BackgroundPeople with upper extremity amputations report receiving insufficient information about treatment options. Furthermore, patients commonly report not knowing what questions to ask providers. A question prompt sheet, or list of questions, can support patient-centered care by empowering patients to ask questions important to them, promoting patient-provider communication, and increasing patient knowledge. This study assessed information needs among people with UE amputations about UE vascularized composite allotransplantation and developed a UE VCA-QPS.MethodsThis multi-site, cross-sectional, mixed-methods study involved in-depth and semi-structured interviews with (...) people with UE amputations to assess information needs and develop a UE VCA-QPS. Qualitative data were analyzed by thematic analysis; quantitative data were analyzed by descriptive statistics. The initial UE VCA-QPS included 130 items across 18 topics.ResultsEighty-nine people with UE amputations participated. Most were male, had a mean age of 46 years, and had a unilateral and below-elbow amputation. Participants desired information about UE VCA eligibility, evaluation process, surgery, risks, rehabilitation, and functional outcomes. After refinement, the final UE VCA-QPS included 35 items, across 9 topics. All items were written at a ≤ 6th grade reading level. Most semi-structured interview participants reported being ‘completely’ or ‘very’ likely to use a UE VCA-QPS.ConclusionPeople with UE amputations have extensive information needs about UE VCA. The UE VCA-QPS aims to address patients’ information needs and foster patient-centered care. Future research should assess whether the UE VCA-QPS facilitates patient-provider discussion and informed decision-making for UE VCA. (shrink)

Tsirelson’s problem deals with how to model separate measurements in quantum mechanics. In addition to its theoretical importance, the resolution of Tsirelson’s problem could have great consequences for device independent quantum key distribution and certified randomness. Unfortunately, understanding present literature on the subject requires a heavy mathematical background. In this paper, we introduce quansality, a new theoretical concept that allows to reinterpret Tsirelson’s problem from a foundational point of view. Using quansality as a guide, we recover all known results on (...) Tsirelson’s problem in a clear and intuitive way. (shrink)

Background: The Directive 2001/20/EC was an important first step towards consistency in the requirements and processes for clinical trials across Europe. However, by applying the same rules to all types of drug trials and transposing the Directive’s principles into pre-existing national legislations, the Directive somewhat failed to meet its facilitation and harmonisation targets. In the field of ethics, the Directive 2001/20/EC conditioned the way of understanding and transposing the “single opinion” process in each country. This led to a situation in (...) which two models of research ethics committees organisation systems exist, being the model in which the “single opinion” is considered to be the decision made by a single ethics committee more effective and simpler in terms of administrative and logistic workload. Method: A survey was conducted in 10 European countries. Members of the European Clinical Research Infrastructures Network working party number 1, with expertise in the field of ethics, responded. Results: There is a major heterogeneity in the composition of ethics committees among the surveyed countries based on the number of members, proportion of experts versus lay members and expertise of the scientific members. A harmonised education of the ethics committees’ membership based in common curricula is recommended by the majority of countries. Conclusions: Despite the efforts for harmonisation of the European Clinical Trial Directive, from an ethical point of view, there remains a plurality of ethics committees' systems in Europe. It is important to comprehend the individual national systems to understand the problems they are facing. (shrink)

This paper is a study about Philadelphia’s comprehensive user engagement sites (CUESs) as the authors address and examine issues related to the upcoming implementation of a CUES while seeking solutions for its disputed questions and plans. Beginning with the federal drug schedules, the authors visit some of the medical and public health issues vis-à-vis safe injection facilities (SIFs). Insite, a successful Canadian SIF, has been thoroughly researched as it represents a paradigm for which a Philadelphia CUES can expand upon. Also, (...) the existing criticisms against SIFs are revisited while critically unpackaged and responded to in favor of the establishment. In the main section, the authors propose the layout and services of the upcoming CUES, much of which would be in congruent to Vancouver’s Insite. On the other hand, the CUES would be distinct from Insite, as the authors emphasize, in that it will offer an information center run by individuals in recovery and place additional emphasis on early education for young healthcare professionals by providing them a platform to work at the site. The paper will also briefly investigate the implementation of a CUES site under an ethical scope of the Harm Reduction Theory. Lastly, the authors recommend some strategic plans that the Philadelphia City government may consider employing at this crucial stage. (shrink)

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

In this article, I examine the seemingly incompatible epistemologies of sex offered by dominance (‘governance’) feminism and queer theory. While these bodies of work, especially when applied to US legal and political activity on prostitution, are commonly viewed as divergent sparring partners, I propose a ‘convergence’ of the two in the form of a revived and enhanced sex-positive feminism. If dominance feminism is the ‘theory of no’ to heterosexuality’s male gender power, and if queer theory is the ‘theory of yes’ (...) to the defiant possibilities of sex, sex-positive feminism is a ‘theory of maybe’: it examines practices of gender and sexuality in multiple contexts to find the ways in which heterosexuality can sometimes reify, and other times resist, the transfer of eroticised dominance and submission to political practices of patriarchy. After tracing the split between feminism and queer theory and arguing for a ‘sex-positive queer feminism’, I use the example of prostitution to consider some theoretical and practical implications of this shift in feminist lenses. (shrink)

ABSTRACT This article attempts to show that arguments in favour of abortion which deny personhood to the fetus (person‐denying arguments) do not work. Several very common person‐denying arguments for abortion are dealt with, and an analysis is provided of two well known person‐denying arguments; those from the philosophers Mary Ann Warren and Michael Tooley. The result is that these fare no better. The conclusion is that there is a fallacy in person‐denying arguments in general.

