Medical-legal partnerships (MLPs) support patients and clinicians by streamlining legal and medical care and helping identify and address a subset of social drivers of health (SDOH). Less is known on the effect of MLPs on the competency of residents regarding SDOH. The aim of this study was to identify how integration of an MLP into a pediatric residency training program affected residents’ experience understanding and addressing SDOH.

Until the last years of his life, Charles Darwin had actually never read Aristotle. The sole reference he makes to his naturalist forebear in _On the Origin of Species_ came in an addition to the fourth edition, published in 1866, in which he mistakenly refers to Aristotle’s summation of Empedocles’ position at _Physica_ II 8, as Aristotle’s own, and notes that ‘we see here the principle of natural selection shadowed forth’ (while disputing the specific scientific point Aristotle – though actually (...) Empedocles – was supposedly making). So when his friend William Ogle, a minor scientist and physician, and an evangelist Christian, published a translation of Aristotle’s _De partibus animalium_ in 1882 and sent a copy to Darwin, he was able to declare that he felt “some self-importance in thus being a kind of formal introducer of the father of Naturalists [Aristotle] to his great modern successor [Darwin].” Ogle, who despite his religious inclinations was nevertheless a strong proponent of Darwin’s theories, did not agree with Aristotle’s scientific theories – not least because Aristotle’s teleological model of animal development, which had been adopted as a model by many post-classical Christian scientists and theologians for centuries, was dealt a serious blow by Darwin’s theory of natural selection. So it is perhaps surprising to see Ogle produce a translation of one of Aristotle’s major biological treatises. By looking at key passages of Aristotle and Ogle’s translation, this paper will examine the reasons for Ogle’s curious choice to publish his work, setting it into the wider scientific, and Darwinian, context of late-nineteenth century Britain, and explaining how Aristotle the teleologist was used by Ogle to re-enforce Darwin’s position as a modern natural historian. (shrink)

After the moral framework of sustainable development, the focus on climate change appears to take a lead in the practice and theory of environmental education. Inherent in this perspective is an apocalyptic message: if we do not rapidly change our use of energy resources, we will severely harm the life conditions of our children and grandchildren. In this article we argue that environmental educators should liberate us from this highly instrumental dictate by taking their cue from our daily care for (...) our environment as revealed in child?s play in nature. Inherent in the interaction of the Homo ludens with nature is a spiral time experience. This time condition elicits a particular responsibility: rather than calculating which means are necessary to prevent future disasters, we should respond with care to the concentric circles of an open and indefinite future. Therefore, environmental education should not aim to prevent future disasters, but foster anticipating care for nature. (shrink)

Traditional research into values has tended to dichotomise young people into categories of self and other orientations. In the present study values were explored within a contemporary context and analysed into more complex value sets. The sample comprised of 111 girls and 133 boys, aged 11-16 , who responded to four open-ended sentences designed to tap philosophies of life, fears and underlying values. The pleasures in life for girls tended to centre on relationships with family, friends and boys, whereas boys (...) enjoyed activities such as sport. Many desired to win the National Lottery, although they also concurrently held humanistic values. The potential impact of these value sets on development during adolescence is discussed. For these young people, the best things in life are free but, like many adults, they dream of fame and fortune. (shrink)

In Book 6 of Apuleius’Metamorphoses, Lucius contemplates his possible death at the hands of the robbers. After one robber threatens to throw him off a cliff, he remarks to himself how easily such an act would kill him (Met.6.26):‘uides istas rupinas proximas et praeacutas in his prominentes silices, quae te penetrantes antequam decideris membratim dissipabunt? nam et illa ipsa praeclara magia tua uultum laboresque tibi tantum asini, uerum corium non asini crassum, sed hirudinis tenue membranulum circumdedit. quin igitur masculum tandem (...) sumis animum tuaeque saluti, dum licet, consulis?’‘Do you see that ravine nearby and the sharp rocks jutting into it which will impale you before you hit the bottom and tear you limb from limb? For that wondrous magic of yours gave you only the appearance and hardships of an ass, but in truth it surrounded you not with the thick hide of an ass but with the thin little membrane of a leech. Why not, therefore, take up your manly spirit at last and seek your safety while you can?’Lucius seems to contradict the description of his metamorphosis at 3.24:pili mei crassantur in setas, et cutis tenella duratur in corium, ‘my hair thickens into bristles and my thin skin hardens into hide’.Met. 6.26 suggests that Lucius’ metamorphosis may not be as complete as it initially seemed: his skin is not the thick hide of an ass but the delicate membrane of a leech. This passage is further complicated by a textual dispute: where all modern editions and most translations readhirudinis, ‘leech’, our earliest and best manuscripts havehirundinis, ‘swallow’. I propose that we should restore ‘swallow’ on the testimony of these manuscripts and because it better reflects Lucius’ initial desire for an avian rather than an asinine transformation. My examination of this passage will also highlight the liminal nature of Lucius’ metamorphosis. Despite his apparent physical transformation, he remains caught between the human and the animal worlds in both mind and body. (shrink)

