The number of children with chronic critical illness (CCI) is a growing population in the United States. A defining characteristic of this population is a prolonged hospital stay. Our study assessed the proportion of pediatric patients with chronic critical illness in U.S. hospitals at a specific point in time, and identified a subset of children whose hospital stay lasted for months to years. The potential harms of a prolonged hospitalization for children with CCI, which include over treatment, infection, disruption of (...) family life, and the intensive utilization of resources—combined with the moral distress experienced by the clinicians who care for the children, suggest the need for ethical analysis of this growing issue to identify actions that could be taken at the clinical and health systems levels to reduce the harms associated with prolonged hospital stay.In this article we present three real cases from our study that involved a very long hospital stay. We applied a framework developed by Mackenzie, Rogers, and Dodds to analyze inherent, situational, and pathogenic vulnerabilities to examine the ways that interventions intended to remedy one source of harm for the children in our cohort inadvertently created other harms. We examined the complex ways that children with protracted hospitalization are vulnerable to the choices made by their family and clinicians, as well as by healthcare systems and communities. Finally, we used this analysis to summarize actions and ethical responses to this growing patient population. Such an understanding is essential to making clinical and ethical decisions that arise for children who are at risk for a very long stay in the hospital. (shrink)

The thought of the ancient atomists about the activity of the soul in the body is an important chapter in the history of reflection on the soul in ancient philosophy. A review of testimonies and fragments attributed to Democritus of Abdera shows its singular conception of the soul as a complex network of transactions through which it exercises, inside compound bodies, its role in driving principle of beings animated. These texts show the tension and dynamism that characterize the activity of (...) the soul and especially the close relationship between the activities of perceiving and thinking, essential activities to the economy of living beings, now for what is the management of biological life, now in terms of knowledge and human action. What we propose here is to examine how Democritus conceived the activity of the soul in its complexity and the various operations through which it accomplishes its function in the animation and the maintenance of life of animate beings, and particularly of human life. To do this, we will take as a basis the testimonies referred to the nature of the soul – especially the testimony of Aristotle and his disciples and commentators – and then examine the activities through which proceeds its role of motor principle, namely the sensations and the intellection. And, finally, we intend to demonstrate that these operations should not be considered, in the context of atomist thought, as two independent and opposed faculties or activities, but as two different levels or degree, contiguous and complementary, of one and the same activity. (shrink)

The thought of the ancient atomists about the activity of the soul in the body is an important chapter in the history of reflection on the soul in ancient philosophy. A review of testimonies and fragments attributed to Democritus of Abdera shows its singular conception of the soul as a complex network of transactions through which it exercises, inside compound bodies, its role in driving principle of beings animated. These texts show the tension and dynamism that characterize the activity of (...) the soul and especially the close relationship between the activities of perceiving and thinking, essential activities to the economy of living beings, now for what is the management of biological life, now in terms of knowledge and human action. What we propose here is to examine how Democritus conceived the activity of the soul in its complexity and the various operations through which it accomplishes its function in the animation and the maintenance of life of animate beings, and particularly of human life. To do this, we will take as a basis the testimonies referred to the nature of the soul – especially the testimony of Aristotle and his disciples and commentators – and then examine the activities through which proceeds its role of motor principle, namely the sensations and the intellection. And, finally, we intend to demonstrate that these operations should not be considered, in the context of atomist thought, as two independent and opposed faculties or activities, but as two different levels or degree, contiguous and complementary, of one and the same activity. (shrink)

