Good medical practice requires evidence of effectiveness to address deficits in care, strive for further improvements, and justly apportion finite resources. Nevertheless, the potential of palliative care is still held back by a paucity of good evidence. These circumstances are largely attributable to perceived ethical challenges that allegedly distinguish dying patients as a special client class. In addition, practical limitations compromise the quality of evidence that can be obtained from empirical research on terminally ill subjects.This critique aims to appraise the (...) need for focused research, in order to develop clinical and policy decisions that will guide health care professionals in their care of dying patients. Weighted against this need are tenets that value the practical and ethical challenges of palliative care research as unique and insurmountable. The review concludes that, provided investigators compassionately apply ethical principles to their work, there is no justification for not endeavouring to improve the quality of palliative care through research. (shrink)

Objective: To survey members of the American Society for Bioethics and Humanities and of the Society for Medical Decision Making to elicit the similarities and differences in their reasoning about two clinical cases that involved ethical dilemmas.Cases: Case 1 was that of a patient refusing treatment that a surgeon thought would be beneficial. Case 2 dealt with end-of-life care. The argument was whether intensive treatment should be continued of an unconscious patient with multiorgan failure.Method: Four questions, with structured multiple alternatives, (...) were asked about each case: identified core problems, needed additional information, appropriate next steps and who the decision maker should be.Observations and results: Substantial similarities were noticed between the two groups in identifying the core problems, the information needed and the appropriate next steps. SMDM members gave more weight to outcomes and trade-offs and ASBH members had patient autonomy trump other considerations more strongly. In case 1, more than 60% of ASBH respondents identified the patient alone as the decision maker, whereas members of SMDM were almost evenly divided between having the patient as the solo decision maker or preferring a group of some sort as the decision maker, a significant difference . In case 2, both groups agreed that the question of discontinuing treatment should be discussed with the family and that the family alone should not be the decision maker.Conclusion: Despite distinctively different methods of case analysis and little communication between the two professional communities, many similarities were observed in the actual decisions they reached on the two clinical dilemmas. (shrink)

This paper explores the role of ‘community’ in the context of global bioethics. With the present globalization of bioethics, new and interesting references are made to this concept. Some are familiar, for example, community consent. This article argues that the principle of informed consent is too individual-oriented and that in other cultures, consent can be community-based. Other references to ‘community’ are related to the novel principle of benefit sharing in the context of bioprospecting. The application of this principle necessarily requires (...) the identification and construction of communities. On the global level there are also new uses of the concept of community as ‘global community.’ Three uses are distinguished: (1) a diachronic use, including past, present, and future generations, (2) a synchronic ecological use, including nonhuman species, and (3) a synchronic planetary use, including all human beings worldwide. Although there is a tension between the communitarian perspective and the idea of global community, this article argues that the third use can broaden communitarianism. The current development towards cosmopolitanism is creating a new global community that represents humanity as a whole, enabling identification of world citizens and evoking a sense of global solidarity and responsibility. The emergence of global bioethics today demonstrates this development. (shrink)

A nonlinear two-variable reaction-diffusion model of bone mineral metabolism, built from an overall self-oscillatory compartmental model of calcium metabolism in vivo, has been studied for its ability to generate spatial and spatio-temporal self-organizations in a two-dimensional space. Analytical and numerical results confirm the theoretical properties previously described for this kind of model. In particular, it is shown that, for a given set of reactional parameter values and certain values of the ratio of the two diffusion coefficients, there exists a set (...) of unstable wavenumbers leading spontaneously to the development, from the homogeneous steady state, of either different types of stationary spatial patterns (hexagonal, striped and re-entrant hexagonal patterns) or more or less complex spatio-temporal expressions. We discuss the relevance of analogies established between some spatial or spatio-temporal structures predicted by the model and some peculiar features of the primary bone trabecular architecture which appear during embryonic ossification. (shrink)

