Shared decision-making is a well-recognized model to guide decision-making in medical care. However, the shared decision-making concept can become exceedingly complex in adolescent patients with varying degrees of autonomy who have most of their medical decisions made by their parents or legal guardians. The complexity increases further in ethically difficult situations such as terminal illness. In contrast to the typical patient-physician dyad, shared decision-making in adolescents requires a decision-making triad that also includes the parents or guardians. The multifactorial nature of (...) these cases can overwhelm treatment teams, with minimal guidance on how to best approach the patient–parents–physician dynamic in an ethically appropriate manner. Estimated time left to live is the paramount ethical consideration for such cases with respect to shared decision-making. This paper offers a sliding scale to serve as a grounding reference for clinicians who care for terminally ill adolescents and hospital ethics committee members for initiating and guiding the ethical discussion for these patients. This paper also elucidates several other ethically salient features inherent to many of these cases, including quality of life, treatability of disease, cultural influences, among others. Yet how each of these variables is weighed is dependent upon the specific circumstances of each individual case. Ultimately, shared decision-making in adolescent patients with terminal illnesses must be a collaborative and ongoing process that thoughtfully weighs the values and ethical responsibilities of the patient, parents, and physician to ideally reconcile differences and come to a consensus on the best management option for each individual patient. (shrink)

Practice wisdom is needed because the challenges people face in life, work and society are not simple and require more than knowledge, actions and decision making capabilities. In professional practice wisdom enhances people's capacity to succeed and evolve and to assist their clients in achieving positive, relevant and satisfying outcomes. Practice Wisdom: Values and Interpretations brings diverse views and interpretations to an exploration of what wisdom in professional practice means and can become: academically, practically and inspirationally. The authors reflect on (...) core dimensions of practice wisdom like ethics, mindfulness, moral virtue, particularisation and metacognition. The chapter authors tackle the trials that practice wisdom seekers encounter including the demand for resilience, perseverance, finding credibility and humility in practice wisdom, and linking wisdom into evidence for sound professional decision making. Readers are invited to consider what the place of practice wisdom encompasses in pursuing good practice outcomes amidst the turmoil and pressure of professional practice today. Do the imperatives of evidence-based practice and accountability leave enough space for wise practice or is wisdom seen by modern practice worlds as unnecessary, antiquated, unrealistic and redundant? Without a doubt these questions are answered positively in this book in support of the place and value of practice wisdom in professional practice today. (shrink)

In this study, we analyse the notion of “differential heterogenesis” proposed by Deleuze and Guattari on a morphogenetic perspective. We propose a mathematical framework to envisage the emergence of singular forms from the assemblages of heterogeneous operators. In opposition to the kind of differential calculus that is usually adopted in mathematical-physical modelling, which tends to assume a homogeneous differential equation applied to an entire homogeneous region, heterogenesis allows differential constraints of qualitatively different kinds in different points of space and time. (...) These constraints can then change in time, opening the possibility for new kinds of differential dynamics and the emergence of distinct entities and forms. Formally, we show that operators with different phase spaces can be assembled on the basis of a result of Rothschild & Stein (1976. Hypoelliptic differential operators and nilpotent groups. Acta Mathematica 137. 247–320). Furthermore, operators with different dynamics can be assembled by means of a partition of the unit.After stating the concept of differential heterogenesis in terms of contemporary mathematics, we show that this construction sheds light on the constitution of the semiotic function. In fact, both the Merleau-Pontian and the Deleuzian approaches share a common conceptualisation of the semiotic function and its emergence in terms of amorphodynamics of heterogeneous assemblages with a divergent actualisation. This divergent actualisation allows the co-constitution of various expression and content planes. Finally, we show that the divergent actualisation can be interpreted as the directions of principal eigenvectors of the actualized flow. (shrink)

