Antibiotic development and usage, and antibiotic resistance in particular, are today considered global concerns, simultaneously mandating local and global perspectives and actions. Yet such global considerations have not always been part of antibiotic policy formation, and those who attempt to formulate a globally coordinated response to antibiotic resistance will need to confront a history of heterogeneous, often uncoordinated, and at times conflicting reform efforts, whose legacies remain apparent today. Historical analysis permits us to highlight such entrenched trends and processes, helping (...) to frame contemporary efforts to improve access, conservation and innovation. (shrink)

Orbell and Dawes develop a non-game theoretic heuristic that yields a ‘cooperator's advantage’ by allowing players to project their own ‘cooperate-defect’ choices onto potential partners (1991, p. 515). With appropriate parameter values their heuristic yields a cooperative environment, but the cooperation depends, simply, on optimism about others' behavior (1991, p. 526). In earlier work, Dawes (1989) established a statistical foundation for such optimism. In this paper, I adapt some of the concerns of Dawes (1989) and develop a game theoretic model (...) based on a modification of the Harsanyi structure of games with incomplete information (1967–1968). I show that the commonly made conjecture that strategic play is incompatible with cooperation and the cooperator's advantage is false. (shrink)

Luke Fildes's iconic painting The Doctor, first exhibited in 1891, has long served as a symbol of the caring, priest-like physician, watching over a sick child as the child's parents place their faith in his ministrations, technologically meager as they may be. As physicians acquired more visible and potent interventions—x-rays, antibiotics, the complex infrastructure of the hospital itself—the 19th-century British scene depicted by Fildes of an individual doctor's watchful waiting would be appropriated by the likes of the American Medical Association (...) in the 1940s to remind the American public of this idealized patient-doctor relationship, augmented by increasingly powerful curative tools at the disposal of... (shrink)

Name der Zeitschrift: Cultura. International Journal of Philosophy of Culture and Axiology Jahrgang: 8 Heft: 2 Seiten: 85-104.

If you consult a medical textbook to learn about the pathogenesis of Lyme disease, you will find a standard narrative. You will learn the disease is caused by the spirochete Borrelia burgdorferi, which is transmitted to people by blacklegged ticks . You will also learn that the natural reservoir for spirochetes in the Northeast is the white-footed mouse , and also likely be told that white-tailed deer are the primary host for gravid female ticks. And that is pretty much the (...) whole story. This limited perspective that considers only four species—spirochetes, mice, ticks, and deer—is entrenched by a reductionist paradigm, one that belies the nature of a .. (shrink)

In November of 1959, William Bean published in the Archives of Internal Medicine a scathing review of Félix Martí-Ibañez’s Centaur: Essays on the History of Medical Ideas. Martí-Ibañez and Bean were two of the leading exponents of the importance of medical humanism during a formative period from the 1950s through the 1970s. But the two physicians differed fundamentally in their views of the ideal relationships among the pharmaceutical industry, the medical profession, and the medical humanities. We situate Bean’s review within (...) its historical context, shedding light on the history and diverging uses of the medical humanities. (shrink)

Literary and philosophical reflections combine with true-life farm anecdotes to offer commentary on seeking the good life in the modern age.

The effects of psycholinguistic variables on reading development are critical to the evaluation of theories about the reading system. Although we know that the development of reading depends on both individual differences (endogenous) and item-level effects (exogenous), developmental research has focused mostly on average-level performance, ignoring individual differences. We investigated how the development of word recognition in Chinese children in both Chinese and English is affected by (a) item-level, exogenous effects (word frequency, radical consistency, and curricular grade level); (b) subject-level, (...) endogenous individual differences (orthographic awareness and phonological awareness); and (c) their interactive effect. We tested native Chinese (Putonghua)-speaking children (n = 763) in grades 1 to 6 with both Chinese character and English word identification (lexical) decision tasks. Our findings show that (a) there were effects of both word frequency and age of acquisition in both Chinese and English, but these item-level effects generally weakened with increasing age; (b) individual differences in phonological and orthographic awareness each contributed to successful performance; and (c) in Chinese, item-level effects were weaker for more proficient readers. We contend that our findings can be explained by theoretical models that incorporate cumulative learning as the basis for development of item-level effects in the reading system. (shrink)

