ObjectivesMany older adults with visual impairment also have significant hearing loss. The aim was to investigate the effectiveness of a newly developed Dual Sensory Loss protocol on communication and wellbeing of older persons with DSL and their communication partners in the Netherlands and Belgium.MethodsParticipants and their communication partners were randomized in the “DSL-protocol” intervention group or a waiting-list control group. The intervention took 3 to 5 weeks. Occupational therapists focused on optimal use of hearing aids, home-environment modifications and effective communication (...) strategies. The primary outcome was the Communication Strategies domain of the Communication Profile for the Hearing Impaired. Secondary outcomes measured in participants were the Low Vision Quality Of Life Adjustment subscale, the Center for Epidemiological Studies - Depression Scale, De Jong Gierveld Loneliness Scale and the Fatigue Assessment Scale. The Hearing Handicap and Disability Inventory - Reaction of Others subscale and the Care-related Quality of Life - 7 Dimensions was measured in communication partners. Measurements were taken at baseline and 3-month follow-up. Linear mixed models were used to analyze effects between groups over time for every outcome measure.ResultsIntention-to-treat analyses showed a significant effect of the DSL-protocol on the use of verbal strategies in favor of the control group, however, this effect was non-significant after adjustment for confounding. Effect sizes of other outcomes varied between −0.23 [−0.57, 0.12] and 0.30 [−0.05, 0.64]. The LMM showed a significant effect on the HHDI-Reaction of others scale in favor of communication partners in the treatment group, however, the effect did not remain significant at a 0.01 significance level and the effect size was very small and non-significant 0.12, 95% CI [−0.27 to 0.51]. Adjusted analyses did not reveal treatment effects.ConclusionThe DSL-protocol did not clearly contribute to the enhancement of communication and wellbeing in DSL-patients. Possible reasons for the lack of effects are OTs not being comfortable giving advice on communication and psychosocial issues or the short-term treatment and follow-up period. Further study is warranted to find out how the protocol may be adapted or whether it is necessary to involve mental healthcare professionals.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NTR2843. (shrink)

This paper describes the perspectives of stakeholders within the North American dairy industry on key issues affecting the welfare of dairy cattle. Five heterogeneous focus groups were held during a dairy cattle welfare meeting in Guelph, Canada in October 2012. Each group contained between 7 and 10 participants and consisted of a mix of dairy producers, veterinarians, academics, students, and dairy industry specialists. The 1-h facilitated discussions were audio-recorded and transcribed verbatim. Content analysis of the resulting transcripts showed that participants (...) across all stakeholder categories identified lameness as the most important welfare issue facing dairy cattle. Other prominent issues of concern included cow comfort, disease, on-farm mortality, stockmanship, painful procedures, injuries, cull cow management, calf management, and restriction of behavioural freedoms. Participants typically gave several reasons for why they considered issues problematic. Underlying reasons were grouped according to animal-centered concerns [at both the individual and at the herd level ] and industry-centered concerns . This analysis identified areas of shared concern among diverse stakeholder groups, which should aid in the development of standards and policies that satisfy stakeholders within and external to the dairy industry. (shrink)

The main concern of this paper is to study the dynamic of a predator–prey system with diffusion. It incorporates the Holling-type-II and a modified Leslie–Gower functional responses under Robin boundary conditions. More concretely, we study the dissipativeness of the system by using the comparison principle, and we derive a criteria for permanence and for predator extinction.

Introduction: Uncertainty is omnipresent in cancer care, including the ambiguity of diagnostic tests, efficacy and side effects of treatments, and/or patients' long-term prognosis. During second opinion consultations, uncertainty may be particularly tangible: doubts and uncertainty may drive patients to seek more information and request a second opinion, whereas the second opinion in turn may also affect patients' level of uncertainty. Providers are tasked to clearly discuss all of these uncertainties with patients who may feel overwhelmed by it. The aim of (...) this study was to explore how oncologists communicate about uncertainty during second opinion consultations in medical oncology.Methods: We performed a secondary qualitative analysis of audio-recorded consultations collected in a prospective study among cancer patients who sought a second opinion in medical oncology. We purposively selected 12 audio-recorded second opinion consultations. Any communication about uncertainty by the oncologist was double coded by two researchers and an inductive analytic approach was chosen to allow for novel insights to arise.Results: Seven approaches in which oncologists conveyed or addressed uncertainty were identified: specifying the degree of uncertainty, explaining reasons of uncertainty, providing personalized estimates of uncertainty to patients, downplaying or magnifying uncertainty, reducing or counterbalancing uncertainty, and providing support to facilitate patients in coping with uncertainty. Moreover, oncologists varied in their choice of words/language to convey uncertainty.Discussion: This study identified various approaches of how oncologists communicated uncertain issues during second opinion consultations. These different approaches could affect patients' perception of uncertainty, emotions provoked by it, and possibly even patients' behavior. For example, by minimizing uncertainty, oncologists may consciously steer patients toward specific medical decisions). Future research is needed to examine how these different ways of communicating about uncertainty affect patients. This could also facilitate a discussion about the desirability of certain communication strategies. Eventually, practical and evidence-based guidance needs to be developed for clinicians to optimally inform patients about uncertain issues and support patients in dealing with these. (shrink)