Identity, self-sufficiency and disability in the context of educational and vocational activity This study focused on relations between identity and sense of self-sufficiency. These relations were analysed in the context of educational and vocational activity. 204 persons without disabilities and 230 persons with different kinds of disability participated in the study. Participants were divided into three groups: 18-24-year-olds - students, 25-30-year-olds - unemployed and 25-30-year-olds - employed. The results revealed that unemployed people have significant problems with identity formation. This group (...) obtained the highest scores on ruminative exploration and the lowest scores on the scales of commitment making and identification with commitment. Self-sufficiency proved to be a moderator of the relations between educational/vocational activity on the one hand and exploration in breadth and exploration in depth on the other hand. In students, level of exploration was high in individuals with a high sense of self-sufficiency whereas in the unemployed strong exploration was observed in the group with low sense of self-sufficiency. The need to conduct studies where participants are recruited from populations which seldom attract researchers' interest, such as the unemployed and people of low social status, is also noted. (shrink)

This descriptive study is an attempt to characterize the field known as clinical ethics, with regard to the function of humanities scholars in the clinical setting, e.g., hospitals and ambulatory care clinics. It is not a strict epidemiological study but a qualitative survey, although it reports some empirical data. Most discussions of medical humanities in the literature are conceptual analyses of particular issues, such as informed consent, abortion, confidentiality, etc. Virtually no empirical studies with data on how many clinical ethicists (...) function in what roles and with what educational backgrounds have been reported. This is the first such study of humanities scholars in clinical ethics and will be followed by companion reports of physicians and hospital chaplains who are, by self-report, involved in clinical ethics. This report is an effort to stimulate and encourage dialogue and is in no way definitive. It is a preliminary study, and other needed studies are already underway. (shrink)

A substantial amount of research showed that agency and communion are two basic dimensions of content in social cognition. Based on the well-supported idea that people typically think about themselves and close others in agentic rather than communal terms, we tested the hypothesis that agentic thinking about unknown others makes them subjectively closer. This hypothesis was confirmed in four experiments differently priming agentic versus communal thinking on others. As predicted, increases in closeness resulting from the agentic thinking about others were (...) constrained to cognitive load conditions where participants were occupied with a parallel task. We conclude that the agentic content of thoughts about others serves as an intuitive, heuristic cue of their psychological closeness. (shrink)

It is evident that disunity is a reality wherever we look in the world today. Even within the Body of Christ there is a lack of unity that is appalling. The universal church needs to develop a greater urgency about it and at the same time, do more about it than most are doing. If the universal church comes to a realization that genuine Christian unity is already ‘an established reality and can progressively be realized and brought into the actualities (...) of life’, perhaps then the universal church would strive harder to create and maintain a sustainable Christian unity making it a ‘lived reality’. As a Reformed family, we believe in the creative and redemptive activity of God, inaugurated in Jesus Christ but not yet completed. The Kingdom of God is a present reality, which will be expressed anew in all its fullness. This is our Christian hope, which is fundamental to our Christian faith and Christian faith is expectant faith. The universal Church therefore must offer the image of a people who are mature in faith and capable of finding a meeting-point beyond denominational barriers and not the image of a people divided and separated because of ecclesiastical differences. It is hoped that the Global Christian Forum will continue to reflect that image. (shrink)

How to estimate the randomness in random sequence generation tasks? The aim of the paper was to discuss the accuracy of the multiple indexes used for random sequences generation results calculation. In the first part of the paper the models explaining deviations from randomness were presented. The key role of the structural limitations interpretation was suggested. Secondly, the multiple indexes of the deviation from randomness used in random sequence generation task studies were presented. The authors concluded that too many indexes (...) are used in the studies of deviation from randomness. In order to avoid such problems two indexes were proposed: entropy and correlation function. The last part of the paper presents the preliminary version of the mathematical of random sequences generation in which the limited capacity of the short-term memory assumption was introduce. (shrink)

