In this paper we study three-valued simple games as a natural extension of simple games. We analyze to which extent well-known results on the core and the Shapley value for simple games can be extended to this new setting. To describe the core of a three-valued simple game we introduce vital players, in analogy to veto players for simple games. Moreover, it is seen that the transfer property of Dubey can still be used to characterize the Shapley value for three-valued (...) simple games. We illustrate three-valued simple games and the corresponding Shapley value in a parliamentary bicameral system. (shrink)

Aims: To assess patient receipt of written information. To ensure patients understand the written information about a resuscitation policy and to determine whether they disapproved of or had concerns about the policy. Methods: All admissions to four wards of the hospital were approached for an interview. A set questionnaire was asked by one of 2 interviewers. Results: 72% of 572 admissions were interviewed. Refusal accounted for only 2 of the people not interviewed. 11% were unable to advocate for themselves by (...) reason of mental incompetence, inability to communicate or impairment secondary to their illness. Of the 401 interviewed only 49% recalled receiving the patient information booklet. Few patients (17%) recalled reading the information in the patient information booklet. They were all then given the paragraph about the hospital’s resuscitation policy. 352 were asked their understanding and only 61% demonstrated that they understood the paragraph. 91% of all 401 patients approved of the hospital having the option of DNR orders. 31% of people however had concerns related to DNR orders. These are discussed. Conclusions: Many acutely unwell patients are unable to advocate for themselves. Written information is a poor method of communicating with patients. There was limited receipt of the information and many misunderstood the paragraph about the hospitals resuscitation policy. There was a wide range of patient thoughts and concerns expressed. (shrink)

This series provides individual textbooks on early Greek poetry, on Greek drama, on philosophy, history and oratory, and on the literature of the Hellenistic period and of the Empire. A chapter on books and readers in the Greek world concludes Part 4. Each part has its own appendix of authors and works, a list of works cited, and an index.

The period from the eighth to the fifth centuries B.C. was one of extraordinary creativity in the Greek-speaking world. Poetry was a public and popular medium, and its production was closely related to developments in contemporary society. At the time when the city states were acquiring their distinctive institutions epic found the greatest of all its exponents in Homer, and lyric poetry for both solo and choral performance became a genre which attracted poets of the first rank, writers of the (...) quality of Sappho, Alcaeus and Pindar, whose influence on later literature was to be profound. This volume covers the epic tradition, the didactic poems of Hesiod and his imitators, and the wide-ranging work of the iambic, elegiac and lyric poets of what is loosely called the archaic age. The contributors make use of recent papyrus finds to fill out the picture of a cosmopolitan and highly sophisticated literary culture which had not yet found its intellectual centre in Athens. (shrink)

This series provides individual textbooks on early Greek poetry, on Greek drama, on philosophy, history and oratory, and on the literature of the Hellenistic period and of the Empire. A chapter on books and readers in the Greek world concludes Part IV. Each part has its own appendix of authors and works, a list of works cited, and an index.

This volume ranges in time over a very long period and covers the Greeks' most original contributions to intellectual history. It begins and ends with philosophy, but it also includes major sections on historiography and oratory. Although each of these areas had functions which in the modern world would not be considered 'Literary', the ancients made a less sharp distinction between intellectual and artistic production, and the authors included in this volume are some of Europe's most powerful stylists: Plato, Herodotus, (...) Thucydides and Demosthenes. (shrink)

At some time around August 324b.c., Antipater, the regent of Macedonia received orders from Alexander the Great that he was to be replaced with another eminent officer in the Macedonian court, Craterus. In addition to his removal from office, Antipater was ordered by Alexander to leave Macedonia for the East, bringing with him fresh levies to replenish those that comprised Craterus' own contingent of veterans from Opis. Though Craterus left Alexander's court shortly thereafter, neither man can be said to have (...) made the journey speedily or directly. A range of reasons has been given to explain Craterus' slow advancement, including the construction of infrastructure to allow the transportation of military resources from east to west, the poor state of his health, and the need to recruit more men. By the time of Alexander's death in June of 323, Craterus and his forces had only reached the province of Cilicia in southeastern Anatolia. Antipater's immediate reaction to his new role is not recorded, but what is known is that he remained steadfast in Macedonia, seemingly in defiance of Alexander's orders. It is the purpose of this paper to evaluate Antipater's refusal to depart from Macedonia, to explore whether tensions between Antipater and his replacement could account for Craterus' sluggish advance and to highlight the impact that Greek domestic politics had on Antipater's position in Macedonia. (shrink)

