BackgroundPeople with upper extremity amputations report receiving insufficient information about treatment options. Furthermore, patients commonly report not knowing what questions to ask providers. A question prompt sheet, or list of questions, can support patient-centered care by empowering patients to ask questions important to them, promoting patient-provider communication, and increasing patient knowledge. This study assessed information needs among people with UE amputations about UE vascularized composite allotransplantation and developed a UE VCA-QPS.MethodsThis multi-site, cross-sectional, mixed-methods study involved in-depth and semi-structured interviews with (...) people with UE amputations to assess information needs and develop a UE VCA-QPS. Qualitative data were analyzed by thematic analysis; quantitative data were analyzed by descriptive statistics. The initial UE VCA-QPS included 130 items across 18 topics.ResultsEighty-nine people with UE amputations participated. Most were male, had a mean age of 46 years, and had a unilateral and below-elbow amputation. Participants desired information about UE VCA eligibility, evaluation process, surgery, risks, rehabilitation, and functional outcomes. After refinement, the final UE VCA-QPS included 35 items, across 9 topics. All items were written at a ≤ 6th grade reading level. Most semi-structured interview participants reported being ‘completely’ or ‘very’ likely to use a UE VCA-QPS.ConclusionPeople with UE amputations have extensive information needs about UE VCA. The UE VCA-QPS aims to address patients’ information needs and foster patient-centered care. Future research should assess whether the UE VCA-QPS facilitates patient-provider discussion and informed decision-making for UE VCA. (shrink)

Concise and understandable, the book explains pertinent findings of modern neuroscience and describes how consciousness arises in complex brains.

A Nobel Prize-winning scientist and a leading brain researcher show how the brain creates conscious experience.

The author takes the reader on a tour that covers such topics as computers, evolution, Descartes, Schrodinger, and the nature of perception, language, and invididuality. He argues that biology provides the key to understanding the brain. Underlying his argument is the evolutionary view that the mind arose at a definite time in history. This book ponders connections between psychology and physics, medicine, philosophy, and more. Frequently contentious, Edelman attacks cognitive and behavioral approaches, which leave biology out of the picture, as (...) well as the currently fashionable view of the brain as a computer. (shrink)

The fundamental claim that the practice of medicine is essentially a moral enterprise remains highly contentious, not least among the dominant traditional moral theories. The medical profession itself is today characterized by multicultural pluralism and moral relativism that have left the Hippocratic moral tradition largely in disarray. In this paper, I attempt to clarify the ambiguity about practicing medicine as a moral enterprise and echo Pellegrino’s call for a phenomenologically and teleologically derived philosophy of medicine. I proffer a realistic trifocal (...) matrix in which the virtuous moral agency and the teleologically derived moral imperative of the physician are comprehensively integrated with an action-guiding practical analytical framework for the resolution of ethical dilemmas in medicine. I argue that this trifocal perspective points us towards an authentic philosophy of medicine that is not only verifiable through Lonerganian self-appropriation, but also authentically objective through the possible moral self-transcendence of the good physician. (shrink)

This book examines how ideas of war and peace have organized frames of reference within the history of political theory. It argues for a political philosophy that takes both conditions seriously and for a style of political theory committed to questioning rather than closure.

In the current debate on the future of bioethics in Africa, several authors have argued for a distinct communitarian African bioethics that can counter the dominancy of Western atomistic principlism in contemporary bioethics. In this article I examine this rather contentious argument and evaluate its validity and viability. Firstly, I trace the contextual origins of contemporary bioethics and highlight the rise and dominance of principlism. I particularly note that principlism was premised on a content-thin notion of the common morality that (...) is in need of enrichment. I also contend that bioethics is essentially two-dimensional, being both conceptual and empirical, and indicate the lag in Africa with regard to conceptual bioethics. I then appeal for authentic engagement by 1) African health care professionals, 2) African health care training institutions, 3) Africa's bioethics development partners, and 4) African bioethicists and philosophers, towards addressing this critical lag. I underline the need to maintain the essential universality of bioethics as a discipline. I particularly argue against the pursuit of a distinct African bioethics, as it appears to be rooted in sterile African ethno-philosophy. Rather, African bioethicists and philosophers would do well to elucidate the universalisability of insights from traditional African thought, for the benefit of bioethics as a whole. Thus we must engage beyond the sterility of a distinct African bioethics - authentically reflecting on the essentially universal contemporary bioethical concerns - to effectively articulate a viable trajectory for bioethics in Africa. (shrink)

