Wie lasst sich pagan-antike Naturphilosophie und Naturkunde mit dem christlichen Glauben vereinbaren? Diese Frage stellte fur das Mittelalter kein akademisch-theoretisches Problem dar, sondern ein Anliegen, das die Deutung der Welt, der menschlichen Existenz und der Ethik unmittelbar betraf. Die Antworten, die das Mittelalter auf diese Fragen zu geben versuchte, differieren je nach Zeit, Standort und Intention der Autoren. Das im Rahmen des Sonderforschungsbereichs Wurzburg-Eichstatt durchgefuhrte Symposium stellt in chronologischer Anordnung verschiedene Antwortmodelle vor und gibt einen Uberblick uber das geistliche Naturverstandnis (...) des Mittelalters von der Karolingerzeit bis ins 14. Jahrhundert. Dabei werden die verschiedenen Disziplinen, die an Natur-wissen interessiert waren (Medizin, Theologie, Artes) unter Berucksichtigung der verschiedenen Gattungen (medizinisches Handbuch, Vision, Lehrdialog, enzyklopadisches Nachschlagewerk) einbezogen. Das Spektrum der behandelten Themen erstreckt sich von einem Karolingischen Arzneibuch uber den `Physiologus', Hermann von der Reichenau, Hildegard von Bingen, den altfranzosischen `Lucidaire' und `Sidrac', die Naturenzyklopadisten Thomas von Cantimpre und Bartholomaus Anglicus und reicht bis hin zu den Arzten Ortolf von Baierland und Paracelsus. (shrink)

The human masticatory system is a complex functional unit characterized by a multitude of skeletal components, muscles, soft tissues, and teeth. Muscle activation dynamics cannot be directly measured on live human subjects due to ethical, safety, and accessibility limitations. Therefore, estimation of muscle activations and their resultant forces is a longstanding and active area of research. Reinforcement learning (RL) is an adaptive learning strategy which is inspired by the behavioral psychology and enables an agent to learn the dynamics of an (...) unknown system via policy-driven explorations. The RL framework is a well-formulated closed-loop system where high capacity neural networks are trained with the feedback mechanism of rewards to learn relatively complex actuation patterns. In this work, we are building on a deep RL algorithm, known as the Soft Actor-Critic, to learn the inverse dynamics of a simulated masticatory system, i.e., learn the activation patterns that drive the jaw to its desired location. The outcome of the proposed training procedure is a parametric neural model which acts as the brain of the biomechanical system. We demonstrate the model’s ability to navigate the feasible three-dimensional (3D) envelope of motion with sub-millimeter accuracies. We also introduce a performance analysis platform consisting of a set of quantitative metrics to assess the functionalities of a given simulated masticatory system. This platform assesses the range of motion, metabolic efficiency, the agility of motion, the symmetry of activations, and the accuracy of reaching the desired target positions. We demonstrate how the model learns more metabolically efficient policies by integrating a force regularization term in the RL reward. We also demonstrate the inverse correlation between the metabolic efficiency of the models and their agility and range of motion. The presented masticatory model and the proposed RL training mechanism are valuable tools for the analysis of mastication and other biomechanical systems. We see this framework’s potential in facilitating the functional analyses aspects of surgical treatment planning and predicting the rehabilitation performance in post-operative subjects. (shrink)

The expression pain refers to a phenomenon intrinsic to individuals. The object of the language of pain is restricted to an individual experience which excludes any form of direct access by others. Speaking about pain is thus one of the most difficult forms of linguistic activities, as has been repeatedly pointed out by Wittgenstein. The difficulties involved in this type of communication are not only dependent upon individual linguistic ability but are also clearly reflected in the state and structure of (...) the linguistic means which are at the disposal of the speakers of a language. Linguistic means vary in status and complexity with respect to the ends which they can be used for.In this paper, I discuss two aspects of communicating pain : types of expression which are involved in speaking about pain, and linguistic activities which are carried out when speaking about pain. The two aspects are interrelated. My analysis makes use of categories belonging to the theory of linguistic activity and to the extended field theory of language. (shrink)

