IntroductionThe objectives of this study are to assess and compare differences in the intensity, frequency, and overall severity of moral distress among a diverse group of healthcare professionals.MethodsParticipants from within Baylor Health Care System completed an online seven-point Likert scale (range, 0 to 6) moral distress survey containing nine core clinical scenarios and additional scenarios specific to each participant’s discipline. Higher scores reflected greater intensity and/or frequency of moral distress.ResultsMore than 2,700 healthcare professionals responded to the survey (response rate 18.14 (...) percent); survey respondents represented multiple healthcare disciplines across a variety of settings in a single healthcare system. Intensity of moral distress was high in all disciplines, although the causes of highest intensity varied by discipline. Mean moral distress intensity for the nine core scenarios was higher among physicians than nurses, but the mean moral distress frequency was higher among nurses. Taking into account both intensity and frequency, the difference in mean moral distress score was statistically significant among the various disciplines. Using post hoc analysis, differences were greatest between nurses and therapists.ConclusionsMoral distress has previously been described as a phenomenon predominantly among nursing professionals. This first-of-its-kind multidisciplinary study of moral distress suggests the phenomenon is significant across multiple professional healthcare disciplines. Healthcare professionals should be sensitive to situations that create moral distress for colleagues from other disciplines. Policy makers and administrators should explore options to lessen moral distress and professional burnout that frequently accompanies it. (shrink)

We acknowledge that empirical support for universal colour categories in colour cognition is insufficient: it relies too heavily on Rosch-Heider's work with the Dani. We offer new evidence supporting universal perceptual-cognitive colour categories. The same data also support language modulating colour-cognition: Universal structures are fine-tuned by language.

In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Multiple Personality and Moral Responsibility”Stephen R. L. Clark (bio)Theaitetos sleeping is not quite “the same” as Theaitetos waking, any more than Alcibiades drunk is Alcibiades sober. Nor am I, at fifty, quite “the same” as Stephen was when he was five. In one way, my sober fifty-year-old waking self can reasonably disclaim responsibility for what Stephen did or seemed to do when he was dreaming, drunk, or (...) five years old. Those other Stephens were not “fully responsible,” were not doing what they freely chose because they chose it—though it would be odd to deny that they were acting willingly. Nor am I now very likely to do the things that—drunk, asleep, or five years old—“I” did: in that sense I can disown those actions and never fully “owned” them anyway. Maybe now I can even disown such actions as I once really owned: once I thought them the right thing, and now I do not.On the other hand, as Stephen Braude says, even children (even, he might have added, dogs) are treated “as if” they are “responsible”: as if, that is, they know what they were doing and may be deterred from doing it again. Should Alcibiades sober be made accountable for what “he” did when drunk? Why not, if this deters him from getting drunk again? Perhaps, as Aristotle suggested, those who do wrong when they are drunk should be fined double the amount. Perhaps those who find it difficult not to drink habitually should be fined ten times the amount. What matters is the amount of money that will put them off, that will force them to “take responsibility” for their own future lives. People who know that they can’t trust themselves when they are drunk, sexually excited, or driving a fast car must put it out of their own power to be in those positions—and if they can’t do that, then others must do it for them. Free men and women “take responsibility,” take charge of their own lives, and wish to be held responsible for what they do and have done. Those who cannot “take control” must, technically, be slaves.There is no point expecting “natural slaves” to take control of their own lives; to measure what they want against what is allowed by society. Such “slaves,” at best, can be controlled by an immediate threat or prize. In a way, it is pointless to punish them, though it may be necessary to imprison, maim, or kill them. Much the same thing may be said of some who are not, strictly, slavish. Should eighty-year-olds be “held responsible” for what they did in their forgotten youth, a world away? They will not be doing it again, and may not, even now, have any greater understanding than the rest of us as to why they did it in the past. “Punishment” in such a case can only [End Page 55] be used to deter others who might follow the same path, to help them to control their lives in ways that do not injure others. Otherwise, we are not strictly speaking of “punishment” at all: perhaps more often than we like to admit, public condemnation, incarceration, or execution is a symbolic elimination of a perceived evil, whether or not we think, or have good grounds for thinking, that the victim is really guilty. The sacrificial victim carries away our anger or unhappiness.Pragmatically, in other words, we punish people for things that—even at the time of the action—they did not control, or which they have long forgotten. For punishment to deter them, they must understand what they are being punished for. For it to reform them, they must accept that the punishment inflicted is just. Those who neither understand nor accept punishment may still be treated harshly, for the sake of others—maimed, or killed, or simply (if we choose to be humane) imprisoned. There are some acts, so Aristotle said, below the level of humanity: such bestiality cannot be punished. It does not follow that the perpetrators should be “free.” Pragmatism permits us to retain the rites of sacrifice, even... (shrink)

