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)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 133-134 [Access article in PDF] Fictional Beings J. M. Coetzee What Does It Mean, "To Understand"? A tennis coach is teaching a young player a forehand topspin drive. He does so with a mixture of demonstrations (nonverbal) and explanations (verbal), such as, "At the moment of impact you roll the wrist over like this" (demonstrates). The player tries the stroke again and again, (...) and each time the coach shakes his head and says, "You haven't got it yet." Then the player gets the stroke right. The coach says "Now you've got it! Now you understand! Now let's do it again!"Is this a legitimate use of the word understand? I think it is. The coach intends the following: At first you may have understood my words but from your actions—the practice strokes you played—I could not see that you had understood my meaning. Then, when you got the stroke right, and could repeat it, I saw that you had finally understood the meaning behind my words.Understanding is in this case the effective translation of words, or words plus demonstrations, into actions, where effectiveness can be easily measured. The translation is from a verbal, or mixed verbal, system into an entirely nonverbal system of electrochemical impulses.Conversely, one can picture an exhaustive analysis of forehand topspin drives by André Agassi, conducted by microphotography, implanted sensors, and so on, to issue in a mixed verbal and diagrammatic account of how Agassi plays the stroke. In this case the physiologic system of the stroke has been successfully translated into a (partially) verbal system. Again, it would be meaningful to say that the sports physiologist who does the analysis has come to understand how the stroke is played.Although in both these cases understanding is conceived of as a translation process, I concentrate from here onward on the translation process from the verbal to the nonverbal, exemplified by understanding how to play a particular stroke.The coach says X and the player tries to "do" X, but fails and fails, until finally he succeeds. When the player has at last "done" X, he has understood. Thereafter, by steps, the player ceases to depend on the coach and the coach's X: the player can do X by himself; he understands X in the sense that whenever he says X to himself he can do X. He has made X his own.I read The Sound and the Fury, the part devoted to Benjy. Benjy says X and I don't understand. I understand the words on the page one by one, many of the sentences I understand one by one in the sense that I can translate them into other English sentences, but I don't understand the logic that gets Benjy from one sentence to the next, I don't understand the references of many words that are usually referential, and sometimes I am baffled by the syntax.For whatever reason, I go on reading Benjy. In a few respects I begin to understand better. For instance, there are sentences that stop in midstride, and I begin to suspect that such sentences stop because Benjy does not want to think what [End Page 133] comes next—that is to say, that the Faulkner behind Benjy means me to understand that Benjy lacks the wherewithal to face what would naturally come next. Mainly, however, I remain in the dark.Then I begin to experience something interesting. I find that I am, in my mind, going through some of the movements of Benjy's language. I am, as it were, practicing the characteristic strokes of his game. Although I remain, for the most part, unable to translate his pages into connected discourse—that is, into a discourse in which the logical connection between one sentence and the next is, however faulty, at least clear—I am better and better able to "do" Benjy."Doing" Benjy in this case means more than parrot-like repetition of Benjy's words. I can now speak of "entering Benjy" in a way that makes sense. I... (shrink)

This article presents Schelling’s claim that nature has an evolutionary process and Hegel’s response that nature is the development of the concept. It then examines whether evolution is progressive. While many evolutionary biologists explicitly repudiate the suggestion that there is progress in evolution, they often implicitly presuppose this. Moreover, such a notion seems required insofar as the shape of life’s history consists in a directional trend. This article argues that, insofar as a notion of progress is indeed conceptually ineliminatable from (...) evolutionary biology or needed to articulate the shape of life’s history, progress should be viewed as constitutive. The section on “Why Schelling and .. (shrink)

Let me begin with a wisp of political history. According to the Earl of Clarendon, in 1639 the king’s “three kingdoms [were] flourishing in entire peace and universal plenty.”1 Yet by 1642 civil war had broken out, and in 1649 the king was beheaded. What had caused this breakdown of civil and political order, a breakdown that was not localized in England but, in fact, rife throughout Europe—1648 like 1848 was a year of revolutions? Clarendon himself is less than acute (...) on the matter, opting generally for a conspiracy theory in which the traitorous plots of ill men were the cause of the rebellion. In his book Behemoth —whose title stands for the Long Parliament, which sat in session from 1640 until the surviving .. (shrink)

Open peer commentary on the article “Modeling Subjects’ Experience While Modeling the Experimental Design: A Mild-Neurophenomenology-Inspired Approach in the Piloting Phase” by Constanza Baquedano & Catalina Fabar. Upshot: Demonstrating the relevance of collecting first-person data and of establishing reciprocal constraints between this these data and behavioral data to overcome the issue of behavioral data replication is an interesting result. However, this result, as such, falls short of offering any theoretical reorientation of the neurophenomenological project, strictly understood.