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Socrates and temporal lobe epilepsy: a pathographic diagnosis 2,400 years later.

PURPOSE: Some enigmatic remarks and behaviors of Socrates have been a subject of debate among scholars. We investigated the possibility of underlying epilepsy in Socrates by analyzing pathographic evidence in ancient literature from the viewpoint of the current understanding of seizure semiology. METHODS: We performed a case study from a literature survey. RESULTS: In 399 BCE, Socrates was tried and executed in Athens on the charge of "impiety." His charges included the "introduction of new deities" and "not believing in the gods of the state," because he publicly claimed that he was periodically and personally receiving a "divine sign," or daimonion, that directed him in various actions. We found textual evidence that his daimonion was probably a simple partial seizure (SPS) of temporal lobe origin. It was a brief voice that usually prohibited Socrates from initiating certain actions. It started when he was a child, and it visited Socrates unpredictably. Moreover, we found at least two descriptions of Socrates' unique behavior that are consistent with complex partial seizures (CPSs). The fact that Socrates had been experiencing both SPSs and CPSs periodically since childhood makes the diagnosis of temporal lobe epilepsy (TLE) likely. CONCLUSIONS: We hypothesize that Socrates had a mild case of TLE without secondary generalization. This is the first report in 2,400 years to present a pathographic diagnosis of TLE in Socrates based on specific diagnostic features in the ancient textual evidence. Our study demonstrates that the knowledge of modern epileptology could help understand certain behaviors of historic figures.

Epilepsy, Temporal Lobe↗

Factor structure of the SOCRATES in a sample of primary care patients.

Motivation or readiness to change has been studied intensively in recent years in research on the use of brief interventions to change alcohol problems in the primary care setting. The purpose of this study was to investigate the factor structure and concurrent and predictive evidence for validity of the short Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), a 19-item self-report instrument developed to measure readiness to change alcohol problems in individuals presenting for specialized alcohol treatment. The participants were 210 men and 91 women who were identified as "at-risk" drinkers in 13 community primary care clinics. These individuals completed the SOCRATES and a number of other assessments as part of a preintervention evaluation. A principal components analysis of the SOCRATES data revealed a two-factor structure: a confirmatory factor analysis showed that this structure was a better fit to the data than the three-factor structure that Miller and Tonigan (1996) identified for the SOCRATES. The two factors (9 and 6 items, respectively), seemed to measure perceived degree of severity of an existing alcohol problem (called "Amrec" because it consisted of Miller and Tonigan's ambivalence and recognition items) and taking action to change or to maintain changes in one that exists (called "Taking Steps"). Predictions of significant and nonsignificant correlations between the two derived factors and other baseline variables (alcohol consumption, related problems and symptoms, and demographic factors) generally were confirmed. In addition, baseline Amrec scores were related in predicted directions to 6-month alcohol consumption and related problems data, but the magnitude of these relationships were reduced when other variables that correlated with Amrec or when the 6-month data were taken into account. In general, Taking Steps showed little or no relationship to the 6-month data. The results are compared to previous work with the SOCRATES and suggestions for future research are discussed.

Adult↗

Scofield as Socrates.

Well, as Socrates exclaimed, "By the dog, Gorgias, there will be a great deal of discussion before we get to the truth of all this." In the course of that discussion, we will find that Mr. Scofield does ask many very pertinent questions about the nature and teaching of ethics. Each question is worth examining in itself. But somewhere along the line, he has wandered into exaggerations, rhetoricities, and illogicisms that make it difficult to "get to the truth of all this." If we were being truly Socratic, I would test each assertion and allow him to respond in turn, and he could question me. In so doing, we might elucidate the ideas behind ethics consultation and evaluate its worth. We might then learn, as Socrates would have us learn, how much we do not know. We might also learn, as Socrates desired, how to pursue the elusive answers. Unfortunately, in this essay, Scofield fails as Socrates.

Decision Making↗

An epistemologically arrogant community of contending scholars: a pre-Socratic perspective on the past, present, and future of the Pavlovian Society.

UNLABELLED: The paper begins with a statement of the Society's purpose and its pre-Socratic roots. The Society differs from other contemporary scientific and scientific-professional societies in that it is thoroughly apolitical, unusually open to discussion and debate, and has had a restricted scholarly written impact. I then suggest and interpret six phases in the Society's history: (1) the pre-Socratic roots; (2) Pavlov and the young Gantt; (3) the Society's Gantt score of years; (4) the Joe McGuigan decade; (5) the Stewart Wolf era; (6) reforming the Society. I conclude with the hope that even if the content of the Society's interests changes, it will preserve the pre-Socratic approach against the various forms of intellectual barbarism that continue to arise. KEYWORDS: Pre-Socratics, disinterested discussion, conflict of ideas, contending scholars, Pavlovian procedures

History, 19th Century↗

Socrates' questions: a focus for nursing.

