Changes in healthcare financing increasingly rely upon patient cost-sharing to control escalating healthcare expenditures. These changes raise new challenges for physicians that are different from those that arose either under managed care or traditional indemnity insurance. Historically, there have been two distinct bases for arguing that physicians should not consider costs in their clinical decisions—an “aspirational ethic” that exhorts physicians to treat all patients the same regardless of their ability to pay, and an “agency ethic” that calls on physicians to (...) be trustworthy advisors to their patients. In the setting of greater patient cost-sharing, physicians' aspiration and agency roles increasingly conflict. Satisfactorily navigating the new terrain of consumer-driven healthcare requires physicians to consider these two roles and how they can best be reconciled so as to maximize quality of care while respecting the heterogeneity of patients' financial resources and willingness to pay. (shrink)

Both realist and anti-realist accounts of natural kinds possess prima facie virtues: realists can straightforwardly make sense of the apparent objectivity of the natural kinds, and anti-realists, their knowability. This paper formulates a properly anti-realist account designed to capture both merits. In particular, it recommends understanding natural kinds as ‘categorical bottlenecks,’ those categories that not only best serve us, with our idiosyncratic aims and cognitive capacities, but also those of a wide range of alternative agents. By endorsing an ultimately subjective (...) categorical principle, this view sidesteps epistemological difficulties facing realist views. Yet, it nevertheless identifies natural kinds that are fairly, though not completely, stance-independent or objective. (shrink)

Among the factors necessary for the occurrence of some event, which of these are selectively highlighted in its explanation and labeled as causes — and which are explanatorily omitted, or relegated to the status of background conditions? Following J. S. Mill, most have thought that only a pragmatic answer to this question was possible. In this paper I suggest we understand this ‘causal selection problem’ in causal-explanatory terms, and propose that explanatory trade-offs between abstraction and stability can provide a principled (...) solution to it. After sketching that solution, it is applied to a few biological examples, including to a debate concerning the ‘causal democracy’ of organismal development, with an anti-democratic (though not a gene-centric) moral. (shrink)

Mature representations of number are built on a core system of numerical representation that connects to spatial representations in the form of a ‘mental number line’. The core number system is functional in early infancy, but little is known about the origins of the mapping of numbers onto space. Here we show that preverbal infants transfer the discrimination of an ordered series of numerosities to the discrimination of an ordered series of line lengths. Moreover, infants construct relationships between individual numbers (...) and line lengths that vary positively, but not between numbers and lengths that vary inversely. These findings provide evidence for an early developing predisposition to relate representations of numerical magnitude and spatial length. A central foundation of mathematics, science and technology therefore emerges prior to experience with language, symbol systems, or measurement devices. (shrink)

Apart from statics, about which I shall say nothing, there were three chief centres of interest in mechanics in the 1660's: the motions of pendulums; the laws of motion; the free fall of heavy bodies and the motion of projectiles.In the first the influence of Huygens was dominant; I have placed it so because it was of very lively contemporary concern. The second area of interest descended partly from Galileo and partly from Descartes; the third from Galileo alone. Perhaps one (...) should consider adding a fourth area, the investigation of central forces, but this in fact did not attract much attention as yet. (shrink)

This paper offers a critique of the emphasis on anti-futurity and failure prevalent in contemporary queer theory. I argue that responsibility for climate change requires commitments to futures that are queer, crip, and feminist. A queer crip feminist commitment to the future is, I contend, informed by radical hope.

This article introduces the Special Issue on ‘Interpretivism and the English School of International Relations’. It distinguishes between what we term the interpretivist and structuralist wings of...

One of the most basic functions of human language is to convey who did what to whom. In the world's languages, the order of these three constituents (subject [S], verb [V], and object [O]) is uneven, with SOV and SVO being most common. Recent experiments using experimentally elicited pantomime provide a possible explanation of the prevalence of SOV, but extant explanations for the prevalence of SVO could benefit from further empirical support. Here, we test whether SVO might emerge because (a) (...) SOV is not well suited for describing reversible events (a woman pushing a boy) and (b) pressures to be efficient and mention subjects before objects conspire to rule out many other alternatives. We tested this by asking participants to describe reversible and non‐reversible events in pantomime, and we instructed some participants to be consistent in the form of their gestures and to teach them to the experimenter. These manipulations led to the emergence of SVO in speakers of both English (SVO) and Turkish (SOV). (shrink)

