Boldly focusing on sexuality as a crucial definer of social order, Being and Symptom argues that there is an "M theory" -- a master theory of theories -- not only in Quantum Physics, but also in Continental Philosophy, Psychoanalysis, and Sociology, disclosing how the ontological structure of the "fantastic four" ingredients of metaphysics (potentiality, impotentiality, actuality, completion) has recurred through time. Öğüt also seeks to turn Thomas Hobbes's political philosophy into a social theory within the fields of sexuality and sovereignty (...) and to locate parallels among Aristotle, Ibn Khaldun, Kant, Hegel, Heidegger, Foucault, Lacan, Agamben, Nash, Derrida, Girard, Kristeva, and Žižek, with a special emphasis on how Žižek has adapted Lacanian psychoanalysis into social theory. Öğüt conveys a highly original analysis of the unconscious of our social (sexual) relations, subjectivities, and politics. (shrink)

It will be assumed that the questions are legitimate.

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients’ perception of material risks, by trained interviewers. Patients’ demographics were obtained. Mann–Whitney U (...) test and Kruskal-Wallis one-way analysis of variance was used. Statistical significance was taken at p < 0.05. Four hundred fourteen patients were eligible of which 26 refused to participate and 24 were excluded due to language barrier. 364 patients were recruited. A higher level of education, being employed and younger age group are factors identified in patients who wanted greater participation in medical decisions. Gender, marital status, type of surgery, and previous surgical history did not affect their level of participation. The complications most patients knew about were Nausea, Drowsiness and Surgical Wound Pain. Patients ranked Heart Attack, Death and Stroke as the most significant risks that they wanted to be informed about in greater detail. Most patients wanted to make a joint decision with the anaesthetist, instead of letting the doctor decide or deciding for themselves. Discussion with the anaesthetist is the preferred medium of communication compared to reading a pamphlet or watching a video. Age and educational level can influence medical decision-making. Despite the digital age, most patients still prefer a clinic consult instead of audio-visual multimedia for pre-operative anaesthetic counselling. The local population appears to place greater importance on rare but serious complications compared to common complications. This illustrates the need to contextualize information provided during informed consent to strengthen the doctor-patient relationship. (shrink)

The variety DMM of De Morgan monoids has just four minimal subvarieties. The join-irreducible covers of these atoms in the subvariety lattice of DMM are investigated. One of the two atoms consisting of idempotent algebras has no such cover; the other has just one. The remaining two atoms lack nontrivial idempotent members. They are generated, respectively, by 4-element De Morgan monoids C4 and D4, where C4 is the only nontrivial 0-generated algebra onto which finitely subdirectly irreducible De Morgan monoids may (...) be mapped by noninjective homomorphisms. The homomorphic preimages of C4 within DMM constitute a proper quasivariety, which is shown to have a largest subvariety U. The covers of the variety within U are revealed here. There are just ten of them. In exactly six of these ten varieties, all nontrivial members have C4 as a retract. In the varietal join of those six classes, every subquasivariety is a variety—in fact, every finite subdirectly irreducible algebra is projective. Beyond U, all covers of [or of ] within DMM are discriminator varieties. Of these, we identify infinitely many that are finitely generated, and some that are not. We also prove that there are just 68 minimal quasivarieties of De Morgan monoids. (shrink)

Издание содержит: познание в контексте культуры; эпистемология социально-гуманитарного знания; история философии: опыт познания культуры и др.

The small, the tiny, and the infinitesimal have been the object of both fascination and vilification for millenia. One of the most vitriolic reviews in mathematics was that written by Errett Bishop about Keisler’s book Elementary Calculus: an Infinitesimal Approach. In this skit we investigate both the argument itself, and some of its roots in Bishop George Berkeley’s criticism of Leibnizian and Newtonian Calculus. We also explore some of the consequences to students for whom the infinitesimal approach is congenial. The (...) casual mathematical reader may be satisfied to read the text of the five act play, whereas the others may wish to delve into the 130 footnotes, some of which contain elucidation of the mathematics or comments on the history. (shrink)

Many feminists (e.g. T. Bettcher and B. R. George) argue for a principle of first person authority (FPA) about gender, i.e. that we should (at least) not disavow people's gender self-categorisations. However, there is a feminist tradition resistant to FPA about gender, which I call "radical feminism”. Feminists in this tradition define gender-categories via biological sex, thus denying non-binary and trans self-identifications. Using a taxonomy by B. R. George, I begin to demystify the concept of gender. We are also able (...) to use the taxonomy to model various feminist approaches. It becomes easier to see how conceptualisations ofgender which allow for FPA often do not allow for understanding female subjugation as being rooted in reproductive biology. I put forward a conceptual scheme: radical FPA feminism. If we accept FPA, but also radical feminist concerns, radical FPA feminism is an attractive way of conceptualising gender. (shrink)

