Since its introduction in the 1980s, futility as a concept has held contested meaning and applications throughout medicine. There has been little discussion within the psychiatric literature about the use of futility in the care of individuals experiencing severe and persistent mental illness (SPMI), despite some tacit acceptance that futility may apply in certain cases of psychiatric illness. In this paper, we explore the literature surrounding futility and argue that its connotation within medicine is to describe situations where patients (or (...) their substitute decision-makers) believe that interventions will almost certainly provide no meaningful benefit. We then provide two arguments in support of the use of futility within the care of individuals experiencing SPMI: that some SPMI can be considered a terminal illness, and that the risk-benefit ratio is a dynamic entity such that futility can help describe what Gillett calls the ‘risk of unacceptable badness’ when it comes to considering how an intervention might impact a patient’s quality of life. We posit that capacity should not pose an obstacle to declaring futility when caring for individuals experiencing SPMI and explain how futility is not antithetical to recovery in mental health. Finally, we describe how using futility within psychiatric practice can allow for a reorientation of care by signalling the need to shift to a palliative approach. (shrink)

Religions, ideologies try to give a complete vision of the world a vision containing both its origin, explanation and a “normative kit”: a collection of precepts and rules, which should regulate human activities and behavior. Their synergetic meaning is clear: if embraced by all they allow for development of strong synergetic effects on the social macro scales. These in turn may lead to creation of order and beauty, of intellectual, spiritual and moral development within men and in society. In this (...) consist the elements of their natural—i.e. not explicitly reasoned out—wisdom. However, as they contain also some elements of harmful consequences—at least if they are literally accepted and in a fundamentalist manner practiced—they cannot be universally accepted. But—rejecting them we lose also the important sourcesof natural—or should we say instinctive—wisdom.Could the solution of this contradiction, of this one of the basic human sources of suffering be looked for in the modern science of complexity?Synergetics and the sciences of complex systems in general offer a solid scientific base for a meta-philosophical, universalist intellectual framework. Its offspring the social synergetics offers concrete propositions of optimized social structures. Optimized in the sense of espousing the main synergetic effects with being at the same time free of the negative “side effects” happening when religions or ideologies are the source of synergism.Finally a connection is discussed between the presented ideas and the concept of “love of wisdom”. The term “love of wisdom” may be understood as striving not only to possess a “sound and serene judgment regarding the conduct of life” but also a practical ability to act according to that judgment.This ability may be also expressed using the information-thermodynamic concepts of synergetics. Indeed without the ever continuing negentropy transformation neither survival of a complex system like man or society nor its continuing development—uncovering of all his “hidden potentials” is possible.To assure maximization of this transformation process creation of strong synergetic effects—of reinforcement, of positive feedback—between all human beings—i.e. not excluding any nations, any social groups, and any individuals—are necessary. Acting towards local and global realization of such a structure everywhere on our planet constitutes the essence of social wisdom.Removing all obstacles towards this goal—obstacles existing on the intellectual, emotional and spiritual level—should be one of the most important tasks of various institutions, of state structures, of purified from mythical elements ideologies, of man oriented sciences and above all of the modern universalism.Thus striving towards its realization is an expression of the love of wisdom. Of wisdom once based on the elements of mythos and now regained in the full light of Logos. (shrink)

Debate among scientists is frequently hampered by intense difficulties in communicating and translating their viewpoints. This well-known fact illustrates the role of unarticulated core knowledge in the activities of sientific communities. But it has been little noticed that the issue afficts not just written science, but especially traditions of experimental activity and their products, including instruments and techniques. The question is addressed on the basis of examples from the history of optics and electromagnetism - Fresnel and Brewster, Maxwell and Hertz (...) - and texts from Kuhn's Structure. Particular attention is paid to interrelations between succeeding theories, and to the notorious problem of theory-choice. (shrink)

This chapter contains section titled: Organizing the Notes for On Certainty Groundlessness and Language‐games Searching for Primary Links Between Language and Reality Seeing Logic and Practice Pictures, Propositions and Reality Forms of Life Practices and Parallels Is the Title on Certainty a Happy One? Is on Certainty a Polemic against Moore? Is Wittgenstein's Main Interest in Moore's Propositions the Nature of Nonsense? Does Wittgenstein Say that the Propositions he is Interested in Form a Class, and Does he Say the Same (...) of all of Them? Are Wittgenstein's Propositions Context‐free? What is the Connection between Wittgenstein's Propositions and Logic? Is Wittgenstein Appealing to Primitive, Pre‐linguistic Reactions as the Basis of our Language‐games? What is Meant by the Sureness in Our Language‐games? How are Our Conclusions Related to the Notions of a Form of Life or World‐picture? How do Wittgenstein's Conclusions Differ from Some Classical and Contemporary Views of Our Relation to the World? Rhees's Development of Wittgenstein's Concerns. (shrink)

