Surgical ethics have generally been framed as general medical ethics applied to surgical contexts. This model is helpful, but may miss some of the special features of the surgical process and relationship. It is suggested in this paper that there are five categories of experience and relationship which are especially important in surgery —rescue, proximity, ordeal, aftermath and presence. The sense of rescue, the feeling of relational proximity, the ordeal and the aftermath of surgery are things which the patient experiences. (...) Understanding these experiences allow surgeons to understand what may be asked of them in an ethical sense. Recognition of the reality and validity of each category in the surgical process highlights the importance of presence, the acts by which the surgeon demonstrates that he is present to the patient throughout the surgical process and its aftermath. While the teaching of communication skills may never compensate for insensitivity, the ideal of presence as virtue and duty can be taught by precept and example. (shrink)

A volume in the SUNY series in Philosophy George R. Lucas Jr., editor.

When philosophers speak of direct perceptual knowledge, they obviously mean to suggest that such knowledge is unmediated ? but unmediated by what? This is where we find evidence of violent disagreement. To clarify matters, I want to identify and briefly describe several important senses of "direct" that have helped shape our understanding of perceptual knowledge. They are (1) "Direct" as Non-Inferential Perception; (2) "Direct" as Unmediating by Objects of Perception; (3) "Direct" as Conceptually Unmediated Perception; (4) "Direct" as Independent Verification (...) of Perceptual Beliefs; and (5) "Direct" as Perception of What is Epistemically Prior. (shrink)

In the later Fichte the reflection splits the world into a fivefoldness of its possible view. To get through all the a priori arranged levels from sensuality to the Doctrine of Science means to use up all the possibilities of the views of the world. I will examine whether Fichte can offer us a direct proof of completeness of the standpoints or at least show indirectly that there must be exactly five of them. Which answer would he give us (...) if we argued that history, skepticism and nonentity could complement the array? -/- Keywords Fivefoldness-worldviews-completeness-proof-history-skepticism -/- Die Reflexion spaltet nach Fichte die Welt in eine Fünffachheit ihrer möglichen Ansicht. Das Durchlaufen der a priori geordneten Stufen von der Sinnlichkeit bis zur Wissenschaftslehre stellt zugleich ein Ausschöpfen der Möglichkeiten dar, sich zur Welt zu verhalten. Ich werde prüfen, ob Fichte uns einen direkten Beweis der Vollständigkeit der Standpunkte geben oder zumindest indirekt dafür argumentieren kann, dass es genau fünf sein müssen. Was würde er uns antworten, wenn wir behaupteten, die Geschichte, der Skeptizismus und die Nullität könnten die Reihe ergänzen? -/- Schlüsselbegriffe Fünffachheit-Weltansichten-Vollständigkeit-Beweis-Geschichte-Skeptizismus. (shrink)

Newton had a fivefold argument that true motion must be motion in absolute space, not relative to matter. Like Newton, Kant holds that bodies have true motions. Unlike him, though, Kant takes all motion to be relative to matter, not to space itself. Thus, he must respond to Newton’s argument above. I reconstruct here Kant’s answer in detail. I prove that Kant addresses just one part of Newton’s case, namely, his “argument from the effects” of rotation. And, to show that (...) rotation is relative to matter, Kant changes the meaning of ‘relative motion.’ However, that change puts Kant’s doctrine in deep tension with Newton’s science. Based on my construal, I correct earlier readings of Kant by John Earman and Martin Carrier. And, I argue that we need to revise Michael Friedman’s influential view of Kant. Kant’s struggle, I conclude, illustrate the difficulties that early modern relationists faced as they turned down Newtonian absolute space ; and it typifies their selective engagement with Newton’s case for it. (shrink)

The paper addresses a problem for the unification of quantum physics with the new Aristotelianism: the identification of the members of the category of substance. I outline briefly the role that substance plays in Aristotelian metaphysics, leading to the postulating of the Tiling Constraint. I then turn to the question of which entities in quantum physics can qualify as Aristotelian substances. I offer an answer: the theory of thermal substances, and I construct a fivefold case for thermal substances, based on (...) the irreversibility of time, the definition of thermodynamic concepts, spontaneous symmetry breaking, phase transitions, and chemical form. (shrink)

This paper investigates how deans and directors at the top 50 global MBA programs (as rated by the "Financial Times" in their 2006 Global MBA rankings) respond to questions about the inclusion and coverage of the topics of ethics, corporate social responsibility, and sustainability at their respective institutions. This work purposely investigates each of the three topics separately. Our findings reveal that: (1) a majority of the schools require that one or more of these topics be covered in their MBA (...) curriculum and one-third of the schools require coverage of all three topics as part of the MBA curriculum, (2) there is a trend toward the inclusion of sustainability-related courses, (3) there is a higher percentage of student interest in these topics (as measured by the presence of a Net Impact club) in the top 10 schools, and (4) several schools are teaching these topics using experiential learning and immersion techniques. We note a fivefold increase in the number of stand-alone ethics courses since a 1988 investigation on ethics, and we include other findings about institutional support of centers or special programs; as well as a discussion of integration, teaching techniques, and notable practices in relation to all three topics. (shrink)