A high risk of morbidity-mortality caused by a harsh and unpredictable environment is considered to be associated with a fast life history strategy, commonly linked with criminal behavior. However, offenders are not the only group with a high exposure to extrinsic morbidity-mortality. In the present study, we investigated the LH strategies employed by two groups of Polish men: incarcerated offenders as well as soldiers and firefighters, whose professions involve an elevated risk of injury and premature death. The subjects were asked (...) to complete the Mini-K and a questionnaire which included a number of biodemographic LH variables. Although biodemographic and psychosocial LH indicators should be closely linked with each other, the actual connection between them is unclear. Thus, this study was driven by two aims: comparing LH strategies in two groups of men with a high risk of premature morbidity-mortality and investigating the relationship between the biodemographic and psychosocial LH dimensions. The study showed that incarcerated men employed faster LH strategies than soldiers and firefighters, but only in relation to biodemographic variables. No intergroup differences emerged regarding psychosocial LH indicators. Moreover, the correlation analysis showed a weak association between biodemographic and psychosocial LH indicators. The results strengthen the legitimacy of incorporating biodemographic LH traits into research models and indicate the need for further research on the accuracy of the Mini-K. The possible explanations for the intergroup differences in LH strategies are discussed. (shrink)

Inspired by Max Weber's thesis on the Protestant ethic, this volume sets out to understand the role and influence of Christianity on overseas Chinese entrepreneurs working in China during its transition from a centrally-planned economy ...

This volume explores a central paradox in the evolution of psychoanalytic thought and practice and the ways in which they were used.

It is hard to imagine a threat to international security or a tension within U.S. foreign policy that does not involve the imposition of economic sanctions. The United Nations Security Council has fourteen sanctions regimes currently in place, and all member states of the United Nations are obligated to participate in their enforcement. The United States has some thirty sanctions programs, which target a range of countries, companies, organizations, and individuals, and many of these are autonomous sanctions that are independent (...) of the measures required by the United Nations. Australia, Canada, the European Union, Japan, South Korea, and others also have autonomous sanctions regimes, spanning a broad range of contexts and purpose. Most well-known are those concerning weapons proliferation, terrorism, and human rights violations; but sanctions are also imposed in such contexts as money laundering, corruption, and drug trafficking. States may also impose sanctions as a means to achieve foreign policy goals: to pressure a foreign state to bend to the sanctioner's will, to punish those who represent a threat to the sanctioner's economic or political interests, or to seek the end of a political regime toward which the sanctioner is hostile, to give but a few examples. (shrink)

In order to investigate whether addressees can make immediate use of speaker‐based constraints during reference resolution, participant addressees' eye movements were monitored as they helped a confederate cook follow a recipe. Objects were located in the helper's area, which the cook could not reach, and the cook's area, which both could reach. Critical referring expressions matched one object (helper's area) or two objects (helper's and cook's areas), and were produced when the cook's hands were empty or full, which defined the (...) cook's reaching ability constraints. Helper's first and total fixations showed that they restricted their domain of interpretation to their own objects when the cook's hands were empty, and widened it to include the cook's objects only when the cook's hands were full. These results demonstrate that addressees can quickly take into account task‐relevant constraints to restrict their referential domain to referents that are plausible given the speaker's goals and constraints. (shrink)

Senior high school is known to be part of the newly implemented K-12 program in the Philippines' educational system. Hence, this program added two years to the academic learning program of students, which mainly focuses on different theoretical and vocational strands that aim to prepare and fully furnish the students for education and employment in the future. Due to adjustments to new online learning amidst the pandemic, students begin to experience various challenges, primarily social support and mental well-being. Hence, this (...) study investigates the relationship between social support and anxiety with 160 respondents from private schools. The findings revealed that social support and anxiety have a significant relationship (r=0.126). (shrink)

This paper provides a new interpretation of the three natures theory of Yogācāra-Vijñānavāda thought by means of an examination of the path theory associated with it, which has not been previously examined in scholarly literature. The paper first examines this path theory in a number of foundational texts to show that the widely accepted pivotal model is not in fact the three natures model that predominates in foundational Yogācāra-Vijñānavāda literature. Second, the paper offers a new interpretation of the three natures (...) theory as providing a new causal model of the arising of suffering, and a corresponding theory of its cessation. This new causal model both makes possible the continued use of the kind of dharma analysis that Abhidharma thought employs to provide a causal analysis of the arising of suffering, and also couches such dharma analysis within the Mahāyāna framework of the emptiness of dharmas. (shrink)

