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In 'The Immorality of Horror Films' (International Journal of Applied Philosophy 20:2 [2006], 278), Gianluca Di Muzio argues that it is immoral to produce, distribute, or watch so-called 'slasher' or 'gorefest' films. Though I am sympathetic, I don't believe that his arguments warrant his conclusion. In this paper, I will respond to Di Muzio. In particular, I will focus on what I take to be his core argument, which is based on the idea that these films discourage morally appropriate reactions to human suffering. Then I will examine two objections to Di Muzio's position which he himself raises and dismisses, and I will argue that Di Muzio does not adequately refute either of the objections. Finally, I will conclude with some sympathetic remarks, and briefly consider what avenues we might pursue in order to argue for the immorality of at least some horror films.

The article discusses Philosopher, Francis Hutcheson's view on absolute beauty as non-epistemic. Topics include Hutcheson's perception of modern aesthetics, and its non-epistemic nature; the independent plausibility and strengths of his views that rely on epistemology, and focuses on external and internal senses.

The article analyzes the character Inara from the television series "Firefly" directed by Joss Whedon.

Though I enjoyed L. Kirk Hagen's article on Derrida ('The Death of Philosophy,' SKEPTIC, Vol. 11, No. 4, 2005), I was disturbed by some implications regarding recent academic philosophy that [...]

In this paper, I argue against the standard interpretation of Mill as a hedonistic utilitarian, and argue instead that Mill holds a 'eudaimonic' conception of happiness. I begin by clarifying exactly what I mean by a eudaimonic conception of happiness, and then examine the textual evidence for this eudaimonic interpretation, as well as the evidence against the standard hedonistic interpretation. Naturally, a great deal of the paper will revolve around an analysis of Mill's Utilitarianism, but special attention will also be paid to On Liberty, reading it as a development of Mill's moral theory rather than a mere application of it. [ABSTRACT FROM AUTHOR]

Severe traumatic brain injury (TBI) has been associated with increased mortality. This study characterizes long-term mortality, life expectancy, causes of death, and risk factors for death among patients admitted within the National Institute on Disability and Rehabilitation Research (NIDRR) TBI Model Systems Programs (TBIMS) who lack command following at the time of admission for inpatient TBI rehabilitation. Of the 8084 persons enrolled from 1988 and 2009, 387 from 20 centers met study criteria. Individuals with moderate to severe TBI who received inpatient rehabilitation were 2.2 times more likely to die than individuals in the U.S. general population of similar age, gender, and race, with an average life expectancy (LE) reduction of 6.6 years. The subset of individuals who were unable to follow commands on admission to rehabilitation was 6.9 times more likely to die, with an average LE reduction of 12.2 years. Relative to the U.S. general population matched for age, gender, and race/ethnicity, these non-command following individuals were more than four times more likely to die of circulatory conditions, 44 times more likely to die of pneumonia, and 38 times more likely to die of aspiration pneumonia. The subset of individuals with TBI who are unable to follow commands upon admission to inpatient rehabilitation are at a significantly increased risk of death when compared with the U.S. general population and compared with all individuals with moderate to severe TBI receiving inpatient rehabilitation. Respiratory causes of death predominate, compared with the general population.

Objective: To estimate the overall and by age-group characteristics at admission and discharge from rehabilitation between 2001 and 2010 of all late-teens and adults undergoing inpatient rehabilitation for a primary diagnosis of traumatic brain injury (TBI) in the United States., Design: Secondary data analysis., Setting: Acute inpatient rehabilitation facilities., Participants: Patients aged 16 years and older receiving inpatient rehabilitation for a primary diagnosis of TBI between 2001 and 2010., Main Outcome Measures: Functional independence, level of disability, and living situation., Results: The incidence of TBI by age group found the largest proportion of cases to be aged 80 years and older, with a gradual decline in incidence in the age group of 30 years, at which point there was a slight increase. Injuries resulted predominantly from falls (49.8%) and motor vehicle crashes (40.8%); however, injuries to the youngest individuals were largely from motor vehicle crashes with decreasing rates as age increased, while injuries due to falls rose as age increased, with the oldest age groups most likely to incur a TBI. Preinjury alcohol misuse and substance use were found to occur in 22.9% and 12.2% of the total population, respectively; however, age distributions demonstrated high preinjury use among individuals younger than 50 years (eg, 46.4% and 30.6% for those aged 20 and 29 years, respectively) with decreasing misuse as age increased. Of the total population, 49.2% were retired, 31.1% employed, 14.1% not working, and 5.6% students. Trends by age showed that younger individuals were more likely to be students or employed (eg, 14.5% and 62.0% for those aged 20 and 29 years, respectively), with employment status peaking for those aged 30 to 39 years, and declining to 3.2% for the oldest age group (80 years and older). The trend of person(s) living alone between pre- and postrehabilitation showed the least amount of change for those aged 16 to 19 years with steadily increasing changes as age increased. Similar trends were seen for residence changes pre- and postrehabilitation, with the youngest most likely to return to living at a private residence, and a gradual decrease in return to living at a private residence as age increased. FIM instrument ("FIM") Motor and Cognitive subscale scores demonstrated that younger individuals had lower scores at admission to rehabilitation and higher scores at rehabilitation discharge., Conclusion: This study provides population estimates for all patients 16 years of age and older receiving inpatient rehabilitation for a primary diagnosis of TBI in the United States between 2001 and 2010. A recent trend shows the aging of the inpatient TBI rehabilitation population. Many characteristics important to rehabilitation outcomes are influenced by age, with older individuals trending toward being female, having less severe TBIs, incurring TBIs as a result of falls, but showing less improvement during rehabilitation, greater resulting disability, and more changes in their living situation postrehabilitation. These findings are of particular interest, as the oldest age groups considered in these analyses did not include the baby boom population.

