In a qualitative study, 22 stroke patients undergoing rehabilitation in three nursing homes were interviewed about constraints on and improvements in their autonomy and about approaches of health professionals regarding autonomy. The data were analysed using grounded theory, with a particular focus on the process of regaining autonomy. An approach by the health professionals that was responsive to changes in the patients’ autonomy was found to be helpful for restoration of their autonomy. Two patterns in health professionals’ approach appeared to (...) be facilitatory: (1) from full support on admission through moderate support and supervision, to reduced supervision at discharge; and (2) from paternalism on admission through partial paternalism (regarding treatment) to shared decision making at discharge. The approach experienced by the patients did not always match their desires regarding their autonomy. Support and supervision were reduced over time, but paternalism was often continued too long. Additionally, the patients experienced a lack of information. Tailoring interventions to patients’ progress in autonomy would stimulate their active participation in rehabilitation and in decision making, and would improve patients’ preparation for autonomous living after discharge. (shrink)

In describing the flawless regularity of developmental processes and the correlation between changes at certain genetic loci and changes in morphology, biologists frequently employ two metaphors: that genes ‘control’ development, and that genomes embody ‘programs’ for development. Although these metaphors have an admirable sharpness and punch, they lead, when taken literally, to highly distorted pictures of developmental processes. A more balanced, and useful, view of the role of genes in development is that they act as suppliers of the material needs (...) of development and, in some instances, as context‐dependent catalysts of cellular changes, rather than as ‘controllers’ of developmental progress and direction. The consequences of adopting this alternative view of development are discussed. (shrink)

Despite strong growth in scientific investigation of the placebo effect, understanding of this phenomenon remains deeply confused. We investigate critically seven common conceptual distinctions that impede clear understanding of the placebo effect: (1) verum/placebo, (2) active/inactive, (3) signal/noise, (4) specific/nonspecific, (5) objective/subjective, (6) disease/illness, and (7) intervention/context. We argue that some of these should be eliminated entirely, whereas others must be used with caution to avoid bias. Clearing away the conceptual underbrush is needed to lay down a path to understanding (...) and harnessing placebo effects in clinical medicine. (shrink)

The foundations of a theory of nonminimal coupling of matter and the gravitational field in the framework of Riemannian (or Riemann-Cartan) geometry are presented. In the absence of matter, the Einstein vacuum field equations hold. In order to allow for a Newtonian limit, the theory contains a new parameter l0 of dimension length. For systems with finite total mass, l0 is set equal to the Schwarzschild radius.

This book is intended for the use of the candid student, devised as a monitory preparation for deeper study of the philosophy of Spinoza. By its means it is hoped that the student may avoid the chief pitfalls of Spinoza-interpretation, and be carried past many of the difficulties encountered by the modern mind in the study of his writings. To this end perhaps the greatest hindrance to be met by the beginner is the ‘popular' exposition that attempts to expound the (...) thought of one age in terms of the favoured categories of another. By providing the necessary safeguards against misinterpretations arising from such causes, the author has sought to awaken interest in the closely knit fabric of Spinoza's doctrine of man and nature and God, and its practical import - and thus to revivify a specimen too long deprived of its native air. (shrink)

The literature on corporate responsibility contains a wide range of arguments for business sector involvement in matters of social and political community. Some writers argue for extensive involvement, while others draw relatively narrow boundaries around the appropriate sphere of a company's nonbusiness activity. One way to classify and clarify these various views is to examine each in light of the notion of business-society relationship which underlies it. Four ways of understanding the business-society relationship are articulated here, together with the arguments (...) for corporate responsibility that emerge from them. (shrink)

This book is intended for the use of the candid student, devised as a monitory preparation for deeper study of the philosophy of Spinoza. By its means it is hoped that the student may avoid the chief pitfalls of Spinoza-interpretation, and be carried past many of the difficulties encountered by the modern mind in the study of his writings. To this end perhaps the greatest hindrance to be met by the beginner is the 'popular' exposition that attempts to expound the (...) thought of one age in terms of the favoured categories of another. By providing the necessary safeguards against misinterpretations arising from such causes, the author has sought to awaken interest in the closely knit fabric of Spinoza's doctrine of man and nature and God, and its practical import - and thus to revivify a specimen too long deprived of its native air. (shrink)

A trait is robust to a genetic or environmental variable if its variation is weakly correlated with variation in that variable. The source of robustness lies in the fact that the developmental processes that give rise to complex traits are nonlinear. A consequence of this nonlinearity is that not all genes are equally correlated with the trait whose ontogeny they control. Here we explore how developmental mechanisms determine and alter the correlation structure between genes and the traits that they control. (...) A formula is developed by which the correlation of a gene or environmental variable with a trait can be calculated if the mechanism that gives rise to the trait is known. The nature of robustness and the ways in which robustness can evolve are discussed in the context of the problems that arise in the analysis of inherently nonlinear systems. BioEssays 24:553–563, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

Protection of study participants is an integral function of the Institutional Review Board. Recently, great efforts were dedicated to enhance investigators’ awareness of ethical principles in conducting human research and to implement reviewing committees’ standards in Jordan to ensure the transparency, versatility, and responsibility in handling human subjects research in the country. The aim of the current study is to evaluate the awareness and attitudes of healthcare investigators in Jordan towards the structure and importance of IRBs. A questionnaire was distributed (...) to 200 investigators and graduate students from the Jordan University of Science and Technology. The majority of the responses indicated positive knowledge towards core ethics guidelines and the importance of IRBs. This includes beneficence, confidentiality, informed consent, and treating participants with respect. In addition, the majority of participants agreed on the importance of the IRB for ensuring the rights, safety, and well-being of the research subjects. Moreover, the majority of participants agreed that the IRB members should be trained on ethics regulations in conducting research and declare any conflict of interest with the investigators. On the other hand, about 30% of participants believed that being reviewed by the IRB would delay research and make it more difficult for the researcher. Jordanian investigators have good awareness of and knowledge about research ethics and the importance of IRBs, though more education is needed. (shrink)

In this book, William H. F. Altman argues that it is not order of composition but reading order that makes Euthyphro, Apology of Socrates, Crito, and Phaedo “late dialogues,” and shows why Plato’s decision to interpolate the notoriously “late” Sophist and Statesman between Euthyphro and Apology deserves more respect from interpreters.

Mark, G. La crisis de la física clásica por obra del experimento.--Thirring, J. La transformación del sistema conceptual de la física.--Hahn, J. La crisis de la intuición.--Nöbeling, J. La cuarta dimensión y el espacio curvo.--Menger, C. La nueva lógica.