« La mesure est le plus grand des biens » et « rien de trop » apparaissent dans les sentences attribuées aux Sept Sages de l’Antiquité Grecque. Elles font état d’une sagesse qui blâme l’excès et invite à la modération. Les échos de ces propos résonnent dans différentes périodes de l’Antiquité et chez des auteurs appartenant aux traditions les plus variées, parmi lesquels se trouve notamment Démocrite. Nombreux sont en effet les fragments qui attestent de sa condamnation des excès, de (...) sa réflexion critique sur les richesses et de son éloge de la modération et de l’équilibre entendus comme conditions du bien-être et de l’action bonne. « La juste proportion est belle en toutes choses » (DK 68 B 102), proclame le philosophe. Cette juste proportion est érigée en condition pour atteindre la « bonne humeur » ( euthymiê ) et le « bien-être » ( euestô ). La réflexion de Démocrite se fonde sur une sorte de principe économique qui s’exprime par la notion de « mesure » ( metriotês ). La capacité à être modéré est aussi le signe distinctif de l’être humain bien accompli (DK 68 B 70), et s’oppose aux différentes formes de l’avidité. Lorsque l’on examine les fragments qui traitent de ce sujet, l’on constate que le philosophe a dressé un inventaire qui prend en compte les domaines les plus divers de la vie. Il est en effet question de la mesure aussi bien dans le cadre des affections comme le plaisir et le désir, que dans celui de la satisfaction de nos besoins élémentaires. Il en est également question pour ce qui est de notre attitude à l’égard des biens matériels et des richesses. Dans cet article nous avons choisi de faire porter l’attention sur la réflexion du philosophe sur les richesses et les biens matériels, en prenant tout particulièrement en compte sa mise en cause du désir dans l’économie de la vie humaine. Classification JEL : B1. (shrink)

This study explores the association between different types of morally challenging interactions during military deployment and response strategies, as well as the mediating role of moral emotions. Interviews with Dutch servicemen who participated in military operations were content coded. We found a relationship between local-cultural and team-related interactions and moral justification; these effects were mediated by other-condemning emotions. Similarly, other-condemning emotions mediated the relationship between local-cultural interactions and relativism. This study points at the importance of other-condemning emotions in shaping military (...) reactions to frequently occurring morally challenging interactions. (shrink)

This study explores the relationship between moral intensity and the use of different sensemaking strategies in military critical incidents. First, narratives of military personnel were used to select prototypical high/low moral intensity critical incidents. In a follow-up, a scenario study was conducted with active duty military personnel to examine the relationship between moral intensity and the use of sensemaking tactics. This study offers three main conclusions. First, the use of sensemaking tactics is strongly tied to the level of moral intensity (...) in the situation. In high-intense situations, the servicemen draw on previous experiences, prediction of consequences, and help of others to recognize and interpret the situation. Less attention goes out to higher level critical thinking. Thus, it seems that in these critical incidents, the servicemen react without giving room for thorough consideration and deliberation. Second, the number of deployments a serviceman experienced influences the perceived seriousness and harmfulness of the situation negatively in low-intense situations. Finally, and in line with earlier studies, the results indicate that the concept of moral intensity is formed out of three rather than the six dimensions originally proposed by Jones. The implications of these findings are discussed. (shrink)

Parents, peers, and teachers provide a powerful context for school students’ well-being. However, a detailed and systematic analysis of how parental, peer, and teacher support relate to students’ well-being, measured by the dimensions self-worth, psychological and physical well-being, is still missing. To address this research gap, the following study investigates 733 adolescent German students from grades 7 and 8 with respect to their perceived supportive relationships at home and within the school context. The study considers gender, socioeconomic status, and school (...) form as potential confounders. The results of the structural equation model, analyzed with the statistical software R, indicate that perceived teacher support was positively related to students’ self-worth and physical well-being, while peer support was related to psychological well-being. Students who perceived their parents as supportive reported higher well-being with respect to all three dimensions investigated. (shrink)

BackgroundPregnant people have been overlooked or excluded from clinical research, resulting in a lack of scientific knowledge on medication safety and efficacy during pregnancy. Thus far, both the opportunities to generate evidence-based knowledge beyond clinical trials and the role of pregnant people in changing their status quo have not been discussed. Some scholars have argued that for rare disease patients, for whom, just like pregnant people, a poor evidence base exists regarding treatments, solidarity has played an important role in addressing (...) the evidence gap. This paper explores whether and how the enactment of solidarity among pregnant people can be stimulated to help address the poor evidence base on medications used during pregnancy.MethodWe use the concept of solidarity formulated by Prainsack and Buyx and enrich their concept by providing an account for stimulating the enactment of solidarity. Then we apply this account to the case of pregnant people who use medication.ResultsSolidarity means enacted commitment on the part of an individual to assisting others with whom the person recognizes a similarity in a relevant respect. Although solidarity cannot be imposed, we argue that the empowerment of people is a crucial concept in understanding how solidarity can be stimulated. Empowerment in the context of pregnant people means creating awareness about their status quo, explaining how scientific research can help close the knowledge gap, and how pregnant people can themselves contribute. In particular, how pregnant people can contribute to the collection of health data to strengthen the evidence base for medications used during pregnancy.ConclusionsWe conclude that acting in solidarity can help change the status quo for pregnant people. Furthermore, we argue that the empowerment of pregnant people and other relevant stakeholders is a way to stimulate the enactment of solidarity. The process of empowerment starts by raising awareness about the lack of evidence on medications used during prengnacy and by explaining to pregnant people how they can contribute to changing the way knowledge is being generated by, for example, sharing data on the health effects of medications. (shrink)

