The foreskin in small boys causes much anxiety in our society. It develops during the second half of gestation, and in premature infants may appear relatively deficient. By term, however, it has grown and protruded to well beyond the glans penis. The inner layer of the foreskin is densely adherent to the surface of the glans and cannot be retracted until it is fully separated, which occurs during the first few years of life. Prior to that time the distal opening (...) of the foreskin is narrow, but because of its adherence there is no significant pocket under the skin to allow accumulation of urine or debris. Later in childhood, after the foreskin is fully separated, urine and dirt can accumulate between the foreskin and the glans, leading to infection and inflammation . With recurrent balanitis, and/or tearing of the delicate foreskin, phimosis or scarring may constrict the distal foreskin.Circumcision has a long history in ancient societies of the Middle East, and is likely to have arisen as an early public health measure for preventing recurrent balanitis, caused by sand accumulating under the foreskin. Circumcision is a major part of the ritual for such religions as Judaism, Christianity, and Islam, and it is probably no accident that all of these arose in the Middle East. By contrast, in religions arising outside the arid Middle East , there is no ritual circumcision. In aboriginal society in Australia, circumcision is practised also.The importance of preventing recurrent balanitis and secondary phimosis in arid, sandy regions was confirmed by the Australian army medical corps in two world wars. During both wars, Australian soldiers were stationed in North Africa and the Middle East, and the incidence of recurrent balanitis caused by sand under the foreskin reached “epidemic” proportions, leading to large numbers …. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Medical Tourism:Crossing Borders to Access Health CareHarriet Hutson Gray (bio) and Susan Cartier Poland (bio)Traveling abroad for one's health has a long history for the upper social classes who sought spas, mineral baths, innovative therapies, and the fair climate of the Mediterranean as destinations to improve their health. The newest trend in the first decade of the twenty-first century has the middle class traveling from developed countries to (...) those with emerging economies to avoid treatment delays, prohibitive costs for life-saving procedures, or simply high costs for elective surgery. Others leave to have access to assisted suicide in countries that have legalized it: Belgium, The Netherlands, and Switzerland. This new era of globalization in health care has arrived without the benefit of international standards, government oversight, or ethical and legal review.Howard Staab, a self-employed carpenter from North Carolina, flew to India for his medically necessary heart surgery, scheduled a side trip to the Taj Mahal, and returned home to work in North Carolina. He spent a total of less than $10,000, instead of the $200,000 required from the local hospital (I, Milstein and Smith 2006).At first blush, the outsourcing of medical care to India seems to be a particular solution for a particular problem. However, the particularity of Mr. Staab is not unique. His experience is emblematic of those patients in the United States with a medical need for major and elective procedures, but who also must bear the total cost of these procedures. These middle-class, under-insured Americans go abroad.In tandem with increasingly aggressive marketing campaigns, American hospitals and companies have begun to leverage their connections in Asia to grow the medical tourism business into a major economic force. What are the consequences of this?Several authors point to the effect on the host country's population, particularly the poor, to be pushed farther down the queue to receive adequate, affordable care. Resources are applied to the foreign trade instead of building the local [End Page 193] medical infrastructure. Another potential problem is the obligation of the home-country physician to provide follow-up care. What are the legal ramifications when the procedure was illegal to begin with? Are there opportunities for redress for medical errors?These factors may be converging into a "perfect storm" for health care in the U.S., in which the potential participation of the major insurance companies in promoting offshore care will be the tipping point in the precarious structure that represents the economic currents in health care. Third-party administrators and self-funded employers may be on the cutting edge in 2009 by providing incentives to employees to travel overseas for care.I. Economic ConsiderationsConnell, John. Medical Tourism: Sea, Sun, Sand and... Surgery. Tourism Management 27: 1093–1100, 2006.As evidence of the interest of traditional tour operators in this newer twist on the industry, the author explores medical tourism as an element of the growth of world tourism. In promoting medical tourism, he urges consideration of such issues as the privatization of health care, the foundational role of technology, and uneven access to health resources.Dunn, Philip. Medical Tourism Takes Flight. H and HN: Hospitals and Health Networks: 40–44, November 2007.Writing for U.S. health care executives, Dunn emphasizes that the reality of medical tourism competes with the local medical center for patients and their insurance dollars in a significant way. He examines the possibility that U.S. insurance plans soon may offer to pay for what is currently a cash only business and that the economic impact to the local medical center could be significant or even devastating.Frontiers of Health Services Management [Selected Articles] 24 (2), Winter 2007.In "Managing Healthcare Services in the Global Marketplace" (pp. 3–18), Bruce J. Fried and Dean M. Harris consider legal, ethical, and financial implications of the international workforce. In "Globalization of Health Care" (pp. 19–30), Lynn Schroth and Ruthy Khawahja point out that the transfer of comprehensive management expertise and intellectual property from U.S. medical centers to international sites is driving the success of collaboration between U.S. and foreign health care centers. In "Is... (shrink)

