Despite spending more on health care than every other industrialized country, the U.S. ranks 37th in health outcomes. These differences cannot be explained away with differences in age and income, or even with quality of care. And, the rate of growth in health care spending in the U.S. continues to increase. The share of the Gross Domestic Product attributable to health care grew from 9% in 1980 to more than 17% in 2011. Health care costs are projected to account for (...) more than one-fifth of our economy by 2021. Despite spending more and more, the U.S. does not have better health outcomes than other countries. Worse, our increasing spending is largely attributable to preventable conditions. More than 85 cents of every dollar spent on health in the U.S. are spent on the treatment and management of chronic diseases, such as those caused by preventable conditions related to obesity and tobacco use. (shrink)

Elimination of state laws that preempt local antismoking ordinances is a national health objective. However, the tobacco industry and its supporters have continued to pursue statelevel preemption of local tobacco control ordinances as part of an apparent strategy to avoid the difusion of grassroots antismoking initiatives. And, an increasing number of challenges to local ordinances by the tobacco industry and persons supported by the tobacco industry are being decided in state supreme courts and courts of appeals. The outcomes of seemingly (...) similar cases about the validity of local smoke-free air ordinances vary signifcantly by state. This paper examines the common and unique aspects of the decisions and the potential implications of court rulings on preemption for future state tobacco control eforts and achievement of national health objectives around the elimination of preemption. Using a search strategy developed for the Centers for Disease Control and Prevention's State Tobacco Activities Tracking and Evaluation System, cases where a state or federal appellate level court made a fnding on the validity of a local smoke-free air ordinance or regulation were identifed in 19 states. In contrast to previous studies, we found that cases in approximately half of states were decided for local governments. We also found that across the states, courts were considering similar factors in their decisions including the extent to which: the local government possessed the authority to pass the ordinance, the ordinance conficted with the state constitution, and state statutes preempt the ordinance. (shrink)

Despite governmental and private antismoking initiatives, tobacco smoking remains a significant public health and economic challenge. The Centers for Disease Control and Prevention estimates that for each year between 1997 and 2001, cigarette smoking and exposure to secondhand smoke caused approximately 438,000 U.S. residents to die prematurely, resulting in 5.5 million years of potential life lost, and in $92 billion dollars of lost productivity. Also, despite convincing scientific data that laws against indoor smoking protect people from the negative health effects (...) of cigarette smoke, not all states have afforded their residents this protection. As of July 2007, 16 states neither restricted nor banned indoor smoking in restaurants, private worksites, or government worksites, and many state statutes only required separate rooms for smokers rather than eliminating all smoking inside buildings. In several states, local governments have attempted to fill this gap by adopting their own antismoking measures. (shrink)

Does law matter regarding public health outcomes? Regardless of what one may think about the answer to this age-old question, in recent years the public health community has increasingly demonstrated and recognized the roles that public health laws and policies play in effectuating long-lasting and broad-based population-wide changes. Public health laws and policies have been instrumental in the following ways: reducing smoking prevalence; reducing underage alcohol-related drinking, driving, crashes, and fatalities; reducing exposure to second-hand smoke; eliminating vaccine–associated paralytic poliomyelitis ; (...) increasing seat-belt use and reducing traffic fatalities; reducing dental carries; and reducing access to and consumption of unhealthy foods and beverages sold in schools and to reductions in caloric intake and overweight. In fact, in a review of the ten greatest public health achievements in the 20th century, all were influenced by policy change. (shrink)

Does law matter regarding public health outcomes? Regardless of what one may think about the answer to this age-old question, in recent years the public health community has increasingly demonstrated and recognized the roles that public health laws and policies play in effectuating long-lasting and broad-based population-wide changes. Public health laws and policies have been instrumental in the following ways: reducing smoking prevalence; reducing underage alcohol-related drinking, driving, crashes, and fatalities; reducing exposure to second-hand smoke; eliminating vaccine–associated paralytic poliomyelitis ; (...) increasing seat-belt use and reducing traffic fatalities; reducing dental carries; and reducing access to and consumption of unhealthy foods and beverages sold in schools and to reductions in caloric intake and overweight. In fact, in a review of the ten greatest public health achievements in the 20th century, all were influenced by policy change. (shrink)