As a preliminary step to beginning to assess the usefulness of clinical vignettes to measure ethical sensitivity in undergraduate medical students, five clinical vignettes with seven to nine ethical issues each were created. The ethical issues in the vignettes were discussed and outlined by an expert panel. One randomly selected vignette was presented to first, second and third year students at the University of Toronto as part of another examination. The students were asked to list the issues presented by the (...) patient problem. Responses from 281 students were obtained. These students identified an average of 2.72 ethical issues per vignette. Each response was classified under the domains of autonomy, beneficence and justice. Comparisons were made between classes and between vignettes. There was considerable variation between classes and the responses to different vignettes seem to indicate that different vignettes measure the various domains in different ways. It does appear that the use of vignettes is one way to measure aspects of ethical sensitivity in medical students but more study is required to clarify exactly what is being measured. (shrink)

An instrument to assess 'ethical sensitivity' has been developed. The instrument presents four clinical vignettes and the respondent is asked to list the ethical issues related to each vignette. The responses are classified, post hoc, into the domains of autonomy, beneficence and justice. This instrument was used in 1990 to assess the ethical sensitivity of students in all four medical classes at the University of Toronto. Ethical sensitivity, as measured by this instrument, is not related to age or grade-point average. (...) Sensitivity increases between the 1st and 2nd year and then decreases throughout the rest of undergraduate medical training, such that the 4th-year students identify fewer issues than those entering medical school. Students expressing a career choice of family medicine identify more issues than their peers. Several problems with the use of the instrument and the interpretation of the data were found. Nonetheless, these findings, if reproducible, are important and their meaning needs further discussion. (shrink)

Gil R, Arroyo-Anllo EM, Ingrand P, Gil M, Neau JP, Ornon C, Bonnaud V. Self-consciousness and Alzheimer’s disease. Acta Neurol Scand 2001: 104: 296–300. # Munksgaard 2001. Objectives – To propose a neuropsychological study of the various aspects of self-consciousness (SC) in Alzheimer’s disease. Methods – Forty-five patients with probable mild or moderate AD were included in the study. Severity of their dementia was assessed by the Mini Mental State (MMS). Fourteen questions were prepared to evaluate SC. Results – No (...) significant correlations were found between SC score and educational level, age, and duration of disease. A significant correlation was found between SC score and the severity of dementia, whereas frontal disturbances were just short of the significance threshold. The various aspects of SC were not impaired to the same degree. The most disturbed ones were awareness of cognitive deficiencies, moral judgements and prospective memory. The least disturbed aspects were awareness of identity and of mental representation of the body. Items relating to anosognosia and moral judgements were significantly correlated with the MMS score, whereas affective state, body representation disorders, prospective memory, and capacities for introspection were not related to the severity of the dementia. Consciousness of identity was sound, regardless of MMS score. Conclusions – AD clearly induces an heterogeneous impairment of SC. SC requires a convergence of many neural networks. In AD, neuronal alterations involve many cortical areas and information sent to the associative frontal cortex from memory, language and visuospatial areas is lacking or disturbed. Thus, the sequential order of successive stimuli cannot be maintained by the heteromodal associative cortex (dorsal convexity of the prefrontal cortex), and the supramodal associative cortex (located rostrally in the frontal lobes) is unable to provide reliable monitoring and assessment of simultaneous neural cognitive networks carrying insufficient and inadequate input. The core deficiency in AD patients might be impaired SC equated with the disability to maintain sequential and simultaneous ‘‘attention to life’’. The Self-Consciousness Questionnaire, a clinical scale providing multidimensional measurement, indicates that different aspects of consciousness are not correlated with overall cognitive deficiency as determined by the MMSE. (shrink)

This series provides individual textbooks on early Greek poetry, on Greek drama, on philosophy, history and oratory, and on the literature of the Hellenistic period and of the Empire. Each part has its own appendix of authors and works, a list of works cited, and an index. This volume studies the revolutionary movement represented by the more creative of the Hellenistic poets and finally the very rich range of authors surviving from the imperial period, with rhetoric and the novel contributing (...) a distinctive flavour to the culture of the time. Appropriately enough, the volume closes with a survey of books and readers in the ancient world, which draws attention to the bookish nature of Greek literature from the Hellenistic period onwards and points forward to its survival into the Middle Ages. (shrink)

