It describes and explains the patient-centered model examining and evaluating qualitative and quantitative research. It comprehensively covers the evolution and the six interactive components of the patient-centered clinical method, taking the reader through the relationships between the patient and doctor and the patient and clinician. All the editors are professors in the Department of Family Medicine at the University of Western Ontario, London, Canada.

Context: Most constructivist discourse is situated at the philosophical-conceptual level, where arguments appeal to the intuition of the reader, while formal-computational models have only been taken into account to a very limited degree so far. Problem: Two types of problems need to be addressed: Synthetically, can constructivist concepts be turned into actual computational implementations? Can these be further conceptual developments in constructivist theory as such, or are they just an application thereof? Conceptually, does the notion of computation square with constructivist (...) approaches at all? Method: Paradigmatically, we discuss the meaning of “computational” in cognitive agents that comply with constructivist concepts. Also, we summarize the contributions. Results: From a constructivist point of view, the concept of “computational model” is ambiguous and depends on whether it is used in the sense of the computational(ist) theory of mind or simply as a tool. Implications: The insights presented in the contributions to this special issue point in the direction of a computational extension of constructivist approaches as well as a constructivist extension to computational approaches. However, while many of the questions we posed were discussed in the contributions and open peer commentaries, some of them were largely neglected and thus are subject to further discussion. (shrink)

With rapidly expanding technological capacity, research has outpaced the existing infrastructure of ethical and regulatory guidance. In the area of incidental findings, this is particularly true.The regulations under which most Institutional Review Boards operate were established over 25 years ago and have not been substantially altered in the intervening years. The technology available today that creates the opportunity for IFs was not conceived of, or considered, in the crafting of those regulations. Therefore, little guidance can be derived directly from these (...) regulations. Rather, aspects of existing ethical guidance and regulations can be adapted to assist IRBs and researchers in dealing with issues surrounding IFs. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Decision-Making as a Broader ConceptJacinta O. A. Tan (bio), Anne Stewart (bio), and Tony Hope (bio)KeywordsCompetence, decision-making, capacity, anorexia nervosa, autonomy, values, identityWe thank Demian Whiting for the thoughtful critique of aspects of our paper (Tan et al. 2006a). A primary aim of our research was to provide empirical grounds on which to stimulate discussion about the nature of decision-making capacity (DMC). Whiting criticizes in particular the concept (...) of 'pathological values' that we suggested might be relevant in the assessment of DMC and in the related issue of deciding when a patient's refusal of beneficial treatment should be overridden.Whiting's central concern is with DMC. Whiting argues that the absence of pathological values should not be a criterion for DMC. We are unclear whether he is also arguing that pathological values do not provide a reason of any kind for overriding treatment refusal. At the end of the paper he writes: "we cannot justify compulsory treatment of patients who have pathological values... on the grounds that these patients lack DMC" (2009, XX). This seems to leave open the possibility that we may be able to justify compulsory treatment of patients who have pathological values on grounds other than that they lack DMC. As we wrote in our response to the discussants of our original paper, "The primary issue for us is whether the reasons for refusal to which we draw attention provide grounds for overriding refusal, and if they do how they can be characterized in such a way as to avoid the ever-present danger of simply overriding autonomy in a patient's best interests" (Tan et al. 2006b, 300).In deciding on whether to use compulsory treatment, there are other relevant factors that may need to be considered, such as the seriousness of the decision, which determines the threshold for competence. However, in this response we consider three issues. First, we argue that the current concept of DMC is by no means so clear cut or generally agreed upon as Whiting implies, and that some of the lack of clarity relates to pathological values. Second, that the concept of DMC is itself dependent on accounts of autonomy, and that it is plausible that pathological values can affect autonomy. Third, we directly consider the question of whether a coherent account of pathological values might be given based on a concept of authenticity.The Current Criteria for DMCWhiting argues that the current criteria for DMC are correct and that an additional criterion along the lines of absence of pathological values should not be added. This argument assumes that there is a clear and agreed understanding of the current criteria. We believe this is not the case for three reasons.(i) Whiting begins his account of DMC by saying that it is normally taken to include: "(1) [End Page 345] understanding (and appreciation)" (2009, 341). Already there is an area of dispute, and the use of parentheses reflects this. The concept of 'appreciation' was developed by Grisso and Applebaum (Grisso, Appelbaum, and Hill-Fotouhi 1997). It is not included in either English common law development, for example (ReC), nor in the criteria specified in the Mental Capacity Act 2005. More important, Grisso and Appelbaum in their comment on our original paper (2006) argue that our work advances thinking about 'appreciation' rather than requiring that we add new elements. The implication is that they believe that what we have called pathological values are relevant to the assessment of capacity and are already included in an account of capacity that incorporates the criterion of 'appreciation.' In our response, we argued that pathological values are not entirely captured within the account of appreciation that Grisso and Appelbaum had previously given. We do not want to revisit that issue here, but the point of relevance is that on one view (that of Grisso and Appelbaum) pathological values are already included in the current criteria for DMC as part of the concept of appreciation, whereas on Whiting's view they are not.(ii) Even if there were agreement over the wording and concepts relevant to DMC there is a further important issue: how are those concepts... (shrink)

