PurposeTo explore the mindfulness practice, its long-term effects, facilitators and barriers, in clinical clerkship students 2 years after participation in an 8-week mindfulness-based stress reduction training.MethodA qualitative study was performed by semi-structured in-depth interviews with 16 clinical clerkship students selected by purposive sampling. Students had participated in a MBSR training 2 years before and were asked about their current mindfulness practice, and the long-term effects of the MBSR training. Thematic analysis was conducted using the constant comparison method. Data saturation was (...) reached after 16 interviews.ResultsMost interviewees were still engaged in regular, predominantly informal, mindfulness practice, although some discontinued mindfulness practice and reported an “unchanged lifestyle.” Three main themes came forward; “focused attention and open awareness” during daily activities as core elements of long-term mindfulness practice; “changes in behavior and coping” that resulted from taking a pause, reflecting, recognizing automatic behavioral patterns and making space for a conscious response; “integration in personal and professional life” by enhanced enjoyment of daily activities, improved work-life-balance and making different career choices. Barriers and facilitators in starting and maintaining mindfulness practice were understanding and intention as “pre-conditions”; practical, personal, and professional factors of students in maintaining practice.ConclusionTwo years after participation in a MBSR training, many interviewees were still engaged in mindfulness practice contributing to both personal and professional changes. In light of the high clerkship demands, MBSR training could be a valuable addition to medical curricula, supporting medical students in developing necessary competencies to become well-balanced professionals. (shrink)

About one third of patients with epilepsy have seizures refractory to the medical treatment. Electrical stimulation mapping is the gold standard for the identification of “eloquent” areas prior to resection of epileptogenic tissue. However, it is time-consuming and may cause undesired side effects. Broadband gamma activity recorded with extraoperative electrocorticography during cognitive tasks may be an alternative to ESM but until now has not proven of definitive clinical value. Considering their role in cognition, the alpha and beta bands could further (...) improve the identification of eloquent cortex. We compared gamma, alpha and beta activity, and their combinations for the identification of eloquent cortical areas defined by ESM. Ten patients with intractable focal epilepsy participated in a delayed-match-to-sample task, where syllable sounds were compared to visually presented letters. We used a generalized linear model approach to find the optimal weighting of each band for predicting ESM-defined categories and estimated the diagnostic ability by calculating the area under the receiver operating characteristic curve. Gamma activity increased more in eloquent than in non-eloquent areas, whereas alpha and beta power decreased more in eloquent areas. Diagnostic ability of each band was close to 0.7 for all bands but depended on multiple factors including the time period of the cognitive task, the location of the electrodes and the patient’s degree of attention to the stimulus. We show that diagnostic ability can be increased by 3–5% by combining gamma and alpha and by 7.5–11% when gamma and beta were combined. We then show how ECoG power modulation from cognitive testing can be used to map the probability of eloquence in individual patients and how this probability map can be used in clinical settings to optimize ESM planning. We conclude that the combination of gamma and beta power modulation during cognitive testing can contribute to the identification of eloquent areas prior to ESM in patients with refractory focal epilepsy. (shrink)

BackgroundAdverse childhood experiences can cause serious mental problems in adolescents and therefore may expected to be associated with higher use of psychosocial care, potentially varying by type of specific ACE. The aim of our study is to explore the association of the number of ACE and types of specific ACE with entering and using psychosocial care.MethodsWe used data from the Slovak Care4Youth cohort study, comprising 509 adolescents from 10 to 16 years old. We used logistic regression models adjusted for age, (...) gender, and family affluence to explore the associations of number and type of specific ACE with the use of psychosocial care.ResultsHaving three or more ACE as well as experiencing some specific ACE increased the likelihood of using psychosocial care. Regarding experience with the death of somebody else you love, we found a decreased likelihood of the use of psychosocial care.ConclusionExperiencing ACE above a certain threshold and parent-related ACE increase the likelihood of adolescent care use. (shrink)

Background: Discussing treatment risks has become increasingly important in medical communication. Still, despite regulations, physicians must decide how much and what kind of information to present. Objective: To investigate patients’ preference for information about a small risk of a complication of colonoscopy, and whether medical and personal factors contribute to such preference. To propose a disclosure policy related to our results. Design: Vignettes study. Setting: Department of Gastroenterology, Academic Medical Centre, the Netherlands. Patients: 810 consecutive colonoscopy patients. Intervention: A home-sent (...) questionnaire containing three vignettes. Vignettes varied in the indication for colonoscopy, complication severity and level of risk. Patients were invited to indicate their wish to be informed and the importance of such information. In addition, sociodemograhic, illness-related and psychological characteristics were assessed. Main outcome measurements: Wish to be informed and importance of information. Results: Of 810 questionnaires, 68% were returned. Patients generally wished to be informed about low-risk complications, regardless of the indication for colonoscopy or the severity of the complication. The level of risk did matter, though (OR = 2.48, SE = 0.28, p = 0.001). The information was considered less important if done for population screening purposes or diagnosis of colon cancer, if the complication was less severe (bleeding) and if the risk was smaller (0.01% and 0.1%). Patients’ information preference was also related to age, mood and coping style. Limitations: Difficulty of vignettes. Conclusions: Patients generally wish to be informed about all possible risks. However, this might become uninformative. A stepwise approach is suggested. (shrink)

Contextual learning pervades our perception and cognition and plays a critical role in adjusting to aversive and stressful events. Our ability to memorise spatial context has been studied extensive...