Food charity in the United States has grown into a critical appendage of agro-food supply chains. In 2016, 4.5 billion pounds of food waste was diverted through a network of 200 regional food banks, a fivefold increase in just 20 years. Recent global trade disruptions and the COVID-19 pandemic have further reinforced this trend. Economic geographers studying charitable food networks argue that its infrastructure and moral substructure serve to revalue food waste and surplus labor in the capitalist food system. The (...) political–legal framework undergirding this revaluation process however is still poorly understood. Drawing on a 6-year institutional ethnography of the food banking economy in West Virginia, this paper takes a supply-side approach to examine the material and moral values driving the expansion of food waste recovery as hunger relief. Empirically, it focuses on the laws, contracts and fiscal incentives regulating charitable food procurement at the U.S. Department of Agriculture and Feeding America. The assemblage of government agencies, private businesses and non-profit organizations enrolled into this gift economy at different scales I argue, serves to enclose food waste into a public–private governance structure that regulates food surpluses and ensures these will not disrupt the scarcity logics driving profitability along primary food circuits. (shrink)

Will globalization promote or hinder social justice throughout the world? In this cogent analysis philosopher Kai Nielsen argues that in its present form capitalist globalization will only ensure that the rich get richer and the poor poorer. Noting that the ratio of the richest countries to the poorest has steadily grown larger under capitalism in the 20th century and that the total dollar value of the world economy has increased fivefold while the number of people living in poverty has doubled, (...) Nielsen clearly demonstrates that globalization has made and still is making a bad situation worse. While inveighing against capitalist globalization, he makes the important point that a globalization based on "market socialism" - to ensure both needed efficiency and an egalitarian conception of justice - would be a trend that people in all nations would welcome. Democratic socialism, despite historical betrayals and recent setbacks, Nielsen contends, is still humanity's best hope for achieving a classless, nonracist, and nonsexist world community. He devotes a number of chapters to a discussion of the critical theory that is the basis of this vision of a completely egalitarian international society, and he compares and contrasts his own position with that of such thinkers as Richard Rorty, John Rawls, Juergen Habermas, G. A. Cohen, and others. This well-argued critique of capitalist globalization and defense of democratic socialism as a viable alternative is essential reading for philosophers, political scientists, students of international relations, and anyone concerned about the future of democratic and egalitarian ideals. (shrink)

Growing detrimental effects on the bio-physical environment have been responsible for a large number of small firms to adopt a more strategic stance toward exploiting green-related opportunities. This article aims to shed light on how internal company factors help to formulate a green business strategy among small manufacturing firms, and how this, in turn, influences their competitive advantage and performance. Based on data received from 153 small Cypriot manufacturers, we propose and test a conceptual model anchored on the Resource-based View (...) of the firm. The findings underscore the critical role of both organizational resources and capabilities in pursuing a green business strategy. The adoption of this strategy was more evident in the case of firms operating in more harmful, as opposed to less harmful, industries. The implementation of a green business strategy was found to generate a positional competitive advantage, with this association becoming stronger under conditions of high regulatory intensity, high market dynamism, high public concern, and high competitive intensity. It was also revealed that this competitive advantage is conducive to gaining heightened market and financial performance. Our study makes a fivefold contribution: it injects a theoretical perspective into a relatively atheoretic field, underlines the role of organizational resources/capabilities as drivers of eco-friendly initiatives, highlights the often neglected strategic aspects of small firms’ ecological business activities, stresses the contingent role of external forces in moderating the positive impact of small firm green business strategy on competitive advantage, and focuses on the performance implications of the small firm’s engagement in environmental operations. (shrink)

In bioethics as in the sciences, enormous discussions often concern the very small. Central to public debate over emerging reproductive and regenerative biotechnologies is the question of the moral status of the human embryo. Because news media have played a prominent role in framing the vocabulary of the debate, this study surveyed the use of language reporting on human embryo research in news articles spanning a two-year period. Terminology that devalued moral status - for example, the descriptors things, property, tissue, (...) or experimental material - was found to outnumber fivefold those that affirmed any degree of moral status above that of inanimate cellular matter ; for example, living, human life, or human being. A quarter of the articles failed to note that the embryos under discussion were human. These findings confirm that even among scientific and philosophical experts a diversity of opinion exists on society's moral obligations to nascent human life. The skewed linguistic distribution also indicates a distinct bias. Concerned readers should take notice when any category of humanity becomes subject to prejudicial and disparaging language and the value of vulnerable human life is trivialized alongside sensational assertions of anticipated medical cures. The responsibility for holding the media to a higher standard of truth and fairness falls to us all. (shrink)

El trabajo versó en torno a las competencias socioemocionales y su trascendencia para la investigación. Se develaron referentes teóricos relativos a tales competencias, que permitieron aportar una conceptualización y una sistemática estructurada en cinco grandes bloques: conciencia emocional, regulación emocional, autonomía emocional, competencia social y competencias de vida y bienestar. La pesquisa estuvo dirigida al diseño y aplicación preliminar de una intervención educativa, desde la actividad de postgrado, destinada a favorecer el desarrollo de las competencias socioemocionales en másteres y doctores (...) en formación. Se obtuvieron resultados parciales positivos, a partir de su introducción en la práctica. The paper deals with socio-emotional competencies and their importance inconducting research. It discloses a framework of references around competencies related concepts and structured into a fivefold grouping: emotional awareness, emotional regulation, emotional autonomy, social competence and powers of life and wellbeing. The research was aimed to design and attempting the education of socio-emotional competencies at masters and Ph. D. training in the field of education. The initial application of the proposal proved to be effective. (shrink)

