Background: Since the passage of the Patient Self-Determination Act, numerous policy mandates and institutional measures have been implemented. It is unknown to what extent those measures have affected end-of-life care, particularly with regard to the do-not-resuscitate order.Methods: Retrospective cohort study to assess associations of the frequency and timing of DNR orders with advance directive status, patient demographics, physician’s specialty and extent of documentation of discussion on end-of-life care.Results: DNR orders were more frequent for patients on a medical service than on (...) a surgical service and were made earlier in the hospital stay for medicine than for surgical patients . 22.18% of all patients had some form of an advance directive in their chart, yet this variable had no impact on the frequency or timing of DNR ordering. Documentation of DNR discussion was significantly associated with the frequency of DNR orders and the time from DNR to death .Conclusions: The physician’s specialty continues to have a significant impact on the frequency and timing of DNR orders, while advance directive status still has no measurable impact. Additionally, documentation of end-of-life discussions is significantly associated with varying DNR ordering rates and timing. (shrink)

Is there a link between how a firm manages its internal and external stakeholders? More specifically, are firms that give employees stock ownership and more say in running the enterprise more likely to engage with external stakeholders? This study seeks to answer these questions by elaborating on mechanisms that link employees to external stakeholders, such as the community, suppliers, and the environment. It tests these relationships using a sample of 347 private, mostly small-to-medium size firms, which completed a stakeholder impact (...) assessment organized by the non-profit B Lab. The results support the hypotheses that both employee ownership and employee involvement are positively associated with external stakeholder engagement. Further, we found that certification plays a role, as employee ownership contributes to external stakeholder engagement only in certified B Corporations, and not in firms that merely completed the B Lab Impact assessment. Our findings have import for stakeholder engagement frameworks, as we show that there is interplay between internal employee stakeholders and external stakeholders that may be important to overall firm–stakeholder management. (shrink)

Important features of the self-concept can be located outside of the individual and inside close or related others. The authors use this insight to reinterpret data previously said to support the empathy-altruism model of helping, which asserts that empathic concern for another results in selflessness and true altruism. That is, they argue that the conditions that lead to empathic concern also lead to a greater sense of self-other overlap, raising the possibility that helping under these conditions is not selfless but (...) is also directed toward the self. In 3 studies, the impact of empathic concern on willingness to help was eliminated when oneness--a measure of perceived self-other overlap--was considered. Path analyses revealed further that empathic concern increased helping only through its relation to perceived oneness, thereby throwing the empathy-altruism model into question. The authors suggest that empathic concern affects helping primarily as an emotional signal of oneness. (shrink)

Although activated spinal cord glia contribute importantly to neuropathic pain, how nerve injury activates glia remains controversial. It has recently been proposed, on the basis of genetic approaches, that toll-like receptor 4 may be a key receptor for initiating microglial activation following L5 spinal nerve injury. The present studies extend this idea pharmacologically by showing that TLR4 is key for maintaining neuropathic pain following sciatic nerve chronic constriction injury. Established neuropathic pain was reversed by intrathecally delivered TLR4 receptor antagonists derived (...) from lipopolysaccharide. Additionally, -naltrexone, -naloxone, and -naloxone, which we show here to be TLR4 antagonists in vitro on both stably transfected HEK293-TLR4 and microglial cell lines, suppressed neuropathic pain with complete reversal upon chronic infusion. Immunohistochemical analyses of spinal cords following chronic infusion revealed suppression of CCI-induced microglial activation by -naloxone and -naloxone, paralleling reversal of neuropathic pain. Together, these CCI data support the conclusion that neuron-to-glia signaling through TLR4 is important not only for initiating neuropathic pain, as suggested previously, but also for maintaining established neuropathic pain. Furthermore, these studies suggest that the novel TLR4 antagonists -naloxone and -naloxone can each fully reverse established neuropathic pain upon multi-day administration. This finding with -naloxone is of potential clinical relevance. This is because -naloxone is an antagonist that is inactive at the -opioid selective receptors on neurons that produce analgesia. Thus, these data suggest that -opioid antagonists such as -naloxone may be useful clinically to suppress glial activation, yet -opioid agonists suppress pain. (shrink)

1 Evidence-based policy requires researchers to provide the answers to ecological questions that are of interest to policy makers. To find out what those questions are in the UK, representatives from 28 organizations involved in policy, together with scientists from 10 academic institutions, were asked to generate a list of questions from their organizations. 2 During a 2-day workshop the initial list of 1003 questions generated from consulting at least 654 policy makers and academics was used as a basis for (...) generating a short list of 100 questions of significant policy relevance. Short-listing was decided on the basis of the preferences of the representatives from the policy-led organizations. 3 The areas covered included most major issues of environmental concern in the UK, including agriculture, marine fisheries, climate change, ecosystem function and land management. 4 The most striking outcome was the preference for general questions rather than narrow ones. The reason is that policy is driven by broad issues rather than specific ones. In contrast, scientists are frequently best equipped to answer specific questions. This means that it may be necessary to extract the underpinning specific question before researchers can proceed. 5 Synthesis and applications. Greater communication between policy makers and scientists is required in order to ensure that applied ecologists are dealing with issues in a way that can feed into policy. It is particularly important that applied ecologists emphasize the generic value of their work wherever possible. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.

