Background: Dignity, an abstract and complex concept, is an essential part of humanity and an underlying guiding principle in healthcare. Previous literature indicates dignity is compromised in people with dementia (PwD), but those PwD maintain the capacity to live with dignity with appropriate external support. Alzheimer’s disease and related dementias (ADRDs) lead to progressive functional decline and increased vulnerability and dependence, leading to heightened risks of PwD receiving inappropriate or insufficient care that diminishes dignity. Considering the increased disease prevalence and (...) the continuously escalating costs of dementia care, establishing a productive value-based guideline may prevent suffering, maximize dignity, and thus promote quality of life (QoL). Aim: The goal of this project is to identify actionable targets for integrating dignity harmoniously and practically into care planning and management for PwD. Research Design: We conducted a concept analysis using Walker and Avant’s eight-step process. A comprehensive literature search was conducted (PubMed and CINAHL) with the keywords “dignity,” “dementia,” “Alzheimer’s disease,” and “dementia care.” Results: A total of 42 out of 4910 publications were included. The concept of dignity in PwD is operationalized as the promotion of worthiness and the accordance of respect that allows the presence and expression of a person’s sense of self, regardless of physical, mental, or cognitive health. The concept has two subdimensions: absolute dignity which encompasses the inherent self and relative dignity characterized by its dynamic reflective nature. Worthiness and respect are the two main attributes, while autonomy is an underlying component of dignity. Specific antecedents of dignity in PwD are empowerment, non-maleficence, and adaptive environmental scaffolding. As a consequence of facilitating dignity in PwD, QoL may be enhanced. Conclusion: As a foundational and necessary humanistic value, incorporating dignity into dementia care can lead to efficient and effective care that optimizes QoL in PwD throughout their disease progression. (shrink)

The early literature on epistemic logic in philosophy focused on reasoning about the knowledge or belief of a single agent, especially on controversies about "introspection axioms" such as the 4 and 5 axioms. By contrast, the later literature on epistemic logic in computer science and game theory has focused on multi-agent epistemic reasoning, with the single-agent 4 and 5 axioms largely taken for granted. In the relevant multi-agent scenarios, it is often important to reason about what agent A believes about (...) what agent B believes about what agent A believes; but it is rarely important to reason just about what agent A believes about what agent A believes. This raises the question of the extent to which single-agent introspection axioms actually matter for multi-agent epistemic reasoning. In this paper, we formalize and answer this question. To formalize the question, we first define a set of multi-agent formulas that we call agent-alternating formulas, including formulas like Box_a Box_b Box_a p but not formulas like Box_a Box_a p. We then prove, for the case of belief, that if one starts with multi-agent K or KD, then adding both the 4 and 5 axioms (or adding the B axiom) does not allow the derivation of any new agent-alternating formulas—in this sense, introspection axioms do not matter. By contrast, we show that such conservativity results fail for knowledge and multi-agent KT, though they hold with respect to a smaller class of agent-nonrepeating formulas. (shrink)

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

Residents are important participants and stakeholders in destination development. Identifying factors that assist in predicting resident pro-environmental behavior (PEB) may contribute to enhanced sustainability. Based on a traditional Chinese culture, this research constructed a model of resident PEB by introducing pro-environmental destination image (PEDI) and Confucianism as the independent and moderating variables, respectively. The structural equation modeling for 402 residents indicated the model had a satisfactory level of predictive power for PEB. The results showed that: (1) PEDI positively affected residents’ (...) environmental identity, pro-environmental attitudes, and PEB; (2) environmental identity and pro-environmental attitudes completely mediated the impact of PEDI on residents’ PEB; and (3) Confucian culture had a positive U-shaped moderating effect in the relationships among these four variables. Overall, these findings advance the understanding of the formation of PEB in Confucian culture and provide theoretical and practical implications for fostering residents’ PEB. (shrink)

AimsAlcohol consumption could lead to a series of health problems and social issues. In the current study, we investigated the resting-state functional brain networks of healthy volunteers before and after drinking through graph-theory analysis, aiming to ascertain the effects of acute alcohol intake on topology and information processing mode of the functional brain networks.Materials and methodsThirty-three healthy volunteers were enrolled in this experiment. Each volunteer accepted alcohol breathalyzer tests followed by resting-state magnetic resonance imaging at three time points: before drinking, (...) 0.5 h after drinking, and 1 h after drinking. The data obtained were grouped based on scanning time into control group, 0.5-h group and 1-h group, and post-drinking data were regrouped according to breath alcohol concentration (BrAC) into relative low BrAC group (A group; 0.5-h data, n = 17; 1-h data, n = 16) and relative high BrAC group (B group; 0.5-h data, n = 16; 1-h data, n = 17). The graph-theory approach was adopted to construct whole-brain functional networks and identify the differences of network topological properties among all the groups.ResultsThe network topology of most groups was altered after drinking, with the B group presenting the most alterations. For global network measures, B group exhibited increased global efficiency, Synchronization, and decreased local efficiency, clustering coefficient, normalized clustering coefficient, characteristic path length, normalized characteristic path length, as compared to control group. Regarding nodal network measures, nodal clustering coefficient and nodal local efficiency of some nodes were lower in B group than control group. These changes suggested that the network integration ability and synchrony improved, while the segregation ability diminished.ConclusionThis study revealed the effects of acute alcohol intake on the topology and information processing mode of resting-state functional brain networks, providing new perceptions and insights into the effects of alcohol on the brain. (shrink)

Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and (...) health policy discuss if age should guide rationing decisions. (shrink)

H.B.G. Casimir's life, interests and works are intertwined with the important developments that have taken place in physics during this century. This book was compiled by his friends and admirers in honour of his 80th birthday and concentrates mainly on Casimir's achievements in the field of physics, though without ignoring the peripheral areas of the history and philosophy of physics in which he was greatly interested. The book is divided into four parts. Part I describes Casimir's teachers, Ehrenfest, Bohr and (...) Pauli, and will be of general interest due to the key role which these physicists played in modern developments. The articles do give new facts and provide new insights into the history of modern physics. Part II consists of essays on recent developments in various areas of physics in which Casimir has taken an active interest, such as the modern concept of time, statistical foundations of electrodynamic theory and field theory. The subjects covered in Part III have been selected because of Casimir's efforts in the industrial research area of physics. They cover past, present and future expectations in research. (shrink)

An outline of the life of Heraclides and his fragmentary writings (on the theory of matter, astronomy, ethical and religious topics) is followed by an attempt to reconstruct his thought. He emerges as not so much a profound thinker as a many-sided writer of considerable literary gifts and occasional flashes of brilliance.

Gotthold Ephraim Lessing, thinker, dramatist and controversialist of many-sided interests, is the most representative figure of the German Enlightenment. His defence of Spinoza, who had traditionally been condemned as an atheist, provoked a major controversy in philosophy, and his publication of H. S. Reimarus' radical assault on Christianity led to fundamental changes in Protestant theology. This volume presents the most comprehensive collection to date in English of Lessing's philosophical and theological writings, several of which are here translated for the first (...) time. They are edited and translated by H. B. Nisbet, who also provides an introduction that sets them in their historical and philosophical contexts. (shrink)

The so-called fourth book of Aristotle's Meteorologica is not about meteorological phenomena at all. It describes the formation out of the four elements of ‘homoeomerous’ substances, by which are meant minerals such as stones and metals, and organic substances like flesh, skin, and hair, and the changes they can undergo under the influence of heat, cold, and moisture. Most commentators, ancient and modern, have seen that it has very little to do with the first three books of the Meteorologica to (...) which it is attached, and Alexander suggested that it should be placed after the second book de Generation et Corruptione. (shrink)

It is proposed in this paper to develop a method by which the most general problem of the algebra of propositions is solved. This problem is to construct all propositions whose truth is independent of the form of the variables. As might be expected this method will enable us to determine without the use of matrices the consistency and independence of propositions, except in the case of those fundamental properties, which taken together define consistency itself. In the discussion which follows (...) no limitations are placed on the meaning of the terms and the word proposition is used simply in the sense of a variable. If we were to say, for example, that our variables must be restricted to zero or one values, we would be introducing a limitation which would reduce the generality of our science. A logic may be false in the sense that its postulates lead to contradictory theorems, or it may be false in the sense that it lacks generality, and the situation is not saved by calling it a two-valued, or a three-valued logic, or a logic of “propositions,” or by designating it by some other euphuism. (shrink)

It seems natural enough to suppose that there must be some very close connection between our feelings of sympathy and our moral principles. A large part, at any rate, of the badness of bad men seems to consist in their lack of real concern for other people, and a large part of the goodness of good men consists in the regard they have for their fellows. Could a man who never felt with of for another be regarded as good, or (...) even as a moral being at all ? We should be inclined to say that this was impossible were it not that some philosophers appear to maintain that reason is the fundamental moral requirement and that unsympathetic beings might act rightly from some purely rational principle. Kant, for example, in a well-known passage, contrasts the man who helps others because he is sympathetically inclined towards them with the man who is too unhappy to feel with them but nevertheless helps them because he thinks he ought to. It is the second of these men, in his view, whose action is most clearly moral. In reply to this we may say that although a man's personal griefs at a particular time may render him at that time unable to feel with others even though he helps them as he ought, nevertheless he could not have performed such an act of heroic beneficence if his heart had never warmed towards anybody. (shrink)