This collection of essays arose directly from a series of seminars conducted at the Institute of Classical Studies of London University during 1967-1968. Most of the material is published for the first time. Articles by Sandbach and Kidd offer arguments concerning kataleptike phantasia as the test of a true presentation, and Posidonius' conception of the role of the emotions in relation to his scientifically based ethical theory. In addition to the positions held by Rist, Sandbach and Kidd, A. C. Lloyd (...) argues that the Stoic categories, as lekta, should be classified under dialectic and grammar rather than physics. S. G. Pembroke argues most cogently for the central importance of the difficult and controversial concept of oikeiosis in Stoicism. In two essays, editor Long, slanting the conclusion of his discussion of lekta towards its ethical implications, argues first that there is no evidence to show that lekta persist outside of acts of thought and communication distinct from the speaker and his reference; and secondly, that "man," because his logos is equal in quality to all the divine which is outside of it, and because it constitutes a unique substance whose identity is unaffected by external events, "can be free, can act as a man, if and only if the external movements of his body follow from a decision which reconciles his own will and moral choice to what is necessarily the case." Finally, in a not altogether satisfactory concluding essay, "The Natural Law and Stoicism," Gerald Watson discusses among other things some of the practical applications of natural law and its later influence posterior to the Stoic use of it. Although the editor does not attempt either to unify the varying positions presented or to present a comprehensive view of Stoicism, he does bring together some stimulating arguments concerning particular problems in Stoic ethics, metaphysics, epistemology and psychology. This book, truly a statement of "work in progress," is sure to arouse further discussion of the important topics discussed within its carefully documented pages.--T. V. U. (shrink)

This book covers a remarkable amount of ground and has become something of a classic. Besides the Discourse and the Meditations, it contains Private Thoughts, the third set of Objections and Replies, most of the Regulae, parts of the Principia and the Dioptrics, together with crrespondence with Elizabeth, Princess Palatine, Mersenne and others.

Last year marked the 20th anniversary of the Foreign Corrupt Practices Act (FCPA) of 1977. The FCPA is the first and only statute prohibiting bribery and other corrupt business practices by U.S. citizens and companies conducting business overseas. This paper provides an overview of the FCPA during the two decades of its existence. More specifically, the objectives of this paper are four-fold. First, the paper provides background information about the FCPA of 1977 and subsequent amendments in 1988. Second, the paper (...) discusses the enforcement of the FCPA since its passage by examining the number of cases prosecuted under the FCPA and the respective penalties imposed. Third, the paper discusses the economic impact of the FCPA by addressing whether the FCPA places U.S. firms at a competitive disadvantage. Fourth, the paper provides public policy recommendations to expand the reach and scope of the FCPA. It covers efforts to criminalize bribery through multilateral organizations, such as the Organization for Economic Cooperation and Development (OECD), the World Trade Organization (WTO), and the Organization of American States (OAS). It also covers bilateral arrangements and efforts by non-governmental organizations such as Transparency International. (shrink)

Using covariant derivatives and the operator definitions of quantum mechanics, gauge invariant Proca and Lehnert equations are derived and the Lorenz condition is eliminated in U(1) invariant electrodynamics. It is shown that the structure of the gauge invariant Lehnert equation is the same in an O(3) invariant theory of electrodynamics.

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

Mindfulness and compassion meditation are thought to cultivate prosocial behavior. However, the lack of diverse representation within both scientific and participant populations in contemplative neuroscience may limit generalizability and translation of prior findings. To address these issues, we propose a research framework calledIntersectional Neurosciencewhich adapts research procedures to be more inclusive of under-represented groups. Intersectional Neuroscience builds inclusive processes into research design using two main approaches: 1) community engagement with diverse participants, and 2) individualized multivariate neuroscience methods to accommodate neural (...) diversity. We tested the feasibility of this framework in partnership with a diverse U.S. meditation center (East Bay Meditation Center, Oakland, CA). Using focus group and community feedback, we adapted functional magnetic resonance imaging (fMRI) screening and recruitment procedures to be inclusive of participants from various under-represented groups, including racial and ethnic minorities, gender and sexual minorities, people with disabilities, neuropsychiatric disorders, and/or lower income. Using person-centered screening and study materials, we recruited and scanned 15 diverse meditators (80% racial/ethnic minorities, 53% gender and sexual minorities). The participants completed the EMBODY task – which applies individualized machine learning algorithms to fMRI data – to identify mental states during breath-focused meditation, a basic skill that stabilizes attention to support interoception and compassion. All 15 meditators’ unique brain patterns were recognized by machine learning algorithms significantly above chance levels. These individualized brain patterns were used to decode the internal focus of attention throughout a 10-min breath-focused meditation period, specific to each meditator. These data were used to compile individual-level attention profiles during meditation, such as the percentage time attending to the breath, mind wandering, or engaging in self-referential processing. This study provides feasibility of employing an intersectional neuroscience approach to include diverse participants and develop individualized neural metrics of meditation practice. Through inclusion of more under-represented groups while developing reciprocal partnerships, intersectional neuroscience turns the research process into an embodied form of social action. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)