Background and objective: Code status discussions may fail to address patients’ treatment-related goals and their knowledge of cardiopulmonary resuscitation (CPR). This study aimed to investigate patients’ resuscitation preferences, knowledge of CPR and goals of care. Design, setting, patients and measurements: 135 adults were interviewed within 48 h of admission to a general medical service in an academic medical centre, querying code status preferences, knowledge about CPR and its outcome probabilities and goals of care. Medical records were reviewed for clinical information (...) and code status documentation. Results: 41 (30.4%) patients had discussed CPR with their doctor, 116 (85.9%) patients preferred full code status and 11 (8.1%) patients expressed code status preferences different from the code status documented in their medical record. When queried about seven possible goals of care, patients affirmed an average of 4.9 goals; their single most important goals were broadly distributed, ranging from being cured (n = 36; 26.7%) to being comfortable (n = 8; 5.9%). Patients’ mean estimate of survival to discharge after CPR was 60.4%. Most patients believed it was helpful to discuss goals of care (n = 95; 70.4%) and the chances of surviving inhospital CPR (n = 112; 83.0%). Some patients expressed a desire to change their code status after receiving information about survival following inhospital CPR (n = 11; 8.1%) or after discussing goals of care (n = 2; 1.5%). Conclusions: Doctors need to address patients’ knowledge about CPR and take steps to avoid discrepancies between treatment orders and patients’ preferences. Addressing CPR outcome probabilities and goals of care during code status discussions may improve patients’ knowledge and influence their preferences. (shrink)

Almost any modern reader's first encounter with Darwin's writing is likely to be the "Historical Sketch," inserted by Darwin as a preface to an early edition of the Origin of Species, and having since then appeared as the preface to every edition after the second English edition. The Sketch was intended by him to serve as a short "history of opinion" on the species question before he presented his own theory in the Origin proper. But the provenance of the "Historical (...) Sketch" is somewhat obscure. Some things are known about its production, such as when it first appeared and what changes were made to it between its first appearance in 1860 and its final form, for the fourth English edition, in 1866. But how it evolved in Darwin's mind, why he wrote it at all, and what he thought he was accomplishing by prefacing it to the Origin remain questions that have not been carefully addressed in the scholarly literature on Darwin I attempt to show that Darwin's various statements about the "Historical Sketch," made primarily to several of his correspondents between 1856 and 1860, are somewhat in conflict with one another, thus making problematic a satisfactory interpretation of how, when, and why the Sketch came to be. I also suggest some probable resolutions to the several difficulties. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:120 HISTORY OF PHILOSOPHY Opera theologica quae latine edidit, 3 vols. (Roterodami, 1651-1660). His religious polemics with Amyrault and Grofius were famous. Paul Dibon, professor at the Ecole Pratique des Hautes Etudes, is the most prominent contemporary historian of seventeenth-century Dutch philosophy and intellectual life; he is perfectly aware of the fact that genuine history can only be founded on solid erudition, and this inventory is a first-class contribution (...) to it. Only those who ignore the difficulties of this kind of research will underestimate the enormous effort it involves--an effort which is, much more than a pedantic and mechanical listing of data, a kind of venatio, requiring a continuous alertness, a surprising amount of imagination and intelligence, a painstaking precision, and an enormous background of knowledge. The letters are arranged in chronological order (with the exception of a few which are undated). Each entry lists the date, the names and locations of the sender and addressee, and the opening words of the letter. The status of the letter (original/ minute/copy/printed) is indicated, as is the library in which the letter is located (and the call number), and/or, if the letter was published, the printed source. Thirty-two libraries were explored. GIORGIO TONELLI State University o/ New York at Binghamton Introduction to Newton's Principia. By I. Bernard Cohen. (Cambridge, Mass.: Harvard University Press, 1971. Pp. xxx+380. $30.00) Over the past dozen years or so Newtonian scholarship has burgeoned as never before, and a first and fundamental result has been the publication of more and more of the wealth of manuscript material and letters that Newton left as a legacy of potential insight and confusion to future scholars. To date, the most imposing of the undertakings in publication have been The Correspondence (1959- ), begun under the editorship of H. W. Turnbull and continued more recently under that of J. F. Scott, and the Mathematical Papers (1967- ), started and continuing under the editorship of D. T. Whiteside. Selected documents of importance have been published by I. Bernard Cohen, assisted by Robert E. Schofield, in Isaac Newton's Papers and Letters on Natural Philosophy... (1958), by A. R. Hall and Marie Boas Hall in Unpublished Scientific Papers o/ Isaac Newton (1962), and by J. W. Herivel in The Background of Newton's Principia (1965); additional documentary material has appeared in studies by Alexandre Koyr6, I. Bernard Cohen, Johannes A. Lohne, D. T. Whiteside, Richard S. Wesffall, J. E. McGuire and P. M. Rattansi, and still others--a full bibliography would run to considerable length. Nor, although the uncertainties in the interpretation of the documents are sometimes overwhelming, has this spate of publication merely served to replace one set of scholarly puzzles by another. The traditional, monolithic and impenetrable image of Newton "with his prism and silent face, / The marble index of a mind for ever / Voyaging through strange seas of Thought, alone..." has lost something of its hypnotic hold, and we begin to discern some of the steps, not to say jogs and leaps, in Newton's actual journey of thought and discovery. The volume here under review introduces another major enterprise in Newtonian scholarship, a "variorum" edition of the Principia. The edition itself, which has yet to appear, will consist primarily of a facsimile reproduction of the third edition (1726)-the last edition that Newton himself supervised----collated line by line with the variant readings in the two prior editions and in a manuscript of the first edition, and with the BOOK REVIEWS 121 corrections, improvements, and additions that Newton entered into copies of the first and second editions. This textual part of the edition was delivered to the press in 1966; additional parts are in various stages of preparation. There is to be a Commentary dealing with the prefaces, definitions, laws of motion, and the first three sections of Book I and most of Book III, along with English versions and modern analytical paraphrases of the sections dealt with, a glossary, and a number of short essays on such topics as the astronomical and physical data used by Newton, the mathematical background to the understanding of the Principia, and the analysis of... (shrink)

