There are marked differences between countries with regard to reimbursement decision-making, yet few studies have tried to understand this process and its consequences by a detailed analysis of the local context and decision-making structure. This article describes reimbursement decision-making and subsequent prescribing patterns of new pharmaceuticals by means of a case study on glitazones in treatment of type 2 diabetes mellitus patients in Denmark. The study shows that institutional arrangements, providing the context in which evidence is used, are highly important (...) for understanding the reimbursement decision-making process. In particular the Danish Medicines Agency (DMA) has shaped the decision to reimburse glitazones on the basis of physician-mediated requests of individual patients. Relatively few patients have been prescribed glitazones since their introduction in 2000, suggesting that individual reimbursement may be an effective instrument in controlling overall expenditure of selected pharmaceuticals, although in the case of glitazones this has likely been achieved at the expense of equality in access to the products. The discussion focuses on the generalizability of the findings to both other pharmaceuticals in the individual reimbursement scheme in Denmark, and to other countries that are trying to balance the need to control overall pharmaceutical care expenditure with the need to secure equality in access to new drugs with therapeutic added value. (shrink)

Philosopher Judith Butler has influenced how people talk about vulnerable bodies and sees vulnerability as universal, existential, and relational. Being vulnerable is part of the human condition. The main theoretical areas that run across Butler’s work; power, knowledge and subjectivity, performativity, and ethics—are of particular relevance to nursing practice. This review aims to explore how Butler’s theoretical work is reflected in research literature within a nursing context. We conducted a scoping review guided by Arksey and O’Malley’s methodological framework. A systematic (...) literature search of CINAHL (EBSCOhost), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), and Web of Science identified 15 papers. Butler’s theoretical work was applied at an individual and social level in research literature within a nursing context. Nurses need to reflect on their clinical practice and role as health professionals in relation to power and performativity in encounters with patients who are marginalized. Nurses’ working conditions, recognition, and understanding are strongly influenced by society, and calling nurses heroes undermines their capacity to challenge and resist the hero identity. The healthcare system’s impact on patient-nurse encounters challenges patients’ and nurses’ subjectivity, performativity, and power relations. The review allowed us to describe how Butler’s theoretical work can facilitate a reflection on nursing practice which is a prerequisite for caring, ethical relationships, and working conditions within a nursing context. Butler’s concepts can provide useful perspectives on how nurses understand, communicate with, and care for patients, as well as a nuanced understanding of the nursing role and power relations and structures. (shrink)

The aim of this study was to compare the acute effects of performing a lower body resistance training program in one long or two shorter sessions in 1 day on training volume and affective measures. Employing a randomized-crossover design, 23 resistance-trained women performed two training days consisting of one long or two short sessions separated by 3.5–5 h. Each training day was separated by 4-6 days and consisted of three sets to failure for six exercises. Training volume were recorded during (...) the sessions. Rating of perceived exertion for effort, rating of perceived exertion for discomfort, session displeasure/pleasure and exercise enjoyment were measured 10 min after each session. Participants also completed a readiness to train questionnaire, 24 h after each session, and which training protocol they preferred, 48 h after the last session. The long session led to higher RPE, RPD and sPDF compared to the short sessions. There was no difference in EES. The short sessions had 3% higher training volume than the long session. There were no differences in perceived readiness to train 24 h after the sessions. Twenty-two participants preferred the long session, while one preferred the short sessions. In conclusion, performing a longer, lower body, resistance training session led to greater perceptions of effort, discomfort and session pleasure than splitting the same program into two shorter sessions among resistance-trained women. However, two shorter sessions led to a greater training volume. (shrink)

A core value of Judaism is leading an ethical life. The Talmud, an authoritative source on Jewish law and tradition, has a number of discussions that deal with honesty in business and decision-making. One motive that can cause individuals to be unscrupulous is the presence of a conflict of interest. This paper will define, discuss, and review five Talmudic concepts relevant to conflict of interest. They are (1) Nogea B’Davar (being an interested party), (2) V’hiyitem N’keyim (behaving to ensure that (...) one is above suspicion) (3) Lifnei Iver (placing a stumbling block before the blind), (4) Shokhad (accepting a bribe), and (5) Geneivat Da’at (deception and undeserved goodwill). Case examples will be used to apply these Talmudic principles to contemporary business practice. This will include discussion of these Talmudic concepts as it applies to specific contemporary business examples relevant to the boardroom, accounting firms, investment banking, politics, and government. It may be impossible to eliminate all conflicts of interest. However, knowledge and awareness of these Talmudic principles can help individuals in business settings better address the ethical issues that they confront. (shrink)

This paper addresses the stalemate on the question whether biodiversity has intrinsic value. I distinguish between a “weak” conception and two “strong” conceptions of intrinsic value in the environmental ethics literature. The strong conceptions of intrinsic value are connected, respectively, to moral standing and to a strongly objectivist account of value. Neither of these forms of value likely applies to biodiversity. However, the weak conception of intrinsic value is neutral about both moral standing and the nature of value and plausibly (...) applies to biodiversity. In addition, weak intrinsic value avoids common objections to the claim that biodiversity is intrinsically valuable. I develop a cumulative argument showing that environmentalists should presume that biodiversity has intrinsic value in the weak sense. (shrink)