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

Two studies examined the link between social dominance and male waist-to-hip ratio (WHR). Groups of four men interacted in a leaderless group discussion. In both studies, men with higher WHRs (associated with current and long-term health status) were rated by other group members as behaving more leader-like when an observer was present, and rated themselves as being more assertive. In Study 2, men with higher WHRs were rated by independent observers as behaving more dominantly, but only when the evaluator was (...) present. These results are discussed in terms of evolutionary models of health, attraction, and intrasexual competition. (shrink)

Nanomedicine is yielding new and improved treatments and diagnostics for a range of diseases and disorders. Nanomedicine applications incorporate materials and components with nanoscale dimensions where novel physiochemical properties emerge as a result of size-dependent phenomena and high surface-to-mass ratio. Nanotherapeutics and in vivo nanodiagnostics are a subset of nanomedicine products that enter the human body. These include drugs, biological products, implantable medical devices, and combination products that are designed to function in the body in ways unachievable at larger scales. (...) Nanotherapeutics andin vivonanodiagnostics incorporate materials that are engineered at the nanoscale to express novel properties that are medicinally useful. These nanomedicine applications can also contain nanomaterials that are biologically active, producing interactions that depend on biological triggers. Examples include nanoscale formulations of insoluble drugs to improve bioavailability and pharmacokinetics, drugs encapsulated in hollow nanoparticles with the ability to target and cross cellular and tissue membranes and to release their payload at a specific time or location, imaging agents that demonstrate novel optical properties to aid in locating micrometastases, and antimicrobial and drug-eluting components or coatings of implantable medical devices such as stents. (shrink)

In some cases people judge it morally acceptable to sacrifice one person’s life in order to save several other lives, while in other similar cases they make the opposite judgment. Researchers have identified two general factors that may explain this phenomenon at the stimulus level: (1) the agent’s intention (i.e. whether the harmful event is intended as a means or merely foreseen as a side-effect) and (2) whether the agent harms the victim in a manner that is relatively “direct” or (...) “personal”. Here we integrate these two classes of findings. Two experiments examine a novel personalness/directness factor that we call personal force, present when the force that directly impacts the victim is generated by the agent’s muscles (e.g., in pushing). Experiments 1a and b demonstrate the influence of personal force on moral judgment, distinguishing it from physical contact and spatial proximity. Experiments 2a and b demonstrate an interaction between personal force and intention, whereby the effect of personal force depends entirely on intention. These studies also introduce a method for controlling for people’s real-world expectations in decisions involving potentially unrealistic hypothetical dilemmas. (shrink)

The growing body of research on temporal and spatial experience lacks a comprehensive theoretical approach. Drawing on Giddens’ framework, we present time-space distanciation as a construct for theorizing the relations between culture, time, and space. TSD in a culture may be understood as the extent to which time and space are abstracted as separate dimensions and activities are extended and organized across time and space. After providing a historical account of its development, we outline a multi-level conceptualization of TSD supported (...) by research on cultural differences in the experience of time and space. We impact this conceptualization by examining two ethnographic case studies. We conclude by highlighting future research directions. TSD is an integrative, interdisciplinary, multi level construct with the potential to guide the burgeoning social science of time and space. (shrink)

