Kripke's Second Paragraph of Philosophical Investigations 201

The received view of Kripke's Wittgenstein on Rules and Private Language is that it fails as an interpretation because, inter alia, it ignores or overlooks what Wittgenstein has to say in the second paragraph of Philosophical Investigations (PI) 201. In this paper, I demonstrate that the paragraph in question is in fact fully accommodated within Kripke's reading, and cannot therefore be reasonably utilised to object to it. In part one I characterise the objection; in part two I explain why it fails; in part three I suggest why commentators might have been motivated to offer it; and in part four I claim that two commentators who have offered it also imply otherwise.     

Randomized controlled trial of an intervention to prevent adherence failure among HIV-infected patients initiating antiretroviral therapy.

OBJECTIVE: Compare the efficacy of a multicomponent social support intervention to standard-of-care counseling on medication adherence among HIV-infected patients initiating antiretroviral therapy. DESIGN: Randomized controlled trial. Generalized estimating equations tested for differences in the percentage of participants achieving 90% adherence. MAIN OUTCOME MEASURES: Pill-taking, electronically monitored over 6 consecutive months; plasma viral load (VL), assessed at 3 and 6 months following initiation of therapy. RESULTS: Of 226 participants who were randomized and began the trial, 87 (38%) were lost to the study by 6 months. The proportion of adherent participants declined steadily over time, with no time by group interaction. Sustained adherence was associated with increased odds of achieving an undetectable VL (OR=1.78; 95% CI=1.01, 3.13). In intention-to-treat analyses, a larger proportion of the intervention group than the control group was adherent (40.15% vs. 27.59%, p=.02) and achieved an undetectable VL p=.04). However, the majority of participants who remained on study experienced some reduction in VL (>or=1-log drop or undetectable), regardless of experimental condition. CONCLUSION: The multicomponent social support intervention significantly improved medication adherence over standard-of-care counseling; evidence for improved virologic outcomes was inconsistent. Early discontinuation of care and treatment may be a greater threat to the health of HIV patients than imperfect medication-taking.     

II—Véronique Munoz-Dardé

ABSTRACT Are there distinctively political values? Certain egalitarians seem to think that equality is one such value. Scheffler's contribution to the symposium seeks to articulate a division of moral labour between norms of personal morality and the principles of justice that regulate social institutions, and using this suggests that the egalitarian critique of Rawls can be deflected. In this paper, instead, I question the status of equality as an intrinsic value. I argue that an egalitarianism which focuses on the status of equality as valuable in itself embraces a theory of value with the worst elements of utilitarianism (in particular its consequentialism) while leaving behind any of the intuitive appeal that utilitarianism has. In its place I press that we need a political conception of egalitarianism which stresses the role of equality as a political ideal without presupposing any values with which we engage beyond those found in the norms of personal morality.     

The Rate and Characteristics of Suicide Attempters in the Native Hawaiian Adolescent Population

Native Hawaiian high school students, N = 1779, were surveyed for symptoms of psycho-pathology and suicide attempts in the previous 6 months. Seventy-seven (4.3%) of the students reported making a suicide attempt. There were no significant differences in prevalence rates for males and females. Depression, anxiety, aggression, substance abuse symptoms, and low family support, but not peer support, were significantly correlated with suicide attempts. On logistic regression, depression, substance abuse, and family support independently predicted attempts. The lack of gender difference may indicate a cultural characteristic of the Hawaiian population that differentiates it from mainstream American populations but likens it to the Native American population.