Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

French end-of-life law aims at protecting patients from unreasonable treatments, but has been used to force caregivers to prolong treatments deemed unreasonable. We describe six cases (five intensi...

Many issues are raised by thinking about “The Idea of Text in Buddhism.” This paper concentrates on scriptures of Indian Buddhism, and considers some of the questions raised or inspired by the papers presented at the 2019 Jerusalem conference on “The Idea of Text in Buddhism.” Consideration is given among other topics to multilingualism, in which context a comparison is offered with the traditions of the Targums in Jewish literature.

When asked why he turned from philosophy to the history of ideas, Isaiah Berlin said that he was worried that if he stayed in philosophy he wouldn't know any more at the end of his life than he had at the beginning. Mark Lilla makes the point in a somewhat more constructive way: "His [Berlin's] instinct told him that you learn more about an idea as an idea when you know something about its genesis and understand why certain people found (...) it compelling and were spurred to action by it".It took me decades longer than the brilliant Oxford don to appreciate the point, but when I did it came as a lightning strike of recognition. My brain seems to have been keyed from the beginning in the syntax of... (shrink)

Recent efforts to support state regulation of risky behavior like cigarette smoking, alcohol consumption, driving without seatbelts and riding motorcycles without helmets have focused on economic justifications—the costs to society of the consequences of these activities. However, opponents have successfully argued that the economic burdens of regulation outweigh the social benefits. To reduce the toll on society of these behaviors, we need justification for regulation that asserts the moral primacy of health and the well‐being of the community.

This article argues against the case for regarding bodies and parts of bodies to be property. It claims that doing so assumes an individualistic conception of the body. It fails to acknowledge that our bodies are made up of non-human material; are unbounded; constantly changing and deeply interconnected with other bodies. It also argues that holding that our bodies are property does not recognise the fact that we have different attitudes towards different parts of our removed bodies and the contexts (...) of their removal. The appropriate legal reform should, therefore, be to produce a statute which can provide a balance between the competing personal, social and interpersonal interests in different body parts. (shrink)

Traditionally, what we are conscious of in self-consciousness is something non-corporeal. But anti-Cartesian philosophers argue that the self is as much corporeal as it is mental. Because we have the sense of proprioception, a kind of body awareness, we are immediately aware of ourselves as bodies in physical space. In this debate the case histories of patients who have lost their sense of proprioception are clearly relevant. These patients do retain an awareness of themselves as corporeal beings, although they hardly (...) feel their bodies . They can initiate movements, and with the help of visual feedback learn to control them. It is shown that the traditional view of the self as immaterial is not supported by these cases. But the argument against this view has to be amended. It relies too much on bodily sensations, and misses the importance of active self-movement. (shrink)

The spider papers.--Natural philosophy.--The mind.--Short scientific and philosophical papers.

The history of Christianity in Africa contains selected information reflecting patriarchal preoccupations. Historians have often downplayed the contributions of significant women, both European and indigenous African. The names of some significant women are given without details of their contribution to the growth of Christianity in Africa. This article considers the contributions of Peggy Hiscock to the growth of Christianity in Zambia. Hiscock was a White missionary who was sent to serve in Zambia by the Methodist Church in Britain. She was (...) the first woman to have been ordained in the United Church of Zambia. Hiscock established the Order of Diaconal Ministry and founded a school for the training of deaconesses in the United Church of Zambia. This article argues that although the nineteenth- and twentieth-century missionary movement in Africa is associated with patriarchy and European imperialism, there were European women missionaries who resisted imperialism and patriarchy both in the Church and society. (shrink)

In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited from (...) KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)

The story of the preceding article continues….

Knowledge is desirable both for its own sake and because without it we will not be able to take the right means to whatever ends we happen to have. Much knowledge is interesting to oneself and others as well as useful, and a man without it will be an impoverished bore, as well as being unsuccessful in his enterprises.

‘Public justice’ is one of the most widely-invoked of the many distinctive terms coined by Herman Dooyeweerd but, strangely, one of the least well analysed. Dooyeewerd holds that that the identity of the state is defined by a single, integrating and directing norm, the establishment of ‘public justice’. Elaborating the implications of this claim has occupied much neo-Calvinist political reflection and guided much political action inspired by that movement. Yet surprisingly little sustained theoretical reflection has been devoted in recent times (...) to examining its inner meaning and coherence. This article offers some preliminary groundwork necessary to that theoretical project. The first part presents a close reading of Dooyeweerd’s account of public justice, identifies ambiguities and inconsistencies in that account, and suggests a reconstruction displaying its wide-ranging dynamic thrust more prominently. The second part identifies two substantial challenges confronting this account: its relative neglect of processes of democratic deliberation and advocacy, and its underdeveloped critical potentials. (shrink)

Much of the critical praise for the film concerns the first of these aims. Bigelow’s use of at least four film crews for every scene affords the sense of being present in the situation, continuously shifting perspective, alert to possible danger. The relative anonymity of the scenery, clearly somewhere in the Middle East but not clearly anywhere in particular, fosters this uneasy sense of immersion in an unfamiliar scenario where the sources of danger are unpredictable. Protracted periods of silence, punctuated (...) by incidental sounds that often turn out to be irrelevant, increase this tension. The occasional quiet ring of tinnitus imparts a sense of the incessant nature of the soldiers’ anxiety. Much of the negative criticism of the film, on the other hand, concerns the psychology of its central characters. Some veterans of the war in Iraq have claimed that it is a wildly inaccurate portrayal of the attitudes and behaviour of professional soldiers. (shrink)