Research about the Olympic Games has primarily focused on preparing athletes for competition. Less attention has been paid to the post-Olympic-phase and athlete well-being during this time. This study explored Australian Olympic athletes’ experiences following the conclusion of the 2016 Rio Olympic Games, including the factors that may have contributed to or challenged their well-being during this time. Eighteen athletes participated in semi-structured interviews and thematic analysis revealed that when Olympic performance appraisal met prior expectations, when athletes planned for a (...) return to work or study, and when support from a variety of sources was readily available, this positively influenced athletes’ well-being during the POP. When these factors were not in place, more challenging post-Games experiences were present, and well-being was compromised. The findings contribute to the broader literature on elite athlete well-being and at an applied level, may be used to inform targeted programs that focus on supporting athletes after an Olympic campaign. (shrink)

A good deal of attention has been given in recent philosophy of religion to the question of whether we can sensibly attribute to God a form of knowledge which the 16th-century Jesuit theologian Luis de Molina termed "middle knowledge". Interest in the doctrine has been spurred by a recognition of its intimate connection to certain conceptions of providence, prophecy, and response to petitionary prayer. According to defenders of the doctrine, which I will call "Molinism", the objects of middle knowledge are (...) all the true counterfactuals of the form, 'If C were to occur, then S would freely do A', where C specifies a particular set of circumstances. (Such propositions are usually referred to as "counterfactuals of freedom" - hereafter "CFs".)' I will try to assess the current status of two distinct questions: (1) Are there true CFs? and (2) Could God know true CFs if there are any? Obviously, Molinism must answer both questions affirmatively. Most of the discussion has focused on the first question. I hope to show that this approach has been a dialectical mistake on the part of critics of Molinism, for the difficulties of giving an affirmative answer to question (2) are, I believe, far easier to state clearly and convincingly. (shrink)

Two experiments employed experience sampling to examine the factors associated with a prospective and retrospective focus during mind wandering. Experiment One explored the contribution of working memory and indicated that participants generally prospect when the task does not require continuous monitoring. Experiment Two demonstrated that in the context of reading, interest in what was read suppressed both past and future-related task-unrelated-thought. Moreover, in disinterested individuals the temporal focus during mind wandering depended on the amount of experience with the topic matter—less (...) experienced individuals tended to prospect, while more experienced individuals tended to retrospect. Together these results suggest that during mind wandering participants’ are inclined to prospect as long as the task does not require their undivided attention and raise the intriguing possibility that autobiographical associations with the current task environment have the potential to cue the disinterested mind. (shrink)

Three experiments investigated the hypothesis that internally generated images and thoughts were driven by meaning complexes, a construct which reflects a synthesis of semantic meaning and personal salience . Experiments 1 and 2 contrasted the mutual inhibition between encoding words and non-words on: the frequency that thoughts and images unrelated to the task were experienced and on the intensity of images generated from long-term memory and maintained under dual task conditions, which whilst familiar were not of particular personal salience . (...) Experiment 3 examined the physiological arousal associated with the experience of TUT in a semantic encoding task. Evidence suggested that, in general, internally generated images and thoughts, irrespective of the personal salience, were suppressed by the co-ordination of information in working memory. In addition, only the experience of spontaneous images and thoughts of personal salience interfered reliably with the encoding/retrieval of semantic information from memory. Finally, in Experiment 3, physiological arousal, as indexed by mean heart rate, was associated with a high frequency of TUT. The results of all three experiments support the notion that the maintenance of spontaneously occurring images and thoughts is simultaneously influenced by both the semantic content and the personal salience of the information held in working memory. (shrink)

The detection and spread of pandemic 2009 H1N1 influenza in the United States led to a complex and multi-faceted response by the public health system that lasted more than a year. When the first domestic case of the virus was detected in California on April 15, 2009, and a second, unrelated case was identified more than 130 miles away in the same state on April 17, 2009, the unique combination of influenza virus genes in addition to its emergence and rapid (...) spread at the end of the typical Northern Hemisphere influenza season suggested the potential for a high morbidity, high mortality event. In response, federal, state, and local public health officials conducted epidemiologic investigations with federal and state laboratory support to help to determine the scope of the H1N1 pandemic. On April 26, the Secretary of the U.S. Department of Health and Human Services declared a public health emergency that was renewed through June 23, 2010. The pandemic that ensued tested virtually every aspect of U.S. public health preparedness and response systems, from laboratory capabilities and capacities to social distancing plans. (shrink)

