“That is no country for old men” is the famous first line of Yeats’s “Sailing to Byzantium,” which reflects upon aging, art, and immortality. Yeats sug­gests in his poem that the aged ought to move from the sensual, physical world of their youth to a world of intellect and timeless beauty. We em­ploy this poem and that line to explore the aging male protagonists in two recent novels: Cormac McCarthy’s No Country For Old Men, and J.M. Coetzee’s Disgrace. We suggest (...) that though both of the novel’s pro­tagonists have aspirations to ’sail to Byzantium’, various factors ranging from their characters to the problematic realities of contemporary south­west America and South Africa make such a wholesale, successful journey impossible even though some progress is made. (shrink)

All illness represents a state of diminished autonomy and therefore the doctor-patient relationship necessarily and justifiably involves a degree of medical paternalism argues the author, an American medical student. In a broad-ranging paper he discusses the concepts of autonomy and paternalism in the context of the doctor-patient relationship. Given the necessary diminution of autonomy which illness inflicts, a limited form of medical paternalism, aimed at restoring or maximising the patient's autonomy is entirely acceptable, and indeed fundamental to the relationship he (...) argues. However, the exercise of this paternalism should be flexible and related to the current 'level of autonomy' of the patient himself. An editorial in this issue comments briefly on this paper. (shrink)

Conscious events interact with memory systems in learning, rehearsal and retrieval (Ebbinghaus 1885/1964; Tulving 1985). Here we present hypotheses that arise from the IDA computional model (Franklin,Kelemen and McCauley 1998; Franklin 2001b) of global workspace theory (Baars 1988, 2002). Our primary tool for this exploration is a flexible cognitive cycle employed by the IDA computational model and hypothesized to be a basic element of human cognitive processing. Since cognitive cycles are hypothesized to occur five to tentimes a second and include (...) interaction between conscious contents and several of the memory systems, they provide the means for an exceptionally fine-grained analysis of various cognitive tasks. We apply this tool to the small effect size of subliminal learning compared to supraliminal learning, to process dissociation, to implicit learning, to recognition vs. recall, and to the availability heuristic in recall. The IDA model elucidates the role of consciousness in the updating of perceptual memory, transient episodic memory, and procedural memory. In most cases, memory is hypothesized to interact with conscious events for its normal functioning. The methodology of the paper is unusual in that the hypotheses and explanations presented are derived from an empirically based, but broad and qualitative computational model of human cognition. (shrink)

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

The demand of many scientific areas for the usage of fractional partial differential equations to explain their real-world systems has been broadly identified. The solutions may portray dynamical behaviors of various particles such as chemicals and cells. The desire of obtaining approximate solutions to treat these equations aims to overcome the mathematical complexity of modeling the relevant phenomena in nature. This research proposes a promising approximate-analytical scheme that is an accurate technique for solving a variety of noninteger partial differential equations. (...) The proposed strategy is based on approximating the derivative of fractional-order and reducing the problem to the corresponding partial differential equation. Afterwards, the approximating PDE is solved by using a separation-variables technique. The method can be simply applied to nonhomogeneous problems and is proficient to diminish the span of computational cost as well as achieving an approximate-analytical solution that is in excellent concurrence with the exact solution of the original problem. In addition and to demonstrate the efficiency of the method, it compares with two finite difference methods including a nonstandard finite difference method and standard finite difference technique, which are popular in the literature for solving engineering problems. (shrink)

The article argues that Kant’s argument for ownership entails a standard of meaningful use by which property regimes can be evaluated: a regime must make it possible for usable objects to be meaningfully used. A particular form of fully communal ownership can satisfy this standard. Further, this form of communal ownership is compatible with Kantian freedom more broadly. I conclude that, if this is so, there is a great deal of space for further consideration of the rightfulness of diverse regimes (...) of ownership and exchange within a Kantian framework. (shrink)

