Background. Decisions to test, enrol and disclose HIV status are among the ethical challenges that may influence adherence to antiretroviral therapy (ART) and HIV care and treatment in adolescents living with HIV. In the Tanzanian setting, how parental perceptions of ethical issues affect adolescents’ adherence to HIV care and treatment is not well known.Objective. To explore parental perceptions of ethical issues in adolescent HIV care and treatment. Methods. The study employed a descriptive qualitative exploratory design and was conducted at Temeke (...) Regional Referral Hospital in Dar es Salaam Care and Treatment Centre (CTC) in the Outpatient Department (OPD). The study population were parents and non-parent caregivers of HIV-infected adolescents 10 - 19 years of age. A total of 16 persons participated in semi-structured interviews after their consent was obtained. All interviews were audiotaped, transcribed verbatim in Swahili and back-translated into English. An inductive content analysis was used, and standards of qualitative rigour applied. Results. Three qualitative themes emerged: balancing adolescents’ autonomy with parents’ desire to protect their children; parental dilemmas regarding disclosure of adolescents’ HIV status; and parental reasons for delayed disclosure.Conclusion. Participants perceived that parental authority should override adolescents’ autonomy in HIV care and treatment. Disclosure of HIV status to adolescents is a challenge to parents. Delays in disclosure often occur because parents feel guilty and because they have fears of rejection by their adolescent children. (shrink)

Incapacitated adults with a legally appointed guardian or conservator may be recruited for or involved with medical, behavioral, or social science research. Much of the research in which such persons participate is aimed at evaluating medical interventions for them, or contributing to general knowledge about disorders from which they may suffer. In this paper we will consider how the appointment of guardians for patients with disorders of consciousness —severe brain injuries that affect a patient’s level of arousal and ability to (...) interact —impacts such patients’ access to research.Such persons may be under guardianship because they have lost decisional capacity (i.e., those in a coma or... (shrink)

As improvements in neuroscience have enabled a better understanding of disorders of consciousness as well as methods to treat them, a hurdle that has become all too prevalent is the denial of coverage for treatment and rehabilitation services. In 2011, a settlement emerged from a Vermont District Court case, Jimmo v. Sebelius, which was brought to stop the use of an “improvement standard” that required tangible progress over an identifiable period of time for Medicare coverage of services. While the use (...) of this standard can have deleterious effects on those with many chronic conditions, it is especially burdensome for those in the minimally conscious state, where improvements are unpredictable and often not manifested through repeatable overt behaviors. Though the focus of this paper is on the challenges of brain injury and the minimally conscious state, which an estimated 100,000 to 200,000 individuals suffer from in the United States, the post-Jimmo arguments presented can and should have a broad impact as envisioned by the plaintiffs who brought the case on behalf of multiple advocacy groups representing patients with a range of chronic care conditions. (shrink)

The Dobbs opinion emphasizes that the state’s interest in the fetus extends to “all stages of development.” This essay briefly explores whether state legislators, agencies, and courts could use the “all stages of development” language to expand reproductive surveillance by using novel developments in consumer health technologies to augment those efforts.

The United States is distinct among high-income countries for its problem with gun violence, with Americans 25 times more likely to be killed by gun homicide than people in other high-income countries.1 Suicides make up a majority of annual gun deaths — though that gap is closing as homicides are on the rise — and the U.S. accounts for 35% of global firearm suicides despite making up only 4% of the world’s population.2 More concerning, gun deaths are only getting worse. (...) In 2021, firearm fatalities approached 50,000, the highest we have seen in at least 40 years.3 The increase in homicides in conjunction with lower crime overall further suggests an problem specifically with guns.4 As devastating as these deaths are, it does not come close to encompassing the mass toll of America’s gun violence epidemic — a toll that disproportionately impacts people of color, with the Black community suffering at the highest rates. A broader and more accurate view of what constitutes gun violence must become a part of the national discourse if we are going to develop effective strategies to combat this crisis.5. (shrink)

Progressive supranuclear palsy is a movement disorder with prominent tau neuropathology. Brain diseases with abnormal tau deposits are called tauopathies, the most common of which is Alzheimer's disease. Environmental causes of tauopathies include repetitive head trauma associated with some sports. To identify common genetic variation contributing to risk for tauopathies, we carried out a genome-wide association study of 1,114 individuals with PSP and 3,247 controls followed by a second stage in which we genotyped 1,051 cases and 3,560 controls for the (...) stage 1 SNPs that yielded P ≤ 10-3. We found significant previously unidentified signals associated with PSP risk at STX6, EIF2AK3 and MOBP. We confirmed two independent variants in MAPT affecting risk for PSP, one of which influences MAPT brain expression. The genes implicated encode proteins for vesicle-membrane fusion at the Golgi-endosomal interface, for the endoplasmic reticulum unfolded protein response and for a myelin structural component. © 2011 Nature America, Inc. All rights reserved. (shrink)