Though dividing one’s attention between two input streams typically impairs performance, detecting a behaviorally relevant stimulus can sometimes enhance the encoding of unrelated information presented at the same time. Previous research has shown that selection of this kind boosts visual cortical activity and memory for concurrent items. An important unanswered question is whether such effects are reflected in processing quality and functional connectivity in visual regions and in the hippocampus. In this fMRI study, participants were asked to memorize a stream (...) of naturalistic images and press a button only when they heard a predefined target tone. Images could be presented with a target tone, with a distractor tone, or without a tone. Auditory target detection increased activity throughout the ventral visual cortex but lowered it in the hippocampus. Enhancements in functional connectivity between the ventral visual cortex and the hippocampus were also observed following auditory targets. Multi-voxel pattern classification of image category was more accurate on target tone trials than on distractor and no tone trials in the fusiform gyrus and parahippocampal gyrus. This effect was stronger in visual cortical clusters whose activity was more correlated with the hippocampus on target tone than on distractor tone trials. In agreement with accounts suggesting that subcortical noradrenergic influences play a role in the attentional boost effect, auditory target detection also caused an increase in locus coeruleus activity and phasic pupil responses. These findings outline a network of cortical and subcortical regions that are involved in the selection and processing of information presented at behaviorally relevant moments. (shrink)

:This paper examines the transmediation of sacrifice in the Isuma “Fast Runner” trilogy, focusing in particular upon The Journals of Knud Rasmussen. In this film the impact of the introduction of Christianity upon traditional Inuit culture in the 1920s sets the stage for literal and metaphorical sacrifice, tied inexorably to the parallel threat of conversion and the transvaluation of traditional shamanistic beliefs. In the process, the film maintains a critical stance with respect to both the ethnographic perspective of the outsider, (...) which it incorporates, and to its own preferred Inuit perspective. My reading of the transmediation of sacrifice in The Journals rests upon the relation between sacrificial substitution and the notion of communion, in both doctrinaire and more secular senses. I argue that the film presents the Inuit characters negotiating a necessary détente with Christian culture, both at the cost of traditional beliefs and in the form of the co-optation and transmediation of ritual within the film's story, a process mirrored in the appropriation of the digital video medium in the fictional re-creation of these events. (shrink)

John Yoo, War by Other Means: An Insider's Account of the War on Terror New York: Atlantic Monthly Press, 2006, pp. 224.

In lieu of an abstract, here is a brief excerpt of the content:418 Feminist Studies 47, no. 2. © 2021 by Feminist Studies, Inc. I Swallowed a Moon Made of Iron Xu Lizhi Translated by Petrus Liu and Lisa Rofel I swallowed a moon; it is made of iron They call it a screw I swallowed this industry’s wastewater A purchase order for unemployment Those youth shorter than the machines die young I swallowed being constantly on the move I swallowed (...) being forced to wander without a home I swallowed the pedestrian overpass I swallowed a life full of limescale I can’t swallow any more All that I have swallowed comes surging Out of my throat Spreading, over the land of my country A poem of disgrace... (shrink)

1. The “puzzle” Physical objects are coloured: roses are red, violets are blue, and so forth. In particular, physical objects have fine-grained shades of colour: a certain chip, we can suppose, is true blue (unique, or pure blue). The following sort of scenario is commonplace. The chip looks true blue to John; in the same (ordinary) viewing conditions it looks (slightly) greenish-blue to Jane. Both John and Jane are “normal” perceivers. Now, nothing can be both true blue and greenish-blue; since (...) the chip is true blue, it is not greenish-blue. Hence Jane, unlike John, is misperceiving the chip. Generalizing, the conclusion is that there is widespread misperception of fine-grained shades. According to Tye (2006), and Cohen, Hardin, and McLaughlin (2006), the previous paragraph amounts to a paradox: an apparently unacceptable conclusion has been drawn from apparently acceptable premises via apparently acceptable reasoning. (See also Hawthorne and Kovakovich 2006, 180-1.) Tye swallows the conclusion, aided by a dose of evolutionary speculation. Hardin (1988), on the other hand, rejects the first premise, and denies that physical objects are coloured. Cohen (2004) and McLaughlin (2003) claim that both Jane and John have the colour of the chip right. Our opening paragraph concealed a crucial parameter. In fact, the chip looks greenish-blue-relative-to- circumstances-C to Jane, and true-blue-relative-to-circumstances-C* to John, and the chip has both these relativized colours.1 All this ingenious philosophizing would be in vain, of course, if the conclusion of the opening paragraph were not puzzling or problematic. So, why is it supposed to be? According to Tye, the conclusion is puzzling because John and Jane are both “normal perceivers” (xx). He seems to think that it is (prima facie) plausible to assume.. (shrink)

Only we must guard against this—not to strain our voice too roughly when conscious of a full stomach or sexual intercourse or physical fatigue. Many politicians and sophists experience this, being induced to engage in competitive debates, some through considerations of glory and ambition, others for pay or political contests. Thus our fellow citizen Niger, when a professional sophist in Galatia, happened to have swallowed a fishbone. But as another sophist had appeared on the scene from abroad and was engaged (...) in declaiming, Niger, fearful that he give the impression of having yielded to the newcomer, himself gave public performances, although the fishbone was still stuck in his throat. A serious and persistent inflammation in consequence developing, as he could not endure the pain, he submitted to a deep surgical incision from without. The fishbone was then removed through the wound site but thereafter the wound itself, becoming troublesome and purulent, caused his death. (shrink)

