Este estudo tem por objetivo conhecer a estrutura e a dinâmica de funcionamento de famílias de nível sociocultural médio-alto, com casais de dupla carreira e filhos em idade escolar. Para tanto, realizou-se um Estudo de Casos Múltiplos (Yin, 1993) com quatro famílias. Para a coleta de dados, foi uti..

Substituted judgment assumes adequate knowledge of patient’s mind-set. However, surrogates’ prediction of individual healthcare decisions is often inadequate and may be based on shared background rather than patient-specific knowledge. It is not known whether surrogate’s prediction of patient’s integrative life-story narrative is better. Respondents in 90 family pairs rank-ordered 47 end-of-life statements as life-story narrative measure and completed instruments on decision-control preference and healthcare-outcomes acceptability as control measures, from respondent’s view and predicted pair’s view. They also scored their confidence in (...) surrogate’s decision-making and familiarity with pair’s healthcare-preferences. Life-story narratives’ prediction was examined by calculating correlation of statements’ ranking scores between respondent-personal and respondent-surrogate Q-sorts and between respondent-surrogate and pair-personal Q-sorts before and after controlling for correlation with respondent-personal scores, and by comparing percentages of respondent-surrogate Q-sorts co-loading with pair-personal vs. respondent-personal Q-sorts. Accuracy in predicting decision-control preference and healthcare-outcomes acceptability was determined by percent concordance. Results were compared among subgroups defined by intra-pair relationship, surrogate’s decision-making confidence, and healthcare-preferences familiarity. Mean age was 35.4 years, 69% were females, and 73 and 80% reported ≥ very good health and life-quality, respectively. Mean surrogate’s decision-making confidence score was 3.35 and 75% were ≥ familiar with pair’s healthcare-preferences. Mean projection, simulation, and adjusted-simulation correlations were 0.68, 0.42, and 0.26, respectively. Out of 180 respondent-surrogate Q-sorts, 24, 9, and 32% co-loaded with respondent-personal, pair-personal, or both Q-sorts, respectively. Accuracy in predicting decision-control preference and healthcare-outcomes acceptability was 47 and 52%, respectively. Surrogate’s decision-making confidence score correlated with adjusted-simulation’s correlation score. There were significant differences among the husband-wife, parent-child, and sibling-sibling subgroups in percentage of respondent-surrogate Q-sorts co-loading with pair-personal Q-sorts and percent agreement on healthcare-outcomes acceptability. Despite high self-reported surrogate’s decision-making confidence and healthcare-preferences familiarity, family surrogates are variably inadequate in simulating life-story narratives. Simulation accuracy may not follow the next-of-kin concept and is 38% based on shared background. (shrink)

Although informed consent is an integral part of clinical practice, its current doctrine remains mostly a matter of law and mainstream ethics rather than empirical research. There are scarce empirical data on patients’ perceived purpose of informed consent, which may include administrative routine/courtesy gesture, simple honest permission, informed permission, patient-clinician shared decision-making, and enabling patient’s self decision-making. Different purposes require different processes.

The current doctrine of informed consent for clinical care has been developed in cultures characterized by low-context communication and monitoring-style coping. There are scarce empirical data on patients' norm perception of information disclosure in other cultures.

