BackgroundThe increased risk of developing attention-deficit hyperactivity disorder (ADHD) in extremely preterm infants is well-documented. Better understanding of perinatal risk factors, particularly those that are modifiable, can inform prevention efforts.MethodsWe examined data from the Extremely Low Gestational Age Newborns (ELGAN) Study. Participants were screened for ADHD at age 10 with the Child Symptom Inventory-4 (N = 734) and assessed at age 15 with a structured diagnostic interview (MINI-KID) to evaluate for the diagnosis of ADHD (N = 575). We studied associations (...) of pre-pregnancy maternal body mass index (BMI), pregestational and/or gestational diabetes, maternal smoking during pregnancy (MSDP), and hypertensive disorders of pregnancy (HDP) with 10-year and 15-year ADHD outcomes. Relative risks were calculated using Poisson regression models with robust error variance, adjusted for maternal age, maternal educational status, use of food stamps, public insurance status, marital status at birth, and family history of ADHD. We defined ADHD as a positive screen on the CSI-4 at age 10 and/or meeting DSM-5 criteria at age 15 on the MINI-KID. We evaluated the robustness of the associations to broadening or restricting the definition of ADHD. We limited the analysis to individuals with IQ ≥ 70 to decrease confounding by cognitive functioning. We evaluated interactions between maternal BMI and diabetes status. We assessed for mediation of risk increase by alterations in inflammatory or neurotrophic protein levels in the first week of life.ResultsElevated maternal BMI and maternal diabetes were each associated with a 55–65% increase in risk of ADHD, with evidence of both additive and multiplicative interactions between the two exposures. MSDP and HDP were not associated with the risk of ADHD outcomes. There was some evidence for association of ADHD outcomes with high levels of inflammatory proteins or moderate levels of neurotrophic proteins, but there was no evidence that these mediated the risk associated with maternal BMI or diabetes.ConclusionContrary to previous population-based studies, MSDP and HDP did not predict ADHD outcomes in this extremely preterm cohort, but elevated maternal pre-pregnancy BMI, maternal diabetes, and perinatal inflammatory markers were associated with increased risk of ADHD at age 10 and/or 15, with positive interaction between pre-pregnancy BMI and maternal diabetes. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 27.1 (2003) 80-97 [Access article in PDF] Literary Truth as Dreamlike Expression in Foucault's and Borges's "Chinese Encyclopedia" Robert Wicks ALTHOUGH THE TOPIC REMAINS MOSTLY unexplored, Michel Foucault had an aesthetic and intellectual attraction towards writers and artists in the Spanish-speaking tradition. For example, at the conclusion of his Histoire de la folie (Madness and Civilization, 1961)—a book which brought him extensive intellectual recognition in (...) France—Foucault drew his readers' attention to José de Goya y Lucientes's (1746-1828) well-known etching, El Sueño de la Razón Produce Monstruos (The Sleep of Reason Brings Forth Monsters, Plate 43 of Los Caprichos, 1797). In Foucault's estimation, by revealing a "night which is doubtless that of classical unreason," Goya's work represented a socially removed condition within which people encounter "what is most solitary" and experience what is "deepest" within themselves. With his reference to Goya's imagery, Foucault illustrated a major theme of his history of madness, namely, how people referred to as "mentally ill" experienced a gradual, physical exclusion from participation in public society, and how they were eventually isolated in a more frightening way: within their physical confinement, they were subject to techniques of psychological and spiritual alienation that reduced them to a condition of utter solitude.In a comparable, if not more central manner, Foucault used as thematic motifs for the preface, first and second chapters of a book for which he is widely known, Les Mots et les choses (The Order of Things, 1966), the work of three major writers and artists from the Spanish-speaking world: Jorges Luis Borges (1899-1986), Diego Velázquez (1599-1660), and Miguel de Cervantes (1547-1616). Among these references, the most popular is probably Foucault's discussion of [End Page 80] Velázquez's Las Meninas—a painting which captured Foucault's interest as a perfect exemplar of its time period—and which inspired him to devote the entire first chapter of his book to decoding the mechanics of its perspectival arrangement. And within the community of those who read, write and discuss the interrelationship between Foucault's thought, literary theory and the contemporary emphasis upon the multivocal quality of textual meaning, Foucault's citation of an excerpt from a short story by Borges—the subject of this essay—is also familiar. Foucault introduced his 1966 book, The Order of Things, with the following words: This book first arose out of a passage in Borges, out of the laughter that shattered, as I read the passage, all the familiar landmarks of my thought—our thought, the thought that bears the stamp of our age and our geography—breaking up all the ordered surfaces and all the planes with which we are accustomed to tame the wild profusion of existing things, and continuing long afterwards to disturb and threaten with collapse our age-old distinction between the Same and the Other. This passage quotes a "certain Chinese encyclopedia" in which it is written that "animals are divided into: (a) belonging to the Emperor, (b) embalmed, (c) tame, (d) suckling pigs, (e) sirens, (f) fabulous, (g) stray dogs, (h) included in the present classification, (i) frenzied, (j) innumerable, (k) drawn with a very fine camelhair brush, (l) et cetera, (m) having just broken the water pitcher, (n) that from a long way off look like flies." In the wonderment of this taxonomy, the thing we apprehend in one great leap, the thing that, by means of the fable, is demonstrated as the exotic charm of another system of thought, is the limitation of our own, the stark impossibility of thinking that. 1The short story from which Foucault extracted the above, quasi-cubistic, excerpt was published in Borges's 1952 collection, Otras Inquisiciones (Other Inquisitions), and is entitled, "The Analytical Language of John Wilkins." Although this story's entirety is rarely surveyed in discussions of Foucault, appreciating its broader contents helps illuminate why Foucault began The Order of Things with this entertaining and bizarre segment. Borges's original... (shrink)