What does it mean to be a good person? Ranging over eternal questions of right and wrong, pleasure and self-control, friendship and courage, Aristotle's lectures on ethics are among the most lasting and profound philosophical works of all time--back cover.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Performance and Gender in Ancient Greece: Nondramatic Poetry in Its SettingAndré LardinoisEva Stehle. Performance and Gender in Ancient Greece: Nondramatic Poetry in Its Setting. Princeton: Princeton University Press, 1997. xi 1 367 pp. Cloth, $39.50.Both gender and performance have been the focus of much research in Greek literature since the mid-1970s, although they usually have been studied by different sets of scholars. A quick gender analysis shows that (...) gender studies, so far, have attracted mainly female scholars (with the prominent exception of Jack Winkler), while the study of the performance contexts of early Greek literature has been dominated by men: Claude Calame, Bruno Gentili, and Wolfgang Rösler, to name but a few. Eva Stehle, for the first time, combines both approaches to present a new reading of various passages in archaic and classical Greek literature.The book consists of six chapters with an introduction and a brief conclusion. The introduction opens with six ancient reports about performances, some of which touch upon the staging or self-presentation of the performers. This self-presentation can encompass many characteristics, including the performers’ physical fitness, social status, wealth, or gender. Stehle argues that the latter was considered particularly important in antiquity and is nowadays most easily detectable, because it is reflected in the language of the texts. This gendered self-presentation of the performers in turn has to be situated within the specific context of the performance. Stehle recognizes three types of performances in early Greece to which she relates the three major genres of poetry: (1) community performances (chapters 1–3), reflected mostly in choral poetry, (2) performances by bards of hexameter poetry (chapter 4), and (3) symposia (chapter 5), where most monodic lyric together with elegy and iambos was performed. Chapter 6 is devoted to Sappho, whose love poetry, Stehle argues, “was designed to escape the tyranny of the performance culture” (323).Another important concept discussed in the introduction is that of “psychological efficacy” (19–21). This relates to the effect a performance is supposed to have on the audience, besides entertainment. In chapter 1, Stehle discusses the psychological efficacy of community poetry, which, she argues, is to renew the community and provide a unifying discourse. Community poetry is mostly, but not exclusively, choral. A chorus can function as both reflection and model of the community, which means that it can speak for or to the audience. Among the fragments Stehle treats in this chapter are Alkman fr. 1, the Swallow Song (PMG 848), the Athenian praise song for Demetrios Poliorketes, Pindar’s Paian 9, Tyrtaios’ Eunomia, Solon’s Salamis elegy, and Archilochos frr. 98–99. [End Page 633]Chapter 2 (“Women in Performance in the Community”) continues the analysis of Alkman fr. 1 and further discusses Alkman fr. 3, Pindar’s Daphnephoria (fr. 94b), Korinna fr. 655, other evidence for songs sung by parthenoi, evidence for performances by adult women (chapter 2.2), and finally a number of inscriptions with women as subjects (chapter 2.3). (Inscriptions are also discussed at the end of chapter 6.) There is, according to Stehle, something of a paradox in the representation of the community by women, who otherwise lack a public voice. This paradox is resolved in Alkman’s partheneia fragments by having the young women downplay the efficacy of their voice. The same holds true for the young women in Pindar’s Daphnephoria fragment. In Korinna fr. 655 the poem “does not limit or depreciate women’s ability to speak effectively” (103), but it is unclear if this is a choral song. Adult women staged themselves as producers of warriors and proper wives. In other words, “women performing communal poetry combined the function of providing reflection and model with a staging of their own subordinate status in the community” (113). Stehle finds in the inscriptions a more positive expression of women’s identities, which she attributes to the “self-sufficient authority” of writing (115).The male body was associated with martial strength and aggressiveness, qualities which could be displayed in armed dances like the pyrrhiche but in other contexts were problematic for addressing the community. Therefore several strategies were developed to mitigate the aggressive... (shrink)

Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient‐centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral tube (...) feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision‐making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end‐of‐life care. (shrink)

Afferent feedback can appreciably alter the pharyngeal phase of swallow. In order to measure the stability of the swallow motor pattern during several types of alterations in afferent feedback, we assessed swallow during a conventional water challenge in four anesthetized cats, and compared that to swallows induced by fixed (20 Hz) and stochastic (1-20Hz) electrical stimulation applied to the superior laryngeal nerve. The swallow motor patterns were evaluated by electromyographic activity (EMG) of eight muscles, based on (...) their functional significance: laryngeal elevators (mylohyoid, geniohyoid, and thyrohyoid); laryngeal adductor (thyroarytenoid); inferior pharyngeal constrictor (thyropharyngeus); upper esophageal sphincter (cricopharyngeus); and inspiratory activity (parasternal and costal diaphragm). Both the fixed and stochastic electrical stimulation paradigms increased activity of the laryngeal elevators, produced short-term facilitation evidenced by increasing swallow durations over the stimulus period, and conversely inhibited swallow-related diaphragm activity. Both the fixed and stochastic stimulus conditions also increased specific EMG amplitudes, which never occurred with the water challenges. Stochastic stimulation increased swallow excitability, as measured by an increase in the number of swallows produced. Consistent with our previous results, changes in the swallow motor pattern for pairs of muscles were only sometimes correlated with each other. We conclude that alterations in afferent feedback produced particular variations of the swallow motor pattern. We hypothesize that specific SLN feedback might modulate the swallow central pattern generator during aberrant feeding conditions (food/liquid entering the airway), which may protect the airway and serve as potentially important clinical diagnostic indicators. (shrink)

