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In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited from (...) KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)

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This paper describes a pilot study of a new model for narrative medicine training, “community-based participatory narrative medicine”, which centers on shared narrative work between healthcare trainees and patients. Nine medical students and eight patients participated in one of two, five-week-long pilot workshop series. A case study of participants’ experiences of the workshop series identified three major themes: the reciprocal and collaborative nature of participants’ relationships; the interplay between self-reflection and receiving feedback from others; and the clinical and pedagogical implications (...) of the CBPNM model. Principles and proposed outcomes of the CBPNM model are presented. (shrink)

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Some of the authors of the essays on Chinese philosophers prefer the pin yin system of romanization for Chinese names and words, while others prefer the Wade‐Giles system. Given that both systems are in wide use today, important names and words are given in both their pin yin and Wade‐Giles formulations. The author's preference is printed first, followed by the alternative romanization within brackets.

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The Indian Buddhist philosopher Vasubandhu is known for his critical contribution to Buddhist Abhidharma thought, his turn to the Mahayana tradition, and his concise, influential Yogacara-Vijñanavada texts. _Paving the Great Way_ reveals another dimension of his legacy: his integration of several seemingly incompatible intellectual and scriptural traditions, with far-ranging consequences for the development of Buddhist epistemology and the theorization of tantra. Most scholars read Vasubandhu's texts in isolation and separate his intellectual development into distinct phases. Featuring close studies of Vasubandhu's (...) _Abhidharmakosabhasya_, _Vyakhyayukti_, _Vimsatika_, and _Trisvabhavanirdesa_, among other works, this book identifies recurrent treatments of causality and scriptural interpretation that unify distinct strands of thought under a single, coherent Buddhist philosophy. In Vasubandhu's hands, the Buddha's rejection of the self as a false construction provides a framework through which to clarify problematic philosophical issues, such as the nature of moral agency and subjectivity under a broadly causal worldview. Recognizing this continuity of purpose across Vasubandhu's diverse corpus recasts the interests of the philosopher and his truly innovative vision, which influenced Buddhist thought for a millennium and continues to resonate with today's philosophical issues. An appendix includes extensive English-language translations of the major texts discussed. (shrink)

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We perceive colour, shape, sound and touch 'bound together' in a single experience. The following arguments about this binding phenomenon are raised: (1) The individual signals passing from neurone to neurone are not bound together, whether as elements of information or physically. (2) Within a single cell, binding in terms of bringing together of information is potentially feasible. A physical substrate may also be available. (3) It is therefore proposed that a bound conscious experience must be a property of an (...) individual cell, not of a group of cells. Since it is unlikely that one specific neurone is conscious, it is suggested that every neurone has a version of our consciousness, or at least some form of sentience. However absurd this may seem it appears to be consistent with the available evidence; arguably the only explanation that is. It probably does not alter the way we should expect to experience the world, but may help to explain the ways we seem to differ from digital computers and some of the paradoxes seen in mental illness. It predicts non-digital features of intracellular computation, for which there is already evidence, and which should be open to further experimental exploration. The arguments given may well prove flawed or the conclusion biologically or physically untenable, but the idea is raised for discussion not least because a formal demonstration that it is invalid may help to identify more fruitful avenues. (shrink)

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It is argued that both neuroscience and physics point towards a similar re-assessment of our concepts of space, time and 'reality', which, by removing some apparent paradoxes, may lead to a view which can provide a natural place for consciousness and language within biophysics. There are reasons to believe that relationships between entities in experiential space and time and in modern physicists' space and time are quite different, neither corresponding to our geometric schooling. The elements of the universe may be (...) better described not as 'particles' but as dynamic processes giving rise, where they interface with each other, to the transfer, and at least in some cases experience, of 'pure'or 'active'information, the mental and physical just reflecting different standpoints. Although this analy-sis draws on general features of quantum dynamics, it is argued that purely quantum level events (and their 'interpretations') are unlikely to be relevant to the understanding of consciousness. The processes that might be able to give rise, within brain cells, to an experience like ours are briefly reviewed. It is suggested that the elementary signals that are integrated to generate a spatial experience may have features more in common with words than pixels. It is further suggested that the laws of integration of words in language may provide useful clues to the way biophysical integration of signals in neurons relates to integration of elements in experiential space. (shrink)