_ Source: _Volume 40, Issue 1, pp 104 - 115 It is intended in this study to present initial reliability and validity data for the Russian adaptation of the Multidimensional Inventory of Religious/Spiritual Well-being, as being related to personality factors and psychopathology. Therefore, the first version of the MI-RSWB-R was applied to a sample of 192 non-clinical subjects, together with the NEO Five Factor Inventory and the Symptom-Check-List. The original six-factor structure of the scale could be replicated for the MI-RSWB-R, (...) which also provides satisfying psychometric properties. In accordance with previous research the RSWB total score was linked to more favorable personality traits such as Extraversion, Openness to Experience, and Agreeableness, which was paralleled by substantial negative correlations with increased psychopathology. Our findings support the reliability and structural validity of the MI-RSWB-R as a standardized instrument for addressing the spiritual dimension in Russian populations. Further research in clinical surroundings is now recommended. (shrink)

Ausgehend von der, von Journalisten und Musikern immer wieder bemühten Metapher des 'Black CNN' wird versucht, das Potenzial der musikalischen Ausdrucksform des HipHop als Kommunikationsstruktur der Schwarzen Minderheit in den USA zu analysieren. Nach einer historisch-kulturellen Erläuterung, die sich mit der Tradition der Reflektion sozialer und politischer Aspekte in den unterschiedlichen musikalischen Äußerungen der Schwarzen Volksgruppe in den USA beschäftigt und schon ansatzweise die Bedeutung dieser Ausdrucksmöglichkeit im Kontext eines 'internal colonialsm' vor Augen führt, werden jene soziodemographischen Entwicklungen nachvollziehbar gemacht, (...) die sich als zentraler Kritikpunkt in den verbalen Artikulationen des HipHop widerspiegeln. Bestehende mediale Dysfunktionen hinsichtlich der Repräsentation von Angehörigen der Schwarzen Minderheit werden mit einem entsprechenden Fallbeispiel belegt. Vor dem theoretischem Hintergrund von 'cultural citizenship' - ein Konzept zur Bestimmung kultureller Teilhabe in der Mediengesellschaft -, werden 25 Textbeispiele, die sich auf HipHop-Veröffentlichungen von 1982 bis 2004 finden, auf ihre Übereinstimmung mit Indikatoren untersucht, die sich aus, den Medien zugeschriebenen, politischen und sozialen Funktionen ableiten lassen. Die angewandte Inhaltsanalyse lässt zahlreiche Entsprechungen erkennen, die sich zum Teil in komplexen, der Kritik- und Kontrollfunktion bzw. Integrationsfunktion der Medien zuzuordnenden Inhalten äußern. (shrink)

The aim of this paper is to investigate the flow of MHD mixed convection nanofluid flow under nonlinear heated due to an extending surface. The transfer of heat in nanofluid subject to a magnetic field and boundary conditions of convective is studied to obtain the physical meaning of the convection phenomenon. The governing partial differential equations of the boundary layer are reduced to ordinary differential equations considering a technique of the transformation of similarity. The transformed equations are solved numerically considering (...) the technique of an efficient numerical shooting applying the Runge–Kutta technique scheme from the fourth-fifth order. The results corresponding to the dimensionless speed, temperature, concentration profiles, and the Nusselt number reduced, and the Sherwood numbers are presented by figures to display the physical meaning of the phenomena. A comparison has been made between the obtained results with the previous results obtained by others and agrees with them if the new parameters vanish. The results obtained indicate the impacts of the nondimensional governing parameters, namely, magnetic field parameter M, Soret number Sr, heat source λ, thermal buoyancy parameter λ T, and solutal buoyancy parameter λ C on the flow, temperature, and concentration profiles being discussed and presented graphically. (shrink)