Can shifting to tidal time potentially slow the catastrophic realities of sea-level rise? Sarah Cameron Sunde’s 36.5 / A Durational Performance with the Sea is a site-specific performance during which Sunde stands in a tidal bay for a full cycle as water engulfs her body and then reveals it again. The public participates. What began in 2013 as a poetic impulse has grown into a complex series of nine durational performances involving communities around the world. In this article, durational performance (...) artist and scholar Raegan Truax gleans insight from Indigenous feminist scholars and Indigenous women-led movements to analyse the choreographic and temporal dynamics of 36.5. Co-writing with the artist, and focusing specifically on Sunde’s durational shift to tidal time, Truax proposes a phenomenological undoing: ‘becoming Sea-swallowed’ as essential to the speculative possibility of ‘becoming otherwise’. (shrink)

How did bioethics manage to grow, flourish and ultimately do so well from a very unpromising birth in the 1970s? Many explanations have been advanced. Some ascribe the field9s growth to a puzzling, voluntary abnegation of moral authority by medicine to non-physicians. Some think bioethics survived by selling out to the biomedical establishment—public and private. This transaction involved bestowing moral approbation on all manner of biomedicine9s doings for a seat at a well-stocked funding table. Some see a sort of clever (...) intellectual bamboozlement at work wherein bioethicists pitched a moral elixir of objective expertise that the morally needy but unsophisticated in medicine and the biological sciences were eager to swallow. While each of these reasons has its defenders, I think the main reason that bioethics did well was that it did good. By using the media to move into the public arena, the field engaged the public imagination, provoked dialogue and debate, and contributed to policy changes that benefitted patients and healthcare providers. (shrink)

This paper investigates Philomela's metamorphosis into a swallow as inferred from Sophocles’ fragmentary Tereus. The first part focusses on the association between the swallow and barbaric language, casting new light on Philomela's characterization in the play. The second investigates the shuttle, the weaving tool which prompts the recognition of Philomela, arguing that the mention of its ‘voice’ in fr. 595 Radt refers not only to the tapestry which it created, but also to the actual sound of the shuttle, (...) which ancient Greeks associated with the swallow, and thus anticipates Philomela's metamorphosis. The representation of Philomela as a speech-impeded and yet vocal character supports the Dionysiac background of the act of vengeance which she and her sister commit. (shrink)

This paper contributes to our understanding of participation in the Eucharist by examining the swallow. The paper begins with a thick description of the swallow as act, as phenomenon, and as symbol. This description reveals the swallow’s interstitial nature, which is then examined for its implications on the meaning of participation in the sacrament. The paper then recommends approaches to the Eucharist for Catholics for whom swallowing is difficult or impossible. The paper finally incorporates these findings with (...) the ex opere operato doctrine, demonstrating participation as efficacious interaction. National Catholic Bioethics Quarterly 13.2 (Summer 2013): 253–262. (shrink)

The primary meaning of haurire is ‘to take by scooping, to draw’, and it is used of liquids and of solids which pour. The first section of this paper will try to show that this meaning is frequent and sometimes missed by the commentators. The second section will trace the development of other meanings showing that this root is not applied to drinking and swallowing, except metaphorically, until well into the first century A.D., except once in Livy.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Meaning of Meat and the Structure of the Odyssey by Egbert J. BakkerSusan A. CurryEgbert J. Bakker. The Meaning of Meat and the Structure of the Odyssey. Cambridge: Cambridge University Press, 2013. xiv + 191 pp. Cloth, $90.Meat-eating in the Odyssey is a risky business. Inextricably intertwined with song itself in the context of the aristocratic feast, meat-eating in excess becomes a weapon of the Suitors in (...) Ithaca as part of a three-year effort “literally to eat Odysseus’ house to ruin” (xi). In the “Otherworld” through which Odysseus and his Companions venture, meat and meat-eating are further problematized: there is too much or not enough of it; what they come across is forbidden; one may become meat oneself, filling the belly of another.This book traces the theme of meat in the Odyssey through a series of case studies that reveal a web of associations between Odysseus’ account of his adventures in the Otherworld and the poet’s account of events in Ithaca. Using a variety of approaches (narratological, folkloric, anthropological, philological), Bakker investigates the numerous “paradigmatic relationships” existing between the “matrix narrative” of the Odyssey, the aoide\, and the epos, the “embedded utterance” or part of the poem narrated by Odysseus himself (3). The theme of meat also allows Bakker to bring the related topics of dining and hospitality, sacrifice and hunting to bear on his exploration of the interconnections, thematic and linguistic, of the aoide\ and the epos. Although this book is weakest where Bakker roams farthest from meat, it nevertheless contains some choice cuts. In particular, he provides fascinating analyses of the Cyclops and Circe episodes and of hunting in the Otherworld (chaps. 4 and 5).We must begin with the “Epilogue: On ‘Interformularity,’” because, for passionate advocates of a particular school of thought on the composition of Homeric poetry, understanding Bakker’s approach to repetitions and allusions within the Odyssey is a prerequisite for accepting the claims he makes throughout the preceding chapters. Bakker favors an approach to the Homeric poems that involves the integration of intertextuality and orality, which he terms “interformularity.” Rather than randomly repeated traditional formulas, Bakker suggests that the repetitions and allusions within the Homeric poems are the result of “a poet’s judgment as to the (degree of) similarity between two contexts” (159). In other words, Bakker argues for meaningful repetition. Situations and similarity of situations determine the appropriate utterance; when similar situations evoke the same utterance or the same utterance gives rise to a similar situation, the language of the utterance becomes formulaic. [End Page 485]Because each of Bakker’s chapters is, for the most part, a separate case study, each will find its own audience beyond Homeric scholars generally. The first chapter, “Epos and Aoide\,” and the second, “Nostos as Quest,” will appeal to fans of intertextuality and folklore motifs, respectively. In the first chapter, Bakker defines and describes, as noted above, the epos and aoide\ of the Odyssey and makes two crucial points regarding the relationship between these on which much of his overall argument depends: first, epic is itself a ravening genre insatiable in its swallowing up of so-called “minor” genres; and, thus, second, the epos does not occupy a secondary position vis-à-vis the aoide\, but “competes with its ‘container,’ shaping the narrative tension within the Odyssey” (3).The second chapter is concerned more with structure than with meat. Bakker, following Anna Bonifazi (“Inquiring into Nostos and its Cognates,” AJP 130.4 [2009]:481–510), extends the definition of nostos to include the idea of survival as well as homecoming. He also discusses the role of quest as “an essential and versatile narrative building-block” (20) and adjusts Vladimir Propp’s quest sequence to accommodate the narrative of Odysseus’ wanderings. Most importantly, this chapter lays the groundwork for the two most significant contributions of Bakker’s study: first, the “Wanderings provide essential exemplars for the crimes committed in Odysseus’ house in his absence”; and second, meat is “a catalyst of crime and transgression” throughout the Odyssey (35).Although more focused on meat, meat-eating, dining, and cattle culture in Homeric society, “Meat in... (shrink)

