Children diagnosed with type 1 diabetes mellitus (T1DM) are at risk for neurocognitive sequelae, including impaired attention functioning. The specific nature of the cognitive deficit varies; current literature underscores early age of diabetes diagnosis and increased disease duration as primary risk factors for this neurocognitive decline. Forty-three children with T1DM were evaluated for Attention Deficit/Hyperactivity Disorder (ADHD) symptomatology using the MOXO continuous performance test (MOXO-CPT) performed during a routine outpatient evaluation. The study cohort demonstrated a significant decline in all four (...) domains of attention functioning. The effect was most pronounced with early age at T1DM diagnosis, a longer disease duration and with poorer glycemic control (represented by higher HbA1c values). With increased disease duration (of 5 plus years), acute hyperglycemia was associated with inattention in the real-time setting. These findings highlight the need for routine screening of neurocognitive function in children with T1DM so that early intervention can be employed during this crucial period of cognitive development. (shrink)

Background Regulations on research ethics in France have evolved considerably over the past four years: the implementation of the Jardé law and of the General Data Protection Regulations have changed the landscape of research ethics for research involving or not involving human persons. In a context of creation of an Institutional Review Board at the University of Bordeaux, France, we sought to explore research ethics practices and perceptions in the medical community of our University Hospital. Methods A short questionnaire was (...) sent to all physicians of the University Hospital of Bordeaux. The questionnaire included closed questions and main topics were: physicians’ education in research ethics, ethics practices concerning researches non implying human persons, and physicians’ perceptions about current regulations. Results 86 questionnaires were sent back. If a majority of physicians have validated Good Clinical Practices trainings, there was a low rate of specific training on fundamental references in research ethics and a high proportion of responders do not consider themselves as educated in research ethics after completion of GCPs. Regulations on research ethics have many implications on medical research, especially by inducing changes in protocols in order to alleviate ethical requirements. Malpractices were acknowledged like false mention of positive opinion from an ethics committee. If If a majority of responders considers regulations as a positive answer to research ethics, a large majority considers it as a constraint and a complexification of research process. For 58%, regulations in research ethics are perceived as a hindrance for research initiatives. Conclusion Because of their impact on research process, regulations seem to constitute a scarecrow for physicians. Lack of training, bad representations and questionable practices highlight the need to improve education and to propose concrete guidance for medical researchers. (shrink)

: Two major philosophers of the twentieth century, the German existential phenomenologist Martin Heidegger and the seminal Japanese Kyoto School philosopher Nishida Kitarō are examined here in an attempt to discern to what extent their ideas may converge. Both are viewed as expressing, each through the lens of his own tradition, a world in transition with the rise of modernity in the West and its subsequent globalization. The popularity of Heidegger's thought among Japanese philosophers, despite its own admitted limitation to (...) the Western "history of being," is connected to Nishida's opening of a uniquely Japanese path in its confrontation with Western philosophy. The focus is primarily on their later works (the post-Kehre Heidegger and the works of Nishida that have been designated "Nishida philosophy"), in which each in his own way attempts to overcome the subject-object dichotomy inherited from the tradition of Western metaphysics by looking to a deeper structure from out of which both subjectivity and objectivity are derived and which embraces both. For Heidegger, the answer lies in being as the opening of unconcealment, from out of which beings emerge, and for Nishida, it is the place of nothingness within which beings are co-determined in their oppositions and relations. Concepts such as Nishida's "discontinuous continuity," "absolutely self-contradictory identity" (between one and many, whole and part, world and things), the mutual interdependence of individuals, and the self-determination of the world through the co-relative self-determination of individuals, and Heidegger's "simultaneity" (zugleich) and "within one another" (ineinander) (of unconcealment and concealment, presencing and absencing), and their "between" (Zwischen) and "jointure" (Fuge) are examined. Through a discussion of these ideas, the suggestion is made of a possible "transition" (Übergang) of both Western and Eastern thinking, in their mutual encounter, both in relation to each other and each in relation to its own past history, leading to both a self-discovery in the other and to a simultaneous self-reconstitution. (shrink)