This column focuses on the philosophical dialogue originated by Socrates. Six questions that Socrates would ask the ancient Greeks are explored in discussing a book written by Phillips entitled Six Questions of Socrates. These questions were: What is virtue? What is moderation? What is justice? What is good? What is courage? What is piety? A human becoming perspective is used as a lens to view the discussion on these questions and the question is posed, "What would it be like to frame discussions on health and quality of life around Socrates' questions?" Parse's teaching-learning processes are presented as a means of creating an environment where dialogue on these questions can occur.

Communication↗

The Socratic method in teaching medical ethics: potentials and limitations.

The Socratic method has a long history in teaching philosophy and mathematics, marked by such names as Karl Weierstrass, Leonard Nelson and Gustav Heckmann. Its basic idea is to encourage the participants of a learning group (of pupils, students, or practitioners) to work on a conceptual, ethical or psychological problem by their own collective intellectual effort, without a textual basis and without substantial help from the teacher whose part it is mainly to enforce the rigid procedural rules designed to ensure a fruitful, diversified, open and consensus-oriented thought process. Several features of the Socratic procedure, especially in the canonical form given to it by Heckmann, are highly attractive for the teaching of medical ethics in small groups: the strategy of starting from relevant singular individual experiences, interpreting and cautiously generalizing them in a process of inter-subjective confrontation and confirmation, the duty of non-directivity on the part of the teacher in regard to the contents of the discussion, the necessity, on the part of the participants, to make explicit both their own thinking and the way they understand the thought of others, the strict separation of content level and meta level discussion and, not least, the wise use made of the emotional and motivational resources developing in the group process. Experience shows, however, that the canonical form of the Socratic group suffers from a number of drawbacks which may be overcome by loosening the rigidity of some of the rules. These concern mainly the injunction against substantial interventions on the part of the teacher and the insistence on consensus formation rooted in Leonard Nelson's Neo-Kantian Apriorism.

Education, Medical↗

Factor structure of the SOCRATES in a clinical sample of adolescents.

This study investigated the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES; W. R. Miller & J. S. Tonigan, 1996) in adolescents presenting for treatment of alcohol use disorder (AUD). The participants were 80 males and 43 females (mean age = 16.8 years) who presented for AUD treatment (95.1% outpatient, 4.9% inpatient). Participants completed assessments at baseline and 1 year and provided information on alcohol use and related variables monthly between these 2 assessments. Principal-components and confirmatory factor analyses of the baseline SOCRATES identified 2 factors, Taking Steps and Recognition, which showed good internal consistency and concurrent and predictive evidence of validity. The results were interpreted as supporting the use of the SOCRATES with clinical samples of adolescents.

Adolescent↗

[Factor structure of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) in alcohol dependent outpatients].

OBJECTIVE: The aim of this study was to investigate the reliability and factor structure of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), version 8, a 19-item self-reported instrument developed to measure readiness to change in alcohol-dependent alcoholics. METHODS: A Confirmatory Factor analysis of the SOCRATES was performed based on the factor structures previously demonstrated by Miller & Tonigan and Maisto et al. in a sample with 326 alcohol-dependent outpatients. The questionnaire was translated into Portuguese, cross-culturally adapted and back-translated into English. During this process SOCRATES underwent some modifications to simplify some complex question formats. RESULTS: The analysis showed that two correlated factors provided the best fit for the data and that these were similar to Maisto et al.'s factors. CONCLUSIONS: There was less evidence to support a three-factor structure. The results are compared to previous studies and the reasons for discrepancies are discussed.

Alcohol Drinking↗

The psychometric properties of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) in a clinical sample of active duty military service members.

The increasing prominence of the construct of readiness to change in the field of substance abuse treatment has led to the development of instruments designed to assess the construct. We examined the psychometric properties of one such instrument, the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), in a sample of treatment-seeking, active duty, U.S. military service members diagnosed with alcohol and/or drug dependence. A principal components analysis of the items was consistent with the tridimensional structure of the SOCRATES found among treatment-seeking civilians but resulted in a 14-item scale, as opposed to the 19-item version found for civilians. Normative data, in the form of means and decile rankings for the SOCRATES subscales, for substance-dependent military patients are provided to complement those available for civilian patients. Future research should examine the concurrent and predictive validity of the scale.