A radical metaphysical theory typically comes packaged with a semantic theory that reconciles those radical claims with common sense. The metaphysical theory says what things exist and what their natures are, while the semantic theory specifies, in terms of these things, how we are to interpret everyday language. Thus may we “think with the learned, and speak with the vulgar.” This semantic accommodation of common sense, however, can end up undermining the very theory it is designed to protect. This paper (...) is a case study, showing in detail how one popular version of temporal parts theory is self-undermining. This raises the specter that the problem generalizes to other metaphysical theories. (shrink)

BackgroundDecision-making in end-stage dementia is a complex process involving medical, social, legal and ethical issues. In ESD, the person suffers from severe cognitive problems leading to a loss of capacity to decide matters regarding health and end-of-life issues. The decisional responsibility is usually passed to clinicians and relatives who can face significant difficulty in making moral decisions, particularly in the presence of life-threatening swallowing problems.AimThis study aimed to understand the decision-making processes of clinical teams and relatives in addressing life-threatening swallowing (...) difficulties in ESD in long-term care in Malta.MethodThe study followed a qualitative approach where six case studies, involving six different teams and relatives of six different patients, were interviewed retrospectively to understand their decision-making in connection with the management of swallowing difficulties in ESD. Data were collected through semistructured interviews with each stakeholder. All data were transcribed and subjected to thematic analysis.ResultsFour themes were identified: the vulnerability of patients in dementia decision-making; the difficult role of relatives in decision-making; the decisional conflict between aggressive care through tube feeding versus oral comfort feeding; a consensus-building decision-making process as ideal to facilitate agreement and respect for patient’s dignity.ConclusionDecision-making to manage swallowing difficulties in ESD is a challenging process, which involves an interpretation of personal values, beliefs, patient preferences, care needs and clinical practice. Better communication between clinicians and relatives in dementia helps promote agreement between stakeholders leading to a care plan that respects the dignity of patients at their end of life. (shrink)

ObjectiveThe effects and possible mechanisms of cerebellar high-frequency repetitive transcranial magnetic stimulation on swallowing-related neural networks were studied using resting-state functional magnetic resonance imaging.MethodA total of 23 healthy volunteers were recruited, and 19 healthy volunteers were finally included for the statistical analysis. Before stimulation, the cerebellar hemisphere dominant for swallowing was determined by the single-pulse TMS. The cerebellar representation of the suprahyoid muscles of this hemisphere was selected as the target for stimulation with 10 Hz rTMS, 100% resting motor threshold, (...) and 250 pulses, with every 1 s of stimulation followed by an interval of 9 s. The motor evoked potential amplitude of the suprahyoid muscles in the bilateral cerebral cortex was measured before and after stimulation to evaluate the cortical excitability. Forty-eight hours after elution, rTMS was reapplied on the dominant cerebellar representation of the suprahyoid muscles with the same stimulation parameters. Rs-fMRI was performed before and after stimulation to observe the changes in amplitude of low-frequency fluctuation and regional homology at 0.01–0.08 Hz, 0.01–0.027 Hz, and 0.027–0.073 Hz.ResultsAfter cerebellar high-frequency rTMS, MEP recorded from swallowing-related bilateral cerebral cortex was increased. The results of rs-fMRI showed that at 0.01–0.08 Hz, ALFF was increased at the pons, right cerebellum, and medulla and decreased at the left temporal lobe, and ReHo was decreased at the left insular lobe, right temporal lobe, and corpus callosum. At 0.01–0.027 Hz, ALFF was decreased at the left temporal lobe, and ReHo was decreased at the right temporal lobe, left putamen, and left supplementary motor area.ConclusionRepetitive transcranial magnetic stimulation of the swallowing cortex in the dominant cerebellar hemisphere increased the bilateral cerebral swallowing cortex excitability and enhanced pontine, bulbar, and cerebellar spontaneous neural activity, suggesting that unilateral high-frequency stimulation of the cerebellum can excite both brainstem and cortical swallowing centers. These findings all provide favorable support for the application of cerebellar rTMS in the clinical practice. (shrink)