Understanding Wisdom Literature: Conflict and Dissonance in the Hebrew Text. By David Penchansky. Grand Rapids, Mich.: William B. Eerdmans Publishing Co., 2012. Pp. xii + 120. $20.

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:242 HISTORY OF PHILOSOPHY his political and religious predispositions prodded him to demonstrate that the roots of modern science were in the Christian Middle Ages. Sarton's particular foibles are best understood by referring them to his pacifist commitments and the moralistic assumption that the values of science are transferable to other human endeavors. Categories such as inductivism, conventionalism and Popperianism are of little help in gaining historical understanding. For (...) this, they are in fact Platonic ideals which have little heuristic value. I would venture that a truly historical historiography of science would aid us in spotting errors in the past and help us in the future. My guess is that a good analysis would reveal a major source of trouble to have stemmed from preconceived notions which the history of science was meant to illustrate. Surely some of them have been philosophical in character, and even Baconian or conventionalist. But until recent times, most of these preconceptions have stemmed from religious, nationalistic, or personal motivations, or from scientists who wanted support for a particular concept. I agree with Agassi only in the suggestion that a parti pris was at the root of our troubles. Why, then, substitute a Popperian preconception for a conventionalist one? Why not, on the contrary, combat their distorting influence and reduce their impact? This is in fact what has happened in recent times. As the history of science has fallen into the hands of a gradually organized profession, the blatant motivations --of any type--which colored past historical writings have slowly receded. By a constant and critical confrontation of opposing views among specialists, the purpose for examining the history of science has slowly been transformed. The older external motivations have given way to an interest in the subject for its own sake and a gradual transformation has been in the making for the last few decades. As happens in other human endeavors, professionalization has already raised the standards in the discipline and there is every reason to think it will continue to do so in the future. We need not really be as pessimistic as Agassi, nor embrace his particular salvation. ROGEa HAm~ University o] Cali]ornia, Berkeley A MEDIEVAL ANALYSIS OF INFINITY IN THE COURSEof arguing that time must have had a beginning, St. Bonaventure (1221-74) put forward a demonstration which in some ways seems to anticipate Cantor's definition of infinity.1 Bonaventure pointed out that, if the world were infinitely old, then there would have been an infinite number of annual revolutions of the sun around the ecliptic. But during each such period there occur (roughly) twelve revolutions of the moon, i.e. lunar months or lunations. Thus there would be one infinity which was twelve times another--which, says Bonaventure, is impossible. This attempted proof might be formulated as the following For other adumbrationsof this definition,see I. Thomas,"A TwelfthCentury Paradoxof the Infinite,"Journal o] Symbolic Logic, XXIII (1958), 133-134, and W. & M. Kneale, The Development of Logic (Oxford,1962),p. 440. NOTES AND DISCUSSIONS 243 reductio ad absurdum, in which a revolution of the sun is specified as the period between successive vernal equinoxes. If there could be an infinite set of past lunations, then clearly it could be put in a one-to-one correspondence with a proper sub-set of itself--viz., with the set of past lunar months during which vernal equinoxes occurred. But this consequence is preposterous; no set could be so correlated with its own sub-set. Therefore the set of past lunar months cannot be infinite, and the world must have had a beginning. The passage, which is found in Bonaventure's commentary on the Sentences of Peter Lombard, reads as follows :2 Si mundus est aeternus, revolutiones solis in orbe suo sunt infmitae ; rursus, pro una revolutions solis necesse est fuisse duodecim ipsius lunae: ergo plus revoluta est luna quam sol; et sol infinities: ergo infinitorum ex ea parle, qua infinita sunt, est reperire excessum. Hoe autem est impossibile : ergo etc. PA~-r~asoN BROWN Harpur College, State University o] New York Sententiarum L/b. H, Dist. I, P.I, Art. I, Quaest. II, as found in S. Bonaventurme, Opera Omnla... (shrink)

