In lieu of an abstract, here is a brief excerpt of the content:Decision-Making as a Broader ConceptJacinta O. A. Tan (bio), Anne Stewart (bio), and Tony Hope (bio)KeywordsCompetence, decision-making, capacity, anorexia nervosa, autonomy, values, identityWe thank Demian Whiting for the thoughtful critique of aspects of our paper (Tan et al. 2006a). A primary aim of our research was to provide empirical grounds on which to stimulate discussion about the nature of decision-making capacity (DMC). Whiting criticizes in particular the concept of (...) 'pathological values' that we suggested might be relevant in the assessment of DMC and in the related issue of deciding when a patient's refusal of beneficial treatment should be overridden.Whiting's central concern is with DMC. Whiting argues that the absence of pathological values should not be a criterion for DMC. We are unclear whether he is also arguing that pathological values do not provide a reason of any kind for overriding treatment refusal. At the end of the paper he writes: "we cannot justify compulsory treatment of patients who have pathological values... on the grounds that these patients lack DMC" (2009, XX). This seems to leave open the possibility that we may be able to justify compulsory treatment of patients who have pathological values on grounds other than that they lack DMC. As we wrote in our response to the discussants of our original paper, "The primary issue for us is whether the reasons for refusal to which we draw attention provide grounds for overriding refusal, and if they do how they can be characterized in such a way as to avoid the ever-present danger of simply overriding autonomy in a patient's best interests" (Tan et al. 2006b, 300).In deciding on whether to use compulsory treatment, there are other relevant factors that may need to be considered, such as the seriousness of the decision, which determines the threshold for competence. However, in this response we consider three issues. First, we argue that the current concept of DMC is by no means so clear cut or generally agreed upon as Whiting implies, and that some of the lack of clarity relates to pathological values. Second, that the concept of DMC is itself dependent on accounts of autonomy, and that it is plausible that pathological values can affect autonomy. Third, we directly consider the question of whether a coherent account of pathological values might be given based on a concept of authenticity.The Current Criteria for DMCWhiting argues that the current criteria for DMC are correct and that an additional criterion along the lines of absence of pathological values should not be added. This argument assumes that there is a clear and agreed understanding of the current criteria. We believe this is not the case for three reasons.(i) Whiting begins his account of DMC by saying that it is normally taken to include: "(1) [End Page 345] understanding (and appreciation)" (2009, 341). Already there is an area of dispute, and the use of parentheses reflects this. The concept of 'appreciation' was developed by Grisso and Applebaum (Grisso, Appelbaum, and Hill-Fotouhi 1997). It is not included in either English common law development, for example (ReC), nor in the criteria specified in the Mental Capacity Act 2005. More important, Grisso and Appelbaum in their comment on our original paper (2006) argue that our work advances thinking about 'appreciation' rather than requiring that we add new elements. The implication is that they believe that what we have called pathological values are relevant to the assessment of capacity and are already included in an account of capacity that incorporates the criterion of 'appreciation.' In our response, we argued that pathological values are not entirely captured within the account of appreciation that Grisso and Appelbaum had previously given. We do not want to revisit that issue here, but the point of relevance is that on one view (that of Grisso and Appelbaum) pathological values are already included in the current criteria for DMC as part of the concept of appreciation, whereas on Whiting's view they are not.(ii) Even if there were agreement over the wording and concepts relevant to DMC there is a further important issue: how are those concepts... (shrink)

Differences in guidance from various organisations is preventing uniform standards of practiceThe emphasis in medical law and ethics on protecting the patient’s right to choose is at an all time high. Apart from circumscribed situations, for instance where the Mental Health Act 19831 is applicable, the only justification for medically treating an adult patient against his or her wishes is on the basis of common law, using the principle of best interests, and only when he or she lacks capacity to (...) refuse treatment. As a result, it is important that clinicians should be able to assess capacity to refuse treatment. Given that judgements of incapacity involve deciding that a person does not have the ability to refuse treatment, a great deal of care needs to go into the assessment and characterisation of incapacity.There is divergence between the characterisation of capacity that is used by the courts and that which is recommended by the British Medical Association . The BMA usefully expands on the first element of capacity as set out in the standard legal definition of capacity in the Re C judgment2 but ignores the other two elements. By doing this, the BMA makes it unclear whether it is rejecting these as relevant to capacity; it also misses the opportunity to expand on these elements in a clinically useful way.We will begin with a description of the BMA’s advice3 and the standard English legal definition of capacity.2,4 Then we will show that there are important discrepancies between these two sources of advice. We think that the BMA ought to clarify its position on capacity in order to safeguard the interests of physicians, healthcare workers, and patients.THE RE C TESTMr C was a patient in a psychiatric secure hospital who had chronic paranoid schizophrenia with …. (shrink)