In this concise book based on his Arne Ryde Lectures in 2002, Young suggests a conceptual framework for studying strategic learning and highlights theoretical developments in the area. He discusses the interactive learning problem; reinforcement and regret; equilibrium; conditional no-regret learning; prediction, postdiction, and calibration; fictitious play and its variants; Bayesian learning; and hypothesis testing. Young's framework emphasizes the amount of information required to implement different types of learning rules, criteria for evaluating their performance, and alternative notions of equilibrium to (...) which they converge. He also stresses the limits of what can be achieved: for a given type of game and a given amount of information, there may exist no learning procedure that satisfies certain reasonable criteria of performance and convergence. In short, Young has provided a valuable primer that delineates what we know, what we would like to know, and the limits of what we can know, when we try to learn about a system that is composed of other learners. (shrink)

Professor H. James Birx shows how the never-ending controversy of human evolution came to be. He details the events that caused thinkers like Charles Darwin to develop his theory of evolution, and what ideas caused some people to reconcile a somewhat mystical theology with a concrete model of the universe. He tells you how Darwin's work infuriated everybody from "God-fearing" Christians to the church heirarchies. Birx explains how scientific advances and philosophical arguments have made beliefs about divine intervention as the (...) origin of man a moot point. He shows how creationism ignores proven scientific facts, and how human evolution remains a much sounder truth. You'll read how some western religions are starting to accept evolution as the process which creates life on earth. You'll also learn why scientific evolution and creationism have not been accepted together and how bold attempts to merge the two ideas have failed miserably. (shrink)

This paper offers a unified explanation for the procreation asymmetry and the non-identity thesis – two of the most intractable puzzles in population ethics. According to the procreation asymmetry, there are moral reasons not to create lives that are not worth living but no moral reasons to create lives that are worth living. I explain the procreation asymmetry by arguing that there are moral reasons to prevent the bad, but no moral reasons to promote the good. Various explanations for the (...) procreation asymmetry have failed to explain the non-identity thesis: if one could create a person with a good life or a different person with a better life, one has a moral reason to create the better life. I argue that reflections on the misfortune of unfulfilled potential allow us to circumvent the non-identity problem. (shrink)

The object of this article is to examine, with the work of Jeremy Bentham as the principal example, one strand in the complex pattern of European social theory during the second half of the eighteenth century. This was of course the period not only of the American and French revolutions, but of the culmination of the movements of thought constituting what we know as the Enlightenment. Like all great historical episodes, the Enlightenment was both the fulfilment of long-established processes and (...) the inauguration of new processes of which the fulfilment lay in the future. Thus the seminal ideas of seventeenth-century rationalism realized and perhaps exhausted their potentialities in the eighteenth-century Enlightenment. The ideas with which this article is concerned, however—conveniently grouped and labelled as the ideas of utilitarianism—only began to achieve systematic development in these later decades of the eighteenth century. Within that period—during the first half and more of Bentham's long life—attempts to apply those ideas to the solution of social problems met largely with failure and frustration. Yet unrealized potentialities remained, the realization of which was reserved for a time when the world of the philosophes no longer existed. The movements for social and political reform which have played so large a part in modern history since the French Revolution may be judged in widely differing ways; but whatever the verdict, these movements surely cannot be understood without due consideration of that part of their origins which lies in eighteenth-century utilitarianism. (shrink)

Aischylos darf als der eigentliche Schöpfer der Tragödie als literarischer Kunstform gelten, so sehr diese im 5. vorchristlichen Jahrhundert auch an ihren kultischen Ursprung gebunden bleibt. Aischylos führt den zweiten Schauspieler ein und nutzt technische Erfindungen zur Steigerung szenischer Effekte. Außerdem ist er der große Gestalter der tetralogischen Komposition, d.h. der Verbindung dreier Tragödien und eines Satyrspiels zu einer Handlungseinhait, die es ihm ermöglicht, die Verkettung von Hybris, Ate und Dike an ganzen Geschlechtern über Generationen hin zur Darstellung zu bringen. (...) Im Mittelpunkt seines Denkens steht die notwendig schuldhafte Existenz des handelnden Menschen, für den die Erfüllung einer überpersönlichen Forderung zugleich den Verstoß gegen eine andere, ebenso gültige Norm bedeutet. Überbrückt wird diese tragische Weltsicht im Glauben an die von Zeus repräsentierte Weltordnung, die den Menschen im einzelnen zwar unbegreiflich bleibt, deren grundsätzliche Sinnhaftigkeit sich ihm jedoch im Leiden erschließt. Adäquaten Ausdruck findet dieses Denken in einer urtümlichen und gewaltigen Sprache, deren Übersetzung in der hier vorliegenden Ausgabe philologisch präzis ist und gleichzeitig das Verständnis des aischyleischen Dramas erleichtert. (shrink)