The most important reason underlying the success of the Crusaders taking Antakya from Muslims and entering the Syrian and Palestinian territories is undoubtedly the division among the Muslims. This division was not only among the dynasties, but also the cities. The Muslim rulers of Damascus have sat up alliances with the Crusaders to protect themselves from neighboring Muslim rulers. Of course, this alliance was more of a role for the Crusaders, making it easier for them to hold on to the (...) region, and strengthening them by acquiring new lands. Damascus's opposition posture caused power and time loosing to Muslim rulers, which served the Crusaders and to take the advantage of this controversy. Damascus continued its opponent position after Saladin (d. 589/1193), and quarrels within the dynasty caused the Crusaders to breathe deeply and as well as Jerusalem to fall into the hands of the Crusaders for a while again. During the Mamluks period, Damascus, who showed his opposing face for a short period of time, but afterwards he attained peace and obedience and also occupied comply with Rukn al-Dīn Baybars al-Bunduqdārī (d. 676/1277). In this article we will analyze the opposing stance of Damascus and his role in the Crusades. Summary: Pearl of Syria, Damascus has a rebellious and oppositional aspect as well. This feature of the city came into prominence further with the coming of the Crusaders to the region. Its oppositional stance and uncompromising aspect sometimes played into the hands of the Crusaders unintentionally. When the Crusaders first came to the surrounding of Antakya, the governor of Damascus, Duqāq did not provide the necessary support to Yaghisiyan who was encircled in Antakya by the Crusaders, due to his inexperience, jealousy and his hostile competition with his brother, Ridvan who is emir of Aleppo. Thus, the Crusaders used this opportunity.Atabeg of Duqāq, Tughtakīn who started to command the city after the death of Duqāq did not support especially Mawdūd who struggled against the Crusaders in Urfa, adequately. Besides, he was accused of getting Mawdūd killed by another separatist power of the region, the Assassins in the great mosque of the city. On top of it, he allied with the Crusaders, because he was troubled with the commander Porsuk sent to the region by the Sultan of Great Saljūq Empire, Mohammed Tapar. He caused the heroic warrior, Porsuk to be defeated near Tel-Dānis by the Crusaders and to die in Al Jazīrah after a short time.Soon after the above events, ‘Imāduddīn Zengī focused on Damascus and tried to establish the Islamic unity. The son of the ruler Böri, called Ismail became isolated because of the poor administration in the city. He resorted to inviting Zangī to the city. However, Ismail was killed by the opponents before the arrival of Zangī, so no result could be accomplished. Later, Zangī focused on the city again. Although he mercilessly treated the resisters in Ba’lebek after occupying there to demotivate the community of Damascus, he faced the serious resistance of the forces of Damascus. While Zangī spent all his energy to Damascus, the king of Jerusalem, Foulque improved his policy for Syria to some extent and could reestablish communication with the states of the Crusaders. The community Damascus helped the Crusaders and eased their work unintentionally once more.The Mamlūk called Uner began to govern Damascus on behalf of the forces of Bori who lost their influence in the city. Uner who developed a close relationship with the Crusaders to prevent the dominance of Zangī in the city did not hesitate to send an envoy to them. He promised to give Banyas to the Crusaders in return for moving Zangī away from Damascus. After the Franks accepted the proposal of Uner, Zangī remained in between the forces of Damascus and the Crusaders and was obliged to recede to Aleppo. In this way, the Crusaders occupied the castle of Banyas. Several locations until Buzaa were seized by the Crusaders in Antakya who found the opportunity.Zangī was martyred in front of Jaabar castle in 541/1146, so his son Nūr al-dīn became the new ruler of Damascus. Nevertheless, the following incidents caused Nūr al-dīn and Uner to get closer to each other, and the Crusaders had to move away from Damascus. First, the administrator of Havran under the control of Uner rose against his governor and turned to the Crusaders. Besides, the Second Crusade in Damascus contributed to the association of Damascus and Aleppo for a while. Following the elimination of both endangers, the association of Damascus and Aleppo resumed. Uner established a close contact with the Crusaders and made a two-year agreement with them to prevent Nūr al-dīn from seizing the city. Uner died after some time, but almost nothing changed. The new governor of the city Mucīruddin ‘Abaq kept the association of the Crusaders. An operation of Nūr al-dīn against the city was averted with the help of the Crusaders again. Mucīruddin got closer to the Crusaders after their help. Their close relationship was strengthened with the mutual visits of the committees of the Crusaders and Damascus. The Artuquid governor Timurtāsh decided to organize a military expedition to Jerusalem after a little while. However, Mucīruddin who worried about the possible dissolution of their association with the Crusaders stopped supporting him, so Timurtāsh failed in his expedition. Mucīruddin improved his relations with the Crusaders further and started to pay tribute to them following their invasion of ‘Asqalān’s in 548/1153. Even, ‘Abaq offered officially his commitment to Jerusalem. Even though the spoilt Crusaders plundered and destroyed the surrounding of Damascus, they kept the administrators of Damascus with them. Moreover, they went further and offered them to give Ba’lebek to them in return for moving Nūr al-dīn away from Damascus. Such acts provoked the community of Damascus who opposed to the dynasty of Bori in the city afterward. Nūr al-dīn welcomed this opportunity and seized Damascus in 549/1154 by means of the public without giving any chance to coming of the Crusaders. Damascus was governed by Nūr al-dīn for approximately twenty years. A disagreement arose among the community of Zangī in the city after the decease of Nūr al-dīn in 569/1174, thus leading to the dominance of Ṣalādīn Ayyubi in the city. The Ayyubids began to govern Damascus, but internal conflicts started among them with the death of Ṣalādīn in 589/1193. Similarly, Damascus was the focus of these conflicts. The Ayyubids in Egypt were the other party of the disagreement. Unfortunately, the Crusaders benefited from such rivalries. When the senior member of the family al-Adil dominated Damascus in 592/1196, the Crusaders who increased their domain had seized Beirut. Egypt and Damascus got closed temporarily during the Fifth Crusade. After the Crusaders withdrew from Damietta, two brothers, al-Muazzam and al-Kᾱmil fought with each other again. Damascus and Egypt chose the Khwarezmian dynasty and Friedrich in Sicilia as ally, respectively. Unexpected death of al-Muazzam during the preparations for the Sixth Crusade resulted in the siege of Damascus by the forces of Egypt. Friedrich reached Akkā over the course of the siege. al-Kᾱmil who played for time to seize Damascus delivered Jerusalem to the Crusaders. Later, the internal conflicts about the new dynasty which arose in Damascus weakened the Ayyubids and made the Crusaders advantageous. Finally, Damascus found tranquility with the dominance of Baybars in the city. (shrink)