One of the vastly exciting areas in modern science involves the study of the brain. Recent research focuses not only on how the brain works but how it is related to what we normally call the mind, and throws new light on human behavior. Progress has been made in researching all that relates to interior man, why he thinks and feels as he does, what values he chooses to adopt, and what practices to scorn. All of these attributes make us (...) human and help to explain art, philosophy, and religions. Motion, sight, and memory, as well as emotions and the sentiments common to humans, are all given new meaning by what we have learned about the brain. In an introductory essay, Vernon B. Mountcastle traces the progress made in brain science during this century. Gerald M. Edelman touches upon features of the brain that challenge the picture of the brain as a machine. Semir Zeki discusses artists and artistic expression as an extension of the function of the brain. Richard S. J. Frackowiak probes the functional architecture of the brain. Mark F. Bear and Leon N Cooper explore whether complex neural systems can be illuminated by theoretical structures. Jean-Pierre Changeux sheds light on the knowledge gained in recent years concerning the neurobiology and pharmacology of drug action and addiction. Alexander A. Borbuly and Giulio Tononi ponder the quest for the essence of sleep, illuminating its complex dynamic process. George L. Gabor Miklos examines variations in neuroanatomies and sensory systems between individuals of the same species as well as variations across the evolutionary spectrum. Emilio Bizzi and Ferdinando A. Mussa-Ivaldi explain how scientists have approached the study of movement, the problems encountered, and the solutions proposed. Marcel Kinsbourne explores the unity and diversity in the human brain. In the concluding essay, Andy Clark points to recent work in neuroscience, robotics, and psychology that stresses the unexpected intimacy of brain, body, and world, supporting his belief that the mind is best understood as a brain at home in its proper bodily cultural and environmental niche. The breadth and scope of subjects covered in this volume attest to the extraordinary progress taking place in the study of the brain. This brilliant collection of essays by those at the forefront of research in this area will be of interest to all those interested in human behavior. Gerald M. Edelman is director of the Neurosciences Institute and chairman of the Department of Neurobiology at the Scripps Research Institute. Jean-Pierre Changeux is professor at the Collbge de France and the Institute Pasteur. (shrink)

Since the late 1990s, a consensus has emerged among scholars of the post-communist transitions that an enfeebled state is not an asset but a liability to a transition economy. Moreover, it is now accepted that underdeveloped fiscal capacity is a leading cause of state weakness in Eastern Europe and the former Soviet Union. This article compares the alternative revenue extraction strategies developed by state leaders in post-communist Poland and Russia. It stresses political institutional constraints to explain why Poland opted for (...) a social pact with labor over household incomes, while Russia developed a system of elite bargaining over corporate profits. (shrink)

So Ross, incorporating Bywater's transposition of συμβέβηκε τοîς αἰσθητοîς from 24 to 20. Thereby Aristotle distinguishes ‘the three types of objects of perception: the ἲδια αἰσθητά, colour, sound, etc. , the objects to which these belong, but which are here described as being contingent on the ἳδια αἰσθητά , and the κοιυà αἰσθητà, such as movement and size ’—D. Ross, Aristotle De Anima , 6; see also 289.

The AIDS crisis poses a special challenge for American health care, which depends heavily on private insurance to pay medical bills. Can we provide adequate health care to all who need it and still meet the financial requirements of the private health insurance industry? More insurance carriers are turning to antibody testing in order to eliminate poor risks from non‐group, direct‐pay pools. Some cost‐conscious employers have attempted to fire AIDS patients summarily or to exclude AIDS coverage from group insurance policies. (...) Various remedies are available for spreading the financial risks of the epidemic, such as covering persons with AIDS under Medicare or in state‐sponsored health insurance pools. Ethical questions about cost and access may also rekindle the debate about the need for national health insurance. (shrink)

It is one of the remarkable and significant consequence of the AIDS epidemic that out of the context of enormous suffering and death there emerged a forceful set of ideas linking the domains of health and human rights. At first, the effort centered on the observation that protecting individuals from discrimination and unwarranted intrusions on liberty were, contrary to previous epidemics, crucial to protecting the public health and interrupting the spread of HIV But in fairly short order, the scope of (...) the health and human rights perspective expanded dramatically to focus on the ways in which the most fundamental social arrangements rendered individuals and communities vulnerable to HIV Racial and ethnic minorities, those who were marginalized, and women were at risk because of their subordinate status. In the face of such an understanding, nothing short of social change could be adequate to the challenge posed by the AIDS epidemic. (shrink)

In the 4 1/2 to 5 days between fertilization and implantation, the mouse conceptus must gain the abilities to implant and produce an embryo. Each of these is the sole developmental responsibility of one of two cell types forming the blastocyst, trophectoderm and inner cell mass (ICM), respectively. Trophectoderm is a polarized transporting epithelium while the ICM is an aggregate of non‐epithelial pluripotent stem cells. These two cell types originate from the division of polar blastomeres when their cleavage furrows parallel (...) their apical surfaces. Blastomeres polarize in response to asymmetric cell–cell contact, and understanding the mechanism of this induction is regarded as the key to understanding the origin of trophectoderm and ICM. Here we propose a model based on transcellular ion current loops for the induction of cell polarity during the development of the first epithelium, trophectoderm. (shrink)

Focusing on the speeches and actions of the Platonic Socrates, this book argues that Plato's political philosophy is a crucial source for reflection on the hazards and possibilities of democratic politics.