Many Roman Catholic female saints have been virgin martyrs whose lives exemplify a feminine Christian ideal. This article examines the legend of the modern virgin martyr Maria Goretti, a spiritual template whose sainthood can be said to institutionalize violence by defining women as sexualized beings and potential rape victims. The social and psychological effects of the legend of Goretti are discussed as a form of spiritual and sexual terrorism.

_The Structure of Appearance_ presents a phenomenalist system which constructs enduring visible objects out of qualia. Nevertheless Goodman does not espouse phenomenalism. Why not? In answering this question this paper explicates Goodman’s views about the nature and functions of constructional systems, the prospects of reductionism, and the character of epistemology.

We use Marya Schechtman’s Narrative Self-Constitution View to support the widespread idea that food can contribute to the construction and expression of our identities and be used to understand others. What foods we consume can be one such way to construct our identities as food itself can have different values: ethically sourced, healthy, culturally significant, etc. However, the ability to constitute one’s own identity in this way depends on the ability to autonomously choose what we consume. We argue that most (...) consumers have much less control over their own consumption habits than is typically assumed (indeed, much of the literature on food and identity relies on the assumption) and thus consumers have diminished autonomy with respect to identity-constitution. We focus on the effects of three such autonomy compromising practices: food impositions, which are social pressures on food choice; manipulative marketing; and impediments to access. Together these practices diminish second-order endorsement of food-related values, generate false beliefs about what one is eating, and create social, economic, or physical barriers which limit access to desired foods. There are, however, spaces where consumers are fighting back against cultural norms and agribusiness and changing their own relationship(s) with consumption, thereby exercising increased autonomy over their food and their identity. (shrink)

The question of what explains individual differences in expertise within complex domains such as music, games, sports, science, and medicine is currently a major topic of interest in a diverse range of fields, including psychology, education, and sports science, to name just a few. Ericsson and colleagues’ deliberate practice view is highly influential perspective in the literature on expertise and expert performance—but is it viable as a testable scientific theory? Here, reviewing more than 25 years of Ericsson and colleagues’ writings, (...) we document critical inconsistencies in the definition of deliberate practice, along with apparent shifts in the standard for evidence concerning deliberate practice. We also consider the impact of these issues on progress in the field of expertise, focusing on the empirical testability and falsifiability of the deliberate practice view. We then discuss a multifactorial perspective on expertise, and how open science practices can accelerate progress in research guided by this perspective. (shrink)

Building on their important findings in The Source of the River, the authors now probe even more deeply into minority underachievement at the college level. Taming the River examines the academic and social dynamics of different ethnic groups during the first two years of college. Focusing on racial differences in academic performance, the book identifies the causes of students' divergent grades and levels of personal satisfaction with their institutions. Using survey data collected from twenty-eight selective colleges and universities, Taming the (...) River considers all facets of student life, including who students date, what fields they major in, which sports they play, and how they perceive their own social and economic backgrounds. The book explores how black and Latino students experience pressures stemming from campus racial climate and "stereotype threat"--when students underperform because of anxieties tied to existing negative stereotypes. Describing the relationship between grade performance and stereotype threat, the book shows how this link is reinforced by institutional practices of affirmative action. The authors also indicate that when certain variables are controlled, minority students earn the same grades, express the same college satisfaction, and remain in school at the same rates as white students. A powerful look at how educational policies unfold in America's universities, Taming the River sheds light on the social and racial factors influencing student success. (shrink)

Speeches and persuasion dominate Plato’s Crito. This paper, paying particular attention to the final passage in the dialogue, shows that the focus on speeches, persuasion and allusions to many other elements of rhetoric is an integral part of Plato’s severe criticism of democracy, one of the main points of the Crito. Speeches allow members of a democracy – represented in our dialogue by Crito – firstly to break the law for self-interested reasons while considering themselves still to be law-abiding citizens, (...) and secondly to feel that they are in a tolerant society preferring logos/persuasive speech above bia/compulsion. Socrates counters Crito’s speeches with speeches of his own, not only to defeat him at his own game, but also to make him aware how dangerous the game is. Real knowledge is preferable to speeches, but a democracy without speeches and rhetoric is doomed. (shrink)