In this paper, we present an ethical and strategic approach to managing organizational crises. The proposed crisis management model (1) offers a new approach to guide an organization’s strategic and ethical response to crisis, and (2) provides a two-by-two framework for classifying organizational crises. The ethically rational approach to crisis draws upon strategic rationality, crisis, and ethics literature to understand and address organizational crises. Recent examples of corporate crises are employed to illustrate the theoretical claims advanced. Finally, the paper provides (...) guidelines for a morally optimal outcome for the organization and its stakeholders. (shrink)

Clinical ethics committees aim to resolve conflict, facilitate communication and ease moral distress in health care. Dialogue in committee discussions is complex and involves a balance between implicitly and explicitly expressed values of patients, families and professionals. Evaluating effectiveness and concrete outcomes is challenging and most studies focus on broad benefits such as quality of care and reduction of unnecessary or unwanted treatments. In this paper we propose ‘physician satisfaction’ as a valuable outcome. We refer to the clinical ethics approach (...) followed at one large paediatric hospital in Australia, propose reasons for the often-expressed feeling of satisfaction and discuss why this feeling matters. We conclude that physician satisfaction is a valid measure of an effective ethics consultation because it implies the person has been listened to and respected by others, and has perhaps developed greater understanding of and insights into their own work and values, and those of others. (shrink)

The upshot of this article is that dance functions in Irigaray’s work in the following three ways: as (1) a symbol of a more positive comportment for heterosexual relationships; (2) an indication that the ambivalence in Irigaray’s work is self-consciously strategic; and (3) an example that teases apart the concepts of negative and positive mimesis, specifically by fleshing out the latter. More concisely, dance constitutes a figure of positive ambivalence (whether between heterosexual lovers, participants in a philosophical dialogue, or aspects (...) of a concept) as self-mimetic, curved silvering in the pursuit of social justice. (shrink)

While acknowledging a certain affinity between his own thought and the Vedanta concept of a world-soul or universal spirit, Josiah Royce nevertheless locates this concept primarily in what he terms the Second Conception of Being—Mysticism. In his early magnum opus, The World and the Individual, Royce utilizes aspects of the Upanishads in order to flesh out his picture of the mystical understanding of and relationship to being. My primary concern in the present investigation is to introduce some nuance into Royce’s (...) conception of Indian thought, which may then serve to suggest similar possibilities for nuance for Royce’s conception of the Absolute. I will attempt to do in two primary ways: first, I will consider Royce’s use of Indian thought via the Upanishads in explicating his second historical conception of Being. I will then turn briefly to Emerson’s poem ‘Brahma’ and the Bhagavad Gita to see if a certain reversal that occurs in both places problematizes Royce’s depiction of the universal spirit in Indian thought as well as opens up new possibilities for Royce’s own Absolute. (shrink)

The goal of this small book and accompanying DVD is to help you to have a better experience in your laboratory by getting you to step back and take a global look at what is involved in making progress in the laboratory.

How can the development of ideas in a scientific field be studied over time? We apply unsupervised topic modeling to the ACL Anthology to analyze historical trends in the field of Computational Linguistics from 1978 to 2006. We induce topic clusters using Latent Dirichlet Allocation, and examine the strength of each topic over time. Our methods find trends in the field including the rise of probabilistic methods starting in 1988, a steady increase in applications, and a sharp decline of research (...) in semantics and understanding between 1978 and 2001, possibly rising again after 2001. We also introduce a model of the diversity of ideas, topic entropy, using it to show that COLING is a more diverse conference than ACL, but that both conferences as well as EMNLP are becoming broader over time. Finally, we apply Jensen-Shannon divergence of topic distributions to show that all three conferences are converging in the topics they cover. (shrink)

Climate action is conventionally framed in terms of overcoming epistemic and practical disagreement. An alternative view is to treat people’s understandings of climate change as fundamentally pluralistic and to conceive of climate action accordingly. This paper explores this latter perspective through a framework of philosophical psychology, in particular Bernard Williams’s distinction between internal and external reasons. This illuminates why the IPCC’s framework of ‘Reasons for Concern’ has an inefficacious relationship to people’s concerns and, hence, why additional reason giving is required. (...) Accordingly, this paper recommends a model of truthful persuasion, which acknowledges the plurality of people’s motivations and sincerely strives to connect the facts of climate change to people’s subjective motivational sets. (shrink)

Written in an engaging narrative style these philosophical investigations undermine racist hierarchies along with false natualistic conceptions of the meanings of race and universalistic understandings of gender, by considering whiteness as it shapes and is infused by gender, class, sexuality, and culture. Central to this project are questions about how it is that culture and the state create such a wide range of different people who understand themselves as white. The essays collected here discuss how one learns to be a (...) good white Southern woman, what it means to pass as white, and whether there really is a dilemma that accompanies white privilege. (shrink)

