This article examines the (bio) ethical and professionalism issues that may arise in the context of medical practice in low and middle income countries (LAMIC), and the challenges this poses for medical regulatory bodies in the regions, in upholding ethics in professional practice. A quadrangle of source of the problems given rise to the breach of ethics in medical practice is identified, and suggested steps, based on ethical principles and concept, is proposed towards the resolution of the problems presented. As (...) LAMIC progress to improve the health of its population, this endeavour should occur hand in hand with contemporary medical ethics theories, taking in context the region’s ethnographic and cultural beliefs and practices. (shrink)

The genes involved in methionine biosynthesis are scattered throughout the Escherichia coli chromosome and are controlled in a similar but not coordinated manner. The product of the metJ gene and S‐adenosylmethionine are involved in the repression of this ‘regulon’.

Few figures of the Middle Ages command the attention of so many modern disciplines as Robert Grosseteste (c. 1170-1253). Theology, Philosophy, History, and Science are all areas which his life and thought continue to have significance and to inspire re-interpretation. Accompanied by a series of original commentaries, this new edition of Grosseteste's work, with English translation, draws together the perspectives of modern scientists and medieval specialists. Volume I of a six volume series, Knowing and Speaking presents two of the earliest (...) of Grosseteste's works, the treatises On the Liberal Arts and On the Generation of Sounds. These are accompanied by a significant Middle English treatise on the Seven Liberal Arts whose anonymous fifteenth-century author translated and excerpted passages from Grosseteste's treatises in a re-imagining of their structure and function.0Each work is treated separately within the volume, which is constructed in three parts. On the Liberal Arts sets Grosseteste's thoughts on the arts subjects and emphasises moral concerns about the purpose of learning. On the Generation of Sounds builds on the theories and statements of On the Liberal Arts in connection to the production of sound, elaborating the earlier position, relating the generation of sounds to human vocal and speech production. (shrink)

The avocado (Persea americana) is a major crop commodity worldwide. Moreover, avocado, a paleopolyploid, is an evolutionary “outpost” among flowering plants, representing a basal lineage (the magnoliid clade) near the origin of the flowering plants themselves. Following centuries of selective breeding, avocado germplasm has been characterized at the level of microsatellite and RFLP markers. Nonetheless, little is known beyond these general diversity estimates, and much work remains to be done to develop avocado as a major subtropical‐zone crop. Among the goals (...) of avocado improvement are to develop varieties with fruit that will “store” better on the tree, show uniform ripening and have better post‐harvest storage. Avocado transcriptome sequencing, genome mapping and partial genomic sequencing will represent a major step toward the goal of sequencing the entire avocado genome, which is expected to aid in improving avocado varieties and production, as well as understanding the evolution of flowers from non‐flowering seed plants (gymnosperms). Additionally, continued evolutionary and other comparative studies of flower and fruit development in different avocado strains can be accomplished at the gene expression level, including in comparison with avocado relatives, and these should provide important insights into the genetic regulation of fruit development in basal angiosperms. BioEssays 30:386–396, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

Dondeyne, A. Pluriformiteit en eenheid van de filosofie.--Peperzak, A. Wegwijzers naar een dialogiek?--Boer, T. de. De eindigheid van de mens en de oneindigheid van de waarheid.--Hollak, J. Wijsgerige reflecties over de scheppingsidee : St. Thomas, Hegel en de Grieken.--Plat, J. Kants kritiek op de rationele psychologie.--Melsen, A. van. Wijsgerige antropologie en de ontwikkeling van natuurwetenschap en techniek.--Buytendijk, F. Het pathisch aspect van de eindigheid.--Struyker Boudier, H. 's Bergbeklimmers einder.

