Background and objectives: Definitions of medical futility, offered by healthcare professionals, bioethicists and other experts, have been rigorously debated by many investigators, but the perceptions of patients of futility have been explored only by a few. Patients were allowed to discuss their concerns about end-of-life care, so that their ideas about treatment futility or utility could be extrapolated by us.Methods: In this cross-sectional study, in-depth, semistructured interviews were conducted with 30 elderly people who were receiving outpatient care in a large, (...) urban Veterans Affairs medical centre in the US. Each of their healthcare providers was also interviewed. Participants were asked to consider four terms commonly used in advance directive forms and to discuss what these terms meant to them. Audiotapes of the open-ended interviews were transcribed and responses were coded and categorised by constant comparison, a commonly used qualitative method.Results: The following four factors were taken into account by the participants when discussing end-of-life interventions and outcomes: expected quality of life; emotional and financial costs of treatment; likelihood of treatment success; and expected effect on longevity.Conclusions: Although the terms “utility” or “futility” were not generally used by the participants, segments of speech indicating their perceptions of these terms were identified. Treatment was not always discussed in the same way by patients and providers, but seemed to reflect the same four concerns. Therefore, it may be fruitful for providers to focus on these concerns when discussing end-of-life treatment options with their patients. (shrink)

Apoptosis is now widely recognized as a common form of cell death and represents a mechanism of cell clearance in many physiological situations where deletion of cells is required. Peptide growth factors, initially characterised as stimulators of cell proliferation, have now been shown to inhibit death in many cell types. Deprivation of growth factors leads to the induction of apoptosis, i.e. condensation of chromatin and degradation in oligonucleosomesized fragments, formation of plasma and nuclear membrane blebs and cell fragmentation into apoptotic (...) bodies which can be taken up by neighbouring cells. Here we discuss the mechanism(;s) by which growth factors may inhibit apoptosis. (shrink)

Synaesthesia is a condition in which one type of stimulation evokes the sensation of another, as when the hearing of a sound produces photisms, i.e. mental percepts of colours. R is a 20 year old colour blind subject who, in addition to the relatively common grapheme-colour synaesthesia, presents a rarely reported cross modal perception in which a variety of visual stimuli elicit aura-like percepts of colour. In R, photisms seem to be closely related to the affective valence of stimuli and (...) typically bring out a consistent pattern of emotional responses. The present case study suggests that colours might be an intrinsic category of the human brain. We developed an empirical methodology that allowed us to study the subject's otherwise inaccessible phenomenological experience. First, we found that R shows a Stroop effect (delayed response due to interference) elicited by photisms despite the fact that he does not show a regular Stroop with real colours. Secondly, by manipulating the colour context we confirmed that colours can alter R's emotional evaluation of the stimuli. Furthermore, we demonstrated that R's auras may actually lead to a partially inverted emotional spectrum where certain stimuli bring out emotional reactions opposite to the normal ones. These findings can only be accounted for by considering R's subjective colour experience or qualia. Therefore the present paper defends the view that qualia are a useful scientific concept that can be approached and studied by experimental methods. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

ABSTRACT BACKGROUND: The objective of this study was to identify factors motivating women to take part in endometriosis research and to determine if these factors differ for women participating in clinical versus basic science studies. METHODS: A consecutive series of 24 women volunteering for participation in endometriosis‐related research were asked to indicate, in their own words, why they chose to volunteer. In addition, the women were asked to rate, on a scale of 0 to 10, sixteen potentially motivating factors. The (...) information was gathered in the form of an anonymous self‐administered questionnaire. RESULTS: Strong motivating factors (mean score >8) included potential benefit to other women's health, improvement to one's own condition, and participation in scientific advancement. Weak motivating factors (mean score <3) included financial compensation, making one's doctor happy, and use of ‘natural’ products. No difference was detected between clinical and basic science study participants. CONCLUSION: This study is the first study to specifically investigate the factors that motivate women to take part in endometriosis research. Understanding why women choose to take part in such research is important to the integrity of the informed consent process. The factors most strongly motivating women to participate in endometriosis research related to improving personal or public health; the weakest, to financial compensation and pleasing the doctor. (shrink)