This article examines the concept of the “education of desire,” which undergirds literary utopian studies’ response to postmodernism’s challenge to the modern utopian impulse. The analysis returns to two classic utopian texts—the work of Miguel Abensour, who coined the term “education of desire,” and Ursula K. Le Guin’s novel about ecological sustainability, “The Dispossessed”—to argue that the education of desire involves a more intimate relationship between desire and domination than literary utopian studies has allowed. This article not only transforms our (...) understanding of a mainstay of utopian studies; it relates this discussion to utopian strains in environmental thought, tracing the tension between the desire for ecological sustainability and the social, political, and economic prescriptions this would entail. (shrink)

This study suggests a conceptual proposal to analyse the ethics of resistance in organisations, drawing on Foucault’s practising self as a refusal and Schaffer’s ethics of freedom in opposition to the legitimacy of managerial control and the ethics of compliance. We argue that ethics is already part of such politics in the form of ethico-politics on the basis of participation in political action in organisations. Hence, the practising self as resistance in the face of the status quo of managerial power (...) in an ongoing dialectical process with others and for others comprises our conceptual proposal as an ethics of resistance. Acknowledging dialectics as the driver of the continuous reconstruction and co-construction of politics and praxis, we propose an ethics from the bottom up with a critical and radical perspective. Our contribution is based on opening up an ethico-political space for those who are ignored or suppressed in the ethics and organisations literature. (shrink)

