In lieu of an abstract, here is a brief excerpt of the content:Medicine-Based Values?Åge Wifstad (bio)KeywordsEthics committees, judgment, common moralityToulmin's DiagnosisIn his classical article with the unforgettable title "How medicine saved the life of ethics" (Toulmin 1982), Stephen Toulmin claims that medicine saved ethics by giving the philosophers a positive reality check through medical challenges: (1) Ethics in medicine is a serious topic, not just something to discuss at seminars. If, for example, both A and B need treatment and there (...) are only enough resources for one, the fundamental interests of these two people compete against each other. (2) In clinical medicine, the individual case might demand a different approach than that suggested by theory. Similarly, an ethicist who is confronted by a diversity of medical cases becomes aware of the fact that solutions drawn from ethical theory can be irrelevant in practice. (3) The moral philosopher has often focused on the individual and his or her universal commitments. The fact that ethical dilemmas can have deep roots in practical challenges and must be understood within a certain context has been "forgotten." (4) In clinically relevant ethics, it is important to find solutions that all involved parties find reasonable. This revitalizes central Aristotelian schools of thought on, for example, ethical judgment and situational understanding.Today, there is a common understanding that in both the education of doctors and in the implementation of medical knowledge and technology there needs to be ethical guidelines and control. Toulmin wants us to see that the background for this agreement is multifaceted. It was not just the ethicists who saved the doctors. The doctors helped the ethicists to escape their academic isolation.Ethics CommitteesThe establishment of ethics committees is perhaps the most interesting example of this. Here it is especially clear how ethical judgment establishes a basis for decision making: Each case presented to an ethics committee is special because one cannot reference decisions made in similar cases. At the same time, we are expected to handle similar cases equally. Consideration of the concrete, individual case must be balanced with the principle of similar treatment. Second, as a committee member, one must interpret and respect ethical principles that cannot be easily defined. Every principle must be interpreted and implemented within a specific and concrete context. Third, one must consider the law, but seen isolated, the implications of relevant rules can be difficult to determine. Fourth, the status of principles and rules are open for interpretation. The most important example of this is the Declaration of Helsinki, which was established through cooperation between the worlds' doctors unions. The strength and end result of such a document can be discussed. Fifth, multiple but partly conflicting juridical and ethical considerations can be [End Page 179] relevant at the same time. An example: Decisions about confidentiality can prevent data gathering that is crucial in ensuring that a research project is scientifically acceptable. Two important ethical considerations are then put up against one another. As a sixth and final point, it can be mentioned that the ethics committee is expected to make a qualitative, scientific judgment. But what kind of quality judgment and how detailed it should be is up for discussion.Two Definitions of Ethical JudgmentThe fact that the committee must base their holistic decision on ethical judgment means that the committee, in an important sense of the word, stands freely: It can be difficult to refer to specific ethical rules or laws when making an external review of the committee's decision. Unless the committee has clearly not followed known principles and rules, then the committee is able to confront criticism by replying that the decision is based on holistic considerations, where many views have been taken into account. In this way, the usage of ethical judgment makes sure that the committee has freedom to act. The catch here is that the committee's responsibility becomes even more obvious. One cannot simply say that the decision is made based on rules and principles formulated by others, such as the state. The committee must, as a unit, be able to defend their decision.The complexity of the work of the committee can, however, make it more tempting to think about ethics in... (shrink)

A certain kind of externalism—"the view from nowhere"—lies at the heart of evidence-based medicine (EBM). As a consequence, the individual case glides out of focus. However, to judge to what extent external knowledge is applicable to an individual case, the clinician has to rely on some sort of knowledge of the case at hand. The article focuses on the tension between the externalism of EBM and the "internal evidence" one has to presuppose when making clinical judgments.

Background:Smart Aging is a serious game (SG) platform that generates a 3D virtual reality environment in which users perform a set of screening tasks designed to allow evaluation of global cognition. Each task replicates activities of daily living performed in a familiar environment. The main goal of the present study was to ascertain whether Smart Aging could differentiate between different types and levels of cognitive impairment in patients with neurodegenerative disease.Methods:Ninety-one subjects (mean age = 70.29 ± 7.70 years)—healthy older adults (...) (HCs,n= 23), patients with single-domain amnesic mild cognitive impairment (aMCI,n= 23), patients with single-domain executive Parkinson's disease MCI (PD-MCI,n= 20), and patients with mild Alzheimer's disease (mild AD,n= 25)—were enrolled in the study. All participants underwent cognitive evaluations performed using both traditional neuropsychological assessment tools, including the Mini-Mental State Examination (MMSE), Montreal Overall Cognitive Assessment (MoCA), and the Smart Aging platform. We analyzed global scores on Smart Aging indices (i.e., accuracy, time, distance) as well as the Smart Aging total score, looking for differences between the four groups.Results:The findings revealed significant between-group differences in all the Smart Aging indices: accuracy (p< 0.001), time (p< 0.001), distance (p< 0.001), and total Smart Aging score (p< 0.001). The HCs outperformed the mild AD, aMCI, and PD-MCI patients in terms of accuracy, time, distance, and Smart Aging total score. In addition, the mild AD group was outperformed both by the HCs and by the aMCI and PD-MCI patients on accuracy and distance. No significant differences were found between aMCI and PD-MCI patients. Finally, the Smart Aging scores significantly correlated with the results of the neuropsychological assessments used.Conclusion:These findings, although preliminary due to the small sample size, suggest the validity of Smart Aging as a screening tool for the detection of cognitive impairment in patients with neurodegenerative diseases. (shrink)