Indigenous communities have always cultivated social studies learning that is interactive, dynamic, and integrated with traditional knowledges. To confront the assimilative and deculturalizing education that accompanied European settlement of the Americas, Montana has adopted Indian Education for All (IEFA). This case study evaluates the Digital Storywork Partnership (DSP), which strives to advance the goals of IEFA within and beyond the social studies classroom through community-centered research and filmmaking. Results demonstrate the potential for DSP projects to advance culturally revitalizing education, community (...) connectedness, and identity-development. The DSP offers a model for social studies education that is not only culturally affirming and revitalizing for Indigenous communities, but also holds potential for use in all communities. We conclude with recommendations for educators, scholars, and community members engaged in similar efforts. (shrink)

Developments in the field of neuroscience, according to its proponents, offer the prospect of an enhanced understanding and treatment of addicted persons. Consequently, its advocates consider that improving public understanding of addiction neuroscience is a desirable aim. Those critical of neuroscientific approaches, however, charge that it is a totalising, reductive perspective–one that ignores other known causes in favour of neurobiological explanations. Sociologist Nikolas Rose has argued that neuroscience, and its associated technologies, are coming to dominate cultural models to the extent (...) that 'we' increasingly understand ourselves as 'neurochemical selves'. Drawing on 55 qualitative interviews conducted with members of the Australian public residing in the Greater Brisbane area, we challenge both the 'expectational discourses' of neuroscientists and the criticisms of its detractors. Members of the public accepted multiple perspectives on the causes of addiction, including some elements of neurobiological explanations. Their discussions of addiction drew upon a broad range of philosophical, sociological, anthropological, psychological and neurobiological vocabularies, suggesting that they synthesised newer technical understandings, such as that offered by neuroscience, with older ones. Holding conceptual models that acknowledge the complexity of addiction aetiology into which new information is incorporated suggests that the impact of neuroscientific discourse in directing the public's beliefs about addiction is likely to be more limited than proponents or opponents of neuroscience expect. (shrink)

The advent of simple in vitro fertilisation techniques has provided the reproductive biologist with an invaluable system for assaying sperm fertilising ability. In particular, they provide a useful way of identifying and characterising gamete‐specific proteins that play a role in sperm‐egg interactions, and in recent years, a growing number of sperm surface proteins have been identified that appear to be involved in these processes. Fertilin β was one of the first sperm membrane proteins to be implicated in egg interactions and (...) it has been proposed that this is mediated by means of binding of its disintegrin‐like domain to cognate integrin receptors on the egg plasma membrane. A recent paper in Science by Cho and colleagues [Cho et al. 1998. Fertilisation defects in sperm from mice lacking fertilin β. Science 281:1857–1859 (Ref. 1)] provides preliminary data on a fertilin β knockout mouse. Whilst fertilin βnull males had greatly reduced fertility, somewhat surprisingly, this could be largely attributed to causes other than impaired binding to the egg plasma membrane. BioEssays 21:183–187, 1999. © 1999 John Wiley & Sons, Inc. (shrink)

What exactly is a genetic disease? For a phrase one hears on a daily basis, there has been surprisingly little analysis of the underlying concept. Medical doctors seem perfectly willing to admit that the etiology of disease is typically complex, with a great many factors interacting to bring about a given condition. On such a view, descriptions of diseases like cancer as genetic seem at best highly simplistic, and at worst philosophically indefensible. On the other hand, there is clearly some (...) practical value to be had by classifying diseases according to their predominant cause when this can be accomplished in a theoretically satisfactory manner. The question therefore becomes exactly how one should go about selecting a single causal factor among many to explain the presence of disease. When an attempt to defend such causal selection is made at all, the standard accounts offered (Koch's postulates, Hill's epidemiological criteria, manipulability) are all clearly inadequate. I propose, however, an epidemiological account of disease causation which walks the fine line between practical applicability and theoretical considerations of causal complexity and attempts to compromise between patientcentered and population-centered concepts of disease. The epidemiological account is the most basic framework consistent with our strongly held intuitions about the causal classification of disease, yet it avoids the difficulties encountered by its competitors. (shrink)

Open Education explores the disruption of the traditional university as a result of the increasingly widespread provision of free online open education.

Presents a portrait of Alamaba rivers, from their origins in the Appalachian highlands to their confluence with the Gulf of Mexico, and promotes the stewardship and preservation of these natural regions.