Capacity and competence in the field of child and adolescent psychiatry are complex issues, because of the many different influences that are involved in how children and adolescents make treatment decisions within the setting of mental health. This article will examine some of the influences which must be considered, namely: developmental aspects, the paradoxical relationship between the need for autonomy and participation and the capacity of children, family psychiatry, and the duty of care towards children and adolescents. The legal frameworks (...) relevant to consideration of consent and competence will be briefly considered, as well as some studies of children's consent, participation and competence. A case vignette will be used as a focus to consider the complexity of the issue of competence in child and adolescent psychiatry, in the particular mental disorder of anorexia nervosa. (shrink)

As leadership discourses in higher education are increasingly being mediated online, texts previously reserved for staff are now being made available in the public domain. As such, these texts become accessible for study, critique and evaluation. Additionally, discourses previously confined to the written domain are now increasingly multimodal. Thus, an approach is required that is capable of relating detailed, complex multimodal discourse analyses to broader sociocultural perspectives to account for the complex meaning-making practices that operate in online leadership discourses. For (...) this purpose, a digital multimodal discourse approach is proposed and illustrated via a small-scale case study of the online leadership discourse of an Australian university. The analysis of two short video texts demonstrates how a digital multimodal discourse perspective facilitates the identification of key multimodal systems used for meaning-making in online communication, how meaning arises through combinations of semiotic choices, and how the results of multimodal discourse analysis using digital technology can reveal larger sociocultural patterns – in this case, divergent leadership styles and approaches as reflected in online discourse, at a time of immense change within the higher education sector. (shrink)

Volume 16, Issue 5, November 2019, Page 514-521.

International education is impacted by multiple discourses, in particular the discourse of university as an educational institution responsible for producing and curating knowledge for the public good, pursuing truth and transforming student life, and the neoliberal marketing discourse which portrays the university as a business organization providing a service for international students as customers/consumers. Following a multimodal discourse analytic perspective, this study examines ‘Why Choose’ webpages of one British and two Australian universities to identify how the apparently conflicting higher education (...) and neoliberal marketing discourses are managed in the interdiscursive space using language, images and videos. The results reveal that ‘Why Choose’ webpages are hybrid texts where the discourse of higher education is upheld in relation to the neoliberal marketing discourse through multimodal strategies of accentuation, infusion and progression. The study argues for the necessity of undertaking a multimodal discourse approach to understand how various positions are negotiated interdiscursively in online media. (shrink)

This paper uses a social semiotic perspective to analyze Donald Trump’s domination of media coverage of the US presidential campaign from 16 June 2015, when he announced his candidacy for nomination as the Republican candidate until 8 November 2016, when he was elected as President of the United States. The paper argues that one of the keys to Donald Trump’s domination of media coverage was that, in presenting himself and his agenda, he foregrounded interpersonal meaning by making himself the focus (...) of attention of the campaign through strategies that invaded various semiotic spaces to form a “sub-semiosphere” of Trump dogma. The effects of this were that what he did and what he said captured the majority of media attention at the expense of his opponents, enabling him to win the election, despite his complete lack of background experience as a politician. (shrink)

This study takes a systemic functional multimodal social semiotic approach to the analysis and discussion of image and text relations in two sets of data. First, patterns of contextualisation of images and text in the online magazines Dabiq and Rumiyah produced by the Islamic extremist organisation which refers to itself as Islamic State are examined. The second data set consists of a sample of texts from Western online news and blog sites which include recontextualisations of images found in the first (...) data set. A sample of examples of the use and re-use of images is discussed in order to identify patterns of similarity and difference when images and text are recontextualised. It is argued that the ISIS material tends to foreground the interpersonal metafunction in combination with the textual metafunction, while the other data set tends to foreground the ideational metafunction. These inferences indicate that further exploration of a larger data set is worth pursuing. Such studies would provide deeper insights helping to distinguish between online material which supports terrorism and that which opposes it, as well as facilitating the further development of multimodal social semiotic approaches to image and text relations. (shrink)

ABSTRACTThis study examines the types of verbal, pictorial, and multimodal metaphors in the genre of sex education picture books for young children in Mainland China. Although being an educational discourse genre that is essentially concerned with transmitting scientific facts, sex education picture books employ a range of metaphors that categorize and construe the biological knowledge of human reproduction in a way that not only facilitates young children’s understanding of scientific concepts but also instills in them particular values and moralities that (...) are socioculturally conditioned. An examination of the source domains from which the metaphors are drawn and the target domains onto which the metaphors are mapped reveals three types of metaphor, namely, personification, domestication, and cross-experience metaphors. The analysis of seven sex education picture books for pre-school children suggests that these types of metaphor are used purposefully for addressing pedagogical as well as ideological con... (shrink)