Adolescent↗

Care of older people in nursing homes: an Intensive Programme as an educational activity within Erasmus-Socrates.

The paper describes and discusses an Intensive Programme as a European educational activity within Erasmus-Socrates. As nurses and European citizens, it is important to know and understand each other's culture and to be able to work within a united Europe. Education plays a leading role in the preparation of professionals who will have to develop these skills. Based on the aims of Erasmus-Socrates, an Intensive Programme entitled 'Care of Older People in Nursing Homes' was designed, sponsored, and implemented over three continuous academic years with the participation of five European countries. The topic was selected due to its importance for Europe, as it is a region with an ageing population. A wide range of themes was covered using lectures, group discussion, exercises and study visits as teaching strategies. Evaluation suggests that the aims of the programme were achieved.

Aged↗

Learning considered within a cultural context. Confucian and Socratic approaches.

A Confucian-Socratic framework is used to analyze culture's influence on academic learning. Socrates, a Western exemplar, valued private and public questioning of widely accepted knowledge and expected students to evaluate others' beliefs and to generate and express their own hypotheses. Confucius, an Eastern exemplar, valued effortful, respectful, and pragmatic acquisition of essential knowledge as well as behavioral reform. Expressions of these approaches in modern postsecondary contexts are discussed, as are the effects these approaches may have for students who either fit or do not fit the cultural ideal.

Culture↗

Transforming pathophysiology instruction through narrative pedagogy and Socratic questioning.

Pathophysiology, heavily content driven, has typically been taught through the use of traditional behavioral pedagogy and a reliance on the formal lecture. The author describes the limitations of this approach to teaching pathophysiology and describes the use of narrative pedagogy and Socratic questioning as alternative methods of instruction to augment lecture methods. Specific strategies for transforming traditional classroom teaching by using Socratic questions in a pathophysiology course for nurse practitioners are described. Student and faculty reactions to the initial efforts to transform pathophysiology instruction are also described.

Education, Nursing, Graduate↗

A socratic dialogue on the question 'what is love in nursing?

It is the thesis of the authors that the caring ethic and moral state of being of nurses ideally suffuses their professional caring and is thus implicit in their ethical decision making. Socratic dialogue is a technique that allows such moral attitudes to be made explicit. This article describes a Socratic dialogue conducted with nurses on the topic: 'What is love in nursing?' The conclusions drawn were based on the belief that the current western-style health care system restricts the practice of nursing in such a way as to limit professional caring and loving possibilities. Nurses who love in the practice of caring go beyond the role definition of the duty of care; they are people who are prepared to think differently about their practice as professionals, and are identified as competent risk takers committed to the betterment of the other. From this dialogue, 'love in nursing' was understood as the willingness and commitment of the nurse to want the good of the other before the self, without reciprocity.

Ethics, Nursing↗

[The extraction of truth: apropos of the Socratic dialogue].

The socratic dialogue is a philosophical method that enables colleagues to investigate which judgements people have about their experiences and how these judgements can be based. In this article, the reader will learn more about the historical background, the organisation, the levels of dialogue, the role of the facilitator. We also pay attention to the results that a regular practise of socratic dialogue can have for professional dentists. The most important one is a growing sensitivity and lucidity in the daily social life with patients and colleagues. In the dialogue, this can be practiced by sharpening the moral perception of concrete details in the lived experience.

Dentist-Patient Relations↗

General practice based teaching exchanges in Europe. Experiences from the EU Socrates programme 'primary health care'.

This paper reviews the experience of international exchange of medical students for general practice. The experience is based on the EU Socrates programme 'Primary Health Care' that offers, since 1992, clinical attachments and research electives in primary care. This programme involves 11 university departments of general practice/primary care in eight countries: Austria - Vienna; Belgium - Gent; Germany Düsseldorf; Italy - Monza, Udine; Netherlands Nijmegen; Slovenia - Ljubljana; Sweden - Göteborg; and the UK - Edinburgh, Imperial College London and Nottingham. More than 150 students have taken part in the programme, most in the last four years. For clinical attachment communication to patients is essential, and students should be able to speak the language of the host university. A research elective in primary care is less demanding and requires students' ability to communicate in English. Despite marked differences in health care structure in the countries involved, it is quite possible to provide a valuable teaching environment in general practice, and the experience gained by students in the exchanges more than equals that what they would gain at home. The added value is in experiencing the influence of another health care system and of working in another academic primary care centre. A substantial number of research electives have been published in international peer reviewed scientific journals with the student as first (occasionally second) author and staff members of the student's host and home university as co-authors. A further benefit of the exchange programme lies in the transfer teaching innovations between universities.

Education, Medical↗