We examine ethical considerations in access to facial transplantation (FT), with implications for promoting health equity. As a form of vascularised composite allotransplantation, FT is still considered innovative with a relatively low volume of procedures performed to date by a small number of active FT programmes worldwide. However, as numbers continue to increase and institutions look to establish new FT programmes, we anticipate that attention will shift from feasibility towards ensuring the benefits of FT are equitably available to those in (...) need. This manuscript assesses barriers to care and their ethical implications across a number of considerations, with the intent of mapping various factors relating to health equity and fair access to FT. Evidence is drawn from an evolving clinical experience as well as published scholarship addressing several dimensions of access to FT. We also explore novel concerns that have yet to be mentioned in the literature. (shrink)

A total of 1918 loci, detected by the hybridization of 938 expressed sequence tag unigenes from 26 Triticeae cDNA libraries, were mapped to wheat homoeologous group 4 chromosomes using a set of deletion, ditelosomic, and nulli-tetrasomic lines. The 1918 EST loci were not distributed uniformly among the three group 4 chromosomes; 41, 28, and 31% mapped to chromosomes 4A, 4B, and 4D, respectively. This pattern is in contrast to the cumulative results of EST mapping in all homoeologous groups, as reported (...) elsewhere, that found the highest proportion of loci mapped to the B genome. Sixty-five percent of these 1918 loci mapped to the long arms of homoeologous group 4 chromosomes, while 35% mapped to the short arms. The distal regions of chromosome arms showed higher numbers of loci than the proximal regions, with the exception of 4DL. This study confirmed the complex structure of chromosome 4A that contains two reciprocal translocations and two inversions, previously identified. An additional inversion in the centromeric region of 4A was revealed. A consensus map for homoeologous group 4 was developed from 119 ESTs unique to group 4. Forty-nine percent of these ESTs were found to be homoologous to sequences on rice chromosome 3, 12% had matches with sequences on other rice chromosomes, and 39% had no matches with rice sequences at all. Limited homology was found between wheat ESTs on homoeologous group 4 and the Arabidopsis genome. Forty-two percent of the homoeologous group 4 ESTs could be classified into functional categories on the basis of blastX searches against all protein databases. (shrink)

Introduction: Schools have become a primary setting for providing mental health care to youths in the U.S. School-based interventions have proliferated, but their effects on mental health and academic outcomes remain understudied. In this study we will implement and evaluate the effects of a flexible multidiagnostic treatment called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems on students' mental health and academic outcomes.Methods and Analysis: This is an assessor-blind randomized controlled effectiveness trial conducted across five (...) school districts. School clinicians are randomized to either MATCH or usual care treatment conditions. The target sample includes 168 youths referred for mental health services and presenting with elevated symptoms of anxiety, depression, trauma, and/or conduct problems. Clinicians randomly assigned to MATCH or UC treat the youths who are assigned to them through normal school referral procedures. The project will evaluate the effectiveness of MATCH compared to UC on youths' mental health and school related outcomes and assess whether changes in school outcomes are mediated by changes in youth mental health.Ethics and Dissemination: This study was approved by the Harvard University Institutional Review Board. We plan to publish the findings in peer-reviewed journals and present them at academic conferences.Clinical Trial Registration:ClinicalTrials.gov ID: NCT02877875. Registered on August 24, 2016. (shrink)

