v. 1. Philosophie. Rechtsphilosophie -- v. 2-4. Volkenrecht -- v. 5-6. Rechtsgeschiedenis. Burgerlijk recht. Procesrecht. Octrooirecht. Studie.

PurposeAsian Americans comprise 21% of matriculating medical students in the United States but little is known about their mental health. With the growing focus on addressing the mental health of medical students, this systematic, nationwide survey assesses the relationship between anxiety and depression symptoms and coping skills among Asian American medical students.Materials and methodsA survey tool comprised of Patient Health Questionnaire-9, General Anxiety Disorder-7, and questions related to coping were emailed to members of the Asian Pacific American Medical Students Association (...) enrolled in a United States medical school during the 2016–2017 academic year. We evaluated associations between anxiety and coping as well as depression and coping.ResultsA total of 511 Asian American medical students completed the survey. Anxiety symptoms were positively correlated with an increase in negative coping skills. Depressive symptoms were not correlated with an increase in negative coping skills.ConclusionProfessionals and medical schools that aim to improve the mental health of medical students should be aware of the needs of specific populations. Asian American students who experience anxiety were more likely to utilize avoidant or negative coping strategies. In addition, Asian American students who experience depressive symptoms were not more likely to utilize these negative coping strategies. Further research must be done to evaluate the factors that influence the use of negative coping strategies to better address anxiety within the Asian American medical student population. (shrink)

Prohibition on sex selection may well be unnecessary and oppressive as well as posing risks to women’s lives The urge to select children’s sex is not new. The Babylonian Talmud, a Jewish text completed towards the end of the fifth century of the Christian era, advises couples on means to favour the birth of either a male or a female child.1 The development of amniocentesis alerted the public in the mid-1970s to the scientific potential for prenatal determination of fetal sex,2 (...) and progressive decriminalisation of abortion afforded choice about continuation of pregnancy. The more recent emergence of preimplantation genetic diagnosis (PGD) obviates resort to abortion, and improved techniques of sperm sorting and diagnosis permit creation of zygotes that will ensure the sex of a future child. Growth of biomedical means to select the sex of future children has been accompanied by fear that such means will be employed to favour births of sons, and so perpetuate devaluation of girl children and women’s inferior family and social status. A reaction to this fear has been the demand for legal and medical professional prohibition of sex selection techniques. For instance, the Council of Europe’s Convention on Human Rights and Biomedicine3 provides in article 14 that: The use of techniques of medically assisted procreation shall not be allowed for the purpose of choosing a future child’s sex, except where serious hereditary sex-related disease is to be avoided. Legislation has been enacted in a number of countries, and proposed in others, to prohibit sex selection on non-medical grounds, such as the Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994 in India. In Canada, for instance, government draft legislation introduced in May 2002 proposes to make it a crime for any person, for the purpose of creating a human …. (shrink)

I defend the following version of the ought-implies-can principle: (OIC) by virtue of conceptual necessity, an agent at a given time has an (objective, pro tanto) obligation to do only what the agent at that time has the ability and opportunity to do. In short, obligations correspond to ability plus opportunity. My argument has three premises: (1) obligations correspond to reasons for action; (2) reasons for action correspond to potential actions; (3) potential actions correspond to ability plus opportunity. In the (...) bulk of the paper I address six objections to OIC: three objections based on putative counterexamples, and three objections based on arguments to the effect that OIC conflicts with the is/ought thesis, the possibility of hard determinism, and the denial of the Principle of Alternate Possibilities. (shrink)

Relatives of persons with severe mental illness face a straining life situation and need support. Exclusion of relatives in mental health care has long been reported. The aim of this study was to describe conceptions of nurses in mental health care about supporting relatives of persons with severe mental illness. Focus group interviews with nurses from all levels of mental health care in Norway were performed. A phenomenographic approach was used. The nurses found that their responsibility first and foremost was (...) the patient, especially to develop an alliance with him or her. Additional premises for supporting relatives were the context framing the nursing care, aspects of the actors, and relational concerns between them. Competing or contradictory demands were found within these premises. Two paths were identified concerning the nurses’ support of relatives: seeing the relative in the shadow of the patient or as an individual person. (shrink)

Pediatric critical careCritical care refers to the health care of children with life-threatening illness or following major surgery or severe injury. This care is offered in different contexts across the globe. In well-resourced environments, critical careCritical care may be provided in pediatric intensive care units, which provide highly complex medical care with advanced, potentially expensive technological devices aimed primarily at sustaining life; whereas in poorly resourced regions, only primary care may be available for critically ill or injured childrenInjured children. Even (...) where PICU facilities are available, they are a scarce and expensive resource. The knowledge and ability to sustain a critically ill or injured child’sInjured children life, potentially with effects on the child and family’s quality of lifeQuality of life and at the expense of other children’s health care, leads to frequent ethical challenges. Ethical issues related to how best to ensure optimal quality of lifeQuality of life and the fair distribution of scarce resources are common. In-depth knowledge and understanding of the individual patient’s medical, scientific and psychosocial context, through interdisciplinary discussion and collaboration; as well as familiarity with the overriding, relevant ethico-legal policiesPolicy and principles is essential for appropriate decision-makingDecision-making. Truthful communicationCommunication with the family is essential, using a shared decision-makingDecision-making process, and the child’s best interestBest interest must be central to every decision. This chapter presents an overview of the recommended approach to, and important considerations for, ethical decision-makingDecision-making in the PICU, using a hypothetical case example. (shrink)