Jon Stewart's study is a major re-evaluation of the complex relations between the philosophies of Kierkegaard and Hegel. The standard view on the subject is that Kierkegaard defined himself as explicitly anti-Hegelian, indeed that he viewed Hegel's philosophy with disdain. Jon Stewart shows convincingly that Kierkegaard's criticism was not of Hegel but of a number of contemporary Danish Hegelians. Kierkegaard's own view of Hegel was in fact much more positive to the point where he was directly influenced by (...) some of Hegel's work. Any scholar working in the tradition of Continental philosophy will find this an insightful and provocative book with implications for the subsequent history of philosophy in the twentieth century. The book will also appeal to scholars in religious studies and the history of ideas. (shrink)

The primary argument against mereological singularism—the view that definite plural noun phrases like ‘the students’ refer to “set-like entities”—is that it is ultimately incoherent. The most forceful form of this charge is due to Barry Schein, who argues that singularists must accept a certain comprehension principle which entails the existence of things having the contradictory property of being both atomic and non-atomic. The purpose of this paper is to defuse Schein’s argument, by noting three necessary and independently motivated restrictions on (...) the metalinguistic predicates ‘atom’ and ‘non-atom’: both are sort, property, and context-relative. With these restrictions in place, Schein’s problematic assumption becomes evident: his presumed singularist analysis of ‘non-atom’ conflates the metalanguage with the meta-metalanguage, i.e. the language used to talk about the metalanguage. (shrink)

Mind-body dualism conceptualizes mind and body as distinct, but there are different ways that dualism may be instantiated. In this study, we examined how Hierarchical Dualism (the belief that mind and body are distinct, and the mind is superior) and Mutual-Influence Dualism (the belief that mind and body are separate but interrelate) related to health behaviors and mental health in three student samples: exclusively queer, exclusively straight, and a mixed university subject pool (N = 535). Participants in each sample endorsed (...) Mutual-Influence Dualism at a higher rate than Hierarchical Dualism. Mutual-Influence dualism was consistently associated with greater engagement in health-promoting behaviors and greater well-being, whereas Hierarchical Dualism differed by sample. These results suggest that dualist beliefs do not uniformly shape the lives of those who hold them: rather, the relation between dualist beliefs and health differs as a function of the type of dualism and the identities we hold. (shrink)

This book presents the framework for a new, comprehensive approach to cognitive science. The proposed paradigm, enaction, offers an alternative to cognitive science's classical, first-generation Computational Theory of Mind. _Enaction_, first articulated by Varela, Thompson, and Rosch in _The Embodied Mind_, breaks from CTM's formalisms of information processing and symbolic representations to view cognition as grounded in the sensorimotor dynamics of the interactions between a living organism and its environment. A living organism enacts the world it lives in; its embodied (...) action in the world constitutes its perception and thereby grounds its cognition. _Enaction_ offers a range of perspectives on this exciting new approach to embodied cognitive science. Some chapters offer manifestos for the enaction paradigm; others address specific areas of research, including artificial intelligence, developmental psychology, neuroscience, language, phenomenology, and culture and cognition. Three themes emerge as testimony to the originality and specificity of enaction as a paradigm: the relation between first-person lived experience and third-person natural science; the ambition to provide an encompassing framework applicable at levels from the cell to society; and the difficulties of reflexivity. Taken together, the chapters offer nothing less than the framework for a far-reaching renewal of cognitive science. Contributors: Renaud Barbaras, Didier Bottineau, Giovanna Colombetti, Diego Cosmelli, Hanne De Jaegher, Ezequiel A. Di Paolo. Andreas K. Engel, Olivier Gapenne, Véronique Havelange, Edwin Hutchins, Michel Le Van Quyen, Rafael E. Núñez, Marieke Rohde, Benny Shanon, Maxine Sheets-Johnstone, Adam Sheya, Linda B. Smith, John Stewart, Evan Thompson. (shrink)