This carefully selected and integrated series of discourses on the central issues of political life presents Robert M. MacIver's views on ethics and politics, society and the state, government and political change, war and peace, and the conditions of a viable international order. It is both a key to the astonishing scope and versatility of MacIver's mind and a major contribution to political thought. Politics and Society elucidates some of the major themes and essential problems of political theory. Here (...) are incisive essays on the nature of understanding in social and political science; on the discontinuities between ethics and politics that render difficult, yet imperative, the ordering of a multigroup society; and on the ever-present tensions between liberty and authority, private interests and the common good. Here too are MacIver's assessments of the forces that make for social change and the transformations requisite to the establishment of a viable international order. And here, with sensitivity and wisdom, are MacIver's articulations of relevant ends and their realization through appropriate means. David Spitz provided a lengthy introduction to this volume on its first publication in 1969 assessing the importance of MacIver's teachings as well as relating these essays within the broader context of MacIver's political and social thought. The republication of this collection now attests to Spitz's conclusion: "The rewards that await the reader of these essays support my conviction that MacIver's eminent achievements, in both method and vision, stamp him as the most distinguished of our social and political theorists."Robert M. MacIver (1882-1970) was Lieber Professor of Political Philosophy and Sociology at Columbia University (1929-1950) and held many other academic posts, directorships and honorary degrees, and in 1962 came out of retirement to be chancellor of the New School for Social Research. Among his most important books were Social Causation and Community, a Sociological Study. David Spitz was professor of political science at Columbia University. He was the author among other books of The Liberal Idea of Freedom. The David and Elaine Spitz Prize is awarded every year for the best book in liberal and/or democratic theory by the International Conference for the Study of Political Thought in his honor. (shrink)

a comprehensive, somewhat Gricean theory of speech acts, including an account of communicative intentions and inferences, a taxonomy of speech acts, and coverage of many topics in pragmatics -/- .

Mindreading (or folk psychology, Theory of Mind, mentalizing) is the capacity to represent and reason about others’ mental states. The Simulation Theory (ST) is one of the main approaches to mindreading. ST draws on the common-sense idea that we represent and reason about others’ mental states by putting ourselves in their shoes. More precisely, we typically arrive at representing others’ mental states by simulating their mental states in our own mind. This entry offers a detailed analysis of ST, considers theoretical (...) arguments and empirical data in favour of and against it, discusses its philosophical implications, and illustrates some alternatives to it. (shrink)

Empirical research pertaining to cardiopulmonary resuscitation (CPR), clinician behaviors related to do-not-resuscitate (DNR) orders and substituted judgment suggests potential contributions to medical ethics. Research quantifying the likelihood of surviving CPR points to the need for further philosophical analysis of the limitations of the patient autonomy in decision making, the nature and definition of medical futility, and the relationship between futility and professional standards. Research on DNR orders has identified barriers to the goal of patient involvement in these life and death (...) discussions. The initial data on surrogate decision making also points to the need for a reexamination of the moral basis for substituted judgment, the moral authority of proxy decision making and the second-order status of the best interests standard. These examples of empirical research suggest that an interplay between empirical research, ethical analysis and policy development may represent a new form of interdisciplinary scholarship to improve clinical medicine. (shrink)