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This book explores the religious concerns of Enlightenment thinkers from Thomas Hobbes to Thomas Jefferson. Using an innovative method, the study illuminates the intellectual history of the age through interpretations of Jesus between c.1650 and c.1826. The book demonstrates the persistence of theology in modern philosophy and the projects of social reform and amelioration associated with the Enlightenment. At the core of many of these projects was a robust moral-theological realism, sometimes manifest in a natural law ethic, but always associated (...) with Jesus and a commitment to the sovereign goodness of God. This ethical orientation in Enlightenment discourse is found in a range of different metaphysical and political identities which intersect with earlier ‘heretical’ tendencies in Christian thought. This intellectual matrix helped to produce the discourses of irenic toleration which are a legacy of the Enlightenment at its best. (shrink)

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Many Christian traditions affirm a doctrine of assurance. According to this doctrine, those who are saved have assurance of their own salvation; that is, the doctrine of assurance tells us that the elect can know their status as elect. In this paper, I explore two developments of the doctrine of assurance by theologians (i.e. John Calvin & Kenneth Keathley) and argue that they fail to accommodate the fallibilistic nature of human knowing. I then develop a fallibilistic doctrine of assurance, which (...) makes such assurance available to most Christians, and respond to an objection from the camp of pragmatic encroachment. (shrink)

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It was love at first sight whenJonathan Calvert saw the Matterhorn in 1953. Something in the way the mountain held sway over him inspired a lifelong passion for natural beauty and adventure. Over the next fifty years, Calvert climbed, hiked, trekked, sailed, kayaked, and dog-sledded in wild places across the globe, following his urge to know. And he hasn t quit yet. In July 2014, he will spend a month in Central Asia traveling the Silk Road through the (...) Pamirs and Tian Shan mountains. In 2015 Calvert returns to the Antarctic in a sailboat to kayak and camp. This book is a record of his adventures, told through memoir, journals, and photographs. Calvert has devoted his life to exploring the world and himself, and he has never gotten to the bottom of the wellspring that is curiosity. Calvert has walked in the footsteps of early explorers, camped above the clouds, come face-to-tusk with a walrus, and, within yards of a summit, talked down the inner voice that cajoled him to quit. He has stumbled into crevasses, kayaked in quiet waters above whales, suffered altitude sickness, and called his family via radio and cell phone relay from a precipitous ledge to say, I made it. Discovering early in life that striking out by himself got the job done best, Calvert is no stranger to singular travels and travails. Yes, he adventures with comrades roped in as a team, paddling together, or taking his turn at the ship s helm but ultimately the journey is one s own. Throughout his life, Calvert has jumped at chance after chance, among them: climbing Alaska s Mount McKinley, Argentina s Aconcagua, and mountains in Switzerland, France, Tanzania, and Nepal; trekking in Tibet, Bhutan, England, and Pakistan; and kayaking the coast of Greenland and the Zhupanova River in the Kamchatka Peninsula. Where s that? Explore these pages, and then you will know.". (shrink)

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The hemidesmosome is a complex junction containing many proteins. The keratin cytoskeleton attaches to its cytoplasmic plaque, while its transmembrane elements interact with components of the extracellular matrix. Hemidesmosome assembly involves recruitment of α6β4 integrin heterodimers, as well as cytoskeletal elements and cytoskeleton-associated proteins to the cell surface. In our cell culture models, these phenomena appear to be triggered by laminin-5 in the extracellular matrix. Cell interaction with laminin-5 apparently induces both phosphorylation and dephosphorylation of subunits of α6β4 integrin. There (...) is emerging evidence that such events are necessary for subsequent cytoskeleton anchorage to the hemidesmosome cytoplasmic plaque. Once assembled, the hemidesmosome plays an essential role in maintaining firm epithelial adhesion to the basement membrane, with hemidesmosome disruption being a hallmark of certain devastating blistering diseases. However, the hemidesmosome is more than just a stable anchor, as it may also be the site of signal transduction, mediated by its α6β4 integrin component. This review discusses our current knowledge of the structure and assembly of the hemidesmosome. BioEssays 20:488–494, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

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In the exceptional book _Divine Holiness and Divine Action_, Mark Murphy defends what he calls the _holiness framework _for divine action. The purpose of our essay-response to Murphy’s book is to consider an alternative framework for divine action, what we call the _agapist framework_. We argue that the latter framework is more probable than Murphy’s holiness framework with respect to_ select _theological desiderata.