In the age of the digital generation, written public data is ubiquitous and acts as an outlet for today's society. Platforms like Facebook, Twitter, Google+ and LinkedIn have profoundly changed how we communicate and interact. They have enabled the establishment of and participation in digital communities as well as the representation, documentation and exploration of social behaviours, and had a disruptive effect on how we use the Internet. Such digital communications present scholars with a novel way to detect, observe, analyse (...) and understand online communities over time. This article presents the formalization of a Social Observatory: a low latency method for the observation and measurement of social indicators within an online community. Our framework facilitates interdisciplinary research methodologies via tools for data acquisition and analysis in inductive and deductive settings. By focusing our Social Observatory on the public Facebook profiles of 187 federal German politicians we illustrate how we can analyse and measure sentiment, public opinion, and information discourse in advance of the federal elections. To this extent, we analysed 54,665 posts and 231,147 comments, creating a composite index of overall public sentiment and the underlying conceptual discussion themes. Our case study demonstrates the observation of communities at various resolutions: “zooming” in on specific subsets or communities as a whole. The results of the case study illustrate the ability to observe published sentiment and public dialogue as well as the difficulties associated with established methods within the field of sentiment analysis within short informal text. (shrink)

ABSTRACTPrior research on attention bias in anxious youth, often utilising a visual dot probe task, has yielded inconsistent findings, which may be due to how bias is assessed and/or variability in the phenomenon. The present study utilises eye gaze tracking to assess attention bias in socially anxious adolescents, and explores several methodological and within-subject factors that may contribute to variability in attention bias. Attention bias to threat was measured in forty-two treatment-seeking adolescents diagnosed with Social Anxiety Disorder. Bias scores toward (...) emotional stimuli and bias scores away from emotional stimuli were explored. Bias scores changed between vigilance and avoidance within individuals and over the course of stimulus presentation. These differences were not associated with participant characteristics nor with self-reported social anxiety symptoms. However, clinician rated severity of social anxiety, explained a signific... (shrink)

We synthesize literature from organization theory and political sociology to develop a conceptual lens from which organizing can be examined as a process whereby institutional structures are changed in ways similar to how social movements change entire societies. Implied is that hegemonic power structures maintain existing institutional structures by either resisting insurgencies or by making them seem senseless in the first place.

Reply to a commentary by Joseph J. Fins on “Financial Side Effects: Why Patients Should Be Informed of Costs.”.

Background: Healthcare providers caring for learning-disabled individuals in institutions face challenges of what is right or wrong in their daily work. Serving this group, it is of utmost importance for the healthcare staff to raise awareness and to understand how ethical values are at stake. Research question: What ethical challenges are discussed among healthcare providers working with adults with learning disabilities? Research design: The study had a qualitative and investigative design. Participants and research context: The study was conducted in a (...) community institution for adults with learning disabilities. Participants were healthcare providers joining regular focused group discussions. Two groups participated and each group consisted of six participants. The conversations were taped and transcribed. Ethical considerations: The study was reported to Norwegian Social Science Data Services and was approved by the regional ethics committee. Findings: Findings are presented in four themes: (a) feeling squeezed between conflicting actions, (b) being the client’s spokesman, (c) searching shared responsibility, and (d) expecting immediate and fixed solutions. The healthcare providers wanted to be the clients’ advocates. They felt obliged to speak up for the clients, however, seeking for someone with whom to share the heavily experienced responsibility. Data likewise revealed that the group discussions created expectations among the healthcare providers; they expected smart and final solutions to the problems they discussed. Discussion: The discussion focuses on everyday ethical challenges, the meaning of being in-between and share responsibility, and the meaning of ethical sensitivity. Conclusion: Ethical challenges can be demanding for the staff; they might feel squeezed in-between contradictory attitudes or feel alone in decision-making. Frequent conversations about ethical challenges do not solve the ethical problems here-and-now, but they do visualize them. This also visualizes the staff’s need for support. (shrink)

The history of the physics of pendular motion rightly begins with Galileo's discovery of the isochronous character of that motion. There is, however, a ‘pre-history’ of the pendulum, centering on its initial recognition as a significant special case requiring explanation. This occurred in the writings of Jean Buridan and Nicole Oresme in the middle of the fourteenth century. Earlier works that might have been construed as discussing pendular motion are considered, as are the explanations for the scholastic ‘discovery’ of pendular (...) motion put forth by Thomas Kuhn and Piero Ariotti. In contrast to these writers, this paper seeks to account for the pendulum's emergence with reference to an imaginary experiment concerning a body moving past the earth's center, medieval theories of impetus, and the proximate physical model of pendular motion, the late medieval heavy suspended church bell. (shrink)