A multidisciplinary text for the health professions, with relevance across the various health disciplines. International scholars, researchers, and teachers contribute their ideas, research findings, and experiences to promote discussion on the nature and teaching of clinical reasoning. Models, guidelines, and strategies are presented. These aim to promote effective clinical reasoning in practice, creative and successful clinical reasoning learning programs, and directions for future research. Annotation copyright by Book News, Inc., Portland, OR.

Bell inequalities are usually derived by assuming locality and realism, and therefore violations of the Bell-CHSH inequality are usually taken to imply violations of either locality or realism, or both. But, after reviewing an oversight by Bell, in the Corollary below we derive the Bell-CHSH inequality by assuming only that Bob can measure along vectors b and b' simultaneously while Alice measures along either a or a', and likewise Alice can measure along vectors a and a' simultaneously while Bob measures (...) along either b or b', without assuming locality. The violations of the Bell-CHSH inequality therefore only mean impossibility of measuring along b and b' simultaneously. (shrink)

In the processual approach to identity, the role of the interaction between subjective and contextual factors in the process of its development is emphasized. Based on the model of Luyckx et al. relationships between identity and educational context, as well as the tendency to experience shame and guilt were analyzed.. 821 people aged from 14-25 and belonging to six educational groups: lower secondary school, basic vocational school, technical upper secondary school, general upper secondary school, post-secondary school and university, took part (...) in the research. Two questionnaires were used: The Dimensions of Identity Development Scale, to allow the measurement of the five dimensions of identity postulated by Luyckx et al and The Personal Feelings Questionnaire-2 to measure of the shame and guilt proneness. The results show that general upper secondary school students in terms of the dimensions of identity are closer to lower secondary school students rather than to their peers from technical and vocational schools. Among general upper secondary school students not only was a higher intensity of an identity crisis observed, but also a strong tendency to experience shame and guilt. Among lower secondary school students and general upper secondary school students, people with diffusion and moratorium as identity statuses prevailed, while in the remaining groups the achievement and foreclosure identity were observed more frequently. A general relationship was also observed, namely, a greater tendency to experience shame was associated with a higher intensity of an identity crisis. (shrink)

Economic sanctions are emerging as one of the major tools of international governance in the post-Cold War era. Gordon considers the issue of sanctions within three ethical frameworks: just war doctrine, deontological ethics, and utilitarianism.

We illustrate an explicit counterexample to Bell's theorem by constructing a pair of dichotomic variables that exactly reproduce the EPR-Bohm correlations in a manifestly local-realistic manner.

It is shown that Bell's theorem fails for the Clifford algebra valued local realistic variables. This is made evident by exactly reproducing quantum mechanical expectation value for the EPR-Bohm type spin correlations observable by means of a local, deterministic, Clifford algebra valued variable, without necessitating either remote contextuality or backward causation. Since Clifford product of multivector variables is non-commutative in general, the spin correlations derived within our locally causal model violate the CHSH inequality just as strongly as their quantum mechanical (...) counterparts. (shrink)

A local, deterministic, and realistic model within a Friedmann-Robertson-Walker spacetime with constant spatial curvature is presented which describes simultaneous measurements of the spins of two fermions emerging in a singlet state from the decay of a spinless boson. Exact agreement with the probabilistic predictions of quantum theory is achieved in the model without data rejection, remote contextuality, superdeterminism, or backward causation. An event-by-event numerical simulation of the model is presented, which confirms our analytical results with the accuracy of 4 in (...) 10,000 parts. (shrink)