The detection and spread of pandemic 2009 H1N1 influenza in the United States led to a complex and multi-faceted response by the public health system that lasted more than a year. When the first domestic case of the virus was detected in California on April 15, 2009, and a second, unrelated case was identified more than 130 miles away in the same state on April 17, 2009, the unique combination of influenza virus genes in addition to its emergence and rapid (...) spread at the end of the typical Northern Hemisphere influenza season suggested the potential for a high morbidity, high mortality event. In response, federal, state, and local public health officials conducted epidemiologic investigations with federal and state laboratory support to help to determine the scope of the H1N1 pandemic. On April 26, the Secretary of the U.S. Department of Health and Human Services declared a public health emergency that was renewed through June 23, 2010. The pandemic that ensued tested virtually every aspect of U.S. public health preparedness and response systems, from laboratory capabilities and capacities to social distancing plans. (shrink)

Edmund D. Pellegrino and David C. Thomasma analyze the virtues that are especially relevant to the practice of good medicine. Their account of the virtues and medicine is complemented by Alasdair MacIntyre’s recent analysis of human development and the acquisition of the moral and intellectual virtues. These two accounts contribute toward analyzing the historical constitution of social practices and relationships in medicine. In particular, the moral and intellectual virtues characteristic of good medicine are acquired and exercised within those healing relationships (...) featured in Pellegrino’s and Thomasma’s phenomenology of medicine. Examining their account of medical practice in light of MacIntyre’s more recent work suggests, however, that their theory of the good of the patient and their understanding of the relation of virtue to altruism and self-interest stand in need of further development. (shrink)

“Free Will” is a philosophical term of art for a particular sort of capacity of rational agents to choose a course of action from among various alternatives. Which sort is the free will sort is what all the fuss is about. (And what a fuss it has been: philosophers have debated this question for over two millenia, and just about every major philosopher has had something to say about it.) Most philosophers suppose that the concept of free will is very (...) closely connected to the concept of moral responsibility. Acting with free will, on such views, is just to satisfy the metaphysical requirement on being responsible for one's action. (Clearly, there will also be epistemic conditions on responsibility as well, such as being aware—or failing that, being culpably unaware—of relevant alternatives to one's action and of the alternatives' moral significance.) But the significance of free will is not exhausted by its connection to moral responsibility. Free will also appears to be a condition on desert for one's accomplishments (why sustained effort and creative work are praiseworthy); on the autonomy and dignity of persons; and on the value we accord to love and friendship. (See Kane 1996, 81ff. and Clarke 2003, Ch.1.). (shrink)

Exposure of man to chemical agents can occur intentionally, as in the treatment of disease, or inadvertently because the environment contains a wide range of synthetic or naturally occurring chemicals. The alkylating agents are a diverse group of compounds (Fig. 1) and comprise a good example of such xenobiotics, since much is known about their occurrence, and their biological effects include carcinogenicity, mutagenicity, toxicity and teratogenicity.Exposure to potentially carcinogenic alkylating agents such as nitrosamines may occur occupationally, from cigarette smoke, from (...) certain foodstuffs and even endogenously through the ingestion of the appropriate precursor chemicals.1 At the other extreme, the cytotoxic effects of agents such as the chloroethylating nitrosamides or mustards have been exploited in the design of certain antitumour drugs.2 The effectiveness of antitumour agents and the other, mostly adverse, biological effects of alkylating agents have been ascribed to their ability to damage cellular macromolecules, in particular DNA. This review concentrates on investigations carried out over the past two years on the role of DNA damage in carcinogenesis, but we shall see how recent advances in this area of research have also led to a better understanding of the mechanisms of the cytotoxic effects of alkylating antitumour agents. (shrink)

The book includes contributions by Sarah-Jayne Blakemore, George F. R. Ellis, Christopher D. Frith, Mark Hallett, David Hodgson, Owen D. Jones, Alicia Juarrero, J. A. Scott Kelso, Christof Koch, Hans Küng, Hakwan C. Lau, Dean Mobbs,...