Incidence and prevalence rates of dengue have increased over the years, and the disease is quickly becoming cause for concern within the public health community. Globally, 128 countries and slightly under four billion people are at risk of contracting dengue. In Sri Lanka, more than half of dengue cases originate in Colombo, which in previous years, used a manual pen-and-paper data management system, which meant that it was not possible to obtain or provide up-to-date information about the severity and spread (...) of dengue. In 2015, two versions of a mobile application called Mo-Buzz Dengue were developed and launched in Colombo, Sri Lanka in order to overcome the challenges of the traditional management system by capitalizing on the rising affordability and ubiquity of mobile phone technology. To keep up with the dynamic nature of disease outbreaks, real-time data need to be visualized in a manner which facilitates discerning and comprehending these patterns. Hence, we used health maps in Mo-Buzz to effectively present this information. The first version of Mo-Buzz was for public health inspectors, digitized data management as well as provided educational materials. The second version of Mo-Buzz was a source of information for the general public, a crowdsourcing platform to provide information relating to dengue transmission, and for health authorities to alert users to dengue-specific developments in their area. This paper illustrates the design considerations of the Mo-Buzz disease surveillance system for the general public. A draft scaled-down version of the PHI system was used to obtain feedback and make incremental design enhancements. Additionally, similar health maps were evaluated in terms of capability and usability. These findings were applied to identify future enhancements to the health map of Mo-Buzz Dengue. (shrink)