The purpose of this study was to determine whether there are underlying dimensions common among traditional traumatic brain injury (TBI) severity indices and, if so, the extent to which they are interchangeable when predicting short-term outcomes. This study had an observational design, and took place in United States trauma centers reporting to the National Trauma Data Bank (NTDB). The sample consisted of 77,470 unweighted adult cases reported to the NTDB from 2007 to 2010, with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) TBI codes. There were no interventions. Severity indices used were the Emergency Department Glasgow Coma Scale (GCS) Total score and each of the subscales for eye opening (four levels), verbal response (five levels), and motor response (six levels); the worst Abbreviated Injury Scale (AIS) severity score for the head (six levels); and the worst Barell index type (three categories). Prediction models were computed for acute care length of stay (days), intensive care unit length of stay (days), hospital discharge status (alive or dead), and, if alive, discharge disposition (home versus institutional). Multiple correspondence analysis (MCA) indicated a two dimensional relationship among items of severity indexes. The primary dimension reflected overall injury severity. The second dimension seemed to capture volitional behavior without the capability for cogent responding. Together, they defined two vectors around which most of the items clustered. A scale that took advantage of the order of items along these vectors proved to be the most consistent index for predicting short-term health outcomes. MCA provided useful insight into the relationships among components of traditional TBI severity indices. The two vector pattern may reflect the impact of injury on different cortical and subcortical networks. Results are discussed in terms of score substitution and the ability to impute missing values.

Background: Clinical outcomes data are playing an increasingly important role in medical decision-making, reimbursement, and provider evaluation, but there are no documented programs that provide outcomes data to surgical residents as part of a structured curriculum. Our objectives were to develop a national collaborative of training programs to unify the efforts between quality and education personnel and demonstrate the feasibility of generating customized reports of patient outcomes for use in surgical education., Study Design: The pool of potential hospitals was evaluated by comparing ACS NSQIP participants with the roster of clinical sites for general surgery residency programs maintained by FREIDA Online. A program and user guide was developed to generate custom reports based on institutional data, and a voluntary pilot was conducted, consisting of initial development, implementation, and feedback stages. Programs that successfully completed installation and report generation were queried for feedback on time and resources used., Results: Of 245 general surgery residency programs, 47% had a NSQIP-affiliated sponsor institution, and an additional 31% had at least 1 NSQIP-affiliated participant institution. Sixty general surgery residency programs have expressed interest in collaboration. Seventeen pilot sites completed training and installation, and were able to independently generate custom reports. The response rate for the post-report survey was 50%. Participants reported that training and installation typically required one 2-hour phone call, and that total time devoted to the project was less than 8 hours., Conclusions: Collaboration between educators and quality improvement personnel from a diverse group of organizations to integrate outcomes data into surgical education is feasible. Obtaining resident and team reports from ACS NSQIP can be done with minimal effort. Future efforts will be aimed at developing a national data-centered curriculum for general surgery programs., (Copyright © 2013 American College of Surgeons. All rights reserved.)

Establishing accurate mathematical models of outcome measures is essential in understanding change throughout the rehabilitation process. The goal of this study is to identify the best-fitting descriptive models for a set of commonly adopted outcome measures found within the Traumatic Brain Injury Model Systems National Database where the modeling is based on data submission through 2011 and the complete range of recorded time points since injury for each individual, where time points range from admission to rehabilitation to 20 years postinjury. The statistical methodology and the application of the methodology contained herein may be used to assist researchers and clinicians in (1) modeling the outcome measures considered, (2) modeling various portions of these outcomes by stratification and/or truncating time periods, (3) modeling longitudinal outcome measures not considered, and (4) establishing models as a necessary precursor in conducting individual growth curve analysis., (Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

