This qualitative study describes the lived experience of physicians who work in communities that have experienced a public mass shooting. Semi-structured interviews were conducted with seventeen physicians involved in eight separate mass casualty shooting incidents in the United States. Four major themes emerged from constant comparative analysis: The psychological toll on physicians: “I wonder if I'm broken”; the importance of and need for mass casualty shooting preparedness: “[We need to] recognize this as a public health concern and train physicians to (...) manage it”; massive media attention: “The media onslaught was unbelievable”; and commitment to advocacy for a public health approach to firearm violence: “I want to do whatever I can to prevent some of these terrible events.”. (shrink)

© 2016 Regents of the University of California.The Review summarizes much of particle physics and cosmology. Using data from previous editions, plus 3,062 new measurements from 721 papers, we list, evaluate, and average measured properties of gauge bosons and the recently discovered Higgs boson, leptons, quarks, mesons, and baryons. We summarize searches for hypothetical particles such as supersymmetric particles, heavy bosons, axions, dark photons, etc. All the particle properties and search limits are listed in Summary Tables. We also give numerous (...) tables, figures, formulae, and reviews of topics such as Higgs Boson Physics, Supersymmetry, Grand Unified Theories, Neutrino Mixing, Dark Energy, Dark Matter, Cosmology, Particle Detectors, Colliders, Probability and Statistics. Among the 117 reviews are many that are new or heavily revised, including those on Pentaquarks and Inflation. The complete Review is published online in a journal and on the website of the Particle Data Group. The printed PDG Book contains the Summary Tables and all review articles but no longer includes the detailed tables from the Particle Listings. A Booklet with the Summary Tables and abbreviated versions of some of the review articles is also available. (shrink)

Drawing on ancient writers, from Aesop to Ovid, classicist and working farmer, Mark Usher compiles in this book an anthology of Greco-Roman passages illustrating how they thought about animals and illuminating they might help us to rethink our relationships with them. Not many contemporary readers will know, for example, the compelling arguments the second century AD Greek philosopher Porphyry makes for vegetarianism, long before a plant-based diet began to garner headlines. Plutarch's serio-comic exposition of the rationality and inherent dignity of (...) non-human creatures-put on the lips of one of Circe's pigs-is so fresh that it sounds like it was formulated just yesterday. The knowledge the poet Theognis derived from Greek sponge divers about the behavior of octopods rivals our contemporary fascination with the octopus. Aristotle's introduction to the scientific study of animal morphology and behavior remains unparalleled for its elegance and insight, and it represents one of the first forays into natural history writing. Seneca, employing an ingenious etymological pun on the word animal, endeavors to show that we humans are morally inferior to our animal cousins, who instinctively know and are satisfied with their place in Nature. The Greeks and Romans, amidst all their magnificent cultural achievements and reckless, destructive behavior, lived closer than most of us to the perils and prospects of their environments. This afforded them a sensitivity to their environments and, in particular, to their fellow creatures that can perhaps help to disabuse us of our disconnectedness from animal life. This small volume demonstrates how astoundingly relevant the ancients still are in this regard. (shrink)

Disagreements about scientific ontology have frequently been reconstructed as the result of a dispute between rival epistemic stances. In this paper, (i) we characterize some of these disagreements as deep disagreements. In addition, we show that deep disagreements about scientific ontology can arise not only from the adoption of different epistemic stances, but also between positions that fall within the same stance. The development of this point allows us, in turn, to establish a distinction between types of deep disagreement and (...) to explore the possibility that there are differences of degree between them. (shrink)

