There is no sharp dividing line between science and philosophy, but philosophical problems tend to have three special features. First, they tend to concern large frameworks rather than specific questions within the framework. Second, they are questions for which there is no generally accepted method of solution. And third they tend to involve conceptual issues. For these reasons a philosophical problem such as the nature of life can become a scientific problem if it is put into a shape where it admits of scientific resolution. Philosophy in the 20th century was characterized by a concern with logic and language, which is markedly different from the concerns of earlier centuries of philosophy. However, it shared with the European philosophical tradition since the 17th century an excessive concern with issues in the theory of knowledge and with scepticism. As the century ends, we can see that scepticism no longer occupies centre stage, and this enables us to have a more constructive approach to philosophical problems than was possible for earlier generations. This situation is somewhat analogous to the shift from the sceptical concerns of Socrates and Plato to the constructive philosophical enterprise of Aristotle. With that in mind, we can discuss the prospects for the following six philosophical areas: (1) the traditional mind-body problem; (ii) the philosophy of mind and cognitive science; (iii) the philosophy of language; (iv) the philosophy of society; (v) ethics and practical reasons; (vi) the philosophy of science. The general theme of these investigations, I believe, is that the appraisal of the true significance of issues in the philosophy of knowledge enables us to have a more constructive account of various other philosophical problems than has typically been possible for the past three centuries. (+info)
A pilot study of cardiovascular risk assessment in Afro-Caribbean patients attending an inner city general practice.
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BACKGROUND: Afro-Caribbean ethnic minorities are at high risk of stroke and the sequelae of hypertension. OBJECTIVE: To investigate cardiovascular risk factors and Dundee risk rank in Afro-Caribbeans attending one inner city general practice and to find which methods of health promotion patients preferred. METHODS: We assessed cardiovascular risk including systolic and diastolic blood pressure in 98 patients of Afro-Caribbean origin. RESULTS: Fifty per cent of the patients had at least two risk factors for cardiovascular disease. Focus groups suggested that the barriers to effective health promotion included lack of risk awareness, cultural and lifestyle influences, time restrictions and language difficulties. CONCLUSIONS: The small pilot study highlights both the need for and some of the problems of GP-based cardiovascular health promotion in Afro-Caribbeans. (+info)
Imprecision in medical communication: study of a doctor talking to patients with serious illness.
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Uncertainty is believed to be a central feature in illness experiences. Conversations between a consultant hematologist and 61 seriously ill patients were transcribed, entered on a database and scrutinized for patterns of language uncertainty by linguistic concordancing analysis. Transcripts were then discussed in detail with the hematologist, and techniques of protocol analysis were used to gain insight into his thought processes during consultations. The main findings were that the doctor used many more expressions of uncertainty than did patients: that evaluative terms were widely used to reassure rather than to worry patients; and that patients and doctor together used certain key terms ambiguously, in a manner which allowed the doctor to feel that facts were not misrepresented while perhaps permitting the patient to feel reassured. (+info)
Assessment of hemispheric language lateralization: a comparison between fMRI and fTCD.
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The cerebral blood flow velocity (CBFV) in the basal arteries during a word-generation task was assessed by functional transcranial Doppler ultrasonography (fTCD) and by functional magnetic resonance imaging (fMRI). The study investigates how event-related CBFV modulations in the middle cerebral artery (MCA) relate to regional cerebral blood flow (rCBF) changes. Both fMRI and fTCD were used in 13 subjects (7 men, 6 women, aged 21 to 44 years). The maximum difference of relative CBFV changes between the left and right MCA during the word-generation task was used as the language laterality index (LIfTCD). For the fMRI examination during the nearly identical language task, the corresponding index was defined by LIfMRI = 100(N(L) - N(R))/(N(L) + N(R)), where N(L) and N(R) refer to the numbers of voxels activated in the left and right hemisphere, respectively. The evoked CBFV changes expressed by LIfTCD and the corresponding laterality index, LIfMRI, estimated by fMRI showed a close linear relation (regression analysis: r = 0.95, p < 0.0001). The results of this study demonstrate that language-related velocity changes in the MCAs relate to rCBF increases in a linear fashion. Since the laterality indices assessed by fMRI and fTCD are in such close agreement both techniques can therefore be used in a complementary way. (+info)
Public understanding of medical terminology: non-English speakers may not receive optimal care.