Unrecognized presuppositions about patient appearance have become increasingly important in medicine, medical ethics and medical law. Symptoms of these historically conditioned assumptions include common ageism, aesthetic surgery, and litigation about ‘wrongful life’. These phenomena suggest a societal intolerance for what is considered an ‘abnormal’ appearance. Among others, eighteenth-century artists and anatomists helped to set these twentieth-century precedents, actually measuring deviations of external traits to analogous deformations of the soul, and drawing moral conclusions from physiognomic measurements. Other eighteenth-century artists countered with (...) pathognomy, recognizing that uneven physical features may indicate humanity, instead of character flaws. We suggest that there is an important and as yet unrecognized role played by visual and perceptual preferences in our judgments concerning normalcy and anomaly. We further suggest a shift away from our current fashion-magazine, youth-oriented aesthetic, and towards an aesthetic of imperfection. Physicians and medical students can be made aware of their historically conditioned reactions to ‘abnormal’ appearing patients by studying the understandings and methods with which artists have portrayed those who are considered deformed in appearance. (shrink)

We analyse the effect of the regulatory T cells (Tregs) in the local control of the immune responses by T cells. We obtain an explicit formula for the level of antigenic stimulation of T cells as a function of the concentration of T cells and the parameters of the model. The relation between the concentration of the T cells and the antigenic stimulation of T cells is an hysteresis, that is unfold for some parameter values. We study the appearance of (...) autoimmunity from cross-reactivity between a pathogen and a self antigen or from bystander proliferation. We also study an asymmetry in the death rates. With this asymmetry we show that the antigenic stimulation of the Tregs is able to control locally the population size of Tregs. Other effects of this asymmetry are a faster immune response and an improvement in the simulations of the bystander proliferation. The rate of variation of the levels of antigenic stimulation determines if the outcome is an immune response or if Tregs are able to maintain control due to the presence of a transcritical bifurcation for some tuning between the antigenic stimuli of T cells and Tregs. This behavior is explained by the presence of a transcritical bifurcation. (shrink)

Usage of psychotropics during pregnancy and lactation has always been a topic of debate and controversy. The debate stems from the potential adverse effects on the growing fetus or infants due to the transfer of psychotropic drugs through placenta or breast milk of mothers receiving them; and the problem of discontinuing psychotropics in lactating mother considering chances of relapse. However, most of the psychotropics are found to be relatively safe when used cautiously during the lactation phase. This article describes available (...) data on the use of psychotropics in lactating mothers, in particular, in relation to the safety profile of infants. (shrink)

Although the recent push toward sustainability is certainly generally a positive development in business and society, we can see many problems in the execution of the theory of sustainability. Where the triple bottom line calls on companies to weigh effects on stakeholders and the environment alongside profit, in practice in many cases, sustainability has been perverted to represent sustainable profits. In these cases, environmental impact and effects on people are only important insofar as they positively contribute to a firm‘s future (...) profits. It is not only practitioners who have often espoused this misappropriated view of sustainability but also academics have lent credibility to this view. In this work, we start by criticizing the often espoused current view of sustainability and remind academics of their responsibility to adapt a more critical view of this narrow focus. We provide examples that show how the current system of capitalism has resulted in outcomes for people and the environment that are patently unacceptable. Reasons are given as to why there is much hesitation to change the status quo. We then call on academics to reexamine what the role of businesses should be within society, what obligations business and corporations should have in society, and how we can encourage meaningful change that results in a better world for future generations. (shrink)

You may not know me well enough to evaluate me in terms of my moral character, but I take it you believe I can be evaluated: it sounds strange to say that I am indeterminate, neither good nor bad nor intermediate. Yet I argue that the claim that most people are indeterminate is the conclusion of a sound argument—the indeterminacy paradox—with two premises: (1) most people are fragmented (they would behave deplorably in many and admirably in many other situations); (2) (...) fragmentation entails indeterminacy. I support (1) by examining psychological experiments in which most participants behave deplorably (e.g., by maltreating “prisoners” in a simulated prison) or admirably (e.g., by intervening in a simulated theft). I support (2) by arguing that, according to certain plausible conceptions, character evaluations presuppose behavioral consistency (lack of fragmentation). Possible reactions to the paradox include: (a) denying that the experiments are relevant to character; (b) upholding conceptions according to which character evaluations do not presuppose consistency; (c) granting that most people are indeterminate and explaining why it appears otherwise. I defend (c) against (a) and (b). (shrink)