Arguably, the most promising and compelling route to demonstrating the significance of Hegel’s thought to contemporary philosophy has been the series of recent readings that construe Hegel as continuing and completing Kant’s Copernican turn. Paul Redding explicitly locates his interpretation within this program, seeing the hermeneutic dimension of Hegel’s thought as providing for the possibility of continuing the Kantian project. Kant’s Copernican turn can be loosely stated as the procedure of reflectively uncovering unexperienced conditions of experience that contribute to the (...) nature of experience in ways that require its further re-determination and re-description. What a hemeneutic take on this reflective procedure adds is that foremost among those conditions are contexts of intersubjective or dialogical relations—structures of recognition. While perhaps disappointing to anyone interested in the problem of textual interpretation, there is finally nothing more to Redding’s account of Hegel’s “hermeneutics” than the establishing of recognitive structures as forming the ultimate horizon of human experience. I take Redding’s relentless tracking of the problem of recognition to be one of his book’s virtues. (shrink)

Feigning symptoms distorts diagnostic evaluations. Therefore, dedicated tools known as symptom validity tests have been developed to help clinicians differentiate feigned from genuine symptom presentations. While a deviant SVT score is an indicator of a feigned symptom presentation, a non-deviant score provides support for the hypothesis that the symptom presentation is valid. Ideally, non-deviant SVT scores should temper suspicion of feigning even in cases where the patient fits the DSM’s stereotypical yet faulty profile of the “antisocial” feigner. Across three studies, (...) we tested whether non-deviant SVT scores, indeed, have this corrective effect. We gave psychology students and clinical experts a case alluding to the DSM profile of feigning. In successive steps, they received information about the case, among which non-deviant SVT outcomes. After each step, participants rated how strongly they suspected feigning and how confident they were about their judgment. Both students and experts showed suspicion rates around the midpoint of the scale and did not respond to non-deviant SVT outcomes with lowered suspicion rates. In Study 4, we educated participants about the shortcomings of the DSM’s antisocial typology of feigning and the importance of the negative predictive power of SVTs, after which they processed the case information. Judgments remained roughly similar to those in Studies 1–3. Taken together, our findings suggest that students and experts alike have difficulties understanding that non-deviant scores on SVTs reduce the probability of feigning as a correct differential diagnosis. (shrink)

First published in 1908 as the second edition of a 1900 original, this book explains the content of the fifth and sixth books of Euclid's Elements, which are primarily concerned with ratio and magnitudes. Hill furnishes the text with copious diagrams to illustrate key points of Euclidian reasoning. This book will be of value to anyone with an interest in the history of education.