The abundance of time-dependent information contained in the Spinal Cord Injury and the Traumatic Brain Injury Model Systems National Databases, and the increased prevalence of repeated-measures designs in clinical trials highlight the need for more powerful longitudinal analytic methodologies in rehabilitation research. This article describes the particularly versatile analytic technique of individual growth curve (IGC) analysis. A defining characteristic of IGC analysis is that change in outcome such as functional recovery can be described at both the patient and group levels, such that it is possible to contrast 1 patient with other patients, subgroups of patients, or a group as a whole. Other appealing characteristics of IGC analysis include its flexibility in describing how outcomes progress over time (whether in linear, curvilinear, cyclical, or other fashion), its ability to accommodate covariates at multiple levels of analyses to better describe change, and its ability to accommodate cases with partially missing outcome data. These features make IGC analysis an ideal tool for investigating longitudinal outcome data and to better equip researchers and clinicians to explore a multitude of hypotheses. The goal of this special communication is to familiarize the rehabilitation community with IGC analysis and encourage the use of this sophisticated research tool to better understand temporal change in outcomes., (Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To determine whether use of neighborhood characteristics derived from U.S. Census Bureau information contributes to the prediction of outcomes after traumatic brain injury (TBI) beyond the variance accounted for by individual characteristics., Design: Cross-sectional analysis of follow-up interviews conducted 1, 2, and 5 years postinjury., Setting: Twelve Traumatic Brain Injury Model Systems (TBIMS) centers., Participants: Patients 16 years of age and older with moderate or severe TBI enrolled in the TBIMS National Database (N=472)., Interventions: None., Main Outcome Measures: Satisfaction With Life Scale and Participation Assessment with Recombined Tools-Objective., Results: Individual characteristics alone accounted for 26% and 48% of variance in life satisfaction and participation, respectively; neighborhood characteristics alone accounted for 6% and 9% of variance, respectively. Models combining both types of characteristics included significant neighborhood and individual predictors for participation but not life satisfaction; however, for participation, prediction only improved beyond that found for individual characteristics alone by 1.2%., Conclusions: The results did not support the hypotheses that characteristics of a person's neighborhood would increase outcome prediction beyond that which can be accomplished based on characteristics of the individual alone. Though neighborhood characteristics were statistically significant in prediction models, the improvement in percent of variance accounted for was negligible. Refinements in conceptualization and methodology are suggested for continued exploration of the contribution of neighborhood characteristics to TBI outcomes., (Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Venous thromboembolism (VTE) remains a clinical problem in surgical oncology. We report the impact of preoperative initiation of subcutaneous heparin on VTE events after pancreatic surgery., Methods: A retrospective cohort study of patients undergoing pancreatic surgery by a single surgeon and enrolled in the American College of Surgeons National Surgery Quality Improvement Program database (FY09/10) was performed. In FY10, a protocol was developed to encourage the use of preoperative pharmacoprophylaxis for high-risk patients. We compared patient characteristics before and after implementation of the protocol. Our primary outcome was 30-day VTE rate and secondary outcomes were bleeding events and 30-day mortality. Outcomes were compared by Student's t-test and Fisher's exact test., Results: Seventy-three patients were studied, 34 patients underwent surgery before and 39 had surgery after implementation of the protocol. All patients received intra-operative intermittent compression boots (ICB) and postoperative pharmacoprophylaxis. Patients in the two groups were statistically equivalent with respect to age, body mass index, procedure length, and VTE risk factors. The percentage of patients with a VTE event decreased significantly after the protocol (17.6% vs. 2.6%, P=0.035). The mean number of units of red blood cells transfused in the OR was not statistically different (0.4 vs. 0.7, P=0.43.) Two patients returned to the operating room for bleeding after the implementation of the protocol. There were no deaths., Conclusions: Intraoperative ICBs with postoperative initiation of subcutaneous heparin pharmacoprophylaxis may be inadequate for VTE prophylaxis for high risk patients. The use of a preoperative dose of subcutaneous heparin in high-risk pancreatic surgery patients resulted in a statistically significant reduction of VTE events.

The medical supplies appropriate for travel will quite naturally depend on the individual and on the nature, scope, and duration of the trip being planned. A basic kit containing nonmedicinal supplies, nonprescription drugs, and prescription medications can be a starting point in planning for both lay and physician travelers, however. Although medical responsibility for assisting in emergency situations during travels as well as liability differ from location to location, in general the physician should not hesitate to give aid in perceived situations of need.

Several risks can be posed by travel, even when the stay is not protracted nor the destination exotic. Air travelers should consider the potential problems associated with decreased cabin pressure, hypoxia, and circadian dysrhythmia, problems that can contraindicate flying for some. Motion sickness can affect those traveling by air, sea, or land; medications are available to combat the symptoms, and several other remedies such as changing visual stimuli are also worth trying. Persons staying in hotels, particularly high rises, should review several general guidelines for defensive action in case of fire and should become familiar with the physical layout and escape routes of the building in which they are staying.

Various medical conditions--cardiovascular and pulmonary problems, thrombosis, diabetes, and others--can present special risks and/or problems in travel. These should be discussed as part of a thorough predeparture evaluation with affected patients who are planning overseas travel. In addition, certain travelers may require medical follow-up on their return. Various travel medicine resource organizations, booklets, and books should be made known to all travelers.