Pediatric critical careCritical care refers to the health care of children with life-threatening illness or following major surgery or severe injury. This care is offered in different contexts across the globe. In well-resourced environments, critical careCritical care may be provided in pediatric intensive care units, which provide highly complex medical care with advanced, potentially expensive technological devices aimed primarily at sustaining life; whereas in poorly resourced regions, only primary care may be available for critically ill or injured childrenInjured children. Even (...) where PICU facilities are available, they are a scarce and expensive resource. The knowledge and ability to sustain a critically ill or injured child’sInjured children life, potentially with effects on the child and family’s quality of lifeQuality of life and at the expense of other children’s health care, leads to frequent ethical challenges. Ethical issues related to how best to ensure optimal quality of lifeQuality of life and the fair distribution of scarce resources are common. In-depth knowledge and understanding of the individual patient’s medical, scientific and psychosocial context, through interdisciplinary discussion and collaboration; as well as familiarity with the overriding, relevant ethico-legal policiesPolicy and principles is essential for appropriate decision-makingDecision-making. Truthful communicationCommunication with the family is essential, using a shared decision-makingDecision-making process, and the child’s best interestBest interest must be central to every decision. This chapter presents an overview of the recommended approach to, and important considerations for, ethical decision-makingDecision-making in the PICU, using a hypothetical case example. (shrink)

Professor Kemp Smith in providing a new edition of Hume’s Dialogues Concerning Natural Religion , embodying all the author’s additions and corrections, has given expression to the perennial interest and fascination which this work has possessed for many minds during the odd one hundred and fifty years since it was first published by Hume’s nephew. The editor himself has performed a great service by contributing an Introduction and a clear and concise summary of the Dialogues , in both of which (...) he expounds his own view as to how Hume’s discussion is to be interpreted. Hume employs three characters—Demea, Philo, and Cleanthes; and. (shrink)

Imperatives cannot be true or false, so they are shunned by logicians. And yet imperatives can be combined by logical connectives: "kiss me and hug me" is the conjunction of "kiss me" with "hug me". This example may suggest that declarative and imperative logic are isomorphic: just as the conjunction of two declaratives is true exactly if both conjuncts are true, the conjunction of two imperatives is satisfied exactly if both conjuncts are satisfied—what more is there to say? Much more, (...) I argue. "If you love me, kiss me", a conditional imperative, mixes a declarative antecedent ("you love me") with an imperative consequent ("kiss me"); it is satisfied if you love and kiss me, violated if you love but don't kiss me, and avoided if you don't love me. So we need a logic of three -valued imperatives which mixes declaratives with imperatives. I develop such a logic. (shrink)

The rapid rise of international collaborative science has enabled access to genomic data. In this article, it is argued that to move beyond mapping genomic variation to understanding its role in complex disease aetiology and treatment will require extending data sharing for the purposes of clinical research translation and implementation.

The article presents an approach to the formation of a decision support system in the management of energy consumption of production technological systems. Such systems allow the company to detect and respond in a timely manner to the appearance of hidden energy losses, to carry out organizational measures aimed at energy saving and to optimize the timing and scope of repair and restoration work. The approach is based on the modeling of stationary sections of energy consumption, presented in the form (...) of precedents, their accumulation and subsequent analysis in the space of influential technological parameters. In addition to the base of precedents, the system includes software modules for assessment and formation of the profile of hidden energy losses, modules of technical condition, forecast and formation of precedents. The analysis of precedents consists in the selection of similar cases of energy consumption, the formation of efficient energy consumption functions and the calculation of energy losses with its help. Hidden energy losses can be calculated in real time for all technological systems of the enterprise. This allows you to build a profile of energy losses of the enterprise. The advantage of this approach in comparison with the known ones is that it allows to adapt to technological systems with different energy sources. The article emphasizes that the method can work with the energy manager with both linear and nonlinear dependence of energy consumption on process parameters. However, the limitations of this approach are noted. Thus, the determination of latent energy losses and technical condition of the equipment requires the participation of qualified specialists of the enterprise, who must be able to analyze the results and propose measures to eliminate energy losses. (shrink)

THE question which I am to raise for discussion is one which has long been debated by philosophers, and consequently I consider it doubtful whether anything very new can be said on the matter. But it may be profitable to review once more the present position of the controversy and to have in mind the reasons which at present make the question of interest and of importance.