The relative neglect of Greek commentary by modern Aristotelian scholarship could be justified, if only the neglectors had sufficient knowledge of the material they disdain. The curt dismissal of ancient views on the active intellect by W. D. Ross is perhaps a paradigm case of misplaced condemnation, for he evidently failed to take account of what their authors were about. It would be open to those who wish to discount these commentators to argue that they were, to a greater or (...) lesser extent, influenced by their Neoplatonism, and that this impairs their judgment on Aristotelian problems. But that would not be sufficient ground for total neglect: it merely indicates the need for careful utilization. One might go so far as to ask whether it is not perfectly possible for a commentator who happened to be a Neoplatonist to offer straightforward and reasonably unbiased commentary on Aristotle. Even if the answer to that question were negative, is it not likely that such Neoplatonic views as he read into Aristotle would at least be slanted towards Aristotelianism? (shrink)

It is demonstrated on the basis of the Dirac equation that quarks cannot be confined by a vector gluon potential of the form(r/r 0)a or[ln(r/r 0]a, a>0, if the quark-gluon interaction conserves parity. In order to confine quarks with the parity-conserving interaction, the effective gluon potential must be a pseudovector or a scalar. These are shown in a simple Yang-Mills field with theSU(2) group.

Edmund D. Pellegrino has played a central role in shaping the fields of bioethics and the philosophy of medicine. His writings encompass original explorations of the healing relationship, the need to place humanism in the medical curriculum, the nature of the patient’s good, and the importance of a virtue-based normative ethics for health care. In this anthology, H. Tristram Engelhardt, Jr., and Fabrice Jotterand have created a rich presentation of Pellegrino’s thought and its development. Pellegrino’s work has been dedicated to (...) showing that bioethics must be understood in the context of medical humanities, and that medical humanities, in turn, must be understood in the context of the philosophy of medicine. Arguing that bioethics should not be restricted to topics such as abortion, third-party-assisted reproduction, physician-assisted suicide, or cloning, Pellegrino has instead stressed that such issues are shaped by foundational views regarding the nature of the physician-patient relationship and the goals of medicine, which are the proper focus of the philosophy of medicine. This volume includes a preface by Dr. Pellegrino and a comprehensive Introduction by the editors. Of interest to medical ethicists as well as students, scholars, and physicians, _The Philosophy of Medicine Reborn_ offers fascinating insights into the emergence of a field and the work of one of its pioneers. “After a long period of dormancy, philosophy of medicine has blossomed with new life. The single most important physician-philosopher in that rebirth has been Edmund Pellegrino. His contributions to virtue theory, the concept of beneficence, the dispute over the internal and external sources of a morality for medicine, and the role of the Hippocratic tradition are all critical. The essays collected in this volume have changed the history of the philosophy of medicine. He shows that philosophy of medicine can be done with both passion and compassion.” —_Robert M. Veatch, Kennedy Institute of Ethics, Georgetown University_ “Edmund Pellegrino's words have helped medical students, faculty, scholars and patients address the challenges they encounter in medicine and medical practice. His personal support has also been critical for many of us in developing programs in medical ethics and philosophy of medicine in our universities. Dr. Pellegrino combines the wisdom of a great physician with those of a great philosopher to produce a body of writing that will continue to inspire us all. This volume contains some of his best and most influential work.” —_Loretta Kopelman, The Brody School of Medicine, East Carolina University_ _ _ “Edmund Pellegrino has been a leading light in the philosophy of medicine for a generation. He was instrumental in the birth of bioethics, founded one of the leading journals, and provided able leadership in organizing early activities of the profession. He has served as department chairman, dean, and university president. Most recently, he chairs the President’s Council on Bioethics. In all this, first and foremost, he has been a physician. Those who are ill and suffering make a claim upon him. To respond to this claim, Pellegrino creatively brings together the worlds of science and of the humanities. For him, that is what medicine is about, making it the most scientific of the humanities and the most humane of the sciences. Fortunately for us, Pellegrino brings these worlds together in thought, as well as in practice. In this selection from his writings, Engelhardt and Jotterand have captured the heart of Pellegrino’s project, both in depth and breadth, so we can also hear that claim of the ill and so we can see what worlds must come together if we are to respond in the appropriate way.” —_George Khushf, University of South Carolina_ “Pellegrino’s work is both a treasure and important for understanding bioethics. His work in philosophy of medicine addresses the crucial questions that are so important to understanding the practice of medicine and the ethics of health care.” —_Kevin Wildes, President, Loyola University_ _ _. (shrink)

"We prove that any variety of relation algebras which contains an algebra with infinitely many elements below the identity, or which contains the full group relation algebra on some infinite group (or on arbitrarily large finite groups), must have an undecidable equational theory. Then we construct an embedding of the lattice of all subsets of the natural numbers into the lattice of varieties of relation algebras such that the variety correlated with a set [italic capital]X of natural numbers has a (...) decidable equational theory if and only if [italic capital]X is a decidable (i.e., recursive) set. Finally, we construct an example of an infinite, finitely generated, simple, representable relation algebra that has a decidable equational theory.'' -- Abstract. (shrink)