Previous research suggests that free will beliefs and moral responsibility beliefs are strongly linked, yet ultimately distinct. Unfortunately, the most common measure of free will beliefs, the free will subscale (FWS) of the Free Will and Determinism Plus, seems to confound free will beliefs and moral responsibility beliefs. Thus, the present research (1,700 participants across two studies) details the development of a 2-factor FWS – the FWS-II – that divides the FWS into a free will subscale and a moral responsibility (...) subscale. The FWS-II showed good fit compared to standard fit thresholds and superior fit compared to the original FWS. The moral responsibility subscale was moderately correlated with general punitive attitudes and specific punitive assignments, even when controlling for the free will subscale. Conversely, the free will subscale was moderately correlated with conservativism and religiosity, even when controlling for the moral responsibility subscale. These results provide evidence that the FWS is better suited – psychometrically, theoretically, and practically – as a 2-factor measure of free will beliefs and moral responsibility beliefs than as a 1-factor measure of free will beliefs. (shrink)

Synaesthesia is a condition in which one type of stimulation evokes the sensation of another, as when the hearing of a sound produces photisms, i.e. mental percepts of colours. R is a 20 year old colour blind subject who, in addition to the relatively common grapheme-colour synaesthesia, presents a rarely reported cross modal perception in which a variety of visual stimuli elicit aura-like percepts of colour. In R, photisms seem to be closely related to the affective valence of stimuli and (...) typically bring out a consistent pattern of emotional responses. The present case study suggests that colours might be an intrinsic category of the human brain. We developed an empirical methodology that allowed us to study the subject's otherwise inaccessible phenomenological experience. First, we found that R shows a Stroop effect elicited by photisms despite the fact that he does not show a regular Stroop with real colours. Secondly, by manipulating the colour context we confirmed that colours can alter R's emotional evaluation of the stimuli. Furthermore, we demonstrated that R's auras may actually lead to a partially inverted emotional spectrum where certain stimuli bring out emotional reactions opposite to the normal ones. These findings can only be accounted for by considering R's subjective colour experience or qualia. Therefore the present paper defends the view that qualia are a useful scientific concept that can be approached and studied by experimental methods. (shrink)

