It describes and explains the patient-centered model examining and evaluating qualitative and quantitative research. It comprehensively covers the evolution and the six interactive components of the patient-centered clinical method, taking the reader through the relationships between the patient and doctor and the patient and clinician. All the editors are professors in the Department of Family Medicine at the University of Western Ontario, London, Canada.

Institutional Review Boards are confronted with new challenges in the face of expanding technologies while fulfll-ing their existing regulatory mandate to ensure that plans are in place to protect subjects and to inform them of risks and benefts of research participation. Existing regulations and guidance do not address the issue of incidental fndings , thus leaving awareness of the issue and the application of ethical principles to IRB judgment alone. In order to assure that researchers are aware of the potential (...) for IFs, IRBs must identify which studies are likely to identify IFs and establish what plans should be put into place prior to study initiation to assure the subjects are appropriately informed of the likelihood of IFs, how IFs will be communicated to subjects, and whether the burden of follow-up falls on the researchers or is the subject's responsibility. (shrink)

With rapidly expanding technological capacity, research has outpaced the existing infrastructure of ethical and regulatory guidance. In the area of incidental findings, this is particularly true.The regulations under which most Institutional Review Boards operate were established over 25 years ago and have not been substantially altered in the intervening years. The technology available today that creates the opportunity for IFs was not conceived of, or considered, in the crafting of those regulations. Therefore, little guidance can be derived directly from these (...) regulations. Rather, aspects of existing ethical guidance and regulations can be adapted to assist IRBs and researchers in dealing with issues surrounding IFs. (shrink)

Context: Most constructivist discourse is situated at the philosophical-conceptual level, where arguments appeal to the intuition of the reader, while formal-computational models have only been taken into account to a very limited degree so far. Problem: Two types of problems need to be addressed: Synthetically, can constructivist concepts be turned into actual computational implementations? Can these be further conceptual developments in constructivist theory as such, or are they just an application thereof? Conceptually, does the notion of computation square with constructivist (...) approaches at all? Method: Paradigmatically, we discuss the meaning of “computational” in cognitive agents that comply with constructivist concepts. Also, we summarize the contributions. Results: From a constructivist point of view, the concept of “computational model” is ambiguous and depends on whether it is used in the sense of the computational(ist) theory of mind or simply as a tool. Implications: The insights presented in the contributions to this special issue point in the direction of a computational extension of constructivist approaches as well as a constructivist extension to computational approaches. However, while many of the questions we posed were discussed in the contributions and open peer commentaries, some of them were largely neglected and thus are subject to further discussion. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Decision-Making as a Broader ConceptJacinta O. A. Tan (bio), Anne Stewart (bio), and Tony Hope (bio)KeywordsCompetence, decision-making, capacity, anorexia nervosa, autonomy, values, identityWe thank Demian Whiting for the thoughtful critique of aspects of our paper (Tan et al. 2006a). A primary aim of our research was to provide empirical grounds on which to stimulate discussion about the nature of decision-making capacity (DMC). Whiting criticizes in particular the concept (...) of 'pathological values' that we suggested might be relevant in the assessment of DMC and in the related issue of deciding when a patient's refusal of beneficial treatment should be overridden.Whiting's central concern is with DMC. Whiting argues that the absence of pathological values should not be a criterion for DMC. We are unclear whether he is also arguing that pathological values do not provide a reason of any kind for overriding treatment refusal. At the end of the paper he writes: "we cannot justify compulsory treatment of patients who have pathological values... on the grounds that these patients lack DMC" (2009, XX). This seems to leave open the possibility that we may be able to justify compulsory treatment of patients who have pathological values on grounds other than that they lack DMC. As we wrote in our response to the discussants of our original paper, "The primary issue for us is whether the reasons for refusal to which we draw attention provide grounds for overriding refusal, and if they do how they can be characterized in such a way as to avoid the ever-present danger of simply overriding autonomy in a patient's best interests" (Tan et al. 2006b, 300).In deciding on whether to use compulsory treatment, there are other relevant factors that may need to be considered, such as the seriousness of the decision, which determines the threshold for competence. However, in this response we consider three issues. First, we argue that the current concept of DMC is by no means so clear cut or generally agreed upon as Whiting implies, and that some of the lack of clarity relates to pathological values. Second, that the concept of DMC is itself dependent on accounts of autonomy, and that it is plausible that pathological values can affect autonomy. Third, we directly consider the question of whether a coherent account of pathological values might be given based on a concept of authenticity.The Current Criteria for DMCWhiting argues that the current criteria for DMC are correct and that an additional criterion along the lines of absence of pathological values should not be added. This argument assumes that there is a clear and agreed understanding of the current criteria. We believe this is not the case for three reasons.(i) Whiting begins his account of DMC by saying that it is normally taken to include: "(1) [End Page 345] understanding (and appreciation)" (2009, 341). Already there is an area of dispute, and the use of parentheses reflects this. The concept of 'appreciation' was developed by Grisso and Applebaum (Grisso, Appelbaum, and Hill-Fotouhi 1997). It is not included in either English common law development, for example (ReC), nor in the criteria specified in the Mental Capacity Act 2005. More important, Grisso and Appelbaum in their comment on our original paper (2006) argue that our work advances thinking about 'appreciation' rather than requiring that we add new elements. The implication is that they believe that what we have called pathological values are relevant to the assessment of capacity and are already included in an account of capacity that incorporates the criterion of 'appreciation.' In our response, we argued that pathological values are not entirely captured within the account of appreciation that Grisso and Appelbaum had previously given. We do not want to revisit that issue here, but the point of relevance is that on one view (that of Grisso and Appelbaum) pathological values are already included in the current criteria for DMC as part of the concept of appreciation, whereas on Whiting's view they are not.(ii) Even if there were agreement over the wording and concepts relevant to DMC there is a further important issue: how are those concepts... (shrink)