Dans ce volume considérable, on été réunies les contributions d'un Congrès international tenu à Louvain en 1998 pour marquer l'achèvement de la première édition de la Théologie Platonicienne de Proclus. Ces contributions, toutes rigoureusement centrées sur la Théol. Plat. concernent (1) les principes et les sources de la Théol. plat. (2) Les méthodes théologiques de Proclus (3) La postérité de la Théol. plat. dans le monde grec, païen comme chrétien, et dans le monde islamique. Des indices très détaillés permettent de (...) retrouver tous les passages cités et commentés dans ce volume. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:A Greek Countryside: The Southern Argolid from Prehistory to the Present Day, with a Register of Sites by Curtis N. Runnels and Mark H. MunnDonald C. HaggisMichael H. Jameson, Curtis N. Runnels and Tjeed H. Van Andel. A Greek Countryside: The Southern Argolid from Prehistory to the Present Day, with a Register of Sites by Curtis N. Runnels and Mark H. Munn. Stanford: Stanford University (...) Press, 1994. xx + 658 pp. 224 figs. 36 tables. 8 back-pocket maps. Cloth, $125.The methodological divide between Greek history and archaeology is bridged in areas of epigraphy, topography, and political geography, or in instances where the data (sites, inscriptions, or destruction levels) manifestly complement or corroborate the text. This "handmaiden" role of archaeology has been challenged in the past two decades, and links between history and archaeology have been strengthened by changes in both disciplines, especially in the range of data utilized if not in method and approach. The archaeologist's reconstruction of long-term history is only enriched by textual documentation; and the historian has found in new approaches to ancient landscapes a wider scope of data, a realm of problems, and a multi-dimensional context for writing history.A new vision of documenting the Greek past is as yet nowhere more effectively illustrated than in A Greek Countrysidey. This book, which is the final publication of the Argolid Exploration Project (and Stanford University Archaeological and Environmental Survey), was conceived in an era of vastly changing approaches to the past and inspired by the first regional and diachronic survey in Greece, the Minnesota Messenia Expedition. The exploration of the southern Argolid also emerged in the context of two vastly different yet complementary excavations at the Paleolithic-Neolithic Franchthi Cave and Classical Halieis. The chronological, methodological, and environmental scope and problem orientation of these projects were important in setting the stage for the examination of human history in the broader region, emphasizing human-environment interaction as important to understanding culture change through time.A Greek Countryside presents the results of the survey (conducted in 1972 and 1979-1983) in the southern Argolid (225 km2) that recovered some 328 sites from an intensive sample of 44 km2. The first three chapters, "Topography," "History," and "Land and Sea in the Southern Argolid," provide an introduction to the study area. They present the synchronous dimensions of observable terrain, environment, and communication routes, and the diachronic perspectives of history (1000 B.C.-modern times), geomorphology, and environmental studies. Chapter 4, "The Archaeological Survey," describes the process and methods of fieldwork, the basis for the identification and functional designations of sites, and the classificatory nomenclature of the observable settlement patterns. Chapter [End Page 333] 5, "Using the Resources of the Land and Sea," is a discussion of agricultural, pastoral, and maritime activities derived from archaeological evidence from Franchthi Cave, Halieis, and wider afield, and from ethnography, studies of ancient and modern agriculture, and Medieval and Venetian records and travelers' accounts. This chapter injects the human element into the natural environment, setting the stage for the patterns of interaction between cultural and natural landscapes. The authors' synthesis and conclusions are presented in the final chapter 6, unambiguously titled, "Fifty Thousand Years of Coevolution of Landscape and Human Settlement."This concluding chapter is wonderfully detailed, referring back to the data presented in previous chapters and forward to the numerous appendices. The appendices are focused treatments of the sites recovered (A); population estimates (B); pseudo-Scylax's periplus (C); Pausanias' account of the south Argolid (D); the town of Hermion (E); the border dispute between Hermion and Epidauros in the first half of the second century B.C. (F); and an account of the Turkish traveler, Evliya Chelebi, in 1669 (G). Chapter 6 is somewhat of an achievement in itself, providing a lucid and fascinating chronological and historical narrative, un-encumbered by tendentious footnotes or cross-references, while making the reader constantly aware of both the data and the interpretive basis for conclusions. Although the diachronic survey maps, showing settlement patterns, are presented earlier in chapter 4, more detailed maps illustrate chapter 6 and are essential and effective complements to the text.The effects of... (shrink)

