SummaryThe dichotomy between ‘scientific’ and ‘practical’ approaches to guideline development is false and divisive. Instead we should concentrate on developing mechanisms to develop and implement valid guidelines to improve patient care. The development of valid guidelines requires considerable expertise and is time consuming and expensive. It is most efficiently done at a regional or national level. The implementation of valid guidelines requires local action including the identification and modification of valid guidelines and a coordinated evidence-based implementation strategy (Grimshaw & (...) class='Hi'>Eccles 1998). (shrink)

A Charter on Medical Professionalism (CMA) has just recently been developed internationally, and the Canadian Medical Association is calling for public dialogue on medical professionalism now that reforms in the Canadian system of health care are imminent. We posit that good practices are at issue; we outline the essence of these in general and also specifically in the knowing, teaching and intervening components of practice. We also see challenges not to, but in, medical professionalism – first and foremost in the (...) profession's definition of good practices and the payer's confinement of insurance coverage to these. (shrink)

Objective Cluster randomised trial (CRT) investigators face challenges in seeking informed consent from individual patients (cluster members). This study examined associations between reporting of patient consent in healthcare CRTs and characteristics of these trials. Study design Consent practices and study characteristics were abstracted from a random sample of 160 CRTs performed in primary or hospital care settings that were published from 2000 to 2008. Multivariable logistic regression was used to examine associations between reporting of patient consent and methodological characteristics, as (...) well as publication features such as date and journal of publication. Results 82 (53.8%) of 160 studies reported obtaining informed consent from individual patients. Reporting of patient consent was independently and positively associated with: smaller cluster size, the evaluation of experimental interventions targeted at patients, data collection from individual patients, publication later than 2004 and publication in higher-impact journals. Conclusions Reporting of consent practices in published CRTs should be improved. Consent practices in published CRTs appear to be related to the type of interventions under study, as well as journal impact and trends in research ethics practices. These findings will inform best practices in trial conduct and ethics review, remediation of errors in consent practices and ethics review and the development of regulatory guidance for CRTs. (shrink)

Owing to unique features of their design, cluster randomized trials complicate the interpretation of standard ethics guidelines. The recently published Ottawa statement on the ethical design and conduct of cluster randomized trials provides researchers and research ethics committees with detailed guidance on the design, conduct and review of cluster trials. The Ottawa statement sets out 15 recommendations, including guidance on the justification of study design, the need for research ethics committee review, the identification of research participants, obtaining informed consent, the (...) role of gatekeepers in protecting cluster interests, the assessment of benefits and harms, and the protection of vulnerable participants. (shrink)

Earlier in this century, many philosophers of science (for example, Rudolf Carnap) drew a fairly sharp distinction between theory and observation, between theoretical terms like 'mass' and 'electron', and observation terms like 'measures three meters in length' and 'is _2° Celsius'. By simply looking at our instruments we can ascertain what numbers our measurements yield. Creatures like mass are different: we determine mass by calculation; we never directly observe a mass. Nor an electron: this term is introduced in order to (...) explain what we observe. This (once standard) distinction between theory and observation was eventually found to be wanting. First, if the distinction holds, it is difficult to see what can characterize the relationship between theory :md observation. How can theoretical terms explain that which is itself in no way theorized? The second point leads out of the first: are not the instruments that provide us with observational material themselves creatures of theory? Is it really possible to have an observation language that is entirely barren of theory? The theory-Iadenness of observation languages is now an accept ed feature of the logic of science. Many regard such dependence of observation on theory as a virtue. If our instruments of observation do not derive their meaning from theories, whence comes that meaning? Surely - in science - we have nothing else but theories to tell us what to try to observe. (shrink)

Modal dimensionalism is realism about spaces, times and worlds—metaphysical indices that make objects spatial, temporal and modal, respectively, and that play the role of alethic relativizers, i.e. items to which matters of truth are relativized. This paper examines several arguments against MD and shows that MD offers a feasible way to understand modal discourse.