Boghossian has argued that Putnam's externalism is incompatible with privileged access, i.e., the claim that a subject can have nonempirical knowledge of her thought contents ('What the externalist can know a priori', PAS 1997). Boghossian's argument assumes that Oscar can know a priori that (1) 'water' aims to name a natural kind; and (2) 'water' expresses an atomic concept. However, I show that if Burge's externalism is correct, then these assumptions may well be false. This leaves Boghossian with two options: (...) (a) (heroically) to show that Burge's externalism is false; or (b) to reformulate the argument such that it does not require the two assumptions in question. I suggest one way of reformulating the argument. (shrink)

Richard Taylor was born in Charlotte, Michigan on 5 November 1919. He received his A. B. from the University of illinois in 1941, his M. A. from Oberlin College in 1947, and his Ph. D. from Brown University in 1951. He has been William H. P. Faunce Professor of Philosophy at Brown University, Professor of Philosophy (Graduate Faculties) at Columbia University, and Professor of Philosophy at the University of Rochester. He is the author of about fifty articles and (...) of five philosophical books. This volume consists of essays presented to Richard Taylor on the occa sion of his sixtieth birthday. Some of the contributors have been Taylor'S students; some have been his colleagues; and all have been, and continue to be, his admirers. I have made several attempts to articulate what it is I (I would not presume to speak for anyone else) admire about Richard Taylor: (1) There is a particular 'flavor' to Taylor's philosophical writing and con versation that is wholly delightful. Like any other flavor, it can be tasted and enjoyed and remembered but never adequately described. (If there should be someone who has picked up this book who does not know what I mean, I recommend that he read the chapter on 'God' in Taylor's Metaphysics. ) (2) Taylor is a masterful dialectician. (shrink)

In this paper, I examine one central strand of Lackey’s The Epistemology of Groups, namely her account of group justified belief and the puzzle cases she uses to develop it. Her puzzle cases involve a group of museum guards most of whom justifiably believe a certain claim but do so on different bases. Consideration of these cases leads her to hold that a group justifiably believes p if and only if (1) a significant proportion of its operative members (a) justifiably (...) believe p on (b) bases that are consistent when combined and (2) the total evidence which members of the group do and should have had sufficiently support p. I question her judgement about these cases and condition 2, by examining the nature of group evidence as well as ‘transmission’ principles governing the relationship between the epistemic standing of members of a group and the group itself. (shrink)

Books reviewed in this article: The Anchor Bible Dictionary. Edited by David Noel Freedman with Gary A. Herion, David F. Graf, John David Pleins. The Gospel of Matthew. By Daniel J. Harrington. Paul: An Introduction to his Thought. By C. K. Barrett. A Radical Jew: Paul and the Politics of Identiy. By Daniel Boyarin. New Testament Theology. By G. B. Caird, completed and edited by L. D. Hurst. The Fatherhood of God from Origen to Athanasius. By Peter Widdicombe. Dieu et (...) le Christ selon Grégoire de Nysse. By Bernard Pottier. Eucharistic Presence: A Study in the Theology of Disclosure. By Robert Sokolowski. Theological Hermeneutics: Development and Significance. By Werner Jeanrond. Theologie aus Efahrung der Gnade. Annäherungen an Karl Rahner: Edited by Mariano Delgado and Mathias‐Lutz Bachmann. Bernhard Welte's Fundamental Theological Approach to Christology.. By Anthony J. Godzieba. Sacred Identity: Exploring a Theology of the Person. By Jane Kopas. A Salvation Audit. By Colin Grant. Medical Ezhics: Sources Of Catholic Teachings, Second Edition. Edited by Kevin O'Rourke and Philip Boyle. Mission and Conversion: Proselytizing in the Religious History of the Roman Empire. By Martin Goodman. Literacy and Power in the Ancient World. Edited by Alan K. Bowman and Greg Woolf. St Cyril of Alexandria: The Christological Controversy. Its History, Theology and Texts. By John A. McGuckin. Ambrose of Milan: Church and Court in a Christian Capital. By Neil B. McLynn. Basil of Cuesareu. By Philip Rousseau. Augustine. By Mary T. Clark. Irenaeus. By Dennis Minns. Divine Heiress: The Virgin Mary and the Creation of Christian Constantinople. By Vasiliki Limberis. The Irish Tradition in Old English Literature. By Charles D. Wright. Relics, Apocalypse and the Deceils of History: Ademar of Chabannes, 989–1034. By Richard Landes. Huguccio: The Life, Works, and Thought of a Twelfth‐Centuy Jurist. By Wolfgang P. Müller. The Presence of God: A History of Western Christian Mysticism, Volume II: The Growth of Mysticism. By Bernard McGinn. Preaching the Crusades: Mendicant Friars and the Cross in the Thirteenth Century. By Christoph T. Maier. Mary Ward: A World in Contemplation. By Henriette Peters. The Letters of Teilhard de Chardin and Lucile Swan. Edited by Thomas M. King and Mary Wood Gilbert. Pseudo‐Marry: By John Donne. Edited, with an Introduction and Commentary, by Anthony Raspa. Donne and the Politics of Conscience in Early Modern England. By M. L. Brown. The Caroline Captivity of the Church: Charles 1 and the Remoulding of Anglicanism. By Julian Davies. Érudition et religion aux XVIIe et XVIIIe siécles. By Bruno Neveu. Cardinal Lavigerie: Churchman, Prophet and Missionary. By François Renault. Dom Columba Marmion: A Biography By Mark Tierney. Christian Mission in the Twentieth Century. By Timothy Yates. Religion in Africa: Experience and Expression. Edited by Thomas D. Blakely, Walter E. A. van Beek and Dennis Thomson. (shrink)