Dans les premiers chants de l’ Enfer, Dante déclare entre les lignes la tâche à laquelle il se sent appelé en tant que « poète chrétien » : d’un côté, il est invité à argumenter avec la rigueur du discours scientifique les vérités fondamentales de la religion ; de l’autre côté, il lui est confié la charge d’entraîner le lecteur dans une lecture anagogique de ces vérités en recourant aux fascinations allégoriques de la poésie. En accomplissant cette mission, Dante obtiendra, (...) pour lui-même et pour les autres êtres humains, cette perfection anthropologique naturelle qui culmine, après la mort terrestre, par le retour aux conditions métaphysiques qui se seraient actualisées en la personne d’Adam s’il n’avait pas péché. Cette conception est déjà opérante dans certaines pages de la Vie nouvelle et du Banquet, mais c’est surtout dans La Divine Comédie que Dante en revient spontanément à ce genre de techniques sur un mode original et particulièrement efficace. On en a un exemple éclairant quand, au Chant III de l’ Enfer, la poésie décrit le tourbillon, apparemment disharmonieux et dépourvu de sens, des sons qui émergent de la cavité infernale, en se basant non seulement sur l’application évidente d’au moins deux artifices rhétoriques déterminés, mais surtout sur l’évocation formellement rigoureuse des règles de la dialectique (selon la terminologie en usage dans les écoles) : le succès de cette opération dépend de la capacité, de la part du lecteur, de retrouver la signification authentique de la terminologie scientifique mise en œuvre en poésie, utilisée pour illustrer les vérités de la foi et la nouvelle beauté de la synthèse entre art poétique et disciplines du Trivium. (shrink)

C’est à travers la lecture de l’Isagoge de Porphyre commentée par Boèce que l’idée d’une organisation hiérarchique du réel, fondée sur la division des genres, des espèces et des différences, était introduite dans le patrimoine culturel des intellectuels du haut Moyen Âge au niveau élémentaire de l’étude de la dialectique. Cette étude, fondement du curriculum pédagogique des arts libéraux, impliquait une considération réaliste des formes de la pensée logiquement ordonnées : seules structures authentiques du point de vue ontologique, les formes (...) sont aussi les seuls objets de la connaissance scientifique puisqu’elles seules sont véritablement exemptes de la vicissitude et de l’accidentalité. Tout au long du haut Moyen Âge, le débat, polymorphe et complexe, sur la nature des universaux introduit donc la comparaison dynamique entre différentes conceptions du réel, de la connaissance et de la science, et aussi de la capacité du langage humain de dire, de manifester et de communiquer la vérité. L’analyse historique de l’évolution et des conséquences de cette perspective philosophique, d’origine porphyrienne d’une part, boécienne et augustinienne de l’autre, se développe ici à travers certains épisodes de la spéculation du haut Moyen Âge, et en particulier à l’époque carolingienne, cherchant à contribuer à une meilleure intelligence de la naissance de la méthodologie des sciences particulières et, plus spécifiquement, de la théologie. (shrink)

This paper discusses some problems related to the practical experience of social research in university institutions. It describes the process of access to field work and the relationship with university managers as key informants during a qualitative research about the present politics of economic..

In his explanation of the nature of the being of reason, Fr. José de Aguilar, S.J. presents a notion of «objective concept» which is common to both known real beings and beings of reaso...

Los desacuerdos acerca de la ontología científica han sido frecuentemente reconstruidos como el resultado de una disputa entre stances epistémicas rivales. En el presente trabajo, (i) caracterizamos algunos de estos desacuerdos como desacuerdos profundos. Además, (ii) mostramos que los desacuerdos profundos sobre ontología científica pueden surgir no solo de la adopción de diferentes stances epistémicas, sino entre posiciones que se encuadran dentro de una misma stance. El desarrollo de ese punto nos permite, a su vez, establecer una distinción entre tipos (...) de desacuerdos profundos y explorar la posibilidad de que existan diferencias de grado entre ellos. (shrink)

Firearm injury in the United States is a public health crisis in which physicians are uniquely situated to intervene. However, their ability to mitigate harm is limited by a complex array of laws and regulations that shape their role in firearm injury prevention. This piece uses four clinical scenarios to illustrate how these laws and regulations impact physician practice, including patient counseling, injury reporting, and the use of court orders and involuntary holds. Unintended consequences on clinical practice of laws intended (...) to reduce firearm injury are also discussed. Lessons drawn from these cases suggest that physicians require more nuanced education on this topic, and that policymakers should consult front-line healthcare providers when designing firearm policies. (shrink)

