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Empirical work has shown that patients and physicians have markedly divergent understandings of treatability statements (e.g., “This is a treatable condition,” “We have treatments for your loved one”) in the context of serious illness. Patients often understand treatability statements as conveying good news for prognosis and quality of life. In contrast, physicians often do not intend treatability statements to convey improvement in prognosis or quality of life, but merely that a treatment is available. Similarly, patients often understand treatability statements as conveying encouragement to hope and pursue further treatment, though this may not be intended by physicians. This radical divergence in understandings may lead to severe miscommunication. This paper seeks to better understand this divergence through linguistic theory—in particular, H.P. Grice’s notion of conversational implicature. This theoretical approach reveals three levels of meaning of treatability statements: (1) the literal meaning, (2) the physician’s intended meaning, and (3) the patient’s received meaning. The divergence between the physician’s intended meaning and the patient’s received meaning can be understood to arise from the lack of shared experience between physicians and patients, and the differing assumptions that each party makes about conversations. This divergence in meaning raises new and largely unidentified challenges to informed consent and shared decision making in the context of serious illness, which indicates a need for further empirical research in this area.
The impact of obsessive–compulsive disorder (OCD) on objective indicators of labour market marginalisation has not been quantified.
Linking various Swedish national registers, we estimated the risk of three labour market marginalisation outcomes (receipt of newly granted disability pension, long-term sickness absence and long-term unemployment) in individuals diagnosed with OCD between 2001 and 2013 who were between 16 and 64 years old at the date of the first OCD diagnosis (n = 16 267), compared with matched general population controls (n = 157 176). Hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regression models, adjusting for a number of covariates (e.g. somatic disorders) and stratifying by sex. To adjust for potential familial confounders, we further analysed data from 7905 families that included full siblings discordant for OCD.
Patients were more likely to receive at least one outcome of interest [adjusted HR = 3.63 (95% CI 3.53–3.74)], including disability pension [adjusted HR = 16.36 (95% CI 15.34–17.45)], being on long-term sickness absence [adjusted HR = 3.07 (95% CI 2.95–3.19)] and being on long-term unemployment [adjusted HR = 1.72 (95% CI 1.63–1.82)]. Results remained similar in the adjusted sibling comparison models. Exclusion of comorbid psychiatric disorders had a minimal impact on the results.
Help-seeking individuals with OCD diagnosed in specialist care experience marked difficulties to participate in the labour market. The findings emphasise the need for cooperation between policy-makers, vocational rehabilitation and mental health services in order to design and implement specific strategies aimed at improving the patients’ participation in the labour market.
Approximately half of the variation in wellbeing measures overlaps with variation in personality traits. Studies of non-human primate pedigrees and human twins suggest that this is due to common genetic influences. We tested whether personality polygenic scores for the NEO Five-Factor Inventory (NEO-FFI) domains and for item response theory (IRT) derived extraversion and neuroticism scores predict variance in wellbeing measures. Polygenic scores were based on published genome-wide association (GWA) results in over 17,000 individuals for the NEO-FFI and in over 63,000 for the IRT extraversion and neuroticism traits. The NEO-FFI polygenic scores were used to predict life satisfaction in 7 cohorts, positive affect in 12 cohorts, and general wellbeing in 1 cohort (maximal N = 46,508). Meta-analysis of these results showed no significant association between NEO-FFI personality polygenic scores and the wellbeing measures. IRT extraversion and neuroticism polygenic scores were used to predict life satisfaction and positive affect in almost 37,000 individuals from UK Biobank. Significant positive associations (effect sizes <0.05%) were observed between the extraversion polygenic score and wellbeing measures, and a negative association was observed between the polygenic neuroticism score and life satisfaction. Furthermore, using GWA data, genetic correlations of -0.49 and -0.55 were estimated between neuroticism with life satisfaction and positive affect, respectively. The moderate genetic correlation between neuroticism and wellbeing is in line with twin research showing that genetic influences on wellbeing are also shared with other independent personality domains.
This article analyzes a rich Swedish data set with information on the electoral turnout of a large sample of adoptees, their siblings, their adoptive parents, and their biological parents. We use a simple regression framework to decompose the parent-child resemblance in voting into pre-birth factors, measured by biological parents’ voting, and post-birth factors, measured by adoptive parents’ voting. Adoptees are more likely to vote if their biological parents were voters and if they were assigned to families in which the adoptive parents vote. We find evidence of interactions between the pre- and post-birth factors: the effect of the post-birth environment on turnout is greater amongst adoptees whose biological mothers are nonvoters. We also show that the relationships between parental characteristics, such as education, and child turnout, persist even in the absence of a genetic link between parent and child. The regression-based framework we utilize provides a basis for the integration of behavior-genetic research into mainstream political science.