This article has interrogated the prophetic role of musicians in Zimbabwe’s political discourse with Winky D’s latest album Eureka Eureka (which was launched on 31 December 2022) being the case study. Two tracks (Dzimba Dzemabwe and Ibotso) have been singled out for analysis. The message of John the Baptist in Luke 3:7–14 has been used as the framework for understanding the prophetic phenomenon of the 1st century AD Palestinian environment. The article has employed the comparative methodology in comparing these two (...) distant figures. The fivefold process of selection, description, juxtaposition, redescription, and rectification and theory formation has been employed as steps in doing a comparative study. The study identified some notable similarities as well as some differences in the messages of Winky D and John the Baptist and concluded that Winky D’s message played a prophetic role in the Zimbabwean political discourse in a similar way that the message of John the Baptist in Luke 3:7–14 played in the 1st century AD Palestinian context. Contribution: The article concluded that Winky D in his album Eureka Eureka played well the prophetic role in the political landscape of Zimbabwe. (shrink)

Parental mental disorders increase the risk for insecure attachment in children. However, the quality of caregiver–infant interaction plays a key role in the development of infant attachment. Dyadic interaction is frequently investigated via global scales which are too rough to uncover micro-temporal mechanisms. Prior research found that the latency to reparation of uncoordinated dyadic states is associated with infant behavioral and neuroendocrine regulation. We investigated the hypothesis that this interactive mechanism is critical in predicting secure vs. insecure attachment quality in (...) infancy. We also assessed the predictive quality of infant attachment regarding neuroendocrine reactivity later in childhood. A subsample of N = 58 dyads from a larger study were analyzed. At 3–8 months postpartum, maternal anxiety disorders were diagnosed via a structured clinical interview as well as dyadic interaction during the Face-to-Face-Still-Face was observed and coded on a micro-temporal scale. Infant attachment quality was assessed with the strange situation paradigm at 12–24 months of age. In an overlapping subsample of N = 39, we assessed child cortisol reactivity at 5 to 6 years of age. Generalized linear modeling revealed that longer latencies to interactive reparation during the reunion episode of the FFSF as well as maternal diagnosis at 3–8 months of age predict insecure attachment in children aged 12–24 months. Cox regressions demonstrated that dyads with infants who developed insecure attachment at 12–24 months of age were 48% less likely to achieve an interactive reparation at 3–8 months of age. Mixed models revealed that compared to securely attached children, children who had developed an insecure attachment at 12–24 months of age had an increased cortisol reactivity at 5 to 6 years of age during free play. The results confirm the hypothesis that the development of attachment is affected by experienced micro-temporal interactive patterns besides diagnostic categories. They also showed that infants of mothers with postpartum anxiety disorders have a more than fivefold increased risk of developing an insecure attachment than the infants of the control group. Moreover, results imply that these patterns may influence neurohormonal regulation even in preschool aged children. (shrink)

In his Fragments of a Journal, playwright Eugene Ionesco wrote: According to Freud, the three obstacles that prevent us from being are anxiety, pity and aversion. This is the threefold chain that binds us. But our chain is fourfold or even fivefold: hatred or aggressiveness are equal hindrances to freedom. Desire is the most serious obstacle to our deliverance. Freudianism can thus, to some extent, be reconciled with Buddhism... Ionesco goes on to suggest that the ultimate implications of psychoanalysis are (...) not far removed from those of Buddhism. In this book Anthony Molino teases out those implications in a collection of writings on the complex relationship between the two disciplines. (shrink)

Basically the anti-infallibility position of the eighteenth and twentieth centuries is fivefold: that infallibility, especially papal, is unfounded, unverified, undesirable, unnecessary, and impossible.

Aristotle was the last, and the most influential of the Greek philosophers. Aristotle studied philosophy as well as different branches of natural sciences. In fact, he had a keen interest in the world of experience and is the founder of at least two sciences: (1) Logic and (2) Biology. Aristotle’s system of philosophy falls into the fivefold division of Logic, metaphysics, physics, ethics and aesthetics. Aristotle talks about the ultimate good being eudaimonia – a good life, a flourishing life, a (...) fulfilled and worthwhile life. Reflecting on ideals and connecting them to reality is only the first step in the search for the good life. A For Aristotle the final end of human life is to flourish, to live well, to have a good life. All acts should aim at this end. According to Aristotle, the good life consists in the possession, over the course of a lifetime, of all those things that are really good for us. Aristotle’s purpose in the Nicomachean Ethics is not just to explain the philosophy of the excellence for human beings but also to demonstrate specifically how human beings can lead lives of excellence as activity in accordance with practical and theoretical reason. The objective of this paper is to study the concept of happiness and the good life according to Aristotle. (shrink)

Violence confronts us increasingly, everywhere: how are we to make sense of it? Its ubiquity begs the question of analytical differentiation. This article seeks to open the field by suggesting a fivefold typology: violence as loss of meaning; violence as non-sense; violence as cruelty; fundamental violence; and founding violence. The idea of analytically differentiating between types of violence cannot avoid the fact that sometimes victims are also perpetrators in other ways, and that even violent activity is not conducted only by (...) essentially violent subjects. Violence needs to be connected to modernity and to problems of identity formation and not only to personal or collective risk. (shrink)