In recent years, we have seen a new concern with ethics training for research and development professionals. Although ethics training has become more common, the effectiveness of the training being provided is open to question. In the present effort, a new ethics training course was developed that stresses the importance of the strategies people apply to make sense of ethical problems. The effectiveness of this training was assessed in a sample of 59 doctoral students working in the biological and social (...) sciences using a pre–post design with follow-up and a series of ethical decision-making measures serving as the outcome variable. Results showed not only that this training led to sizable gains in ethical decision making but also that these gains were maintained over time. The implications of these findings for ethics training in the sciences are discussed. (shrink)

Objective: The field of clinical ethics is relatively new and expanding. Best practices in clinical ethics against which one can benchmark performance have not been clearly articulated. The first step in developing benchmarks of clinical ethics services is to identify and understand current practices.Design and setting: Using a retrospective case study approach, the structure, activities, and resources of nine clinical ethics services in a large metropolitan centre are described, compared, and contrasted.Results: The data yielded a unique and detailed account of (...) the nature and scope of clinical ethics services across a spectrum of facilities. General themes emerged in four areas—variability, visibility, accountability, and complexity. There was a high degree of variability in the structures, activities, and resources across the clinical ethics services. Increasing visibility was identified as a significant challenge within organisations and externally. Although each service had a formal system for maintaining accountability and measuring performance, differences in the type, frequency, and content of reporting impacted service delivery. One of the most salient findings was the complexity inherent in the provision of clinical ethics services, which requires of clinical ethicists a broad and varied skill set and knowledge base. Benchmarks including the average number of consults/ethicist per year and the hospital beds/ethicist ratio are presented.Conclusion: The findings will be of interest to clinical ethicists locally, nationally, and internationally as they provide a preliminary framework from which further benchmarking measures and best practices in clinical ethics can be identified, developed, and evaluated. (shrink)

The editorial in the September 1982 issue of this journal and many articles before and since have addressed the problem of informed consent. Is it possible? Is it a useful concept? Is there anything new to be said about it? In this article the basic rationale of the rule (patient autonomy) is explained and the extent of the rule explored. Various exceptions have been offered by the law and an attempt is made to catalogue the chief of these. A number (...) of specially vulnerable groups are then identified, the most important, and vexed, being children. How can informed consent be secured in the case of young patients? Finally, a few problems are mentioned in an attempt to get this subject back to reality. The appeal to the principle primum non nocere may be medical paternalism in disguise. Informed consent is the competing principle that reminds us of the primacy of human autonomy. A pointer is given to the future: even the use of sound recordings to explain medical procedures and to activate informed consent so that it may become a reality and not just a lawyer's myth, should be considered. (shrink)

BackgroundInformation and communication technology solutions have the potential to support active and healthy aging and improve monitoring and treatment outcomes. To make such solutions acceptable, all stakeholders must be involved in the requirements elicitation process. Due to the COVID-19 situation, alternative approaches to commonly used face-to-face methods must often be used. One aim of the current article is to share a unique experience from the Pharaon project where due to the COVID-19 outbreak alternative elicitation methods were used. In addition, an (...) overview of common functional, quality, and emotional goals identified by six pilot sites is presented to complement the knowledge about the needs of older adults.MethodsOriginally planned face-to-face co-creation seminars were impossible to carry out, and all pilot sites chose alternative requirements elicitation methods that were most suitable in their situation. The elicited requirements were presented in the form of goal models. In one summary goal model, we provide an overview of common functional, quality, and emotional goals.ResultsDifferent elicitation methods were combined based on the digital literacy of the target group and their access to digital tools. Methods applied without digital technologies were phone interviews, reviews of literature and previous projects, while by means of digital technologies online interviews, online questionnaires, and virtual co-creation seminars were conducted. The combination of the methods allowed to involve all planned stakeholders. Virtual and semi-virtual co-creation seminars created collaborative environment comparable to face-to-face situations, while online participation helped to save the time of the participants. The most prevalent functional goals elicited were “Monitor health,” “Receive advice,” “Receive information.” “Easy to use/comfortable,” “personalized/tailored,” “automatic/smart” were identified as most prevalent quality goals. Most frequently occurring emotional goals were “involved,” “empowered,” and “informed.”ConclusionThere are alternative methods to face-to-face co-creation seminars, which effectively involve older adults and other stakeholders in the requirements elicitation process. Despite the used elicitation method, the requirements can be easily transformed into goal models to present the results in a uniform way. The common requirements across different pilots provided a strong foundation for representing detailed requirements and input for further software development processes. (shrink)

