This book is a study in philosophy of religion, which proposes a new inversion model of self-transcendence. At the same time, the study examines the relation between self-transcendence and prosociality in order to broaden our understanding of self-transcendence also as a moral concept relevant to human behavior and its ethical reflection. The inversion model of self-transcendence is based both on the intentionality analysis of consciousness and phenomenological analysis of self-transcendence conducted on examples of great figures of spirituality from the East (...) and the West - an anonymous medieval Christian author of «The Cloud of Unknowing», an Indian sage Ramana Maharshi, and a contemporary spiritual teacher Eckhart Tolle. (shrink)

Clinical ethics consultation is largely outside the scope of regulation and oversight, despite its importance. For decades, the bioethics community has been unable to reach a consensus on whether there should be accountability in this work, as there is for other clinical activities that influence the care of patients. The American Society for Bioethics and Humanities, the primary society of bioethicists and scholars in the medical humanities and the organizational home for individuals who perform CEC in the United States, has (...) initiated a two‐step quality attestation process as a means to assess clinical ethics consultants and help identify individuals who are qualified to perform this role. This article describes the process. (shrink)

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...) on the pathway to an eventual certification process for clinical ethics consultants. (shrink)

With the publication of The Social Frameworks of Knowledge? the English speaking world has at last been given a serious opportunity to approach the complex sociological thought of Georges Gurvitch. However, as the author himself admits in the Preface, this book appears ?abstract and schematic particularly to the uninitiated?.1 The aim of this paper will be to try to relate this translated work to the main body of Gurvitch's writing and particularly to his stance in the sociology of knowledge. First (...) I will examine the intellectual origins of his sociology of knowledge and his attitude to his predecessors in the field. Secondly I will compare his approach to the sociology of knowledge to that of P. L. Berger and T. Luckmann. (shrink)

Psychiatric disorders present distinct clinical challenges which are partly attributable to their multifactorial aetiology and the absence of laboratory tests that can be used to confirm diagnosis or predict risk. Psychiatric disorders are highly heritable, but also polygenic, with genetic risk conferred by interactions between thousands of variants of small effect that can be summarized in a polygenic risk score. We discuss four areas in which the use of polygenic risk scores in psychiatric research and clinical contexts could have ethical (...) implications. First, there is concern that clinical use of polygenic risk scores may exacerbate existing health inequities. Second, research findings regarding polygenic risk could be misinterpreted in stigmatising or discriminatory ways. Third, there are concerns associated with testing minors as well as eugenics concerns elicited by prenatal polygenic risk testing. Fourth, potential challenges that could arise with the feedback and interpretation of high polygenic risk for a psychiatric disorder would require consideration. While there would be extensive overlap with the challenges of feeding back genetic findings in general, the potential clinical use of polygenic risk scoring warrants discussion in its own right, given the recency of this possibility. To this end, we discuss how lay interpretations of risk and genetic information could intersect. Consideration of these factors would be necessary for ensuring effective and constructive communication and interpretation of polygenic risk information which, in turn, could have implications for the uptake of any therapeutic recommendations. Recent advances in polygenic risk scoring have major implications for its clinical potential, however, care should be taken to ensure that communication of polygenic risk does not feed into problematic assumptions regarding mental disorders or support reductive interpretations. (shrink)

Its aim is to point out the role of the individual in the history and the role played by the personality in historical development and its influence. The individual chapters cover several past millennia of human history and show the multiplicity of historical processes and their relevance to the present world.--From Publisher's website.

Introduction Currently, The nature and scope of Clinical Ethics Protocols in Madrid are not well understood.Objectives The main objective is to describe the features of ‘guideline/recommendation’ type CEPs that have been or are being developed by existing Clinical Ethics Committees in Madrid. Secondary objectives include characterisation of those CECs that have been the most prolific in reference to CEP creation and implementation and identification of any trends in future CEP development.Methods We collected CEPs produced and in process by CECs accredited (...) in the public hospitals in Madrid, Spain, from 1996 to 2008.Results CECs developed 30 CEPs, with 10 more in process. The most common topic is refusal of treatment . If CEPs addressing terminal illness, Do-Not-Resuscitate orders and advance directives are placed into a separate ‘ethical problems at the end of life’ category, this CEP subject emerges as the most common . There is a relationship between the age of the CEC and the development of CEPs . CECs now seem to be more likely to engage in CEP development.Conclusions The CECs in Madrid, Spain, have developed a significant number of CEPs and there is a trend towards continued development. The most frequent topics are ethical problems at the end of life and refusal of treatment by the patient. (shrink)