Este trabajo surge a partir de la investigación general de las técnicas hidropónicas teniendo en cuenta sus ventajas y desventajas para de esta forma poder encontrar aquel factor determinante a través de una comparación de técnicas hidropónicas que permitan clasificarlas y escoger la mejor opción que genere menos impacto ambiental negativo y demuestre ser más productivo en los entornos urbanos. Adicionalmente, un factor determinante en las ciudades es su espacio limitado por lo que la mejor opción también deberá incluir un (...) óptimo manejo del espacio que permita a casi cualquier individuo poder aplicarlos desde su entorno sin recurrir a excesivas modificaciones. Como principal resultado se escogió a la Hidroponía recirculante como método predominante por los excelentes resultados que se obtienen con relación a los demás, adicionalmente, este puede ser fácilmente aplicado en los ambientes urbanos por su versatilidad y buen manejo de recursos. Palabras Clave: Hidroponia, ambiente, urbano, comparativa, técnicas, cultivo. Referencias [1]J. López, «La producción hidropónica de cultivos,» IDESIA, vol. 36, nº 2, pp. 139-141, 2018. [2]J. Lee, A. Rahman, J. Behrens, C. Brennan, B. Ham, H. Seok Kim, C. Won, S. Yun, H. Azam y M. Kwon, «Nutrient removal from hydroponic wastewater by a microbial consortium,» New Biotechnology, vol. 41, pp. 15-24, 2018. [3]H. Ku, C. Tiong, A. Suresh y B. Ong, «“Active” hydroponic greenhouse system to kick-start and augment reforestation program through carbon sequestration e an experimental and theoretical feasibility study,» Journal of Cleaner Production, vol. 129, pp. 637-646, 2016. [4]J. Beltrano y D. Gimenez, Cultivo en hidroponía, Buenos Aires: Universidad de la Plata, 2015. [5]L. Ramírez, M. Pérez, P. Jiménez, H. Giraldo y E. Gómez, «Evaluación preliminar de sistemas acuapónicos e hidropónicos en cama flotante para el cultivo de orégano,» Revista Facultad de Ciencias Básicas, vol. 7, nº 2, pp. 242-259, 2011. [6]S. Hosseinzadeh, D. Testai, M. BKheet y J. De Graeve, «Degradation of root exudates in closed hydroponic systems using UV/H2O2: Kinetic investigation, reaction pathways and cost analysis,» Science of the Total Environment, vol. 1, pp. 1-9, 2019. [7]N. Camarena, A. Rojas y M. Santos, «Fluoride bioaccumulation by hydroponic cultures of camellia,» Chemosphere, vol. 136, pp. 56-62, 2015. [8]W. Wang, Y. Ma, L. Fu, Y. Cui y M. Yaqoob, «Physical an mechanical properties of hydroponic lettuce for automatic harvesting,» Informatión processing in agriculture, vol. 1, pp. 2214-3173, 2020. [9]M. Zárate, Manual de Hidroponia, Coyoacán: Universidad Autónoma de Mexico, 2014. [10]S. Magwaza, L. Magwaza, A. Odindo y C. Buckley, «Partially treated domestic wastewater as a nutrient source for tomatoes grown in a hydroponic system: effect on nutrientabsorption and yield,» Heliyon, vol. 6, nº 12, pp. 2405-8440, 2020. [11]C. ARANO, «Hidroponía: Algunas paginas de historia,» Tecnología de Producción, nº 58, pp. 24-32, 2007. [12]G. Guzmán, Hidroponia en Casa: Una actividad familiar, Costa Rica: Ministerio de Agricultura y ganaderia, 2004. [13]J. Gilsanz, HIDROPONIA, Montevideo : Unidad de Comunicación y Transferencia de Tecnología, 2007. [14]C. Miller, «El debate de hidroponia orgánica: Perspectivas norteamericanas sobre si la producción hidropónica merece ser certificada como orgánica.,» Productores de Hortalizas, nº 6, pp. 36-38, 2017. [15]A. Herrera, «Manejo de la solución nutritiva en la producción de tomate en hidroponía,» Terra Latinoamericana, vol. 17, nº 3, pp. 221-229, 1999. [16]C. Espinal y D. Matulić, «Recirculating Aquaculture Technologies,» Biomedical and Life Sciences, pp. 35-76, 2020. [17]H. Resh, «Técnicas de cultivo con flujo laminar de nutrientes,» de Cultivos Hidroponicos, España, Mundi-Prensa, 2001, pp. 35-37. [18]P. Blanca y L. Teresa, «Sistemas recirculantes y su interés en el cutlivo de ornamentales,» Tecnología de producción, nº 35, pp. 34-36, 2006. [19]C. Magán, «Recirculación de las soluciones nutritivas, Manejo y Control Microbiologico,» InfoAgro, nº 2, pp. 1-2, 2016. [20]S. Goddek, A. Joyce, B. Kotzen y M. Dos-Santos, «Aquaponics and Global Food Challenges,» Aquaponics Food Production Systems. Springer, vol. 1, nº 1, pp. 3-17, 2019. [21]S. G. Verdoliva, D. Gwyn Jones, A. Detheridge y P. Robson, «Controlled comparisons between soil and hydroponic systems reveal increased water use efficiency and higher lycopene and β-carotene contents in hydroponically grown tomatoes,» Scientia Horticulturae, pp. 3002-4238, 2020. [22]A. Chaudhry y V. Mishra, «A Comparative Analysis of Vertical Agriculture Systems in Residential Apartments, » de 2019 Advances in Science and Engineering Technology International Conferences, Dubai, United Arab Emirates, United Arab Emirates, 2019. [23]T. Mazhar, G. Jianmin, L. Imran, S. Kashif, Q. Waqar, S. Sher y C. Jiedong, «Modern plant cultivation technologies in agriculture under controlled nvironment: a review on aeroponics,» Journal of Plant Interactions, vol. 13, nº 1, pp. 338-352, 2012. [24]K. Janiak, A. Jurga, J. Kuźma, W. Breś y M. Muszyński, «Surfactants effect on aeroponics and important mass balances of regenerative life support system – Lettuce case study,» Science of the Total Environment, vol. 718, nº137324, pp. 1-12, 2020. [25]F. Rahman, I. Jahan, R. Biplob, N. Farhin y J. Uddin, «Automated Aeroponics System for Indoor Farming using Arduino,» de 2018 Joint 7th International Conference on Informatics, Electronics & Vision and 2018 2nd International Conference on Imaging, Vision & Pattern Recognition, Kitakyushu, Japan, 2018. [26]M. Caldeyro Stajano, «La Hidroponía Simplificada como Tecnología apropiada, para implementar la Seguridad Alimentaria en la Agricultura Urbana.,» Cuadernos del CEAgro, nº 8, pp. 71-76, 2006. (shrink)