Combining information from two or possibly several blocks of data is gaining increased attention and importance in several areas of science and industry. Typical examples can be found in chemistry, spectroscopy, metabolomics, genomics, systems biology and sensory science. Many methods and procedures have been proposed and used in practice. The area goes under different names: data integration, data fusion, multiblock analyses, multiset analyses and a few more. This book is an attempt to give an up-to-date treatment of the most used (...) and important methods within an important branch of the area; namely methods based on so-called components or latent variables. These methods have already obtained an enormous attention in for instance chemometrics, bioinformatics, machine learning and sensometrics and have proved to be important both for prediction and interpretation. The book is primarily a description of methodologies, but most of the methods will be illustrated by examples from the above-mentioned areas. The book is written such that both users of the methods as well as method developers will hopefully find sections of interest. In the end of the book there is a description of a software package developed particularly for the book. This package is freely available in R and covers many of the methods discussed. To distinguish the different type of methods from each other, the book is divided into five parts. Part I is introduction and preliminary concepts. Part II is the core of the book containing the main unsupervised and supervised methods. Part III deals with more complex structures and, finally, Part IV discusses alternative unsupervised and supervised methods. The book ends with Part V discussing the available software. Our recommendation for reading the book are as follows. A minimum read of the book would involve chapters 1, 2, 3, 5 and 7. Chapters 4, 6 and 8 are more specialized and chapters 9 and 10 contain methods we think are more advanced or less obvious to use. We feel privileged to have so many friendly colleagues who were willing to spend their time on helping us to improve the book by reading separate chapters. We would like to express our thanks to: Rasmus Bro, Margriet Hendriks, Ulf Indahl, Henk Kiers, Ingrid MaÌ⁽ge, Federico Marini, AÌ⁽smund Rinnan, Rosaria Romano, Lars Erik Solberg, Marieke Timmerman, Oliver Tomic, Johan Westerhuis and Barry Wise. Of course, the correctness of the final text is fully our responsibility! (shrink)

Fifteen original essays open up a novel area of inquiry: the distinctively ethical dimensions of women's experiences of and in aging. Contributors distinguished in the fields of feminist ethics and the ethics of aging explore assumptions, experiences, practices, and public policies that affect women's well-being and dignity in later life. The book brings to the study of women's aging a reflective dimension missing from the empirical work that has predominated to date. Ethical studies of aging have so far failed to (...) emphasize gender. And feminist ethics has neglected older women, even when emphasizing other dimensions of 'difference.' Finally work on aging in all fields has focused on the elderly, while this volume sees aging as an extended process of negotiating personal and social change. (shrink)

The main aim of this study is to test the validity of the Motivation, Engagement, and Thriving in User Experience (METUX) model (Peters et al., 2018) in higher education. We propose a process model in which we investigate how the need-satisfaction of digital learning tools within the interface sphere and task sphere accounts for engagement, learning, and well-being. A total of 426 higher education students drawn from two subsamples participated in this cross-sectional study. A structural equation model shows that interface (...) autonomy and competence satisfaction positively predict task autonomy and competence. Task competence, in turn, negatively predicts focused attention and positively predicts perceived usability and well-being. Task autonomy positively predicts perceived usability and reward. Based on our results, we provide some initial support for the METUX model in higher education. However, more validation work is needed to improve the scale that measures need-satisfaction in the interface and task spheres. Moreover, we find no support for the effect of task sphere on learning. Further investigations are needed into how METUX can be used in domain- and situation-specific contexts to account for increases in engagement, learning, and well-being. Finally, future studies need to include all aspects of the METUX model in order to fully test its validity. (shrink)

