Historians of the Roman Empire have been nearly unanimous in giving the ill-fated Caesar whom Hadrian designated as his successor the cognomen Verus ascribed to him by Spartianus.2 Following the same biographer Annalists have given the names Aurelius and Annius to his father and grandfather. Noris in his Epistola Consularis3 maintained against Pagi that the original names of this prince were Lucius Ceionius Commodus, that neither he nor any of his family bore the names Aurelius, Annius, or Verus ascribed to (...) them in the Historia Augusta, but that the name Verus has been mistakenly reflected upon him from his more famous son L. Verus Augustus the colleague of M. Aurelius Antoninus. De Tillemont4 rejected Noris’ opinion on purely literary grounds, saying, ‘il est bien difficile de croire qu'un auteur ait esté assez ignorant et assez malheureux pour nommer toujours un prince, mesme en faisant exprès son histoire, d'un nom qu'il n'a jamais eu.’ By consequence the mistake, if mistake it be, is become inveterate and is repeated5 down to our own day. Klebs6 alone rejects the jiame, and the error is not corrected in Dr. Bury's edition of Gibbon. (shrink)

Silence has gained a prominent role in the field of psychotherapy because of its potential to facilitate a plethora of therapeutically beneficial processes within patients’ inner dynamics. This study examined the phenomenon from a conversation analytical perspective in order to investigate how silence emerges as an interactional accomplishment and how it attains interactional meaning by the speakers’ adjacent turns. We restricted our attention to one particular sequential context in which a patient’s turn comes to a point of possible completion and (...) receives a continuer by the therapist upon which a substantial silence follows. The data collection consisted of 74 instances of such post-continuer silences. The analysis revealed that silence can retroactively become part of a topic closure sequence, can become shaped as an intra-topic silence, and can be explicitly characterized as an activity in itself that is relevant for the therapy in process. Only in this last case, the absence of talk is actually treated as disruptive to the ongoing talk. Although silence is often seen as a therapeutic instrument that can be implemented intentionally and purposefully, our analysis demonstrated how it is co-constructed by speakers and indexically obtains meaning by adjacent turns of talk. In the ensuing turns, silence indeed shows to facilitate access to the patient’s subjective experience at unconscious levels. (shrink)

Moral Case Deliberations are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support, it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases. These limitations warrant (...) research into complementary ways of providing CES to healthcare professionals. Our research objective was therefore to develop a low threshold CES tool based on a series of MCDs on autonomy in long-term care. We used a qualitative research design in which we analyzed the process and content of a series of MCDs, combined with reflections on the theoretical background of MCD. In total 28 MCDs were analyzed by means of a thematic content analysis. In various rounds of development, the results of the analysis were combined with theoretical reflections on CES. Consequently, the tool was evaluated in three focus groups and adjusted. The CES tool, called ‘moral compass’, guides the users through a series of six subsequent questions in order to methodically reflect on their concrete moral dilemma, in the form of a booklet of 23 pages. It combines a methodical element that encourages and structures a reflection process with a substantive element, including norms, values, options, strategies, and insights regarding dealing with client autonomy. By using data from a series of MCDs, combined with theoretical reflections on MCD, ethics support and moral learning, we developed a thematic, low-threshold CES tool that supports healthcare professionals in daily practice in dealing with moral questions regarding client autonomy. It integrates examples and insights from earlier MCDs on the same topic. The moral compass is not a replacement of, but can be used complementary to MCD. The feasibility and impact of the moral compass need to be investigated in an evaluative follow-up study. The methodology presented in this paper may be used to develop moral compasses on different topics in various healthcare organizations. (shrink)

In biological electron transport the spin, and thus the magnetic property of electrons, is neglected. Furthermore, no attention is paid to the fact that the great majority of biologically important molecules are chiral, and during excitation a magnetic moment is induced in them. It is shown, both theoretically and experimentally, that the magnetic moment of the electron and the magnetic transition moment of the optically active molecules may interact. The main consequences of such an interaction are a higher probability of (...) the occurrence of optically active molecules in triplet states, and the polarization of transported electrons. (shrink)

Through ten case studies by international specialists, this book investigates the circulation and production of scientific knowledge between 1750 and 1945 in the fields of agriculture, astronomy, botany, cartography, medicine, statistics, and zoology. The book will interest scholars and undergraduate and graduate students concerned with the connections between the history of science, imperial history, and global history.

BackgroundCommunity engagement within biomedical research is broadly defined as a collaborative relationship between a research team and a group of individuals targeted for research. A Community Advisory Board is one mechanism of engaging the community. Within genomics research CABs may be particularly relevant due to the potential implications of research findings drawn from individual participants on the larger communities they represent. Within such research, CABs seek to meet instrumental goals such as protecting research participants and their community from research-related risks, (...) as well as intrinsic goals such as promoting the respect of participants and their community. However, successful community engagement depends on the degree to which CABs legitimately represent and engage with communities targeted for research. Currently, there is little literature describing the use of CABs in genomics research taking place in developing countries, and even less in the field of genomics research relating to mental illness. The aim of this article is to describe and consider the contributions made by a researcher-driven, population-specific CAB in a genomics of schizophrenia research project taking place in South Africa, from the perspective of the research team.DiscussionFour broad discussion topics emerged during the CAB meetings namely: 1) informed consent procedures, 2) recruitment strategies, 3) patient illness beliefs and stigma experiences, and 4) specific ethical concerns relating to the project. The authors consider these discussions in terms of their contributions to instrumental and intrinsic goals of community engagement.SummaryThe CAB gave valuable input on the consent processes and materials, recruitment strategies and suggested ways of minimizing the potential for stigma and discrimination. All of these contributions were of an instrumental nature, and helped improve the way in which the research took place. In addition, and perhaps more importantly, the CAB made a unique and important contribution relating to intrinsic functions such as promoting the respect and dignity of research participants and their community. This was particularly evident in ensuring sensitivity and respect of the community’s traditional beliefs about schizophrenia and its treatment, and in this way promoting a respectful relationship between the research team and the participants. (shrink)