Adverse events that harm patients can also have a harmful impact on health care workers. A few health care organizations have begun to provide psychological support to these Second Victims, but there is uncertainty over whether these discussions are admissible as evidence in malpractice litigation or disciplinary proceedings. We examined the laws governing the admissibility of these communications in 5 states, and address how the laws might affect participation in programs designed to support health care workers involved in adverse events. (...) We found that privilege is uneven from stateto- state, and also unclear. Ambiguity alone could have a chilling effect on Second Victim programs. We propose legislation to protect volunteer and health care worker communications provided by peer counselors, or failing this, updating of statutory provisions to explicitly include these communications within the ambit of existing protections. Enhancing protections could help to foster an environment of healing for both patients and caregivers. (shrink)

The harmful impact of an adverse event ripples beyond injured patients and their families to affect physicians, nurses, and other health care staff that are involved. These “Second Victims” may experience intense feelings of anxiety, guilt, and fear. They may doubt their clinical competence or ability to continue working at all. Some go on to suffer post-traumatic stress disorder and depression.Medical institutions long ignored this problem, preferring to believe that adverse events, or “errors,” occur due to incompetence — the unfortunate (...) work of a few “bad” practitioners who deserve, if anything, a reprimand for their negligence. Study after study has rejected this attribution and shown that adverse events in health care stem primarily from systemic flaws, not “bad apples.” Devastating errors, in other words, can, do, and always will happen in the care of competent, well-trained, and caring practitioners. (shrink)

Participants were asked to draw inferences about correlation from single x,y observations. In Experiment 1 statistically sophisticated participants were given the univariate characteristics of distributions of x and y and asked to infer whether a single x, y observation came from a correlated or an uncorrelated population. In Experiment 2, students with a variety of statistical backgrounds assigned posterior probabilities to five possible populations based on single x, y observations, again given knowledge of the univariate statistics. In Experiment 3, statistically (...) naïve participants were given a problem analogous to that given in Experiment 1, framed verbally. Experiment 4 replicated Experiment 3 but added an “impossible to determine” response option. Models that rely on computing sample correlations make no predictions about these investigations. From a Bayesian perspective, participants’ inferences in all four experiments tended to make probabilistically valid inferences as long as the single datum was directional. The results are discussed in light of the Brunswikian notion of vicarious functioning. (shrink)

Bijural services as factors of production -- Commentary A on Breton and Salmon -- Commentary B on Breton and Salmon -- The challenge of incomplete law and how different legal systems respond -- Commentary C on Pistor and Xu -- Commentary D on Pistor and Xu -- Coevolution as an influence in the development of legal systems -- Commentary E on Breton and Des Ormeaux -- Commentary F on Breton and Des Ormeaux -- The demand for bijurally trained Canadian lawyers (...) -- Commentary G on Davis and Trebilcock -- Commentary H on Davis and Trebilcock. (shrink)

This paper challenges the traditional assumption that descriptive and prescriptive sciences are essentially distinct by presenting a study on the implicit normativity of the production and presentation of biomedical scientific facts within evidence-based medicine. This interdisciplinary study serves as an illustration of the potential worth of the concept of implicit normativity for bioethics in general and for integrated empirical ethics research in particular. It demonstrates how both the production and presentation of scientific information in an evidence-based decision-support contain implicit presuppositions (...) and values, which pre-structure the moral environment of the clinical process of decision-making. As a consequence, the evidence-based decision support did not only support the clinical decision-making process; it also transformed it in a morally significant way. This phenomenon undermines the assumption within much of the literature on patient autonomy that information disclosure is a conditional requirement before patient autonomy even starts; patient autonomy is already influenced during the production and presentation of information. These results imply an increased responsibility of those who produce and present evidence-based facts(i.e. scientists in general and physicians in particular). The insights of this study not only involve a different focus on both theory and practice of patient autonomy and informed consent, but they also call for a broader scope of morality than does traditional empirical research in bioethics. The concept of implicit normativity within integrated empirical ethics research calls for a strong cooperation between bioethicists and descriptive scientists, i.e., a cooperation that goes beyond the discipline-specific epistemic values and that takes place during all phases of the research process. (shrink)