"What do grown children owe their parents?" Over two decades ago philosopher Jane English asked this question and came up with the startling answer: nothing (English 1979). English joins many contemporary philosophers in rejecting the once-traditional view that grown children owe their parents some kind of fitting repayment for past services rendered. The problem with the traditional view, as argued by many, is, first, that parents have duties to provide fairly significant services to their growing children, and persons do not (...) owe repayment for others' mere performance of duty; second, even where parents go above and beyond duty in their loving and generous rearing of their children, the benefits are bestowed, at least on young children, without their voluntary acceptance and consent, and so, again, fail to generate any obligation of subsequent repayment on their part (see Blustein 1982: 182-3). Moreover, the entire idiom of obligation and repayment, in English's 1 words, "tends to obscure, or even to undermine, the love that is the correct ground of filial obligation" (352). English's alternative, however -- that children strictly "owe" their parents nothing except what flows naturally from whatever love and affection exist between them -- also strikes many as problematic. Christina Hoff Sommers offers examples of what seem to be clearly delinquent adult children, who simply don't "feel" like sharing their lives with their aging parents, or providing any emotional or financial support to them, and so don't (Sommers 1986: 440-41). Sommers points out that we need some talk of obligations in order to fill in the cracks in human relationships where love and affection fail: "The ideal relationship cannot be 'duty-free,' if only because sentimental ties may come unraveled, often leaving one of the parties at a material disadvantage'" (450-51). Sommers proposes as her alternative to English that legitimate duties arise out of special relationships defined by social roles: being a father or mother, a son or a daughter, "is socially as well as biologically prescriptive; it not only defines what one is; it also defines who one is and what one owes" (447).. (shrink)

Hereditary breast and ovarian cancers are frequently attributed to germline mutations in the tumor suppressor genes BRCA1 and BRCA2. BRCA1/2 act to repair double‐strand breaks (DSBs) and suppress the demise of unstable replication forks. Our work elucidated a dynamic interplay between BRCA2 and the WRN DNA helicase/exonuclease defective in the premature aging disorder Werner syndrome. WRN and BRCA2 participate in complementary pathways to stabilize replication forks in cancer cells, allowing them to proliferate. Whether the functional overlap of WRN and BRCA2 (...) is relevant to replication at gaps between newly synthesized DNA fragments, protection of telomeres, and/or metabolism of secondary DNA structures remain to be determined. Advances in understanding the mechanisms elicited during replication stress have prompted the community to reconsider avenues for cancer therapy. Insights from studies of PARP or topoisomerase inhibitors provide working models for the investigation of WRN's mechanism of action. We discuss these topics, focusing on the implications of the WRN‐BRCA2 genetic interaction under conditions of replication stress. (shrink)

By combining a flanker task and a cuing task into a single paradigm, the authors assessed the effects of orienting and alerting on conflict resolution and explored how normal aging and Alzheimer’s disease (AD) modulate these attentional functions. Orienting failed to enhance conflict resolution; alerting was most beneficial for trials without conflict, as if acting on response criterion rather than on information processing. Alerting cues were most effective in the older groups— healthy aging and AD. Conflict resolution was impaired only (...) in AD. Orienting remained unchanged across groups. These findings provide evidence of different life span developmental and clinical trajectories for each attentional network. (shrink)

Debates in fields studying the biological aspects of aging and longevity, such as biogerontology, are often split between ‘anti-aging’ approaches aimed largely at treating diseases and those focusing more on maintaining, promoting, and even enhancing health. However, it is far from clear what this ‘health’ is that would be maintained, promoted, or enhanced. Interestingly, what few have yet to fully reflect on is that there is still no theory of health within the health or aging sciences that would provide an (...) integrative explanatory framework akin to other scientific theories. After clarifying why such a theory could be useful, I discuss five general features of medical theories that could be used to evaluate the utility of a given proposal. With these features in hand, I suggest that philosophers and scientists work together on analyzing actual medical research (experimental analysis), and the ways in which a theoretical construct of ‘health’ is being progressively identified and measured therein. I conclude by suggesting that research fields studying stress and aging might be particularly helpful in developing candidates for theory construction due to their broad scope, increasing specificity, and potential for providing integrative explanations. (shrink)

The Cognitive Reserve (CR) hypothesis suggests that the brain actively attempts to cope with neural damages by using pre-existing cognitive processing approaches or by enlisting compensatory approaches. This would allow an individual with high CR to better cope with aging than an individual with lower CR. Many of the proxies used to assess CR indirectly refer to the flexibility of thought. The present paper aims at directly exploring the relationships between CR and creativity, a skill that includes flexible thinking. We (...) tested a sample of 72 adults (aged between 45 and 78) assessing both their level of CR and their creativity. To evaluate CR we used the proxies commonly used in literature, namely, three subtests from the WAIS (vocabulary, similarities, and digit span) and the years of education. We also used an ad-hoc test asking people to report how frequently they tend to perform activities that are believed to increase CR. We used verbal creativity tasks (alternative uses and generation of acronyms) to assess individual levels of creativity. We asked participants to describe their main occupation (present or past) and coded each occupation as creative or not creative. Results (controlling for age-related differences) showed that scores from the WAIS correlated positively with creativity performance, even though correlations varied across the subtests. Focusing on the frequency and type of activities that people perform, and comparing individuals who have or had a creative job to those with a routine job, a clear relationship between creativity and CR emerged. This effect was more relevant than the level of job complexity. Implications for the study of CR and aging are discussed. (shrink)