The objectives of this study were to develop a high-density chromosome bin map of homoeologous group 7 in hexaploid wheat, to identify gene distribution in these chromosomes, and to perform comparative studies of wheat with rice and barley. We mapped 2148 loci from 919 EST clones onto group 7 chromosomes of wheat. In the majority of cases the numbers of loci were significantly lower in the centromeric regions and tended to increase in the distal regions. The level of duplicated loci (...) in this group was 24% with most of these loci being localized toward the distal regions. One hundred nineteen EST probes that hybridized to three fragments and mapped to the three group 7 chromosomes were designated landmark probes and were used to construct a consensus homoeologous group 7 map. An additional 49 probes that mapped to 7AS, 7DS, and the ancestral translocated segment involving 7BS also were designated landmarks. Landmark probe orders and comparative maps of wheat, rice, and barley were produced on the basis of corresponding rice BAC/PAC and genetic markers that mapped on chromosomes 6 and 8 of rice. Identification of landmark ESTs and development of consensus maps may provide a framework of conserved coding regions predating the evolution of wheat genomes. (shrink)

We present a solution to the problem of defining a counterpart in Algebraic Set Theory of the construction of internal sheaves in Topos Theory. Our approach is general in that we consider sheaves as determined by Lawvere-Tierney coverages, rather than by Grothendieck coverages, and assume only a weakening of the axioms for small maps originally introduced by Joyal and Moerdijk, thus subsuming the existing topos-theoretic results.

This book provides a clear and nuanced appraisal of Hegel's treatment of Africa, India, and Islam, and of the implications of this treatment for postcolonial and global studies. Analyzing Hegel's master-slave dialectic and his views on Africa, India, and Islam, it situates these views not only within Hegel's historical scheme but also within a broader European philosophical context and the debates they have provoked within Hegel scholarship. Each chapter explores various in depth readings of Hegel by postcolonial critics, investigating both (...) the Eurocentric and potentially global nature of his dialectic. Ultimately, the book shows both where of this profoundly influential thinker archetypally embodies certain Eurocentric traits that have characterized modernity and how, ironically, he himself gives us the tools for working towards a more global vision. Offering a concise introduction not only to an important dimension of Hegel's thought - his orientation towards "empire" - but also to the various issues raised by postcolonial theory and global studies, this book will be of use to philosophers as well as advanced students of literary and cultural theory alike. (shrink)

GEORGE BOOLE died one hundred years ago. This essay from Cork is intended as commemorative of a great man, for too long forgotten in the College he served so well.

The study presents the broad outlines for a relationalist interpretation of the Indian epistemological doctrine svataḥ prāmāṇya. Due to the inadequacy of the main western interpretations thereof, the paper’s approach can be considered an inference to the best explanation. Its main part is devoted to the typologization of various epistemological doctrines based on the svataḥ prāmāṇya principle in terms of strong and weak disjunctivism. Three paradigm cases of strong disjunctivism and a special variety of weak disjunctivism have thus been identified (...) in Indian epistemology, which allowed to draw a conclusion that strong disjunctivism constituted one of its general paradigms. (shrink)

In Chinese scholarship, Xunzi is often regarded as an eclectic Confucian master who accepted some form of utilitarian thoughts (e.g. Fung Yu-lan, Mou Zongsan and Xu Fuguan). This characteristic was also observed by some western scholars such as Benjamin I. Schwartz. In a recent study, I argued that the basic character of Xunzi’s philosophy is utilitarianism in a broad sense based on an examination on his intellectual criticism and political criticism. Xunzi asserts that humans are innately driven by self-interested desires, (...) and he evaluates all intellectual works and political behaviours by their utility. However, he does not limit utility to only basic animal desires such as food and sex. In Xunzi’s view, humans also have innate emotions; hence, these emotions should also be accounted for in their utility. This is similar to John Stuart Mill’s redefinition of Bentham’s concept of utility. Are Xunzi’s and Mill’s concepts of utility exactly the same? This question has yet to be examined. This article is a comparative study between utilitarianism and Xunzi’s philosophy which especially explores the compatibility of these two philosophies. (shrink)

