DRGs may contain costs, but they threaten to restrict access to health care, to compromise its quality, and to impede the development of new medical technologies. Immediate corrections are necessary to ensure that hospitals continue to serve the poorest and sickest.

It is perhaps most useful to approach the Doctor-Patient relationship (DPR) by admitting that it’s complicated. We review some of the strategies that have been employed to mitigate this complexity, zeroing in on one that promises to capture the main features of the DPR without eliminating some of its more important, existential components; pieces of the puzzle that must be retained if we are to avoid oversimplification and the errors that can arise by ignoring important foundational properties. We believe that (...) a useful way to look at the DPR and to capture essential features that must be balanced in the process is provided by Partnership Theory and its definition in terms of the so-called domination and partnership systems. We apply this theory to the DPR and investigate the implications of this application to health care. We see that in the absence of mitigating circumstances, adoption of the patient-as-partner model serves healthcare well and is flexible enough to accommodate circumstances that dictate modifications. (shrink)

The author starts from the traditional American notion that technology might offer a way to decrease the horror and suffering of warfare. He points out that historically this assumption is flawed in that past technological advances, from gunpowder weapons to bombers, have only made warfare more--not less--bloody. With a relentless logic, Colonel Dunlap takes to task those who say that the Revolution in Military Affairs has the potential to make war less bloody. He covers the technological landscape from precision-guided munitions (...) and Information Warfare to the use of space for military operations to raise issues that could pose difficult ethical, legal and moral problems for statesmen and soldiers. Some of these conundrums are so confounding that the author could claim that in all humility his only purpose was to raise these issues to prompt debate. But Colonel Dunlap takes the next step to outline several broad thematic avenues that may help us all address the difficult problems that lie ahead. (shrink)

A gathering of more than 120 beautiful color photographs from both professional and amateur photographers captures the timeless splendor of the Ozark region and includes an informative introduction that reviews the history and unique topography of the area. UP.

Louis Frédéric Ancillon was a member of the Prussian Academy of Sciences and Belles Lettres whose imagined dialogue between Berkeley and Hume was read to the Academy in 1796 and published in 1799. It is important as an indicator of the reception of Hume and Berkeley in francophone philosophical circles in late eighteenth-century Prussia. Our introduction is followed by an English translation with notes.

Memory exhibits episodic superposition, an analog of the quantum superposition of physical states: Before a cue for a presented or unpresented item is administered on a memory test, the item has the simultaneous potential to occupy all members of a mutually exclusive set of episodic states, though it occupies only one of those states after the cue is administered. This phenomenon can be modeled with a nonadditive probability model called overdistribution (OD), which implements fuzzy-trace theory's distinction between verbatim and gist (...) representations. We show that it can also be modeled based on quantum probability theory. A quantum episodic memory (QEM) model is developed, which is derived from quantum probability theory but also implements the process conceptions of global matching memory models. OD and QEM have different strengths, and the current challenge is to identify contrasting empirical predictions that can be used to pit them against each other. (shrink)

Werner syndrome is a rare autosomal recessive disorder that mimics some of the characteristics of aging. The gene for this disorder has recently been identified as a helicase of the recQ subclass(1). Other phenotypically distinctive disorders caused by different helicase mutations include Bloom syndrome, Cockayne syndrome, xeroderma pigmentosum and trichothiodystrophy. Possible mechanisms by which helicases might produce the variable phenotypes are discussed. These include altered nucleotide excision repair and RNA polymerase II‐mediated transcription. The discovery of the helicase defect in Werner (...) syndrome provides a road map for future study of its unique pathogenesis and conceivable, but unproved, relationship to the aging process. (shrink)

Gilles Deleuze is now regarded as one of the most radical philosophers of the twentieth century. His work is hugely influential across a range of subjects, from philosophy to literature, to art, architecture and cultural studies. _Gilles Deleuze: Key Concepts_ provides a guide to Deleuzian thought for any reader coming to his writings for the first time. This new edition is fully revised and updated and includes three new chapters on the event, psychoanalysis and philosophy.

Since the publication of Husserl's Logische Untersuchungen at the outset of this century, the notion of phenomenology has had a long and important history on the European continent. Of the many claims made on its behalf perhaps the most interesting is that phenomenology is able to ground philosophical assertions in a manner which is neither purely formal nor purely empirical, i.e., that phenomenology as a method is capable of transcending this very distinction. For example, phenomenologists argue that their reduction of (...) essences provides a way of knowing which is neither analytic nor synthetic but both. Having reached such an eidetic intuition phenomenologists claim to have attained a non-trivial universality and necessity. (shrink)

Aristotle assesses as valid three first figure syllogisms, each of which contains at least one premiss expressing a de re contingency. In fact, all three of these moods (namely, Barbara-QQQ, Barbara-XQM, and Barbara-LQM) are invalid. Utilizing the concept of ampliation, this paper shows how the mood Barbara-QQQ must be refined if it is to be deemed valid. It can then become clear as to how Barbara-XQM and Barbara-LQM can be disambiguated and ultimately validated. In treating all three moods, some theses (...) from S4 will be exploited in the context of distinguishing de dicto and de re modes of attributing possibility and necessity. Various Aristotelian propositional forms and rules of inference, including argumentation by ecthesis, will shape the presentation. The viability of Aristotle’s views on the convertibility of universal negative apodeictic propositions will emerge as decisive in evaluating the success of his modal syllogistic. (shrink)