George Christopher Stead's aim, throughout his scholarly work, was to lay bare and explain. He was very good at it, as this first piece in 1961 shows. It is a fine example of Stead's mature thinking. All the features that distinguish his work and made it fresh at the time are apparent here: clarity and directness, thoroughness of research, a gift for illustration of a technical point of logic from plain examples; and the, perhaps most noticeable, sign of an (...) essay on some patristic theme's being his very own–the presence in it of critical appraisal. Though Stead was, sometimes and in other contexts, to voice sharply destructive criticism, his appraisals are usually conducted, as in this first essay, so that sympathy with the ancient writer is preserved. (shrink)

Horizontal transfer (HT) is the transmission of genetic material between non‐mating species, a phenomenon thought to occur rarely in multicellular eukaryotes. However, many transposable elements (TEs) are not only capable of HT, but have frequently jumped between widely divergent species. Here we review and integrate reported cases of HT in retrotransposons of the BovB family, and DNA transposons, over a broad range of animals spanning all continents. Our conclusions challenge the paradigm that HT in vertebrates is restricted to infective long (...) terminal repeat (LTR) retrotransposons or retroviruses. This raises the possibility that other non‐LTR retrotransposons, such as L1 or CR1 elements, believed to be only vertically transmitted, can horizontally transfer between species. Growing evidence indicates that the process of HT is much more general across different TEs and species than previously believed, and that it likely shapes eukaryotic genomes and catalyses genome evolution. (shrink)

The particle internal clock conjectured by de Broglie in 1924 was investigated in a channeling experiment using a beam of ∼80 MeV electrons aligned along the 〈110〉 direction of a 1 μm thick silicon crystal. Some of the electrons undergo a rosette motion, in which they interact with a single atomic row. When the electron energy is finely varied, the rate of electron transmission at 0° shows a 8% dip within 0.5% of the resonance energy, 80.874 MeV, for which the (...) frequency of atomic collisions matches the electron’s internal clock frequency. A model is presented to show the compatibility of our data with the de Broglie hypothesis. (shrink)

In this thesis, I deal with the notions of a condition holding for some proposition and a proposition being true in a certain number of possible worlds. These notions are called propositional quantifiers and numerical modalizers respectively. In each chapter, I attempt to dispose of a system. A system consists of: a language; axioms and rules of inference; and an interpretation. To dispose of a system is to prove its decidability and its consistency and completeness for the given interpretation. I (...) shall, in passing, make applications to de definability, translatability and other topics. In Chapter 1, I consider the system 5SQ. Its language is that of 55 with Q as a fresh unary operator. Its axioms and rules of inference are those for 85 plus the following special axiom-schemes for Q: 1) QA::>MA 2) Q A ::> L V L 3) L ::> 4) Q A ::> L Q A. 'QA' is interpreted as 'A is true in exactly one possible world.' I dispose of the system by showing that every formula in it is equivalent to one in normal form. In Chapter 2 I consider the system S5n. Its language is that of S5 but with the unary operators Qk for each non-negative integer k. Its axioms and rules are those of S5 plus the following special axiom-schemes for Qk: 1) Qk A>~Q1 A, 1˂K 2) Qk A ≡ Vki≡oQi ˄ Qk-I 3) L ˂ 4) Qk A ˂ L Qk A 5) Qo A ≡ L ~ A, 1 ≥ 0, k ≥ 1 ‘Qk A’ is interpreted as 'A is true in exactly k possible worlds.' I dispose of this system by generalising the normal forms of S5Q. In the chapters 3-5, I consider three systems which result from adding propositional quantifiers to S5. The first two systems, S5╥+ and S5╥, contain the usual axioms and rules for quantifiers. The first contains, in addition, the axiom-scheme G = )). The last, S5╥-, results from S5╥ by restricting the Scheme of Specification, viz., A > A, B free for P in A, to formulas B of the propositional calculus. To interpret these systems we must specify which propositions the variable P ranges over. For St╥-, we merely require that if p and q are propositions, then and are also propositions. For S5╥+, we also require that each possible world be describable i.e. that there be a proposition which is true in that world alone. And for S5╥, we require not that each possible world be describable but that there be a proposition which is true in just those possible worlds which are describable. Again, we dispose of the systems by normal forms. This requires that we eliminate quantifiers and nested occurrences of L by adding new symbols to the language. For S5╥+, the operators Qk suffice. For S5╥, the operators Qk suffice. For S5╥, we also require the constant g and a fresh unary operator N. For S5╥-, even greater additions are required. In the last two chapters, 6 and 7, I turn to systems which have essentially the same language as S5╥. However, ‘Qk A' is now interpreted as 'A is true in exactly k possible worlds accessible from the given world.' Different conditions on R, the relation of accessibility, lead to different axioms. In chapter 6 I consider the conditions of reflexivity, symmetry and transitivity, and in Chapter 7 the conditions of being a partial, convergent, total or dense order. I prove consistency and completeness by the method of maximally consistent systems. The method can yield decidability results, but I do not go into the matter. I have, as a rule, not given acknowledgements for well-established results or terminology. The main references are at the end of each chapter. Fuller references are in the bibliography. (shrink)