Insulin is stored within the pancreas in an inactive Zn2+‐bound hexameric form prior to release. Similarly, clinical insulins contain Zn2+ and form multimeric complexes. Upon release from the pancreas or upon injection, insulin only becomes active once Zn2+ disengages from the complex. In plasma and other extracellular fluids, the majority of Zn2+ is bound to human serum albumin (HSA), which plays a vital role in controlling insulin pharmacodynamics by enabling removal of Zn2+. The Zn2+‐binding properties of HSA are attenuated by (...) non‐esterified fatty acids (NEFAs) also transported by HSA. Elevated NEFA concentrations are associated with obesity and type 2 diabetes. Here we present the hypothesis that higher NEFA levels in obese and/or diabetic individuals may contribute to insulin resistance and affect therapeutic insulin dose‐response profiles, through modulation of HSA/Zn2+ dynamics. We envisage this novel concept to have important implications for personalized treatments and management of diabetes‐related conditions in the future. (shrink)

Editors Wanda Teays, John-Stewart Gordon, and Alison Dundes Renteln have assembled the works of an interdisciplinary, international team of experts in bioethics into a comprehensive, innovative and accessible book. Topics covered range from torture and lethal injection to euthanasia, sex selection, vulnerable human subjects, to health equity, safety and public health, and environmental disasters like Bhopal, Fukushima, and more.

Morality can help guide behavior and facilitate relationships. Although moral judgments by autistic people are similar to neurotypical individuals, many researchers argue that subtle differences signify deficits in autistic individuals. Moral foundation theory describes moral judgments in terms of differences rather than deficits. The current research, aimed at assessing autistic individuals’ moral inclinations using Haidt’s framework, was co-designed with autistic community members. Our aim was to describe autistic moral thinking from a strengths-based perspective while acknowledging differences that may pose interpersonal (...) challenges among autistic youth. We assessed 25 autistic and 23 neurotypical children’s moral judgments using the Moral Foundations Questionnaire for Kids. We used semi-structured interviews and qualitative analysis with a subset of participants to describe children’s moral reasoning. Analyses suggested that autistic and neurotypical children make similar judgments about moral transgressions across all five moral foundations. General linear mixed modeling showed that the greatest predictor of recommending punishment was how bad children deemed moral transgressions to be. We also found a trend that autistic children were more likely to recommend punishment for harmless norms violations than were neurotypical children. Future research could use longitudinal methods to understand the development of moral judgments among autistic and neurotypical children. (shrink)

This volume captures the individuality, the national and personal identity, the cultural exchange, and the self-consciousness that have long been sensed as peculiarly potent in the Hellenistic world. The fields of history, literature, art, philosophy, and religion are each presented using the format of two essays followed by a response. Conveying the direction and focus of Hellenistic learning, eighteen leading scholars discuss issues of liberty versus domination, appropriation versus accommodation, the increasing diversity of citizen roles and the dress and gesture (...) appropriate to them, and the accompanying religious and philosophical ferment. The result is an arresting view of the incredible and unprecedented diversity of the Hellenistic world. (shrink)

David Hume was a highly original thinker. Nevertheless, he was a writer of his time and place in the history of philosophy. In this book, M. A. Stewart puts Hume’s writing in context, particularly that of his native Scotland, but also that of British and European philosophy more generally. Through meticulous research Stewart brings to life the circumstances by means of which we can get a deeper understanding of Hume’s writings on the nature and reach of human reason, (...) the foundation of morals, and, especially, on the philosophy of religion. Stewart pays particular attention to Hume’s intellectual development, beginning with his education at the College of Edinburgh, the writing of his Treatise of Human Nature, and his subsequent philosophical responses to criticisms of that book. He argues that Hume’s scepticism set him at odds with the Christian Stoicism of Scottish contemporaries including that of Francis Hutcheson - and shows that this conflict played a major role in his failure to obtain the Edinburgh Moral Philosophy Chair in 1745. Stewart’s detailed study of the physical character of Hume’s surviving manuscripts in Chapters 8 and 9 provides the best available dating of his early ‘Essay on Modern Chivalry’, his ‘Early Fragment on Evil’ and the periods of composition of his Dialogues Concerning Natural Religion. Other chapters compare Hume’s theory of abstraction with that of Locke and Berkeley, provide the 17th and 18th century philosophical context of the central argument of his essay ‘Of miracles’, and consider the 18th and 19th century reception of his writings in England and Ireland. (shrink)

