Mobility: Disability and Life in the Spirit

Abstract : The author employs the narrative of his own personal experience of disability as an entry to several large issues: the place of body; the challenge of mobility; the processes of medical treatment, therapy, and fitness training; the network of dependence upon family, friends, and society; and the challenge to actively avail oneself of the resources of this network. The power of the human spirit is affirmed as the prerequisite for moving the body and attaining the possibilities of one's life. This power is the work of God's Spirit. A concept of body‐spiriting is suggested. The argument is framed in two parts: (1) in the world in my own skin, and (2) living in the presence of God.     

Maximal care considerations when treating patients with end-stage heart failure: ethical and procedural quandaries in management of the very sick

Deciding who should receive maximal technological treatment options and who should not represents an ethical, moral, psychological and medico-legal challenge for health care providers. Especially in patients with chronic heart failure, the ethical and medico-legal issues associated with providing maximal possible care or withholding the same are coming to the forefront. Procedures, such as cardiac transplantation, have strict criteria for adequate candidacy. These criteria for subsequent listing are based on clinical outcome data but also reflect the reality of organ shortage. Lack of compliance and non-adherence to lifestyle changes represent relative contraindications to heart transplant candidacy. Mechanical circulatory support therapy using ventricular assist devices is becoming a more prominent therapeutic option for patients with end-stage heart failure who are not candidates for transplantation, which also requires strict criteria to enable beneficial outcome for the patient. Physicians need to critically reflect that in many cases, the patient’s best interest might not always mean pursuing maximal technological options available. This article reflects on the multitude of critical issues that health care providers have to face while caring for patients with end-stage heart failure.     

X-rated material and perpetration of sexually aggressive behavior among children and adolescents: is there a link?

Longitudinal linkages between intentional exposure to x-rated material and sexually aggressive behavior were examined among youth 10-15 year olds surveyed nationally in the United States. At Wave 1 in 2006, participants (n = 1,588) were queried about these exposures and outcomes in the preceding 12 months. Wave 2 data (n = 1,206) were collected approximately 12 months after Wave 1 and Wave 3 data (n = 1,159) were collected approximately 24 months after Wave 1. Thus, data for this project represent a 36-month time frame. A marginal model with generalized estimating equations was used to represent the population-average odds of sexually aggressive behavior over the 36 months as a function of exposure to x-rated material over the same time and to account for clustering in the data within person over time. An average of 5% of youth reported perpetrating sexually aggressive behavior and 23% of youth reported intentional exposure to x-rated material. After adjusting for other potentially influential proximal (i.e., sexual aggression victimization) and distal characteristics (e.g., substance use), we found that intentional exposure to violent x-rated material over time predicted an almost 6-fold increase in the odds of self-reported sexually aggressive behavior (aOR: 5.8, 95% CI: 3.2, 10.5), whereas exposure to nonviolent x-rated material was not statistically significantly related (aOR: 1.7, 95% CI: 0.94, 2.9). Associations were similar for boys and girls (boys nonviolent x-rated material aOR = 2.0, 95% CI: 0.8, 4.7; violent x-rated material aOR = 6.5, 95% CI: 2.7, 15.3; girls nonviolent x-rated material aOR = 1.2, 95% CI: 0.5, 3.2; violet x-rated material aOR = 6.1, 95% CI: 2.5, 14.8).     

Epistemology Without History is Blind

In the spirit of James and Dewey, I ask what one might want from a theory of knowledge. Much Anglophone epistemology is centered on questions that were once highly pertinent, but are no longer central to broader human and scientific concerns. The first sense in which epistemology without history is blind lies in the tendency of philosophers to ignore the history of philosophical problems. A second sense consists in the perennial attraction of approaches to knowledge that divorce knowing subjects from their societies and from the tradition of socially assembling a body of transmitted knowledge. When epistemology fails to use the history of inquiry as a laboratory in which methodological claims can be tested, there is a third way in which it becomes blind. Finally, lack of attention to the growth of knowledge in various domains leaves us with puzzles about the character of the knowledge we have. I illustrate this last theme by showing how reflections on the history of mathematics can expand our options for understanding mathematical knowledge.     

Resisting temptation of unhealthy food: interaction between temptation-elicited goal activation and self-control

Counteractive control theory suggests that the cognitive accessibility of a goal in response to a temptation cue predicts self-regulation of behaviour consistent with that goal. The current study provided a novel test of this effect in the eating domain, exploring the moderating role of trait self-control. A sample of 124 women (18–25 years) completed a lexical decision task to assess cognitive accessibility of the weight-management goal after food temptation priming. Eating self-regulation was operationalised as unhealthy snack food intake measured in a task disguised as a taste-test. Participants completed trait self-control and temptation experience intensity measures. Cognitive accessibility predicted lower food intake, but only among high self-control participants. The relationship was mediated by temptation experience intensity: participants with high cognitive accessibility felt less tempted, and subsequently ate less food. Results suggest that changing the processes underlying the temptation experience, rather than the cognitive accessibility of a goal may more effectively enhance self-regulation among low self-control individuals.     

RALPH BURHOE: RECONSIDERING THE MAN AND HIS VISION OF YOKING RELIGION AND SCIENCE

Ralph Wendell Burhoe was a leading figure in relating religion and science in the second half of the twentieth century. His autodidactic style and character as a public intellectual resulted in a vision that is comprehensive in its concern for the salvation of society. He does not fit easily into academic frameworks, even though he has been influential upon scholars who work in academia. This article discusses some conundrums posed by his work. There are also brief presentations of the concerns that motivated Burhoe, his style of work, and the content of his vision.     

Frontotemporal neural systems supporting semantic processing in Alzheimer’s disease

We hypothesized that semantic memory for object concepts involves both representations of visual feature knowledge in modality-specific association cortex and heteromodal regions that are important for integrating and organizing this semantic knowledge so that it can be used in a flexible, contextually appropriate manner. We examined this hypothesis in an fMRI study of mild Alzheimer’s disease (AD). Participants were presented with pairs of printed words and asked whether the words matched on a given visual–perceptual feature (e.g., guitar, violin: SHAPE). The stimuli probed natural kinds and manufactured objects, and the judgments involved shape or color. We found activation of bilateral ventral temporal cortex and left dorsolateral prefrontal cortex during semantic judgments, with AD patients showing less activation of these regions than healthy seniors. Moreover, AD patients showed less ventral temporal activation than did healthy seniors for manufactured objects, but not for natural kinds. We also used diffusion-weighted MRI of white matter to examine fractional anisotropy (FA). Patients with AD showed significantly reduced FA in the superior longitudinal fasciculus and inferior frontal-occipital fasciculus, which carry projections linking temporal and frontal regions of this semantic network. Our results are consistent with the hypothesis that semantic memory is supported in part by a large-scale neural network involving modality-specific association cortex, heteromodal association cortex, and projections between these regions. The semantic deficit in AD thus arises from gray matter disease that affects the representation of feature knowledge and processing its content, as well as white matter disease that interrupts the integrated functioning of this large-scale network.