Originally published in 1936, this book presents the ancient Greek text of the paraphrases and quotations of Zeno's philosophical arguments, together with a facing-page English translation and editorial commentary. Detailed notes are incorporated throughout and a bibliography is also included. This book will be of value to anyone with an interest in Zeno and ancient philosophy.

The following brief memoir of Wittgenstein needs a few preliminary words of explanation. Among those who attended his lectures and discussions in the years it covers was D. G. James, who later became Professor of English at Bristol University and then Vice-Chancellor of Southampton University. I met him both in Bristol and Southampton, and on one occasion suggested to him that some of us who had known Wittgenstein, but who had not become professional philosophers, might write down our recollections of (...) him, and that he and I should start. What prompted the suggestion was, I think, the publication of Norman Malcolm's book, and a feeling that the non-professionals might have something to contribute to the assessment of Wittgenstein, particularly as a person. I wrote a preliminary draft and sent it to James; but he never responded, there was much else to do, I let the matter rest, and now James is dead. I wrote in about the year 1960 on holiday and away from any books of reference and from my own notes of Wittgenstein's lectures and conversations. I have shown the typescript to a few interested people, but because of its preliminary and unfinished nature have not previously thought of publication. It has recently been suggested to me that it might be of more general interest, and I publish it now as it was written, with one or two trifling alterations. I am well aware of its limitations. It was intended to give an impression of Wittgenstein as a person rather than as a philosopher, and the rather miscellaneous collection of remarks in section 3 have that in view rather than any more strictly ‘philosophical’ intention. Others may well question some of the detail and disagree with some of the opinions expressed. And there are some things which I might put rather differently today. But if the memoir has any interest it is best left as it was written. (shrink)