Nurses are the closest healthcare providers to patients and emotional labor is the most invisible part of nursing work. However, the management of emotions to promote organizational goals and to ensure patient satisfaction may have both positive and negative impacts on nurses' working life. The purpose of this cross‐sectional, descriptive study was to examine the emotional labor behaviors of nurses and their opinions on emotional labor. Two hundred nineteen nurses working at public hospitals in Ankara between September and December 2018 (...) participated to this study. Data were collected using the sociodemographic characteristics form and “The Scale of Emotional Labor Behavior for Nurses.” Nurses had higher scores on the deep and sincere emotional acting subdimensions of the emotional labor scale than the surface acting subdimension. Findings suggest that nurses act deeply and intimately, instead of surface acting. Most of the nurses expressed that nurses were emotionally affected when caring for patients; however, nurses had to control their feelings toward patients and behave professionally to meet the expectations of their managers, which may lead to an implicit emotional dissonance. Based on the results of this study, we suggest to support nurses emotionally and to incorporate the topic of emotional labor into educational programs. (shrink)

Rush Rhees, a close friend of Wittgenstein and a major interpreter of his work, shows how Wittgenstein's _On Certainty_ concerns logic, language, and reality – topics that occupied Wittgenstein since early in his career. Authoritative interpretation of Wittgenstein's last great work, _On Certainty_, by one of his closest friends. Debunks misconceptions about Wittgenstein's _On Certainty_ and shows that it is an essay on logic. Exposes the continuity in Wittgenstein's thought, and the radical character of his conclusions. Contains a substantial and (...) illuminating afterword discussing current scholarship surrounding _On Certainty_, and its relationship to Rhees's work on this subject. (shrink)

Visual working memory is a construct hypothesized to store a small amount of accurate perceptual information that can be brought to bear on a task. Much research concerns the construct's capacity and the precision of the information stored. Two prominent theories of VWM representation have emerged: slot-based and continuous-resource mechanisms. Prior modeling work suggests that a continuous resource that varies over trials with variable capacity and a potential to make localization errors best accounts for the empirical data. Questions remain regarding (...) the variability in VWM capacity and precision. Using a novel eye-tracking paradigm, we demonstrate that VWM facilitates search and exhibits effects of fixation frequency and recency, particularly for prior targets. Whereas slot-based memory models cannot account for the human data, a novel continuous-resource model does capture the behavioral and eye tracking data, and identifies the relevant resource as item activation. (shrink)

This study looks at the differences and changes observed in the visual design of the covers of French editions of women’s fashion magazines over a period of twenty-one years. To this end, the study aims to identify the changes that can be observed over the years in the design of the covers of the magazines Vogue, Elle, Marie Claire, and Cosmopolitan. However, the main aim of the study is to analyze how these visual signs on the covers of French magazines (...) are designed “differently” and how these signs create a “difference” in comparison to each other. By analyzing these visual elements, the aim of the study is to show the development of design trends and their impact on the visual communication strategies and brand identities of magazines. (shrink)

This article examines interactivity using the concept of dialogic relationships introduced by Russian philosopher Mikhail Bakhtin and the concept of transtextuality, proposed by French literary theorist Gérard Genette. These concepts help to reveal two parallel strata of interactivity: the stratum of interactivity between the viewer and the message and the stratum of interactivity that exists inside the message and its surrounding. It concludes that interactivity can be conceived as a relation and that the message is a co-creation. The study contributes (...) to the theory of interactivity, which challenges the existing – and rather limited – advertising theories and offers an alternative Bakhtinian perspective on the phenomenon of interactivity. (shrink)