ABSTRACT BackgroundIt isn’t clear how lay people balance the various ethical interests when addressing medical issues. We explored lay people’s ethical resolution models in relation to abortion. MethodsIn a tertiary healthcare setting, 196 respondents rank-ordered 42 opinion-statements on abortion following a 9-category symmetrical distribution. Statements’ scores were analyzed by averaging-analysis and Q-methodology. ResultsRespondents’ mean (SD) age was 34.5(10.5) years, 53% were women, 68% Muslims (31% Christians), 28% Saudis (26% Filipinos), and 38% healthcare-related. The most-agreeable statements were “Acceptable if health-benefit to (...) woman large,” “Acceptable if congenital disease risk large,” and “Woman’s right if fetus has congenital disease.” The most-disagreeable statements were “State’s right even if woman disagrees,” “Acceptable even with no congenital disease risk,” and “Father’s right even if woman disagrees.” Q-methodology identified several resolution models that were multi-principled, consequentialism-dominated, and associated with respondents’ demographics. The majority of Christian women and men identified with and supported a relatively “fetus rights plus State authority-oriented” model. The majority of Muslim women and men identified with and supported a “conception-oriented” model and “consequentialism plus virtue-oriented” model, respectively. One or more of three motives-related statements received extreme ranks on averaging-analysis and in 33% of the models. Conclusions1) On average, consequentialism, focusing on a woman’s health-benefit and congenital disease risk, was the predominant approach. This was followed by the rights approach, favoring a woman’s interest but taking context into account. 2) Q-methodology identified various ethical resolution models that were multi-principled and partially associated with respondents’ demographics. 3) Motives were important to some respondents, providing empirical evidence against adequacy of principlism. (shrink)

Disclosure of near miss medical error (ME) and who should disclose ME to patients continue to be controversial. Further, available recommendations on disclosure of ME have emerged largely in Western culture; their suitability to Islamic/Arabic culture is not known.

The quality of arm movements typically improves in the sub-acute phase of stroke affecting the upper extremity. Here, we used whole arm kinematic analysis during reaching movements to distinguish whether these improvements are due to true recovery or to compensation. Fifty-three participants with post-acute stroke performed ∼80 reaching movement tests during 4 weeks of training with the ArmeoSpring exoskeleton. All participants showed improvements in end-effector performance, as measured by movement smoothness. Four ArmeoSpring angles, shoulder horizontal rotation, shoulder elevation, elbow rotation, (...) and forearm rotation, were recorded and analyzed. We first characterized healthy joint coordination patterns by performing a sparse principal component analysis on these four joint velocities recorded during reaching tests performed by young control participants. We found that two dominant joint correlations [SH with elbow rotation and SE with forearm rotation] explained over 95% of variance of joint velocity data. We identified two clusters of stroke participants by comparing the evolution of these two correlations in all tests. In the “Recoverer” cluster, both joint correlations converged toward the respective correlations for control participants. Thus, Recoverers relearned how to generate smooth end-effector movements while developing joint movement patterns similar to those of control participants. In the “Compensator” cluster, at least one of the two joint correlations diverged from the corresponding correlation of control participants. Compensators relearned how to generate smooth end-effector movements by discovering various new compensatory movement patterns dissimilar to those of control participants. New compensatory patterns included atypical decoupling of the SE and forearm joints, and atypical coupling of the SH rotation and elbow joints. There was no difference in clinical impairment level between the two groups either at the onset or at the end of training as assessed with the Upper Extremity Fugl-Meyer scale. However, at the start of training, the Recoverers showed significantly faster improvements in end-effector movement smoothness than the Compensators. Our analysis can be used to inform neurorehabilitation clinicians on how to provide movement feedback during practice and suggest avenues for refining exoskeleton robot therapy to reduce compensatory patterns. (shrink)

