The health care needs of rural populations often differ from those of their urban counterparts. And the ethical dilemmas that caregivers face are distinctively shaped in rural settings, not only by resource constraints, but by the nature of life in small, close-knit communities as well.

Clinicians at quaternary centers see part of their mission as providing hope when others cannot. They tend to see sicker patients with more complex disease processes. Part of this mission is offering longshot treatment modalities that are unlikely to achieve their stated goal, but conceivably could. When patients embark on such a treatment plan, it may fail. Often treatment toward an initial goal continues beyond the point at which such a goal is feasible. We explore the progression of care from (...) longshot to fantasy using two pediatric cases. This progression may be differentiated into four distinct stages of care related to the potential of achieving the initial goals of care. Physicians are often ill prepared for the progression of treatments from a longshot hope to an unfeasible and, therefore, typically unjustified intervention. We present a structured approach to guide clinicians at referral institutions where these situations may be common. The transition of care from “longshot” to “fantasy” is an inherent part of quaternary care for the sickest of patients that has been underexplored. Physicians are often poorly equipped to approach that transition. We advocate this approach to the shift from longshot to fantasy with the belief that such a structured method will have multiple benefits, including: reduced suffering for the patient; decreased emotional burden on patient and family; decreased provider moral distress; increased likelihood of seeking high quality palliative care earlier; and provision of honest and straightforward information to patients and their families. (shrink)

While Russian political parties appear to be institutionalizing to some degree at the national level, they are surprisingly absent at the regional level. This is a result of the dynamics of Russia's dual economic and political transition. Regional elites prefer a “partial reform equilibrium” in political institutional development so that they can avoid widening the sphere of accountability for their decisions in order to protect the gains they have made in the early stage of the economic transition. Strong political institutions—like (...) competitive political parties that penetrate the periphery—would render transitional winners more broadly accountable to wider societal interests as well as to national political actors. The argument suggests that the territorial penetration and further institutionalization of Russia's party system are not necessarily inevitable. Under the conditions of dual, simultaneous economic and political transitions, elites may prefer an equilibrium of political underinstitutionalization to preserve their early winnings from the economic transition. (shrink)

Subset Spaces were introduced by L. Moss and R. Parikh in [8]. These spaces model the reasoning about knowledge of changing states.In [2] a kind of subset space called intersection space was considered and the question about the existence of a set of axioms that is complete for the logic of intersection spaces was addressed. In [9] the first author introduced the class of directed spaces and proved that any set of axioms for directed frames also characterizes intersection spaces.We give (...) here a complete axiomatization for directed spaces. We also show that it is not possible to reduce this set of axioms to a finite set. (shrink)

"We shall become more Scandinavian." This sentence was pronounced in 2013 by French President François Hollande's entourage.1 It was the starting point for new legislation, notably on transparency, along with a general attempt to diminish the gap between the ruling class and ordinary people. Hollande was seemingly trying to transform "French political culture, a Latin culture, into a Scandinavian culture."2Hollande was not alone in this attempt. During the 2017 presidential campaign, Emmanuel Macron stated that his political project was "exactly like (...) the Scandinavian model," adding that this Scandinavian model "works much better than ours."3 He also pointed out that he saw the "moralization" of public life as one... (shrink)