A longitudinal, epidemiological study was carried out in a rural area of Kenya with a population of about 28,000 between 1974 and 1980. Population registration during this time showed that population growth was very high between 1974 and 1978 (4·4% per year) and much lower in 1979 and 1980 (1·1%). Natural increase was nearly as high as in Kenya as a whole (3·7%) in this period. Fertility was somewhat lower than in all Kenya (the crude birth rate was 46 per (...) 1000) while mortality was substantially lower (7 per 1000). Evidence is presented supporting the argument that these low mortality rates are genuine. Levels of temporary and permanent migration are high and probably characteristic for many parts of Kenya. The change in population growth in 1979 and 1980 is probably due to changes in economic conditions leading in particular to less in-migration and to more out-migration. (shrink)

Summary If action theory is to be relevant for the study of social phenomena, its scope has to be enlarged so as to include social structures. A hermeneutic theory of action, which draws on the thoughts of Gadamer, Merleau-Ponty, Ricoeur and Giddens, can meet this requirement. The hermeneutic concept of action, which emphasises the importance of tradition, style and rituals, demonstrates that action and structure presuppose and explain each other. The mutual relationship between action and structure is particularly clear in (...) theories of human development in the domain of psychology, psychotherapy and education. These theories can be used to construct a theory of social evolution, as has been developed by Habermas. By integrating structural, theoretical and critical points of view, a hermeneutic theory of action opens a perspective in which action theory and social theory might be successfully combined. (shrink)

It has been argued that organizational structures (the way tasks are defined, allocated, and coordinated) can influence moral agency in organizations. In particular, low values on different structural parameters (functional concentration, specialization, separation, and formalization) are said to foster an organizational context (allowing for relating to the goals and output of the organization, moral deliberation, and social connectedness) that is conducive to moral agency. In this paper, we investigate the relation between the organizational structure and moral agency in the case (...) of a.s.r. (a large Dutch insurance company). While our empirical results fit the thesis that low values on structural parameters positively relate to moral agency, they also refine our understanding of the influence of structural parameters. In particular, our data suggest that the influence of functional concentration not only depends on whether it is low, but also on the type of criterion used for identifying business units; they suggest that the specific organizational context may put a limit to lowering design parameters and points at several non-structural factors that have an influence on the relation between structure and moral agency. In all, the paper contributes to a more detailed understanding of the conditions conducive to moral agency in organizations. (shrink)

Contrary to received opinion, the Aristotelian Square of Opposition (square) is logically sound, differing from standard modern predicate logic (SMPL) only in that it restricts the universe U of cognitively constructible situations by banning null predicates, making it less unnatural than SMPL. U-restriction strengthens the logic without making it unsound. It also invites a cognitive approach to logic. Humans are endowed with a cognitive predicate logic (CPL), which checks the process of cognitive modelling (world construal) for consistency. The square is (...) considered a first approximation to CPL, with a cognitive set-theoretic semantics. Not being cognitively real, the null set Ø is eliminated from the semantics of CPL. Still rudimentary in Aristotle’s On Interpretation (Int), the square was implicitly completed in his Prior Analytics (PrAn), thereby introducing U-restriction. Abelard’s reconstruction of the logic of Int is logically and historically correct; the loca (Leaking O-Corner Analysis) interpretation of the square, defended by some modern logicians, is logically faulty and historically untenable. Generally, U-restriction, not redefining the universal quantifier, as in Abelard and loca, is the correct path to a reconstruction of CPL. Valuation Space modelling is used to compute the effects of U-restriction. (shrink)

