Background. Decisions to test, enrol and disclose HIV status are among the ethical challenges that may influence adherence to antiretroviral therapy (ART) and HIV care and treatment in adolescents living with HIV. In the Tanzanian setting, how parental perceptions of ethical issues affect adolescents’ adherence to HIV care and treatment is not well known.Objective. To explore parental perceptions of ethical issues in adolescent HIV care and treatment. Methods. The study employed a descriptive qualitative exploratory design and was conducted at Temeke (...) Regional Referral Hospital in Dar es Salaam Care and Treatment Centre (CTC) in the Outpatient Department (OPD). The study population were parents and non-parent caregivers of HIV-infected adolescents 10 - 19 years of age. A total of 16 persons participated in semi-structured interviews after their consent was obtained. All interviews were audiotaped, transcribed verbatim in Swahili and back-translated into English. An inductive content analysis was used, and standards of qualitative rigour applied. Results. Three qualitative themes emerged: balancing adolescents’ autonomy with parents’ desire to protect their children; parental dilemmas regarding disclosure of adolescents’ HIV status; and parental reasons for delayed disclosure.Conclusion. Participants perceived that parental authority should override adolescents’ autonomy in HIV care and treatment. Disclosure of HIV status to adolescents is a challenge to parents. Delays in disclosure often occur because parents feel guilty and because they have fears of rejection by their adolescent children. (shrink)

Ecological theory is built upon assumptions about the fundamental nature of organism-environment interactions. We argue that two mutually exclusive sets of such assumptions are available and that they have given rise to alternative approaches to studying ecology. The fundamentally different premises of these approaches render them irreconcilable with one another. In this paper, we present the first logical formalisation of these two paradigms.The more widely-accepted approach - which we label the demographic paradigm - includes both population ecology and community ecology (...) (synecology). Demographic ecology assumes that the environment is relatively stable and that biotic processes, governed predominantly by resource availability, are the most important of ecological and evolutionary influences. Moreover, ecological processes are assumed to translate into directional selection pressures that drive significant evolutionary change on a local scale through the process of optimisation. (shrink)

Nineteenth-century Russia reverberated with ideas of women's liberation as a condition of genuine equality in society. These ideas came to form the basis of an entire tradition linking the "woman's" question and the "social" question together and defining the democratic character of the women's movement in Russia.

Decompressive craniectomy is a technically straightforward procedure whereby a large section of the cranium is temporarily removed in cases where the intracranial pressure is dangerously high. While its use has been described for a number of conditions, it is increasingly used in the context of severe head injury. As the use of the procedure increases, a significant number of patients may survive a severe head injury who otherwise would have died. Unfortunately some of these patients will be left severely disabled; (...) a condition likened to the RUB, an acronym for the Risk of Unacceptable Badness. Until recently it has been difficult to predict this outcome, however an accurate prediction model has been developed and this has been applied to a large cohort of patients in Western Australia. It is possible to compare the predicted outcome with the observed outcome at 18 months within this cohort. By using predicted and observed outcome data this paper considers the ethical implications in three cases of differing severity of head injury in view of the fact that it is possible to calculate the RUB for each case. (shrink)

The purpose of this study is to determine the relative frequency of course offerings on social issues and business ethics in American business schools. Specifically, a random sample of the curricula of 119 American business schools were analyzed in order to gauge the importance given to coursework on ethics and social issues. The findings indicated that the incidence of such courses was generally low in American business curricula, particularly at the graduate level. These findings are discussed in light of the (...) current concern for more responsible corporate behavior. (shrink)

Late in the second part of the Therapeutikê methodos, which Galen was completing after a twenty-year gap since beginning the work as a whole, the text in Kühn includes a comment which looks like a Galenic aside made parenthetically to himself while dictating. The sentence reads: ἐκεῖθεν οὖν αὐτὰ μεταφέρειν ἐνταῦθα σκοπούμενον ὅτῳ βέλτιον ἐξ αὐτῶν χρῆσθαι, ‘So to consider transferring them to here from there to make better use of them’. The rendering in the new Loeb volume 3, p. (...) 345 is not clear. (shrink)

There is an ever-greater emphasis on the maintenance of professional standards in communication among medical professionals. Much of the focus to date revolves around discourse between patients and families in the clinical arena and reflects standards developed by accrediting agencies and the government. Little has been written about the communication among professionals occurring in the administrative milieu that is largely unseen by those not engaged in the direct provision of or receipt of medical care. That rumours are a part of (...) the interactive discourse is likely not unfamiliar to most in academia. Their potential for damage to the workplace and individuals is very real and requires recognition and in some situations, corporate action. There are options to reduce the likelihood of these kinds of communications and to manage them actively when they occur. What may result is an environment that leads to greater organisational confidence and individual productivity. (shrink)

This full-length study of Plato's dialogue Phaedrus, now in paperback, is written in the belief that such concerted scrutiny of a single dialogue is an important part of the project of understanding Plato so far as possible 'from the inside' - of gaining a feel for the man's philosophy. The focus of this account is on how the resources both of persuasive myth and of formal argument, for all that Plato sets them in strong contrast, nevertheless complement and reinforce each (...) other in his philosophy. Not only is the dialogue in its formal structure a dovetail of myth and argument, but the philosophic life that it praises is also shaped by an acknowledgement of the limitations of argument and the importance of mythical understanding. By means of this correlation of form and content Plato invites his readers, through the very act of reading, to take a first step along the path of the philosophical life. (shrink)