While executive functions and self-regulated learning strategy use have been found to be related in several populations, this relationship has not been studied in adult online distance education. This is surprising as self-regulation, and thus using such strategies, is very important here. In this setting, we studied the relation between basic executive functions and reported SRL-strategy use within a correlational design with 889 adult online distance students. In this study, we performed regression analyses and took age and processing speed into (...) consideration, as processing speed and EFs decrease with age, whereas self-regulation is reported to increase with age. Cognitively measured working memory was not related to reported SRL-strategy use in adult ODE students. Thus, even though the SRL-components within the strategies seem to elicit working memory, reported SRL-strategy use is not related to the functioning of this basic EF. This means that if SRL-strategy use needs to be increased in adult ODE students, training of working memory might not be an effective manner for achieving that goal. Better shifting and processing speed were related to less reported SRL-strategy use, which might suggest that SRL-strategies might be used to compensate for lower shifting and lower processing speed. With increasing age, the number of contacts with peers or teachers decreases. This latter finding might be of relevance during the pandemic since contacts with others is importance during lockdown. (shrink)

Uitgave ter gelegenheid van de vierhonderdste geboortedag van de Nederlandse jurist, diplomaat en schrijver Hugo de Groot (1583-1645).

Taking as its point of departure the works of Jacques Ellul, Sven Birkerts, George Steiner, Uwe Poerksen, and others, this article explores the status of language in a technicized civilization. It is argued that language has devolved under the impact of technology, particularly in the dimension of values and ethics. This diagnosis points to the way from which a possible cure may emerge.

The Bohr-Heisenberg scheme, which forms the basis of any current version of the standard or Copenhagen interpretation of quantum mechanics, is shown to be internally inconsistent. Although the inconsistencies demonstrated here are directly relatable to Einstein's opinion that it is unsatisfactory to interpret physical theory solely in terms of the knowledge gained from experimental outcomes, it is nevertheless shown that Einstein's view requires important modification. The implications of the Bohr-Heisenberg schem's self-inconsistency are discussed in relation to Bell's theorem and Aspect's (...) experiments. (shrink)

In a reflective and richly entertaining piece from 1979, Doug Hofstadter playfully imagined a conversation between ‘Achilles’ and an anthill (the eponymous ‘Aunt Hillary’), in which he famously explored many ideas and themes related to cognition and consciousness. For Hofstadter, the anthill is able to carry on a conversation because the ants that compose it play roughly the same role that neurons play in human languaging; unfortunately, Hofstadter’s work is notably short on detail suggesting how this magic might be achieved1. (...) Conversely in this paper - finally reifying Hofstadter’s imagination - we demonstrate how populations of simple ant-like creatures can be organised to solve complex problems; problems that involve the use of forward planning and strategy. Specifically we will demonstrate that populations of such creatures can be configured to play a strategically strong - though tactically weak - game of HeX (a complex strategic game).We subsequently demonstrate how tactical play can be improved by introducing a form of forward planning instantiated via multiple populations of agents; a technique that can be compared to the dynamics of interacting populations of social insects via the concept of meta-population. In this way although, pace Hofstadter, we do not establish that a meta-population of ants could actually hold a conversation with Achilles, we do successfully introduce Aunt Hillary to the complex, seductive charms of HeX. (shrink)

Viewed in the light of the remarkable performance of ‘Watson’ - IBMs proprietary artificial intelligence computer system capable of answering questions posed in natural language - on the US general knowledge quiz show ‘Jeopardy’, we review two experiments on formal systems - one in the domain of quantum physics, the other involving a pictographic languaging game - whereby behaviour seemingly characteristic of domain understanding is generated by the mere mechanical application of simple rules. By re-examining both experiments in the context (...) of Searle’s Chinese Room Argument, we suggest their results merely endorse Searle’s core intuition: that ‘syntactical manipulation of symbols is not sufficient for semantics’. Although, pace Watson, some artificial intelligence practitioners have suggested that more complex, higher-level operations on formal symbols are required to instantiate understanding in computational systems, we show that even high-level calls to Google translate would not enable a computer qua ‘formal symbol processor’ to understand the language it processes. We thus conclude that even the most recent developments in ‘quantum linguistics’ will not enable computational systems to genuinely understand natural language. (shrink)

This article addresses the problem of legislation and adjudication in early states, offering examples from Africa and other parts of the world. It discusses the problems of legitimacy and governance, especially in the context of multi-ethnic populations. For some of its generalizations it draws upon a previous study of twenty-one early states.