In this paper we focus on conversational thinking to demonstrate the value of public reasoning in building a decent world and true democracies. We shall take into account the views of selected scholars, especially John Rawls and Jürgen Habermas, on law and democratic practice, to explain why post-colonial Africa is weighed down by sociopolitical hegemonies that have aversion to their opposition and eliminate room for strong institutions, rule of law and human rights. In light of conversational thinking, this eliminates any (...) chance for “creative struggle,” i.e. a philosophers struggle against the post-colonial imaginary/social agents to dethrone strong individuals and create strong institutions. In the absence of these indices which a conversational orientation may engender, it is difficult to transform bogus democracy into true democracy and thus to create a decent society. Post-colonial Africa mired in social regression, political crisis and economic stagnation urgently needs conversational tonics to overcome the ineffectiveness of bogus democracy. We postulate a thesis about three structural transformations forming what we call Democratic Transformational Programme. (shrink)

Health security has become a popular way of justifying efforts to control catastrophic threats to public health. Unfortunately, there has been little analysis of the concept of health security, nor the relationship between health security and other potential aims of public health policy. In this paper I develop an account of health security as an aversion to risky policy options. I explore three reasons for thinking risk avoidance is a distinctly worthwhile aim of public health policy: that security is intrinsically (...) valuable, that it is necessary for social planning and that it is an appropriate response to decision-making in contexts of very limited information. Striking the right balance between securing and maximizing population health thus requires a substantive, and hitherto unrecognized, value judgment. Finally, I critically evaluate the current health security agenda in light of this new account of the concept and its relationship to the other aims of public health policy. (shrink)

Of the many genes mutated on the road to tumor formation, few have received as much attention as p53. The gene has come to occupy center stage for the simple reason that it is more frequently altered in human tumors than any other known gene, undergoing mutation at a significant rate in almost every tumor type in which it has been studied. This association between p53 mutation and tumorigenesis has spurred a flurry of research attempting to delineate the normal function (...) of p53 and, by extension, the role of p53 mutation in tumor formation. At the cellular level, p53 has been shown to suppress growth. Recent efforts to further discern the function of p53 have centered on the underlying molecular basis for this growth suppression. In particular, research has focused on the identification of cellular molecules (specifically DNA and proteins) with which the p53 protein associates. p53 has now been shown to bind DNA in a sequence‐specific manner, and mounting evidence suggests that p53 acts as a transcription factor, perhaps regulating the expression levels of genes involved in the inhibition of cell growth. The logical next step in understanding p53 function involves the resolution of two questions: (1) what are the physiological transcriptional targets of p53, and (2) what cellular proteins regulate or mediate the ability of p53 to modulate transcription? Some initial clues to these puzzles are now emerging, and these form the subject of this review. (shrink)

This chapter addresses questions about commodification in the sphere of security and prisons. It surveys potential forms of commodification and considers arguments that aim to show that they are morally wrong or unjust. The chapter considers the relationship between commodification and privatization. It examines economic, legal and moral commodification arguments against private prisons and prison labor. The economic arguments against private prisons considered here focus on efficiency and perverse incentives. The legal arguments focus on dignity and the commodification of the (...) person. The moral arguments focus on human equality and corruption of important goods. The arguments against prison labor begin with the question of whether prison labor is market activity and then consider the possibility that prison labor may contribute to mass incarceration. The moral arguments focus on exploitation. The chapter also considers the relevance of the racial dimension of mass incarceration to arguments about commodification. (shrink)

To be human is to be engaged in relationships of friendship, trust, and love. These relationships cannot flourish unless information essential to each relationship is kept within the confines of that relationship--unless the individuals involved have knowledge of, and control over, the information about themselves that is available within their particular relationships. This knowledge of and control over information about oneself is the core of "privacy"; privacy's role in maintaining relationships explains its importance to us. Technological advances in computing have (...) made it possible to glean bits of information about an individual from a variety of relationships--personal, professional, medical, financial--and to combine them into a "virtual mosaic" of that individual. In plucking information about an individual from various discrete relationships, and making it available in yet other relationships, this activity violates that individual's right to privacy. (shrink)

Though I find the project significant and unprecedented in this way, I am not convinced that it is entirely successful, and I will try to explain here the grounds of my concern. We can begin with Greco’s list of requirements for an adequate theory of knowledge, and the relationship he sees between simple reliabilism and his own theory, agent reliabilism.

This paper critically explores the way in which ‘trafficking’ has been framed as a problem involving organized criminals and ‘sex slaves’, noting that this approach obscures both the relationship between migration policy and ‘trafficking’, and that between prostitution policy and forced labour in the sex sector. Focusing on the UK, it argues that far from representing a step forward in terms of securing rights and protections for those who are subject to exploitative employment relations and poor working conditions in the (...) sex trade, the current policy emphasis on sex slaves and ‘victims of trafficking’ limits the state's obligations towards them. (shrink)