The essay seeks to vindicate the importance of the humanities or liberal arts deriving from their crucial contribution to the “humanization of humanity”. This vindication is timely in view of the wide-spread curtailment of humanistic or liberal education in many institutions of higher learning. It is also timely as a pedagogical antidote to the fascination with violence in our world (which often culminates in “crimes against humanity”). In a first step, the paper traces the historical development of the humanities or (...) liberal arts in the West. Next, I highlight some crucial features of humanistic education : the emphasis on ethical and character formation ; the fine-tuning of moral judgment ; and the cultivation of a sensus communis. Another central feature is that such education offers a counterpoint to the overwhelming preoccupation today with career training and utilitarian objectives. In the words of Martha Nussbaum : it is “not for profit”, but serves an intrinsic good. In this respect, humanistic pedagogy bears a close affinity to the needed education for democracy and world citizenship. (shrink)

The essay seeks to vindicate the importance of the humanities or liberal arts deriving from their crucial contribution to the “humanization of humanity”. This vindication is timely in view of the wide-spread curtailment of humanistic or liberal education in many institutions of higher learning. It is also timely as a pedagogical antidote to the fascination with violence in our world (which often culminates in “crimes against humanity”). In a first step, the paper traces the historical development of the humanities or (...) liberal arts in the West. Next, I highlight some crucial features of humanistic education : the emphasis on ethical and character formation ; the fine-tuning of moral judgment ; and the cultivation of a sensus communis. Another central feature is that such education offers a counterpoint to the overwhelming preoccupation today with career training and utilitarian objectives. In the words of Martha Nussbaum : it is “not for profit”, but serves an intrinsic good. In this respect, humanistic pedagogy bears a close affinity to the needed education for democracy and world citizenship. (shrink)

Let M\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathcal{M}}$$\end{document} be a fine structural mouse. Let D\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathbb{D}}$$\end{document} be a fully backgrounded L[E]\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${L[\mathbb{E}]}$$\end{document}-construction computed inside an iterable coarse premouse S. We describe a process comparing M\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathcal{M}}$$\end{document} with D\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathbb{D}}$$\end{document}, through forming iteration trees on M\documentclass[12pt]{minimal} (...) \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\mathcal{M}}$$\end{document} and on S. We then prove that this process succeeds. (shrink)

This graduate-level_text by a master in the field builds a function theory of the rational field that combines aspects of classical and intuitionist analysis. Topics include recursive convergence, recursive and relative continuity, recursive and relative differentiability, the relative integral, elementary functions, and transfinite ordinals. 1961 edition.

Alberto Cortes, in [1], attempts to show that Leibniz's Principle of The Identity of Indiscernibles is a principle restricted to individuals, and that photons appear to violate L. L is stated by Leibniz as “no two substances are completely similar, or differ solo numero.” In second-order quantification theory with identity L becomes.