Lateral moraines constructed along west to east sloping outlet glaciers from mountain centred, pre-last glacial maximum (LGM) ice fields of limited extent remain largely preserved in the northern Swedish landscape despite overriding by continental ice sheets, most recently during the last glacial. From field evidence, including geomorphological relationships and a detailed weathering profile including a buried soil, we have identified seven such lateral moraines that were overridden by the expansion and growth of the Fennoscandian ice sheet. Cosmogenic 10Be and 26Al exposure ages of 19 boulders from the crests of these moraines, combined with the field evidence, are correlated to episodes of moraine stabilisation, Pleistocene surface weathering, and glacial overriding. The last deglaciation event dominates the exposure ages, with 10Be and 26Al data derived from 15 moraine boulders indicating regional deglaciation 9600 ± 200 yr ago. This is the most robust numerical age for the final deglaciation of the Fennoscandian ice sheet. The older apparent exposure ages of the remaining boulders (14,600–26,400 yr) can be explained by cosmogenic nuclide inheritance from previous exposure of the moraine crests during the last glacial cycle. Their potential exposure history, based on local glacial chronologies, indicates that the current moraine morphologies formed at the latest during marine oxygen isotope stage 5. Although numerous deglaciation ages were obtained, this study demonstrates that numerical ages need to be treated with caution and assessed in light of the geomorphological evidence indicating moraines are not necessarily formed by the event that dominates the cosmogenic nuclide data.
A collection of lichens made in 1998 (by WQ) from the bark of Austrocedrus chilensis at a locality in southern Chile, disclosed two species of Pannaria not hitherto recorded from the Chilean lichen mycobiota (Galloway & Quilhot 1999): (1) the pantemperate taxon Pannaria conoplea (Ach.) Bory, which is widespread in the Northern Hemisphere as well as having rare outliers in East Africa, Venezuela, Ecuador and Australia (see Jørgensen 1978; Swinscow & Krog 1988; Jørgensen & Galloway 1992; Jørgensen & Arvidsson 2004), and (2) Pannaria tavaresii P. M. Jørg., known earlier from North America (including Mexico and Jamaica), Portugal, Macaronesia (Jørgensen 1978), Australia (Jørgensen & Galloway 1992), Sardinia and Italy (Nimis 1993) and previously collected in 1986 from near Valdivia in Chile. The discovery of Pannaria conoplea and P. tavaresii in Chile adds to the known Pannaria mycobiota of Chile (Galloway & Quilhot 1999), bringing the total number of species of this genus in Chile to 23. Eleven taxa formerly placed in Psoroma, are now correctly accommodated in Pannaria (see Jørgensen 2001b; Elvebakk & Galloway 2003; Jørgensen & Sipman 2004; Passo et al. 2004). Both Pannaria conoplea and P. tavaresii are within the currently accepted circumscription of Pannaria (Jørgensen 1994, 2004a, 2004b). Descriptions of the Chilean material are given below.
F. W. Maitland (1850–1906) was a legal historian who began and ended his intellectual career writing about some of the enduring problems of modern political thought – What is freedom? What is equality? What is the state? His first publication, printed privately in 1875, was an extended essay entitled ‘A historical sketch of liberty and equality as ideals of English political philosophy from the time of Hobbes to the time of Coleridge’. This sketch takes as its starting point the basic question, ‘What is it that governments ought to do?’, only to conclude that such questions are ‘not one[s] which can be decided by a bare appeal to first principles, but require much economic and historical discussion’. Among his final publications, written nearly thirty years later, are the series of shorter essays collected in this book, each of which addresses itself less directly but with equal force to the question of what it is that states, and by extension the governments of states, actually are. In between these excursions into political theory, Maitland produced the work on which his fame has come to rest, the historical investigations into the foundations and workings of English law and of English life which have gained him the reputation as perhaps the greatest of all modern historians of England.
Persons are either natural or artificial. The only natural persons are men. The only artificial persons are corporations. Corporations are either aggregate or sole.
This, I take it, would be an orthodox beginning for a chapter on the English Law of Persons, and such it would have been at any time since the days of Sir Edward Coke. It makes use, however, of one very odd term which seems to approach self-contradiction, namely, the term ‘corporation sole’, and the question may be raised, and indeed has been raised, whether our corporation sole is a person, and whether we do well in endeavouring to co-ordinate it with the corporation aggregate and the individual man. A courageous paragraph in Sir William Markby's Elements of Law begins with the words, ‘There is a curious thing which we meet with in English law called a corporation sole’, and Sir William then maintains that we have no better reason for giving this name to a rector or to the king than we have for giving it to an executor. Some little debating of this question will do no harm, and may perhaps do some good, for it is in some sort prejudicial to other and more important questions.
A better statement of what we may regard as the theory of corporations that is prevalent in England could hardly be found than that which occurs in Sir Frederick Pollock's book on Contract.