We present a computational analysis of de re, de dicto, and de se belief and knowledge reports. Our analysis solves a problem first observed by Hector-Neri Castañeda, namely, that the simple rule -/- `(A knows that P) implies P' -/- apparently does not hold if P contains a quasi-indexical. We present a single rule, in the context of a knowledge-representation and reasoning system, that holds for all P, including those containing quasi-indexicals. In so doing, we explore the difference between reasoning (...) in a public communication language and in a knowledge-representation language, we demonstrate the importance of representing proper names explicitly, and we provide support for the necessity of considering sentences in the context of extended discourse (for example, written narrative) in order to fully capture certain features of their semantics. (shrink)

ObjectivePeer victimization is a substantial early life stressor linked to psychiatric symptoms and poor academic performance. However, the sex-specific cognitive or behavioral outcomes of bullying have not been well-described in preadolescent children.MethodsUsing the baseline dataset of the Adolescent Brain Cognitive Development Study 2.0.1 data repository, we evaluated associations between parent-reported bullying victimization, suicidality, and non-suicidal self-injury, as well as internalizing and externalizing behavioral problems, cognition, and academic performance.ResultsOf the 11,015 9-10-year-old children included in the analyses, 15.3% experienced bullying victimization, as (...) reported by the primary caregiver. Of these, boys were more likely to be bullied than girls. Children who were bullied were more likely to display NSSI or passive suicidality and active suicidality. Bullied children also had lower cognitive scores, greater behavioral problems, and poorer grades. Across all participants, boys had poorer grades and greater behavioral problems than girls; however, bullied boys had greater behavioral problems than girls in several areas. Compared to their non-bullied peers, bullied children with greater non-suicidal self-injury or suicidality also had greater behavioral problems and poorer grades.ConclusionThese findings highlight the sex-specific effects of bullying, and the negative associations of bullying victimization with cognitive performance, behavioral problems, and academic performance. Future longitudinal studies will identify the natural history and neural correlates of these deficits during adolescence. (shrink)

This book collects texts from three specialists in ancient philosophy which deal with the question of perceptive and intellective knowledge in antiquity. They try to present, in their different analyzes, the complex interrelationship among perception and thought in ancient authors, like Heraclitus, Parmenides, Democritus, Plato and Aristotle. The purpose of the texts is to expose the visible field - the perceptual knowledge domain - interacts with the invisible - the domain of reason and thought. In other words, that among them (...) there is no a radical separation of these two areas, although they are clearly distinct. (shrink)

BackgroundIn December 2014, China announced that only voluntarily donated organs from citizens would be used for transplantation after January 1, 2015. Many medical professionals worldwide believe that China has stopped using organs from death-row prisoners.DiscussionIn the present article, we briefly review the historical development of organ procurement from death-row prisoners in China and comprehensively analyze the social-political background and the legal basis of the announcement. The announcement was not accompanied by any change in organ sourcing legislations or regulations. As a (...) fact, the use of prisoner organs remains legal in China. Even after January 2015, key Chinese transplant officials have repeatedly stated that death-row prisoners have the same right as regular citizens to “voluntarily donate” organs. This perpetuates an unethical organ procurement system in ongoing violation of international standards.ConclusionsOrgan sourcing from death-row prisoners has not stopped in China. The 2014 announcement refers to the intention to stop the use of organs illegally harvested without the consent of the prisoners. Prisoner organs procured with “consent” are now simply labelled as “voluntarily donations from citizens”. The semantic switch may whitewash sourcing from both death-row prisoners and prisoners of conscience. China can gain credibility only by enacting new legislation prohibiting use of prisoner organs and by making its organ sourcing system open to international inspections. Until international ethical standards are transparently met, sanctions should remain. (shrink)