As I understand it, the Sokal affair is about affirmative action for ideas. Should arguments felt to be under-represented in the culture-at-large be admitted into prestigious haunts like Social Text even if they don't meet the standard intellectual tests? Alan Sokal got tired of what he saw as an excess of affirmative action in the ideas purveyed by cultural studies. So he devised a test in the form of a hoax: Could an author who deliberately met no standards whatsoever make (...) it into Social Text merely by parading past the judges their own sympathies, dressed up in a jargon they would recognize and citing these same judges as authoritative? The test came back positive. The issue, then, is what to make of the results. (shrink)

Juturna drives Turnus’ chariot now here now there, hoping to throw off Aeneas’ pursuit, but he follows the twisted circles of her course. Virgil compares her to a black hirundo flying through a rich man's house out into the colonnades and then round the pools or fishtanks. Hirundo can mean swallow, martin, or even swift. All these birds eat insects and air-borne spiders; they do not eat human food. The common swallow chiefly eats flies, and feeds the nestlings (...) on flies; it also eats wasps and bees. Its average prey size is much greater than the house martin's. Virgil's hirundo gathers pabula parua for the nestlings. W F. J. Knight in the Penguin translation writes ‘tiny scraps of food’; C. Day Lewis translates ‘crumbs of food’. If Virgil meant scraps of meat or crumbs of bread, stolen from the rich man's dinner table, then Virgil did not know what these birds eat. (shrink)

In many cases of family trauma, victims are left with the burden of rebuilding relationships that have been damaged. This paper illustrates that inappropriate pressure to forgive can harm victims of abuse. This pressure can come from a combination of assumptions. Firstly, often forgiveness is conflated with reconciliation, and those who put pressure on victims to forgive do so to avoid uncomfortable blame or estrangement. Secondly, anger is often inappropriately understood as a morally blameworthy emotion to hold. I draw on (...) Amia Srinivasan’s (2018) work on affective injustice to address this assumption and argue that pressure to forgo anger, forgive, and reconcile stems from a mistaken interpretation of these concepts and is ultimately harmful. I demonstrate this by using examples where victims have found their voices stifled by the mistaken coding of anger as morally blameworthy and forgiveness as morally required. (shrink)

This chapter contains sections titled: Saddle Up and Swallow Your Pride The Made Hunter: Product and Agent Horses and Humans: A Foxhunting Partnership Foxhunting Resonances Notes.

ON DECEMBER 10, 1991 Charles Shonubi, a Nigerian citizen but a resident of the USA, was arrested at John F. Kennedy International Airport for the importation of heroin into the United States.1 Shonubi's modus operandi was ``balloon swallowing.'' That is, heroin was mixed with another substance to form a paste and this paste was sealed in balloons which were then swallowed. The idea was that once the illegal substance was safely inside the USA, the smuggler would pass the balloons and (...) recover the heroin. On the date of his arrest, Shonubi was found to have swallowed 103 balloons containing a total of 427.4 grams of heroin. There was little doubt about Shonubi's guilt. In fact, there was considerable evidence that he had made at least seven prior heroin-smuggling trips to the USA (although he was not tried for these). In October 1992 Shonubi was convicted in a United States District Court for possessing and importing heroin. Although the conviction was only for crimes associated with Shonubi's arrest date of December 10, 1991, the sentencing judge, Jack B. Weinstein, also made a ®nding that Shonubi had indeed made seven prior drug-smuggling trips to the USA. The interesting part of this case was in the sentencing. According to the federal sentencing guidelines, the sentence in cases such as this should depend on the total quantity of heroin involved. This instruction was interpreted rather broadly.. (shrink)

“He devoured her with his eyes.” This expression and many other signs point to the illusion common to both realism and idealism: to know is to eat. After a hundred years of academicism, French philosophy remains at that point. We have all read Brunschvicg, Lalande, and Meyerson,2 we have all believed that the spidery mind trapped things in its web, covered them with a white spit and slowly swallowed them, reducing them to its own substance. What is a table, a (...) rock, a house? Answer: a certain assemblage of “contents of consciousness,” a class of such contents. Oh digestive philosophy! Yet nothing seemed more obvious: is not the table the actual content of my perception? Is not my perception the present state of my consciousness? Nutrition, assimilation! Assimilation, Lalande said, of things to ideas, of ideas by ideas, of minds by minds. The corpulent skeletons of the world were picked clean by these diligent diastases: assimilation, unification, identification. The simplest and plainest among us vainly looked for something solid, something not just mental, but would encounter everywhere only a soft and very genteel mist: themselves. (shrink)