In this essay, I read Stuart Hall’s idea of “politics without guarantees” as meaning that all concepts are saturated with history and that no use of a concept can prevent it from being co-opted. The contribution of this reading is that it shifts the task of critical theory: if all concepts carry limitations and can be used to advance domination, then critical theorists need not search for pure concepts or worry about how to prevent our concepts from being captured. Instead, (...) our task is to strategically leverage always already imperfect concepts with a view toward shared political goals. For an example of this kind of critical theory, I look to W. E. B. Du Bois’s uses of “human,” “humanity,” and “human rights” in Black Reconstruction, which I suggest were informed by how he came to understand “humanity” in John Brown. (shrink)

Rogers, C. R. and Skinner, B. F. Some issues concerning the control of human behavior.--Broudy, H. S. Didactics, heuristics, and philetics.--Craig, R. An analysis of the psychology of moral development of Lawrence Kohlberg.--Scudder, J. R., Jr. Freedom with authority: a Buber model for teaching.--Hook, S. Some educational attitudes and poses.--Strike, K. A. Freedom, autonomy, and teaching.--Elkind, D. Piaget and Montessori.--Raywid, M. A. Irrationalism and the new reformism.--Doll, W. E., Jr. A methodology of experience: the process of inquiry.--Neff, F. C. Competency-based (...) teaching and trained fleas.--Brown, A. "What could be bad?" Some reflections on the accountability movement. (shrink)

This letter to the editor responds to commentaries in the September‐October 2021issue of the Hastings Center Report by Douglas B. White and Bernard Lo, by Govind Persad, and by Virginia A. Brown, which were themselves responding, in part, to the article “Life‐Years and Rationing in the Covid‐19 Pandemic: A Critical Analysis,” by MaryKatherine Gaurke, Bernard Prusak, Kyeong Yun Jeong, Emily Scire, and Daniel P. Sulmasy.

A hippocampal patient is described who shows preserved item recognition and simple recognition-based recollection but impaired recall and associative recognition. These data and other evidence suggest that contrary to Aggleton & Brown's target article, Papez circuit damage impairs only complex item-item-context recollection. A patient with perirhinal cortex damage and a delayed global memory deficit, apparently inconsistent with A&B's framework, is also described.

The United States District Court of Kansas, in Gudenkauf v. Stauffer, Znc., granted the defendants motion for summary judgment for the plaintiff's claims of pregnancy-related discrimination under the Americans with Disabilities Act and the Family and Medical Leave Act of 1993, but the court denied a similar motion for the plaintiff's claim under the Pregnancy Discrimination Act. The court found summary judgment to be appropriate for the ADA claim based on its finding that the plaintiff's pregnancy did not constitute an (...) impairment as required by the statute; as for the FMLA claim, it determined that the defendants failure to grant the plaintiff's leave request did not violate the statute. However, the court determined that summary judgment was inappropriate for the PDA claim because of material questions of fact about whether the defendant had acted with discriminatory intent.In considering the motions for summary judgment, the court accepted the following facts as incontrovertible. Plaintiff Michaela Gudenkauf worked for the defendant Stauffer, Inc. (shrink)

The central idea of this paper is that forming the black hole horizon is attended with the transition from the classical regime of evolution to the quantum one. We offer and justify the following criterion for discriminating between the classical and the quantum: creations and annihilations of particle-antiparticle pairs are impossible in the classical reality but possible in the quantum reality. In flat spacetime, we can switch from the classical picture of field propagation to the quantum picture by changing the (...) overall sign of the spacetime signature. To describe a self-gravitating object at the final stage of its classical evolution, we propose to use the Foldy–Wouthuysen representation of the Dirac equation in curved spacetimes, and the Gozzi classical path integral. In both approaches, maintaining the dynamics in the classical regime is controlled by supersymmetry. (shrink)