When the first edition of Pediatric Psychopharmacology published in 2002, it filled a void in child and adolescent psychiatry and quickly establishing itself as the definitive text-reference in pediatric psychopharmacology. While numerous short, clinically focused paperbacks have been published since then, no competitors with the scholarly breadth, depth, and luster of this volume have emerged. In the second edition, Christopher Kratochvil, MD, a highly respected expert in pediatric psychopharmacology, joins the outstanding editorial team led by Dr. Martin and Dr. (...) Scahill. In the new edition, the editors streamline the flow of information to reflect the growth in scientific data since the first edition appeared. The overall structure of the book remains the same, with major sections on underlying biology; somatic interventions; assessment and treatment; and special considerations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hermeneutics, Neuroscience and PsychiatryMichael T. H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM (bio)Hermeneutic practice in mental health has been a theme in Philosophy, Psychiatry, & Psychology (PPP) since its very beginnings. In this essay I argue that hermeneutics, the theory and practice of interpretation, promotes therapeutic interaction between mental health professionals, patients and their family.Why does this patient present in such a way at this (...) particular point in time? The distressing symptoms are there. The changes in behavior are obvious. Impairments of functions are hurting. A mental illness clearly runs in the family. There were early losses of loved ones, physical abuse at home, bullying by peers and self-medication with drugs and alcohol. Three in four adults with a mental illness first experienced that before they turned 24. The brain goes through major reorganization during adolescence and early adulthood. If synaptic pruning went wrong, psychoses emerged. When stresses activated the hypothalamic–pituitary–adrenal axis the elevated cortisol level impacted the size and function of the hippocampus and amygdala in the genetically vulnerable; anxiety, depression, bipolar, and personality disorders developed. The patient needs a voice/language to describe all these experiences and events and the psychiatrist needs a discourse to make sense of them.Eisenberg laments the swings between "brainlessness" and "mindlessness" in psychiatry. Engel argues for a "biopsychosocial" discourse. The major challenge for psychiatry is how to organize clinical information of different nature (categories, dimensions, narratives; i.e., objective vs. subjective, personal vs. interpersonal) into a coherent and comprehensible account for us all. Mental illnesses are not only neuropsychiatric spectrum disorders but also dysfunctions of social relationship and environmental/ecological adaptation. Psychiatry as a clinical neuroscience per se lacks the semantics to address the rich interactions between the physical, psychological, social, cultural, and spiritual in the illness experience of our patients. Explanation in the diagnostic formulation (objective scientific discourse on cause and effect) and understanding in the patient narrative (subjective ordinary everyday discourse on significance and meaning) are irreducible to each other (Wong, 2018). They instead interact with one another to achieve an integrative formulation, not through merging different discourses into a single assertion/monologue but via the dialectic/dialogue of "explaining more in order to understand better," as Ricoeur puts it, and between "the whole and the parts," as Schleiermacher highlights.This "therapeutic hermeneutic circle" of "explanation vs understanding" and "the whole vs the parts" includes symptoms behavior function and life events. It correlates between bio-psychosociocultural-spiritual dimensions/perspectives and does not reduce them to any particular/single [End Page 13] stance. The whole integrates the parts and the parts enrich the whole. It explains but does not explain away. It understands through an articulation of meaning and significance. This discourse is a multilayered (bio-psycho-social-cultural-spiritual) personal narrative that formulates diagnosis and care in a correlative (linking different voices/discourses) and non-reductive (no particular voice/discourse is prejudiced against) manner that is comprehensible to us all (Wong, 2021).PPP will be an excellent forum for discussing clinical hermeneutics in the future. In this digital era of social media and virtual reality, hermeneutics has the never-ending task to tackle the unprecedented challenges to meaning illness and health posed by polarizing discourses.Michael T. H. Wong Michael T.H. Wong, MBBS, MD, MA, MDiv, PhD, FRCPsych, FRANZCP, FHKAM, is Hon Clinical Professor, Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, HKSAR, China. Michael is Chair, Section of Philosophy & Humanities in Psychiatry, World Psychiatric Association. He is an Organizational Partner & International Lead with The Collaborating Centre for Values-Based Practice in Health and Social Care, St Catherine's College Oxford. He is Advisor to the Chinese Health Foundation of Australia.ReferencesWong M. T. H. (2018). Ricoeur and the third discourse of the person: From philosophy and neuroscience to psychiatry and theology. London: Lexington Books. Google ScholarWong, M. T. H. (2021). Values, meanings, hermeneutics and mental health. In Stoyanov, D., Fulford, K. M. W. F., Stanghellini, G., Van Staden, W., & Wong, M. TH. (Eds.), International perspectives in values-based mental health practice: Case studies and commentaries (pp. 341–349... (shrink)