Glover suggests that representational systems for planning versus control are mapped exclusively to the inferior (IPL) versus superior (SPL) parietal lobules respectively. Yet, there is ample evidence that the IPL and SPL both contribute to action planning and control. Alternatively, I distinguish between the parietal-frontal systems involved in the representation of acquired manual skills versus nonskilled actions.

Response to Mark Weinstein's "Reason and the Child." Questions the connection between "rationality" and children's moral status.

A premise of Corballis's theory is that speech arose when vocalization co-opted existing gestural functions in the left ventral premotor cortex. Yet, visuomotor functions in this region remain largely unchanged between humans and macaques and have no discernible connection to gestural communication. This functional continuity suggests that language production is not the result of modifying existing motor functions in this region.

The goal of the current study is to investigate the effects of the distractive textual information on the activation of predictive inference online, and how the readers with high or low working memory capacity differ in their online activation and text memory. To test the two hypothesis of attentional competition and semantic integration, we conducted three experiments to investigate whether a local prediction and a global prediction, both of which could be derived from the description of a critical event, are (...) generated in the mind of the reader, and how this generation process is influenced by contextual and cognitive factors of the reader. The results of Experiment 1 and 2 suggest that the elaboration of the global aspects in the narrative reduces the local prediction, but makes the global prediction more salient to occur. The evidence from Experiment 3 confirms the hypothesis that even automatic processes are constrained by distant contextual factors, in combination with differences in working memory, and examines how referentially local and global predictions are intertwined in text comprehension. Overall, these data support the immediate integration hypothesis across sentence boundaries at different representation levels, as well as interaction assumptions of different processing levels within referentially local and referentially global processing contexts. (shrink)

Despite being acknowledged as a major global health challenge, growing levels of antimicrobial resistance (AMR) in pathogenic and commensal organisms have proven an awkward fit for international health frameworks. This article surveys the history of attempts to coordinate international responses to AMR alongside the origins and evolution of the current international health regulations (IHR). It argues that AMR, which encompasses a vast range of microbial properties and ecological reservoirs, is an awkward fit for the ‘organismal’ philosophies that centre on the (...) rapid control of individual pathogens that have characterised international policy-making since the 19th century. (shrink)

There is currently great controversy over the contribution antimicrobial use in animal agriculture has made to antimicrobial resistance in pathogenic bacteria with negative consequences for human health. In light of this, the approval process for antimicrobials used in US animal agriculture, known as New Animal Drug Application or NADA, is currently being revised by the federal government. We explore the public deliberations over the development of these new policies focusing our attention on the interaction between pharmaceutical companies and the U.S. (...) Food and Drug Administration. What appears to be an antagonistic public discourse is examined in terms of its ability to simultaneously legitimate the roles of the Food and Drug Administration as the official arbiter of policy on antimicrobial use in animal agriculture and as a protector of the public welfare, as well as the role of pharmaceutical companies as the producers of safe and effective products necessary for the protection of public well-being. (shrink)

Medicine today, as both art and science, embodies a split personality. The ensuing tension—between individualized consideration, experience, and judgment on the one hand, and standardization, objective evidence, and guidelines on the other—plays out in the simultaneous aspirations of the medical humanities and evidence-based medicine, and in a host of other telling terms and movements. This is not a new tension, however. We turn in this paper to the critical but complex history of the term “personal equation” as both reflective and (...) generative of this tension on both sides of the Atlantic during a formative period in medicine from the mid-19th through the mid-20th centuries. The term was featured in almost every... (shrink)