This paper explores the use of advance directives in clinical dementia research. The focus is on advance consent to participation of demented patients in non-therapeutic research involving more than minimal risks and/or burdens. First, morally relevant differences between advance directives for treatment and care, and advance directives for dementia research are discussed. Then attention is paid to the philosophical issue of dementia and personal identity, and the implications for the moral authority of research advance directives. Thirdly, a number of practical (...) shortcomings of advance directives for non-therapeutic dementia research are explored and attention is paid to the role of proxies. It is concluded that upon a closer look the initial attractiveness of advance directives for dementia research is lessened, and that it is doubtful whether these instruments can compensate for the lack of subject consent in case of non-therapeutic dementia research involving more than minimal risks and/or burdens for the incompetent demented subject. (shrink)

[Herbert F.] Tucker has shown us in a very practical way that the concept of meaning is the problem of problems, not only in hermeneutics but in literary theory and, indeed, literary study generally. It may well be that in literary study there can be no talk of meaning that is not ambiguous, that does not require us to speak in figures or by means of metaphorical improvisations. It would not necessarily follow that our talk of meaning is merely provisional (...) or without philosophical authority since we know now that considerable authority attaches to ordinary language, whence we obtain our use of the word "meaning" as well as the figurations that we use to talk our way around it. To be sure, the discipline of literary study is now rapidly filling with grave masters who take our figures to mean that meaning is literally unspeakable—only so many transferences and substitutions within a system of differences alarmingly vast . This is itself a terrific idea, or a terrific figure, although it is used mainly to expose the thoughtless way we talk about meaning as well as our offhand assumptions about the conditions that make understanding possible. Our problem in literary study is not that meaning is unspeakable—even if it were it would not be a problem—but that we rarely reflect on the subject of meaning in a disciplined way. In our time, meaning as a topic of study is the preserve of logicians. It is almost exclusively a theme of analytical philosophy, and even those not bound by this philosophy address themselves to the analytical tradition when they speak of meaning.1 It is time that we entered into this discourse on meaning; a paper as fine as Tucker's should serve as a summons.· 1. Among numerous cases, see John R. Searle, "Metaphor" and "Literal Meaning," Expression and Meaning , pp. 76-136, and "Intentionality and the Use of Language," in Meaning and Use, ed. Avishai Margalit , pp. 181-97.Gerald l. Bruns, professor of English at the University of Iowa, is the author of Modern Poetry and the Idea of Language and Inventions: Writing, Textuality, and Interpretation in Literary History. (shrink)

This paper attempts to explore a number of conceptual issues surrounding genetic testing. It looks at the meaning of the terms, genetic information and genetic testing in relation to the definition set out by the Advisory Committee on Genetic Testing in the UK, and by the Task Force on Genetic Testing in the USA. It argues that the special arrangements that may be required for the regulation of genetic tests should not be determined by reference to the nature or technology (...) of the test, but by considering those morally relevant features that justify regulation. Failure to do so will lead to the regulation of genetic tests that need not be regulated, and would fail to cover other tests which should be regulated. The paper also argues that there is little in the nature of the properties of gene tests, using DNA or chromosomes, that in itself justifies a special approach. (shrink)

Many religious people are alarmed about features of the current age - violence in the media, a pervasive hedonism, a marginalization of religion, and widespread abortion. These concerns influence politics, but just as there should be a separation between church and state, so should there be a balance between religious commitments and secular arguments calling for social reforms. Robert Audi offers a principle of secular rationale, which does not exclude religious grounds for action but which rules out restricting freedom except (...) on grounds that any rational citizen would accept. The book describes the essential commitments of free democracy, explains how religious and secular moral considerations can be integrated to facilitate co-operation in a world of religious pluralism, and proposes ideals of civic virtue that express the mutual respect on which democracy depends. Audi offers a balanced and sophisticated treatment of the relations between religion and politics in a modern, secular society. (shrink)

The notion of autonomy commonly employed in medical ethics literature and practices is inadequate on three fronts: it fails to properly identify nonautonomous actions and choices, it gives a false account of which features of actions and choices makes them autonomous or nonautonomous, and it provides no grounds for the moral requirement to respect autonomy. In this paper I offer a more adequate framework for how to think about autonomy, but this framework does not lend itself to the kinds of (...) practical application assumed in medical ethics. A general problem then arises: the notion of autonomy used in medical ethics is conceptually inadequate, but conceptually adequate notions of autonomy do not have the practical applications that are the central concern of medical ethics. Thus, a revision both of the view of autonomy and the practice of “respect for autonomy” are in order. (shrink)