The imbalance between supply of organs for transplantation and demand for them is widening. Although the current international drive to re-establish procurement via non-heart beating organ donation/donor is founded therefore on necessity, the process may constitute a desirable outcome for patient and family when progression to brain stem death does not occur and conventional organ retrieval from the beating heart donor is thereby prevented. The literature accounts of this practice, however, raise concerns that risk jeopardising professional and public confidence in (...) the broader transplant programme. This article focuses on these clinical, ethical, and legal issues in the context of other approaches aimed at increasing donor numbers. The feasibility of introducing such an initiative will hinge on the ability to reassure patients, families, attendant staff, professional bodies, the wider public, law enforcement agencies, and the media that practitioners are working within explicit guidelines which are both ethically and legally defensible. (shrink)

Physicians who care for critically ill people with opioid use disorder frequently face medical, legal, and ethical questions related to the provision of life-saving medical care. We examine a complex medical case that illustrates these challenges in a person with relapsing injection drug use. We focus on a specific question: Is futility an appropriate and useful standard by which to determine provision of life-saving care to such individuals? If so, how should such determinations be made? If not, what alternative decisionmaking (...) framework exists? We determine that although futility has been historically utilized as a justification for withholding care in certain settings, it is not a useful standard to apply in cases involving people who use injection drugs for non-medical purposes. Instead, we are welladvised to explore each patient's situation in a holistic approach that includes the patient, family members, and care providers in the decision-making process. The scope of the problem illustrated demonstrates the urgent need to definitively improve outcomes in people who use injection drugs. Increasing access to high quality medication-assisted treatment and psychiatric care for individuals with opioid use disorder will help our patients achieve a sustained remission and allow us to reach this goal. (shrink)

Citizens today are increasingly expected to be knowledgeable about and prepared to engage with biomedical knowledge. In this article, I wish to reframe this ‘public understanding of science’ project, and place fresh emphasis on public understandings of research: an engagement with the everyday laboratory practices of biomedicine and its associated ethics, rather than with specific scientific facts. This is not based on an assumption that non-scientists are ‘ignorant’ and are thus unable to ‘appropriately’ use or debate science; rather, it is (...) underpinned by an empirically-grounded observation that some individuals may be unfamiliar with certain specificities of particular modes of research and ethical frameworks, and, as a consequence, have their autonomy compromised when invited to participate in biomedical investigations. Drawing on the perspectives of participants in my own sociological research on the social and ethical dimensions of neuroscience, I argue that public understanding of biomedical research and its ethics should be developed both at the community level and within the research moment itself in order to enhance autonomy and promote more socially robust science. Public bioethics will have to play a key role in such an endeavour, and indeed will contribute in important ways to the opening up of new spaces of symmetrical engagement between bioethicists, scientists and wider publics—and hence to the democratisation of the bioethical enterprise. (shrink)

This article identifies two trends in Dooyeweerd’s conception of ‘cosmic time’, and elaborates their consequences for the philosophy of history. The first trend, connecting time to modal diversity and the order of the modal aspects, prevails in Dooyeweerd’s analysis. The application of the second trend, emphasizing that in each relation frame the temporal order governs subject-subject relations and subjectobject relations, sheds a new light on the interpretation of history conceived of as development of the culture and civilization of mankind. The (...) distinction of faith and religion and the position of the aspect of faith in the order of the modal aspects play important parts in this discussion, in particular with respect to the possibility of transcending time. (shrink)