We investigated how two cues to contrast—beat gesture and contrastive pitch accenting—affect comprehenders' cognitive load during processing of spoken referring expressions. In two visual‐world experiments, we orthogonally manipulated the presence of these cues and their felicity, or fit, with the local (sentence‐level) referential context in critical referring expressions while comprehenders' task‐evoked pupillary responses (TEPRs) were examined. In Experiment 1, beat gesture and contrastive accenting always matched the referential context of filler referring expressions and were therefore relatively felicitous on the global (...) (experiment) level, whereas in Experiment 2, beat gesture and contrastive accenting never fit the referential context of filler referring expressions and were therefore infelicitous on the global level. The results revealed that both beat gesture and contrastive accenting increased comprehenders' cognitive load. For beat gesture, this increase in cognitive load was driven by both local and global infelicity. For contrastive accenting, this increase in cognitive load was unaffected when cues were globally felicitous but exacerbated when cues were globally infelicitous. Together, these results suggest that comprehenders' cognitive resources are taxed by processing infelicitous use of beat gesture and contrastive accenting to convey contrast on both the local and global levels. (shrink)

Volume 19, Issue 10, October 2019, Page 3-7.

Examines the processes of scientific creativity and discovery, and proposes a model of scientific development.

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

When is it that two objects compose a whole? Or, put another way, if Z is an object composed of X and Y, then what must be done to bring it about that X and Y both exist and Z does not exist? The author defends an answer to what is now know as the Special Composition Question.

The ability to judge accurately whether or not an action can be accomplished successfully is critical for selecting appropriate response options that enable adaptive behaviors. Such affordance judgments are thought to rely on the perceived fit between environmental properties and knowledge of one's current physical capabilities. Little, however, is currently known about the ability of individuals to judge their own affordances following a stroke, or about the underlying neural mechanisms involved. To address these issues, we employed a signal detection approach (...) to investigate the impact of left or right hemisphere injuries on judgments of whether a visual object was located within reach while remaining still. Regarding perceptual sensitivity and accuracy in judging reachability, there were no significant group differences between healthy controls, right brain damaged and left brain damaged stroke patients. However, while healthy controls and RBD patients demonstrated a negative response criterion and thus overestimated their reach capability, LBD patients' average response criterion converged to zero, indicating no judgment tendency. Critically, the LBD group's judgment tendency pattern is consistent with previous findings in this same sample on an affordance judgment task that required estimating whether the hand can fit through apertures. Lesion analysis suggests that this loss of judgment tendency may be associated with damage to the left insula, the left parietal and middle temporal lobe. Based on these results, we propose that damage to the left ventro-dorsal stream disrupts the retrieval and processing of a stable criterion, leading to stronger reliance on intact on-line body-perceptive processes computed within the preserved bilateral dorsal network. (shrink)

The routine practice of clinical research involving patient-subjects without informed consent prior to 1966 unquestionably was unethical. Does it follow that all clinical research involving competent adult patient-subjects is unethical without informed consent?In his landmark 1966 paper, Henry Beecher noted that of the 50 example studies he had originally compiled in preparation for that paper, only two even mentioned consent, and he observed further that mention of consent is “meaningless unless one knows how fully the patient was informed”. Some of (...) the studies in Beecher’s paper, such as one comparing sulfadiazine with no treatment to assess the complications of streptococcal pharyngitis (when the... (shrink)

The Patient Preference Predictor (PPP) proposal places a high priority on the accuracy of predicting patients’ preferences and finds the performance of surrogates inadequate. However, the quest to develop a highly accurate, individualized statistical model has significant obstacles. First, it will be impossible to validate the PPP beyond the limit imposed by 60%–80% reliability of people’s preferences for future medical decisions—a figure no better than the known average accuracy of surrogates. Second, evidence supports the view that a sizable minority of (...) persons may not even have preferences to predict. Third, many, perhaps most, people express their autonomy just as much by entrusting their loved ones to exercise their judgment than by desiring to specifically control future decisions. Surrogate decision making faces none of these issues and, in fact, it may be more efficient, accurate, and authoritative than is commonly assumed. (shrink)