Pediatric critical careCritical care refers to the health care of children with life-threatening illness or following major surgery or severe injury. This care is offered in different contexts across the globe. In well-resourced environments, critical careCritical care may be provided in pediatric intensive care units, which provide highly complex medical care with advanced, potentially expensive technological devices aimed primarily at sustaining life; whereas in poorly resourced regions, only primary care may be available for critically ill or injured childrenInjured children. Even (...) where PICU facilities are available, they are a scarce and expensive resource. The knowledge and ability to sustain a critically ill or injured child’sInjured children life, potentially with effects on the child and family’s quality of lifeQuality of life and at the expense of other children’s health care, leads to frequent ethical challenges. Ethical issues related to how best to ensure optimal quality of lifeQuality of life and the fair distribution of scarce resources are common. In-depth knowledge and understanding of the individual patient’s medical, scientific and psychosocial context, through interdisciplinary discussion and collaboration; as well as familiarity with the overriding, relevant ethico-legal policiesPolicy and principles is essential for appropriate decision-makingDecision-making. Truthful communicationCommunication with the family is essential, using a shared decision-makingDecision-making process, and the child’s best interestBest interest must be central to every decision. This chapter presents an overview of the recommended approach to, and important considerations for, ethical decision-makingDecision-making in the PICU, using a hypothetical case example. (shrink)

Strong evidence shows that exposure and engagement with the natural world not only improve human wellbeing but can also help promote environmentally friendly behaviors. Human-nature relationships are at the heart of global agendas promoted by international organizations including the World Health Organization’s “One Health” and the United Nations “Ocean Decade.” These agendas demand collaborative multisector interdisciplinary efforts at local, national, and global levels. However, while global agendas highlight global goals for a sustainable world, developing science that directly addresses these agendas (...) from design through to delivery and outputs does not come without its challenges. In this article, we present the outcomes of international meetings between researchers, stakeholders, and policymakers from the United Kingdom and Brazil. We propose a model for interdisciplinary work under such global agendas, particularly the interface between One Health and the UN Ocean Decade and identify three priority research areas closely linked to each other: human-nature connection, conservation-human behavior, and implementation strategies. We also discuss a number of recommendations for moving forward. (shrink)

This essay sets forth the decisive notions and postulates of process philosophy in Process Philosophy and Social Thought, edited by John B. Cobb, Jr. and W. Widick Schroeder. After commenting on the circumstances in which process philosophy came to be a major option among philosophical theologians, I provide some amplification of those notions and postulates. Then, selecting material from the eighteen articles in the volume, I offer several critical assessments of the process viewpoint and its relation to science and to (...) the contemporary call for liberation. (shrink)

As A. B. Lloyd points out, the passage from Herodotus which includes this sentence is the most important non-Egyptian commentary on Ancient Egyptian shipbuilding. In the years following the discovery of the Dynasty IV ships buried beside Khufu's pyramid at Giza , J. S. Morrison suggested a change in the translation of the word επκτωσαν. Traditionally, and in Lloyd's commentary, the verb μπακτω has been interpreted as meaning ‘to caulk’. Morrison, however, believes that επκτωσαν ought to refer to (...) reinforcement of a ship's fastenings with papyrus ropes. He bases this interpretation on the evidence of the Khufu boats, which are sewn through v-shaped mortises across the hull's width , and on the argument that caulking is better done from the outside. Lloyd has challenged this translation, but we would like to support it with some further evidence, in particular evidence of Egyptian shipbuilding practice. (shrink)

Principled discussions of civil rights became inherently less likely as a direct result of the observation by Earl Warren, in Brown v. Board of Education, that, respecting freedmen, “Education of Negroes was almost non-existent, and practically all of the race were illiterate,” and in proportion as that observation increasingly became the foundation of common opinion on the subject. Warren's observation was not true in any meaningful or non-trivial sense. Nevertheless, it served to perpetuate the myth of a backward people needing (...) help to catch up instead of the truth of a people being held back. That is the perspective – the disadvantaged group perspective – that ultimately infected all discussion of civil rights, even after the designation of so-called “disadvantaged groups” had been extended beyond American blacks. To define civil rights, we may well begin with what all mankind would likely recognize. Thus the dictionary definition of “civil rights” stands: “the rights that belong to all individuals in a nation or community touching property, marriage, and the like.” In that definition the term “rights” may be further expanded to mean “legitimate claims,” following the definition of right as law – as “a claim or title or interest in anything whatever that is enforceable by law.” This definition applies with minimal distinction of regimes intruding and, therefore, without the host of recent complications in the United States that create the impression that civil rights have something to do with pluralism. Previously, the generic definition was thought to exhaust the meaning of the term in the United States. (shrink)

