Principles Behind Definitions of Diseases – a Criticism of the Principle of Disease Mechanism and the Development of a Pragmatic Alternative

Many philosophers and medical scientists assume thatdisease categories or entities used to classify concrete cases ofdisease, are often defined by disease mechanisms or causalprocesses. Others suggest that diseases should always be definedin this manner. This paper discusses these standpoints criticallyand concludes that they are untenable, not only when `diseasemechanism' refers to an objective mechanism, but also when`mechanism' refers to a pragmatically demarcated part of thetotal ``objective' causal structure of diseases. As an alternativeto principles that use the concept of disease mechanism oranalogous concepts, a pragmatic approach is suggested anddescribed. This approach has been suggested before, but inproblematic or inadequate versions. This paper proposes a versioncompiled of two ``pragmatic principles' and shows that they aremuch more adequate than the principle of disease mechanism. Withreference to a case study of a still ongoing internationaldiscussion of various candidates for a classification system formalignant lymphomas, including REAL (Revised European–AmericanClassification of Lymphoid Neoplasms) in which the concept ofdisease mechanism or analogous concepts plays a very small part,it is shown just how pivotal these two pragmatic principles canbe in actual discussions of definitions of diseases. Finally, itis pointed out that with regard to modern philosophy of languageit may, at least in some cases, be problematic to distinguishbetween the two pragmatic principles as they stand.     

Representative design: Does the addition of a defender change the execution of a basketball shot?

ObjectiveThe aim of this study was to examine the influence of a defender on the performance of a motor skill from an invasion sport.DesignHighly skilled basketball players performed different variations of basketball shots using a randomised test schedule.MethodParticipants completed a total of 30 test trials comprising 6 trials of 5 different shot types in both defended and undefended conditions.ResultsThe presence of a defender led to significant changes in several behavioral measures including faster shot execution times, longer jump times, and an increase in the amount of time that the ball spent in the air as it travelled to the basket after being released from the shooter's hand. These behavioral changes were accompanied by an overall decline in shooting accuracy of over 20%. Defended shots also tended to elicit greater amounts of movement variability which, when interpreted in conjunction with the other findings, suggests that participants were attempting to adapt their movements to accommodate for the changing demands of the performance environment. Comparisons across different shot types revealed that the influence of the defender was generally context and task dependent.ConclusionsThe results have important implications for representative task design, and highlight how the manipulation of key information sources can have a marked effect upon behavioral responses.     

Is the loss of diagnosticity of the eye region of the face a common aspect of acquired prosopagnosia?

A recent study published in this journal has shown an abnormal performance at discriminating differences with respect to the eyes of unfamiliar faces in two acquired prosopagnosic patients, but preserved processing of the mouth region. Here we extend these findings by showing a similar lack of sensitivity to the eyes in the very same face matching experiment for the prosopagnosic patient PS, who also showed normal performance for detecting differences in the mouth region. These results complement previously published evidence that the patient PS presents a lack of sensitivity to diagnostic information located on the eyes of familiar faces during individual face recognition tasks. More generally, they indicate that the impaired processing of the eyes of faces is a fundamental aspect of acquired prosopagnosia that can arise following damage to different brain localizations.     

Must the bearer of a right have the concept of that to which he has a right?

Stevens critiques what he calls the "conceptual possession requirement" as defined by Michael Tooley in his article, "Abortion and infanticide," Philosophy and Public Affairs 1972 Fall; 2(1): 37-65. Tooley argued that a being has a right to something only if it has the concept of that thing. He claimed that fetuses and infants do not have a serious right to life because they have no concept of a continuing self, and that therefore abortion and infanticide are morally permissible. Stevens contends that the conceptual possession requirement is not valid, offers a counterexample to Tooley's argument, and defends his reasoning against what he presumes might be Tooley's counterarguments.     

Inhibition of return for the length of a line?