As Gelven points out in his Preface, this is the only section-by-section commentary on the full text of Being and Time. Being and Time is divided not only into two "divisions" of six chapters each but also into eighty-three numbered "sections". As such it provides an efficient and useful handbook for those who try to make their way through the rugged terrain of Heidegger's text, especially for the beginner. Gelven's prose is crisp and clean and uncluttered by Germanicisms. He often (...) uses uncomplicated and helpful illustrations. The interpretation stresses the importance of the analysis of "understanding" taking § 31 as "the key to Being and Time". In fact, Gelven groups §§ 25-38 as a whole under the single heading "Understanding". Such an emphasis seems entirely legitimate. He treats the historical sources of Being and Time but often leaves them undeveloped. He is content, for example, to devote a single paragraph to Dilthey whose influence upon Heidegger is so decisive, with the comment that not much is ever said about Dilthey in English philosophical literature. One also finds it a bit hard to swallow the author's argument that "Dasein" means literally "to be here" and, in sentence form: "Here I am, open to possibilities". In all, however, Gelven's work is a distinctive contribution and not a mere reworking of already familiar themes.--J. D. C. (shrink)

In 1940, John and Morag Aitkenhead set up Kilquhanity School in rural Galloway, inspired by the writings of A.S. Neill and the practices at Summerhill School. In 1962, Aitkenhead wrote that he had swallowed ‘hook, line and sinker’ Neill's theories and that ‘but for him and his example, there could never have been this free school in Scotland’. Historians and commentators have tended to share his view, for example, describing Aitkenhead as a ‘disciple’ of Neill and Kilquhanity as an ‘approximate’ (...) of Summerhill with its weekly meeting, informality of relations between adults and children and a valuing of freedom and happiness over academic achievement.However, this article, drawing on primary research with ex-pupils and staff, uncovers significant differences of philosophy and practice between the two schools, particularly in relation to pupils’ contribution to the Kilquhanity School community through the daily practice of ‘useful work’. These differences raise questions about the positioning of Kilquhanity as simply a less well-known and less radical ‘Summerhill in Scotland’ and expose an often neglected fault line within the progressive and radical movements with which both schools are associated. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Are We There Yet?A Narrative of Firsthand Interpreter Experiences in the Medical Field and Insights to Aid Language Access ComplianceHilda Sanchez-HerreraMy Spanish interpreting journey began in 2008. In those days, very little training was available, and online studies were very new and rare. Early trainings involved out-of-town interpreter and translation conferences, reading the recently released Culturally and Linguistically Appropriate Services (CLAS) standards documents, and participating in the diversity events (...) at the hospital and in the community. Eventually, I did three different medical interpreter training programs, each teaching me something new and improving my skills. The first few years opened my eyes to what it meant for one to be trained, qualified, and certified. It has been a marvelous learning experience.Now, with sixteen years of experience and the vastness and richness of being an interpreter in various settings, I continue to learn to be flexible, patient, and courageous. I've also learned to be a teacher because clinical staff have one perspective of what interpreting is, and we have another. I've learned to be courageous because the field of Language Access is very demanding and involves encountering a lot of biases and judgmental perspectives. Language Access champions advocate throughout the nation so that those who are working in this field will have better working conditions. Collaborations started in the community, extending into social services, legal, and beyond.Interpreting sessions that had the most impact are many, but a few stand out, including a patient I assisted who had presumed Locked-In Syndrome and a domestic abuse female at a maternal-fetal appointment. I have had to explain to a family what it means to be brain dead and have interpreted for numerous palliative care sessions.The presumed Locked-In syndrome patient was quite the experience. I had recently started working on the floor at the hospital and was making my rounds to Spanish-speaking inpatients. One morning, I arrived just as the physician team was making their rounds. I listened to the briefing: a 42-year-old female had suffered a stroke. She could not speak and could not use her extremities. The team had done what they could and reached the conclusion that she was "locked-in" because she was aware but their neurological exams were inconclusive. I asked if they had used the video or phone interpreting services and they said yes but it was not fruitful. I offered to rule out a language barrier. They agreed.It was then that the patient began making great progress in her recovery. The team was amazed at the patient's reaction. She cried when she heard her language spoken. We established communication via a board and eye signals. Speech therapy came and they were able to assess her ability to speak and swallow. While she remained approximately 6 months in the hospital, it was not until the last two [End Page 154] months that she made great strides, and it was all due to language access. Eventually, she was transferred to another healthcare facility closer to home. I was overjoyed and wondered why they had not had this success earlier. It was later determined that the connections were not good, and the interpreter could not "see" what the patient was doing.The domestic violence female was an emotional one for me. I was scheduled to assist at two of her appointments that morning: one at maternal fetal and the other at ENT. Upon arrival, I greeted her and noticed her eyes were watery and her face seemed a little swollen, but I did not want to make her feel embarrassed, so I remained quiet. I accompanied her to the ENT appointment first. The doctor asked her questions, and she seemed nervous. Still no intervention. We finished and went to the maternal-fetal appointment. On the way to the office, I asked if she was ok. She began to cry and said in a soft tone, looking around, that her partner had hit her on the way to the clinic.I was shocked! I knew that permission was needed to share this information with the providers and that her safety was critical. She thought... (shrink)

Poland ceased to exist in the last third of the eighteenth century, swallowed up by its three immediate neighbours—Austria, Prussia, and Russia. Following the Napoleonic Wars and the subsequent red...