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INTRODUCTION: Many systems of telephone triage are being developed (including NHS Direct, general practitioner out of hours centres, ambulance services). These rely on the ability to determine key facts from the caller. Level of consciousness is an important indicator after head injury but also an indicator of severe illness. AIMS: To determine the general public's understanding of the term unconscious. METHODS: A total of 700 people were asked one of seven questions relating to their understanding of the term unconscious. All participants were adults who could speak sufficient English to give a history to a nurse. RESULTS: Correct understanding of the term unconscious varied from 46.5% to 87.0% for varying parameters. Those with English as their first language had a better understanding (p<0.01) and there was a significant variation with ethnicity (p<0.05). CONCLUSIONS: Understanding of the term unconscious is poor and worse in those for whom English is not a first language. Decision making should not rely on the interpretation of questions using technical terms such as unconscious, which may have a different meaning between professional and lay people. (+info)
Effect of language barriers on follow-up appointments after an emergency department visit.
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OBJECTIVE: To determine whether patients who encountered language barriers during an emergency department visit were less likely to be referred for a follow-up appointment and less likely to complete a recommended appointment. DESIGN: Cohort study. SETTING: Public hospital emergency department. PARTICIPANTS: English- and Spanish-speaking patients (N = 714) presenting with nonemergent medical problems. MEASUREMENTS AND MAIN RESULTS: Patients were interviewed to determine sociodemographic information, health status, whether an interpreter was used, and whether an interpreter should have been used. The dependent variables were referral for a follow-up appointment after the emergency department visit and appointment compliance, as determined by chart review and the hospital information system. The proportion of patients who received a follow-up appointment was 83% for those without language barriers, 75% for those who communicated through an interpreter, and 76% for those who said an interpreter should have been used but was not (P =. 05). In multivariate analysis, the adjusted odds ratio for not receiving a follow-up appointment was 1.92 (95% confidence interval [CI], 1.11 to 3.33) for patients who had an interpreter and 1.79 (95% CI, 1.00 to 3.23) for patients who said an interpreter should have been used (compared with patients without language barriers). Appointment compliance rates were similar for patients who communicated through an interpreter, those who said an interpreter should have been used but was not, and those without language barriers (60%, 54%, and 64%, respectively; P =.78). CONCLUSIONS: Language barriers may decrease the likelihood that a patient is given a follow-up appointment after an emergency department visit. However, patients who experienced language barriers were equally likely to comply with follow-up appointments. (+info)
Participation of the left posterior inferior temporal cortex in writing and mental recall of kanji orthography: A functional MRI study.
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To examine the neuropsychological mechanisms involved in writing kanji (morphograms), we used functional MRI (fMRI) in 10 normal volunteers, all right-handed, native Japanese speakers. The experimental paradigms consisted of kana-to-kanji transcription, mental recall of kanji orthography and oral reading and semantic judgement of kana words. The first two tasks require manual and mental transcription of visually presented kana words into kanji, respectively, whereas the last two tasks involve language processing of the same set of stimulus words without recall of kanji. The transcription and mental recall tasks yielded lateralized activation of the left posterior inferior temporal cortex (PITC). By contrast, neither oral reading nor semantic judgement produced similar activation of the area. These results, in good accordance with lesion data, provide converging evidence that the left PITC plays an important role in writing kanji through retrieval of their visual graphic images, and suggest language-specific cerebral organization of writing. The set of fMRI experiments also provides new neuroimaging data on the cortical localization of basic language functions in people using a non-alphabetical language. (+info)
Shared cognitive representations of perceptual and semantic structures of basic colors in Chinese and English.
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Two perceptual structures (based on colors) and one semantic structure (based on names) of eight basic chromatic colors were obtained from three judged similarity tasks for 41 Mandarin Chinese-speaking females in Taiwan and 35 English-speaking females in the United States. Major findings include the following: (i) there are robust and reliable individual differences among individuals, (ii) the structures for Chinese and English speakers are similar, and (iii) the semantic structure of color names is similar to the perceptual structures of colors. The results place strong constraints on theories relating to individual differences, linguistic relativity, and the relation of perceptual and semantic structures for colors. (+info)