Çocuk evliliği, tarih boyunca farklı toplumlarda bilinen ve uygulanan sosyal bir olgu olsa da son zamanlarda, modern duyarlılıkları giderek daha fazla rahatsız eden bir hal almıştır. Son iki asır öncesine kadar, Avrupa hukuki düşüncesinde çocuklar yargı önünde farklı bir muamele görmelerine imkan veren istisnai bir statüye sahip değildi. Diğer taraftan, İslam hukukunun çocuklara, özel bir hukuki statü kazandırma konusunda bazı öncü adımlar attığını söyleyebiliriz. Nitekim, en eski İslam hukuku kitaplarının bile, insanın fiziksel ve zihinsel gelişim aşamalarına ve her bir aşamada (...) ortaya çıkan hukuki hükümlere dair son derece teknik ayrıntılarla dolu olduğunu görebiliriz. Ancak çocuk hakları konusundaki bu erken farkındalığa rağmen, çocuk evliliği olgusu hem İslam toplumlarında hem de İslam hukukunda kendini gösterebilmiştir. Çünkü, İslam çocuk hukuku, ilk ortaya çıktığı dönemin kültürel şartlarından ciddi şekilde etkilenmiştir. Üstelik bu kültürel şartlar, İslam dünyası boyunca İslam çocuk hukukunun temel zemini olma işlevini sürdüre gelmiştir. Bu çalışma, alimlerin çocuk evliliğini delillendirmek üzere yapageldikleri bazı aşırı yorumları ortaya koymaya ve konuyla ilgili âyetleri metinsel bağlamıyla daha uyumlu bir şekilde okumaya çalışmaktadır.Özet: Her bağlam için geçerli olabilecek, standart bir çocuk tanımı yapmak göründüğünden daha güçtür. Bu nedenle çocuk araştırmaları sahasında çalışan akademisyenlerin, muhtelif sosyal disiplinler tarafından yapılacak herhangi bir çocuk tarifi konusunda memnuniyetsizlik içinde olması doğaldır. Diğer yandan, İslam hukukunda baştan beri ayrıntılı bir çocuk hukuku teorisi mevcuttur. İslam hukuk düşüncesinde, insanlar doğum ile yetişkinlik arasındaki gelişim döneminde üç aşamadan geçerler: Çocukluk (küçüklük), buluğ ve rüşt. Bütün fıkıh mezhepleri, insanın doğumu ile ergenliği arasındaki dönemde küçük çocuk sayılacağı kanaatindedirler. Bu çocukların mallarının en iyi şekilde idare edilebilmesi için yasal temsilcileri bulunmak zorundadır. Fakîhler çocuğun velisinin, özellikle de baba veya baba tarafından dedenin, velâyeti altındaki küçük çocuklar üzerinde mücbir bir yetkisi olduğu (velâyet-i mücbire) konusunda geniş bir fikir birliğine sahiptirler. Buna göre veliler, velâyetleri altında bulunan çocukları uygun gördükleri kişilerle evlendirme yetkisine de sahiptirler. Fakat zaman zaman beşik kertmesi olarak da anılan bu uygulama bir ön sözleşmeden ibarettir. Yani bu sözleşme doğrudan doğruya fiziksel boyutları da olan müşterek bir evlilik hayatını meşru kılmamaktadır. Çünkü cinsel hayatın ancak buluğdan sonra gerçekleşmesi ön görülmektedir. Modernite öncesi İslam tarihi boyunca, İbn Şubrume (ö. 144/761), Ebû Bekr el-Esamm (ö. 200/816) ve Osman el-Bettî (ö. 143/760) gibi bir kaç fakih dışında küçük çocukların evlenmesine kategorik olarak karşı çıkan kimselere pek rast gelinmemektedir.Hanefi mezhebinde, herhangi bir zihinsel özrü olmaksızın buluğa eren erkek ve kız çocuklar evlilik konusunda mücbir velâyetin kapsamı dışına çıkarlar. Bu, evlilik sözleşmelerini bizzat gerçekleştirebilecekleri anlamına gelmektedir. Fakat veli, uygunsuz bulduğu evliliğe karşı dava açarak bunu yargı yoluyla geçersiz kılma yoluna gidebilir. Diğer üç Sunnî mezhep ise erkek ve kız çocuklar arasında bir ayrım yapar: Buluğa eren erkek kendi evlilik akdini yapabilme hakkını elde ederken aynı durumdaki kız çocuklar velâyet altında kalmaya devam ederler. Şâfiʿî mezhebine göre, velâyeti gerekli kılan illet (bekaret) hâlâ geçerliliğini korumaktadır. Dolayısıyla veli, kızları evlendirme konusundaki icbâri yetkisini elinde tutmaya devam etmektedir. Bu durumda kızın rızasının alınması, akdin geçerliliği için şart olmaktan ziyade sadece nezaket gereğidir. Rüşte ulaşmak veya fizyolojik olgunlaşma sürecini tamamlamak ise İslam hukukunda evlilik için şart görülmemiştir.Modern zamanlara kadar geleneksel İslam hukukunun erken evlilik lehinde gösterdiği bu yaklaşımda herhangi bir değişiklik olmamıştır. 1917 yılında çıkan Hukuk-ı Aile Kararnamesi daha önce benzeri görülmemiş bir dizi düzenleme getirmiştir: İlk olarak, evlilik yaşı erkek için on sekiz kız için ise on yedi olarak belirlenmiştir. On sekiz yaşın altındaki erkeklerin hakimden evlenme izni alması; on yedi yaşından küçük kızların ise hem veli onayı hem de hakim iznine sahip olması zorunlu hale getirilmiştir. On iki yaşın altındaki erkekler ile dokuz yaşından küçük kızların ise asla evlendirilemeyeceği kararlaştırılmıştır.Mantıkî bağlam ve sentaktik yapı elverişli olmamasına rağmen fakihler çocuk evliliğini desteklemek üzere bazı Kur’ân âyetlerine (Nisâ 4/3-6, Nisâ 4/127, Talâk 65/4) referansta bulunmuşlardır. Makale içeriğinde detaylı şekilde açıklandığı üzere zorlama yorumlamalarda bulunmuşlardır. Bu makale, söz konusu âyetlere daha tutarlı bir yorum getirmeye çalışmaktadır. Aynı şekilde, Kur’an’ın çocuk evliliğini kolaylaştırıcı bir tavır içerisinde olmadığını, çocukların evlendirilebilmesi yönündeki yaklaşımların tarihsel ve kültürel şartlara bağlı olarak yapılan bazı zorlama yorumlara dayandığını ileri sürmektedir.Hz. ʿÂişe’nin Hz. Peygamber ile oldukça erken bir yaşta evlendiğine dair nakledilen rivâyet de konuyla ilgili olarak ileri sürülen başka bir argümandır. Bu rivâyetin sahih olduğuna inanılmaktadır. Buna rağmen ilginç bir şekilde bu rivâyet çok az fakih tarafından kullanılmıştır. Bunun sebebi, fakîhlerin Hz. Peygamberin mahremiyetinden bahsetmek istememeleri olabilir. Rivâyetin hücciyeti konusuna kuşkuya kapılmış olmaları da mümkündür. Söz konusu rivâyete daha yakından bakıldığında, ifadedeki menfi üslup hemen dikkat çekmektedir. Çünkü rivâyette Hz. ʿÂişe, Hz. Peygamberle evlendiği günü anlatırken sürekli olarak fizyolojik ve psikolojik açıdan olumsuz koşullardan bahsetmektedir. Nitekim Hz. ʿÂişe birden bire oynamakta olduğu salıncaktan alınmakta ve kendisinin de bilmediği bir yere doğru götürülmektedir. Rivâyet, sadece çocuk evliliğinin cevazını ortaya koymakla yetinmemekte, sanki aynı zamanda çocukların uygunsuz koşullardaki evlilik taleplerine bile itaatkar olmaları gerektiğini salık vermektedir. İçerik yanında teknik olarak bakıldığında bu rivâyet, haber-i vâhiddir. Çünkü rivâyet, sadece Hz. ʿÂişe tarafından bilinebilecek detayları içermektedir. Tarihî açıdan bir öneme sahip olmasına rağmen dinî hükümlere kanıt olma niteliğinden yoksundur. Çünkü bu rivâyette, râvi konuyla ilgili Hz. Peygamber’e ait resmi bir açıklamayı nakletmemekte; sadece kendi zaviyesinden maruz kaldığı bir durumdan bahsetmektedir. (shrink)