Background: The use of race as a category in medical research is the focus of an intense debate, complicated by the inconsistency of presumed independent variables, race and ethnicity, on which analysis depends. Interpretation is made difficult by inconsistent methods for determining the race or ethnicity of a participant. The failure to specify how race or ethnicity was determined is common in the published literature.Hypothesis: Criteria by which they assign a research participant to racial or ethnic categories are not reported (...) by published articles.Methods: Methods were reviewed for assigning race and ethnicity of research participants in 268 published reports reporting associations among race , health outcome and genotype.Results: Of the 268 published reports reviewed, it was found that 192 did not explain their methods for assigning race or ethnicity as an independent variable. This was despite the fact that 180 of those reports reached conclusions about associations among genetics, health outcome and race or ethnicity.Conclusions: More attention needs to be given to the definition of race and ethnicity in genetic studies, especially in those diseases where health disparities are known to exist. (shrink)

The program of a physical concept of information is outlined in the framework of quantum theory. A proposal is made for how to avoid the intuitive introduction of observables. The conventional and the Everett interpretations in principle may lead to different dynamical consequences. An ensemble description occurs without the introduction of an abstract concept of information.

H. D. Lewis; I—Mind and Body—Some Observations on Mr. Strawson's Views: The Presidential Address, Proceedings of the Aristotelian Society, Volume 63, Issue 1, 1.

The two passages in question are I. the discussion of Justice in Bk. V. chs. I-II, and in particular the definition and subdivisions of Corrective Justice ; and II. the discussion of the voluntaryand προαρεσς in Bk. III chs. II-II. My object is to show that each is better understood if it is seen in the light of contemporary legal ideas and practice.

In the second book of his Epitoma rei militaris Vegetius sets himself the task of describing the organization of the antiqua legio of the Roman Army, the units into which it was divided, its officers, the arms of its soldiers, and its tactical employment on the field of battle. Interspersed in this account are frequent references to changes that had been subsequently effected and were in operation in the author's lifetime. But although these annotations destroy the synthesis of the book, (...) and the transition from past to present is not always clearly indicated, the disentanglement of Vegetius' own additions from the material provided by his source or sources is not the chief difficulty that confronts the modern historian. For with few exceptions in chapters 4–14 Vegetius describes the antiqua legio in the imperfect, the legion of his own time in the present indicative, with the not infrequent addition of the word ‘nunc’ or ‘hodie.’ The great problem is to discover whether in his account of the antiqua legio the author is referring to any one period of Roman History, and, if so, whether its limits can be exactly defined. Many solutions have been attempted. Some scholars have thought that the period is earlier than Hadrian; the more generally accepted theory is that the antiqua legio can be identified with the legion as it was constituted in the reign of Diocletian. Recently two German historians have subjected the evidence to fresh consideration, and, while one of them agrees with the majority in selecting the age of Diocletian for his answer to the problem, the other believes that he can date the period to which Vegetius is referring to the late second century A.D. (shrink)

This paper conducts a critical examination of the "usual psychopharmacology standards" for clinical research. Four main areas are inspected: What is "it" that is being treated in a clinical drug study? How much is really known concerning the psychological alterations brought about by psychiatric drug treatment? To what extent are sources of bias actually controlled for in "controlled" drug treatment studies? How does the usual "dropout pattern" influence the alleged "clinical findings" of controlled drug treatment studies? The overall conclusion reached (...) is that the "usual standards" cannot produce a realistic picture of either safety or efficacy. Conceptual and methodological reforms are suggested. (shrink)