OBJECTIVES: To study the accuracy of reviewing ward notes (chart review) as a measure of the quality of care rendered to patients with "Do Not Resuscitate" (DNR) orders. DESIGN: We reviewed the charts of 19 consecutive, competent inpatients with DNR orders for evidence that the staff addressed a broad range of patient care needs called Concurrent Care Concerns (CCCs), such as withholding treatments other than resuscitation itself, and attention to patient comfort needs. We then interviewed the patient, consultant physician, house (...) officer, and primary nurse and compared the ward notes with the understandings of these staff members. SETTING: The medical service of an urban university medical centre. RESULTS: The average number of documented CCCs addressed per DNR order was 1.1. The ward notes generally agreed with the perceptions of patients, house officers, and nurses (% agreement with notes = 79%, 77%, and 82%; kappa = 0.43, 0.40, 0.50). Consultant physicians' understandings were poorly reflected in the ward notes (% agreement = 59%; kappa = 0.18). They overestimated attention to CCCs compared with the notes (P < 0.0001) and with other observers (P < 0.0001). CONCLUSION: Chart review for attention to CCCs accurately reflects the understandings of patients, house officers, and nurses, but consultant physicians report more attention to CCCs than is recorded in the ward notes or understood by other observers. Better communication regarding end-of-life care plans should be encouraged. (shrink)

This book covers a remarkable amount of ground and has become something of a classic. Besides the Discourse and the Meditations, it contains Private Thoughts, the third set of Objections and Replies, most of the Regulae, parts of the Principia and the Dioptrics, together with crrespondence with Elizabeth, Princess Palatine, Mersenne and others.

Informal logic has expanded the concept of an 'argument' beyond that presented traditionally by formal logicians-to include arguments as encountered in 'real-life'. Existent definitions of argument structure are argued to be inadequate by failing to fully recognise that, ultimately, arguments have a human source. Accordingly, a new definition is proposed which appeals to relevant cognitive and behavioural factors. The definition retains some traditional concepts, but introduces the term 'supportive' as a modification to 'premiss'. The concept of a 'persuader' is also (...) developed. The definition is argued to capture more fully the intricacies, subtleties and rich diversity of informal arguments. (shrink)

Placebo-controlled trials are controversial when individuals might be denied existing beneficial medical interventions. In the case of malaria, most patients die in rural villages without healthcare facilities. An artesunate suppository that can be given by minimally skilled persons might be of value when patients suddenly become too ill for oral treatment but are several hours from a facility that can give injectable treatment for severe disease. In such situations, by default, no treatment is (or can be) given until the patient (...) reaches a facility, making the placebo control design clinically relevant; alternative bioequivalence designs at the facility would misrepresent reality and risk incorrect conclusions. We describe the ethical issues underpinning a placebo-controlled trial in severe malaria. To protect patients and minimise risk, all patients were referred immediately to hospital so that each had a higher chance of prompt treatment through participation. There was no difference between artesunate and placebo in patients who reached clinic rapidly; among those who could not, a single artesunate suppository significantly reduced death or permanent disability, a finding of direct and indirect benefit to patients in participating villages and elsewhere. (shrink)

The level of medical care to patients and the success of the implementation of the national project "Health" depend on the health status and doctor's professionalism. Modern healthcare reform is being implemented by optimizing costs, merging medical organizations, closing ineffective hospitals, expanding the use of high-tech care and informatization of the doctor's activities. All this makes it necessary to assess the health of doctors. Scientists have studied the quality of life and identified the professional burnout of doctors in children's clinics (...) in different age groups. Primary care pediatricians have a higher quality of life score when compared to the standard [1]. However, all groups have a high level of professional burnout. The pre-retirement group of doctors has more unfavorable profile. They are highly professional specialists but may experience emotional discomfort because the pension system has been reformed. This situation requires the introduction of preventive work with doctors of this age as a group with great potential and capable of professional longevity. (shrink)

In this article, we discuss the relationships between discrimination, harassment, and the glass ceiling, arguing that many of the factors that preclude women from occupying executive and managerial positions also foster sexual harassment. We suggest that measures designed to increase numbers of women in higher level positions will reduce sexual harassment. We first define and discuss discrimination, harassment, and the glass ceiling, relationships between each, and relevant legislation. We next discuss the relationships between gender and sexual harassment, emphasizing the influence (...) of gender inequality on sexual harassment. We then present recommendations for organizations seeking to reduce sexual harassment, emphasizing the role that women executives may play in such efforts and, importantly, the recursive effects of such efforts on increasing the numbers of women in higher level positions in organizations. (shrink)