Background Posthumous organ procurement is hindered by the consenting process. Several consenting systems have been proposed. There is limited information on public relative attitudes towards various consenting systems, especially in Middle Eastern/Islamic countries. Methods We surveyed 698 Saudi Adults attending outpatient clinics at a tertiary care hospital. Preference and perception of norm regarding consenting options for posthumous organ donation were explored. Participants ranked (1, most agreeable) the following, randomly-presented, options from 1 to 11: no-organ-donation, presumed consent, informed consent by donor-only, (...) informed consent by donor-or-surrogate, and mandatory choice; the last three options ± medical or financial incentive. Results Mean(SD) age was 32(9) year, 27% were males, 50% were patients’ companions, 60% had ≥ college education, and 20% and 32%, respectively, knew an organ donor or recipient. Mandated choice was among the top three choices for preference of 54% of respondents, with an overall median[25%,75%] ranking score of 3[2,6], and was preferred over donor-or-surrogate informed consent (4[2,7], p vs. 11[6,11], respectively, p = 0.002). Compared to females, males more perceived donor-or-surrogate informed consent as the norm (3[1,6] vs. 5[3,7], p vs. 8[4,9], p vs. 5[2,7], p Conclusions We conclude that: 1) most respondents were in favor of posthumous organ donation, 2) mandated choice system was the most preferred and presumed consent system was the least preferred, 3) there was no difference between preference and perception of norm in consenting systems ranking, and 4) financial (especially in females) and medical (especially in males) incentives reduced preference. (shrink)

BackgroundConsenting for retrospective medical records-based research (MR) and leftover tissue-based research (TR) continues to be controversial. Our objective was to survey Saudis attending outpatient clinics at a tertiary care hospital on their personal preference and perceptions of norm and current practice in relation to consenting for MR and TR.MethodsWe surveyed 528 Saudis attending clinics at a tertiary care hospital in Saudi Arabia to explore their preferences and perceptions of norm and current practice. The respondents selected one of 7 options from (...) each of 6 questionnaires.ResultsRespondents' mean (SD) age was 33 (11) years, 42% were males, 56% were patients, 84% had ≥ secondary school education, and 10% had previously volunteered for research. Respectively, 40% and 49% perceived that the norm is to conduct MR and TR without consent and 38% and 37% with general or proposal-specific consent; the rest objected to such research. There was significant difference in the distribution of choices according to health status (patients vs. companions) for MR (adjusted Kruskal-Wallis test P = 0.03) but not to age group, gender, education level, or previous participation in research (unadjusted P = 0.02 - 0.59). The distributions of perceptions of current practice and norm were similar (unadjusted Marginal Homogeneity test P = 0.44 for MR and P = 0.89 for TR), whereas the distributions of preferences and perceptions of norm were different (adjusted P = 0.09 for MR and P = 0.02 for TR). The distributions of perceptions of norm, preferences, and perceptions of current practice for MR were significantly different from those of TR (adjusted P < 0.009 for all).ConclusionsWe conclude that: 1) there is a considerable diversity among Saudi views regarding consenting for retrospective research which may be related to health status, 2) the distribution of perceptions of norm was similar to the distribution of perceptions of current practice but different from that of preferences, and 3) MR and TR are perceived differently in regard to consenting. (shrink)

Mobile health research involving pervasive sensors, mobile apps and other novel data collection tools and methods present new ethical, legal, and social challenges specific to informed consent, data management and bystander rights. To address these challenges, a participatory design approach was deployed whereby stakeholders contributed to the development of a web-based commons to support the mHealth research community including researchers and ethics board members. The CORE platform now features a community forum, a resource library and a network of nearly 600 (...) global members. The utility of the participatory design process was evaluated by analyzing activities carried out over an 8-month design phase consisting of 86 distinct events including iterative design deliberations and social media engagement. This article describes how participatory design yielded 55 new features directly mapped to community needs and discusses relationships to user engagement as demonstrated by a steady increase in CORE member activity and followers on Twitter. (shrink)

Analytical study of philosophy; includes comparative study of world-renowned philosophers and their ideologies.