The earlier volume in this series dealt with two religions of Indian origin, namely, Buddhism and Jainism. The Indian religious scene, however, is characterized by not only religions which originated in India but also by religions which entered India from outside India and made their home here. Thus religious life in India has been enlivened throughout its history by the presence of religions of foreign origin on its soil almost from the very time they came into existence. This volume covers (...) three such religions—Zoraoastrianism, Judaism, and Islam. In the case of Zoraostianism, even its very beginnings are intertwined with India, as Zoroastrianism reformed a preexisting religion which had strong links to the Vedic heritage of India. This relationship took on a new dimension when a Zoroastrian community, fearing persecution in Persia after its Arab conquest, sought shelter in western India and ultimately went on to produce India’s pioneering nationalist in the figure of Dadabhai Naoroji ( 1825-1917), also known as the Grand Old Man of India. Jews found refuge in south India after the destruction of the Temple by the Romans in 70 C.E. and have remained a part of the Indian religious scene since then, some even returning to Israel after it was founded in 1948. Islam arrived in Kerala as soon as it was founded and one of the earliest mosques in the history of Islam is found in India. Islam differs from the previously mentioned religions inasmuch as it went on to gain political hegemony over parts of the country for considerable periods of time, which meant that its impact on the religious life of the subcontinent has been greater compared to the other religions. It has also meant that Islam has existed in a religiously plural environment in India for a longer period than elsewhere in the world so that not only has Islam left a mark on India, India has also left its mark on it. Indeed all the three religions covered in this volume share this dual feature, that they have profoundly influenced Indian religious life and have also in turn been profoundly influenced by their presence in India. (shrink)

The earlier volume in this series dealt with two religions of Indian origin, namely, Buddhism and Jainism. The Indian religious scene, however, is characterized by not only religions which originated in India but also by religions which entered India from outside India and made their home here. Thus religious life in India has been enlivened throughout its history by the presence of religions of foreign origin on its soil almost from the very time they came into existence. This volume covers (...) three such religions—Zoraoastrianism, Judaism, and Islam. In the case of Zoraostianism, even its very beginnings are intertwined with India, as Zoroastrianism reformed a preexisting religion which had strong links to the Vedic heritage of India. This relationship took on a new dimension when a Zoroastrian community, fearing persecution in Persia after its Arab conquest, sought shelter in western India and ultimately went on to produce India’s pioneering nationalist in the figure of Dadabhai Naoroji ( 1825-1917), also known as the Grand Old Man of India. Jews found refuge in south India after the destruction of the Temple by the Romans in 70 C.E. and have remained a part of the Indian religious scene since then, some even returning to Israel after it was founded in 1948. Islam arrived in Kerala as soon as it was founded and one of the earliest mosques in the history of Islam is found in India. Islam differs from the previously mentioned religions inasmuch as it went on to gain political hegemony over parts of the country for considerable periods of time, which meant that its impact on the religious life of the subcontinent has been greater compared to the other religions. It has also meant that Islam has existed in a religiously plural environment in India for a longer period than elsewhere in the world so that not only has Islam left a mark on India, India has also left its mark on it. Indeed all the three religions covered in this volume share this dual feature, that they have profoundly influenced Indian religious life and have also in turn been profoundly influenced by their presence in India. (shrink)

PurposeTo use the power of knowledge acquisition and machine learning in the development of a collaborative computer classification system based on the features of age-related macular degeneration (AMD).MethodsA vocabulary was acquired from four AMD experts who examined 100 ophthalmoscopic images. The vocabulary was analyzed, hierarchically structured, and incorporated into a collaborative computer classification system called IDOCS. Using this system, three of the experts examined images from a second set of digital images compiled from more than 1000 patients with AMD. Images (...) were annotated, and features were identified and defined. Decision trees, a machine learning method, were trained on the data collected and used to extract patterns. Interrelationships between the data from the different clinicians were investigated.ResultsSix drusen classes in the structured vocabulary were largely sufficient to describe all the identified features. The decision trees classified the data with 76.86% to 88.5% accuracy and distilled patterns in the form of hierarchical trees composed of 5 to 15 nodes. Experts were largely consistent in their characterization of soft, and to a lesser extent, hard drusen, but diverge in definition of other drusen. Size and crystalline morphology were the main determinants of drusen type across all experts.ConclusionsMachine learning is a powerful tool for the characterization of disease phenotypes. The creation of a defined feature set for AMD will facilitate the development of an IDOCS-based classification system. (shrink)