The attitudes of women patients with cancer were explored when they were invited to participate in one of three randomised trials that included chemotherapy at two university centres and a satellite centre. Fourteen patients participating in and 15 patients declining trials were interviewed. Analysis was based on the constant comparative method. Most patients voiced positive attitudes towards clinical research, believing that trials are necessary for further medical development, and most spontaneously argued that participation is a moral obligation. Most trial decliners, (...) however, described a radical change in focus as they faced the actual personal choice. Almost no one got an impression of clinical equipoise between treatments in the trials, and most patients expressed discomfort with randomisation. A patient’s choice to participate was mainly determined by whether the primary focus was on treatment effect or on adverse effects. Both knowledge about and feelings towards trials originated mostly from the media, although paradoxically the media were largely seen as untrustworthy. Mistrust was shown towards the pharmaceutical industry, and although most patients originally trusted that doctors primarily pursued the interest of patients, they did not trust the adequacy of doctors or industry in maintaining self-regulation. Thus, public control measures were judged to be essential. (shrink)

The Search for the Legacy of the USPHS Syphilis Study at Tuskegee is a collection of essays from experts in a variety of fields seeking to redefine the legacy of the infamous Tuskegee Syphilis Study. The essayists place the legacy of the study within the evolution of racial and ethnic relations in the United States. Contributors include two leading historians on the study, two former United States Surgeons General, and other prominent scholars from a wide range of fields.

In the article the basic procedures for finding of connective elements and resolving conflicts of references is analyzed. On the basis of this, a generalized algorithm is proposed that combines advantages of existing procedures for search for connective elements between phrases. The advantages of the selected procedures and their sequence are described, the formal description of input data and the results of the algorithm are presented. To optimize the procedure for scanning the text, the algorithm is performed as an iterative (...) reduction of the candidates for communication elements. This is achieved through the confirmation of non-conflict links and the gradual resolution of conflicts. (shrink)

Robots are now associated with various aspects of our lives. These sophisticated machines have been increasingly used in different manufacturing industries and services sectors for decades. During this time, they have been a factor in causing significant harm to humans, prompting questions of liability. Industrial robots are presently regarded as products for liability purposes. In contrast, some commentators have proposed that robots be granted legal personality, with an overarching aim of exonerating the respective creators and users of these artefacts from (...) liability. This article is concerned mainly with industrial robots that exercise some degree of self-control as programmed, though the creation of fully autonomous robots is still a long way off. The proponents of the robot’s personality compare these machines generally with corporations, and sporadically with, inter alia, animals, and idols, in substantiating their arguments. This article discusses the attributes of legal personhood and the justifications for the separate personality of corporations and idols. It then demonstrates the reasons for refusal of an animal’s personality. It concludes that robots are ineligible to be persons, based on the requirements of personhood. (shrink)

Background To describe the preferences for disclosure of individual biomarker results among mothers participating in a longitudinal birth cohort. Methods We surveyed 343 mothers that participated in the Health Outcomes and Measures of the Environment Study about their biomarker disclosure preferences. Participants were told that the study was measuring pesticide metabolites in their biological specimens, and that the health effects of these low levels of exposure are unknown. Participants were asked whether they wanted to receive their results and their child's (...) results. In addition, they were asked about their preferred method (letter vs in person) and format (more complex vs less complex) for disclosure of results. Results Almost all of the study participants wanted to receive their individual results (340/343) as well as their child's results (342/343). However, preferences for receiving results differed by education level. Mothers with less than a college degree preferred in-person disclosure of results more often than mothers with some college education or a college degree (34.3% vs 17.4% vs 7.9%, p<0.001). Similarly, mothers with less than a college education preferred a less complex disclosure format than mothers with some college education or a college degree (59.7% vs 79.1% vs 86.3%, p<0.0001). Conclusion While almost all study participants preferred to receive results of their individual biomarker tests, level of education was a key factor in predicting preferences for disclosure of biomarker results. To ensure effective communication of this information, disclosure of biomarker results should be tailored to the education level of the study participants. (shrink)