The current work builds a definition of irritability from both academic definitions and lay perspectives. In Study 1, a quantitative content analysis of academic definitions resulted in eight main content categories. In Study 2, a community sample of 39 adults participated in qualitative interviews. A deductive thematic analysis resulted in two main themes. The first main theme dealt with how participants positioned irritability in relation to other negative states. The second dealt with how participants constructed irritability as both a loss (...) of control and as an experience that should be controlled. The discussion integrates the findings of both studies and provides a concise, but comprehensive definition. (shrink)

Critical social theory has long been marked by a deep, creative, and productive relationship with psychoanalysis. Whereas Freud and Fromm were important cornerstones for the early Frankfurt School, recent thinkers have drawn on the object-relations school of psychoanalysis. Transitional Subjects is the first book-length collection devoted to the engagement of critical theory with the work of Melanie Klein, Donald Winnicott, and other members of this school. Featuring contributions from some of the leading figures working in both of these fields, including (...) Axel Honneth, Joel Whitebook, Noëlle McAfee, Sara Beardsworth, and C. Fred Alford, it provides a synoptic overview of current research at the intersection of these two theoretical traditions while also opening up space for further innovations. Transitional Subjects offers a range of perspectives on the critical potential of object-relations psychoanalysis, including feminist and Marxist views, to offer valuable insight into such fraught social issues as aggression, narcissism, “progress,” and torture. The productive dialogue that emerges augments our understanding of the self as intersubjectively and socially constituted and of contemporary “social pathologies.” Transitional Subjects shows how critical theory and object-relations psychoanalysis, considered together, have not only enriched critical theory but also invigorated psychoanalysis. (shrink)

This paper focuses on 3 features of Freyenhagen's Aristotelian version of Adorno. (a) It challenges the strict negativism Freyenhagen finds in Adorno. If we have morally relevant interests in ourselves, it is implicit that we have a standard by which to understand what is both good and bad for us (our interests). Because strict negativism operates without reference to what is good, it seems to be detached from real interests too. Torture, it is argued, is, among other things, a violation (...) of those interests. (b) Freyenhagen identifies the “impulse” in Adorno as an untutored yet moral reaction to morally demanding situations. The plausibility of this primitivism and its compatibility with Adorno's general worries about immediacy are considered. (c) The disruptive character of Adorno's version of the categorical imperative, its willingness to complicate action through wholesale reflection on the norms of what we are committing ourselves to, is set in contrast with Freyenhagen's Aristotelian claim that certain notions, such as “humanity,” cannot be intelligibly questioned. (shrink)