This paper consists of two parts. The first criticizes the usual interpretation of the so-called existential quantifier as denoting existence. It is argued that it symbolizes “someness,” as is obvious from its definition as not-all-not, as in “Some citizens will vote,” which is analyzable as “Not all citizens will abstain from voting.” The second part of the paper argues that “existence” is fivefold: real, phenomenal, conceptual, semiotic, and fantastic. A definition and a criterion are proposed for every one of them. (...) Real existence is identified with mutability; phenomenal existence, with occurrence in someone’s sensory experience; conceptual existence, as occurrence in a conceptual system; semiotic existence, as the ability of a sign to excite a reaction in an animal perceiving it; and fantastic existence, as occurrence in a work of fiction that contains or suggests it. Finally, a general concept of existence in a given context is defined with the help of the characteristic function of the said context. In other words, an existence predicate is defined, and so Anselm’s famous proof of the existence of God is shown to be formally correct. (shrink)

This paper shows how Wyclif is able at the same time to claim that whatever is is a proposition and to develop a nontrivial theory of propositional truth and falsity. The study has two parts: 1) Starting from Wyclif's fivefold propositional typology – including a propositio realis and asic esse sicut propositio significat – we will analyse the three different kinds of real predication, the distinction between primary and secondary signification of propositions and the status of logical truth as opposed (...) to metaphysical truth. Furthermore, the notion of ens logicum will be compared to Walter Burley's propositio in re of which it appears to be a close analogon. 2) The second part deals with two semantic and metaphysical implications of the "pan-propositionalism": the extended notion of being called upon to explain the truth of so-called non-standard propositions and the relation between contents of the divine mind as "arch-truth-makers" and eternal as well as contingent truths. (shrink)

The aim of this paper is to situate the early Indian (Nikāya) Buddhist notion of karmic causation within the mental causation discourse in the Western analytic tradition, which concerns causal transactions involving mental events, such as desires, beliefs, and intentions, whether the transactions are between mental events, or between mental events and physical events. Karmic causation involves actional causes, in concert with non-actional causes, and their experiential effects on the actor, in concert with non-experiential effects. The problems generated by karmic (...) causation in Buddhism overlap with those generated by mental causation in the Western analytic tradition. They include how the mental aspects relate to the physical aspects of the self, sense perception, and action, as well as how the mental and physical aspects of an actional cause relate to the experiential and non-experiential aspects of an effect on the actor. -/- To make sense of mental causation, it is crucial to understand a cluster of associated concepts such as causation, the self, sense perception, and action. Similarly, to make sense of karmic causation, it is crucial to understand a cluster of associated concepts such as dependent arising (paṭiccasamuppāda), the fivefold laws of nature (pañca-niyāma), the five aggregates (pañca-khandha), the six sense bases (Saḷayatana), action (karma), and results (vipāka). I shall discuss these concepts under the headings of causation, the self, sense perception, and action before I move on to address karmic causation in the context of the mental causation debate. (shrink)

Food insecurity and the loss of soil nutrients and productive capacity in Africa are serious problems in light of the rapidly growing African population. In semi-arid central Tanzania currently practiced traditional crop production systems are no longer adaptive. Organic crop production methods alone, while having the capacity to enable food security, are not feasible for these small-scale farmers because of the extra land, skill, resources, and 5–7 years needed to benefit from them—particularly for maize. Maize, grown by 94 % of (...) farmers, has substantial nitrogen needs. The most practical ways of satisfying maize nutrient needs is via integrated soil fertility management, a combination of organic and Green Revolution methods. Maize has been shown in research to outyield the indigenous crops millet and sorghum in nearly all situations including drought. Conservation Agriculture (CA) in Africa has two main categories—organic and herbicide-mediated. The organic version of CA, despite years of promotion, has had a low rate of adoption. Herbicide-mediated zero tillage CA via backpack sprayer can substantially increase conventional maize yields while at the same time nearly eliminating erosion and increasing rainwater capture up to fivefold. Glyphosate herbicide is a non-proprietary product produced in Africa and approved for small farm use. The systemic nature of glyphosate allows the killing of perennial grasses that would otherwise need deep plowing to kill. The rooted weed residues protect the soil from erosion. The risks of glyphosate use are substantially outweighed by the benefits of increased food security and crop system sustainability. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:DAVID HUME AND EIGHTEENTH CENTURY MONETARY THOUGHT: A CRITICAL COMMENT ON RECENT VIEWS To the argument that it makes little difference what precise roles were played by various actors in a great movement, and that the busy modern reader cannot be bothered to go behind the scenes of popular successes, the answer is simple: it is on the whole better to call men and events by their right names; (...) it is on the whole wiser not to make false diagrams of the way things happen. What, after all, are we so busy about? Jacques Barzun, Darwin, Marx, Wagner The praise that has been bestowed upon David Hume's monetary thought in recent years would suggest that however little attention is paid to the history of economic thought otherwise, no one is averse to a long and respectable lineage.1 However, it is just when an individual is singled out and focused upon that the most misleading ideas can arise; furthermore, when the scholars who provide this attention are renowned authorities in specialized fields, their views receive very widespread circulation. It would not be easy to find a contemporary student of the eighteenth century who would assert that the mercantilists believed real wealth to consist of gold and silver, yet the late Harry Johnson made just such an assertion not very long ago, and the number of economists who read Harry Johnson must far outnumber those who read eighteenthcentury scholars.2 By the same token, the liberal praise bestowed upon those credited with having "demolished" mercantilism, such as David Hume, requires careful scrutiny. A recent article by Dietrich Fausten3 has shown how different Hume's analysis 157 actually was from modern monetarism, despite the many attempts to designate Hume the father of monetarist doctrines, and this critical approach can be taken farther. Before turning to an examination of Hume's position, it may be worthwhile to make a methodological point. There are those who consider delving into indebtedness and priorities "antiquarian" (but not if their own contributions are in question!). After all, they claim, Hume's views are there in black and white, he wrote elegantly and his philosophical merits are widely admired; does it really matter if Hume did not acknowledge his sources, that he was somewhat inconsistent, or that he caricatured his opponents? Surely some compassion is appropriate for someone who wrote at the very dawn of "economic science." This is to miss the point of such historical scrutiny altogether. If compassion were required, why should it be bestowed upon Hume, rather than on such predecessors as Gervaise, Cantillon or Vanderlint? Scholars employ certain critical standards in judging published work; let us employ these standards to Hume and if sympathy be required, let it follow and not precede the analysis. II The following passage is certainly one of the most frequently quoted in the history of economics but its importance for our argument makes repetition necessary. Suppose, that all the money of Great Britain were multiplied fivefold in a night, must not the contrary effect follow? Must not all labour and commodities rise to such an exorbitant height, that no neighbouring nations could afford to buy from us; while 158 their commodities, on the other hand, became comparatively so cheap, that, in spite of all the laws which could be formed, they would be run in upon us, and our money flow out; till we fall to a level with foreigners, and lose that great superiority of riches, which had laid us under such disadvantages?4 Two points should be noted about the above. First, Hume assumes a sudden, large inflow of money to make his point. This is a very different thing from the small [relative to the money stock] and steady inflow advocated by the so-called mercantilists. Secondly, Hume assumes that this sudden inflow is met by instantaneous adjustment in prices. Otherwise, if the change in, say, wages attracts more labour, there is no reason why the increased money supply could not lead to a greater output and thus avoid inflation. International labour mobility was a standard feature of mercantilist thought and so it will be seen that Hume's "new" result is obtained by his... (shrink)