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

Two studies examined the link between social dominance and male waist-to-hip ratio (WHR). Groups of four men interacted in a leaderless group discussion. In both studies, men with higher WHRs (associated with current and long-term health status) were rated by other group members as behaving more leader-like when an observer was present, and rated themselves as being more assertive. In Study 2, men with higher WHRs were rated by independent observers as behaving more dominantly, but only when the evaluator was (...) present. These results are discussed in terms of evolutionary models of health, attraction, and intrasexual competition. (shrink)

The growing body of research on temporal and spatial experience lacks a comprehensive theoretical approach. Drawing on Giddens’ framework, we present time-space distanciation as a construct for theorizing the relations between culture, time, and space. TSD in a culture may be understood as the extent to which time and space are abstracted as separate dimensions and activities are extended and organized across time and space. After providing a historical account of its development, we outline a multi-level conceptualization of TSD supported (...) by research on cultural differences in the experience of time and space. We impact this conceptualization by examining two ethnographic case studies. We conclude by highlighting future research directions. TSD is an integrative, interdisciplinary, multi level construct with the potential to guide the burgeoning social science of time and space. (shrink)

Nanomedicine is yielding new and improved treatments and diagnostics for a range of diseases and disorders. Nanomedicine applications incorporate materials and components with nanoscale dimensions where novel physiochemical properties emerge as a result of size-dependent phenomena and high surface-to-mass ratio. Nanotherapeutics and in vivo nanodiagnostics are a subset of nanomedicine products that enter the human body. These include drugs, biological products, implantable medical devices, and combination products that are designed to function in the body in ways unachievable at larger scales. (...) Nanotherapeutics andin vivonanodiagnostics incorporate materials that are engineered at the nanoscale to express novel properties that are medicinally useful. These nanomedicine applications can also contain nanomaterials that are biologically active, producing interactions that depend on biological triggers. Examples include nanoscale formulations of insoluble drugs to improve bioavailability and pharmacokinetics, drugs encapsulated in hollow nanoparticles with the ability to target and cross cellular and tissue membranes and to release their payload at a specific time or location, imaging agents that demonstrate novel optical properties to aid in locating micrometastases, and antimicrobial and drug-eluting components or coatings of implantable medical devices such as stents. (shrink)

In some cases people judge it morally acceptable to sacrifice one person’s life in order to save several other lives, while in other similar cases they make the opposite judgment. Researchers have identified two general factors that may explain this phenomenon at the stimulus level: (1) the agent’s intention (i.e. whether the harmful event is intended as a means or merely foreseen as a side-effect) and (2) whether the agent harms the victim in a manner that is relatively “direct” or (...) “personal”. Here we integrate these two classes of findings. Two experiments examine a novel personalness/directness factor that we call personal force, present when the force that directly impacts the victim is generated by the agent’s muscles (e.g., in pushing). Experiments 1a and b demonstrate the influence of personal force on moral judgment, distinguishing it from physical contact and spatial proximity. Experiments 2a and b demonstrate an interaction between personal force and intention, whereby the effect of personal force depends entirely on intention. These studies also introduce a method for controlling for people’s real-world expectations in decisions involving potentially unrealistic hypothetical dilemmas. (shrink)