Bone marrow is the main site for hematopoiesis in adults. It acts as a niche for hematopoietic stem cells (HSCs) and contains non‐hematopoietic cells that contribute to stem cell dormancy, quiescence, self‐renewal, and differentiation. HSC also exist in resting spleen of several species, although their contribution to hematopoiesis under steady‐state conditions is unknown. The spleen can however undergo extramedullary hematopoiesis (EMH) triggered by physiological stress or disease. With the loss of bone marrow niches in aging and disease, the spleen as (...) an alternative tissue site for hematopoiesis is an important consideration for future therapy, particularly during HSC transplantation. In terms of harnessing the spleen as a site for hematopoiesis, here the remarkable regenerative capacity of the spleen is considered with a view to forming additional or ectopic spleen tissue through cell engraftment. Studies in mice indicate the potential for such grafts to support the influx of hematopoietic cells leading to the development of normal spleen architecture. An important goal will be the formation of functional ectopic spleen tissue as an aid to hematopoietic recovery following clinical treatments that impact bone marrow. For example, expansion or replacement of niches could be considered where myeloablation ahead of HSC transplantation compromises treatment outcomes. (shrink)

Editors Wanda Teays, John-Stewart Gordon, and Alison Dundes Renteln have assembled the works of an interdisciplinary, international team of experts in bioethics into a comprehensive, innovative and accessible book. Topics covered range from torture and lethal injection to euthanasia, sex selection, vulnerable human subjects, to health equity, safety and public health, and environmental disasters like Bhopal, Fukushima, and more.

In lieu of an abstract, here is a brief excerpt of the content:Studying Penguins to Understand BirdsJacinta O. A. Tan (bio), Anne Stewart (bio), Ray Fitzpatrick (bio), and Tony Hope (bio)Keywordsanorexia nervosa, treatment decision-making, competence, valuesWe are grateful to Grisso, Appelbaum, Charland, and Vollmann for their thoughtful commentaries on our paper. We would like to respond by picking up on some of the points they make, although we do not address all the issues raised.Our general aims in the paper are (...) less immediately pragmatic than are the central concerns of Grisso and Appelbaum. Our interest is primarily in a number of ethical, and related conceptual, issues that arise from empirical data. In the long run, of course, we believe that these ethical and conceptual issues are important to the care of people with mental disorders, but our focus is philosophical.Our central interest is what justifies overriding treatment refusal. We are unhappy with a "status" approach according to which, for example, the mere fact that a person suffers a mental disorder provides grounds for overriding her wishes. Such an approach, it seems to us, fails to identify reasons, and discriminates against those with mental disorder, a view shared by the Law Commission (The Law Commission 1995). We are, on the other hand, attracted by the approach that grounds any overriding of treatment refusal on lack of capacity (or competence) to make treatment decisions. The concept of capacity has been well developed through legal cases and conceptual analysis, not least by Grisso and Appelbaum themselves. We were struck, however, first through clinical experience, and subsequently from the pilot study reported in our paper, that many patients with anorexia nervosa who refuse treatment do not necessarily lack capacity, using the current criteria, and yet show features or give reasons that raise serious doubts as to whether it is right to respect their refusal of treatment.To avoid reliance on a "status" approach, the issue with which we are grappling is whether the concept of capacity (and therefore lack of capacity) can be developed to encompass some of our findings, and whether it is ethically right to do so. Charland makes the important point that the concept of competence, or capacity, has both a descriptive and a prescriptive component. It is for this reason that the question of whether, for example, we should extend the criteria for capacity is part of the question of when it is morally right to override treatment refusal.Grisso and Appelbaum suggest that our work advances "our thinking about appreciation, rather than requiring that we add new elements" (2006, 297). From our perspective, and at this stage, it is a secondary issue whether we are suggesting a development of appreciation, or a new element (e.g., "pathological values"). The primary issue for us is whether the reasons for refusal to which we draw attention provide grounds for overriding refusal, and if they do how they can be characterized in [End Page 299] such a way as to avoid the ever-present danger of simply overriding autonomy in a patient's best interests.We chose to study anorexia nervosa for various reasons, but we expect that the issues raised have a more general relevance (such as to substance abuse and impulse control disorders as Grisso and Appelbaum and Charland suggest). We do not expect the results to be relevant to all, or even most, mental disorders. Our main interest is not the specific management of people with anorexia, but how the data challenge, and help to develop, the concept of capacity, and the ethical analysis of overriding patient refusal of treatment. Our paper aims to address what we understand Charland to be referring to by the "pretheoretical desiderata" (2006, 283) of the concept of capacity. One reason why we chose anorexia as the focus of this work is because it is different from many mental disorders in the issues that it raises. In this it is, perhaps, rather like studying penguins to better understand the concept of bird just because penguins, although clearly birds, have unusual features.We agree, therefore, with Grisso and Appelbaum's caution that it would be unwise to jump in and change the MacCAT-T on the basis of the results... (shrink)

In schools, trustworthiness is a foundational value taught to students through values education as well as the school activities, ethos and climate. A key determining factor for the establishment o...