Most of the surveys that were undertaken in the 19th century, particularly in France, among workers, were conducted essentially from viewpoints of social legislation, philanthropy, or were even animated by a bias against the labor movement. Marx, however, in the survey that he initiated in 1880, not only wanted to deliver information on working and living conditions of the workers to the public, but tried to clarify by the questionnaires the thoughts of the workers themselves on their own situation and (...) its social causes. The questionnaire containing about one hundred different questions utilizes, therefore, in adapting itself to the labor movement of the time and the character of the workers' education, the relevant categories of the Marxian theory of society.As an appendix, the essay contains a german translation of the questionnaire itself.Les enquêtes sur la situation sociale des ouvriers organisées dans le cours du xixe siècle en Angleterre et surtout en France, étaient entreprises avec des intentions de politique sociale ou de philanthropie ou même d’hostilité contre le mouvement ouvrier. Elles n’avaient souvent qu’un intérêt déterminé, limité à la mise au jour de l’état des choses réeL Au contraire, lorsque Marx organise en 1880 une enquête par questionnaires,, il ne veut pas seulement donner à l’opinion publique des informations précises sur les conditions de travail et de vie des ouvriers français ; le questionnaire qui, pour la première fois, s’adresse exclusivement aux ouvriers, eux-mêmes doit aussi servir à éclairer la classe ouvrière elle-même sur sa situation réelle et les causes sociales de sa misère. Aussi le questionnaire détaillé, qui comprend 100 questions, utilise-t-il les catégories essentielles de la théorie marxiste de la société de manière adaptée à l’état du mouvement ouvrier et à l’éducation de la classe ouvrière à cette époque.On a reproduit, en appendice de l’article, une traduction allemande du questionnaire. (shrink)

This volume addresses the issues of the Third Age--that time after retirement when financial stability and reduced obligations to others, together, allow for freedom--and good health makes it possible to enjoy that freedom. How, in this special time of life, is meaning and purpose to be found? And what alternatives are available? These difficult questions are responded to by scholars in the field of aging, some themselves in the Third Age.

Why, despite well-established and well-publicized intergovernmental processes that date back to the early 1970s, have we been unable to put in place effective mechanisms to combat climate change? Why, despite the existence of extensive global human rights machinery, do we live in a world where mass kidnapping, rape, torture, and murder continue to blight the lives of so many? Why, despite a great deal of effort on the part of intergovernmental organizations and nonstate actors, have we been unable to make (...) much of a difference to the lives of the ultra-poor and attenuate the very worst aspects of growing global inequalities? Most fundamentally, why have the current international system and the outcomes that it has produced remained so inadequate in the postwar period? (shrink)

Response to the first number of The Owl has been encouraging. The editor wishes to thank the many individuals who have written asking to be placed or maintained on the mailing list, and also those who have responded to the request for correspondence pertaining to Hegel scholarship. It is hoped that this interest will further manifest itself in continued applications for membership in the Hegel Society of America, in order that the Society, through The Owl and its other functions, may (...) better serve students and scholars of Hegel in America. * * * We are indebted to Professor Robert Perkins of the University of South Alabama, and to Professor Don Verene of Northern Illinois University for their assistance in publishing the first two numbers of The Owl. Although henceforward this operation will be handled entirely by the Department of Philosophy of The Florida State University, HSA membership applications should continue to be directed to the Treasurer, c/o the Department of Philosophy, Northern Illinois University, Dekalb, Illinois 60115. * * * More than 2700 copies of The Owl are mailed quarterly to individuals and departments of philosophy in the United States, Canada and Europe. THE EDITOR ASKS DEPARTMENTAL CHAIRMEN EITHER TO POST THE THE OWL OR CALL IT TO THE ATTENTION OF APPROPRIATE FACULTY AND STUDENTS IN THE DEPARTMENT. As noted in out initial issue, the mailing list will gradually be restricted to those who either belong to the Society, or have indicated by a note to the editor their interest in continued receipt of the newsletter. This procedure is necessary due to the increased cost of future issues which we expect to have professionally printed and enlarged in scope. (shrink)

This text examines the philosophy of Paul Weiss. Much of Dr Weiss's impact has come through his example, discussions, and such activities as founding and editing the Review of Metaphysics and founding and leading the Metaphysical Society of America.

Emmanuel Lévinas es de los primeros críticos de un totalitarismo de la razón y de un centralismo del sujeto. Esto no significa que descarte la razón y se abandone a un irracionalismo; tampoco significa que el sujeto sea sentenciado a muerte; se trata más bien de un cambio de coordenadas del pensamiento tradicional, el cual es cuestionado por el otro, asunto fundamental en el presente artículo y en todo el pensamiento de Lévinas.