We attempt to identify and evaluate the association between key characteristics of not-for-profit hospitals and market concentration, as measured by the Herfindahl–Hirschman Index, using data available from the American Hospital Association, the Centers for Medicare and Medicaid Services, and the Internal Revenue Service Form 990. Our goal is to provide decision support to policy makers on factors that contribute to market competitiveness, which has been linked to improvements in efficiency, costs, and access to health care. We find that contributions are (...) positively associated with market concentration. This could indicate that well-run NP hospitals are rewarded both financially as well as with increased market share. We also find that a higher percentage of Medicare patients is positively correlated with market concentration. This could be explained by the fact that Medicare reimbursement rates are generally lower than those paid by private insurers ; thus, hospitals might not necessarily choose to operate in areas with high Medicare populations. Further, median income is negatively associated with market concentration. One explanation for this effect could be the fact that a population with a higher median income is in a better position to pay for services, making them attractive to hospitals as a potential market. Finally, we find that the presence of managers with voting rights on the boards of directors has no significant impact. (shrink)

The practical aspect of ancient philosophy has been recently made a focus of renewed metaphilosophical investigation. After a brief presentation of three accounts of this kind developed by Martha Nussbaum, Pierre Hadot, and Michel Foucault, the model of the therapeutic argument developed by Nussbaum is called into question from the perspectives offered by her French colleagues, who emphasize spiritual exercise (Hadot) or the care of the self (Foucault). The ways in which the account of Nussbaum can be defended are then (...) discussed, including both a ‘negative’ defense, i.e. the indication of the weaknesses of Hadot and Foucault’s proposals, and a ‘positive’ one focused on the points in which Nussbaum can convincingly address doubts about her metaphilosophical account. In response to these analyses, some further remarks made by Hadot and Foucault are discussed in order to demonstrate that their accounts are not as distant from Nussbaum after all. Finally, a recent metaphilosophical study by John Sellars together with a therapeutic (medical) model developed by the author of the present article are suggested as providing a framework for potential reconciliation between all three accounts discussed and a resource for further metaphilosophical studies. (shrink)

Kant did not explain the method of his foundation of ethics expressly. However, we can comprehend it as the demonstration of the originality of morality. For morality cannot be derived from anything non-moral – such a relation of derivation would destroy it. Therefore, there cannot be a justification or proof of morality in the strong sense, there can only be a “groundwork”, as the term “Grundlegung” is normally translated in English. This groundwork or grounding consists in disclosing the place or (...) topos and the turn or trope of its originating. According to Kant, the first is the will as practical reason; the latter is the turn of the will towards itself as autonomy. The result of such groundwork is, first, the evidence of the authenticity of morality and, hence, its unconditional validity – since such original validity is not conditioned on anything extra-moral. Second, we get a normative criterion for the contents of morality, which in Kant takes the form of the Categorical Imperative. The article seeks to defend the view that there is no alternative to Kant’s method of the foundation of ethics. However, by describing this method in a purely formal way, the author aims to open up thepossibility to implement it in another way and with other results than Kant does. (shrink)

Some features of Hegel’s Philosophy of History make it hardly acceptable in the 21st century. It proposes a final destination (Endzweck) of history, together with a principle of rational, dialectic necessity to take it there. In fact, these conceptions are not as absurd as they may seem to contemporary eyes. Nevertheless, the article doesn’t pretend to defend them, but aims to show that there is, behind these two, a third principle which is well worth to be defended –and which, in (...) fact, can systematically maintained without support from the other two. This we can call the “Principle of ethical asymmetry in history”. However, we also can name it by the formula Hegel himself coined: the “progress in the consciousness of liberty”. To explain this idea, the article evidences that the fundamental characteristic of all normativity is practical knowledge de se. In morality or ethics, this turns reflexive and self-determining. Liberty in Hegel’s sense effectively realizes this knowledge de se not only in a formal and abstract way, as in Kant, but concretely in history and in specific communities. However, since liberty in this process always remains linked to that normative self-comprehension which constitutes our practical self-consciousness, the processes of historical realization of liberty are normatively irreversible. Precisely for this process has an element of objective and unconditional aspect. The article concludes with some remarks as to how this principle of ethical asymmetry in history can serve as a basis of e new ethical theory which is strongly normative and, at the same time, sensitive to historic context an human finitude. (shrink)

The chapter is devoted to the analysis of ancient Stoic philosophy as a source of resilience for soldiers. At first, some historical cases are investigated, from a Roman Emperor Marcus Aurelius to more recent instances from Vietnam and Iraq. Secondly, in turn, the Epictetus' distinction between the controllable and the uncontrollable is introduced with the focus on the prescription to assign value only to the former as the Stoic source of resilience. Finally, some further questions are briefly addressed including the (...) ones concerning the sources of the Stoicism's appeal to the soldiers, its more particular applications as well as the potential drawbacks of the Stoic resilience. (shrink)

Keine ausführliche Beschreibung für "Zum höchsten Dasein" verfügbar.