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

PurposeTo evaluate the relationship between intraocular straylight perception and: (i) contrast sensitivity (CS), (ii) halo size, and (iii) hazard recognition distance, in the presence and absence of glare.Subjects and methodsParticipants were 15 (5 female) ophthalmologically healthy adults, aged 54.6–80.6 (median: 67.2) years. Intraocular straylight (log s) was measured using a straylight meter (C-Quant; Oculus GmbH, Wetzlar, Germany). CS with glare was measured clinically using the Optovist I device (Vistec Inc., Olching, Germany) and also within a driving simulator using Landolt Cs. (...) These were presented under both static or dynamic viewing conditions, and either with or without glare. Hazard detection distance was measured for simulated obstacles of varying contrast. For this, the participant was required to maintain a speed of 60 km/h within a custom-built nighttime driving simulator. Glare was simulated by LED arrays, moved by cable robots to mimic an oncoming car’s headlights. Halo size (“halometry”) was measured by moving Landolt Cs outward originating from the center of a static glare source. The outcome measure from “halometry” was the radius of the halo (angular extent, in degrees visual angle).ResultsThe correlation between intraocular straylight perception, log s, and hazard recognition distance under glare was poor for the low contrast obstacles (leading/subdominant eye: r = 0.27/r = 0.34). Conversely, log CS measured with glare strongly predicted hazard recognition distances under glare. This was true both when log CS was measured using a clinical device (Optovist I: r = 0.93) and within the driving simulator, under static (r = 0.69) and dynamic (r = 0.61) conditions, and also with “halometry” (r = 0.70). Glare reduced log CS and hazard recognition distance for almost all visual function parameters.ConclusionIntraocular straylight was a poor predictor of visual function and driving performance within this experiment. Conversely, CS was a strong predictor of both hazard recognition and halo extent. The presence of glare and motion lead to a degradation of CS in a driving simulator. Future studies are necessary to evaluate the effectiveness of all above-mentioned vision-related parameters for predicting fitness to drive under real-life conditions. (shrink)

Ulrich Claesges, author of an important book on Husserl’s theory of the constitution of space, has edited the famous lectures of 1907 in which Husserl examines the phenomena of "thing" and "space." The introduction to this course has already been published as Die Idee der Phänomenologie. Claesges includes supplementary texts dating from 1906-1917, with one from 1926. It is in the introduction to this course that Husserl uses the transcendental reduction for the first time, and quite appropriately; for the (...) reduction is motivated by the peculiarities inherent in our experience of things. Husserl is persuaded by his analysis of this experience that he must turn to another kind of experience as the basis for philosophy. The reduction is mentioned only a few times in this volume, however. (shrink)

Deontic logicians try to fix the logically relevant aspects of the meanings of normative expressions and to reveal the logical relations between the corresponding sentences. From the very beginning, however, logicians and philosophers engaged in work on axiomatic Systems of deontic logic have faced so called problem of the "paradoxes of deontic logic". What is covered by this label are deontic formulae which are provable in logic harmless-looking axiomatic systems, but which seem to be clearly false on certain natural interpretations (...) providing them with that content. The problem of these paradoxes has been intensively discussed within the last decades. In the course of the debate, even quite fundamental assumptions of deontic logic have been newly questioned - for it seemed possible that involvement in paradoxes flows already from these very assumptions. In this work a new kind of formal semantics for a deontic language is developed. It embodies semantical considerations inspired by R.M. Hare's analyses of the meanings of normative expressions, a point of special importance being the representation within semantics of Hare's central concept of the universalizability of normative propositions. Those deontic formulae typically suspected of paradoxicality are shown by the author to be non-theorems of the logic thereby generated. Some of the customary formal semantics for deontic logic prove to be special cases of the semantics put forward, so that the author is in a position to explain the coming about of several typically paradoxical formulae: they become formal semantically valid just in case certain restrictions are introduced into the new semantic framework established. The book ends with the result that the assumptions hitherto taken as basic for deontic logic may be retained, at least as far as the paradoxes are concerned. For it has been shown that one can avoid the paradoxes without dropping those assumptions by use of a more intricate kind of formal semantics. The book will serve as an introduction to central questions of deontic logic, which, unsettled as they were, led to a rather sceptic attitude towards the prospects of this discipline. Nortmann offers a new semantics to overcome the problems. (shrink)