Inhibition of return is most often measured using an exogenous spatial cuing method. The experiments presented here follow up on a small number of studies that have examined whether a similar effect occurs for nonspatial stimulus attributes. In Experiments 1 and 2, the task was to identify a target line as either short or long. In this context, targets on valid trials were of the same length as that of a preceding cue, whereas targets on invalid trials were of a different length than that of a preceding cue. The results were similar to those in spatial orienting studies in that responses were slower for valid than for invalid targets only at stimulus onset asynchronies (SOAs) longer than 300 msec. In Experiment 3, the stimuli were the same but the task was to detect the onset of the target line. This task change resulted in slower responses for valid than for invalid targets at all SOAs. A similar result was observed in Experiment 4, in which validity was defined by color rather than line length, and the task was to identify the target color. The discussion centers on an opponent process approach to interpreting cuing effects, and consequent difficulties in distinguishing spatial and nonspatial cuing effects based on their time course.     

Is the Ambivalence a Sign of the Multiple-Self Nature of the Human Being? Interdisciplinary Remarks

Ambivalence is a constituent feature of human beings. The aim of this article is to systematise the fundamental sources of ambivalence (neuropsychic, socio-cultural and situational) and highlight that ambivalence can be considered as an external sign or manifestation of a complex and multiple internal human nature; that is, a human being constituted by multiple selves. In this paper the self is viewed as a principle of organization and integration for action, that is, as a complex neurological process and not as a static entity. The purpose is to show how by assuming ambivalence and the multiple-self, social and anthropological theories can offer a more realistic view of human beings.     

The Parable of the Sower: a case study examining the use of the Godly Play® method as a spiritual intervention on a psychiatric unit of a major children’s hospital

This case study examines the use of Godly Play® as a pastoral intervention on a psychiatric unit at Children’s Health – Children’s Medical Center in Dallas, Texas. The chaplain adapts Godly Play®, more typically used as a programme of Christian formation in churches and schools, for this setting, leading a ‘Purpose and Meaning’ group weekly whose goal is to provide inpatients with a developmentally appropriate way of reflecting on and expressing their own sense of identity, purpose and meaning within the personal, social and spiritual milieu in which they identify themselves as members. The case study examines how the method is adapted as a spiritual intervention in a clinical setting, and analyses its effectiveness in meeting the stated goals of the group.     

Why a common commemoration of the Reformation?

This article provides information about the fact that today any commemoration of the Reformation can only be celebrated in ecumenical communion. In contrast to earlier Reformation jubilees, the commemoration of the Reformation in 2017 is taking place, for the first time, in an ecumenical era. The year 2017 refers back to the year 1517, that is, to a time when the break with the Catholic Church had not yet happened. Martin Luther himself did not intend the division of the Church, nor did he visualise the founding of a new church, but the renewal of all Christendom. This failed in his time. Therefore one should regard the ecumenical search for the restoration of unity as the – indeed very belated – success of the Reformation. The commemoration of ??a reformation is an ecumenical opportunity, if it is committed to living the triad of gratitude for the reformation’s positive aims, of repentance for the sins of division and subsequent confessional wars, and of hope for a greater unity between Lutherans and Catholics.     

For the Sake of a Stone? Inanimate Things and the Demands of Morality

Everyday inanimate things such as stones, teapots and bicycles are not objects to which moral agents could have direct duties; they do not have moral status. It is usually assumed that there is therefore no reason to think that a morally good person would, on account of her goodness, be disposed to treat them well for their own sakes. I challenge this assumption. I begin by showing that to act for the sake of an entity need not be to suppose that it has moral status, but simply to regard it as an end in itself. Having done this, I argue that it is not, as is conventionally assumed, implausible to suppose that to be morally good is to be disposed to treat at least some inanimate things gently, and to do so, moreover, for the sake of those things, rather than for some other reason.     

Is Satan a Lover of the Good?

There are, apparently, two inherited stories of intentional action. On the motivational story, intentional agents are pursuers of goals. On the evaluative story, intentional agents are pursuers of value. In a spirit of unification, we might try to supplement the motivational story with the evaluative one – or even collapse the former into the latter. The problem with such moves is that they cannot accomodate certain pathologies of agency. Thus, they convert apparently perverse agents – like Satan and self-haters – into closet lovers of the good. I argue that pathological agents like Satan and self-haters are not lovers of the good. They are just lovers of success in action. We can make sense of such agents as practical reasoners because the cares that constitute us as practical reasoners are plural.     

