Background: Decisions of patients, families, and health care providers about medical care at the end of life depend on many factors, including the societal culture. A pan-European study was conducted to determine the frequency and types of end of life practices in European intensive care units , including those in Israel. Several results of the Israeli subsample were different to those of the overall sample.Objective: The objective of this article was to explore these differences and provide a possible explanation based (...) on the impact of culture on end of life decision making.Method: All adult patients admitted consecutively to three Israeli ICUs who died or underwent any limitation of life saving interventions between 1 January 1999 and 30 June 2000 were studied prospectively . These patients were compared with a similar sample taken from the larger study carried out in 37 European ICUs. Patients were followed until discharge, death, or 2 months from the decision to limit therapy. End of life decisions were prospectively organised into one of five mutually exclusive categories: cardiopulmonary resuscitation , brain death, withholding treatment, withdrawing treatment, and active shortening of the dying process . The data also included patient characteristics , specific therapies limited, and the method of SDP.Results: The majority of patients had treatment withheld, none underwent SDP, 62 received CPR , 31 had brain death , and 18 underwent withdrawal of treatment . The primary reason given for limiting treatment was that the patient was unresponsive to therapy . End of life discussions were held with 132 families , the vast majority of which revolved around withholding treatment and the remainder concerned withdrawing treatment .There was a statistically significant association between the type of end of life decision and region—that is, the northern region of Europe, the central region, the southern region, and Israel.Conclusions: Regional culture plays an important part in end of life decision making. Differences relating to end of life decision making exist between regions and these differences can often be attributed to cultural factors. Such cultures not only affect patients and their families but also the health care workers who make and carry out such decisions. (shrink)

An analytical investigation into compressible gas flow with slight rarefactions through the insect trachea and tracheoles during the closed spiracle phase is undertaken, and a complete set of asymptotic analytical solutions is presented. We first obtain estimates of the Reynolds and Mach numbers at the channel terminal ends where the tracheoles directly deliver respiratory gases to the cells, by comparing the magnitude of the different forces in the compressible gas flow. The 2D Navier–Stokes equations with a slip boundary condition are (...) used to investigate compressibility and rarefied effects in the trachea and tracheoles. Expressions for the velocity components, pressure gradients and net flow inside the trachea are then presented. Numerical simulations of the tracheal compressible flow are performed to validate the analytical results from this study. This work extends previous work of Arkilic et al. :167–178, 1997) on compressible flows through a microchannel. Novel devices for microfluidic compressible flow transport may be invented from results obtained in this study. (shrink)

An essay which is occasionally provocative, though somewhat cursory, in its delineation of the American democratic ideal. The author reviews the intellectual contributions of the philosophers of the Enlightenment, the Puritan tradition, ethical idealism and pragmatism to the American political tradition. But these various contributions have provided only a partial expression of the ideal of Americanism. This, the author thinks, is a personalist ethic, issuing in a "democratic personalism." --J. F. D.

As the gap between the need for and supply of human organs continues to widen, the aim of securing additional sources of these “gifts of the body” has become a seemingly overriding moral imperative, one that could—and some argue, should—override the widespread ban on organ markets. As a medical practice, organ transplantation entails the inherent risk that one human being, a donor, will become little more than a means to the end of healing for another human being and that he (...) or she will come to have a purely instrumental value. With the establishment of organ markets, not only will the harms of instrumentalization be a reality—the ends of medicine will be further compromised and confused. (shrink)

A collection of essays by a British master of Marxism, this book ranges over a wide variety of related topics--ethics, human rights, social theory, ideology, religion, and philosophy. The essays are reprints or adaptations of previous articles and addresses, and are unified by the author's sympathetic interpretation of Marxist thought. Especially instructive and timely is a chapter on Sartre and Marxism.--J. F. D.

Vleeskens, F. D. A. Spinoza en zijn tijd.--Klever, W. N. A. Ervaring en rede.--Petry, M. J. De Regenboog.--Bend, J. G. van der. Spinoza's liberale rechtsstaat.--Sperna Weiland, J. Vrijheid.

This comprehensive survey is particularly valuable for the intelligence and originality with which it approaches aesthetic speculation. The author permits the original texts to serve as the basis of his study, and exhibits each of the major aesthetic systems of the period as an integral whole involving logical and psychological principles. Each of the writers chosen from the tradition is criticized in his own terms, without detracting from the originality of his contribution to the body of aesthetic theory. A few (...) of the lesser-known aestheticians of the 18th century here receive fuller discussion than has previously been available.--J. F. D. (shrink)

The digital shift leads to increasing changes. Employees can deal with changes through informal learning that enables needs-based development. For successful informal learning, self-regulated learning is crucial, i.e., to set goals, plan, apply strategies, monitor, and regulate learning for example by applying resource strategies. However, existing SRL models all refer to formal learning settings. Because informal learning differs from formal learning, this study investigates whether SRL models can be transferred from formal learning environments into informal work settings. More precisely, are (...) all facets relevant, and what are the relational patterns? Because informal workplace learning occurs through interaction with the context, this study investigates the influence of context, i.e., organizational learning culture and job characteristics on SRL. Structural equation modeling of N = 170 employees in various industries showed the relevance of the self-reported metacognitive strategies planning, monitoring, and regulation; the resource strategies help-seeking and effort regulation; and deep processing strategy elaboration. However, there was no evidence for organization strategies. The learning strategies were associated with self-efficacy and mastery-approach goal orientation. Regarding context, results supported indirect effects over self-motivational beliefs of learning strategies. Organizational learning culture was connected with mastery-approach goal orientation, whereas job characteristics autonomy and feedback were related to self-efficacy, which were again related to SRL strategies. Therefore, context can empower employees not only to accomplish their tasks but to develop themselves by applying SRL strategies. The results are discussed, and practical implications are outlined. (shrink)

My discussion addresses the differences between analytic and continental philosophy concerning the use of logic and exact reasoning in philosophical practice. These differences are mainly examined in the light of the controversial dominance of Hegel's concept of logic (and theory of concept) in twentieth-century continental philosophy. The inquiry is developed in two parts. In the first (Sections 1-2), I indicate some aspects of the analytic-continental divide, pointing to the role that the topic 'logic and philosophy' plays in it. In the (...) second part (Sections 3-6), I give a short account of the views of logic which are typical of the three main trends of continental philosophy (see Table 1). I also suggest how, with the aid of some typical analytical devices, some continental 'anti-logical' attitudes may be corrected, on their own terms. (shrink)