Previous research has focused on the relation between social class and prosocial behavior. However, this relation is yet unclear. In this work, we shed light on this issue by considering the effect of the level of empathy and the social class of the recipient of help on two types of prosociality, namely helping and caring. In one experimental study, we found that for high-class participants, empathy had a positive effect on helping, regardless of the recipient’s social class. However, empathy had (...) no effect for low-class participants. When it comes to caring, empathy had a positive effect for both high and low-class participants, but only when the recipient of help belonged to the same social class. This highlights that empathy by itself is not sufficient to promote cooperative relations and that the social class of the recipient of help should be taken into account to shed light on this issue. (shrink)

Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. -/- Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. -/- The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations.

Rationale: Deep brain stimulation (DBS) of the hippocampus is proposed for enhancement of memory impaired by injury or disease. Many pre-clinical DBS paradigms can be addressed in epilepsy patients undergoing intracranial monitoring for seizure localization, since they already have electrodes implanted in brain areas of interest. Even though epilepsy is usually not a memory disorder targeted by DBS, the studies can nevertheless model other memory-impacting disorders, such as Traumatic Brain Injury (TBI). Methods: Human patients undergoing Phase II invasive monitoring for (...) intractable epilepsy were implanted with depth electrodes capable of recording neurophysiological signals. Subjects performed a delayed-match-to-sample (DMS) memory task while hippocampal ensembles from CA1 and CA3 cell layers were recorded to estimate a multi-input, multi-output (MIMO) model of CA3-to-CA1 neural encoding and a memory decoding model (MDM) to decode memory information from CA3 and CA1 neuronal signals. After model estimation, subjects again performed the DMS task while either MIMO-based or MDM-based patterned stimulation was delivered to CA1 electrode sites during the encoding phase of the DMS trials. Each subject was sorted (post hoc) by prior experience of repeated and/or mild-to-moderate brain injury (RMBI), TBI, or no history (control) and scored for percentage successful delayed recognition (DR) recall on stimulated vs. non-stimulated DMS trials. The subject’s medical history was unknown to the experimenters until after individual subject memory retention results were scored. Results: When examined compared to control subjects, both TBI and RMBI subjects showed increased memory retention in response to both MIMO and MDM-based hippocampal stimulation. Furthermore, effects of stimulation were also greater in subjects who were evaluated as having pre-existing mild-to-moderate memory impairment. Conclusion: These results show that hippocampal stimulation for memory facilitation was more beneficial for subjects who had previously suffered a brain injury (other than epilepsy), compared to control (epilepsy) subjects who had not suffered a brain injury. This study demonstrates that the epilepsy/intracranial recording model can be extended to test the ability of DBS to restore memory function in subjects who previously suffered a brain injury other than epilepsy, and support further investigation into the beneficial effect of DBS in TBI patients. (shrink)

Despite unprecedented medical advancements and the near eradi­cation of many serious diseases, there are growing epidemics of preventable illness brought about in part by the overemphasis on individual autonomy and the neglect of obligations to others. Insofar as these diseases develop because of individual choice, this permissiveness hampers the moral analysis of growing epidemics like childhood obesity. While society has contributed to its rapid progression, childhood obesity finds its origins in lifestyle choices implemented at home. Consequently, parents have an unparalleled (...) duty to prevent and correct obesity and unhealthy lifestyles in their children. Failure to do so undoubtedly violates a parent’s duty and suggests medical neglect. However, our current understanding of medical neglect is too narrow to be applicable to chronic, preventable illnesses. Relevant principles of tort law may broaden our understanding of neglect to better reflect the nature of parental and societal liability in preventable illnesses. (shrink)

While there seems to be much evidence that perceptual states can occur without being conscious, some theorists recently express scepticism about unconscious perception. We explore here two kinds of such scepticism: Megan Peters and Hakwan Lau's experimental work regarding the well-known problem of the criterion -- which seems to show that many purported instances of unconscious perception go unreported but are weakly conscious -- and Ian Phillips' theoretical consideration, which he calls the 'problem of attribution' -- the worry that many (...) purported examples of unconscious perception are not perceptual, but rather merely informational and subpersonal. We argue that these concerns do not undermine the evidence for unconscious perception and that this sceptical approach results in a dilemma for the sceptic, who must either deny that there is unconscious mentality generally or explain why perceptual states are unique in the mind such that they cannot occur unconsciously. Both options, we argue, are problematic. (shrink)

