Healthcare workers (HCWs) are often assumed to have a duty to work, even if faced with personal risk. This is particularly so for professionals (doctors and nurses). However, the health service also depends on non-professionals, such as porters, cooks and cleaners. The duty to work is currently under scrutiny because of the ongoing challenge of responding to pandemic influenza, where an effective response depends on most uninfected HCWs continuing to work, despite personal risk. This paper reports findings of a survey (...) of HCWs (n = 1032) conducted across three National Health Service trusts in the West Midlands, UK, to establish whether HCWs’ likelihood of working during a pandemic is associated with views about the duty to work. The sense that HCWs felt that they had a duty to work despite personal risk emerged strongly regardless of professional status. Besides a strong sense that everyone should pull together, all kinds of HCWs recognised a duty to work even in difficult circumstances, which correlated strongly with their stated likelihood of working. This suggests that HCWs’ decisions about whether or not they are prepared to work during a pandemic are closely linked to their sense of duty. However, respondents’ sense of the duty to work may conflict with their sense of duty to family, as well as other factors such as a perceived lack of reciprocity from their employers. Interestingly, nearly 25% of doctors did not consider that they had a duty to work where doing so would pose risks to themselves or their families. (shrink)
This brief tour of American law has demonstrated a little of the breadth and currency of legal liability actions which affect nursing. As health care changes and nursing roles change with it, so too will the nature of liability in this area. The American penchant for litigation is such that the chances of disentangling nurses from the continued onslaught of negligence litigation seem remote.
Cowan's review shows that a short-term memory limit of four items is consistent with a wide range of phenomena in the field. However, he does not explain that limit, whereas an existing theory does offer an explanation for capacity limitations. Furthermore, processing capacity limits cannot be reduced to storage limits as Cowan claims.
The core issue of our target article concerns how relational complexity should be assessed. We propose that assessments must be based on actual cognitive processes used in performing each step of a task. Complexity comparisons are important for the orderly interpretation of research findings. The links between relational complexity theory and several other formulations, as well as its implications for neural functioning, connectionist models, the roles of knowledge, and individual and developmental differences, are considered.
This characterization serves as a prelude to a strange (in my estimation) debate whether a certain thesis of "metaphysical nihilism" is wholly necessary, viz., that the only physical entities that truly exist are nature's most fundamental and smallest physical parts, I don't propose that we follow Williams into these mists; let us linger with the conception of "smallest part" that propels him onward.
A review, with reflections, of Michael S. Gazzaniga's (2011) book, Who's in Charge? Free Will and the Science of the Brain. Gazzaniga, a distinguished neuroscientist, wishes to connect contemporary understandings of the functioning of the human brain to the proper functioning of the American courtroom. What effect, if any, should these current understandings (and current technologies) have on legal conceptions of personal responsibility, guilt, and punishment? If, as many neuroscientists hold, the functioning of the brain wholly determines the functioning of (...) the mind, can people rightly be held responsible for their actions? Gazzaniga argues that they can. (shrink)
Most academic papers on ethics in pandemics concentrate on the duties of healthcare professionals. This paper will consider non-professional healthcare workers: do they have a moral obligation to work during an influenza pandemic? If so, is this an obligation that outweighs others they might have, e.g., as parents, and should such an obligation be backed up by the coercive power of law? This paper considers whether non-professional healthcare workers—porters, domestic service workers, catering staff, clerks, IT support workers, etc.—have an obligation (...) to work during an influenza pandemic. It uses data collected as part of a study looking at the attitudes of healthcare workers to working during a pandemic to suggest the philosophical arguments explored. These include: being in a position to do good, the ethics of work, competing obligations to family members and in particular to children and the obligations of citizens in a state of national emergency. We also look at whether compulsory measures are justified to support a national health service during a health emergency. We conclude that even if they are, compulsion should not be restricted to non-professionals who happen to be working in the health service at the time. Rather, compulsion involving a larger pool of people with the relevant skills and abilities is more equitable. (shrink)
Many weak or readily saturable nuclear magnetic resonances can be detected only by the use of the dispersion mode in a nuclear induction system, and dispersion records of complicated or partially resolved spectra may be difficult to interpret. However, it is shown in this paper that, for systems obeying Bloch or Redfield equations, the Kronig-Kramers (K-K) relations may justifiably be used to transform a dispersion record taken in the presence of saturation, under slow modulation conditions, into the more readily interpretable (...) absorption record. The K-K relations are shown to apply to the derivatives of the absorption and dispersion line shapes, which are the quantities usually recorded, and to transform a modulation-broadened dispersion curve into the appropriate modulation-broadened absorption curve. The relations hold for derivatives of any order and may, therefore, be applied to records from an apparatus employing phase-sensitive detection at any harmonic of the modulation frequency. Results are presented for some analytical cases, and details of the computational method are given. Simple trapezoidal integration is found to yield high accuracy. The resonance of 9Be in beryl is used to confirm the applicability of the K-K relations in the presence of saturation. (shrink)
Bioethicists have long been concerned that seriously ill patients entering early phase (‘phase I’) treatment trials are motivated by therapeutic benefit even though the likelihood of benefit is low. In spite of these concerns, consent forms for phase I studies involving seriously ill patients generally employ indeterminate benefit statements rather than unambiguous statements of unlikely benefit. This seeming mismatch between attitudes and actions suggests a need to better understand research ethics committee members’ attitudes toward communication of potential benefits and risks (...) of early phase studies to potential subjects. We surveyed the members of two U.S. research ethics committees using a phase I gene transfer study scenario, and compared the results to a previous survey of potential subjects’ perceptions and attitudes toward benefit and risk for the same protocol. The results show that there is indeed a gap between the subjects’ perceptions and the committee members’ views on what is appropriate to be communicated to research subjects. This discrepancy is the product of both the commonly assumed optimism of the subjects and to a “protective pessimism” of the research ethics committee members. We discuss this discrepancy using “frameworks of trust” and demonstrate the need to incorporate these frameworks into the existing model of informed consent. (shrink)
The decay of 40K has been reinvestigated and values of the branching ratio, defined as the ratio of gamma or electron capture to beta transitions, have been determined by two methods, giving the values 0·124±0·002 and 0·121±0·004 respectively. The absolute beta and gamma decay rates and the half-life have been measured, the value of the latter being 1·28±0±02 ? 109 years. A fresh determination of the gamma energy is described, and evidence as to the mode of decay is discussed. Finally, (...) the results are given of experiments on the reflection of electrons by solid source supports. (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)