Beliefs About the Outcomes of Extramarital Sexual Relationships as a Function of the Gender of the “Cheating Spouse”

A person perception experiment was conducted toexamine people's beliefs about the outcome of anextramarital sexual relationship involving ahypothetical single friend and a married person. Twohundred and eleven undergraduate students (80 males and129 females; most of whom were Caucasian) were theparticipants in the experiment. The married person inthe vignette was presented as either a man or a woman (and always the opposite gender of the singlefriend) and as having low or high investments in themarriage (as indicated by number of children and yearsmarried). Results indicated that the participants' perceptions of the outcome of this type ofextramarital relationship depended on the gender of themarried person/single friend. Participants were morelikely to believe that the married person loved the extramarital partner, was committed to theextramarital relationship, and would marry theextramarital partner, if the married person was a womanrather than a man. The investment manipulations had noeffect on participants' perceptions of therelationship. The results were discussed as they relateto other beliefs about male vs. femalesexuality.     

Can the components of a cognitive model predict the severity of generalized anxiety disorder?

Over the past decade, a number of well-controlled studies have supported the validity of a cognitive model of generalized anxiety disorder (GAD) that has four main components: intolerance of uncertainty, positive beliefs about worry, negative problem orientation, and cognitive avoidance. Although these studies have shown that the model components are associated with high levels of worry in nonclinical samples and with a diagnosis of GAD in clinical samples, they have not addressed the question of whether the model components can predict the severity of GAD. Accordingly, the present study sought to determine if the model components are related to diagnostic severity, worry severity, and somatic symptom severity in a sample of 84 patients with a primary diagnosis of GAD. All model components were related to GAD severity, although positive beliefs about worry and cognitive avoidance were only modestly associated with the severity of the disorder. Intolerance of uncertainty and negative problem orientation had more robust relationships with the severity of GAD (and with worry severity, in particular). When participants were divided into Mild, Moderate, and Severe GAD groups, intolerance of uncertainty and negative problem orientation distinguished the Moderate and Severe GAD groups from the Mild GAD group, even when age, gender, and depressive symptoms were statistically controlled. Overall, the results lend further support to the validity of the model and suggest that intolerance of uncertainty and negative problem orientation are related to the severity of GAD, independently of sociodemographic and associated clinical factors. The theoretical and clinical implications of the findings are discussed.     

Exposure to Violence as a Mediator of the CU–Aggression Relationship: on the Importance of Establishing the Causal Direction of Variables in a Path Analysis

The current study sought to determine which of three variables—callous-unemotional (CU) traits, exposure to violence (ETV), and aggressive offending—did the best job of mediating the other two variables. This question was addressed in a sample of 1170 male delinquents from the Pathways to Desistance study using three waves of data and the comparison pathways approach to mediation. Consistent with predictions, ETV successfully mediated the CU–aggression relationship, whereas the two control pathways (ETV?→?CU?→?aggression and CU?→?aggression → ETV) were non-significant. These results suggest that certain variables are better suited to serving as mediators than other variables. Hence, while personality-based constructs like CU traits perform well as independent variables and behavioral measures like aggressive offending make for effective dependent variables, mediation is perhaps best served by social cognitive, affective-motivational, perceptual, and experiential variables, the latter of which is the category into which exposure to violence falls. From a theoretical standpoint, these findings suggest that exposure to violence may trigger or prime aggressive offending in individuals possessing strong CU traits. Exposure to violence may therefore serve as one mechanism with the capacity to link CU traits to later aggressive offending, with implications for both prevention and intervention.     

Gregory the Great’s Metaphor of the Physician of the Heart as a Model for Pastoral Identity

The identity of the Roman Catholic priesthood remains in serious crisis. Scholars have called for a return to traditional sources to find possible solutions, including the Early Church Fathers and the Hebrew Bible. Following Oden, this article further explores Pope Gregory the Great’s The Book of Pastoral Rule and his ideals regarding pastoral identity. Of unique importance is his notion of the pastor as a “physician of the heart,” unrecognized previously as central to his project.