Insulin is stored within the pancreas in an inactive Zn2+‐bound hexameric form prior to release. Similarly, clinical insulins contain Zn2+ and form multimeric complexes. Upon release from the pancreas or upon injection, insulin only becomes active once Zn2+ disengages from the complex. In plasma and other extracellular fluids, the majority of Zn2+ is bound to human serum albumin (HSA), which plays a vital role in controlling insulin pharmacodynamics by enabling removal of Zn2+. The Zn2+‐binding properties of HSA are attenuated by (...) non‐esterified fatty acids (NEFAs) also transported by HSA. Elevated NEFA concentrations are associated with obesity and type 2 diabetes. Here we present the hypothesis that higher NEFA levels in obese and/or diabetic individuals may contribute to insulin resistance and affect therapeutic insulin dose‐response profiles, through modulation of HSA/Zn2+ dynamics. We envisage this novel concept to have important implications for personalized treatments and management of diabetes‐related conditions in the future. (shrink)

This volume captures the individuality, the national and personal identity, the cultural exchange, and the self-consciousness that have long been sensed as peculiarly potent in the Hellenistic world. The fields of history, literature, art, philosophy, and religion are each presented using the format of two essays followed by a response. Conveying the direction and focus of Hellenistic learning, eighteen leading scholars discuss issues of liberty versus domination, appropriation versus accommodation, the increasing diversity of citizen roles and the dress and gesture (...) appropriate to them, and the accompanying religious and philosophical ferment. The result is an arresting view of the incredible and unprecedented diversity of the Hellenistic world. (shrink)

Morality can help guide behavior and facilitate relationships. Although moral judgments by autistic people are similar to neurotypical individuals, many researchers argue that subtle differences signify deficits in autistic individuals. Moral foundation theory describes moral judgments in terms of differences rather than deficits. The current research, aimed at assessing autistic individuals’ moral inclinations using Haidt’s framework, was co-designed with autistic community members. Our aim was to describe autistic moral thinking from a strengths-based perspective while acknowledging differences that may pose interpersonal (...) challenges among autistic youth. We assessed 25 autistic and 23 neurotypical children’s moral judgments using the Moral Foundations Questionnaire for Kids. We used semi-structured interviews and qualitative analysis with a subset of participants to describe children’s moral reasoning. Analyses suggested that autistic and neurotypical children make similar judgments about moral transgressions across all five moral foundations. General linear mixed modeling showed that the greatest predictor of recommending punishment was how bad children deemed moral transgressions to be. We also found a trend that autistic children were more likely to recommend punishment for harmless norms violations than were neurotypical children. Future research could use longitudinal methods to understand the development of moral judgments among autistic and neurotypical children. (shrink)

This article is about the history of logic in Australia. Douglas Gasking (1911?1994) undertook to translate the logical terminology of John Anderson (1893?1962) into that of Ludwig Wittgenstein's (1921) Tractatus. At the time Gilbert Ryle (1900?1976), and more recently David Armstrong, recommended the result to students; but it is reasonable to have misgivings about Gasking as a guide to either Anderson or Wittgenstein. The historical interest of the debate Gasking initiated is that it yielded surprisingly little information about Anderson's traditional (...) (syllogistic or Aristotelian) logic and its relation to classical (first-order predicate or Russellian) logic, the ostensible topic; but the materials now exist to interpret Anderson's logic in classical logic, possibly as an algebra of classes. This would be of little interest to contemporary logicians, but it might shed some light on Anderson's philosophy. (shrink)

This article is concerned with developing a philosophical approach to a number of significant changes to academic publishing, and specifically the global journal knowledge system wrought by a range of new digital technologies that herald the third age of the journal as an electronic, interactive and mixed-media form of scientific communication. The paper emerges from an Editors' Collective, a small New Zealand-based organisation comprised of editors and reviewers of academic journals mostly in the fields of education and philosophy. The paper (...) is the result of a collective writing process. (shrink)

This book is a clear and concise history of the soul in western philosophy, from Plato to cutting-edge contemporary work in philosophy of mind. Packed with arguments for and against a range of different, historically significant philosophies of the soul Addresses the essential issues, including mind-body interaction, the causal closure of the physical world, and the philosophical implications of the brain sciences for the soul's existence Includes coverage of theories from key figures, such as Plato, Aquinas, Locke, Hume, and Descartes (...) Unique in combining the history of ideas and the development of a powerful case for a non-reductionist, non-materialist account of the soul. (shrink)