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Performing Difference is a compilation of seventeen essays from some of the leading scholars in history, criticism, film, and theater studies. Each author examines the portrayal of groups and individuals that have been traditionally marginalized or excluded from dominant historical narratives. As a meeting point of several fields of study, this book is organized around three meta-themes: race, gender, and genocide. Included are analyses of films and theatrical productions from the United States, as well as essays on cinema from Southern (...) and Central America, Europe, and the Middle East. Topically, the contributing authors write about the depiction of race, ethnicities, gender and sexual orientation, and genocides. This volume assesses how the performing arts have aided in the social construction of the "other" in differing contexts. Its fundamental premise is that performance is powerful, and its unifying thesis is that the arts remain a major forum for advancing a more nuanced and humane vision of social outcasts, not only in the realm of national imaginations, but in social relations as well."--Jacket. (shrink)

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Several types of amygdala-dependent learning can be blocked by local infusion of NMDA antagonists into the amygdala. This blockade shows anatomical, pharmacological, temporal, and behavioral specificity, providing a pattern of data more consistent with a role for NMDA receptors in learning than in arousal or attention, and supporting the contention that an “LTP-like” process is a neural substrate for memory formation.

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The goal of this paper is to examine the impact of leadership and promotion regulatory focus on employees’ willingness to engage in unethical pro-organizational behavior . Building from a person–situation interactionist perspective, we investigate the interaction of leadership style and how leaders frame messages, as well as test a three-way interaction with promotion focus. Using an experimental design, we found that inspirational and charismatic transformational leaders elicited higher levels of UPB than transactional leaders when the leaders used loss framing, but (...) not gain framing. Furthermore, followers’ promotion regulatory focus moderated this relationship such that the effect held for followers with low promotion focus, but not for individuals with high promotion focus. Our findings extend the understanding of UPB, offer theoretical mechanisms to explain when this behavior occurs, and contribute to leadership theory and research on ethical decision making. (shrink)

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Some of the basic terminology of Yogācāra philosophy needs reevaluation. Whereas commentaries almost universally gloss the term dvaya ('duality') with some version of the phrase grāhya grāhaka ca (lit. 'grasped and grasper', but usually translated as 'subject and object'), in fact this gloss is absent from the earliest strata. The term and its gloss are derived from separate streams of Yogācāra reasoning - one from discussions of linguistic conceptualization and the other from discussions of perception. Once we see that these (...) two are distinct, it becomes clear that the commentarial literature asserts their identity in order to philosophically unify Yogācāra thought. One upshot of this is that even in this later assertion 'duality' refers not to the distinction between internal and external reality (as in 'textbook' Yogācāra), but to the falsely projected distinction between mental subjects and mental objects. (shrink)

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The Consensus Statement of the Third International Congress on Concussion in Sport in November 2008 defined concussion as a “complex pathophysiologic process affecting the brain, induced by traumatic biochemical forces.” Definitions of concussion vary slightly between various professional organizations of neurosurgeons, neurologists, and orthopedic surgeons, but all share the common characteristics of trauma affecting the head or body resulting in transient neurologic deficits or symptoms. Underlying the symptoms of concussion is a complex pathophysiologic process at the cellular level. While concussion (...) is typically thought of as resulting from a direct impact to the head, a concussion can also be sustained as a result of an impact to the body causing the force of the impact to be transmitted to and absorbed by the brain. (shrink)

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In a recent exchange with prominent skeptical theists, Paul Draper has argued that skeptical theism bears no relevance to Humean versions of the argument from suffering. His argument rests, however, on a particular way of construing epistemically rational updating procedures that is not adopted by all forms of skeptical theism. In particular, a perspectival variety of skeptical theism, I argue, is relevant to his Humean arguments. I then generalize this result and explain how any argument from evil employing probabilistic premises (...) is similarly threatened. (shrink)

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In this paper, I argue that no strong doctrine of the Fall can undermine the propriety of epistemic self-trust. My argument proceeds by introducing a common type of philosophical methodology, known as reflective equilibrium. After a brief exposition of the method, I introduce a puzzle for someone engaged in the project of self-reflection after gaining a reason to distrust their epistemic selves on the basis of a construal of a doctrine of the Fall. I close by introducing the worry as (...) a formal argument and demonstrate the self-undermining nature of such an argument. (shrink)

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A Critique of Western Buddhism: Ruins of the Buddhist Real, by Glenn Wallis. Bloomsbury Publishing, 2019. 232 pp., Hb. £90.00, ISBN-13: 9781474283557; Pb. £26.99, ISBN-13: 9781350155213.