Arthur Caplan has argued that the presumptive naturalness, universality, and inevitability of aging are no obstacles to conceptualizing aging as a disease since those traits are themselves merely contingent. Moreover, aging lends itself to discussion in terms of diagnostic symptomatology and etiology. Is aging therefore a disease? I argue that aging need not be shown to be unnatural or a disease in order to make it the subject of biomedical interest. I suggest that rather than ask "Is aging a disease?", (...) the better point of philosophical departure would be to ask "Is aging objectionable such that its prevention and cure ought to be sought?". In this way, the moral issues at stake emerge more clearly. Chief among these issues are the potential results of curing aging and the implications for the prospect of meaningful human life without the de facto limitations that aging (and perhaps death) put upon it. A convincing argument that aging should be cured, therefore, would need to show that human significance warrants and possibly seeks such a cure and that the social costs of curing aging are morally acceptable. Keywords: aging, disease, cure, immortality CiteULike Connotea Del.icio.us What's this? (shrink)

Slowing the aging process would be one of the most dramatic and momentous ways of enhancing human beings. It is also one that mainstream science is on the brink of pursuing. The state of the science, together with its possible impact, make it an important example for how to think about research into all enhancement technologies.

Search is a prerequisite for successful performance in a broad range of tasks ranging from making decisions between consumer goods to memory retrieval. How does aging impact search processes in such disparate situations? Aging is associated with structural and neuromodulatory brain changes that underlie cognitive control processes, which in turn have been proposed as a domain-general mechanism controlling search in external environments as well as memory. We review the aging literature to evaluate the cognitive control hypothesis that suggests that age-related (...) change in cognitive control underlies age differences in both external and internal search. We also consider the limits of the cognitive control hypothesis and propose additional mechanisms such as changes in strategy use and affect that may be necessary to understand how aging affects search. (shrink)

This study was designed to investigate the effects of aging on consciousness in recognition memory, using the Remember/Know/Guess procedure . Remembering and Knowing. In E. Tulving & F. I. M. Craik , The Oxford Handbook of Memory. Oxford University Press.). In recognition memory, older participants report fewer occasions on which recognition is accompanied by recollection of the original encoding context. Two main hypotheses were tested: the speed mediation hypothesis . The processing-speed theory of adult age differences in cognition. Psychological Review, (...) 3, 403–428) and the executive-aging hypothesis . An application of prefrontal cortex function theory to cognitive aging. Psychological Bulletin, 120, 272–292). A group of young and a group of older adults took a recognition test in which they classified their responses according to Gardiner, J. M., & Richarson-Klavehn, A. . Remembering and Knowing. In E. Tulving & F. I. M. Craik , The Oxford Handbook of Memory. Oxford University Press. remember-know-guess paradigm. Subsequently, participants completed processing speed and executive function tests. The results showed that among the older participants, R responses decreased, but K responses did not. Moreover, a hierarchical regression analysis supported the view that the effect of age in recollection experience is determined by frontal lobe integrity and not by diminution of processing speed. (shrink)

Good aging : toward an ethics of aging -- The ethics of love -- Why we do not love the elderly -- Taking care of your old self -- Love for aging neighbors.

What does it mean to be an adult? In this original and compelling work, John Russon answers that question by leading us through a series of rich reflections on the psychological and social dimensions of adulthood and by exploring some of the deepest ethical and existential issues that confront human life: intimacy, responsibility, aging, and death. Using his knowledge of the history of philosophy along with the combined resources of psychology, sociology, and anthropology, he explores the behavioral challenges of becoming (...) an adult and examines the intimate relationships that are integral to healthy development. He also studies our experiences of time and space, which address both aging and the crucial role that our material environments play in the formation of our personalities. Of special note is Russon's provocative assessment of the economic and political contexts of contemporary adult life and the distinctive problems they pose. Engaging and accessible, Adult Life is for anyone seeking the profound lessons our human culture has learned about living well. (shrink)

I never expected to live till I was over 90. Some of my relatives have done so, one of my cousins will have her 100th birthday in October this year (2023), but my mother died when she was 59, and I...