This extremely accessible textbook provides a wide-ranging analysis of the relations between philosophy and feminist thought. Examining not only feminist critiques of philosophical ideas, Gatens also looks at the ways in which feminist theory can be informed by philosophical analysis and debates. Gatens adopts an historical approach, beginning with an analysis of Mary Wollstonecraft's critique of Rousseau. She then examines attempts by Harriet Taylor and J. S. Mill to extend liberal principles to women's situation. Other chapters discuss the work of (...) more recent philosophers, including Simone de Beauvoir, Luce Irigaray, Mary Daly and Dale Spender. Gatens concludes with a discussion of current debates in the politics of sexual difference. (shrink)

This book presents the framework for a new, comprehensive approach to cognitive science. The proposed paradigm, enaction, offers an alternative to cognitive science's classical, first-generation Computational Theory of Mind. _Enaction_, first articulated by Varela, Thompson, and Rosch in _The Embodied Mind_, breaks from CTM's formalisms of information processing and symbolic representations to view cognition as grounded in the sensorimotor dynamics of the interactions between a living organism and its environment. A living organism enacts the world it lives in; its embodied (...) action in the world constitutes its perception and thereby grounds its cognition. _Enaction_ offers a range of perspectives on this exciting new approach to embodied cognitive science. Some chapters offer manifestos for the enaction paradigm; others address specific areas of research, including artificial intelligence, developmental psychology, neuroscience, language, phenomenology, and culture and cognition. Three themes emerge as testimony to the originality and specificity of enaction as a paradigm: the relation between first-person lived experience and third-person natural science; the ambition to provide an encompassing framework applicable at levels from the cell to society; and the difficulties of reflexivity. Taken together, the chapters offer nothing less than the framework for a far-reaching renewal of cognitive science. Contributors: Renaud Barbaras, Didier Bottineau, Giovanna Colombetti, Diego Cosmelli, Hanne De Jaegher, Ezequiel A. Di Paolo. Andreas K. Engel, Olivier Gapenne, Véronique Havelange, Edwin Hutchins, Michel Le Van Quyen, Rafael E. Núñez, Marieke Rohde, Benny Shanon, Maxine Sheets-Johnstone, Adam Sheya, Linda B. Smith, John Stewart, Evan Thompson. (shrink)

Moving beyond both realist and anti-realist accounts of mathematics, Shapiro articulates a "structuralist" approach, arguing that the subject matter of a mathematical theory is not a fixed domain of numbers that exist independent of each other, but rather is the natural structure, the pattern common to any system of objects that has an initial object and successor relation satisfying the induction principle.

The central contention of this book is that second-order logic has a central role to play in laying the foundations of mathematics. In order to develop the argument fully, the author presents a detailed description of higher-order logic, including a comprehensive discussion of its semantics. He goes on to demonstrate the prevalence of second-order concepts in mathematics and the extent to which mathematical ideas can be formulated in higher-order logic. He also shows how first-order languages are often insufficient to codify (...) many concepts in contemporary mathematics, and thus that both first- and higher-order logics are needed to fully reflect current work. Throughout, the emphasis is on discussing the associated philosophical and historical issues and the implications they have for foundational studies. For the most part, the author assumes little more than a familiarity with logic comparable to that provided in a beginning graduate course which includes the incompleteness of arithmetic and the Lowenheim-Skolem theorems. All those concerned with the foundations of mathematics will find this a thought-provoking discussion of some of the central issues in the field today. (shrink)

Increased productivity may have negative impacts on farm animal welfare in modern animal production systems. Efficiency gains in production are primarily thought to be due to the intensification of production, and this has been associated with an increased incidence of production diseases, which can negatively impact upon FAW. While there is a considerable body of research into consumer attitudes towards FAW, the extent to which this relates specifically to a reduction in production diseases in intensive systems, and whether the increased (...) incidence of diseases represents a barrier to consumer acceptance of their increased use, requires further investigation. Therefore a systematic review of public attitudes towards FAW was conducted, with a specific focus on production diseases in intensive systems. Four databases were searched to identify relevant studies. A screening process, using a set of pre-determined inclusion criteria, identified 80 studies, with the strength of evidence and uncertainty assessed for each. A thematic analysis led to the identification of 6 overarching themes constructed from 15 subthemes. The results demonstrate that the public are concerned about FAW in modern production systems. Concern varied in relation to age, gender, education and familiarity with farming. Naturalness and humane treatment were central to what was considered good welfare. An evidence gap was highlighted in relation to attitudes towards specific production diseases, with no studies specifically addressing this. However, the prophylactic use of antibiotics was identified as a concern. A number of dissonance strategies were adopted by consumers to enable guilt free meat consumption. (shrink)