The subject of the present paper is the central conception of a philosophy that has been particularly dominant and influential, and the following remarks are prompted because of difficulties experienced in the attempt to understand that philosophy. The aim of the paper is to point out what seems to be a serious defect in that type of philosophy; but it is even more its aim to emphasize the danger into which philosophy in all its forms may easily fall, and against (...) which it must exercise precautions. (shrink)

No one who is interested in the problem of value and attempts to read through the literature on the subject can fail to be struck by the extraordinary diversity of opinion. Some of this difference of view is traceable to ambiguities in language; there are various terms employed, each of which, of course, may or may not express anyvalid idea—terms like value, values, kinds of value, sorts of things that have value, value-objects, things that have value. The terms value and (...) values are subject to and lead to much confusion, even on the part of those who are aware of the existence of such a danger. Much of the difference may probably be due to two other importantfactors: first, the education and training in earlier years whereby emotional reactions to words instead of intelligent understanding of their meaning and validity are induced, and, second, the continual reliance upon moral experience, which reliance may seem to be necessary, but which may be invalidated by the consideration, generally overlooked and unappraised, that moral, like social, experience might not be what it is if certain views were not entertainedand did not prevail. The latter possibility would put moral and social studies on a plane quite different from that of physical investigations, for the moral and social inquirer would always have to bear in mind that the facts with which he is confronted, and to which he seeks to appeal, may exist to confront him and his fellowmen only in the sense that they arise from the acceptance and effectuation of a belief or theory, and would not be but for the effectuation of the belief or theory. The other factor, that of the influence of education and training upon emotional reactions, is also important in relation to a study of value, for it is necessary to be on guard against confusing reactions to words and reactions to objects, things, or situations. (shrink)

It is well known to readers of the Republic that, according to Plato's representation, a casual meeting of several friends develops into a sederunt for the express purpose of finding a solution to the question, what is justice? The question has its origin in the remark of the aged Cephalus, quoting Pindar, that whoever lives a life of justice and holiness, Sweet hope, the nourisher of age, his heart Delighting, with him lives; which most of all Governs the many veering (...) thoughts of man. (shrink)

The question of contacts between philosophers and historians of natural science, of mutual assistance and collaboration in their work, is an exceptionally important one from both the theoretical and practical points of view. This constitutes an organic component of the overall task, posed by Lenin, of strengthening the alliance between the leading natural scientists and Marxist philosophers. Here a businesslike approach is particularly needed. Lenin's behests lay in two directions. First, they have to do with the treatment of problems in (...) the history of knowledge from the standpoint of philosophy, and, second, they deal with the treatment of problems of dialectical philosophy on the basis of generalization from the data of the history of natural science. The two problems are interrelated, but they can also be considered as relatively independent. The common dialectical foundation of both sets of problems is the idea of the unity, the interconnection, of the historical and the logical. What are the behests of Lenin, and how are they being carried out? (shrink)

In the UK, over 70% of AIDS, including new cases, is located in a few Districts in central London where the distribution of previously occurring and new cases is essentially confined to the original risk groups of homosexual/bisexual men, drug addicts of both sexes, and some of their sexual partners and consorts. But control policy is still based on the assumption that HIV has already spread from persons in these risk groups into the general population, and that it will spread (...) hereafter at an increased rate because of heterosexual transmission to cause a widespread epidemic of AIDS.The basis and implications of this policy were investigated in the South East region adjacent to London, Analysis of demographic and epidemiological data shows that, with one exception, there is very little extension of AIDS from affected Districts in London to the surrounding region or even to the suburban fringe. Where AIDS is prevalent, as in this exception, the distribution follows the same, original pattern which relates essentially to risks arising from life-styles. There is no significant association between the prevalence or spread of AIDS and conventional markers of deprivation, economic and social disadvantage.Allocations of personnel, services and expenditure, assessed from returns required under the AIDS Control Act of 1987 and official registration data, continue to follow the original policy assumptions. They are therefore unrelated to the numbers of existing and new cases, disproportionate and unrealistic. Claims that this widespread excess of effort is justified by the fact that AIDS has not spread to the general population are falsified by the continuation of cases almost exclusively in risk groups. There is nothing in the data required under the Act or in registrations in this main locus of AIDS in the UK to suggest any change in this or to justify continuation of current expenditure and redundant activities.There is no evidence in these data that ethnic variations in the resident populations of Districts are associated with variations in the prevalence of AIDS. However, the larger figures available in some of the national data do indicate a disproportionate increase in some minority ethnic groups. Further detail about risks factors in these groups are required and, meanwhile, effort and expenditure should be re-orientated toward treatment, contact tracing and other public health measures for more effective containment of the continuing spread of AIDS in all the high risk groups. (shrink)

Causes for celibacy, divorces and successful marriage are discussed in the article. Absence of true love and inability to build and keep it are the main reasons for family disruption. Amorousness, immature love and various forms of false or flawed love substitute the true feeling. It is caused by increased women’s independence, loss of mutual understanding and trust (due to infidelity or jealousy), incompatibility of characters or values. Celibacy is often conditioned by physical disability, revaluation of freedom and independence, huge (...) requirements to partners, consumer attitude to life, infertility, alcohol and drug abuse, abnormalities in personality and sexuality. (shrink)

The title of this article might quite well be given the more hackneyed form, Has Kant answered Hume? Much of the discussion pertains to this latter question, but as the aim is also to emphasize some points concerned with Kant himself a deviation in title may be permissible.