In this paper a new method, elimination of Skolem functions for monotone formulas, is developed which makes it possible to determine precisely the arithmetical strength of instances of various non-constructive function existence principles. This is achieved by reducing the use of such instances in a given proof to instances of certain arithmetical principles. Our framework are systems ${\cal T}^{\omega} :={\rm G}_n{\rm A}^{\omega} +{\rm AC}$ -qf $+\Delta$ , where (G $_n$ A $^{\omega})_{n \in {\Bbb N}}$ is a hierarchy of (weak) subsystems (...) of arithmetic in all finite types (introduced in [14]), AC-qf is the schema of quantifier-free choice in all types and $\Delta$ is a set of certain analytical principles which e.g. includes the binary König's lemma. We apply this method to show that the arithmetical closures of single instances of $\Pi^0_1$ -comprehension and -choice contribute to the growth of extractable bounds from proofs relative to ${\cal T}^\omega$ only by a primitive recursive functional in the sense of Kleene. In subsequent papers these results are widely generalized and the method is used to determine the arithmetical content of single sequences of instances of the Bolzano-Weierstraß principle for bounded sequences in ${\Bbb R}^d$ , the Ascoli-lemma and others. (shrink)

We all know that ships are safest in the harbor; but alas, that is not what ships are built for. They are destined to leave the harbor and to confront the challenges that are waiting beyond the harbor mole. A similar challenge confronts the practice of research. Research at work cannot play it safe and stay in whatever theoretical and methodological harbors in which it may have found shelter in the past. Still less can it examine and maintain its foundations (...) in the dry dock. Research is more like a ship that must be repaired on the open sea. Yet foundationalist ideas persist in the practice of research. Counter to what is often assumed, today’s dominating model for research--the fallibilist model of critical rationalism--has not really overcome the empirical foundationalism of earlier, positivist research practices. This paper analyses two major foundationalist traps that are currently in the upswing and work against reflective research practice. (shrink)

When young children learn to use language, they start to use their hands in co‐verbal gesturing. There are, however, considerable differences between children, and it is not completely understood what these individual differences are due to. We studied how children at 4 years of age employ speech and iconic gestures to convey meaning in different kinds of spatial event descriptions, and how this relates to their cognitive abilities. Focusing on spontaneous illustrations of actions, we applied a semantic feature (SF) analysis (...) to characterize combinations of speech and gesture meaning and related them to the child's visual‐spatial abilities or abstract/concrete reasoning abilities (measured using the standardized SON‐R test). Results show that children with higher cognitive abilities convey significantly more meaning via gesture and less solely via speech. These findings suggest that young children's use of cospeech representational gesturing is positively related to their mental representation and reasoning abilities. (shrink)

Open peer commentary on the article “Constructivist Model Building: Empirical Examples From Mathematics Education” by Catherine Ulrich, Erik S. Tillema, Amy J. Hackenberg & Anderson Norton. Upshot: I address the value of Ulrich et al.’s distinction between three types of second-order models. I conclude that their work contributes to the theorizing of adaptive teaching on the basis of a constructivist stance on knowing and learning.

This volume provides a clear and exhaustive exposition of Buddhist epistemology and logic, based on the works of classical thinkers such as Vasubandhu, Dinnaga,..

This paper examines Johann Ulrich Bilguer’s 1761 dissertation on the inutility of amputation practices, examining reasons for its influence despite its nonconformance to genre expectations. I argue that Bilguer’s narratives of patient suffering, his rhetorical likening of surgeons to soldiers, and his attention to the horrific experiences of war surgeons all contribute to the dissertation’s wide impact. Ultimately, the dissertation offers an example of affective rhetorics employed during the Enlightenment, demonstrating how bodies and environments—those “ambient rhetorics” made visible in (...) a text—can contribute to an analysis of genre deviations and widen the scope of genre studies. (shrink)

Many religious people are alarmed about features of the current age - violence in the media, a pervasive hedonism, a marginalization of religion, and widespread abortion. These concerns influence politics, but just as there should be a separation between church and state, so should there be a balance between religious commitments and secular arguments calling for social reforms. Robert Audi offers a principle of secular rationale, which does not exclude religious grounds for action but which rules out restricting freedom except (...) on grounds that any rational citizen would accept. The book describes the essential commitments of free democracy, explains how religious and secular moral considerations can be integrated to facilitate co-operation in a world of religious pluralism, and proposes ideals of civic virtue that express the mutual respect on which democracy depends. Audi offers a balanced and sophisticated treatment of the relations between religion and politics in a modern, secular society. (shrink)