Failings of a categorical systemFor decades, standardized classification systems have attempted to define psychiatric disorders in our mental health care system, with the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association (APA), 2013) and International Statistical Classification of Diseases and Related Health Problems 10th revision (ICD-10; World Health Organization, 2010) being internationally best-known. One of the major advantages of the DSM must be that it has seriously diminished the international linguistic confusion regarding psychiatric disorders. Since (...) its introduction, it contributed extensively towards one common international language for defining and conceptualizing psychiatric disorders. Strikingly, within the field of psychological testing a similar step forward seems to have not yet been taken. At present, there exists no international standard for the use of psychological tests that takes the definition of a specific symptom as listed in DSM-5 as its starting point, and reliably and validly measures this symptom. Rather, the majority of tests are measuring constructs consisting of a multitude of symptoms. For example, the Beck’s Depression Inventory (Beck et al., 1996) measures core symptoms of depression summing up to a depression score. Accordingly, we believe it is time for a change. The diagnostics of psychiatric disorders, where disorders are defined as nosological units with a single cause, a single organic substrate, and a single time course, has been problematic for centuries. The field of psychiatry has always been ambivalent about its desire to follow a medical model (Blaney, 2015), but afflicted due to its definitions of pathology. The definition of a psychiatric disorder in DSM-5 offers little room for a clear cut pathogenesis and harsh demarcation of syndromes. This is reflected in the DSM-5, where it states: “A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning” (APA, 2013, p.20). An unfortunate and recognized consequence of this definition within the current system is that many symptoms overlap within categories of psychiatric disorders and patients end up diagnosed with many co-morbid disorders.Two fundamental problemsRegardless of new attempts to improve the diagnostics of psychiatric disorders, the DSM-5 represents the status quo. Consequently, the distinction between diagnosis and classification remains substantial and more than a discussion on semantics. We identify two fundamental problems within the current framework. Generally, a psychiatric diagnosis is considered to be descriptive (Hengeveld and Schudel, 2003). The clinician will describe a syndrome (its nature, timespan, and severity) within the framework of a disorder, and often include a differential diagnosis, predisposing protective or vulnerability factors, and provoking or maintaining factors. Within the DSM-5 framework, a similar ‘approach to clinical case formulation’ is taken (APA, 2013, p. 19). Evidently, a descriptive diagnosis has a hypothetical character. It consists of the clinician’s hypothesis and is based on his or hers professional considerations according to the abovementioned factors. Once the clinician has formulated a descriptive diagnosis, it is then complementary ‘translated’ into a DSM-5 classification. Herein lies the problem. For the layman, the existence of this distinction between diagnosis and classification is usually unknown. Preceding treatment, the clinician will give the client a classification of the existing psychiatric problems and the client may attribute more meaning to it than appropriate, thereby fostering the risk of reification. Second, the DSM-5 is a categorical system. Thus, individual disorders are regarded as discrete units – ‘you either have it, or you don’t’. DSM-5 states about this: “(…) scientific evidence places many, if not most, disorders on a spectrum with closely related disorders that have shared symptoms, shared genetic and environmental risk factors (…)”. And “(…) we have come to recognize that the boundaries between disorders are more porous than originally perceived.” (APA, 2013, p. 6). This leads to a fundamental problem. Because the overwhelming majority of psychiatric disorders examined thus far using taxometric methods appear to be dimensional in nature (Haslam, 2003; Widiger and Samuel, 2005), consequently all of their categorizations become artificial and debatable. Even though DSM-5 took a modest step towards a more dimensional approach, its core remains categorical. To illustrate, consider the Borderline Personality Disorder (BPD). This classification consists of nine diagnostic criteria of which a minimum of five need to be present for the diagnosis of BPD. A simple numerical combination algorithm leads to a staggering number of 256 distinct presentations of BPD (Albion et al., 2013). Due to this chameleon-like nature, the disorder’s diagnostic validity becomes questionable. Strikingly, this number is relatively small when compared to other conditions, e.g., there are 636,120 ways to have posttraumatic stress disorder (Galatzer-Levy and Bryant, 2013).DSM-5 does propose an alternative model for personality disorders based on personality functioning and traits (APA, 2013, p. 761), as a possible answer to the problem that most patients fit with multiple co-morbid personality disorders or to the category of personality disorder not otherwise specified. In November 2012, the chair committee of APA decided to move this alternative model to section III of DSM-5 and to sustain the categorical system in section II. A potential solutionDSM-5 and its predecessors have brought about an invaluable improvement regarding the formulation of a common international language for psychiatric disorders. However, the individual disorders fit poorly with its starting point of discrete units and strict boundaries. Van Os (2014) has argued for a better balance between the categorical and personalized aspects of psychiatric disorders. We argue for a two-step