Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

The peripheral nervous system has classically been separated into a somatic division composed of both afferent and efferent pathways and an autonomic division containing only efferents. J. N. Langley, who codified this asymmetrical plan at the beginning of the twentieth century, considered different afferents, including visceral ones, as candidates for inclusion in his concept of the “autonomic nervous system”, but he finally excluded all candidates for lack of any distinguishing histological markers. Langley's classification has been enormously influential in shaping modern (...) ideas about both the structure and the function of the PNS. We survey recent information about the PNS and argue that many of the sensory neurons designated as “visceral” and “somatic” are in fact part of a histologically distinct group of afferents concerned primarily autonomic function. These afferents have traditionally been known as “small dark” neurons or B-neurons. In this target article we outline an association between autonomic and B-neurons based on ontogeny, cell phenotype, and functional relations, grouping them together as part of a common reflex system involved in homeostasis. This more parsimonious classification of the PNS, made possible by the identification of a group of afferents associated primarily with the ANS, avoids a number of confusions produced by the classical orientation. It may also have practical implications for an understanding of nociception, homeostatic reflexes, and the evolution of the nervous system. (shrink)

Bayesians take “definite” or “single-case” probabilities to be basic. Definite probabilities attach to closed formulas or propositions. We write them here using small caps: PROB(P) and PROB(P/Q). Most objective probability theories begin instead with “indefinite” or “general” probabilities (sometimes called “statistical probabilities”). Indefinite probabilities attach to open formulas or propositions. We write indefinite probabilities using lower case “prob” and free variables: prob(Bx/Ax). The indefinite probability of an A being a B is not about any particular A, but rather about the (...) property of being an A. In this respect, its logical form is the same as that of relative frequencies. For instance, we might talk about the probability of a human baby being female. That probability is about human babies in general — not about individuals. If we examine a baby and determine conclusively that she is female, then the definite probability of her being female is 1, but that does not alter the indefinite probability of human babies in general being female. Most objective approaches to probability tie probabilities to relative frequencies in some way, and the resulting probabilities have the same logical form as the relative frequencies. That is, they are indefinite probabilities. The simplest theories identify indefinite probabilities with relative frequencies.3 It is often objected that such “finite frequency theories” are inadequate because our probability judgments often diverge from relative frequencies. For example, we can talk about a coin being fair (and so the indefinite probability of a flip landing heads is 0.5) even when it is flipped only once and then destroyed (in which case the relative frequency is either 1 or 0). For understanding such indefinite probabilities, it has been suggested that we need a notion of probability that talks about possible instances of properties as well as actual instances.. (shrink)

The book deals with the notion of Downward Causation from a wide array of perspectives, including physics, biology, psychology, social science, communication studies, text theory, and philosophy. The book includes proponents as well as opponents discussing the validity of the notion.

P. B. Downing; VII.—Subjunctive Conditionals, Time Order, and Causation, Proceedings of the Aristotelian Society, Volume 59, Issue 1, 1 June 1959, Pages 125–140.

Originally published in 1969. This book explains what is wrong with the traditional methodology of "inductive" reasoning and shows that the alternative scheme of reasoning associated with Whewell, Pierce and Popper can give the scientist a useful insight into the way he thinks.

Social and political scientists, historians and others, have put forward a number of widely differing views concerning the ‘character’ of Islamic millenarian and/or Mahdist movements in Africa. The same is true of course with regard to the opinions ofscholars concerning the transformative capacity of Islam as an ideology. In this paper I want to look at one aspect only of Islamic millenarianism in the West African context, viz. its allegedly revolutionary character.

In those twenty or so pages of section xi of Part Two of the Philosophical Investigations in which Wittgenstein discusses the concept of noticing an aspect and its place among the concepts of experience, there are three passages which are explicitly concerned with the relations between seeing and interpreting in the experience of noticing an aspect.

Questions of political identity and citizenship, raised by the creation of the `new Europe', pose new questions that political theorists need to consider. Reflection upon the circumstances of the new Europe could help them in their task of delineating conceptual structures and investigating the character of political argument.Does it make sense to use concepts as `citizenship' and `identity' beyond the borders of the nation-state? What does it mean when we speak about `European Citizenship' and `European Identity'? It is argued that (...) the pluralism that has led theorists to offer a conception of citizenship based upon principles of right, rather that the common good, applies even more strongly at the level of the European political order. Developing a contractarian theory of federation, an account of the basis of a European citizenship will be offered in which federalism emerges out of an overlapping consensus of European citizens on the terms of their political association. `European Citizenship' and `European Identity' are discussed in the context of the so-called `European Union', and not in the wider context of Europe `as a whole', or for that matter on an even broader `cosmopolitan' scale. However, the gist of the article is that arguments for concepts of `citizenship' and `identity' that go beyond borders of nation-states and that are applied to the `European Union', could have implications for an even wider application.Finally, and in conclusion, the context will be elaborated in which the normative concept of shared liberal citizenship identity should be realized on a pan-national, European level. (shrink)

Originally published in 1960, The Future of Man is a chronicle of Professor Medwar's Reith lectures of 1959. The book outlines his predictions about the future estate of man, with the 'process of foretelling, rather than with what is actually foretold'. He asks, can we predict the future size of populations? What is the evidence and theoretical background for the belief that human intelligence is declining? Could human beings become uniformly excellent or is inborn diversity and inequality a necessary part (...) of the texture of human populations? The lectures tried to answer these questions and attempts to end with a definition of the biological standing of man. This book will be of interest to anthropologists, biologists and natural historians. (shrink)

First published in 1972, The Hope of Progress presents collection of essays and lectures dealing with the history of scientific ideas and the impact of science on society. The principle piece in this volume is the author's 1969 presidential address to the British Association 'On The Effecting of All Things Possible', an argument for believing in the ability of science to solve the problems it has itself created, and which too many of us believe insoluble. It contains author's Romanes Lecture (...) on 'Science and Literature' and a well known critique of J.D. Watson's notorious account of the discovery of the molecular structure of DNA, The Double Helix. Other chapters discuss the possibility of the control and domination by science of the body and mind of Man- though the author concludes in 'The Genetic Improvement of Man' 'I think that, in the main, for many centuries to come, we shall have to put up with human beings as they are at present constituted'. This book will be useful for scholars and researchers of history of science, philosophy of science, natural science, and philosophy in general. (shrink)

Originally published in 1923 as part of a series of handbooks for teachers, this book sets out a possible course of instruction in citizenship through the teaching of history and geography. Showan includes a helpful bibliography for students and teachers alike who are seeking more information on teaching a subject in such a way, as he says in his preface, 'as to inculcate a respect for our national institutions, a desire and an aptitude for public and social service … and (...) an abiding love for England'. This book will be of value to anyone interested in the history of education, particularly citizenship education. (shrink)