A collection of essays from some of the world's leading intellectual historians, representing an international spectrum of research into the history of philosophy, intellect, science and music. This collection of essays addresses, in specific historical ways and from particular disciplinary standpoints, the problem of knowledge and what used to be called the classification of the sciences. What is, or what passes for, knowledge? What are its divisions, and how should they be related? Who possesses this knowledge, and to what uses (...) has it been put? How is it transmitted, and how can its history be understood and written? Ranging across the epistemological barrier formed by the revolution of modern science, these contributions inquire into the changing disciplinary patterns of the tumultuous times between the renaissance and the enlightenment, that saw the fragmentation of old ideals and the creation of European modernity. Contributors: Donald R. Kelley, Ann Blair, Paul Nelles, Constance Blackwell, Ulrich Schneider, Martin Mulsow, J.B. Schneewind, Donald Verene, Peter Miller, Ann Moyers, Michael Seidler, Anthony Pagden, Paula Findlen, Anthony Grafton, Heikki Mikkeli, Nicholas Jardine, Londa Schiebinger. (shrink)

Following promulgation of the Nuremberg code in 1947, the ethics of research on human subjects has been a challenging and often contentious topic of debate. Escalation in the use of research participants in low-income countries over recent decades , has intensified the debate on the ethics of international research and led to increasing attention both to exploitation of vulnerable subjects and to considerations of how the 10:90 gap in health and medical research could be narrowed. In 2000, prompted by the (...) discussions over several years that led to the US NIH launching a capacity building programme on research ethics for members of research ethics committees in developing countries, we advanced a ‘new look’ for the ethics of international research.1 Since then progress has been made on several fronts.First, our ideas—considered somewhat radical and impractical at the time—have been provocatively addressed by scholars who have either contested them or advanced similar conceptions of what obligations international researchers have to research participants and communities in low income countries before, during and after clinical trials. Second, those researchers who have been sympathetic to our ideas have either endeavoured to put these into practice or have investigated the feasibility of doing so. Third, the intractability of the 10/90 gap and the escalation of interest in global health have sensitised many to the need to amplify the uptake of these ideas in practice.Here, we briefly review the conceptual and practical developments in international research ethics. While much conceptual progress has been made (and the concepts are now appearing …. (shrink)

This article revisits theologian Ulrich Duchrow’s three-decade-old use of the Protestant notion of status confessionis to denounce the capitalist global economy. Scholars quickly dismissed Duchrow’s argument; however, philosopher Thomas Pogge has developed a remarkable “negative duty”—based critique of the current global economic order that might help revitalize Duchrow’s position. The article argues that sound reasons exist for the churches to declare the contemporary world economy a—provisionally termed—status confessionis minor. After explaining the inadequacy of Duchrow’s original position and summarizing Pogge’s (...) account, the article develops a twofold argument. First, Pogge’s in-depth inquiry into the world economy gives Duchrow’s call for a status confessionis a strong yet narrowing economic foundation. Second, to declare the world economy a status confessionis minor is theological-ethically justifiable if the limited though indispensable “prophetic” significance of doing so is acknowledged. Thus, Duchrow’s approach is justified, but only partially. (shrink)

In 1931 the mathematical logician Kurt Godel published a revolutionary paper that challenged certain basic assumptions underpinning mathematics and logic. A colleague of Albert Einstein, his theorem proved that mathematics was partly based on propositions not provable within the mathematical system and had radical implications that have echoed throughout many fields. A gripping combination of science and accessibility, Godel’s Proof by Nagel and Newman is for both mathematicians and the idly curious, offering those with a taste for logic and philosophy (...) the chance to satisfy their intellectual curiosity. (shrink)

Although social scientists have identified diverse behavioral patterns among children from dissimilarly structured families, marketing scholars have progressed little in relating family structure to consumption-related decisions. In particular, the roles played by members of single-mother families—which may include live-in grandparents, mother’s unmarried partner, and step-father with or without step-sibling(s)—may affect children’s influence on consumption-related decisions. For example, to offset a parental authority dynamic introduced by a new stepfather, the work-related constraints imposed on a breadwinning mother, or the imposition of adult-level (...) household responsibilities on children, single-mother families may attend more to their children’s product preferences. -/- Without a profile that includes socio-economic, behavioral, and psychological aspects, efficient and socially responsible marketing to single-mother households is compromised. Relative to dual-parent families, single-mother families tend to have fewer resources and less buying power, children who consume more materialistic and compulsively, and children who more strongly influence decision making for both own-use and family-use products. Timely research would ensure that these and other tendencies now differentiate single-mother from dual-parent families in ways that marketers should address. Hence, our threefold goal is (1) to consolidate and highlight gaps in existing theory applied to studying children’s influence on consumption-related decision making in single-mother families, and (2) to propose a hybrid framework that merges two theories conducive to such research, and (3) to identify promising research propositions for future research. (shrink)