The failure to maintain a canonical Christian understanding of the family as a microcosm of the church oriented toward deification instead of a microcosm of society aimed at social ends has opened Christians up to an uncritical adoption of non-Christian approaches in medical decision making. This article begins by identifying the Christian family crisis not as a liberal versus conservative debate centered on the form and function of the family, but more fundamentally as an ecclesial versus sociological understanding of the (...) Christian family. The article presents a historical sketch of the circumstances that have led to this contemporary crisis in the Western Christian family, followed by an analysis that provides a canonical account of the Christian family as exemplified in the thought of Gregory the Theologian. This article concludes by looking at the specific issue of labor and delivery in the United States, and the implications for a canonical Christian understanding of labor and delivery in light of contemporary medical practices. (shrink)

The restoration of "forgotten" names to the bosom of our culture is a natural and necessary accompaniment of the political freedom beginning to make its way in our country. Free and continuous creativity is being reunited with the reader, the listener, and the participant, who had been tragically alienated from it. Our half-knowledge, intellectual arbitrariness, and opportunism are becoming clearer, more acute, and more shameful. All this is an inevitable accompaniment of one of the most prestigious and, it would seem, (...) least labor consuming trends in contemporary publishing and journal policy. The publication of texts of Russian philosophers has marked journals as different in character and mission as Novyi mir, Voprosy filosofii, Literaturnaia ucheba, Druzhba narodov, Volga, and many others. In most cases they are more or less well known works reprinted from the YMCA Press, equipped with prefaces—some better, some worse—and devoid of any sort of real intellectual commentary. (shrink)

Open peer commentary on the article “Second-Order Science: Logic, Strategies, Methods” by Stuart A. Umpleby. Upshot: This article argues that we do not need a new scientific method or a “second-order science” to deal with the facts that the individual characteristics of observers may affect the nature and quality of their observations and that the application of scientific theories may affect the systems they describe. It also argues that Umpleby has not given us good reason to think that we do.

While protection of autonomy is crucial to the practice of medicine, there is the persistent risk of a disconnect between the notion of self-determination and the need for a socially responsible medical system. An example of unbridled autonomy is the preferential use of costly medications without an appreciation of the impact of using these more expensive drugs on the resource pool of others. In the USA, costly medications of questionable incremental benefit are frequently prescribed with the complicity of both doctors (...) and patients. Limiting self-determination in medication choices via an appreciation of the principle of justice reaches a better moral balance, while at the same time acknowledging the goals of doing good and avoiding harm in patient care. (shrink)

Recognized in his day as a man of letters equaling Rousseau and Voltaire in France and rivaling Samuel Johnson, David Hume passed from favor in the Victorian age--his work, it seemed, did not pursue Truth but rather indulged in popularization. Although Hume is once more considered as one of the greatest British philosophers, scholars now tend to focus on his thought rather than his writing. To round out our understanding of Hume, M. A. Box in this book charts the interrelated (...) development of Hume's literary ambitions, theories of style, and compositional practice from his Treatise in 1739 through the Enquiries. In so doing, Box makes the case for Hume's career-long concern with the presentational modes of reaching an audience for his philosophical writings. Hume reacted to the popular failure of his masterpiece, A Treatise of Human Nature, Box suggests, by self-consciously exploring strategies in his subsequent works for agreeably bringing his readership to participate in the act of philosophizing. Combining a sensitive grasp of the ways Restoration period and eighteenth-century writers conceived the relations between rhetoric and philosophy with sound readings of particular texts, Box shows how Hume's literary concerns went beyond matters of style to involve persona, structure, and doctrine. While this book helps explain long-standing ambiguities surrounding Hume, especially by pointing out the tension between his created persona and his own voice, it also serves as an excellent introduction to his philosophy. (shrink)

Paper-based privacy policies fail to resolve the new changes posed by electronic healthcare. Protecting patient privacy through electronic systems has become a serious concern and is the subject of several recent studies. The shift towards an electronic privacy policy introduces new ethical challenges that cannot be solved merely by technical measures. Structured Patient Privacy Policy (S3P) is a software tool assuming an automated electronic privacy policy in an electronic healthcare setting. It is designed to simulate different access levels and rights (...) of various professionals involved in healthcare in order to assess the emerging ethical problems. The authors discuss ethical issues concerning electronic patient privacy policies that have become apparent during the development and application of S3P. (shrink)