this study was to investigate possible associations between obstructive sleep apnea and fatigue. This naturally led to considering the association between OSA and excessive sleepiness, depression, and anxiety.BackgroundOSA is a highly prevalent sleep disorder, associated with a risk of hypertension, cardiovascular events, daytime sleepiness, poor cognitive function, and sudden death during sleep. Both excessive sleepiness, fatigue, and symptoms of depression are frequently reported.Method5,464 patients referred to a university hospital for obstructive sleep apnea underwent standard respiratory polygraphy. The (...) severity of OSA was defined as either mild, moderate, or severe, using the apnea–hypopnea index. Validated questionnaires were used to assess excessive sleepiness, pathological fatigue, depression, and anxiety.ResultsNearly 70% of the patients were men, and median age was 50 years. One in three had moderate-to-severe OSA. Excessive sleepiness and pathological fatigue were present in 43 and 39%, respectively. The prevalence of possible depression and anxiety was 19 and 28%, respectively. The proportion of patients with male sex, obesity, and excessive sleepiness increased with the severity of OSA. In contrast, the proportion of patients with pathological fatigue did not increase with OSA severity, and there was a decrease in depression and anxiety with increasing OSA severity.ConclusionOur study reports that pathological fatigue, as well as anxiety and depression, did not increase with OSA severity, whereas excessive sleepiness did. Knowledge concerning conditions related to OSA severity may be indicative of pretest probability of OSA and thus change the priority for polygraphy. Furthermore, the high prevalence rates of fatigue, anxiety, and depression among these patients warrant further investigations. (shrink)

The core principles of 7th century Korean Buddhist thinker and practitioner Wŏnhyo’s harmonization in non-obstruction thought and Wilberian Integral Theory may help us to understand ourselves and the world better and thus act and live well together accordingly in this contemporary world facing global crises. Whatare particularly noteworthy in Wŏnhyo’s thought and life is that as much as reality is unobstructed (無礙) in its profound calm so can our mode of being and relationships be awakened to its natural harmony (...) free of conflicts (和諍會通). This ideal can be optimally pursued by coming back to the source of One Mind (一心) while extensively benefiting sentient beings. Wŏnhyo consistently pursued and realized this soteriological project through his practice, works, and expediently dedicated life. The most recent version of Wilber’ Integral Theory consists of Integral Approach, Integral Methodological Pluralism, and Integral Post-Metaphysics. Their core principles consist of the AQAL (all quadrants, all levels, all lines, all states, and all types) and holons with their twenty tenets (holonic laws). Extensively utilizing scientific achievements Wilber attempted to map the whole developmental territory of occasions ranging from matter to Spirit or Emptiness and to formulate the Theory of Everything and then apply it to various fields including business, spirituality, and ecology. Within this framework, however, MarkEdwards tried to add an integral epistemology with its interpretive part and to complement Wilber’s more evolutionary ranking ascent with involutionary egalitarian descent. By also critiquing representational—and thus somewhat reifying—tendency of the AQAL framework and proposing to read it as an interpretive lens hesaves Integral Theory from internal conflicts and rendered it more consistent. Being based on experience and vast scholarship both Wŏnhyo’s and Wilberian visions have an integral nature. Whereas Wŏnhyo’s Enlightenment-anchored high vision-logic enabled him to actualize harmonization unobstructedly, backed by scientific achievements as well as his practice Wilber pioneered the AQAL Integral Theory, and then by adding an interpretive dimension Wilber has made it more balanced and consistent system. Now facing the human-caused threats of various global crises as well as the usual complexities of our ordinary life, we need to draw on mankind’s cultural resources including these two spectacular achievements. We may then further develop these soteriological visions in such a way as to satisfy hopefully all justifiable needs of men as well as the world in a futuristic perspective. (shrink)

In an earlier piece in these pages, I described the health effects of the still massive problem of global poverty: The poor worldwide face greater environmental hazards than the rest of us, from contaminated water, filth, pollution, worms, and insects. They are exposed to greater dangers from people around them, through traffic, crime, communicable diseases, sexual violence, and potential exploitation by the more affluent. They lack means to protect themselves and their families against such hazards, through clean water, nutritious food, (...) satisfactory hygiene, necessary rest, adequate clothing, and safe shelter. They lack the means to enforce their legal rights or to press for political reform. (shrink)

The following case breaks with tradition by having only one commentary upon it, and that is from the doctor who submitted the case. We invite readers to make their own analysis of his comments, and to respond as appropriate.