Current debates about “Darwinizing culture” have typically focused on the validity of memetics. In this article we argue that meme-like inheritance is not a necessary requirement for descent with modification. We suggest that an alternative and more productive way of Darwinizing culture can be found in the application of phylogenetic methods. We review recent work on cultural phylogenetics and outline six fundamental questions that can be answered using the power and precision of quantitative phylogenetic methods. However, cultural evolution, like biological (...) evolution, is often far from treelike. We discuss the problems reticulate evolution can cause for phylogenetic analyses and suggest ways in which these problems can be overcome. Our solutions involve a combination of new methods for the study of cultural evolution , and the triangulation of different lines of historical evidence. Throughout we emphasize that most debates about cultural phylogenies can only be settled by empirical research rather than armchair speculation. (shrink)

Since the Harvard Committees bold and highly successful attempt to redefine death in 1968 (Harvard Ad Hoc committee, 1968), multiple controversies have arisen. Stimulated by several factors, including the inherent conceptual weakness of the Harvard Committees proposal, accumulated clinical experience, and the incessant push to expand the pool of potential organ donors, the lively debate about the definition of death has, for the most part, been confined to a relatively small group of academics who have created a large body of (...) literature of which this issue of the Journal of Medicine and Philosophy is an example. Law and public policy, however, have remained essentially unaffected. This paper will briefly review the multiple controversies about defining death in an attempt to explain why they have and will remain unresolved in the academic community and have even less chance of being understood and resolved by politicians, legislators, and the general public. Considering this, we will end by suggesting the probable course of public policy and clinical practice in the decades ahead. (shrink)

At the time of this writing, a widely publicized, waived-consent trial is underway. Sponsored by Northfield Laboratories, Inc. (Evanston, IL) the trial is intended to evaluate the emergency use of PolyHeme®, an oxygen-carrying resuscitative fluid that might prevent deaths from uncontrolled bleeding. The protocol allows patients in hemorrhagic shock to be randomized between PolyHeme® and saline in the field and, still without consent, randomized between PolyHeme® and blood after arrival at an emergency department. The Federal regulations that govern the waiver (...) of consent restrict its applicability to circumstances where proven, satisfactory treatments are unavailable. Blood - the standard treatment for hemorrhagic shock - is not available in ambulances but is available in hospitals. The authors argue that the in-hospital stage of the study fails to meet ethical and regulatory standards. (shrink)

Geron recently announced that it had begun enrolling patients in the world's first-in-human clinical trial involving cells derived from human embryonic stem cells (hESCs). This trial raises important questions regarding the future of hESC-based therapies, especially in spinal cord injury (SCI) patients. We address some safety and efficacy concerns with this research, as well as the ethics of fair subject selection. We consider other populations that might be better for this research: chronic complete SCI patients for a safety trial, subacute (...) incomplete SCI patients for an efficacy trial, and perhaps primary progressive multiple sclerosis (MS) patients for a combined safety and efficacy trial. (shrink)

The advanced donation program was proposed in 2014 to allow an individual to donate a kidney in order to provide a voucher for a kidney in the future for a particular loved one. In this article, we explore the logistical and ethical issues that such a program raises. We argue that such a program is ethical in principle but there are many logistical issues that need to be addressed to ensure that the actual program is fair to both those who (...) do and do not participate in this program. (shrink)

One way of increasing the supply of vital organs without violating the dead donor rule is to declare death on cardiopulmonary criteria after withdrawing life support. The question then is how quickly death may be declared.

The contributors to The Moral of the Story, all preeminent political theorists, are unified by their concern with the instructive power of great literature. This thought-provoking combination of essays explores the polyvalent moral and political impact of classic world literatures on public ethics through the study of some of its major figures-including Shakespeare, Dante, Cervantes, Jane Austen, Henry James, Joseph Conrad, Robert Penn Warren, and Dostoevsky. Positing the uniqueness of literature's ability to promote dialogue on salient moral and intellectual (...) virtues, editor Henry T. Edmonson III has culled together a wide-ranging exploration of such fundamental concerns as the abuse of authority, the nature of good leadership, the significance of "middle class virtues" and the needs of adolescents. This collection reinvigorates the study of classic literature as an endeavor that is not only personally intellectually satisfying, but also an inimitable and unique way to enrich public discourse. (shrink)

Early last year, the GenEthics Consortium (GEC) of the Washington Metropolitan Area convened at George Washington University to consider a complex case about genetic testing for Alzheimer disease (AD). The GEC consists of scientists, bioethicists, lawyers, genetic counselors, and consumers from a variety of institutions and affiliations. Four of the 8 co-authors of this paper delivered presentations on the case. Supplemented by additional ethical and legal observations, these presentations form the basis for the following discussion.

We show that strong measure zero sets -totally bounded metric space) can be characterized by the nonexistence of a winning strategy in a certain infinite game. We use this characterization to give a proof of the well known fact, originally conjectured by K. Prikry, that every dense \ subset of the real line contains a translate of every strong measure zero set. We also derive a related result which answers a question of J. Fickett.