Background The consistency of codes governing disclosure of terminal illness to patients and families in Islamic countries has not been studied until now. Objectives To review available codes on disclosure of terminal illness in Islamic countries. Data source and extraction Data were extracted through searches on Google and PubMed. Codes related to disclosure of terminal illness to patients or families were abstracted, and then classified independently by the three authors. Data synthesis Codes for 14 Islamic countries were located. Five codes (...) were silent regarding informing the patient, seven allowed concealment, one mandated disclosure and one prohibited disclosure. Five codes were silent regarding informing the family, four allowed disclosure and five mandated/recommended disclosure. The Islamic Organization for Medical Sciences code was silent on both issues. Conclusion Codes regarding disclosure of terminal illness to patients and families differed markedly among Islamic countries. They were silent in one-third of the codes, and tended to favour a paternalistic/utilitarian, family-centred approach over an autonomous, patient-centred approach. (shrink)

Background: Medical chaperones (MC) are underutilised. The influence of Islamic culture on the use of MC is not known. Aim: To examine physicians’ use and perception of MC in Islamic culture. Setting: A major tertiary care hospital in Saudi Arabia. Methods: 315 self-administered questionnaires were distributed to attendees of grand rounds of 13 departments. Results: 186 (59%) questionnaires were completed. 64.5% of the respondents were 30–49 years old, 75.8% were men and 31.2% were in training; 79% had a clinic load (...) of under 50 patients per week and 47.8% had postgraduate training (PGT) in an Islamic country. MC were reported to be infrequently (⩽25% of the time) used by 44.1% (69.2% female vs 39% male physicians, p = 0.001; 58.6% in training vs 36.8% attending, p = 0.007; 52.1% PGT in Islamic vs 35.6% in western countries, p = 0.027), offered by 52.7% (78.9% female vs 46.8% male physicians, p<0.001) and requested by 79% of patients. MC were reported to be commonly (>75% of the time) used, offered by physicians and requested by patients by 38.2%, 29% and 7.5% of respondents, respectively. The most frequently cited reasons for not using MC were privacy/confidentiality (36.6%) and understaffing (30.5%). Equal numbers of respondents perceived MC use as a protection for physicians or patients (67.7% and 65.6%, respectively). Conclusions: MC are underutilised even in Islamic culture, especially among female physicians. Training in western countries is favourably associated with MC use. Underutilisation appears to be related to privacy/confidentiality, understaffing and failure of patients to request a MC. (shrink)

The University of Michigan conference “Where Religion, Policy, and Bioethics Meet: An Interdisciplinary Conference on Islamic Bioethics and End-of-Life Care” in April 2011 addressed the issue of brain death as the prototype for a discourse that would reflect the emergence of Islamic bioethics as a formal field of study. In considering the issue of brain death, various Muslim legal experts have raised concerns over the lack of certainty in the scientific criteria as applied to the definition and diagnosis of brain (...) death by the medical community. In contrast, the medical community at large has not required absolute certainty in its process, but has sought to eliminate doubt through cumulative diagnostic modalities and supportive scientific evidence. This has recently become a principal model, with increased interest in data analysis and evidence-based medicine with the intent to analyze and ultimately improve outcomes. Islamic law has also long employed a systematic methodology with the goal of eliminating doubt from rulings regarding the question of certainty. While ample criticism of the scientific criteria of brain death (Harvard criteria) by traditional legal sources now exists, an analysis of the legal process in assessing brain death, geared toward informing the clinician’s perspective on the issue, is lacking. In this article, we explore the role of certainty in the diagnostic modalities used to establish diagnoses of brain death in current medical practice. We further examine the Islamic jurisprudential approach vis-à-vis the concept of certainty (yaqīn). Finally, we contrast the two at times divergent philosophies and consider what each perspective may contribute to the global discourse on brain death, understanding that the interdependence that exists between the theological, juridical, ethical, and medical/scientific fields necessitates an open discussion and active collaboration between all parties. We hope that this article serves to continue the discourse that was successfully begun by this initial interdisciplinary endeavor at the University of Michigan. (shrink)

Fractional calculus is nowadays an efficient tool in modelling many interesting nonlinear phenomena. This study investigates, in a novel way, the Ulam–Hyers and Ulam–Hyers–Rassias stability of differential equations with general conformable derivative. In our analysis, we employ some version of Banach fixed-point theory. In this way, we generalize several earlier interesting results. Two examples are given at the end to illustrate our results.

