Background and objectives: Physicians are exposed to matters of existential character at work, but little is known about the personal impact of such issues. Methods: To explore how physicians experience and cope with existential aspects of their clinical work and how such experiences affect their professional identities, a qualitative study using individual semistructured interviews has analysed accounts of their experiences related to coping with such challenges. Analysis was by systematic text condensation. The purposeful sample comprised 10 physicians (including three women), (...) aged 33–66 years, residents or specialists in cardiology or cardiothoracic surgery, working in a university hospital with 24-hour emergency service and one general practitioner. Results: Participants described a process by which they were able to develop a capacity for coping with the existential challenges at work. After episodes perceived as shocking or horrible earlier in their career, they at present said that they could deal with death and mostly keep it at a distance. Vulnerability was closely linked to professional responsibility and identity, perceived as a burden to be handled. These demands were balanced by an experience of meaning related to their job, connected to making a difference in their patients’ lives. Belonging to a community of their fellows was a presupposition for coping with the loneliness and powerlessness related to their vulnerable professional position. Conclusions: Physicians’ vulnerability facing life and death has been underestimated. Belonging to caring communities may assist growth and coping on exposure to existential aspects of clinical work and developing a professional identity. (shrink)

Desmosomes are junctions involved in intercellular adhesion of epithelial cells and hemidesmosomes are junctions involved in adhesion of epithelia to basement membranes. Both are characterised at the ultrastructural level by dense cytoplasmic plaques which are linked to the intermediate filament cytoskeleton of the cells. The plaques strongly resemble each other suggesting a relationship between the two kinds of junctions, as implied by their names. Recent characterisation of the molecular components of the junctions shows they are, in fact, quite unrelated implying (...) that structural similarity is fortuitous. The molecular biology raises many fascinating problems relating to their structure and function. (shrink)

Citing of previous publications is an important factor in knowledge development. Because of the great amount of publications available, only a selection of studies gets cited, for varying reasons. If the selection of citations is associated with study outcome this is called citation bias. We will study determinants of citation in a broader sense, including e.g. study design, journal impact factor or the funding source of the publication. As a case study we assess which factors drive citation in the human (...) literature on phthalates, specifically the metabolite mono phthalate. A systematic literature search identified all relevant publications on human health effect of MEHP. Data on potential determinants of citation were extracted in duplo. Specialized software was used to create a citation network, including all potential citation pathways. Random effect logistic regression was used to assess whether these determinants influence the likelihood of citation. 112 Publications on MEHP were identified, with 5684 potential citation pathways of which 551 were actual citations. Reporting of a harmful point estimate, journal impact factor, authority of the author, a male corresponding author, research performed in North America and self-citation were positively associated with the likelihood of being cited. In the literature on MEHP, citation is mostly driven by a number of factors that are not related to study outcome. Although the identified determinants do not necessarily give strong indications of bias, it shows selective use of published literature for a variety of reasons. (shrink)

Centuries of scientific progress have been devoted to reducing uncertainty. Newtonian physics, introduced over 300 years ago, allowed for precise prediction of planetary and tidal motion, falling bodies and infinitely more, in addition to allowing the construction of the material world. The 20th century witnessed a revolution in our understanding of organ and cellular function and dysfunction, elucidation of pathways, mediators, receptors, and molecular interactions, and breakthroughs in the characterization of replication, transcription, and translation, all of which has been integral (...) to our understanding of human physiology and pathophysiology. Clinical epidemiology has had a revolutionary impact on our .. (shrink)

This paper examines Hume’s ‘Title Principle’ and its role in a response to one of the ‘manifest contradictions’ he identifies in the conclusion to Book I of A Treatise on Human Nature. This ‘contradiction’ is a tension between two ‘equally natural and necessary’ principles of the imagination, our causal inferences and our propensity to believe in the continued and distinct existence of objects. The problem is that the consistent application of causal reason undercuts any grounds with have for the belief (...) in continued and distinct existence, and yet that belief is as ‘natural and necessary’ as our propensity to infer effects from causes. The TP appears to offer a way to resolve this ‘contradiction’. It statesWhere reason is lively, and mixes itself with some propensity, it ought to be assented to. Where it does not, it never can have any title to operate upon us.’ In brief, if it can be shown that the causal inferences that undermine the belief in external world are not ‘lively’ nor mixed with some propensity’ then we have grounds for think that they have no normative authority. This is in part a response to another ‘manifest contradiction’, namely the apparently self-undermining nature of reason. In this paper I examine the nature and grounds of the TP and its relation to these ‘manifest contradictions’. (shrink)

THE AUDIENCE IS THE REAL or imaginary group of persons who are in fact acquainted, could be acquainted, or are meant to be acquainted with a given text. Etymologically, the term "audience" refers to a group of listeners. This meaning of the term goes back to a time when the primary form of acquaintance with the work of an author was through the spoken word. From the invention of the printing press, however, until the time when the use of the (...) radio became widespread, written texts were the primary way of learning about an author's work. Although contemporary media have changed this to a certain extent, in science and the humanities it is still true that the audience for an author's work consists largely of readers. For my present purposes, the distinction between readers and listeners is immaterial and, hence, I often refer to an audience as a group of readers, although what I say about it will apply, mutatis mutandis, to listeners as well. (shrink)

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

While I am in broad agreement with the main thrust of Fine’s and Milonakis’s argument, I pose sixteen questions for them. The first ten questions relate to the history of economic thought ; substantive issues of economic theory ; methodological and philosophical matters ; and the other social sciences. I conclude by asking six questions about the ‘old’ and ‘new’ economics imperialism, the prospects for mainstream economics, and the precise nature of the political-economy alternative that Fine and Milonakis propose. Is (...) it simply Marxian political economy in disguise? (shrink)

The essays are arranged in two sections of ethical topics and a section on philosophy, evolution, and the human sciences that includes the title essay, “Making Sense of Humanity.” In World, Mind and Ethics, excellent pieces by Elster, Sen, Jardine, Hookway, McDowell, Nussbaum, Charles Taylor, Altham, and Hollis range even more widely: over ethics, political philosophy, and epistemology, reflecting some of the breadth of Williams’s interests.