ABSTRACT This article attempts to show that affirmative action can be supported by the doctrine of double effect which recognises distinctions between desired and unintended effects such that the responsibility for acts falls on the side of the former rather than the latter. With this doctrine it may also be seen why affirmative action programmes cannot be simply equated with numerical quota systems, nor can they be called discriminatory, at least not under the definition of discrimination utilised.

Ethical issues arise in the world’s first population-level treatment of severe lead poisoning caused by small-scale mining for gold in rural Nigeria. Emergency medical intervention and environmental cleanup have reduced the mortality in children younger than 5 years from lead poisoning from over 40 to 2.5 per cent leaving little evidence of the harms caused by lead poisoning. In the absence of obvious sequelae, family adherence to long-term intensive therapy to remove accumulated lead reservoirs in children wanes and some community (...) miners challenge safer mining interventions to prevent recontamination of the environment with lead. This letter raises questions regarding community versus individual rights in public health interventions and patient autonomy. (shrink)

Preemption is a powerful strategy used by special interest groups to undermine strong, local public health standards. Currently, 20 states in the U.S. have preemption ordinances in place related to clean indoor air initiatives. These preemption laws are the direct result of an ongoing and aggressive campaign of tobacco companies to thwart clean indoor air initiatives, which ultimately, according to tobacco industry internal documents, cause significant reductions in their annual revenues. Clean indoor air policies have arisen from a greater understanding (...) of the documented health risks associated with exposure to secondhand smoke and action by local government to protect the public from these hazards. The efforts of the tobacco industry undermine local authority and seek to shift policy action to the state and federal levels, where the industry has greater political influence. (shrink)

Preemption is a powerful strategy used by special interest groups to undermine strong, local public health standards. Currently, 20 states in the U.S. have preemption ordinances in place related to clean indoor air initiatives. These preemption laws are the direct result of an ongoing and aggressive campaign of tobacco companies to thwart clean indoor air initiatives, which ultimately, according to tobacco industry internal documents, cause significant reductions in their annual revenues. Clean indoor air policies have arisen from a greater understanding (...) of the documented health risks associated with exposure to secondhand smoke and action by local government to protect the public from these hazards. The efforts of the tobacco industry undermine local authority and seek to shift policy action to the state and federal levels, where the industry has greater political influence. (shrink)

The Quest for Meaning explores the deep-seated human need to create a life that is meaningful. In an effort to understand this need, author William Cooney examines the works of philosophers from Plato to Sartre as well as the insights of artists, poets, writers, psychologists, and film-makers. He discusses the nature of humanness, creation, freedom, and choice, all of which are facets of a meaningful life. Cooney also addresses postmodernism, arguing that it does not offer real guidance for (...) those seeking a life of significance. Maintaining that some ways of creating meaning are preferable to others, he concludes that it is up to each individual to craft a meaningful life and that this process must take place within a context of giving and receiving. (shrink)

By the end of the 21st century humans could have increasingly bionic bodies with greatly enhanced brains and sensory organs. They could be spending their abundant leisure in a variety of richly detailed, stimulating worlds provided by virtual reality technology, while computers and robots of various kinds do their work for them. What should we think of this prospect?

With the growth of epistemology, an important debate in philosophy of religion has arisen: can mystical encounters—purported feelings of intense unity with the divine—serve as epistemic warrants? In this paper, I examine two of the most prominent and promising standards by which to determine the veridicality of such encounters—those of William Alston and Richard Swinburne—and demonstrate their respective strengths and shortcomings. Considering these shortcomings, I compose and defend my own set of criteria to use in evaluating the veridicality of putative (...) mystical experiences which draws upon the subject’s religious tradition, rationality, and affectivity. (shrink)

This highly accessible combination of articles with readable and teachable supporting introductions and text enables students to understand assigned readings well enough to be able to come to class ready to ask intelligent questions and engage in critical discussion.

The controversial author discusses past theories of morality, the language of right and wrong, and the principles of modern ethics.

This book presents a contemporary application of Aristotle's metaphysical concepts to the domains of biology and psychobiology. Professor Cooney reconstructs the form/matter or hylomorphic analysis of organisms and mental functions by linking Aristotle's concept of form to that of information in biological control systems. The resulting hylomorphic theory challenges the orthodoxy of contemporary philosophy by offering an alternative to both materialism and dualism. Professor Cooney makes his book accessible to a wide audience by providing clear digests of the (...) scientific information and philosophical issues relevant to his arguments. (shrink)

For too long, Spinoza's ethics was misread as an ethics of ideals, in which the most virtuous life possible was said to consist of the life of pure reasoning. The "free man," Spinoza's paragon of virtue, was understood to be the individual who is neither helped nor harmed by anything external. The goal, on this view, was to transcend the life of the body, of the material, and of the political, in order to focus solely on becoming like God by (...) increasing one's store of rational ideas.This, of course, is an impoverished understanding of Spinoza's aims. Not only does it cast virtue as something unattainable for actually existing, materially and socially embedded individuals, but it overlooks a vast swath of Spinoza's... (shrink)

With the growth of epistemology, an important debate in philosophy of religion has arisen: can mystical encounters—purported feelings of intense unity with the divine—serve as epistemic warrants? In this paper, I examine two of the most prominent and promising standards by which to determine the veridicality of such encounters—those of William Alston and Richard Swinburne—and demonstrate their respective strengths and shortcomings. Considering these shortcomings, I compose and defend my own set of criteria to use in evaluating the veridicality of putative (...) mystical experiences which draws upon the subject’s religious tradition, rationality, and affectivity. (shrink)

The authors of this book consult fifteen thinkers, from various fields, who have a profound understanding of the important role that education plays in our world. Each chapter opens with an Introduction and concludes with a discussion and questions.