On Death, by the Epicurean philosopher Philodemus of Gadara, is among the most significant philosophical treatments of the theme surviving from the Greco-Roman world. The author was an influential figure in first-century B.C.E. Roman society, associated with poets such as Virgil and politicians such as the father-in-law of Julius Caesar. The surviving copies of his treatises were carbonized following the eruption of Vesuvius in 79 C.E. This edition contains the Greek text, newly reconstituted with the help of the infrared imaging (...) technology that has revolutionized the study of Philodemus’s works in the twenty-first century, and completely translated into English for the first time. An extensive introduction provides background on Philodemus and his writings, accompanying notes enrich the text, and forty-four pages of photographs illustrate the papyrus manuscript from which the translation is drawn. (shrink)

Patient safety has only recently been subjected to wide-spread systematic study. Healthcare differs from other high risk industries in being more diverse and multi-contextual, and less certain and regulated. Also many patient safety problems are low-frequency events associated with many, varied contributing factors. The subject of this paper is the epistemology of patient safety (the science of the method of finding out about patient safety). Patient safety research is considered here on the background of a risk management framework which requires (...) researchers to: • Understand the context - as a subset of healthcare quality, services and systems research, with technical and human behavioural (cultural) components and a range of external and internal organisational influences, a wide range of research disciplines is necessary • Identify the risks - identify the things that go wrong and the frequency and nature of different types of incidents from sources such as medical record review, observational studies, audit, incident and medico-legal reports • Analyse the risks - deconstruct the things that go wrong, identifying contributing factors and trying to detect trends and patterns in contributing factors, detection, mitigation factors, ameliorating factors and actions taken to reduce risk • Evaluate the risks - decide on priorities, identifying preventive and corrective strategies and judging the risk- and cost-benefit of potential corrective strategies such as standardisation or simplification of a process or device • Manage the risk - evaluate and scope preventive and/or corrective strategies and then implement these, or place the problem on a risk register pending solution, or accept that what is needed is unaffordable • Communicate and consult - use interactive sessions, audit, on-going feedback, reminders and patient mediated prompts • Monitor and review the state of the problem - get baseline trends and patterns so that changes can be tracked and properly attributed to an intervention A hierarchy of levels of evidence has been proposed for clinical research and we argue that insufficient weighting has been given to lower ranked levels of research and to qualitative research, although critical interpretive synthesis is now gaining acceptance in mainstream thinking (e.g. by the Cochrane Collaboration). Fundamental challenges remain including how to grasp the elusive concept of patient safety, how to quantify, characterise and cost the problems, how to judge the extent to which harm can be attributed to errors, violations or system failures, how to identify contributing factors and the extent to which they can be implicated, how to judge whether incidents or their precursors are preventable, how to generate strong evidence to make healthcare safer and how to translate research into practice. Future directions include addressing the mundane as well as rare, dramatic events, and developing further research in non-hospital settings and in developing countries. In summary, a mixture of qualitative and quantitative methods, using information from all available data sources and combining retrospective, real time and prospective study designs, is necessary to address some of the more difficult patient safety problems. (shrink)

Algebraic structures on linguistic sets associated with a linguistic variable are introduced. The linguistics with single closed binary operations are only semigroups and monoids. We describe the new notion of linguistic semirings, linguistic semifields, linguistic semivector spaces and linguistic semilinear algebras defined over linguistic semifields. We also define algebraic structures on linguistic subsets of a linguistic set associated with a linguistic variable. We define the notion of linguistic subset semigroups, linguistic subset monoids and their respective substructures. We also define as (...) in case of deals in classical semigroups, linguistic ideals in linguistic semigroups and linguistic monoids. This concept of linguistic ideals is extended to the case of linguistic subset semigroups and linguistic subset monoids. We also define linguistic substructures. (shrink)

The new classes of super special codes are constructed in this book using the specially constructed super special vector spaces. These codes mainly use the super matrices. These codes can be realized as a special type of concatenated codes.