Despite optimistic reports about the results of amputation for advanced vascular disease, the patient’s assessment of advantages and disadvantages is seldom acknowledged. A detailed social study of 67 amputees has revealed considerable disparity between the patient’s views and those of the medical staff. About a third of the patients are forced to retire from active work by the amputation; about three-quarters report a serious decline in their social activities; only about half are really independent with prostheses in the long term; (...) a quarter report severe and intractable symptoms related to their amputation stumps; only about a quarter feel that the amputation was definitely beneficial; and only about one in five feel that the medical staff have provided adequate support during their hospital stay. Amputees face physical and financial disability, isolation, and discomfort. Every effort must be made to explain the implications of amputation honestly and realistically and to ensure continuing patient assessment and support. (shrink)

Balancing Change and Tradition in Global Education Reform is an invaluable resource for policymakers, faculty, students, and anyone interested in how decisions made about the education system ultimately affect the quality of education, educational access, and social justice.

Evidence that placebo acupuncture is an effective treatment for chronic pain presents a puzzle: how do placebo needles appearing to patients to penetrate the body, but instead sitting on the skin’s surface in the manner of a tactile stimulus, evoke a healing response? Previous accounts of ritual touch healing in which patients often described enhanced touch sensations suggest an embodied healing mechanism. In this qualitative study, we asked a subset of patients in a singleblind randomized trial in irritable bowel syndrome (...) to describe their treatment experiences while undergoing placebo treament. Analysis focused on patients’ unprompted descriptions of any enhanced touch sensations and any significance patients assigned to the sensations. We found in 5/6 cases, patients associated sensations including “warmth” and “tingling” with treatment efficacy. The conclusion offers a “neurophenomenological” account of the placebo effect by considering dynamic effects of attentional filtering on early sensory cortices, possibly underlying the phenomenology of placebo acupuncture. (shrink)

The prospect of using cell-based interventions to treat neurological conditions raises several important ethical and policy questions. In this target article, we focus on issues related to the unique constellation of traits that characterize CBIs targeted at the central nervous system. In particular, there is at least a theoretical prospect that these cells will alter the recipients' cognition, mood, and behavior—brain functions that are central to our concept of the self. The potential for such changes, although perhaps remote, is cause (...) for concern and careful ethical analysis. Both to enable better informed consent in the future and as an end in itself, we argue that early human trials of CBIs for neurological conditions must monitor subjects for changes in cognition, mood, and behavior; further, we recommend concrete steps for that monitoring. Such steps will help better characterize the potential risks and benefits of CBIs as they are tested and potentially used for treatment. (shrink)

The neo-Kohlbergian approach to moral reasoning development maintains that intermediate concepts lie between bedrock moral schemas and professional codes of ethics and deal with issues of confidentiality, competence, informed consent, allocation of resources and professional autonomy (Rest et. al, 1999b Rest, J., Narvaez, D., Bebeau, M., & Thoma, S. J. (1999b). Postconventional moral thinking: A neo-Kohlbergian approach. Lawrence Erlbaum Associates.[Crossref], [Google Scholar]). Intermediate concepts provide concrete guides for behavior, they contrast general moral schemas that are concerned with issues of fairness, (...) justice and equality. This paper outlines the development and testing of a prototype Intermediate Concept Measure for teachers (TICM). Results indicate that the TICM has respectable psychometric properties and assesses a construct in the moral domain. (shrink)

Gold & Stoljar 's attempt to disentangle the body-mind problem in time for the end of the decade of the brain deserves praise for its diligence and courage in moving onto the treacherous ground of interdisciplinary discourse. In making their point, they should not have stopped half-way: a more clearly defined experimental paradigm seems necessary to solve this exciting and substantial problem.