Respecting and encouraging autonomy in the elderly is basic to the practice of geriatrics. In this paper, we examine the practice of cardiopulmonary resuscitation (CPR) and "artificial" feeding in a geriatric unit in a general hospital subscribing to jewish orthodox religious principles, in which the sanctity of life is a fundamental ethical guideline. The literature on the administration of food and water in terminal stages of illness, including dementia, still shows division of opinion on the morality of withdrawing nutrition. We (...) uphold the principle that as long as feeding by naso-gastric (N-G) or percutaneous endoscopic gastrostomy (PEG) does not constitute undue danger or arouse serious opposition it should be given, without causing suffering to the patient. This is part of basic care, and the doctor has no mandate to withdraw this. The question of CPR still shows much discrepancy regarding elderly patients' wishes, and doctors' opinions about its worthwhileness, although up to 10 percent survive. Our geriatric patients rarely discuss the subject, but it is openly ventilated with families who ask about it, who are then involved in the decision-making, and the decision about CPR or "do-not-resuscitate" (DNR) is based on clinical and prognostic considerations. (shrink)

Routine management of geriatric problems often raises ethical problems, particularly regarding autonomy of the old person. The carers or children may be unaware of the sensitivity of role reversal in dealing with the financial affairs; the need for a residential carer may compromise the old person’s privacy. Attending a day centre confers much benefit, but one must understand the old person’s resistance to change in the proposal of a new daily regimen. Similarly his or her autonomy must be the priority (...) in planning for admittance to an old age home, and not the assumption that the family knows best. A common dilemma is the assessment of an old person’s competency in decision making, either about management of his affairs, or regarding consent to treatment, or participation in research. Because cognitive capacity is not always identical with competency, meaningful tools have recently been developed in which the emphasis is on the specific situation to be investigated. (shrink)

Visual cultures are being increasingly discussed in the history of science literature, although relatively very little of that work concerns the nuclear age. In addition, within the discrete yet bourgeoning literature on global nuclear art and culture, Oceania is often overlooked despite its central role in the development of the American, British, and French nuclear weapon capabilities, as well as their associated colonial legacies. This article serves to redress both concerns by examining the visual politics of Maralinga in relation to (...) settler-colonial and Aboriginal experiences, vulnerabilities and presentations. I do so by surveying artworks with a connection to the Australian experience of nuclear colonialism and find that the figure of biological life has been conspicuously left absent from contemporary non-Indigenous Australian depictions of British nuclear testing in Australia. (shrink)

We prove linear and polynomial growth properties of sets and functions that are existentially definable in the ordered group of integers with divisibility. We determine the laws of addition with order and divisibility.

This book focuses on two central debates:how to introduce higher ethical standardshow to regulate business activity and prosecute offenders The authors bring ...

Rationale, aims and objectives To compare the pharmacotherapeutic approaches to diabetic hypertension of family physicians (FPs) and general practitioners (GPs). Methods A retrospective prescription-based study was conducted in 15 out of a total of 20 health centres, involving 115 primary care physicians – 77 FPs and 38 GPs, representing 74% of the primary care physicians of Bahrain. Prescriptions were collected during May and June 2000 to comprise a study population of 1266 diabetic-hypertensive patients. Results As monotherapy, angiotensin-converting enzyme (ACE) inhibitors (...) (37.9%) and β-blockers (38.3%) were the most commonly prescribed classes of antihypertensives by FPs and GPs, respectively. Calcium channel blockers (CCBs) were ranked third by both categories of physicians. For two-drug combinations, a β-blocker and an ACE inhibitor was the combination of choice for both physician categories. Patients managed by the FPs were more likely to receive a β-blocker–CCB combination (17.4 vs. 14.9%) or a diuretic–ACE inhibitor combination (16.7 vs. 11.4%) and less likely to receive a β-blocker–diuretic combination (11.8 vs. 16.7%) than those managed by the GPs. The proportion of patients receiving antihypertensive combinations was 40.6 and 38.5% for FPs and GPs, respectively. While the GPs prescribed CCB as a monotherapy to the elderly most often, the FPs choice was a β-blocker. Diuretics were less preferred by both FPs and GPs. β-Blocker–ACE inhibitor was again the most preferred combination of both FPs and GPs. FPs prescribed CCB–β-blocker combinations more often than GPs (P = 0.01), whereas CCB–ACE inhibitor combinations were less preferred (P = 0.09). A trend towards excessive use of short-acting nifedipine as monotherapy for elderly patients, both by FPs and by GPs, was noticed. Glibenclamide, alone or in combination with metformin, was the foremost antidiabetic drug prescribed by FPs and GPs. Middle-aged (45–64 years) patients seen by GPs were more likely to receive glibenclamide than those treated by FPs (P = 0.001) and less likely to receive gliclazide (P = 0.01). Combinations of a β-blocker with either glibenclamide or insulin were prescribed considerably more often by GPs.Conclusions Within the same practice setting, a substantial difference was observed between FPs and GPs in terms of preference for different classes of drugs in the management of diabetic hypertension. The compliance of both FPs and GPs was suboptimal; overall, the compliance of the FPs was closer to the recommended guidelines, however. Educational programmes should specifically address these inadequacies in order to improve the quality of health care. (shrink)