We argue that the pratyabhijñā system of Kaśmir Śaivism holds an inconsistent position. On the one hand, the Pratyabhijñā regards Śiva as an impersonal mechanism and the universe, including persons, as not having agency; call this the Impersonal Component. On the other hand, it considers Śiva himself as a person, and individual persons as having agency sufficient to respond to Śiva; call this the Personal Component. We maintain that the Personal Component should be affirmed and the Impersonal Component rejected. The (...) Impersonal Component’s claim that Śiva is unaware of and unaffected by his manifestation should be rejected, and the doctrine of satkāryavāda should be modified. The universe is Śiva’s manifestation, in the first instance, but it also has a relative autonomy from him. Moreover, humans have agency and freedom. Their actions effect Śiva. He grows and develops in response to his manifestation. (shrink)

L. M. de Rijk supposed in 1982 that two anonymous logical tracts in the Viennese Codex 4698, fol. 18r–27v, may be the work of Martinus Anglicus to whom a tract on consequences and one on obligations are ascribed in that codex. The tract on supposition of which the Viennese codex hands down only a fragment of the beginning is contained completely in Hs I 613 of the Stadtbibliothek Mainz, fol. 20vb–21vb. This finding ensures the authorship of Martinus Anglicus and allows (...) to ascribe an Introduction into Logic in some seven parts to him. Martin’s tract on supposition and the more detailed one by Thomas Manlevelt show some resemblances in structure and content, the first being presumably the later one. This paper presents an edition of Martin’s Tractatus de suppositione from the Mainz manuscript and an introduction regarding the author and his work. (shrink)

David Balme's major critical edition of Aristotle's largest and perhaps least studied treatise is based on a collation of the 26 known extant manuscripts and a study of the early Latin translations. Begun in 1975, with his work towards the Loeb editio minor of books VII–X, this edition of all ten books, including a very full apparatus criticus, was largely complete by 1989 when Professor Balme died, but it needed extensive work to put it in publishable form. This work has (...) been carried out by Allan Gotthelf, Balme's friend and associate. Volume I of the edition contains the complete text of the Historia Animalium, the critical apparatus, and Balme's introduction to the manuscripts, expanded and updated with the assistance of Friederike Berger, and in consultation with the editors of forthcoming editions of the extant medieval translations. A substantial index to the text has been provided by Liliane Bodson in collaboration with Professor Gotthelf. (shrink)

Kuznet︠s︡ov, I. V. Kategorii︠a︡ prichinnosti i ee poznavatelʹnoe znachenie.--Shali︠u︡tin, S. M. Ob otrazhenii kak obshchem svoĭstve materii.--I︠U︡rgelenas, D. I. Teorii︠a︡ otrazhenii︠a︡ i poni︠a︡tie informat︠s︡ii.--Korneeva, A. I. Vozrastai︠u︡shchai︠a︡ rolʹ logicheskogo myshlenii︠a︡ v poznanii mira.--Klimashevskiĭ, G. Teoretiko-poznavatelʹnai︠a︡ rolʹ myslennogo ėksperimenta v fizike.-- Podosetnik, V. M. Gnoseologicheskoe znachenie faktov v poznanii obshchestvennykh i︠a︡vleniĭ.