In this article, complete synchronization and antisynchronization in the identical financial chaotic system are presented. The proposed control strategies depend on first-order sliding mode and adaptive integral sliding mode for complete synchronization and antisynchronization of the identical financial chaotic system. In the primary case, the system parameters should be known, and first-order sliding mode control is utilized for synchronization and antisynchronization while in the second case, the system parameters are considered unknown. An adaptive integral sliding mode control strategy is utilized (...) for synchronization and antisynchronization of the system considering the parameters unknown. The error system is changed into a particular structure containing a nominal part and several unknown terms to utilize the adaptive integral sliding mode control. Then, this error system is stabilized using integral sliding mode control. The stabilizing controller is usually developed based on the nominal part plus the compensator control part. To suppress the high-frequency oscillation phenomenon, smooth continuous compensator control can be used rather than conventional discontinuous control. The compensator controller along with the adapted law is derived such that the time derivative of the Lyapunov function becomes strictly negative. The effectiveness of the proposed method was tested through computer simulations. The proposed control strategies are verified for that Identical 4D hyperchaotic financial system to attain complete synchronization and antisynchronization along with the improved performance. (shrink)

A large body of evidence on the activity of regulatory T (Treg) cells was gathered during the last decade, and a similar number of reviews and opinion papers attempted to integrate the experimental findings. The abundant literature clearly delineates an exciting area of research but also underlines some major controversies. A linear cause–result interpretation of experimental maneuvers often ignores the fact that the activity of Treg cells is orchestrated with the effector T (Teff) cells within an intricate network of physiological (...) immune homeostasis. Every modulation of the activity of the effector (cytotoxic) immune system revolves to affect the activity of regulatory (suppressive) cells through elaborate feedback loops of negative and positive regulation. The lack of IL‐2 production by innate Treg cells makes this cytokine a prime coupler of the effector and suppressive mechanisms. Here we attempt to integrate evidence that delineates the involvement of IL‐2 in primary and secondary feedback loops that regulate the activity of suppressive cells within the elaborate network of physiological immune homeostasis.©2007 Wiley Periodicals, Inc BioEssays 30:875–888, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

The exact process that leads to the eruption of autoimmune reactions against β cells and the evolution of diabetes is not fully understood. Macrophages and T cells may launch an initial immune reaction against the pancreatic islets of Langerhans, provoking inflammation and destructive insulitis. The information on the molecular mechanisms of the emergence of β cell injury is controversial and points to possibly important roles for the perforin–granzyme, Fas–Fas-ligand (FasL) and tumor-necrosis-factor-mediated apoptotic pathways. FasL has several unique features that make (...) it a potentially ideal immunomodulatory tool. Most important, FasL is selectively toxic to cytotoxic T cells and less harmful to regulatory T cells. This review discusses the intrinsic sensitivity of β cells to FasL-mediated apoptosis, the conditions that underlie this β cell sensitivity, and the feasibility of using FasL to arrest autoimmunity and prevent islet allograft rejection. In both the autoimmune and transplant settings, it is imperative to progress from the administration of nonspecific immunosuppressive therapy to the concept of β-cell-specific immunomodulation. FasL evolves as a prime candidate for antigen-specific immunomodulation. BioEssays 28: 211–222, 2006. © 2006 Wiley periodicals, Inc. (shrink)