An integrated statement is made concerning the semantic status of nodes in a propositional semantic network, claiming that such nodes represent only intensions. Within the network, the only reference to extensionality is via a mechanism to assert that two intensions have the same extension in same world. This framework is employed in three application problems to illustrate the nature of its solutions.The formalism used here utilizes only assertional information and no structural, or definitional, information. This restriction corresponds to many of (...) the psychologically motivated network models. Some of the psychological implications of network processes called node merging and node splitting are discussed. Additionally, it is pointed out that both our networks and the psychologically based networks are prone to memory confusions about knowing unless augmented by domain‐specific inference processes, or by structural information. (shrink)

SNePS, the Semantic Network Processing System 45, 54], has been designed to be a system for representing the beliefs of a natural-language-using intelligent system (a \cognitive agent"). It has always been the intention that a SNePS-based \knowledge base" would ultimatelybe built, not by a programmeror knowledge engineer entering representations of knowledge in some formallanguage or data entry system, but by a human informing it using a natural language (NL) (generally supposed to be English), or by the system reading books or (...) articles that had been prepared for human readers. Because of this motivation, the criteria for the development of SNePS have included: it should be able to represent anything and everything expressible in NL; it should be able to represent generic, as well as speci c information; it should be able to use the generic and the speci c information to reason and infer information implied by what it has been told; it cannot count on any particular order among the pieces of information it is given; it must continue to act reasonably even if the information it is given includes circular de nitions, recursive rules, and inconsistent information. (shrink)

Cognitive agents, whether human or computer, that engage in natural-language discourse and that have beliefs about the beliefs of other cognitive agents must be able to represent objects the way they believe them to be and the way they believe others believe them to be. They must be able to represent other cognitive agents both as objects of beliefs and as agents of beliefs. They must be able to represent their own beliefs, and they must be able to represent beliefs (...) as objects of beliefs. These requirements raise questions about the number of tokens of the belief representation language needed to represent believers and propositions in their normal roles and in their roles as objects of beliefs. In this paper, we explicate the relations among nodes, mental tokens, concepts, actual objects, concepts in the belief spaces of an agent and the agent's model of other agents, concepts of other cognitive agents, and propositions. We extend, deepen, and clarify our theory of intensional knowledge representation for natural-language processing, as presented in previous papers and in light of objections raised by others. The essential claim is that tokens in a knowledge-representation system represent only intensions and not extensions. We are pursuing this investigation by building CASSIE, a computer model of a cognitive agent and, to the extent she works, a cognitive agent herself. CASSIE's mind is implemented in the SNePS knowledge-representation and reasoning system. (shrink)

We describe a knowledge representation and inference formalism, based on an intensional propositional semantic network, in which variables are structures terms consisting of quantifier, type, and other information. This has three important consequences for natural language processing. First, this leads to an extended, more natural formalism whose use and representations are consistent with the use of variables in natural language in two ways: the structure of representations mirrors the structure of the language and allows re-use phenomena such as pronouns and (...) ellipsis. Second, the formalism allows the specification of description subsumption as a partial ordering on related concepts (variable nodes in a semantic network) that relates more general concepts to more specific instances of that concept, as is done in language. Finally, this structured variable representation simplifies the resolution of some representational difficulties with certain classes of natural language sentences, namely, donkey sentences and sentences involving branching quantifiers. The implementation of this formalism is called ANALOG (A NAtural LOGIC) and its utility for natural language processing tasks is illustrated. (shrink)

Functional diversity holds the promise of understanding ecosystems in ways unattainable by taxonomic diversity studies. Underlying this promise is the intuition that investigating the diversity of what organisms actually do—i.e. their functional traits—within ecosystems will generate more reliable insights into the ways these ecosystems behave, compared to considering only species diversity. But this promise also rests on several conceptual and methodological—i.e. epistemic—assumptions that cut across various theories and domains of ecology. These assumptions should be clearly addressed, notably for the sake (...) of an effective comparison and integration across domains, and for assessing whether or not to use functional diversity approaches for developing ecological management strategies. The objective of this contribution is to identify and critically analyze the most salient of these assumptions. To this aim, we provide an “epistemic roadmap” that pinpoints these assumptions along a set of historical, conceptual, empirical, theoretical, and normative dimensions. (shrink)