Civics and Moral Educationwas implemented as a new moral education programme in Singapore schools in 1992. This paper argues that the underlying theme is that of citizenship training and that new measures are under way to strengthen the capacity of the school system to transmit national values for economic and political socialisation. The motives and motivation for retaining a formal moral education programme have remained strong. A discussion of the structure and content of key modules in Civics and Moral Education (...) shows how curriculum writers have attempted to integrate separate strands of civics and moral education from earlier programmes and present them in a less divisive manner. The paper also assesses the impact of the written civics and moral education programme on teachers and pupils, and the way in which strategies have been used by curriculum agencies to overcome possible obstacles at the curriculum implementation phase. (shrink)

I demonstrate that Bell's theorem is based on circular reasoning and thus a fundamentally flawed argument. It unjustifiably assumes the additivity of expectation values for dispersion-free states of contextual hidden variable theories for non-commuting observables involved in Bell-test experiments, which is tautologous to assuming the bounds of ±2 on the Bell-CHSH sum of expectation values. Its premises thus assume in a different guise the bounds of ±2 it sets out to prove. Once this oversight is ameliorated from Bell's argument by (...) identifying the impediment that leads to it and local realism is implemented correctly, the bounds on the Bell-CHSH sum of expectation values work out to be ±2√2 instead of ±2, thereby mitigating the conclusion of Bell's theorem. Consequently, what is ruled out by any of the Bell-test experiments is not local realism but the linear additivity of expectation values, which does not hold for non-commuting observables in any hidden variable theories to begin with. (shrink)

We show that the respective oversights in the von Neumann's general theorem against all hidden variable theories and Bell's theorem against their local-realistic counterparts are homologous. When latter oversight is rectified, the bounds on the CHSH correlator work out to be ±2√2 instead of ±2.

In this chapter, we identify and present predominant debates at the intersection of ethics and imagination. We begin by examining issues on whether our imagination can be constrained by ethical considerations, such as the moral evaluation of imagination, the potential for morality’s constraining our imaginative abilities, and the possibility of moral norms’ governing our imaginings. Then, we present accounts that posit imagination’s integral role in cultivating ethical lives, both through engagements with narrative artworks and in reality. Our final topic of (...) consideration focuses on the possibility of imagination constituting or constructing new ethical or political frameworks. (shrink)

An experiment is proposed to test Bell’s theorem in a purely macroscopic domain. If realized, it would determine whether Bell inequalities are satisfied for a manifestly local, classical system. It is stressed why the inequalities should not be presumed to hold for such a macroscopic system without actual experimental evidence. In particular, by providing a purely classical, topological explanation for the EPR-Bohm type spin correlations, it is demonstrated why Bell inequalities must be violated in the manifestly local, macroscopic domain, just (...) as strongly as they are in the microscopic domain. (shrink)

The question of observability of sign changes under 2pi rotations is considered. It is shown that in certain circumstances there are observable consequences of such sign changes in classical physics. A macroscopic experiment is proposed which could in principle detect the 4pi periodicity of rotations.

For three decades, Angela Y. Davis has written on liberation theory and democratic praxis. Challenging the foundations of mainstream discourse, her analyses of culture, gender, capital, and race have profoundly influenced democratic theory, antiracist feminism, critical studies and political struggles. Even for readers who primarily know her as a revolutionary of the late 1960s and early 1970s she has greatly expanded the scope and range of social philosophy and political theory. Expanding critical theory, contemporary progressive theorists - engaged in justice (...) struggles - will find their thought influenced by the liberation praxis of Angela Y. Davis. _The Angela Y. Davis Reader_ presents eighteen essays from her writings and interviews which have appeared in _If They Come in the Morning, Women, Race, and Class, Women, Culture, and Politics,_ and _Black Women and the Blues_ as well as articles published in women's, ethnic/black studies and communist journals, and cultural studies anthologies. In four parts - "Prisons, Repression, and Resistance", "Marxism, Anti-Racism, and Feminism", "Aesthetics and Culture", and recent interviews - Davis examines revolutionary politics and intellectualism. Davis's discourse chronicles progressive political movements and social philosophy. It is essential reading for anyone interested in contemporary political philosophy, critical race theory, social theory, ethnic studies, American studies, African American studies, cultural theory, feminist philosophy, gender studies. (shrink)