Graphical AbstractThe hiccup may have evolved to remove swallowed air from the stomach, which may help suckling mammals to consume more milk.

In lieu of an abstract, here is a brief excerpt of the content:Can Two Wrongs Make a Right?Toby Williamson (bio)"Service users, carers, and professionals disagree about the nature of mental disorder in startling new revelation!" On first appearances Fulford and Colombo's use of linguistic-analytic and empirical methods to demonstrate this point may not seem as if it is telling those in the mental health world anything that they do not already know. The bipolar/dialectical axis (choose your preferred term depending on (...) your ideological position) with the anti-psychiatry movement at one end and the biogeneticists at the other is both well-known and well-documented. Yet it is precisely that flippancy, and the practical implications that flow from it, that make this work so fundamentally important to the theory, application, and experience of mental health practice at the beginning of the twenty-first century.Discussions about different models of mental disorder usually play themselves out in arguments within services, or between services and service users and informal carers, about the most appropriate approach to take in addressing a service users needs, or in abstract discussions (often over a drink after work) about the nature of mental health and mental health problems. From blood and fur flying in the bull pit, to swallows endlessly chasing their tails high in the sky. Sadly, the results of this all too often are bitter and unresolved conflicts, different parties digging themselves even further into defensive, entrenched positions, and the least powerful (usually service users) suffering the most as a consequence. Both sides believe the other to be wrong yet cannot convince them of this; an example, albeit with slight variation, of two wrongs not making a right. Rarely are the debates grounded in a constructive, creative, and problem-solving approach on a day-to-day basis, partly because hitherto there does not seem to have been either sufficient empirical evidence to base this upon, or the conceptual as well as practical tools with which to grapple with the issues.Generally speaking, mainstream research in mental health has tended to focus on issues such as symptoms and treatment interventions (James and Burns 2002). However, surveys of service users' views still show considerable problems in the way services are received and experienced by users (Rose 2001). Other surveys, together with user-led research, such as Strategies for Living at the Mental Health Foundation, have also shown how the focus of users' concerns maybe very different to that of service providers (Faulkner and Layzell 2000; Nicholls et al, 2003; Repper 2000). Indeed, a piece of research carried out in the 1990s, which would probably still hold true today, showed that service users prioritized practical issues such as personal finance, housing, and social support, whereas professionals saw issues such as treatment and monitoring as being the highest priority (Shepherd, Murray, and Muijen 1995). Combining this, one might well argue that there is fairly clear evidence of the [End Page 159] differences in value bases and models of mental disorder deployed by service users and mental health professionals. However, actually trying to scientifically map this, and taking into account differences between professions, not to mention the views of informal carers, would appear to be a gargantuan task. Yet Fulford and Colombo appear to have very successfully done this in the research supporting this article, as well as the article itself. Their discussion of the concept of mental disorder, and the difficulties of defining it, not only effortlessly demonstrates the theoretical and philosophical problems that lie at the heart of psychiatry and mental health systems, of which Professor Fulford along with others has already written extensively (Dickenson and Fulford 2000), but also should resonate at a very practical level for most people who have been at the providing or receiving end of mental health services. But going beyond this they also provide perhaps the simplest, yet most effective solution—to embrace diversity and find ways of working with it, rather than running shy of it or even worse, attempting to homogenize it. As they say, "the difficulties in use presented by the concept of mental disorder are not a liability, heuristically speaking, but an asset" (Fulford and Colombo 2004, 132).The article is also very timely because... (shrink)

Born at 24 weeks gestation, Baby G now lies in a neonatal intensive care unit two months post-birth. He has pulmonary hypoplasia, congenital scoliosis, and swallowing issues that will require placement of a feeding tube, and bowel dystonia that interferes with his ability to absorb feedings. Shortly after birth, he experienced a cardiopulmonary arrest and now has obvious neurological impairments. As a result of incomplete development of his lungs and severe chronic lung disease, he cannot breathe on his own. Because (...) of his chronic respiratory failure, tracheostomy and long-term assisted ventilation was offered as an option that would allow him to be discharged from the acute care setting. However, his congenital.. (shrink)

Literary people have had less difficulty in understanding George Santayana than have philosophers, and it is particularly we Anglo-American philosophers who complain that he is enigmatic. We have read his books as arguments of a professor of philosophy, and failed to recognize that he was a sage, one who sought wisdom and found redemption. Anthony Woodward's Living in the Eternal succeeds as no other book on Santayana in showing how to understand this philosophy as the confessions of the freedom and (...) joy of spiritual ascent. Santayana is like no modern philosopher, save Spinoza, and passing over the medieval and Renaissance wise men who were well known to Santayana, but to whom Woodward has no reference, he is most like "some Gnostic Christian of Alexandria, in the early centuries of the faith, for whom love has been swallowed up in knowledge and the believer consummated in the sage". We are apt, at first reading of the "attempt to be godlike," to explode: "but Santayana was a materialist and an atheist! How can he, more than any other modern philosopher, have more to say about spirit?". (shrink)