This anthology on creativity represents a lifetime of reading and study by the late Charles Dewey Tenney, a philosopher who had been a student of Alfred North Whitehead at Harvard. In a series of fourteen essays Tenney considers the various factors that can be identified in creativity, followed by the recorded testimony of philosophers, artists, historians, explorers, scientists and others, both theorists and practitioners. The contributors extend in time from Aristotle and Sophocles to Buckminster Fuller and May Sarton. They include (...) such diverse thinkers as Martin Luther, Karl Marx, Lewis Carroll, Julian Huxley, Albert Einstein, Abraham Lincoln, Gertrude Stein, Henry Nelson Wieman and Alfred North Whitehead. In all, more than 300 of the world's most creative individuals are included. Contents: Discovery, Invention and Creation; Roots of Discovery; Environs of Discovery; Agents of Discovery; Hinderances to Discovery; Observation and Discovery; Reason in Discovery; Reverie Discovery; Imagination in Discovery; Sensibility and Discovery; Method in Discovery; Artistry in Discovery; Diffusion; and Foresight and Discovery. (shrink)

Background: There is evidence that household point-of-use water treatment products can reduce the enormous burden of water-borne illness. Nevertheless, adoption among the global poor is very low, and little evidence exists on why. Methods: We gave 600 households in poor communities in Dhaka, Bangladesh randomly-ordered two-month free trials of four water treatment products: dilute liquid chlorine, sodium dichloroisocyanurate tablets, a combined flocculant-disinfectant powdered mixture, and a silver-coated ceramic siphon filter. Consumers also received education on the dangers of untreated drinking water. (...) We measured which products consumers used with self-reports, observation, and chlorine tests. We also measured drinking water's contamination with E. coli. Findings: Households reported highest usage of the filter, although no product had even 30% usage. E. coli concentrations in stored drinking water were generally lowest when households had Water Guard. Households that self-reported product usage had large reductions in E. coli concentrations with any product as compared to controls. Conclusion: Traditional arguments for the low adoption of POU products focus on affordability, consumers' lack of information about germs and the dangers of unsafe water, and specific products not meshing with a household's preferences. In this study we provided free trials, repeated informational messages explaining the dangers of untreated water, and a variety of product designs. The low usage of all products despite such efforts makes clear that important barriers exist beyond cost, information, and variation among these four product designs. Without a better understanding of the choices and aspirations of the target end-users, household-based water treatment is unlikely to reduce morbidity and mortality substantially in urban Bangladesh and similar populations. © 2011 Luoto et al. (shrink)

The Alternative Model of Personality Disorders integrates several theoretical models of personality functioning, including interpersonal theory. The interpersonal circumplex dimensions of warmth and dominance can be conceptualized as traits similar to those in AMPD Criterion B, but interpersonal theory also offers dynamic hypotheses about how these variables that change from moment to moment, which help to operationalize some of the processes alluded to in AMPD Criterion A. In the psychotherapy literature, dynamic interpersonal behaviors are thought to be critical for identifying (...) therapeutic alliance ruptures, yet few studies have examined moment-to-moment interpersonal behaviors that are associated with alliance ruptures at an idiographic level. The current study examined the concurrent and cross-lagged relationships between interpersonal behaviors and alliance ruptures within each session in the famous Gloria films. Interpersonal behaviors as well as alliance ruptures were calculated at half minute intervals for each dyad. We identified distinct interpersonal patterns associated with alliance ruptures for each session: Gloria ’s warmth was positively related with withdrawal ruptures concurrently in the session with Carl Rogers; Gloria’s dominance and coldness were related with increased confrontation ruptures in the session with Fritz Perls concurrently, while her coldness was also predicted by confrontation ruptures at previous moments; lastly, both Gloria’s dominance and Albert Ellis’s submissiveness were positively related with withdrawal ruptures. These interpersonal patterns demonstrated the promise of using AMPD dimensions to conceptualize momentary interpersonal processes related to therapy ruptures, as well as the clinical importance of attuning to repetitive, dyad-specific interpersonal cues of ruptures within each session. (shrink)