In an attempt to learn from COVID-19, this essay features six responses to the question: what did COVID-19 teach us, expose in us, or purge out of us when it comes to spiritual formation in Christ? Each response was written independently of the others by one of the coauthors. Diane J. Chandler focuses in on how COVID-19 exposed grievous inequities for ethnic groups in the American church and broader society. Kelly M. Kapic reminds us of the goodness of human finitude (...) and how COVID restrictions have forced many of us to embrace our limitations. Siang-Yang Tan reflects on eight lessons he has learned during this pandemic year in his role shepherding a local church. James C. Wilhoit calls us to consider the structures that are needed for local church leadership to make wise and godly decisions in times of crisis. Richard Peace draws our attention to what might be learned from the forced monasticism brought about by COVID-19 quarantines. Finally, Ruth Haley Barton pauses to consider the interdependence of human life that has been dramatically illustrated by this pandemic. While these six responses certainly do not exhaust all there is for the church to learn from COVID, we present them in the spirit of “O Lord, teach us what we do not see” and hope they will inspire your own reflections. (shrink)

Maternal opioid use during pregnancy is a growing national problem and can lead to newborns developing neonatal opioid withdrawal syndrome soon after birth. Recent data demonstrates that nearly every 15 min a baby is born in the United States suffering from NOWS. The primary treatment for NOWS is opioid replacement therapy, commonly oral morphine, which has neurotoxic effects on the developing brain. There is an urgent need for non-opioid treatments for NOWS. Transcutaneous auricular neurostimulation, a novel and non-invasive form of (...) electrostimulation, may serve as a promising alternative to morphine. tAN is delivered via a multichannel earpiece electrode worn on and around the left ear, targeting two cranial nerves—the vagus and trigeminal nerves. Prior research suggests that auricular neurostimulation exerts an anxiolytic effect on the body by releasing endogenous opioids and reduces withdrawal symptoms in adults actively withdrawing from opioids. In this first-in-human prospective, open-label trial, we investigated tAN as an adjuvant to morphine therapy in eight infants >33 weeks gestational age suffering from NOWS and receiving oral morphine treatment. Infants received tAN for 30 min 1 h before receiving a morphine dose. tAN was delivered at 0.1 mA below perception intensity at two different nerve targets on the ear: Region 1, the auricular branch of the vagus nerve; and Region 2, the auriculotemporal nerve. tAN was delivered up to four times daily for a maximum of 12 days. The primary outcome measures were safety [heart rate monitoring, Neonatal Infant Pain Scale, and skin irritation] and morphine length of treatment. tAN was well-tolerated and resulted in no unanticipated adverse events. Comparing to the national average of 23 days, the average oral morphine LOT was 13.3 days and the average LOT after tAN initiation was 7 days. These preliminary data suggest that tAN is safe and may serve as a promising alternative adjuvant for treating NOWS and reducing the amount of time an infant receives oral morphine. (shrink)

PurposeThe purpose of this study was to introduce an orthogonal experimental design to improve the efficiency of building and optimizing models for freezing of gait prediction.MethodsA random forest model was developed to predict FOG by using acceleration signals and angular velocity signals to recognize possible precursor signs of FOG. An OED was introduced to optimize the feature extraction parameters.ResultsThe main effects and interaction among the feature extraction hyperparameters were analyzed. The false-positive rate, hit rate, and mean prediction time were 27%, (...) 68%, and 2.99 s, respectively.ConclusionThe OED was an effective method for analyzing the main effects and interactions among the feature extraction parameters. It was also beneficial for optimizing the feature extraction parameters of the FOG prediction model. (shrink)

En este artículo se explora el contenido de una ética de la inmanencia, de inspiración spinozista a partir de una confrontación teórica con las diferentes posiciones éticas bionaturalistas de Hana Jonas y Alasdair Macloeyre; la crítica al dualismo y al materialismo en filosofía de la mente que ba planteado Jobo Searle; y la lectura pragmatista y posmoderna de Spinoza realizada por Richard Rorty. Del curso de esta confrontación se desprende, provisionalmente una ética de contenido material que concibe la liberación como (...) una forma de conocimiento del yo dadas sus condiciones inmanentes de vida. (shrink)

Türk milleti dünyanın en zengin kültürüne sahip olduğu gibi en zengin diline de sahiptir. Ancak daha eski çağların dil verileri ne yazık ki, yazılı vesikalara aktarılmamış, karanlık dönem olarak kalmıştır. O bakımdan Türkçenin Altay veya Proto-Türk devri hakkında bilgimiz sınırlıdır ve sahip olduğumuz kelime sayısı da çok azdır. Eski Türkçe adlanan bu lügat sadece Orhun-Yenisey yazıtları ile tespit edilen ve Uygur yazıtları ile devam eden Türkçenin malum en eski yazılı kaynaklarının sözlüğüdür. Yer yüzündeki diller arasında Türkçenin yerine baktığımızda, Ural-Altay dil (...) grubunun Altay koluna bağlı bir dil olduğu ve geçmişinin M.Ö. 4000’li yıllara indiği görülür. Bu tarihten, M.Ö. 5. yüzyıla kadar olan dönem genel olarak Altay veya Proto-Türk devri olarak adlandırılır. Bu dönemde Türkçe ile ilgili az da olsa birtakım dil kalıntılarına rastlanır; ancak bunun yeterli olmaması ve bu dönemden bize yazılı herhangi bir metnin ulaşmaması, bu çağların karanlık dönem olarak adlandırılmasına neden olmuştur. Bu dönemde Türkçenin Çuvaşça ve Yakutça ile henüz ayrılmadığı, hattâ daha eskiye gittiğimizde Moğol, Mançu, Tunguz dilleriyle aynı çatı altında toplandığı varsayılır. Bilindiği gibi daha önce Eski Türkçe döneminin ayrı ayrı metinlerini kapsayan birçok sözlük çalışması yapılmıştır. Ancak bu sözlükler birbirinden bağımsız hazırlanmış, bir kısmı Göktürk dönemi ile Orhun Yazıtlarını, diğer bir kısmı da Uygur dönemi ile bu dönem metinlerini temel almıştır. Eski Türkçe bir bütün olarak düşünüldüğünde, bu sözlüklerin bazı yönlerden yetersiz kaldığı bir gerçektir. Bu çalışmanın genel amacı, daha önce ortaya konulan Eski Türkçe sözlükleri bir araya getirerek Göktürk ve Uygur dönemlerini birlikte ele alan, daha kapsamlı ve tek bir sözlük oluşturmaktır. O bakımdan daha önce meydana getirilen sözlük çalışmaları temel alınarak ortaya yeni bir sözlük konulmuştur. (shrink)

