Clinical red blood cell transfusion guidelines have been widely adopted in clinical practice, resulting in standardized transfusion practices in hospitalized patients with anemia. Standardization of transfusion practice has been welcomed by clinicians and health systems as a mechanism for reducing unnecessary, harmful, and costly practice variation that results in healthcare disparities. However, overzealously applied guidelines can have deleterious consequences for individual patients, ultimately resulting in and/or exacerbating healthcare disparities, rather than resolving them. This article provides empirical examples of the adverse (...) consequences from the well-meaning attempt to standardize transfusion practice based on clinical practice guidelines and discusses the ethical implications of standardized transfusion practice. (shrink)

Background Inadequate knowledge among health care providers (HCPs) and parents of affected children limits the understanding and utility of secondary genetic findings (SFs) in under-represented populations in genomics research. SFs arise from deep DNA sequencing done for research or diagnostic purposes and may burden patients and their families despite their potential health importance. This study aims to evaluate the perspective of both groups regarding SFs and their choices in the return of results from genetic testing in the context of orofacial (...) clefts.Methods Using an online survey, we evaluated the experiences of 252 HCPs and 197 parents across participating cleft clinics in Ghana and Nigeria toward the return of SFs across several domains.Results Only 1.6% of the HCPs felt they had an expert understanding of when and how to incorporate genomic medicine into practice, while 50.0% agreed that all SFs should be returned to patients. About 95.4% of parents were willing to receive all the information from genetic testing (including SFs), while the majority cited physicians as their primary information source (64%).Conclusions Overall, parents and providers were aware that genetic testing could help in the clinical management of diseases. However, they cited a lack of knowledge about genomic medicine, uncertain clinical utility, and lack of available learning resources as barriers. The knowledge gained from this study will assist with developing guidelines and policies to guide providers on the return of SFs in sub-Saharan Africa and across the continent. (shrink)

How (Not) to Be Secular is what Jamie Smith calls "your hitchhiker's guide to the present" -- it is both a reading guide to Charles Taylor's monumental work A Secular Age and philosophical guidance on how we might learn to live in our times. Taylor's landmark book A Secular Age (2007) provides a monumental, incisive analysis of what it means to live in the post-Christian present -- a pluralist world of competing beliefs and growing unbelief. Jamie Smith's book is a (...) compact field guide to Taylor's insightful study of the secular, making that very significant but daunting work accessible to a wide array of readers. Even more, though, Smith's How (Not) to Be Secular is a practical philosophical guidebook, a kind of how-to manual on how to live in our secular age. It ultimately offers us an adventure in self-understanding and maps out a way to get our bearings in today's secular culture, no matter who "we" are -- whether believers or skeptics, devout or doubting, self-assured or puzzled and confused. This is a book for any thinking person to chew on. (shrink)

Cet article fournit les principaux résultats de la mission effectuée en mai 2011 dans le cadre du projet concernant la sculpture architecturale byzantine de la côte occidentale de la mer Noire. La première partie présente et décrit les ensembles architecturaux d’où proviennent les sculptures sur lesquelles ont été prélevés des échantillons de marbre. La seconde partie a trait aux caractéristiques spécifiques des marbres analysés : vingt échantillons de marbre prélevés sur des sculptures provenant surtout de Sozopol, mais aussi d’Obzor et (...) de Pomorie, ont été analysés afin de connaître leur provenance. Les différentes méthodes d’analyses ont montré que la majorité des échantillons étaient issus de l’île de Proconnèse. Néanmoins, quatre des vingt échantillons présentent une composition minéralogique et chimique différente de celle des marbres de Proconnèse : deux sont en marbre pentélique, un autre en marbre de Thasos et le dernier est très probablement en marbre local. (shrink)

Practical deliberation often involves conditional judgements about what will (likely) happen if certain alternatives are pursued. It is widely assumed that the conditionals useful in deliberation are counterfactual or subjunctive conditionals. Against this, I argue that the conditionals of deliberation are indicatives. Key to the argument is an account of the relation between 'straightforward' future-directed conditionals like ' If the house is not painted, it will soon look quite shabby' and * "w e r e ' ' e d F (...) D C s like ' If the house were not to be painted, it would soon look quite shabby': an account on which both of these types of FDCs are grouped with the indicatives for semantic treatment and on which, while conditionals of both types are properly used in means/ends deliberations, those of the ' were'ed-up variety are especially well suited for that purpose. (shrink)