Computationalism, the notion that cognition is computation, is a working hypothesis of many AI researchers and Cognitive Scientists. Although it has not been proved, neither has it been disproved. In this paper, I give some refutations to some well-known alleged refutations of computationalism. My arguments have two themes: people are more limited than is often recognized in these debates; computer systems are more complicated than is often recognized in these debates. To underline the latter point, I sketch the design and (...) abilities of a possible embodied computer system. (shrink)

Political representation lies at the core of modern politics. Democracies, with their vast numbers of citizens, could not operate without representative institutions. Yet relations between the democratic ideal and the everyday practice of political representation have never been well defined and remain the subject of vigorous debate among historians, political theorists, lawyers, and citizens. In this volume, an eminent group of scholars move forward the debates about political representation on a number of fronts. Drawing on insights from political science, history, (...) political theory, economics, and anthropology, the authors provide much-needed clarity to some of the most vexing questions about political representation. They also reveal new and enlightening perspectives on this fundamental political practice. Topics discussed include representation before democracy, political parties, minorities, electoral competition, and ideology. This volume is essential reading for anyone interested in the ideal and the reality of political representation. (shrink)

BackgroundThe Arab population in Israel is a minority ethnic group with its own distinct cultural subgroups. Minority populations are known to underutilize genetic tests and counseling services, thereby undermining the effectiveness of these services among such populations. However, the general and culture-specific reasons for this underutilization are not well defined. Moreover, Arab populations and their key cultural-religious subsets (Muslims, Christians, and Druze) do not reside exclusively in Israel, but are rather found as a minority group in many European and North (...) American countries. Therefore, focusing on the Arab population in Israel allows for the examination of attitudes regarding genetic testing and counseling among this globally important ethnic minority population.MethodsWe used a qualitative research method, employing individual interviews with 18 women of childbearing age from three religious subgroups (i.e., Druze, Muslim, and Christian) who reside in the Acre district, along with focus group discussions with healthcare providers (HCPs; 9 nurses and 7 genetic counselors) working in the same geographical district.ResultsA general lack of knowledge regarding the goals and practice of genetic counseling resulting in negative preconceptions of genetic testing was identified amongst all counselees. Counselors’ objective of respecting patient autonomy in decision-making, together with counselees’ misunderstanding of genetic risk data, caused uncertainty, frustration, and distrust. In addition, certain interesting variations were found between the different religious subgroups regarding their attitudes to genetic counseling.ConclusionsThe study highlights the miscommunications between HCPs, particularly counselors from the majority ethno-cultural group, and counselees from a minority ethno-cultural group. The need for nuanced understanding of the complex perspectives of minority ethno-cultural groups is also emphasized. Such an understanding may enhance the effectiveness of genetic testing and counseling among the Arab minority group while also genuinely empowering the personal autonomy of counselees from this minority group in Israel and other countries. (shrink)

This article proposes to analyse some aspects of the appropriation of New School thinking in Brazil, particularly Deweyan pragmatism, in the 1950s and 1960s. The analysis is based on the assumption that the developmentalist ideology that punctuated the debate on the economic, political and social restructuring of the country in these two decades constituted fertile ground for the return and expansion of pragmatist thinking amongst Brazilian educators, articulating itself, sometimes in contradictory ways, with this ideology. The focus of the analysis (...) will be on the writings of the group of educators which circulated around the figure of Anísio Teixeira, at the time director of the National Institute for Pedagogic Studies, an organ linked to the Ministry of Education and Culture, which set itself the task of producing research that would support public policy in the field of education, as well as constituting itself as a center for teacher education and the stimulus and development of innovative experiences in the public school system. The appropriation of Deweyan pragmatism, in this context, had a triple perspective: pragmatism as scientific method, implying a specific conception of science, particularly the social sciences, with emphasis on the application of scientific knowledge in the solution of practical problems; as a way of democratic life; and as a synonym for experimentalism, in the sphere of schooling. (shrink)