En este texto reconstruyo una concepción decolonial de la belleza, a partir del pensamiento de Robin Wall Kimmerer y Édouard Glissant, de acuerdo con la cual la belleza constituye una condición del mundo que, no obstante, debemos cuidar. En estos dos pensamientos, provenientes de tradiciones diferentes, la belleza es tanto lo que se ve amenazado por el proyecto colonial occidental, como lo que permite su resistencia decolonial. Reconstruir la belleza del mundo es necesario y, sin embargo, imposible: su búsqueda implica (...) no solo atender al llamado de las diferencias, sino también a las instancias en las que se niegan a ser escuchadas. (shrink)

¿Es el desideratum secularista de separación Iglesia-Estado capaz de enfrentar las consecuencias negativas de la revitalización política de los conservadurismos religiosos y la instrumentalización de la religiosidad popular para fines antiigualitarios? La respuesta negativa es la tesis de la que parto para analizar por qué los liberalismos secularistas y postsecularistas no pueden procesar ni en la teoría ni en la práctica la reordenación política de las iglesias cristianas conservadoras (católicas y evangélicas) en nuestra región. Esto no me conduce a abrazar (...) una teología política ni un relativismo abstencionista. Me interesa estudiar la plausibilidad de desarrollar una postura ético-política anticlerical que no desprecia la religiosidad popular ni el potencial emancipador en los fenómenos religiosos, en un mundo en el que no es ni moral ni históricamente viable soslayarlos insistiendo en colocarlos en la esfera inasible de lo privado o en un pasado sublimado en procesos de secularización. La hipótesis guía de este artículo es que la cuestión normativa y política básica sobre la que tratan la mayor parte de los debates sobre secularización en la actualidad es la participación de las iglesias en lo político por medio de la formación del juicio y la voluntad públicos. -/- . (shrink)

En este texto reconstruyo una concepción decolonial de la belleza, a partir del pensamiento de Robin Wall Kimmerer y Édouard Glissant, de acuerdo con la cual la belleza constituye una condición del mundo que, no obstante, debemos cuidar. En estos dos pensamientos, provenientes de tradiciones diferentes, la belleza es tanto lo que se ve amenazado por el proyecto colonial occidental, como lo que permite su resistencia decolonial. Reconstruir la belleza del mundo es necesario y, sin embargo, imposible: su búsqueda implica (...) no solo atender al llamado de las diferencias, sino también a las instancias en las que se niegan a ser escuchadas. (shrink)

¿Es el desideratum secularista de separación Iglesia-Estado capaz de enfrentar las consecuencias negativas de la revitalización política de los conservadurismos religiosos y la instrumentalización de la religiosidad popular para fines antiigualitarios? La respuesta negativa es la tesis de la que parto para analizar por qué los liberalismos secularistas y postsecularistas no pueden procesar ni en la teoría ni en la práctica la reordenación política de las iglesias cristianas conservadoras (católicas y evangélicas) en nuestra región. Esto no me conduce a abrazar (...) una teología política ni un relativismo abstencionista. Me interesa estudiar la plausibilidad de desarrollar una postura ético-política anticlerical que no desprecia la religiosidad popular ni el potencial emancipador en los fenómenos religiosos, en un mundo en el que no es ni moral ni históricamente viable soslayarlos insistiendo en colocarlos en la esfera inasible de lo privado o en un pasado sublimado en procesos de secularización. La hipótesis guía de este artículo es que la cuestión normativa y política básica sobre la que tratan la mayor parte de los debates sobre secularización en la actualidad es la participación de las iglesias en lo político por medio de la formación del juicio y la voluntad públicos. -/- . (shrink)