This paper explores the ethical and conceptual implications of the findings from an empirical study (reported elsewhere) of decision-making capacity in anorexia nervosa. In the study, ten female patients aged thirteen to twenty-one years with a diagnosis of anorexia nervosa, and eight sets of parents, took part in semistructured interviews. The purpose of the interviews was to identify aspects of thinking that might be relevant to the issue of competence to refuse treatment. All the patient-participants were also tested using the (...) MacArthur Competence Assessment Tool—Treatment test of competence. This is a formalized, structured, interviewer-administered test of competence, which is a widely accepted clinical tool for determining capacity. The young women also completed five brief, self-administered questionnaires to assess their levels of psychopathology. The issues identified from the interviews are described under two headings: difficulties with thought processing and changes in values. The results suggest that competence to refuse treatment may be compromised in people with anorexia nervosa in ways that are not captured by traditional legal approaches. (shrink)

Guthrie contends that religion can best be understood as systematic anthropomorphism - the attribution of human characteristics to nonhuman things and events. Religion, he says, consists of seeing the world as human like. He offers a fascinating array of examples to show how this strategy pervades secular life and how it characterizes religious experience.

Did George Eliot’s work as translator of the critical writings on religion of Ludwig Feuerbach and Benedict Spinoza influence her work as a novelist? Did she hold a comprehensive philosophy of religion? Through an examination of her non-fictional and fictional writings this chapter argues that we should take seriously Eliot’s claim that her novels are ‘experiments in life’. Building on the critiques of religion offered by Spinoza and Feuerbach, Eliot’s novels address the philosophical question: is morality possible in a godless (...) world? The capacities necessary to a moral life are imagination, sympathy, and reflection. Her fiction contributes to the reformation of moral consciousness by experimenting with the interplay between these capacities. (shrink)

Modern, or continental, rationalism refers to the works of the seventeenth‐century philosophers René Descartes, Baruch Spinoza, and Gottfried Leibniz. While there is much to mark each philosopher off from the others, there are nevertheless several shared fundamental assumptions that warrant the common title of “rationalist.” Each philosopher believed that mathematics and geometry were appropriate models on which to base philosophical methodology. Each, whilst critical of founding knowledge on mere faith – which they believed could only lead to skepticism – nevertheless (...) relied on theological arguments at various points in their philosophies. All three philosophers share a distrust of the notion that sensation, emotion (passion), and the body are capable of providing knowledge. Reason alone, on all three philosophers' accounts, is the a priori faculty which can provide secure foundations for human knowledge. It is Descartes' philosophy that has received most critical attention from feminist theorists. Spinoza has received less attention and Leibniz is all but ignored. At the end of this article, some attempt will be made to explain this uneven treatment of the modern rationalists. (shrink)

This book comprises all of John Bell's published and unpublished papers in the field of quantum mechanics, including two papers that appeared after the first edition was published. It also contains a preface written for the first edition, and an introduction by Alain Aspect that puts into context Bell's great contribution to the quantum philosophy debate. One of the leading expositors and interpreters of modern quantum theory, John Bell played a major role in the development of our current understanding of (...) the profound nature of quantum concepts. First edition Hb (1987): 0-521-33495-0 First edition Pb (1988): 0-521-36869-3. (shrink)

Stewart Shapiro's ambition in Vagueness in Context is to develop a comprehensive account of the meaning, function, and logic of vague terms in an idealized version of a natural language like English. It is a commonplace that the extensions of vague terms vary according to their context: a person can be tall with respect to male accountants and not tall (even short) with respect to professional basketball players. The key feature of Shapiro's account is that the extensions of vague (...) terms also vary in the course of conversations and that, in some cases, a competent speaker can go either way without sinning against the meaning of the words or the non-linguistic facts. As Shapiro sees it, vagueness is a linguistic phenomenon, due to the kinds of languages that humans speak; but vagueness is also due to the world we find ourselves in, as we try to communicate features of it to each other. (shrink)

Clarke, Moira On the East coast of America, every 13 or 17 years, billions of red-eyed magicicadas emerge from underground. For the next few weeks every tree resounds with a near-deafening symphony, a courting ritual that has been measured at 94 decibels. Finally, the resulting offspring burrow back into the earth, there to remain inactive for the exact same duration, 13 or 17 years.