approach.Particularly due to the ‘weak boundaries’ between disorders, it might be beneficial to limit ourselves by merely categorizing clients into the main categories of the DSM-5 according to their most prominent symptoms (Van Os, 2014), i.e. their main complaint. In other words, clinicians could first ask themselves whether the symptomatology is concerning a neurodevelopmental disorder, or a bipolar and related disorder, or a depressive disorder, and so on. It will drastically reduce the over 400 classifications in DSM-5 down to 20 categories. Van Os (2014) even argues to combine some of the main categories, reducing this number even further to 15 categories. The advantages of reducing the over 400 classifications are fivefold: 1) a syndrome, being an aggregation of symptoms, creates a false relation between symptoms that are that are already heterogeneous themselves; 2) 15 broad categories are functional: it results into a very heterogeneous group of clients within a category and thus prevents stereotypes and invites further personalizing of complaints; and 3) a dimensional measure of a symptom rather than a syndrome will correspond better with the client regardless of it not providing the complete picture. Focusing on the main complaint will indicate where there is an immediate need for care (Van Os, 2014); 4) it will allow clinicians to recognise subthreshold conditions more easily (Magruder and Calderone, 2000); and 5) it might facilitate the development of clear demarcations between normal and abnormal functioning (Kessler, 2002; Widiger and Samuel, 2005). Please, see also Table 1.This also fits well within scientific advances, as thus far strongest evidence has been found for a distinction between internalizing and externalizing disorders, even superseding these 15 main categories (DSM-5; APA, 2013, p.13, but see Weiss et al., 1998). The second step would concern the personalized aspect, which we argue to define on a level of core symptoms of the specific main category, to be agreed upon later. To assess these core symptoms, the field of psychological testing could develop an internationally applicable instrument to reliably and validly measure each (core) symptom on a dimensional scale. Many of these instruments are readily available and have proven its psychometric properties within scientific research. Elements from these instruments could be easily transformed to work within the new system. Within the field of psychology, this approach could aid development of a common international language to define symptoms, analogous to the field of psychiatry. Importantly, current psychological testing mainly implies the use of self-report measures. This leads to an abundance of auto-amnestic information. To increase the reliability and validity of psychological tests to assess DSM-5 symptoms, it may be important to add two additional information resources. This would entail psychological tests where a next of kin answers questions about the symptom of the client, and psychological tests that include the clinicians’ judgment, such as structured clinician-based interviews. Conversely, we also need to acknowledge the well-known limitations of clinical judgment (e.g., Faust, 1986; Garb, 1998). Advantages of a new frameworkThe changes we suggest have big implications and are not easily implemented in the current framework. Clients may prefer the comfort of a single clear label, similar to what they are used to in other areas of medicine. Health insurance providers and policy makers may argue for single labels as well. Therefore, it would require a lot of explanation from our clinicians to promote a change. Our suggestions for broader categories may not disambiguate the current situation better than the existing approach, but it will promote personalisation of health care. Difficulties in diagnostic reliability will remain in disorders that fall on the boundaries of the taxons, e.g., schizoaffective disorder versus bipolar disorder with psychotic characteristics, which may benefit from further study. There are also some politically tinged questions to keep in mind: How will we finance our health care, and how will we ensure a gradual transition from the current financing system, including clients who already have their labels? What about visitations from insurers and health inspection? How can they control for a good standard of quality in health care when considering the increasing heterogeneity? Nevertheless, we argue that the benefits outweigh the disadvantages. We will see a shift from a categorical to a personalized approach, which will lead to less (self) stigmatizing, less estrangement, and it will challenge reification thinking. DSM-V states that “a reformulation of research goals should also keep DSM-5 central to the development of dimensional approaches to diagnosis that will likely supplement or supersede current categorical approaches to diagnosis in coming years” (APA, 2013, p. 13). Our proposition for psychological testing on symptom level could contribute to this development. Furthermore, this new approach will do more justice to the heterogeneity of symptoms within and outside of classification categories, see also Table 1. Moreover, in this new approach we join forces of expert knowledge from the fields of psychiatry and psychological science. Finally, it offers new and potentially better opportunities to map health care needs. This in turn will lead to a better interface for allocation of appropriate treatment. It will present a clearer picture of when preventative care is preferred over treatment and vice versa. Importantly, health care needs will be more closely attuned to the ‘own story’ of the client.We argue for the national and international psychological associations in Europe and the United States of America to support the idea of a collective approach to develop an internationally standardized psychological testing battery to reliably assess all the core symptoms of the main categories in DSM-5. (shrink)