Ömer Naci Soykan'ın ülkemizde yayımlanan armağan kitaplar konusunda eleştirel bir yaklaşımı vardı. Bu eleştiri, armağan kitapların büyük çoğunluğunun "armağan" edildikleri düşünür ya da filozofla ilgili neredeyse hiçbir ciddi çalışmayı içermemesiyle ilgiliydi. Ona göre bir armağan kitabın öncelikli amacı "armağan" edildiği kişinin felsefi görüşlerine yer vermek olmalıydı. Dolayısıyla Soykan hayattayken kendisiyle ilgili bir armağan kitap çıkarmayı düşündüğümüzü dile getirdiğimizde ilk sözü "İçinde benim düşüncelerimle ilgili yazılar olacaksa olsun, yoksa istemiyorum!" olmuştu. "Sağdan soldan toplama yazılarla, tematik bütünlüğü olmayan yazıların art arda getirilmesiyle (...) oluşturulmuş bir armağan kitap olmaz. Armağan kitap, (bir "Festschrift") öncelikle o kişiyle, o kişinin düşünceleriyle ilgili yazılardan oluşması gerekir" diye de eklemişti. Bu kitabın gecikmesinin bir başka nedeni belki de Soykan'ın bu kadar açık biçimde dile getirdiği bu sözlerdi çünkü eleştirdiği türde bir armağan kitap hazırlamak görece kolay olabilirdi. Geç oldu ancak olması gereken gibi oldu! Kitaptaki her yazarın katkısı Soykan'ın görüşleri üzerine, onları açımlayan, değerlendiren, belki yer yer de eleştiren değerli çalışmalar olarak ortaya çıktı. Böylelikle onun isteğini de bir bakıma yerine getirmiş olduk. (shrink)

En este artículo se pretende analizar hasta qué punto las filosofías de Ortega y Wittgenstein compartirían un horizonte filosófico común. En este sentido se presentan, aunque con matices distintos, los siguientes elementos comunes: el rechazo del realismo metafísico y el cientismo, el abandono de la concepción sustancialista del sujeto, la irrupción en la discusión filosófica del significado o el sentido como algo que necesita comprensión o aclaración, la urgencia de solucionar el problema de la autenticidad.

Es un error buscar en la religión la justificación para la igualdad entre mujeres y hombres. Estos intentos ya se dieron en los años 70 en Argelia, Marruecos y Túnez. Los tres países árabes donde el pensamiento reformista tuvo más representantes y mayor impacto. Numerosas asociaciones feministas reclamaron el derecho de las mujeres al acceso a la esfera pública y exigieron la derogación de las leyes más discriminatorias, como el repudio o la poligamia. Para dotarse de mayor legitimidad en países (...) que mantenían el islam como religión del Estado, el feminismo laico dejó de lado su universalismo y buscó aliarse con la religión, intentando encontrar elementos feministas en el Corán, tal y como explica la abogada argelina Wassyla Tamzali. Sin dejar de poner el foco sobre el trabajo y la condición de las mujeres para mostrar la desigualdad existente, aseguraba que los ideales de igualdad eran plenamente compatibles con las Escrituras sagradas. (shrink)

Existen conceptos o concepciones sobre la realidad que permean asiduamente el despliegue del pensamiento y la vida en sus devenires cotidianos o fácticos. En este sentido, quien comienza a formarse en los quehaceres de la investigación filosófica, encara con alguna frecuencia la responsabilidad de confrontar aquellas nociones que, bajo la forma de precomprensiones, obstruyen las transiciones comprensivas e interpretativas propias de toda tarea investigativa. En este caso, la posibilidad de distinguir el contenido característico de las ideologías naturalistas, de aquellas otras (...) que le son propias a las filosofías trágicas o inmanentistas, quizá pueda incidir argumentalmente en las tensiones dialógicas que hoy atraviesan a las culturas cuando se pone de manifiesto el deseo de reivindicar posiciones totalitarias o relativistas en relación con esferas de la vida y del pensamiento humanos tan diversas como la política, la religión, el género, la sexualidad, la etnia, la raza, entre otras. La tarea de quien se forma en investigación filosófica consiste, en buena medida, en advertir que los conceptos filosóficos logran vivificarse cuando ceden a la interlocución vital que les proponen constantemente las contingencias propias de todo lapso histórico. En efecto, algunos asuntos se palpan en la atmósfera de un tiempo determinado; también se encuentran en las tramas tangibles de las existencias humanas. (shrink)

"Este libro nos propone una reflexión ensayística sobre la "crisis de la escuela" a partir de una visión genealógica, considerando la manera en que las nuevas tecnologías de comunicación (sobre todo, los aparatos móviles de acceso a las redes informáticas) y, particularmente, los modos de vida que ellos implican, están afectando el funcionamiento de esa institución clave de la modernidad. La intención es detectar y problematizar los factores involucrados en la creciente incompatibilidad de esos modos de ser y estar en (...) el mundo, que son tan actuales, con las ya anticuadas instalaciones escolares; identificar los sentidos de estas transformaciones históricas y ofrecer algunas pistas que permitan delinear posibles respuestas al conflicto o, al menos, reformular las preguntas para que sean más productivas." --Contratapa. (shrink)