How should we understand the emotional rationality? This first part will explore two models of cognition and analogy strategies, test their intuition about the emotional desire. I distinguish between subjective and objective desire, then presents with a feeling from the "paradigm of drama" export semantics, here our emotional repertoire is acquired all the learned, and our emotions in the form of an object is fixed. It is pretty well in line with the general principles of rationality, especially the lowest reasonable (...) principles. Turned to the second part of this side of reasonable. I will inquire how emotional beliefs, desires, and behaviors contribute to the rationality. I will present a very general biological hypothesis: emotions by controlling highlights the characteristics of perception and reasoning, so that we remove the difficulties due in particular to lead to paralysis; they are being simulated by a simplified perception of information, thus limiting our practice and cognitive choice. How are we to understand emotional or axiological rationality? I pursue analogies with both the cognitive and the strategic models, testing them against intuitions about emotional desires. We distinguish two different classes of desires, the subjective and the objective, and propose that emotions have a semantics that derives from "paradigmatic scenarios", in terms of which our emotional repertoire is learned and the formal objects of our emotions fixed. This fits in well with emerging facts about how our emotional capacities develop, and it can also be squared with the general principles of rationality, particularly minimal rationality. In the second part, I return to the perspective of rationality. I ask how emotions contribute to the rationality of beliefs, desires, and behavior. I proffer a very general biological hypothesis: Emotions spare us the paralysis potentially induced by a particular predicament by controlling the salience of features of perception and reasoning; they temporarily mimic the informational encapsulation of perception and so circumscribe our practical and cognitive options. (shrink)

The puzzling case of the broken arm -- Hernias, diets, and drugs -- Why physicians cannot know what will benefit patients -- Sacrificing patient benefit to protect patient rights -- Societal interests and duties to others -- The new, limited, twenty-first-century role for physicians as patient assistants -- Abandoning modern medical concepts: doctor's "orders" and hospital "discharge" -- Medicine can't "indicate": so why do we talk that way? --"Treatments of choice" and "medical necessity": who is fooling whom? -- Abandoning informed (...) consent -- Why physicians get it wrong and the alternatives to consent: patient choice and deep value pairing -- The end of prescribing: why prescription writing is irrational -- The alternatives to prescribing -- Are fat people overweight? -- Beyond prettiness: death, disease, and being fat -- Universal but varied health insurance: only separate is equal -- Health insurance: the case for multiple lists -- Why hospice care should not be a part of ideal health care I: the history of the hospice -- Why hospice care should not be a part of ideal health care II: hospice in a postmodern era -- Randomized human experimentation: the modern dilemma -- Randomized human experimentation: a proposal for the new medicine -- Clinical practice guidelines and why they are wrong -- Outcomes research and how values sneak into finding of fact -- The consensus of medical experts and why it is wrong so often. (shrink)

It is commonly believed in research ethics that some form of equipoise is a necessary condition for justifying randomized clinical trials, that without it clinicians are violating the moral duty to do what is best for the patient. Recent criticisms have shown how complex the concept of equipoise is, but often retain the commitment to some form of equipoise for randomization to be justified. This article rejects that claim. It first asks for what one should be equally poised (scientific or (...) clinical equipoise), then asks who should be equally poised (scientist, clinician, or subject), and finally asks why any of these players need be equally poised between treatment options. The article argues that only the subject's evaluation of the options is morally relevant and that even the subject need not be equally poised or indifferent between the options in order to volunteer for randomization. All that is needed is adequately informed, free, and unexploited consent. It concludes equipoise is irrelevant. (shrink)

In its October 2001 issue, this journal published a series of articles questioning the Whole-Brain-based definition of death. Much of the concern focused on whether somatic integration - a commonly understood basis for the whole-brain death view - can survive the brain's death. The present article accepts that there are insurmountable problems with whole-brain death views, but challenges the assumption that loss of somatic integration is the proper basis for pronouncing death. It examines three major themes. First, it accepts the (...) claim of the "disaggregators" that some behaviors traditionally associated with death can be unbundled, but argues that other behaviors (including organ procurement) must continue to be associated. Second, it rejects the claims of the "somaticists," that the integration of the body is critical, arguing instead for equating death with the irreversible loss of "embodied consciousness," that is, the loss of integration of bodily and mental function. Third, it defends higher-brain views against the charge that they are necessarily "mentalist," that is, that they equate death with losing some mental function such as consciousness or personhood. It argues, instead, for the integration of bodily and mental function as the critical feature of human life and that its irreversible loss constitutes death. (shrink)