Neste artigo eu defendo que o conhecimento de proposições filosóficas pode e deve desempenhar o papel de ideal regulador das aulas de Filosofia no Ensino Médio. Grosso modo, penso haver dois tipos de conhecimento pressupostos nas aulas de Filosofia no Ensino Médio: o primeiro, que, por conveniência, chamarei de conhecimento filosófico disposicional, e o segundo, o conhecimento filosófico proposicional. O primeiro consiste naquele conhecimento que leva em conta apenas certas habilidades filosóficas de identificação de teses, de identificação e análise de (...) argumentos etc. O segundo envolve a garantia da verdade de uma proposição filosófica via justificação. Argumento que o conhecimento filosófico disposicional, embora seja um pressuposto epistemológico suficiente a ser tomado para a confecção de uma aula de Filosofia no Ensino Médio, não é necessário. Isso porque esse tipo de conhecimento não desempenha satisfatoriamente a função de objetivo último das aulas de Filosofia, se considerarmos uma característica fundamental da Filosofia: qual seja, aquela atividade que, através de seus autores, possui enquanto objetivo último obter conhecimento de certas proposições filosóficas. Além disso, argumento que o primeiro tipo de conhecimento é adequadamente desenvolvido somente se regulado por um ideal de conhecimento do segundo tipo. Assim considerado, além de fazermos, de fato, a Filosofia presente na sala de aula, tendemos a ter ganhos consideráveis para a postura dos alunos frente às questões filosóficas fundamentais. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume 29, Number 2, November 2003, pp. 267-282 Skepticism and Philo's Atheistic Preference DAVID O'CONNOR [H]owever consistent the world may be... with the idea of... a very powerful, wise, and benevolent Deity... it can never afford us an inference concerning his existence. The consistence is not absolutely denied, only the inference.1 The whole presents nothing but the idea of a blind nature, impregnated by a great vivifying (...) principle, and pouring forth from her lap, without discernment or parental care, her maimed and abortive children. (DNR, 211) The true conclusion is, that the original source of all things is entirely indifferent to all these principles, and has no more regard to good above ill than to heat above cold, or to drought above moisture, or to light above heavy. (DNR, 212) There may four hypotheses be framed concerning the first causes of the universe: that they are endowed with perfect goodness, that they have perfect malice, that they are opposite and have both goodness and malice, that they have neither goodness nor malice.... The fourth... seems by far the most probable. (DNR, 212) David O'Connor is Professor of Philosophy, Seton Hall University, South Orange, New Jersey 07079. e-mail: [email protected] 268 David O'Connor What I have said concerning natural evil will apply to moral, with little or no variation; and we have no more reason to infer, that the rectitude of the supreme Being resembles human rectitude than that his benevolence resembles the human. Nay, it will be thought, that we have still greater cause to exclude from him moral sentiments, such as we feel them; since moral evil, in the opinion of many, is much more predominant above moral good than natural evil above natural good. (DNR, 212) Thus Philo in part 11 of Hume's Dialogues concerning Natural Religion. I In the first of these passages, Philo is denying that the existence of "a very powerful, wise, and benevolent Deity" can justifiably be inferred from the facts of good and evil present to our experience. But power, wisdom, and benevolence are essential qualities of the God of traditional theism, thus Philo is here denying that the existence of such a being can justifiably be inferred from the empirical evidence of good and evil. The other passages show us Philo going further than this, indeed all the way to what seems to be a preference for moral atheism. The term is J. C. A. Gaskin's, and he defines it thus: "[moral atheism] will be [the position of] anyone who denies the existence of any god having moral attributes."2 In the second and third passages specifically, this prima facie preference is absolute ("[t]he whole presents nothing but the idea of a blind nature... without discernment" and "the original source of all things is entirely indifferent," respectively), while it is relative and more cautiously expressed in the fourth passage. And the fifth passage says at least as much as the first and perhaps as much as the second and third. Yet Philo very early in the book declares himself a skeptic on such metaphysical topics as "the origin of worlds" (DNR, 132), "the existence and properties of spirits" (DNR, 135), "the powers and operations of one universal spirit, existing without beginning and without end; omnipotent, omniscient, immutable, infinite" (DNR, 135). The principal reason he gives is the "weakness, blindness, and narrow limits of human reason... even in subjects of common life and practice" (DNR, 131). Considering these limits, surely it is very likely that "we have... got quite beyond the reach of our faculties" (DNR, 135) if and when we turn to such metaphysical topics as those he just listed. On these matters, which "run wide of common life... [t]he mind must remain in suspense... and it is that very suspense or balance, which is the triumph of skepticism" (DNR, 135-6). Hume Studies Philo's Atheistic Preference 269 While the first of the passages I quoted in the beginning clearly squares with this skeptical outlook, and so does at least part of the fifth, it would seem that the rest of the quoted material does not... (shrink)

This essay will provide a comparative analysis of themes at work in both Jacques Derrida and Félix Ravaisson. By putting these thinkers in dialogue will I believe offers valuable insights into questions of deconstruction and vitalism. I will examine Derrida’s remarks on Ravaisson in On Touching: Jean Luc Nancy, and use his thoughts as a way of explaining the similarities and differences between Derrida and Ravaisson and thus of Derrida’s proximity to and distance from the vitalist tradition. I will (...) also be able to demonstrate the conceptual requirements and conditions for thinking how deconstruction operates, casting light on the ways in which deconstruction offers the conceptual resources to think a general theory of bodies and identities. (shrink)