This article explores the enduring mysteries of consciousness and the afterlife, two enigmatic topics that have fascinated humanity for ages. Despite extensive scientific efforts, the existence of an afterlife remains unproven, and understanding consciousness remains a significant challenge. The research introduces innovative hypotheses through simple thought experiments with empirical evidence and robust theoretical foundations. It delves into the complexities of consciousness, its relationship with the brain, and the need for interdisciplinary approaches encompassing physics, psychology, and philosophy. Boldly contemplating the probability (...) of a continuous consciousness after death, the study argues that existing evidence strongly supports this idea. Beyond theoretical implications, it envisions practical outcomes, suggesting that insights into these mysteries could enhance human well-being and contribute to a more harmonious world. In summary, this article embarks on a quest to shed light on age-old questions about consciousness and the afterlife. Through fresh methodologies, it aims to provide new perspectives that could reshape our understanding of existence and inspire intellectuals to positive individual and societal advancements. -/- . (shrink)

There are a number of problematic features within the current treatment of time in physical theories, including the “timelessness” of the Universe as encapsulated by the Wheeler–DeWitt equation. This paper considers one particular investigation into resolving this issue; a conditional probability interpretation that was first proposed by Page and Wooters. Those authors addressed the apparent timelessness by subdividing a faux Universe into two entangled parts, “the clock” and “the remainder of the Universe”, and then synchronizing the effective dynamics of the (...) two subsystems by way of conditional probabilities. The current treatment focuses on the possibility of using a realistic clock system; namely, a coherent-state description of a damped harmonic oscillator. This clock proves to be consistent with the conditional probability interpretation; in particular, a standard evolution operator is identified with the position of the clock playing the role of time for the rest of the Universe. Restrictions on the damping factor are determined and, perhaps contrary to expectations, the optimal choice of clock is not necessarily one of minimal damping. (shrink)

Here, I discuss how natural biological evolution might have selected human origin and the psychology of the better mind-brain. However, all humans are closely related; why do we make crimes, war, hate, and jealousy their primary reasons and overcoming methodologies? How can they gain their best happiness? What kind of philosophy apply to annalize this big question and convince humankind to evolve their mind? How we could achieve our optimum potential happiness by developing hidden intelligence to make the world a (...) happier place to live in. (shrink)

Social media applications such as Twitter, YouTube and Facebook have attained huge popularity, with more than three billion people and organizations predicted to have a social networking account by 2015. Social media offers a rapid avenue of communication with the public and has potential benefits for communicable disease control and surveillance. However, its application in everyday public health practice raises a number of important issues around confidentiality and autonomy. We report here a case from local level health protection where the (...) friend of an individual with meningococcal septicaemia used a social networking site to notify potential contacts. (shrink)

This article explores egg freezing experiences of women in Turkey. Since 2014, it has been legal in Turkey to use egg freezing technology for ageing women, while it was previously allowed only for disease-related purposes. In cooperation with a private fertility clinic in Istanbul, the authors conducted 21 interviews with older, single women who held either professional or managerial positions and who were undergoing or had undergone the procedure. Drawing on a qualitative analysis of these interviews, the authors explore the (...) social context in which women postpone motherhood and decide to freeze their eggs. The study also looks at the women’s emotional responses to ageing that were triggered by the experience of egg freezing and their narratives of empowerment as a result of the procedure. (shrink)