This paper provides a discussion of Jacques Rancière’s former teacher at École Normale Supérieure, then famous for fashioning Marxism with the philosophical gauge of structuralism, Louis Althusser. Perhaps a brief discussion on the relation between the two would render context to the origins of Rancière's philosophico-political praxis, specifically the humble beginnings of conceptualizing an egalitarian method out of his philosophical rupture with Althusserianism. Meanwhile, to reduce the philosophical enterprise of Althusser into its practical shortcomings and silence during the revolutionary events (...) of May 1968 in France would do an injustice to the magnitude of his contribution to contemporary French political theory and his major revisions in the theoretical direction of the Parti communiste français. Thus, the following discussions focus on sketching Althusser's theoretical foundations, which possibly clarifies the political decision he has made during May '68: a demand for organization over spontaneous revolutionary activity based on the authority of theoretical practice over the ideological activities—a decision that became the point of departure for Rancière's subversion of both mastery and the structural inequality Althusserianism entail. The whole piece is guided by the following two-fold question—a question, perhaps, akin to Badiou's inquiry: What were the philosophico-political interventions of Louis Althusser, and why did Rancière move away from his direction? (shrink)

Name der Zeitschrift: Paragrana Jahrgang: 23 Heft: 2 Seiten: 75-84.

With age might come a decline in crucial driving skills. The effect of a collision warning system on older drivers' head movements behavior at intersections was examined.Methods: Twenty-six old-adults, between 55 and 64 years of age, and 16 Older drivers between 65 and 83 years of age, participated in the study. A CWS and a front-back in-vehicle camera were installed in each of the participants' own vehicles for 6 months. The CWS was utilized to identify unsafe events during naturalistic driving (...) situations, and the IVC was used to capture head direction at intersections. The experimental design was conducted in three phases, 2 months each. Unsafe events were recorded by the CWS during all phases of the study. In the second phase, the CWS feedback was activated to examine its effect on drivers' head movement' behavior at intersections.Results: Older drivers drove significantly more hours in total during the intervention phase than the baseline phase and the carryover phase. The study revealed no significant differences between the head movements of older and old-adult drivers at intersections. For intersection on the left direction, a significant improvement in drivers' head movements' behavior was found at T-junctions, turns and four-way intersections from phase 1 to phase 3, however, two intersection types presented a decrease along the study phases. The head movements' behavior at roundabouts and merges was better at phase 1 compared to phase 3. There was no significant reduction of the mean number of CWS unsafe events across the study phases.Conclusions: The immediate feedback provided by the CWS was effective in terms of participants' head movements at certain intersections but was harmful in others. However, older drivers drove many more hours during the active feedback phase, implying that they trusted the system. Therefore, in the light of this complex picture, using the technological feedback with older drivers should be followed with an additional mediation or follow-up to ensure safety. (shrink)

Growth factor receptor tyrosine kinases (RTKs), such as the fibroblast growth factor receptor (FGFR), play a major role in how cells communicate with their environment. FGFR signaling is crucial for normal development, and its misregulation in humans has been linked to developmental abnormalities and cancer. The precise molecular mechanisms by which FGFRs transduce extracellular signals to effect specific biologic responses is an area of intense research. Genetic analyses in model organisms have played a central role in our evolving understanding of (...) these signal transduction cascades. Genetic studies in the nematode C. elegans have contributed to our knowledge of FGFR signaling by identifying genes involved in FGFR signal transduction and linking their gene products together into signaling modules. This review will describe FGFR-mediated signal transduction in C. elegans and focus on how these studies have contributed to our understanding of how FGFRs orchestrate the assembly of intracellular signaling pathways. BioEssays 23:1120–1130, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

In public and political practice, argumentation involves verbal manipulations, which have not been sufficiently studied in modern argumentation theory. This paper proposes to analyse such manipulations as speech acts, by means of the pragmadialectical theory of argumentation.

Objectives: To investigate the extent to which family physicians in Lithuania inform their patients about possible side-effects when a common treatment is proposed. To examine the relation between physicians’ estimation of the severity and frequency of these side-effects and their willingness to inform patients. To identify the reasons for informing or not informing the patients.Methods: A questionnaire, presenting three hypothetical cases involving decisions about ordinary medical treatments and a series of general questions about information about side-effects, was distributed to 500 (...) Lithuanian GPs. The response rate was 42%.Results: The respondents differed considerably with regard to their willingness to inform patients about side-effects, but they informed their patients significantly more if the side effect was considered to be common and serious, than in cases when it was considered to be rare and trivial. The majority of the respondents informed their patients primarily to enable them to react appropriately to the side-effects in question. The major reason for not informing was that the side-effects were considered too rare to be relevant to the patient’s decision-making.Conclusion: Information, given to patients about side-effects by Lithuanian GPs, is not in accordance with the principle of respect for patients’ autonomy and requirements of Lithuanian legislation. (shrink)