To avoid misinterpretations one should substitute the ambiguous notion of 'new disease' with 'emerging disease'. A disease can be classified emergent in at least five dif férent historical situations; 1) it existed before it could be first identified but was overlooked from a médical point of view because it could not be conceptualized as a nosological entity; 2) it existed but was not noticed until a quantitative and/or qualitative change in its mani festations; 3) it did not exist in a (...) particular région of the world before its introduction from other régions; 4) it never existed in a human population but only in an animal population; 5) it is completely new - the triggering germ and/or necessary environmental conditions did not exist prior to the first clinical manifestations. A sériés of historical examples illustrate this classification. (shrink)

This book provides a detailed account of intellectual, other neuropsychological and behavioral manifestations of general pediatric diseases. The conditions discussed include the whole range of pediatric diseases - genetic syndromes, other congenital conditions, metabolic, endocrine, gastrointestinal, infectious, immunologic, toxic, trauma, and neoplastic, as well as sensory disabilities including deafness and blindness. Although the book is not intended to discuss cognitive and behavioral manifestations of conditions usually considered to be primary neurological disease, some of those, including cerebral palsy, muscular dystrophy, myotonic (...) dystrophy and epilepsy, are included.Where possible, a. (shrink)

Upshot: We respond to three main challenges that the commentaries have raised. First, we argue that to deal successfully with the hard problem of consciousness, it is not enough to posit a remedy by which to move beyond the hard problem. Second, we argue that it makes no sense to explain identity. Yet this does not commit us to definitions by fiat. The strategy we pursue here, and in the target article, is not to explain identity but to explain away (...) the appearance of non-identity. Finally, while we are sympathetic to Varela’s call for a paradigm shift in consciousness studies, we argue here, and in the target article, that this call can only be properly successful if the hard problem is dismantled. (shrink)

AimsThis study evaluates a protocol for early, routine ethics consultation for patients on extracorporeal membrane oxygenation to support decision-making in the context of clinical uncertainty with the aim of mitigating ethical conflict and moral distress.MethodsWe conducted a single-site qualitative analysis of EC documentation for all patients receiving ECMO support from 15 August 2018 to 15 May 2019. Detailed analysis of 20 ethically complex cases with protracted ethics involvement identifies four key ethical domains: limits of prognostication, bridge to nowhere, burden of (...) treatment and system-level concerns. There are three subthemes: relevant contextual factors, the role of EC and observed outcomes. Content analysis of transcripts from interviews with 20 members of the multidisciplinary ECMO team yields supplemental data on providers’ perceptions of the impact of the early intervention protocol.ResultsLimited outcome data for ECMO, unclear indications for withdrawal, adverse effects of treatment and an obligation to attend to programme metrics present significant ethical challenges in the care of this patient population. Upstream EC mitigates ethical conflict by setting clear expectations about ECMO as a time limited trial, promoting consistent messaging among multiple services and supporting surrogate decision-makers. When ECMO becomes a ‘bridge to nowhere’, EC facilitates decision-making that respects patient values yet successfully sets limits on non-beneficial use of this novel therapy.ConclusionData from this study support the conclusion that ECMO poses unique ethical challenges that necessitate a standardised protocol for early, routine EC—at least while this medical technology is in its nascent stages. (shrink)

L'A. établit la biographie de Jean le Géomètre en se référant à ses poèmes et à ses épigrammes. Ces poèmes à Basile le Nothos apportent des éclaircissements sur sa carrière comme poète lauréat et sur ses attachements politiques. Il a notamment été renvoyé du service militaire juste après 985 à cause de son attachement à la faction de Basile le Nothos. Ces poèmes à Psenas prouvent indirectement qu'il a vécu au monastère de Kyros vers la fin de sa vie.

Based on two workshops held February 1990 in New York and March 1990 in San Francisco. Following the presentation and discussion of three clinical case histories, psychotherapists James F. Masterson, Marian Tolpin, and Peter E. Sifneos compare and contrast developmental, self, and object relations.

Open peer commentary on the article “Exploring the Depth of Dream Experience: The Enactive Framework and Methods for Neurophenomenological Research” by Elizaveta Solomonova & Xin Wei Sha. Upshot: This commentary focuses on an ontological claim made by the authors of this target article: that perceiving, imagining and dreaming are inseparable. It explores how best to understand this “inseparability condition.” It is shown that the evidence needed to justify a strict reading of the inseparability condition is lacking, while there is room (...) for a more relaxed rendition of the inseparability condition. The inferred lesson is that in developing an enactive neurophenomenology of dreaming, it is a non-trivial task to achieve clarity about the ontology of dreaming, and its relationship to imagining as well as perceiving. (shrink)

Human aesthetic experiences are pervasive; they are triggered by faces, art, natural scenery, foods, ideas, theories, and decision-making situations, among many sources, and seem to be a distinctive trait of our species. Our moral sense, understood as our capacity to judge events, actions, or people as good or bad, appropriate or inappropriate, also seems to be an exclusively human endowment (Ayala 2010). As part of the scientific efforts to characterize the biological foundations of our human uniqueness, recently there has been (...) interest in the brain’s underpinnings of aesthetic reactions to art on the one hand, and in the neural correlates of moral judgment and decision-making on the other (Greene and Paxton .. (shrink)

This book is the fifty-first volume of Current Legal Problems and contains the now customary selection of high quality essays by a group of outstanding scholars. This volume gathers together a galaxy of stars from the academic firmament to provide in a particularly valuable and broad-ranging set of contributions a stimulating study of legal theory at the end of the millennium.

Written with poignancy and compassion, ____Do We Still Need__ ____Doctors?__ is a personal account from the front lines of the moral and political battles that are reshaping America's health care system.