The discipline of parallelization in the manifold of all possible measurement results is shown to be responsible for the existence of all quantum correlations, with the upper bound on their strength stemming from the maximum of possible torsion within all norm-composing parallelizable manifolds. A profound interplay is thus uncovered between the existence and strength of quantum correlations and the parallelizability of the spheres S^0, S^1, S^3, and S^7 necessitated by the four real division algebras. In particular, parallelization within a unit (...) 3-sphere is shown to be responsible for the existence of EPR and Hardy type correlations, whereas that within a unit 7-sphere is shown to be responsible for the existence of all GHZ type correlations. Moreover, parallelizability in general is shown to be equivalent to the completeness criterion of EPR, in addition to necessitating the locality condition of Bell. It is therefore shown to predetermine both the local outcomes as well as the quantum correlations among the remote outcomes, dictated by the infinite factorizability of points within the spheres S^3 and S^7. The twin illusions of quantum entanglement and non-locality are thus shown to stem from the topologically incomplete accountings of the measurement results. (shrink)

Literary racial impersonation occurs when a narrative work fails to express the perspective of a minority ethnic or racial group. Interestingly, even when these works express moral themes congenial to promoting empathetic responses towards these groups, they can be met with public outrage if the group’s perspective is portrayed inaccurately. My goal in this paper is to vindicate the intuition that failure to express the perspective of a minority group well renders the work defective, both aesthetically and morally. I argue (...) that available frameworks exploring the connections between aesthetic and moral realms of value are inadequate to analyzing this phenomenon and propose a novel connection between aesthetic and moral values. Specifically, I demonstrate that the primary defect of literary racial impersonation is aesthetic and contingently constitutes a moral defect in our current social context. (shrink)

Although the neural systems that underlie spoken language are well-known, how they adapt to evolving social cues during natural conversations remains an unanswered question. In this work we investigate the neural correlates of face-to-face conversations between two individuals using functional near infrared spectroscopy and acoustical analyses of concurrent audio recordings. Nineteen pairs of healthy adults engaged in live discussions on two controversial topics where their opinions were either in agreement or disagreement. Participants were matched according to their a priori opinions (...) on these topics as assessed by questionnaire. Acoustic measures of the recorded speech including the fundamental frequency range, median fundamental frequency, syllable rate, and acoustic energy were elevated during disagreement relative to agreement. Consistent with both the a priori opinion ratings and the acoustic findings, neural activity associated with long-range functional networks, rather than the canonical language areas, was also differentiated by the two conditions. Specifically, the frontoparietal system including bilateral dorsolateral prefrontal cortex, left supramarginal gyrus, angular gyrus, and superior temporal gyrus showed increased activity while talking during disagreement. In contrast, talking during agreement was characterized by increased activity in a social and attention network including right supramarginal gyrus, bilateral frontal eye-fields, and left frontopolar regions. Further, these social and visual attention networks were more synchronous across brains during agreement than disagreement. Rather than localized modulation of the canonical language system, these findings are most consistent with a model of distributed and adaptive language-related processes including cross-brain neural coupling that serves dynamic verbal exchanges. (shrink)

Forlagets beskrivelse: Informative, analytical and stimulating, this book examines the relationship between professional knowledge and clinical practice.Biography.

The embryonic vertebrate face is composed of similarly sized buds of neural crest‐derived mesenchyme encased in epithelium. These buds or facial prominences grow and fuse together to give the postnatal morphology characteristic of each species. Here we review the role of neural crest cells and foregut endoderm in differentiating facial features. We relate the developing facial prominences to the skeletal structure of the face and review the signals and genes that have been shown to play an important role in facial (...) morphogenesis. We also examine two experiments one at the genetic level and one at the signal level in which transformation of facial prominences and subsequent change of jaw identity was induced. We propose that signals such as retinoids and BMPs and downstream transcription factors such as Distal‐less related genes specify jaw identity. BioEssays 25:554–568, 2003. © 2003 Wiley Periodicals, Inc. (shrink)