Physicists regularly invoke universal laws, such as those of motion and electromagnetism, to explain events. Biological and medical scientists have no such laws. How then do they acquire a reliable body of knowledge about biological organisms and human disease? One way is by repeatedly returning to, manipulating, observing, interpreting, and reinterpreting certain subjects—such as flies, mice, worms, or microbes—or, as they are known in biology, “model systems.” Across the natural and social sciences, other disciplinary fields have developed canonical examples that (...) have played a role comparable to that of biology’s model systems, serving not only as points of reference and illustrations of general principles or values but also as sites of continued investigation and reinterpretation. The essays in this collection assess the scope and function of model objects in domains as diverse as biology, geology, and history, attending to differences between fields as well as to epistemological commonalities. Contributors examine the role of the fruit fly Drosophila and nematode worms in biology, troops of baboons in primatology, box and digital simulations of the movement of the earth’s crust in geology, and meteorological models in climatology. They analyze the intensive study of the prisoner’s dilemma in game theory, ritual in anthropology, the individual case in psychoanalytic research, and Athenian democracy in political theory. The contributors illuminate the processes through which particular organisms, cases, materials, or narratives become foundational to their fields, and they examine how these foundational exemplars—from the fruit fly to Freud’s Dora—shape the knowledge produced within their disciplines. Contributors Rachel A. Ankeny Angela N. H. Creager Amy Dahan Dalmedico John Forrester Clifford Geertz Carlo Ginzburg E. Jane Albert Hubbard Elizabeth Lunbeck Mary S. Morgan Josiah Ober Naomi Oreskes Susan Sperling Marcel Weber M. Norton Wise. (shrink)

Since the time, about a century ago, when DeMorgan, Boole and Jevons, inaugurated the study of the logic of numerically definite reasoning, no one has been concerned to establish the validity rules for a very general type of numerically definite inference which is a strong analogue of the classical syllogism. The reader will readily agree that the traditional rules of syllogistic inference cannot even begin to decide whether the following proportionally quantified syllogism is a valid argument: at most 4/7 p (...) are at most 2/3 not-m and at least 3/5 s are precisely 7/8 m, hence, at most 1/3 s are p. Likely reasons, of broad methodological interest, why this readily definable type of formal inference has been neglected will presently be proposed. Among the masters of twentieth century logic, Hilbert and Bernays have, to be sure, meticulously shown how such numerically definite propositions as “at least 7 individuals have the property p” can be expressed in the predicate calculus with the use of the identity relation. They do not, since their concern with such propositions is indirect, proceed to establish a systematic calculus of classes whose “size” or extent is numerically definite. As we shall always notice, traditional logic and even ordinary Boolean algebra prefer to generalize about the laws governing the interrelationship of classes in inference systems without making any hypotheses concerning class “size” or extent except by the classical quantifier “some”, which quantifier admits the measure or extent of a class only in terms of the proposition that a given class contains or does not contain at least one member. Such a restricted admission of the relevance for inference of class size is among the fundamental reasons for the neglect of proportional quantifiers, i.e., quantifiers where numerical value is any rational number r such that 0/100 ≤ r ≤ 100/100. It can, of course, also be pointed out that the traditional syllogism and ordinary Boolean algebra do not i.e. measure, numerically define, the degree of inclusion of one class in another. Inclusion is taken either as total or partial, with no discrimination of the degree of partial inclusion. (shrink)

Probability theory is important because of its relevance for decision making, which also means: its relevance for the single case. The propensity theory of objective probability, which addresses the single case, is subject to two problems: Humphreys’ problem of inverse probabilities and the problem of the reference class. The paper solves both problems by restating the propensity theory using (an objectivist version of) Pearl’s approach to causality and probability, and by applying a decision-theoretic perspective. Contrary to a widely held view, (...) decision making on the basis of given propensities can proceed without a subjective-probability supplement to propensities. (shrink)