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Giving an account of the relation between evolution and consciousness is painted as posing a dilemma between panpsychism, with minimal consciousness in every grain of matter, and radical emergence, with consciousness appearing as from nowhere in living structures. Panpsychism has been seen as suffering from a combination problem and radical emergence as unjustified in physics. The underpinning of physics now lies in field theory, which may provide a way out on both sides. Only, and always, in a field theory account (...) do influences at different points in spacetime combine in the same indivisible event. Radical emergence is also inherent to field theory. Moreover, by providing rich patterns of influence involving both discrete identities and quantitative values, field theory might provide a basis for sensed propositional meaning with subjects and predicates. Ordered condensed matter within living tissue may support unusual emergent dynamic units uniquely suited to building representations of the world with sensed meaning. The evolution of consciousness may then be seen as a tractable biological problem centred on increasingly sophisticated ways for external world dynamics to be mirrored by internal representations with semantic content, based in field relations within condensed matter with genetically encoded complex order. (shrink)

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Although psychologist impairment has received attention from researchers, there is a paucity of empirical data aimed at determining the point at which such impairment necessitates action. The purpose of this study was to provide such empirical data. Members of Division 42 ( n = 285) responded to vignettes describing a psychologist whose symptoms of either depression or substance abuse varied across five levels of severity. Results identified specific levels of impairment at which psychologists were deemed too impaired to practice psychotherapy, (...) as well as significant differences between ratings of increasingly severe impairment. Practical and ethical implications of these results are discussed. (shrink)

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This essay defends a Buddhist answer to the question of how a skeptical tradition might account for its moral position. Two domains in Buddhist thought and practice are often considered to be dissimilar, perhaps contradictory. On the one hand, there is an aspiration to nirvana and a philosophy that describes everything as “emptiness” and rejects, with apparent universality, “attachment to views.” On the other hand, Buddhist traditions of practice recommend actions based in compassion and loving kindness, and the cultivation of (...) contentment, introspective awareness, and peace of mind. It is argued that these arenas are not in conflict, but are linked through Buddhist psychology, wherein the proven limitations of concepts are quite explicitly leveraged to show that beings hampered by such limits ought to think and act with epistemic humility. The result is not nihilism, but a method for improving our perspectives on ourselves and our society—a method that may serve as a model for humanistic research. (shrink)

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This book explores and expounds upon questions of paradox and contradiction in theology with an emphasis on recent contributions from analytic philosophical theology. It addresses questions such as: What is the place of paradox in theology? Where might different systems of logic (e.g., paraconsistent ones) find a place in theological discourse (e.g., Christology)? What are proper responses to the presence of contradiction(s) in one's theological theories? Are appeals to analogical language enough to make sense of paradox? Bringing together an impressive (...) line-up of theologians and philosophers, the volume offers a range of fresh perspectives on a central topic. It is valuable reading for scholars of theology and philosophy of religion. (shrink)

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Several lines of evidence suggest that children born via Cesarean section are at greater risk for adverse health outcomes including allergies, asthma and obesity. Vaginal seeding is a medical procedure in which infants born by C-section are swabbed immediately after birth with vaginal secretions from the mother. This procedure has been proposed as a way to transfer the mother's vaginal microbiome to the child, thereby restoring the natural exposure that occurs during vaginal birth that is interrupted in the case of (...) babies born via C-section. Preliminary evidence indicates partial restoration of microbes. However, there is insufficient evidence to determine the health benefits of the procedure. Several studies, including trial, are currently underway. At the same time, in the clinic setting, doctors are increasingly being asked to by expectant mothers to have their babies seeded. This article reports on the current research on this procedure and the issues it raises for regulators, researchers, physicians, and patients. (shrink)

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