This article addresses the issue of asking questions as an important element of international business negotiation where there are differences in cultural background. A Dutch-Spanish difference in questioning was related to differences between the two parties in uncertainty reduction and negotiation goals. All 480 questions in 8 simulated Kelley game negotiations were reviewed: both monocultural and intercultural, i.e. 2 cultures and 3 languages. This analysis may also allow an illustration of the Sapir-Whorf Hypothesis which holds, at least in its weak (...) version, that culture frames language and language frames culture. It may also be possible to determine the extent to which intercultural differences between Dutch and Spanish questioning behaviours - assuming they can be ascertained in comparison with monocultural Dutch and Spanish behaviour - are language bound. In other words, do negotiators use a different typology of questions in their native language than in a neutral language? A comparison of the monocultural and intercultural data makes it possible to illustrate the above hypothesis, and to establish how far the L1-culture connection differs from that of the L2-culture. For another similar test on culture-language relations in South African mathematics texts and their readers, see Prins and Ulijn. The uncertainty reduction theory of Berger and the negotiation models developed by Fisher and Ury and Mastenbroek are related to question behaviour, which is analysed with the Verbal Response Mode Taxonomy of Stiles. Pre- and post-negotiation questionnaires were developed and administered to relate the results of the linguistic analysis to the perceptions of the negotiators in order to test the ecological validity of UR. Asking questions appeared to be a critical success factor in both monocultural and intercultural business negotiation on the basis of their relation with UR variables and Kelley game profit levels, but in a different sense to Gudykunst et al., who suggest that questions reduce uncertainty by increasing attributional confidence in a general way, seemingly irrespective of a national cultural background. In this study the Dutch, starting from a higher level of issue-related global confidence, used questions significantly less than the Spanish to attribute confidence to the person, indicating a cultural difference. Most questioning differences appeared to be language - as well as culture-bound. The Spanish asked significantly more for acknowledgement, and the Dutch asked more indirect questions with disclosure, but the two groups did not differ in global uncertainty and attributional confidence after their negotiations. They seemed to reduce uncertainty by adopting a passive, unobtrusive observation strategy. It may be that the type of information needed to become more confident depends on the communicator's personality rather than on his or her cultural background. Dutch and Spanish managers would therefore be advised to balance openness and vagueness to reach their negotiation goals in maximizing profits by using a combination of clear and ambiguous questions and answers and to be aware of the linguistic differences in questioning between Spanish and Dutch, which may even be carried over to English when it is used as a tool of communication. (shrink)

Historically the emergence of a precise technical meaning for probability, as distinct from its vague popular useage, has taken time; and confusion still arises from the concept of probability having different meanings in different flelds of discourse. Its technical meaning and appropriate rules are surveyed in the flelds of logic , mathematics , and science , and the relation between these three aspects of probability theory discussed. ‐. M. S. B.

John Stuart Mill's Utilitarianism continues to serve as a rich source of moral and theoretical insight. This collection of articles by top scholars offers fresh interpretations of Mill's ideas about happiness, moral obligation, justice, and rights. Applying contemporary philosophical insights, the articles challenge the conventional readings of Mill, and, in the process, contribute to a deeper understanding of utilitarian theory as well as the complexity of moral life.

Apresentam-se os resultados clínicos principais de uma primeira investigação efectuada a familiares de doentes sob tratamento paliativo no domicílio da área de Lisboa, com o instrumento de medida da satisfação SERVQUAL Modificado. Dos 58 familiares/doentes que responderam ao questionário apenas uma minona estava insatisfeita (uma classe de 5 indivíduos mostra-se francamente insatisfeita), uma classe de 15 estava moderadamente satisfeita, havendo 38 individuos fortemente satisfeitos com a qualidade e prontidäo dos serviços prestados. Porém urna percentagem elevada de doentes, segundo a opinião (...) retrospectiva dos cuidadores, faleceu com sintomatologia agravada, nomeadamente dores (60%), obstipação (67%) e depressão/ansiedade (43%). Discute-se a consistência e validade do questionáno SERVQUAL Modificado, contextualizam-se os resultados no que é o standard da prática da MCP e integram-se na promoção da dignidade humana no fim da vida. We present the main clinical findings of research on palliative home care, carried out among relatives of patients in the Lisbon area. An adapted version of SERVQUAL was used. Of a total of 58 carers surveyed only a small number (5) was unsatisfied 15 were only moderately satisfied. 38 family carers were strongly satisfied with the services. Yet, a high percentage of patients, as viewed in retrospect by their relatives died with some aggravated symptoms: 60% with more pain, 67% constipation, and 43% anxiety/depression. We discuss the consistency and validity of this adapted SERVQUAL tool and the main results are contextualized beanng in mind the standard practice of palliative medicine and the pursuit of human dignity in death. (shrink)