Human-eyelid conditioning was the principal source of information on Pavlovian conditioning, especially human, in the 1950s and 1960s, but it suffered a sharp decline in productivity, beginning in the late 1960s. The present article treats the decline as a case study with potential implications concerning the survival contingencies of research specialties. We make use of questionnaire data from eyelid-conditioning researchers and examine a variety of publication, topic-of-investigation, and institutional data to identify the major factors in the decline of human-eyelid conditioning.

Wisely, the authors begin this book by describing it as a polemic. They argue that most contemporary analytic metaphysics is a waste of time and resources since contemporary ‘neo-scholastic’ metaphysical theorizing cannot hope to attain objective truth given its penchant for making a priori claims about the nature of the world which are backed up by appeal to intuition. In engaging in this activity, metaphysicians have, the authors claim, abandoned hope of locating any interesting connection between their metaphysical pronouncements and (...) how our best empirical theories describe the world. Moreover, the success attained by empirical science just cannot be matched by metaphysical theorizing and so, faced with this asymmetry, empirical science wins: a priori metaphysical theorizing must give way to a naturalistic form of metaphysics, a positive account of which the authors attempt to elucidate in the second and third, rather lengthy chapters of the book.The first chapter consists of a statement of the authors’ negative view, a vigorous, sustained and sometimes withering attack upon contemporary a priori metaphysics. Most ire is reserved for those who indulge in what the authors call ‘pseudo-scientific metaphysics’; that is, those who pay lip service to keeping their metaphysical speculation in tune with physics, only to constrain their ontology in such a way that the entities and processes within it do not even play a role in current physical theory, or are in straightforward contradiction with it. Much philosophy of science and scientific metaphysics is too superficial and simplistic to deserve the name and bears more relation to ‘the philosophy of “A” Level chemistry’. The guilty in this respect include David Lewis, Jaegwon Kim, Jonathan Lowe, Donald Davidson, Jerry Fodor, Crawford Elder, Trenton Merricks among …. (shrink)

The discovery of selective associability of cues in classical conditioning has often been treated as an embarrassment to Pavlov, because he has been represented as a proponent of the "equivalence of associability of cues." According to that doctrine, except for the influence of differences in stimulus intensity, all environmental stimuli are equally susceptible to becoming conditioned stimuli if they are arranged in a suitable time-relation to any effective unconditioned stimulus . The current paper asks whether Pavlov explicitly made such a (...) claim and, if not, whether he could have endorsed equivalence of associability. Scientific controversy, the role that "the classics" play in scientific specialties, and the emblematic standing of the founding figures of a discipline or specialty constitute a framework for discussion of Pavlov's stand on the equivalence of associability. (shrink)

From its earliest beginnings, American conditioning research using human subjects had to deal with the possibility that subjects might voluntarily control the reaction that the experimenter attempts to condition, with the result that voluntary control contaminates the study of conditioning in humans. A preliminary solution to the problem was achieved around 1940, ending the time frame of this survey. This article provides an historical survey of the conceptual background of the opposition of volition and reflexes; describes manifestations of the problem (...) in conditioning research; and critically examines earlier efforts to solve the problem as well as the presumptive solution that disposed of the issue by 1940. Lessons from this story are adduced. (shrink)

The operation of voluntary processes can contaminate the study of Pavlovian conditioned responses in humans. The problem of voluntary control had apparently been solved by about 1940, particularly in human eyelid conditioning. Nonetheless, the problem returned in the early 1950s, calling forth a variety of methodological procedures for removing voluntary responses and/or voluntary-responding subjects from eyelid-conditioning data. During the 1960s, disagreement arose regarding the efficiency and comparability of alternative data-correction procedures; the rationale for data-correction; and whether, and under what experimental (...) conditions, eyelid-conditioning data ought to be corrected for voluntary responding. Circumstances that supported voluntary-response methodology are described, and points at which the methodology conflicted with the technical background of Pavlovian conditioning are noted. A diagnosis is offered for the failure, between 1950 and 1980, to solve again the problem of volition. (shrink)