Originally published in 1973. The volume is divided into four sections: The introduction places the position of the Buddhist Tantras within Mahayana Buddhism and recalls their early literary history, especially the Guhyasamahatantra; the section also covers Buddhist Genesis and the Tantric tradition. The foundations of the Buddhist Tantras are discussed and the Tantric presentation of divinity; the preparation of disciples and the meaning of initiation; symbolism of the mandala-palace Tantric ritual and the twilight language. This section explores the Tantric teachings (...) of the inner Zodiac and the fivefold ritual symbolism of passion. The bibliographical research contains an analysis of the Tantric section of the Kanjur exegesis and a selected Western Bibliography of the Buddhist Tantras with comments. (shrink)

Church leadership plays an important and irreplaceable role in the planting and the configuration of the missional congregation. The key to the formation of missional communities is their leadership. In that regard, this article explores Classical Ghanaian Pentecostal Churches’ leadership and leadership formation from a missiological perspective. This was done through an exposition on their leadership system. It was argued that Classical Ghanaian Pentecostal Churches’ leadership is based on the Fivefold Ministry. These leadership functions were therefore discussed in the light (...) of their missiological implication. The conclusion arrived at is that it is not enough to discover one’s spiritual gift or calling; these gifts should be developed and nurtured through mentoring and proper theological education, with the ultimate purpose being to participate in the Missio Dei. (shrink)

Practice-based philosophy of science has gradually arisen in the sociology of scientific knowledge (SSK) and science and technology studies (STS) during the past decades. It studies science as an ensemble of practices and theorising as one of these practices. A recent study has shown how the practice-based approach can be methodologically justified with reference to Peirce and Dewey. In this article, I will explore one consequence of that notion: science, as practice, is necessarily social. I will disambiguate five different senses (...) in which science is social. First, science presupposes language, which is essentially social. Second, practices, including science, are adaptations of the behaviour of an organism to an environment, of which other organisms are a part. Third, practices, including science, are public and hence shareable. Fourth, scientific knowledge can serve as a vehicle of social and moral reform. Fifth, scientific knowledge can be applied to improve the human condition. This fivefold result bears on the problem of realism. (shrink)

The Five Greatest Kinds discussed in Plato‘s Sophist are taken to be just one instance of a fivefold structure found in various related texts. Contemporary linguistic theories are a source for ideas about its functioning.

I unpack the contents of the motto that “meaning is use” in fivefold fashion and point to the elements it contains, which are open to an ideological exploitation, the main reason for its strong appeal among intellectual circles. I indicate how the sense of it, “where there is use, there is meaning”, has encouraged equalitarian accounts of meaning and truth . I then present and discuss Austin’s distinction between the Sentence and the Statement, which entails the presence of meaning preceding (...) the use, and directing it, and offer a new proof that Sentences are impossible to eliminate in any semantic scheme of things. Austin’s distinction, as explained and defended, refutes the contention that “meaning is use”. I proceed to his doctrine of Locution and Illocution, reflecting the previous, indicating by a series of examples, that illocutionary varieties, which are varieties but not variances , can never extend beyond the se-mantic scope generically contained in the original, content; that is to say, the Sentence. Those that do, and they are several, violate the rules of sense. I enumerate his vast differences with Wittgenstein, and proceed to defend Austin’s noted conservatism against the novelties endorsed by the former and his disciples. Charging Wittgenstein’s private language attack as circular, I conclude by marking their further contrast on the actual foundations of meaning and truth. (shrink)

Quest after values and their realization constitute innate necessity for human being. This presupposes knowledge of Reality and knowledge of the value-schema. In this context, a distinction can be drawn between descriptive awareness of Reality and prescriptive awareness of Values. For the latter, the pῡrva mimāmsā system postulates ‘codanā’ as a means of knowledge. In Indian Culture, two types of values are enunciated, viz. preyas and śreyas. The Taittirῑya upaniṣad puts forth a five-dimensional theory of human constitution and accordingly advocates (...) a fivefold value-schema. In general, theory of puruṣartha has been accepted by all the cultural traditions of India with variant details. It would be interesting and enlightening to discuss different aspects and issues concerning this theory. Knowledgeable scholars may delineate on related issues as well. (shrink)

In bioethics as in the sciences, enormous discussions often concern the very small. Central to public debate over emerging reproductive and regenerative biotechnologies is the question of the moral status of the human embryo. Because news media have played a prominent role in framing the vocabulary of the debate, this study surveyed the use of language reporting on human embryo research in news articles spanning a two-year period. Terminology that devalued moral status—for example, the descriptors things, property, tissue, or experimental (...) material —was found to outnumber fivefold those that affirmed any degree of moral status above that of inanimate cellular matter; for example, living, human life, or human being. A quarter of the articles failed to note that the embryos under discussion were human. These findings confirm that even among scientific and philosophical experts a diversity of opinion exists on society's moral obligations to nascent human life. The skewed linguistic distribution also indicates a distinct bias. Concerned readers should take notice when any category of humanity becomes subject to prejudicial and disparaging language and the value of vulnerable human life is trivialized alongside sensational assertions of anticipated medical cures. The responsibility for holding the media to a higher standard of truth and fairness falls to us all. (shrink)

