Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. -/- Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. -/- The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations.
As a 2006 Institute of Medicine report highlights, surprisingly little empirical attention has been paid to how prisoners arrive at decisions to participate in modern research. With our study, we aimed to fill this gap by identifying a more comprehensive range of factors as reported by prisoners themselves during semistructured interviews. Our participants described a diverse range of motives, both favoring and opposing their eventual decision to join. Many are well-recognized considerations among nonincarcerated clinical research participants, including a desire for (...) various forms of personal benefit, altruism, and concern about study risks and inconveniences. However, a number of influences seem unique to prisoners. Participants did not report that they were not coerced into enrolling, and they have even been under pressure not to enroll. However, many sought to enroll in order to obtain access to better health care, raising a concern about whether they were unfairly exploited. (shrink)
We investigate the Sp(2, R) model for light and heavy nuclei and compare it to recent applications of the Sp(6, R) model. The same Hamiltonian is used and the basis states will have good angular momentum. We not only confirm that the restricted space of the Sp(6, R) model gives the dominant contribution but also that there is no practical difference from the Sp(6, R) model calculations. The Sp(2, R) model is then applied to the chain of Ba-isotopes which show, (...) according to a recent application of the geometrical model, a dominant prolate behavior with an important γ-unstable component. They represent limiting cases where the Sp(2, R) model can be put to an extreme test. (shrink)
This book taps the best American thinkers to answer the essential American question: How do we sustain our experiment in government of, by, and for the people? Authored by an extraordinary and politically diverse roster of public officials, scholars, and educators, these chapters describe our nation's civic education problem, assess its causes, offer an agenda for reform, and explain the high stakes at risk if we fail.
What makes Christopher P. Long’s study of Aristotle’s ontology especially rewarding is that it is philosophically motivated. The goal is not simply to “get right what Aristotle said,” but rather to think in dialogue with Aristotle, which implies a willingness to think beyond and even against him. Long makes the general philosophical motivation of his book perfectly clear: it is the desire to find “a way between the totalizing tendencies of modernism and the anarchy of postmodernism”. This is an (...) ethical motivation, since for Long justice requires both a recognition of the fundamental autarchy of each being and a recognition of principles. But why turn back to an ancient Greek philosopher in this contemporary debate? The reason is that Long sees Aristotle as pointing “to a form of knowledge that is neither totalizing nor anarchic”. This third way of knowing is described by Long as a matter of conceptualizing the individual in such a way as to acknowledge its singularity and not reduce it to the mere instantiation of a concept. It is to see the individual neither as an inexplicable singularity nor as only the particular instantiation of a universal. Long finds this neither/nor in Aristotle’s concept of the τόδε τι, which he at one point aptly describes as “the very conceptualization of that which always escapes the concept” : “The term τόδε τι designates this individual emerging out of its isolated singularity, prior to its being reduced to particularity, the mere instantiation of a dominating concept”. Thus we get the following account of what a non-totalizing and non-anarchic form of knowledge would be like and therefore of what Long seeks to find in Aristotle. (shrink)