To investigate the current status of hospital clinical ethics committees (CEC) and how they have evolved in Canada over the past 20 years, this paper presents an overview of the findings from a 2008 survey and compares these findings with two previous Canadian surveys conducted in 1989 and 1984. All Canadian hospitals over 100 beds, of which at least some were acute care, were surveyed to determine the structure of CEC, how they function, the perceived achievements of these committees and (...) opinions about areas with which CEC should be involved. The percentage of hospitals with CEC in our sample was found to be 85% compared with 58% and 18% in 1989 and 1984, respectively. The wide variation in the size of committees and the composition of their membership has continued. Meetings of CEC have become more regularised and formalised over time. CEC continue to be predominately advisory in their nature, and by 2008 there was a shift in the priority of the activities of CEC to meeting ethics education needs and providing counselling and support with less emphasis on advising about policy and procedures. More research is needed on how best to define what the scope of activities of CEC should be in order to meet the needs of hospitals in Canada and elsewhere. More research also is needed on the actual outcomes to patients, families, health professionals and organisations from the work of these committees in order to support the considerable time committee members devote to this endeavour. (shrink)

If the physical mind is located in quantized space of the brain then how does the physical mind become the self? This remains an unresolved problem. It can be restated as how mental representations or mental states get their informational contents, and of doing so in terms of the natural functions brain states have? We call these natural brain functions not teleosemantic functions, but rather teleological functions. This is because teleosemantics portrays mental representations which must have informational contents that track (...) “operational explanations of cognitive capacities” while teleological functions do not as they are hidden in quantized space, suggesting that mind is physical. Specifically teleonomic capacities have been built into us by natural selection, which naturally leads to a teleogical notion of function. Our claim is that teleofunctionality as unification of mental states has natural functions that carry intrinsic dispositions that may be broadly defined as ‘subjectivity’ or intrinsic information content of mental states. Mental states have intrinsic dispositions to change their functions, producing correspondences to the world that includes further layers of subtlety hidden in quantized space. How does intrinsic information self-replicate content in cases of mental misrepresentation? The putative special virtue of teleosemantics and its ability to give a theory of error through ‘uncertainty’ is discussed based on a teleological functionalist epistemology. (shrink)

© 2014 Taylor Francis. The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus testing of every client presenting for services in venues where HIV prevalence is high. Because older adults have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent and ever HIV testing in a probability sample of at-risk (...) adults seeking services in needle exchange sites, sexually transmitted disease clinics, and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months or ever. Aging-related disparities in HIV testing exist among clients of these high HIV prevalence venues and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis. (shrink)

This new edition brings Farquharson's authoritative 1944 translation up to date and includes a helpful introduction and notes for the student and general reader. Rutherford includes a selection of letters from Marcus to his tutor Fronto--most of which date from his earlier years--that offer personal detail and help to fill out the somber portrait of the emperor that is found in the Meditations.

RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)

Il contributo sostiene che una versione lunga e composita del Viaggio notturno del profeta e della sua ascensione, attribuita a Ibn ‘Abbas attraverso una figura più tarda conosciuta come al-Bakri, è diventata molto popolare e largamente diffusa nel tredicesimo secolo. Qui si propone una traduzione del viaggio celeste di Muhammad a partire da un importante manoscritto inedito di Istanbul copiato nella penisola araba verso la fine del tredicesimo secolo. Questa traduzione si propone come strumento per gli studiosi interessati alla tradizione (...) islamica delle ascensioni celesti e per chi si occupa delle possibile influenze musulmane sull’opera di Dante. Nonostante non si dimostri che Dante avesse avuto accesso diretto a questa fonte nel momento in cui componeva la divina commedia, ci sono prove sufficienti che le versioni di questo racconto fossero diffuse in diverse parti del Mediterraneo, prima e durante la vita di Dante. L’autore fa propria la recente ipotesi interpretativa di Bencheikh che sottolinea il ruolo fondamentale della versione di Bakri del Mi’râj per la composizione dell’ormai noto Libro della Scala, tradotto in latino e lingua francese antico in al-Andalus nella seconda metà del tredicesimo secolo.This article argues that a long and composite version of the narrative of Muhammad's night journey and ascension, one often ascribed to Ibn 'Abbas via a later figure known as al-Bakri, became especially popular and widely distributed in the thirteenth-century CE. It offers a translation of the Tour of Paradise section from a particularly important unpublished Istanbul manuscript preserving this version, copied in the Arabian peninsula near the end of the thirteenth-century. This translation could serve as a resource to scholars who are interested in the history of Islamic ascension narratives, and interested in the question of possible Muslim influences on Dante's Divine Comedy. While the author of this article does not argue that Dante must have been aware of this particular manuscript as he composed his masterwork, he claims that there is enough evidence to suggest that versions of this narrative circulated in different parts of the Mediterranean before and during Dante's lifetime. He supports the earlier conjecture by Bencheikh that the Bakri versions were likely foundational to the composition of the now famous "Book of Muhammad's Ladder" that was translated into Latin and Old French in al-Andalus / Spain in the second half of the thirteenth-century. (shrink)