The United States Court of Appeals for the Seventh Circuit held, in Murrey v. United States ), that claims for a physician's failure to obtain a patient's informed consent are not barred by the Federal Tort Claims Act as a species of misrepresentation. The court further held that the claim was not barred by the failure to include the issue of informed consent in the administrative claim. This decision reduces the burden on plaintiffs to state every cognizable claim consistent with (...) the facts in an administrative proceeding; the failure to do so would prevent them from raising the claim in court.The patient, Thomas Murrey, a sixty-eight-year-old U.S. veteran, sought treatment at a Veteran's Administration hospital in North Chicago, Illinois. VA doctors diagnosed him with prostate cancer, and advised him to undergo surgery to remove his entire prostate. (shrink)

Treatment-resistant symptoms complicate the clinical course of schizophrenia, and a large proportion of patients do not reach functional recovery. In consequence, polypharmacy is frequently used in treatment-refractory cases, addressing psychotic positive, negative and cognitive symptoms, treatment-emergent side effects caused by antipsychotics and comorbid depressive or obsessive-compulsive symptoms. To a large extent, such strategies are not covered by pharmacological guidelines which strongly suggest antipsychotic monotherapy. Add-on strategies comprise combinations of several antipsychotic agents and augmentations with mood stabilizers; moreover, antidepressants and experimental (...) substances are applied. Based on the accumulated evidence of clinical trials and meta-analyses, combinations of clozapine with certain second-generation antipsychotic agents and the augmentation of antipsychotics with antidepressants seem recommendable, while the augmentation with mood stabilizers cannot be considered superior to placebo. Forthcoming investigations will have to focus on innovative pharmacological agents, the clinical spectrum of cognitive deficits and the implementation of cognitive behavioral therapy. (shrink)

Background: Neonatal nurses report a great deal of ethical challenges in their everyday work. Seemingly trivial everyday choices nurses make are no more value-neutral than life-and-death choices. Everyday ethical challenges should also be recognized as ethical dilemmas in clinical practice. Research objective: The purpose of this study is to investigate which types of ethical challenges neonatal nurses experience in their day-to-day care for critically ill newborns. Research design: Data were collected through semi-structured qualitative in-depth interviews. Phenomenological-hermeneutic analysis was applied to (...) interpret the data. Participants and research context: Six nurses from neonatal intensive care units at two Norwegian hospitals were interviewed on-site. Ethical considerations: The study is designed to comply with Ethical Guidelines for Nursing Research in the Nordic Countries and the Helsinki declaration. Findings: Findings suggest that nurses experience a diverse range of everyday ethical challenges related to challenging interactions with parents and colleagues, emotional strain, protecting the vulnerable infant, finding the balance between sensitivity and authority, ensuring continuity of treatment, and miscommunication and professional disagreement. Discussion: A major finding in this study is how different agents involved in caring for the newborn experience their realities differently. When these realities collide, ethical challenges arise. Findings suggest that acting in the best interests of the child becomes more difficult in situations involving many agents with different perceptions of reality. Conclusion: The study presents new aspects which increases knowledge and understanding of the reality of nursing in a neonatal intensive care unit, while also demanding increased research in this field of care. (shrink)

This paper proposes a Cournot game organized by three competing firms adopting bounded rationality. According to the marginal profit in the past time step, each firm tries to update its production using local knowledge. In this game, a firm’s preference is represented by a utility function that is derived from a constant elasticity of substitution production function. The game is modeled by a 3-dimensional discrete dynamical system. The equilibria of the system are numerically studied to detect their complex characteristics due (...) to difficulty to get an explicit form for those equilibria. For the proposed utility function, some cases with different value parameters are considered. Numerical simulations are used to provide an experimental evidence for the complex behavior of the evolution of the system. The obtained results show that the system loses its stability due to different types of bifurcations. (shrink)

Within the context of Born-Infeld (BI) nonlinear electrodynamics (NED) we revisit the non-relativistic, spinless H-atom. The pair potential computed from the Born-Infeld equations is approximated by the Morse type potential with remarkable fit over the critical region where the convergence of both the short and long distance expansions slows down dramatically. The Morse potential is employed to determine both the ground state energy of the electron and the BI parameter.