This paper reports the introduction of electronic handsets, like those used on the television show 'Who Wants To Be A Millionaire?' into the teaching of philosophical logic. Logic lectures can provide quite a formidable challenge for many students, occasionally to the point of making them ill. Our rationale for introducing handsets was threefold: to get the students thinking and talking about the subject in a public environment; to make them feel secure enough to answer questions in the lectures because the (...) system enabled them to do this anonymously; and to build their confidence about their learning by their being able to see how they were progressing in relation to the rest of the students in the class. We have achieved all of these and more. Our experience has revealed that the use of handsets encourages a more dynamic form of student interaction in an environment - the lecture - that can, in the wrong hands, be utterly enervating, but they also provide an opportunity for the lecturer to respond to students' difficulties at the time when they really matter. In this paper, we discuss our case of rapid adoption, our grounds for judging it a success, and what that success seems to have depended on. (shrink)

This is the first full discussion of Philoponus' account of matter.

Was die Frage nach der Funktion der Sprache im Erkenntnisprozeß betrifft, haben wir zuerst die verschiedenen Theorien dargestellt. Nach einer Reihe alleinstehender Personen wie Derbolav, Bühler, Jost, Glinz behandeln wir die Strömungen der symbolischen Logik und der linguistic analysis. Die symbolische Logik will das Denken in einer logischen Modellsprache analysieren. Die linguistic Analysis betrachtet die gewöhnliche Umgangssprache als Trägerin des Denkens und will, daß alle Philosophen und Wissenschaftler sich in dieser gewöhnlichen Umgangssprache ausdrücken, die bei guter Analyse für jeden intelligenten (...) Menschen verständlich ist. Die Strömungen der Phänomenologie und des Existentialismus äußern die Erfahrung, daß der Mensch seine Existenz ganz in einer sprechenden Welt erfährt und daß sich seine Existenz in der Sprache vollzieht : die Sprache ist das Haus seines Daseins. Keine Sache kann in unserem Bewußtsein zur Existenz gelangen, wenn wir sie nicht zu Wort bringen können. Die Ethnolinguisten und Psycholinguisten sind zu dem Ergebnis gekommen, daß die Formen, in denen ein Mensch jeweils denkt, von den unerbittlichen und unentrinnbaren Strukturen der Wörter mit ihren Bedeutungen und den Strukturen der Wortkombinationen kontrolliert werden. Diese Strukturen sind die Strukturen der jeweiligen Muttersprache. Das Denken eines Menschen vollzieht sich in seiner Sprache. Die Strukturen der Sprache liefern die Modelle für das Denken, für die Analyse der Eindrücke. Unser ganzes Denken bewegt sich in einer denkerisch-sprachigen Welt. Jedes Denken muß sich in Sprachstrukturen kanalisieren lassen. Die Sprache ist das formgebende Organ des Denkens. Die Denkanalyse vollzieht sich in Sprache. In einem bestimmten Augenblick der Entwicklung des Kindes begegnen sich Sprache und Denken ; dann wird das Denken „sprachig” und das Sprechen „denkerisch”. Von nun an werden die meisten Reize der physischen Welt durch ein sprachiges zweites Reizsystem gefiltert ; die Reize werden „in Sprache übersetzt”. Dieser Sprachfilter ist auch in der Analyse nach der dynamischen Erfassung der Reize vorhanden. Diese Daten aus den Theorien der Linguistic Analysis, der Phänomenologie, des Existentialismus, der Ethnolinguistik und Psycholinguistik kann man in direkte Verbindung bringen mit der neoklassischien Theorie, die über ein Erfassen von Erkenntnis-Daten in einer Intuition spricht, die implizit die Möglichkeit zu einem Explizitieren und Analysieren enthält. Somit kommen wir zu folgendem Schema : Reize, sprachiger Empfangsapparat ↓ Erfassung der Reize, Konzeption, Sicht ↓ Denk-Sprachanalyse ↓ Die phonische Äußerung der Denk-Sprachanalyse. Zum Schluß geben wir noch ein Beispiel für eine Kons ta tierungs-Sicht, Ihre Denk-Sprachanalyse und die phonische Äußerung ihrer Denk-Sparchanalyse. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 45, no. 1. © 2019 by Feminist Studies, Inc. 67 Leila J. Rupp Queer Dilemmas of Desire The dilemmas of desire confronting young women in contemporary US society are all too familiar. In the face of the persistent double standard that separates sluts from good girls, young women mobilize a variety of strategies: they lack desire, deny desire, restrain desire, police desire, and sometimes embrace desire. They (...) confront expectations to be sexy but not too sexual even as they insist on the right to be just as sexually active as men. Even in the hookup scene on college campuses, potentially liberating in its facilitation of noncommittal sexual encounters, young women worry about hooking up too much. It is a familiar story, but one that most often leaves behind young women with queer desires. Where they do appear, there are hints that they are not as likely to suppress their desires as straight women, no doubt because it is hard to ignore one’s desires when they fly in the face of heteronormative expectations. But it is also hard to come to grips with queer desires, and that is why the dilemmas I explore here are different. Unlike young straight women working to control their desires, the queer students whose stories I tell report awareness and acceptance of their attractions, sometimes from a very young age. Yet they encounter other kinds of dilemmas, especially uncertainty about the boundary between erotic love and intense friendship, a dilemma harking back to an earlier world of romantic friendship. And in the end, despite a contemporary social context in which nonnormative sexualities are more visible than ever before, 68 Leila J. Rupp experiencing queer desires continues to elicit confusion. Much has changed, but much has not. We know a great deal about straight dilemmas of desire. On the one hand, the double standard that separates sluts from good girls has persisted, despite the loosening of restrictions we associate with the sexual revolution of the long 1960s. In the face of slut shaming, young women continue to mobilize a variety of strategies, which Deborah Tolman has documented so eloquently in Dilemmas of Desire. Young women of color face additional obstacles to enjoying their desire, as the Latina girls we encounter in Lorena Garcia’s Respect Yourself, Protect Yourself make clear through their policing of their own and other girls’ sexuality in the face of racist stereotypes of unrestrained sexuality and teenage motherhood.1 On the other hand, a whole raft of commentators depict young women increasingly insisting on the right to be just as sexual as men. From Ariel Levy’s Female Chauvinist Pigs to Peggy Orenstein’s Girls and Sex to Nancy Jo Sales’ American Girls, critics lament young women embracing sex as a form of empowerment.2 The tension arising from the contradictory responses of young women to the demands placed on their sexuality is nowhere clearer than in the ongoing debate about the impact of hookup culture on women. Is hooking up good for women because it allows them to be sexual while pursuing their studies and career goals unencumbered by intimate relationships, as Hannah Rosin has suggested? Or is it, as Kathleen Bogle first argued in Hooking Up, exploitative in fashioning sexual encounters around men’s preference for sex without commitment? Or is it somewhere in between, with some 1. See Leora Tanenbaum, Slut! Growing up Female with a Bad Reputation (New York: HarperCollins, 2000); Emily White, Fast Girls: Teenage Tribes and the Myth of the Slut (New York: Berkeley Books, 2002); Sarah A. Miller, “’How You Bully a Girl:’ Sexual Drama and the Negotiation of Gendered Sexuality in High School,” Gender & Society 30, no. 5 (2016): 721–44; Deborah L. Tolman, Dilemmas of Desire: Teenage Girls Talk about Sexuality (Cambridge, MA: Harvard University Press, 2002); and Lorena Garcia, Respect Yourself, Protect Yourself: Latina Girls and Sexual Identity (New York: New York University Press, 2012). 2. Ariel Levy, Female Chauvinist Pigs: Women and the Rise of Raunch Culture (New York: Free Press, 2005). See also Peggy Orenstein, Girls and Sex: Navigating the Complicated New Landscape (New York: HarperCollins, 2016); Nancy Jo Sales, American Girls: Social Media and the Secret Lives of... (shrink)

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Schwinger’s algebra of microscopic measurement, with the associated complex field of transformation functions, is shown to provide the foundation for a discrete quantum phase space of known type, equipped with a Wigner function and a star product. Discrete position and momentum variables label points in the phase space, each taking \(N\) distinct values, where \(N\) is any chosen prime number. Because of the direct physical interpretation of the measurement symbols, the phase space structure is thereby related to definite experimental configurations.

Title: Thinking Matter: Materialism in Eighteenth-Century BritainPublisher: University of Minnesota PressISBN: 0816660581Author: John W. YoltonTitle: Perceptual Acquaintance from Descartes to ReidPublisher: University of Minnesota PressISBN: 0816611629Author: John W. Yolton.