The prime purpose of this paper is, first, to restore to discourse-bound occasion sentences their rightful central place in semantics and secondly, taking these as the basic propositional elements in the logical analysis of language, to contribute to the development of an adequate logic of occasion sentences and a mathematical (Boolean) foundation for such a logic, thus preparing the ground for more adequate semantic, logical and mathematical foundations of the study of natural language. Some of the insights elaborated in this (...) paper have appeared in the literature over the past thirty years, and a number of new developments have resulted from them. The present paper aims at providing an integrated conceptual basis for this new development in semantics. In Section 1 it is argued that the reduction by translation of occasion sentences to eternal sentences, as proposed by Russell and Quine, is semantically and thus logically inadequate. Natural language is a system of occasion sentences, eternal sentences being merely boundary cases. The logic has fewer tasks than is standardly assumed, as it excludes semantic calculi, which depend crucially on information supplied by cognition and context and thus belong to cognitive psychology rather than to logic. For sentences to express a proposition and thus be interpretable and informative, they must first be properly anchored in context. A proposition has a truth value when it is, moreover, properly keyed in the world, i.e. is about a situation in the world. Section 2 deals with the logical properties of natural language. It argues that presuppositional phenomena require trivalence and presents the trivalent logic ${\rm PPC}_{3}$ , with two kinds of falsity and two negations. It introduces the notion of Σ-space for a sentence A (or / A /, the set of situations in which A is true) as the basis of logical model theory, and the notion of / ${\bf P}^{A}$ / (the Σ-space of the presuppositions of A), functioning as a 'private' subuniverse for / A /. The trivalent Kleene calculus is reinterpreted as a logical account of vagueness, rather than of presupposition. ${\rm PPC}_{3}$ and the Kleene calculus are refinements of standard bivalent logic and can be combined into one logical system. In Section 3 the adequacy of ${\rm PPC}_{3}$ as a truth-functional model of presupposition is considered more closely and given a Boolean foundation. In a noncompositional extended Boolean algebra, three operators are defined: $1_{a}$ for the conjoined presuppositions of a, ã for the complement of a within $1_{a}$ , and â for the complement of $1_{a}$ within Boolean 1. The logical properties of this extended Boolean algebra are axiomatically defined and proved for all possible models. Proofs are provided of the consistency and the completeness of the system. Section 4 is a provisional exploration of the possibility of using the results obtained for a new discourse-dependent account of the logic of modalities in natural language. The overall result is a modified and refined logical and model-theoretic machinery, which takes into account both the discourse-dependency of natural language sentences and the necessity of selecting a key in the world before a truth value can be assigned. (shrink)

On 17 November 1820 there appeared a Dutch translation of Oersted's pamphlet concerning the discovery of the effect of an electric current on a magnetic needle suspended in the earth's magnetic field . In the Netherlands a number of physicists were immediately interested in the electromagnetic and electrodynamic discoveries made by Oersted and the French physicists. They repeated and extended the experiments, and constructed new modifications of the galvanic battery for better results. They made no fundamental discoveries in this field (...) of physics, but the fact that their work was important follows from the experiments of van Beek, which confirmed Amp`ere's theory of molecular magnetic currents. Van Beek as well as Speyert van der Eyk corresponded with Amp`ere about electromagnetic and electrodynamic phenomena. In the Utrecht Universiteitsmuseum there is an unpublished letter of Amp`ere to van Beek, which is published at the end of this article. (shrink)

In this article, an introduction to a proposed more comprehensive treatment of the subject, I wish to discuss the contribution that the parabasis makes to the understanding and interpretation of Aristophanes’ comedies. The study of this part of the plays has in the past concentrated upon two main areas: firstly, its role in the development of comedy, including questions about its original position in the dramatic structure and its relationship to other elements such as the parodos and agon; and secondly, (...) its role as the repository of Aristophanes’ personal views.1I shall touch but incidentally on the first of these, though my argument will have some bearing on it; to the second I shall return at the end. My aim is to consider an aspect of the parabasis that has not so much been neglected as dismissed as non-existent: the relation between the contents of the parabasis and those of the rest of the play. It is generally agreed that the parabasis deals with matters that are irrelevant to the dramatic action, but I wish to argue that it has a significant role as the focus of the most important themes in the play: far from breaking up the unity of the play, the parabasis provides indications as to where that unity is to be found, besides giving hints about the meaning of the play and the nature of Aristophanic comedy generally.2. (shrink)

A. M. Ritchie; XII—Can Animals See? A Cartesian Query, Proceedings of the Aristotelian Society, Volume 64, Issue 1, 1 June 1964, Pages 221–242, https://doi.org/.