'Pataphysics: The Poetics of an Imaginary Science is a survey that attempts to describe a hypothetic philosophy--the avant-garde pseudo-science imagined by Alfred Jarry. 'Pataphysics is a supplement to metaphysics, accenting it, then replacing it, in order to create a philosophic alternative, whose discipline can study cases, not of conception, but of exception: variance , alliance , and deviance . 'Pataphysics synthesizes the romantic schism between a literal, scientized discourse and a figural, poeticized discourse, and my thesis suggests that this revision (...) of the signifier "science" by 'pataphysics is symptomatic of a postmodern transition in science from a paradigm of absolutism to a paralogy of relativism. Structured as a descriptive explication, which emphasizes a theoretical perspective, this survey is divided into five chapters: the first chapter recounts the history of the conflict between science and poetry ; the second chapter examines the avant-garde pseudo-science of 'pataphysics itself ; and finally, the last three chapters discuss the influence of 'pataphysics upon the poetics of its subsequent successors . While my thesis focuses upon theories of textual poetics rather than poetry itself , my thesis does nevertheless strive to be as conceptually encyclopedic as 'pataphysics itself: instead of normalizing 'pataphysics within one theoretical perspective, this survey alludes intermittently to 'pataphysical enterprises that constitute exceptions to such a genealogy of Jarryites. What is at stake is the status of poetry in a world of science. How might poetry reclaim its own viable truth? How might science benefit from its own poetic irony? For the postmodern condition, such questions have already opened up a novel space for speculative imagination; hence, this survey presents itself as a kind of primer for a future of possible research. (shrink)

This article explores the enduring mysteries of consciousness and the afterlife, two enigmatic topics that have fascinated humanity for ages. Despite extensive scientific efforts, the existence of an afterlife remains unproven, and understanding consciousness remains a significant challenge. The research introduces innovative hypotheses through simple thought experiments with empirical evidence and robust theoretical foundations. It delves into the complexities of consciousness, its relationship with the brain, and the need for interdisciplinary approaches encompassing physics, psychology, and philosophy. Boldly contemplating the probability (...) of a continuous consciousness after death, the study argues that existing evidence strongly supports this idea. Beyond theoretical implications, it envisions practical outcomes, suggesting that insights into these mysteries could enhance human well-being and contribute to a more harmonious world. In summary, this article embarks on a quest to shed light on age-old questions about consciousness and the afterlife. Through fresh methodologies, it aims to provide new perspectives that could reshape our understanding of existence and inspire intellectuals to positive individual and societal advancements. -/- . (shrink)

are ambiguous. In the mouth of someone who cannot remember whether it was Michael, or rather someone else, who was top scorer, can express the epistemic possibility that Michael led the league in scoring. But from someone who knows that Michael did not even play last season, but is wondering what would have happened if he had, means something quite different. Now where it has this quite different meaning, may still turn out to be the expression of some epistemic possibility. (...) Perhaps where does not express the epistemic possibility of ‘Michael led the league in scoring’, it expresses the epistemic possibility of ‘Michael would have led the league in scoring’. Analysis of this ‘would have’ statement, together with an exploration of the suspicion that the ‘might have’ statement is ambiguous between these two epistemic possibilities, will have to await another occasion. The important point for present purposes is that is ambiguous between an expression of the epistemic possibility of ‘Michael led the league in scoring’ and some quite different reading. (shrink)

What are the criteria for reasonable clinical judgements? The reasonableness of macro-level decision-making has been much discussed, but little attention has been paid to the reasonableness of applying guidelines generated at a macro-level to individual cases. This paper considers a framework for reasonable clinical decision-making that will capture cases where relevant guidelines cannot reasonably be followed. There are three main sections. (1) Individual claims on healthcare from the point of view of concerns about equity are analysed. (2) The demands of (...) responsibility and equity on professional clinical performance are discussed, and how the combination of these demands emerges into seven requirements that constitute the framework is explored. Since this framework is developed to assist in reasonable clinical decision-making, practical implications of all these requirements are also suggested. (3) Challenges concerning the framework are discussed. First, a crucial presumption that the framework relies upon is considered—namely, clinicians’ willingness to justify their decisions as requested. Then how public deliberation may influence clinical decision-making is discussed. Next is a consideration of how clinicians’ need to have confidence in their own judgements in order to perform in a manner worthy of trust would be compatible with adherence to the framework supported by public deliberation. It is concluded that fair distribution in the interplay between macro- and micro-level considerations can be secured by legitimising procedures on each level, by ensuring well-organised and continuing public debate and by basing individual clinical judgements upon well-justified and principled normative bases. (shrink)