Privacy issues surrounding the use of social media sites have been apparent over the past ten years. Use of such sites, particularly Facebook, has been increasing and recently business organizations have begun using Facebook as a means of connecting with potential customers or clients. This paper presents an empirical study of perceived privacy violations to examine factors that influence the expectations of privacy on Facebook. Results of the study suggest that the more important Facebook is to users, the more likely (...) they are to perceive privacy violations and the more likely those violations are to be considered serious. Furthermore, how information is used is more important than the way this information is accessed. (shrink)

In this paper we shall introduce the variety FWHA of frontal weak Heyting algebras as a generalization of the frontal Heyting algebras introduced by Leo Esakia in [ 10 ]. A frontal operator in a weak Heyting algebra A is an expansive operator τ preserving finite meets which also satisfies the equation $${\tau(a) \leq b \vee (b \rightarrow a)}$$, for all $${a, b \in A}$$. These operators were studied from an algebraic, logical and topological point of view by Leo Esakia (...) in [ 10 ]. We will study frontal operators in weak Heyting algebras and we will consider two examples of them. We will give a Priestley duality for the category of frontal weak Heyting algebras in terms of relational spaces $${\langle X, \leq, T, R \rangle}$$ where $${\langle X, \leq, T \rangle}$$ is a WH -space [ 6 ], and R is an additional binary relation used to interpret the modal operator. We will also study the WH -algebras with successor and the WH -algebras with gamma. For these varieties we will give two topological dualities. The first one is based on the representation given for the frontal weak Heyting algebras. The second one is based on certain particular classes of WH -spaces. (shrink)

This is a clearly written account of Martin's views of analytic truth, containing, in addition to the philosophical considerations, some novel formal results. The formal theory offered is shown to satisfy plausible adequacy conditions, and is notable for economy of assumptions--a reflection of Martin's conviction that semantical metalanguages should, so far as possible, be neutral to issues in ontology. But one need not share the author's extensionalist outlook in order to find much of interest here.--A. R. A.

While outcomes for children with T-cell acute lymphoblastic leukemia have improved dramatically, survival rates for patients with relapsed/refractory disease remain dismal. Prior studies indicate that glucocorticoid resistance is more common than resistance to other chemotherapies at relapse. In addition, failure to clear peripheral blasts during a prednisone prophase correlates with an elevated risk of relapse in newly diagnosed patients. Here we show that intrinsic GC resistance is present at diagnosis in early thymic precursor T-ALLs as well as in a subset (...) of non-ETP T-ALLs. GC-resistant non-ETP T-ALLs are characterized by strong induction of JAK/STAT signaling in response to interleukin-7 stimulation. Removing IL7 or inhibiting JAK/STAT signaling sensitizes these T-ALLs, and a subset of ETP T-ALLs, to GCs. The combination of the GC dexamethasone and the JAK1/2 inhibitor ruxolitinib altered the balance between pro- and anti-apoptotic factors in samples with IL7-dependent GC resistance, but not in samples with IL7-independent GC resistance. Together, these data suggest that the addition of ruxolitinib or other inhibitors of IL7 receptor/JAK/STAT signaling may enhance the efficacy of GCs in a biologically defined subset of T-ALL.Leukemia advance online publication, 30 May 2017; doi:10.1038/leu.2017.136. (shrink)