Comparing the _kāraka_ theory as presented in Pāṇiniʼs (_ca_. fifth-fourth century BC) and Candragominʼs (_ca_. fifth century AD) systems of grammar, Joshi and Roodbergen observed that in the _Cāndrasūtra_, the heading rule Pāṇ 2.3.1 (_anabhihite_), which plays an important role for all the _kāraka_ rules, is missing. Deshpande, however, criticized their understanding. According to him, Patañjali (_ca_. second century BC), in his _Mahābhāṣya_, already dealt with the question of whether the general principle _uktārthānām aprayogaḥ_ can justify the omission of this (...) heading rule; under the influence of Patañjali, Candragomin took the position that it is not necessary to explicitly provide Pāṇ 2.3.1. The present paper revisits this issue on the basis of some newly edited Cāndra materials, the _Cāndrapañjikā_ and the _Śabdārthacintā_, which were both written by the eminent Sinhalese grammarian Ratnamati or Ratnaśrījñāna (_ca_. tenth century AD). Ratna’s detailed explanation not only confirms that Deshpande’s assumption is correct, but it also clarifies that the problem pointed out by Pāṇinians in the case of the omission of Pāṇ 2.3.1 can be solved by resorting to the theory of the fivefold meaning of a nominal stem. (shrink)

14o JOURNAL OF THE HISTORY OF PHILOSOPHY 34: X .JANUARY t996 method of reading the dialogues in an ascending order of philosophical importance need not be reflected completely or consistently in the tetralogical scheme. I pass over the account of Thrasyllus' logos-theory which Tarrant derives from an elusive section of Porphyry's commentary on Ptolemy's Harmonics in order to discuss the more important conclusions he draws in chapter 6, "The Neopythagorean Parmenides." By carefully sifting passages in Proclus' commentary on the Parmenides (...) and Simplicius' commentary on the Physics, Tarrant adds to our still incomplete picture of the development of a Neoplatonic ontology out of the hypotheses of Plato's Parmenides. E. R. Dodds made a brilliant case in this regard for Moderatus, the late first century A.D. Neopythagorean, but Tarrant finds even earlier evidence for it by ascrib- ing to Thrasyllus this quasi-Neoplatonic, fivefold ontology: transcendent One, one-being = the intelligibles, the third principle = the soul, physical particulars, matter. Epistle 2's "King of all" is drawn into Tarrant's net as an "esoteric" or symbolic emblem of the transcendent One. He argues plausibly that, since Thrasyllus was instrumental in getting this and other Epistles included in the standard edition of Platonic works, the connections he finds among the Parmenides, the Epistles, and pas- sages in the latter commentators are not facile and are worthy of.. (shrink)

IntroductionAccurately predicting the competitive performance of elite athletes is an essential prerequisite for formulating competitive strategies. Women’s all-around speed skating event consists of four individual subevents, and the competition system is complex and challenging to make accurate predictions on their performance.ObjectiveThe present study aims to explore the feasibility and effectiveness of machine learning algorithms for predicting the performance of women’s all-around speed skating event and provide effective training and competition strategies.MethodsThe data, consisting of 16 seasons of world-class women’s all-around speed (...) skating competition results, used in the present study came from the International Skating Union. According to the competition rules, distinct features are filtered using lasso regression, and a 5,000 m race model and a medal model are built using a fivefold cross-validation method.ResultsThe results showed that the support vector machine model was the most stable among the 5,000 m race and the medal models, with the highest AUC. Furthermore, 3,000 m points are the main characteristic factors that decide whether an athlete can qualify for the final. The 11th lap of the 5,000 m, the second lap of the 500 m, and the fourth lap of the 1,500 m are the main characteristic factors that affect the athlete’s ability to win medals.ConclusionCompared with logistic regression, random forest, K-nearest neighbor, naive Bayes, neural network, support vector machine is a more viable algorithm to establish the performance prediction model of women’s all-around speed skating event; excellent performance in the 3,000 m event can facilitate athletes to advance to the final, and athletes with outstanding performance in the 500 m event are more likely competitive for medals. (shrink)

The present paper is an attempt at examining the value configuration and the socio-demographical profiles of the local political elites in four countries of East-Central Europe: Romania, the Czech Republic, Bulgaria, and Poland. The treatment is a comparative one, predominantly descriptive and exploratory, and employs, as a research method, the case-study, being a quite circumscribed endeavor. The cases focus on the members of the Municipal/Local Council in four towns similar in terms of demography and developmental strategies (i.e. small-to-medium sized communities (...) of around 35,000 inhabitants, with economies largely based on food industry and commercial activities): Tecuci (Galați county, Romania), Česká Lípa (Liberec region, Czech Republic), Targovishte (Targovishte province, Bulgaria), and Oleśnica (Lower Silesia province, Poland). Hypothesizing that the local elites of the former Sovietized Erurope tend to differ in outlook, priorities, and value attainment, as compared to their Western counterparts, the paper considers the former’s attitudes and perspectives in regard to seven values: a series of values customarily connected with the concept of ‘democracy’ (i.e. citizen participation, political conflict, gradual change, economic equality), state intervention in economy, decentralization and increased local autonomy, cultural-geographical self-identification. The study uses, as well, five models of value attainment in what concerns the ‘ideal portrait’ of the local councilor (Putnam 1976): ethical, pragmatic, technocratic, political, and gender. According to the results of a study applying a standard written questionnaire among the local councilors of the three communities in the period December 2010-February 2013, the paper distinguishes among three corresponding types of local elites: (1) ‘predominantly elitistic,’ (2) ‘democratic elitist,’ and (3) ‘predominantly democratic,’ following two types of explanation accounting for the differences among the four cases: the legacy of the defunct regime and the degree of administrative decentralization. (shrink)