"The availability of a paperback version of Boyle's philosophical writings selected by M. A. Stewart will be a real service to teachers, students, and scholars with seventeenth-century interests. The editor has shown excellent judgment in bringing together many of the most important works and printing them, for the most part, in unabridged form. The texts have been edited responsibly with emphasis on readability.... Of special interest in connection with Locke and with the reception of Descarte's Corpuscularianism, to students of (...) the Scientific Revolution and of the history of mechanical philosophy, and to those interested in the relations among science, philosophy, and religion. In fact, given the imperfections in and unavailability of the eighteenth-century editions of Boyle’s works, this collection will benefit a wide variety of seventeenth-century scholars." --Gary Hatfield, University of Pennsylvania. (shrink)

Professor Parkinson in his lecture on ‘The Translation Theory of Understanding’ discusses two stages in the development of a false but influential tradition which he finds common to Locke's Essay Concerning Human Understanding and Professor George Steiner's After Babel. He is not, of course, alleging any direct historical influence of the one on the other; neither is he principally addressing Steiner's book as a whole, but rather the account of understanding upon which it appears to be founded. I should like (...) to take his paper as the starting-point for my own, but begin from a somewhat broader view than he does of the legacy of Locke. With Parkinson's constructive position I have no quarrel, and I shall not address myself directly to it. (shrink)

In most countries in Africa, the epidemiologic profile of HIV/AIDS is significantly different from that of the USA or Europe. Women in Africa are as likely to be HIV positive as men, while young women are significantly more likely to be HIV positive than young men. How can health research in Africa be made more responsive and relevant to women’s health needs? And how would a human rights perspective change the conduct of biomedical and social scientific research on gender and (...) HIV/ AIDS in Africa? The application of a human rights framework to HIV/AIDS typically has focused on social justice issues employing national and international legal structures to legislate and advocate for HIV positive persons. This essay, however, offers some broad considerations of the links between the health of African women, biomedical and social scientific research, HIV/AIDS, research ethics, and the human rights movement. (shrink)

Over the past decade, global health has emerged as one of the fastest growing academic programs in the United States. Ethics training is cited widely as an essential feature of U.S. global health programs, but generally it is not deeply integrated into the global health teaching and training curricula. A discussion about the pedagogy of teaching global health ethics is long overdue; to date, only a few papers specifically engage with pedagogy rather than competencies or content. This paper explores the (...) value of case study pedagogy for a full-semester graduate course in global health ethics at an American university. I address some of the pedagogical challenges of teaching global health ethics through my innovative use of case study methodology—the “prospective case study”. (shrink)

Moira Gatens investigates the ways in which differently sexed bodies can occupy the same social or political space. Representations of sexual difference have unacknowledged philosophical roots which cannot be dismissed as a superficial bias on the part of the philosopher, nor removed without destroying the coherence of the philosophical system concerned. The deep structural bias against women extends beyond metaphysics and its effects are felt in epistemology, moral, social and political theory. The idea of sexual difference is contextualised in (...) _Imaginary Bodies_ and traced through the history of philosophy. Using her work on Spinoza, Gatens develops alternative conceptions of power, new ways of conceiving women's embodiment and their legal, political and ethical status. (shrink)

This article is about the history of logic in Australia. Douglas Gasking (1911?1994) undertook to translate the logical terminology of John Anderson (1893?1962) into that of Ludwig Wittgenstein's (1921) Tractatus. At the time Gilbert Ryle (1900?1976), and more recently David Armstrong, recommended the result to students; but it is reasonable to have misgivings about Gasking as a guide to either Anderson or Wittgenstein. The historical interest of the debate Gasking initiated is that it yielded surprisingly little information about Anderson's traditional (...) (syllogistic or Aristotelian) logic and its relation to classical (first-order predicate or Russellian) logic, the ostensible topic; but the materials now exist to interpret Anderson's logic in classical logic, possibly as an algebra of classes. This would be of little interest to contemporary logicians, but it might shed some light on Anderson's philosophy. (shrink)