Tactile distance perception is believed to require that immediate afferent signals be referenced to a stored representation of body size and shape (the body model). For this ability, recent studies have reported that the stored body representations involved are highly distorted, at least in the case of the hand, with the hand dorsum represented as wider and squatter than it actually is. Here, we aim to define the neural basis of this phenomenon. In a behavioural experiment participants estimated the distance (...) between touches on two points by adjusting the length of a visually-presented line on the screen. The technique of multidensional scaling (MDS) was used to reconstruct a perceptual map of tactile space. Analysis of spatial distortion using Procrustes alignment showed that maps were stretched in the mediolateral hand axis. In order to determine the neural correlates of these body distortions, we performed an fMRI study. For each participant, we used a searchlight pattern classifier with Euclidean distance on pre-defined regions of interests (ROIs). In order to relate the representations between the different points and to computational models, we compare response-pattern dissimilarity matrices in these ROIs. Similar to the behavioural experiment, we used MDS to reconstruct maps of the neural representation of tactile space using the values from the dissimilarities matrices. We were able to reconstruct the perceptual map of tactile space in the contralateral primary somatosensory and motor cortices. This suggests that these areas are critical to generate the tactile representations of the dorsum of the hand. (shrink)

We examined the neural basis of tactile distance perception by analyzing activity patterns induced by tactile stimulation of nine points on a 3 x 3 square grid on the hand dorsum using functional magnetic resonance (fMRI). We used a searchlight approach within pre-defined regions of interests (ROIs) to compute the pairwise Euclidean distances between the activity patterns elicited by tactile stimulation. Then, we used multidimensional scaling (MDS) to reconstruct skin space at the neural level and compare it with skin space (...) at the perceptual level. Our reconstructions of the shape of skin space in contralateral primary somatosensory (SI) and motor (M1) cortices reveal that it is distorted in a way that matches the perceptual shape of skin space. This suggests that early sensorimotor areas are critical to processing tactile distance perception. (shrink)

Sir Arthur Stanley Eddington was a key figure in the development of modern astrophysics, who also made important contributions to the philosophy of science and popular science writing. The Arthur Eddington Memorial Trust was set up after his death in order to hold annual lectures on the relationship between scientific thought and aspects of philosophy, religion or ethics. This 2012 collection gathers together six of these lectures, including contributions by Sir Edmund Whittaker, Herbert Dingle, Richard B. Braithwaite, John C. (...) class='Hi'>Eccles, Dame Kathleen Lonsdale, and Baroness Mary Warnock, together with Eddington's 1929 Swarthmore Lecture on Science and the Unseen World. A preface written by the Astronomer Royal, Baron Rees of Ludlow, is also included. This is a fascinating book that will be of value to anyone with an interest in the philosophy of science and Eddington's legacy. (shrink)