In this article, I examine the moral dimensions of gender affirmation. I argue that the moral value of gender affirmation is rooted in what Iris Murdoch called loving attention. Loving attention is central to the moral value of gender affirmation because such affirmation is otherwise too fragile or insincere to have such value. Moral reasons to engage in acts that gender affirm derive from the commitment to give and express loving attention to trans people as a way of challenging their (...) marginalization. In the latter part of the paper, I will discuss how my arguments bear on recent arguments by Robin Dembroff and Daniel Wodak (2018) on the use of gender-neutral language. They argue that we have a duty not to use gender-specific pronouns for anyone. Their conclusion turns, in part, on a rejection of gender affirmation as a moral duty. The value of gender affirmation, rooted in our moral perception of trans people, should make us skeptical of this conclusion, in favor of a more nuanced and pluralistic approach to the ethics of gendering. (shrink)

Dubbed “Nietzsche without his hammer” by literary critic James Wood, the Romanian philosopher E. M. Cioran is known as much for his profound pessimism and fatalistic approach as for the lyrical, raging prose with which he communicates them. Unlike many of his other works, such as On the Heights of Despair and Tears and Saints, The New Gods eschews his usual aphoristic approach in favor of more extensive and analytic essays. Returning to many of Cioran’s favorite themes, The New Gods (...) explores humanity’s attachment to gods, death, fear, and infirmity, in essays that vary widely in form and approach. In “Paleontology” Cioran describes a visit to a museum, finding the relatively pedestrian destination rife with decay, death, and human weakness. In another chapter, Cioran explores suicide in shorter, impressionistic bursts, while “The Demiurge” is a shambolic exploration of man’s relationship with good, evil, and God. All the while, The New Gods reaffirms Cioran’s belief in “lucid despair,” and his own signature mixture of pessimism and skepticism in language that never fails to be a pleasure. Perhaps his prose itself is an argument against Cioran’s near-nihilism: there is beauty in his books. (shrink)

Interpretation of the classics in political theory seems to go in waves. For a while we had John Locke, the bourgeois thinker. Now we seem to be in a Locke-as-radical-democrat phase. Locke-the-bourgeois had problems of its own, but a radically democratic Locke -- not just the old Locke as liberal democrat but Locke as quasi-Leveller -- strains the interpretative imagination more than most; yet in recent years, several different kinds of argument have been advanced in support of it, both textual (...) and contextual. The most effective argument has proceeded by situating Locke in the context of radical Whig politics in the 1670s and '80s, the struggles over religious toleration and the royal succession, in particular the �Exclusion Crisis� of 1679-81. This contextual argument has been accompanied by various textual interpretations having to do with Locke's conceptions of property, consent, representation, the right of revolution and natural law. Among other things, these are supposed to show that while Locke had nothing explicit to say about the extent of the franchise, the weight of evidence suggests that he would have supported a fairly wide franchise, perhaps even something like the (almost) manhood suffrage advocated by the Levellers (at least according to some, and probably the most convincing, interpretations of their ideas). Most recently, in these pages, Martin Hughes, building on the work of James Tully and Richard Ashcraft in particular, has pushed the argument as far as it can probably go. His argument on taxation and suffrage has provided a motivation here for a wider exploration of Locke's views on representation, consent and the franchise. (shrink)

_Zettel, _ an en face bilingual edition, collects fragments from Wittgenstein's work between 1929 and 1948 on issues of the mind, mathematics, and language.

MORALITY is an area of culture that is highly susceptible to philosophical skepticism. This has been so at least since the time of the Greek Sophists. But modern Western civilization seems to be especially prone to philosophical doubts about the moral enterprise because of widely shared assumptions and views in the modern age about the knowledge-yielding powers of the human mind. This particular trouble spot in the culture has received extensive philosophical attention ever since the seventeenth century, but activity in (...) moral philosophy has never been greater than in our own time. (shrink)

I believe that the world is a totality of things: there are no properties, or relations, or sets, or states of affairs, or facts, or events; there are only particular things. I also believe that all true statements can be expressed in a canonical language which includes names of things and logical terms only: there will be no predicates in this language. For what is a predicate? Some say that predicates are names of universals which individual things exemplify, or names (...) of sets of which individual things are members. If this is so, it is obvious that a nominalist's canonical language cannot have any predicates. Others say that predicates name nothing, but are satisfied by particular things. What, however, is satisfaction, and how is it different from naming? Semantic relations such as satisfaction, we are told, are not ‘in’ the world. But then a nominalist has no use for them. (shrink)

Romanian born E.M. Cioran, who lived in Paris until his death in 1995, writes of politics, of history, and of the utopian dream. "Cioran has a claim to be regarded as among the handful of original minds... writing today".--NEW YORK TIMES.