Objective To ascertain and improve the understanding and use of chaperones among the patients of an English general practice (GP). Background Doctors have long been advised to have a third party present during intimate physical examinations. Little is known about the understanding of the term in the general population in England and the consequences of this for the promotion and use of chaperones in GP. We audited the understanding and use of chaperones in an English GP. The aim of the (...) study was to increase the awareness of the availability of chaperones in our population. Methods A questionnaire was given randomly to 100 patients attending the GP surgery. Participants were asked about their awareness of and frequency of requesting a chaperone while undergoing intimate examinations. Based on the initial results, a poster was designed for the waiting room to increase awareness. Data were collected with the same questionnaire to see if the new poster altered surgery attendees understanding and likely subsequent use of chaperones. Results In the initial audit, 29% of patients were unaware of the term chaperone, and only one person (1%) had ever requested a chaperone. After the introduction of a specially designed poster, the results showed an improvement in awareness from 71% to 89%, and the likely frequency of using a chaperone increased from 1% to 4%. Conclusion There is a need to improve the understanding of the general population about chaperones if we are to see greater use of chaperones in GP. (shrink)

In spite of a continuing long and rich history of caring for patients, many nurses have not been satisfied with their work. One cause among others for this dissatisfaction is that nurses often do not care for one another. The philosophy of a Buddhist Sangha, or community, is similar to the philosophy of western communitarian ethics. Both philosophies emphasize the importance of people working together harmoniously towards a common good. In this article, unsatisfactory nurse-nurse relationships have been considered and a (...) model for communitarian nursing practice has been suggested based on a Buddhist Sangha. (shrink)

Spinoza has been appropriated as a philosophical forefather of deep ecology. I identify what I take to be the relevant components of Spinoza ’s metaphysics, which, at face value, appear to be harmonious with deep ecology’s commitments. However, there are central aspects of his moral philosophy which do not appear to be “environmentally friendly,” in particular the sentiments expressed in the Ethics IV35C1 and IV37S1. I describe environmental ethics’ treatment of these passages and then indicate what I take to be (...) a more satisfactory route toward “ecologizing Spinoza.”. (shrink)

Background Professional autonomy, which directly affects the quality of professional nursing in patient care, and cognitive flexibility, which is an important factor for adaptation to change and developing nursing roles, are important concepts for nursing. Research objectives This research was carried out to determine the effect of cognitive flexibility on attitudes towards professional autonomy in nurses. Research design This was a descriptive study. Participants and research context The research was conducted with 415 nurses working in a city hospital of a (...) province, meeting the inclusion criteria and agreeing to participate in the study. A questionnaire form, The Cognitive Flexibility Inventory (CFI), and the Attitude Toward Professional Autonomy Scale for Nurses (APASN) were used to collect data. Ethical considerations Ethical approval was obtained from the university ethics committee before starting the study. Institutional permission was obtained from the city hospital where the study was conducted. Electronic informed consent was obtained from the nurses included in the study. Findings In the study, the mean CFI score was 80.62 ± 11.55 and the mean APASN score was 70.42 ± 18.79. There was a weak positive correlation (r = 0.270; p < 0.05) between CFI and APASN scores. Moreover, the effect of the CFI mean score on the APASN mean score was found to be statistically significant (β = 0.278; p < 0.001). Furthermore, CFI explains 7.7% of APASN. Conclusion In the study, nurses’ attitudes towards professional autonomy and cognitive flexibility scores were found to be at a good level. Cognitive flexibility has a positive effect on attitudes towards professional autonomy. Interventional studies that will increase the level of cognitive flexibility are recommended in the development of nurses' attitudes towards professional autonomy. (shrink)