What moral character is and is not.

Louise Mitchell discusses character in "Integrity and virtue: The forming of good character" (The Linacre Quarterly 82, no. 2: 149-169). I argue that she is mistaken in identifying character as a potency and that it is rather the sum of one's moral habits and dispositions. I establish this by showing that if one correctly applies the division Aristotle presents in the text that Mitchell relies on, it follows that character belongs in the category of habit. I further support this conclusion by considering how people commonly speak of moral character. I then show that the text from the Summa Theologiae Mitchell relies on concerns sacramental character and not moral character; moreover, if we apply the reasoning contained there to moral character, we are again led to see that it should be categorized as a habit. Lastly, I explain that a human being's potency for character lies in the soul's rational powers. SUMMARY: I defend the common-sense view that moral character is the sum of one's moral habits and dispositions in response to Louise Mitchell who maintains that moral character is a potency. I do so by applying Aristotle's threefold division of things that exist in the soul-namely, potency, habit, and emotion-and also by examining how Aristotle speaks about character and how the average person speaks about character. In addition, I show why humans are the only animals that have the potential to develop character, and how this potential lies in the rational faculties of our soul.

Factors associated with caregivers' underestimation of quality of life in patients with Alzheimer's disease.

OBJECTIVE: The aim of this study was to identify the factors associated with differences between how Alzheimer's disease (AD) patients and their caregivers rate the patient's health-related quality of life (QoL). METHODS: Cross-sectional, multicentre study. Patients were 65 years or more, suffering from mild to moderate AD, native French speakers, with a main caregiver. Interrater agreement of the QoL-AD was assessed using the intraclass coefficient. A generalised linear model was used to identify factors related to the difference in health-related QoL scores between patients and their caregivers. RESULTS: The 122 patients of the study were 82 ± 6 years old and mainly women (69%). Independent factors related to the difference between patients and caregivers were: Mini Mental State Exam score (ß = 0.32; 95% CI = 0.05-0.59); instrumental activities of daily living score (ß = -0.61; 95% CI = -1.14 to -0.07); total Neuropsychiatric Inventory score (ß = 0.10; 95% CI = 0.05-0.59), and Zarit's burden score (ß = 0.09; 95% CI = 0.01-0.17). CONCLUSION: Practitioners must take into account the trend towards underestimation when health-related QoL is rated by caregivers or proxies.

Rearranging the world: neural network supporting the processing of temporal connectives.

Temporal connectives (before/after) give us the freedom to describe a sequence of events in different orders. Studies have suggested that 'before-initiating' sentences, in which events are expressed in an order inconsistent with their actual order of occurrence, might need additional computation(s) during comprehension. The results of independent component analysis suggest that these computations are supported by a neural network connecting the bilateral caudate nucleus with the right middle frontal gyrus, left precentral gyrus, bilateral parietal lobule and inferior temporal gyrus. Among those regions, the caudate nucleus and the left middle frontal gyrus showed greater activations for 'before' than 'after' sentences. The functional network observed in this study may support sequence learning and processing in a general sense.

Severe selenium deficiency secondary to chylous loss.

Selenium deficiency is observed in patients with poor intake. We report the first case of a child with lymphangiomatosis who presented a myopathy associated with severe cardiomyopathy secondary to selenium deficiency due to selenium loss in chylous fluid.

Inaccuracy of Tl-201 brain SPECT in distinguishing cerebral infections from lymphoma in patients with AIDS.

PURPOSE: Studies have suggested using Tl-201 brain SPECT to differentiate lymphoma from infectious processes and to determine the timing for biopsy or empirical therapy for patients with AIDS-related brain lesions. This study prospectively investigated the utility of Tl-201 SPECT in distinguishing central nervous system lymphoma from non-neoplastic disease in patients with AIDS. MATERIALS AND METHODS: Fourteen patients with AIDS and focal abnormalities on computed tomography or magnetic resonance imaging underwent brain SPECT before diagnosis (12 by biopsy, 2 by clinical course and response to therapy). A an uptake ratio (UR) was obtained by drawing a region of interest around the lesion, measuring average counts per pixel, and dividing this value by the value of a non-lesion-containing contralateral region of interest. The UR cutoff producing the highest accuracy (TP+TN/TP+TN+FP+FN) in discriminating lymphoma from another condition was determined from URs generated from these 14 patients. RESULTS: Five patients had lymphoma, five had toxoplasmosis, one had Herpes simplex virus encephalitis, two had progressive multifocal leukoencephalopathy, and one had gliosis (UR, 0.8). Patients were separated into categories of lymphoma or nonlymphoma. The mean UR was 2.2 +/- 1.6 (range, 1.0 to 3.85) for lymphoma and 1.7 +/- 0.8 (range, 0.7 to 3.2) for nonlymphoma. Only a UR of 1.63 resulted in sensitivity and specificity better than 50% (60% and 55%, respectively), with an accuracy of 57%, positive predictive value of 43%, and negative predictive value of 71%. CONCLUSIONS: Tl-201 brain SPECT appears unreliable for differentiating primary lymphoma from nonmalignant brain lesions in patients with AIDS. Early brain biopsy is necessary to establish a definitive diagnosis when appropriate.