Если вы налаживаете деловые и культурные связи со странами Востока, вам не обойтись без знания истоков культуры мусульман, их ценностных ориентиров, менталитета и правил поведения в самых разных ситуациях. Обо всем этом вы узнаете, прочитав книгу.

BY OVEREMPHASIZING MATERIALISTIC VALUES, we have perverted the culture and set modern Western civilization on a self-destructive course. Some critics have said that the economy, science, and technology are the only healthy aspects of our society. We have what I have called a saber-toothed tiger civilization. In the evolutionary process, the saber-toothed tiger developed great tusks as effective weapons in combat, but perished because they obstructed its eating. We have developed a culture that is highly successful in advancing science and (...) technology and producing wealth and power, but in doing so we have undermined and subjectivized the sectors of the culture that underwrite our identity, the meaning of our existence, and the norms and values by which we live our lives, organize our society, and run our institutions, including even science and the economy. But unlike the saber-toothed tiger, we can discover our error and correct our course. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:DOES GOD HAVE A QUIDDITY ACCORDING TO AVICENNA* IN THE NEW critical edition of Avicenna's MemphyS'ics by S. Van Riet at Louvain (I, 1977; II, 1980; III, 1983), Gerard Verbeke states that according to Avicenna, "L'Etre necessaire n'a pas une essence qui est distincte de son existence" (II, p. * 42, at note 159), i.e. that the Necessary Being does not have an essence that is distinct from its (...) existence. One looks in vain for a precise reference to an Avicennian text. On the other hand, in a three-part study, Albert G. Judy, O.P., "Avicenna's Me1taphy8'ics in the Summa contra Gentiles," published in Angelicum, part I: 52 (1975) 340-384; part II: 541-586; part Ill: 53 (1976) 183-226, states quite clearly that the "First" does not have a quiddity but only an "anity" (anitas)... (546), and that Avicenna... finds that the absolutely necessary being cannot have what every other reality has, namely, a quiddity, a "whatness " distinct from its" whether-ness" or anitas (547-548). Moreover, the first appendix of Judy's article contains a redaction of the 1495 and the 1508 Venice editions of ltletaphyiscs 8.4, which differs chiefly in punctuation from the excellent Van Riet text based on five Latin MSS. A slightly more nuanced position is. found in Etienne Gilson's Elements of Christian Philosoph;y (Garden City, N. Y.: Doubleday, 1960), p. 127: "... such exactly had been the con- * Delivered before the Society for the Study of Islamic Philosophy and Science meeting in conjunction with The American Catholic Philosophical Association in Milwaukee, Wisconsin, on April 12, 1985. 79 80 E. M. MACIEROWSKI clusion of Avicenna: the first has no quiddity (quidditatem non habet)," a claim that cites (305, note 28) secondary literature which one can trace as far back as Father M.-D. RolandGosselin 's edition of the De ente et essentia. What is at stake in this dispute? What if God does not have a quiddity? It would seem that He should be utterly unknowable, if quiddity or essence is a principle of knowledge as well as of being. Such would be plausible consequences of Gilson's and Judy's position. What, on the other hand, if God does have a quiddity? One possible inference, if we happened to have access or insight into the divine quiddity, is that we could have a sort of mystical union with God, perhaps even in this life; or again, one might draw pantheistic conclusions. Verbeke does not follow such paths. His inference points toward a rawrochement between Avicenna's doctrine and that of St. Thomas Aquinas, who maintained not only that God is His own essence (and therefore that it is reasonable to speak of a divine essence) but also that God's essence is no other than His esse, His being or existence. Accordingly, for scholars to have such opposed views about so important a topic even at the hermeneutical level of Avicenna's position points to a serious difficulty. Since Judy does offer texts in support of his interpretation, let us consider the evidence, using his section numbers and Van Riet's pages and lines: Judy, section 4=Van Riet 398.83-399.84 goes thus in Latin: Redibo igitur et dicam quod primum non habet quidditatem, nisi anitatem, quae sit discreta ab ipsa. This text he renders, "The first does not have a quiddity, except an 'anity,' which is distinct from it" (549). The other text in Latin (Judy, section 13=Van Riet 401.31-32) goes thus: Igitur necesse esse non habet quidditatem nisi quod est necesse esse, et haec est anitas, which he renders, "Therefore necessary being does not have a quiddity, but only the fact of its necessary being, and this is DOES GOD HAVE A QUIDDITY ACCORDING TO AVICENNA 81 'anity'" (559). We wonder, however, why nisi should be translated "except" in section 4 and "hut only" in section 13. One would have expected a sed solum or a sed tantum to justify the rendering "but only." Accordingly, the translation should be corrected to read, " Therefore the necessary being has no quiddity except that it is necessary being, and this... (shrink)

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