The exact process that leads to the eruption of autoimmune reactions against β cells and the evolution of diabetes is not fully understood. Macrophages and T cells may launch an initial immune reaction against the pancreatic islets of Langerhans, provoking inflammation and destructive insulitis. The information on the molecular mechanisms of the emergence of β cell injury is controversial and points to possibly important roles for the perforin–granzyme, Fas–Fas-ligand (FasL) and tumor-necrosis-factor-mediated apoptotic pathways. FasL has several unique features that make (...) it a potentially ideal immunomodulatory tool. Most important, FasL is selectively toxic to cytotoxic T cells and less harmful to regulatory T cells. This review discusses the intrinsic sensitivity of β cells to FasL-mediated apoptosis, the conditions that underlie this β cell sensitivity, and the feasibility of using FasL to arrest autoimmunity and prevent islet allograft rejection. In both the autoimmune and transplant settings, it is imperative to progress from the administration of nonspecific immunosuppressive therapy to the concept of β-cell-specific immunomodulation. FasL evolves as a prime candidate for antigen-specific immunomodulation. BioEssays 28: 211–222, 2006. © 2006 Wiley periodicals, Inc. (shrink)

Height preferences reflecting positive assortative mating for height—wherein an individual’s own height positively predicts the preferred height of their mate—have been observed in several distinct human populations and are thought to increase reproductive fitness. However, the extent to which assortative preferences for height differ strategically for short-term versus long-term relationship partners, as they do for numerous other indices of mate quality, remains unclear. We explore this possibility in a large representative sample of over 500 men and women aged 15–77 from (...) Canada, Cuba, Norway and the United States. Participants’ own heights were measured, and they indicated their height preferences for a long-term and short-term mate using graphic stimuli containing metric indices. Replicating the “male-taller norm,” participants on average preferred taller-than-average male mates, and shorter-than-average female mates. Positive assortative preferences for height were observed across sexes and samples, however the strength of these height preferences varied with relationship context for men, and not for women. Taller men preferred relatively shorter women for short-term relationships than for long-term relationships, indicating stronger assortative preferences for height in a long-term context. These results provide preliminary evidence that, in addition to mate preferences for other physical traits related to mate quality such as masculinity in the body, face, and voice, assortative preferences for height do vary as a function of expected relationship length, but this was surprisingly only observed in preferences for female height. (shrink)

This contribution addresses the anthropocenic challenge from a dialectical perspective, combining a diagnostics of the present with a prognostic of the emerging future. It builds on the oeuvres of two prominent dialectical thinkers, namely Georg Wilhelm Friedrich Hegel and Pierre Teilhard de Chardin. Hegel himself was a pre-anthropocenic thinker who did not yet thematise the anthropocenic challenge as such, but whose work allows us to emphasise the unprecedented newness of the current crisis. I will especially focus on his views on (...) Earth as a planetary process, emphasising that the “spirit” of technoscience is basically monitoring the impacts of its own activities on geochemistry and evolution. Subsequently, I will turn attention to Teilhard de Chardin, a palaeontologist and philosopher rightfully acknowledged as one of the first thinkers of the Anthropocene whose oeuvre provides a mediating middle term between Hegel’s conceptual groundwork and the anthropocenic present. Notably, I will discuss his views on self-directed evolution, on the on-going absorption of the biosphere by the noosphere, and on emerging options for “sublating” the current crisis into a synthetic convergence towards the Omega point. I will conclude that, after disclosing the biomolecular essence of life, biotechnology must now take a radical biomimetic turn ; that reflection itself must become distributed and collective; and, that the anthropocenic crisis must be sublated into the noocene. (shrink)

Europe and the European Union are now on the agenda, and there are heated discussions concerning both monetary and social unification. Ralf Dahrendorf, a Euroskeptic, has recently pointed out that “The worst part of the European Union is the deadly boredom surrounding most of the issues with which it deals.” The endless technical questions tackled by experts and interest groups are important and unavoidable, but they concern only those occasionally affected by them. Rarely is the fundamental question ever posed: “What (...) is the real reason why we are seeking European Union?”1For their part, philosophers have rediscovered an old theme:…. (shrink)