It is only when mixing two or more pure substances along a reversible path that the entropy of the mixing can be made physically manifest. It is not, in this case, a mere mathematical artifact. This mixing requires a process of successive stages. In any finite number of stages, the external manifestation of the entropy change, as a definite and measurable quantity of heat, isa fully continuous function of the relevant variables. It is only at an infinite and unattainable limit (...) thata non-uniform convergence occurs. And this occurs when considered in terms of the number of stages together with a distinguishability parameter appropriate to the particular device which is used to achieve reversibility. These considerations, which are of technological interest to chemical engineers, resolve a paradox derived in chemical theory called Gibbs'' Paradox. (shrink)

Today’s business students are tomorrow’s business leaders. To ensure they have skills in creating profitable, pro-social, ethical organizations, we need to consider alternative methods of teaching CSR. In this proposed symposium, we will present different approaches to international CSR/Service-Learning.

University human research ethics application procedures can be complicated and daunting, especially for international students unfamiliar with the process and the language. We conducted focus groups and interviews with four research higher degree and 21 Master’s coursework international students at an Australian university to gain their views on the human ethics application process. We found the most important influences on their experience were: the time it took to do an application; support from supervisors, peers and others; their own language skills; (...) and their lack of familiarity with research ethics procedures. To improve the experience of international students undertaking research involving human research ethics applications, we recommend universities provide guidance on institutional ethics review processes, concepts and terminology, with translations in a range of languages, together with guidance on how to conduct research ethically within and outside the students’ own countries. We also recommend curricula be developed to further students’ understanding of the importance of ethical research practice, and that these curricula be embedded in undergraduate and postgraduate degree programs and reflected in course learning outcomes. (shrink)

The widespread potential for somatic fusion among different conspecific multicellular individuals suggests that such fusion is adaptive. However, because recognition of non‐kin (allorecognition) usually leads to a rejection response, successful somatic fusion is limited to close kin. This is consistent with kin‐selection theory, which predicts that the potential cost of fusion and the potential for somatic parasitism decrease with increasing relatedness. Paradoxically, however, Crozier1 found that, in the short term, positive‐frequency‐dependent selection eliminates the required genetic polymorphism at allorecognition loci. The (...) ‘Crozier paradox’ may be solved if allorecognition is based on extrinsically balanced polymorphisms, for example at immune loci. Alternatively, the assumption of most models that self fusion is mutually beneficial is wrong. If fusion is on average harmful, selection will promote unconditional rejection. However, we propose that fusion within individuals is beneficial, selecting for the ability to fuse, but fusion between individuals on average costly, selecting for non‐self recognition (rather than non‐kin recognition). We discuss experimental data on fungi that are consistent with this hypothesis. BioEssays 30:1193–1203, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

In welchem Verhaltnis steht die Seelenlehre zur Kosmologie in Platons Phaidon?

I examine two challenges that collaborative research raises for science. First, collaborative research threatens the motivation of scientists. As a result, I argue, collaborative research may have adverse effects on what sorts of things scientists can effectively investigate. Second, collaborative research makes it more difficult to hold scientists accountable. I argue that the authors of multi-authored articles are aptly described as plural subjects, corporate bodies that are more than the sum of the individuals involved. Though journal editors do not currently (...) conceive of the authors of multi-authored articles this way, this conception provides us with the conceptual resources to make sense of how collaborating scientists behave.Keywords: Collaborative research; Authorship; Multi-authored articles; Responsibility; Reward system; Plural subject. (shrink)

ABSTRACT:The notion of stakeholder salience based on attributes (e.g., power, legitimacy, urgency) is applied in the family business setting. We argue that where principal institutions intersect (i.e., family and business); managerial perceptions of stakeholder salience will be different and more complex than where institutions are based on a single dominant logic. We propose that (1) whereas utilitarian power is more likely in the general business case, normative power is more typical in family business stakeholder salience; (2) whereas in a general (...) business context legitimacy is socially constructed; for family stakeholders, legitimacy is based on heredity; and (3) whereas temporality and criticality are somewhat independent in general-business urgency, they are linked in the family business case because of family ties and family-centered non-economic goals. We apply this theoretical framework to position and integrate the contributions to this special section ofBusiness Ethics Quarterlyon “Stakeholder Theory, Ethics, Corporate Social Responsibility, and Family Enterprise.”. (shrink)

The Oxford Handbook of Epistemology contains 19 previously unpublished chapters by today's leading figures in the field. These chapters function not only as a survey of key areas, but as original scholarship on a range of vital topics. Written accessibly for advanced undergraduates, graduate students, and professional philosophers, the Handbook explains the main ideas and problems of contemporary epistemology while avoiding overly technical detail.