For a theory T, we study relationships among IΔ n +1 (T), LΔ n+1 (T) and B * Δ n+1 (T). These theories are obtained restricting the schemes of induction, minimization and (a version of) collection to Δ n+1 (T) formulas. We obtain conditions on T (T is an extension of B * Δ n+1 (T) or Δ n+1 (T) is closed (in T) under bounded quantification) under which IΔ n+1 (T) and LΔ n+1 (T) are equivalent. These conditions depend (...) on Th Πn +2 (T), the Π n+2 –consequences of T. The first condition is connected with descriptions of Th Πn +2 (T) as IΣ n plus a class of nondecreasing total Π n –functions, and the second one is related with the equivalence between Δ n+1 (T)–formulas and bounded formulas (of a language extending the language of Arithmetic). This last property is closely tied to a general version of a well known theorem of R. Parikh. Using what we call Π n –envelopes we give uniform descriptions of the previous classes of nondecreasing total Π n –functions. Π n –envelopes are a generalization of envelopes (see [10]) and are closely related to indicators (see [12]). Finally, we study the hierarchy of theories IΔ n+1 (IΣ m ), m≥n, and prove a hierarchy theorem. (shrink)

Sympatric speciation illustrates how natural and sexual selection may create new species in isolation without geographic barriers. However, recent genomic reanalyses of classic examples of sympatric speciation reveal complex histories of secondary gene flow from outgroups into the radiation. In contrast, the rich theoretical literature on this process distinguishes among a diverse range of models based on simple genetic histories and different types of reproductive isolating barriers. Thus, there is a need to revisit how to connect theoretical models of sympatric (...) speciation and their predictions to empirical case studies in the face of widespread gene flow. Here, theoretical differences among different types of sympatric speciation and speciation‐with‐gene‐flow models are reviewed and summarized, and genomic analyses are proposed for distinguishing which models apply to case studies based on the timing and function of adaptive introgression. Investigating whether secondary gene flow contributed to reproductive isolation is necessary to test whether predictions of theory are ultimately borne out in nature. (shrink)

Zonulin is a physiological modulator of intercellular tight junctions, which upregulation is involved in several diseases like celiac disease (CeD). The polyQ gliadin fragment binds to the CXCR3 chemokine receptor that activates zonulin upregulation, leading to increased intestinal permeability in humans. Here, we report a general hypothesis based on the structural connection between the polyQ sequence of the immunogenic CeD protein, gliadin, and enteric coccidian parasites proteins. Firstly, a novel interaction pathway between the parasites and the host is described based (...) on the structural similarities between polyQ gliadin fragments and the parasite proteins. Secondly, a potential connection between coccidial infections as a novel environmental trigger of CeD is hypothesized. Therefore, this report represents a promising breakthrough for coccidian research and points out the potential role of coccidian parasites as a novel trigger of CeD that might define a preventive strategy for gluten‐related disorders in general. Also see the video abstract here: https://youtu.be/oMaQasStcFI. (shrink)

BackgroundKnowledge about the psychosocial experiences of sick-listed workers in the first months of sick leave is sparse even though early interventions are recommended. The aim of this study was to explore psychosocial experiences of being on sick leave and thoughts about returning to work after 8–12 weeks of sickness absence.MethodsSixteen individuals at 9–13 weeks of sick leave participated in semi-structured individual interviews. Data was analyzed through Giorgi’s descriptive phenomenological method.ResultsThree themes emerged: energy depleted, losing normal life, searching for a solution. (...) A combination of health, work, and family challenges contributed to being drained of energy, which affected both work- and non-work roles. Being on sick leave led to a loss of social arenas and their identity as a contributing member of society. Participants required assistance to find solutions toward returning to work.ConclusionEven in this early stage of long-term sick leave, sick listed workers faced complex challenges in multiple domains. Continuing sick leave was experienced as necessary but may challenge personal identity and social life. Those not finding solutions may benefit from additional early follow-up that examine work-related, social and personal factors that influence return to work. (shrink)

While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in (...) implementing system-wide ethics consultation services. Specifically, we identify four models for organizing, developing, and enhancing ethics consultation activities within a system created through acquisitions: train-the-trainer, local capacity-building, circuit-riding, and consolidated accountability. We note each model’s benefits and challenges. To our knowledge, this is the first paper to consider the broader landscape of issues affected by consolidation. We anticipate that clinical ethicists, volunteer consultants, and hospital administrators will benefit from our recommendations. (shrink)