The view developed in this book is that when looking at a representational painting we see a ‘real likeness’: something that is worked in paint, that really exists, that resembles what is depicted, and that, in virtue of that resemblance, counts as the same kind of thing as what is depicted. This Real Likeness view is applied not only to representation in painting, but also representation in photography and in novels. For each of these three art forms, the Real Likeness (...) view is presented as the best solution to a problem. A constraint on any plausible solution to that problem is ‘the Non Distraction Thesis’: (ND) Attending to the medium of a representational work cannot inevitably be a distraction from attending to its content, or vice versa. (p. 21) In this review, I present and discuss the problem, (ND) and the real likeness view in three consecutive sections. My focus will be Morris’s discussion of paintings, which constitutes the first part of the book and which is used when applying the view to photography and novels. Morris makes an interesting and significant contribution with his book, I think. However, to present his view as standing alone in opposition to the ‘dominant’ views of depiction, photography and literary fiction is, in my opinion, to exaggerate its novelty. The view has some (albeit perhaps not ‘dominant’) siblings in the literature on depiction and photography, notably Aasen (2015), Briscoe (2016), Martin (2012), Nanay (2016) and Wiesing (2009), who, like Morris, identify something which is seen in a picture or a photograph, is additional to it and what it represents and plays a vital representational role. Some issues in the philosophy of perception, attention and language, are also clearly relevant but not engaged with. While I mainly have to bypass these issues, towards the end of this review I will compare Morris’s view to its siblings in the depiction literature and try to identify something that I believe stands out about it. (shrink)

Martin Heidegger’s view of conformity comes in his description and understanding of Das Man or “the One”. There is controversy within Heidegger scholarship regarding the interpretation of Das Man as an existential mode. Most scholars interpret Das Man to mean the existential mode of inauthenticity and delineate the two modes of authenticity and inauthenticity in Heideggerian existentialism. Less popularly, scholars like Hubert Dreyfus and Michael Zimmerman interpret the positive and negative aspects of Das Man and suggest the third mode (...) of indifference in Heidegger’s _Being and Time_. This paper follows Dreyfus’ understanding of Das Man to posit indifference as a third mode of being that is structurally similar to inauthenticity but motivationally different from it. It then uses this difference to categorize two forms of moral conformity in Hannah Arendt’s analysis of the difference between a morality of custom and a morality of conviction. The problematic of this paper concerns the distinction between these two forms of moral conformity and the moral status of people like Adolf Eichmann whose actions Arendt describes as the banality of evil. Usually seen as preservative of morality, Arendt shows how conformity may be a site for moral conflict. (shrink)

Explores the symbiosis of philosophy and literature in understanding negativity.

Working from home (WFH) is a new reality and norm in today’s work culture. COVID-induced lockdown introduced the concept of WFH for many people. Blurring home and workplace boundaries was a prominent cause of disorientation in people’s lives. Hence, WFH becomes a significant phenomenon to explore as it raises the fundamental question of body and space in shaping people’s experiences. To study this, the researchers designed a phenomenological inquiry and examined the lived phenomenon of WFH during the COVID lockdown. Borrowing (...) theoretical concepts from philosophers Martin Heidegger and Merleau-Ponty, they aimed to understand human experiences from an embodied perspective. They interviewed a few adults (age group 27–50) in three urban Indian cities during the first phase of the COVID-19 lockdown. The participants’ experiences were transcribed, and Interpretative Phenomenological Analysis (IPA) was conducted. The IPA themes highlighted their varied lived experiences and lifeworld, such as distractions in working from home, their changed routines, habits, and social interaction. The findings are discussed through phenomenological psychology concepts such as embodied cognition, body memory, extended self, shared empathy, intersubjectivity and pre-reflective bodily intelligence in coping. The study’s contribution is that it advances a methodological understanding by interpreting people’s experiences from a phenomenological view of being-in-the-world in which the individual is not an isolated entity but is in the world/placed in the world with other people and the environment. (shrink)

This edited text recaptures many of Joe L. Kincheloe's national and international influences. An advocate and a scholar in the social, historical, and philosophical foundations of education, he dedicated his professional life to his vision of critical pedagogy. The authors in this volume found mentorship, as well as kinship, in Joe and express the many ways in which he and his work made profound differences in their work and lives. Joe's research always pushed the limits of what critically reflective and (...) informed teaching entailed, never diluting the import of comprehending the complexity of sociopolitical, cultural, economic, and educational discourses and practices. Dedicated to a praxis of social and political activism rooted in students' development as citizens and workers, the labor of teachers as action researchers, cultural workers, and social mediators is always at the heart of all he achieved. We who were so influenced directly and indirectly by him knew his genius and relished the generosity with which he shared his ideas, advice, encouragement, and art. The world is better because of Joe L. Kincheloe scholarship-inextricably related to "critical" critical thinking and enactment of education that tenaciously interrupts complacency, mediocrity, always responding thoughtfully to particular educational contexts. (shrink)