Proceedings of a conference held Dec. 4-5, 1998 at the Universit'at G'ottingen.

In lieu of an abstract, here is a brief excerpt of the content:"But I Don’t Feel It":Values and Emotions in the Assessment of Competence in Patients With Anorexia NervosaJochen Vollmann (bio)Keywordscompetence assessment, mental capacity, informed consent, psychiatry, anorexia nervosaThe respect of the self-determination of patients obliges physicians to obtain the patient's consent before providing medical treatment. One important condition for a valid informed consent is the patient's competence to make autonomous health care decisions. Therefore, a proper assessment of competence (...) to make health care decisions is crucial particularly in patients with mental disorders (Vollmann 2000; Helmchen and Vollmann 2001). In recent years, several empirical studies on the assessment of competence in patients suffering from different mental disorders have been performed using the MacArthur Competence Assessment Tool-Treatment (MacCAT-T; Grisso and Appelbaum1998). This assessment tool is based on legal standards of competence such as understanding, reasoning, appreciation, and expressing a choice. Since its first publication, the MacCAT-T has been widely accepted as a "gold standard" of competence assessment in the psychiatric literature. In recent years the MacCAT-T has been applied to patients suffering from depression, schizophrenia, dementia, angina pectoris, and normal controls (for overview, see Welie [2001] and Bauer and Vollmann [2002]).Tan and her colleagues (2006) use the MacCAT-T the first time to assess competence to make treatment decisions in patients with anorexia nervosa. Coming from clinical practice, the authors have noticed that the MacCAT-T might not work in this group of patients. Therefore, they use semi-structured interviews in addition to the MacCAT-T to identify aspects of thinking that might be relevant to the issue of competence to refuse treatment. They use grounded theory techniques for a qualitative analysis of the data as well as five brief, self-administered questionnaires to ascertain levels of psychopathology.The results of the study show that anorexia nervosa can have complex and variable effects on concentration, beliefs, and thought processing without affecting the ability to perform well on the MacCAT-T. At the same time, participants also report a change in their value system as well as in their personal identity. The authors argue that the results of their studies suggest that the competence to refuse treatment might be compromised in [End Page 289] people with anorexia nervosa in ways that are not captured by the MacCAT-T. This is an interesting finding in patients with anorexia nervosa, because in all other studies with patients suffering from mental disorders such as dementia, depression, and schizophrenia, the MacCAT-T identified more patients as limited in their competence to make health care decisions in comparison with other methods of competence assessment such as clinical judgment (Vollmann et al. 2003). The authors argue on the basis on their qualitative, semistructured interviews that anorexia nervosa–specific difficulties with a thought process and the change of values are missed by the MacCAT-T.Furthermore, Tan and her associated could not find a relationship between the participants' scores on the psychopathological scales, the MacCAT-T scores, and their difficulties expressed during the qualitative interviews, although the small size of the study precludes statistical analysis. In an earlier study, clinical dementia scales but not neuropsychological testing correlated with formal (MacCAT-T) and clinical assessment of competence. Therefore, psychopathological factors might play a different role in different subgroups of patients suffering from different mental problems. However, the idea of an objective neuropsychological model of competence assessment, again, finds no support in the presented empirical data.The qualitative data from patients with anorexia nervosa underline the problem of the cognitive bias of the MacCAT-T assessment and the illusion of value-free categories. It has been argued that the cognitive focus for the MacCAT-T is in itself a normative convention and that the MacCAT-T is missing the complexity of the process to make health care decisions in real life. Therefore, values and emotions should be considered in addition to cognitive functions in assessing competence to make health care decisions (Breden and Vollmann 2004; see also "Mental capacity" 2004). Although many authors agree that the cognitive approach of capacity assessment is important but not sufficient for the assessment of competence to make health care decisions, it remains an... (shrink)

Advance patient directives are various forms of anticipatory medical directives made by competent individuals for the eventuality of future incompetence. They are therefore appropriate instruments for competent patients in the early stage of Alzheimer's disease to document their self-determined will in the advanced stages of dementia. Theoretical objections have been expressed against the concept of advance patient directives (problems of authenticity and identity) which, however, cannot negate the fundamental moral authority of advance patient directives. Therefore, patients, family members, and physicians (...) should make use of the appropriate form of advance directive as part of common treatment and care planning. Advance directives, when utilized intelligently, represent appropriate instruments for shared decision-making by patient, family members and physician. They should be utilized to a greater extent, particularly for the treatment planning of demented patients. (shrink)