The distinction between “empathy” and “sympathy” in the context of ethics is a dynamic and challenging one. The eighteenth century texts of David Hume and Adam Smith used the word "sympathy," but not "empathy," although the conceptual distinction marked by empathy was doing essential work in their writings. After discussing the early uses of these terms, this article is organized historically. Two traditions are distinguished. The first is the Anglo-American tradition, and it extends from Hume and Smith to the twenty-first (...) century work of Michael Slote. Stephen Darwall’s contribution is applied in engaging Hume and Smith. Finally, the interrelation of empathy, sympathy and altruism is explored in the work of John Rawls and Thomas Nagel. The second tradition is the Continental one. It extends from the spirituality of Johann Herder to the phenomenological movement of Edmund Husserl, Martin Heidegger, Max Scheler, and Edith Stein. The intentional analysis of empathy is directly relevant to the constitution of the social community in a broad, normative relationship with the "Other.". (shrink)

Protagoras’ declaration that “man is the measure of all things” is conventionally discussed in the context of epistemology. There was, however, a communal or social dimension to this even in ancient Greece. In the unfolding process of time, this latter dimension assumed greater intensity and expanded systematically into all aspects of human relations. The centrality of money in these relations speaks to the transition from “man is the measure of all things” to money is the measure of all things. It (...) is precisely this thesis that the present essay proposes to defend. (shrink)

From the most prominent thinkers in Latin American philosophy, literature, politics, and social science comes a challenge to conventional theories of globalization. The contributors to this volume imagine a discourse in which revolution requires no temporalized march of progress or takeovers of state power but instead aims at local control and the material conditions for human dignity.

El ejercicio físico es un agente importante en el mantenimiento de la salud y en la prevención de diversas enfermedades. El cuidado en la enfermedad coronaria, la hipertensión, la diabetes, la obesidad, el cáncer, la osteoporosis y el incremento de la salud mental se han relacionado con la actividad física y el ejercicio. En este artículo se resumen los efectos de la realización de deporte en las enfermedades más comunes de la sociedad actual. Sin embargo, la mayoría de la población (...) no practica actividad física. Por lo tanto, es preciso que los médicos prescriban más frecuentemente el ejercicio físico. (shrink)

Anthony Preus - The Myth of Aristotle's Development and the Betrayal of Metaphysics - Journal of the History of Philosophy 40:4 Journal of the History of Philosophy 40.4 536-537 Book Review The Myth of Aristotle's Development and the Betrayal of Metaphysics Walter E. Wehrle. The Myth of Aristotle's Development and the Betrayal of Metaphysics. Lanham, MD: Rowman & Littlefield, 2000. Pp. xiii + 279. Cloth, $75.00. Walter Wehrle was a clever scholar who struggled all his life with a crippling illness (...) that led to his death at the age of forty-nine. His widow, with the help of a friend and colleague, David Schum, saw this posthumous book into print. Wehrle focuses on one argument line used by some of those who have theories of Aristotle's development:.. (shrink)

"This book may be described as an attempt to do two things; first, to explain religion through nature and man; and, secondly, to construe Christianity through religion. The author conceives religion to be a joint product of the mind within man and the nature around him, the mind being the source of the ideas which constitute its soul, the nature around determining the usages and customs which build up its body. He does not think, therefore, that any one of its (...) special forms can be explained without the local nature which begot and shaped it, or that its general being can be resolved and construed without the reason or thought which is common to the race. He sees in religion the greatest of all man's unconscious creations, and the most potent of the means which the past, while it was still a living present, formed for the making of the man and the times that were yet to be." -- From the Preface. (shrink)