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.
Increasingly, ethical concerns are being raised regarding bioenergy production. However, the ethical issues often do not stand out very clearly. The aim of the present paper is to improve on this situation by analyzing the bioenergy discussion from the perspective of land use. From this perspective, bioenergy production may give rise to ethical problems because it competes with other forms of land use. This may generate ethical problems mainly for two reasons. First, bioenergy production may compete, directly or indirectly, with (...) food production; and as consequence the food security of poor people may be adversely affected (social aspects arguments). Secondly, the production of bioenergy may directly or indirectly lead to deforestation and other changes of land use that have a negative effect on greenhouse gas emissions (environmental arguments). So from this perspective the main challenge raised by bioenergy production is to secure responsible land use. The purpose of the paper is not to advocate, or promote, a specific ethical position on bioenergy, but to structure the main arguments found. The paper falls in two parts. One part addresses social aspects arguments for using agricultural land for bioenergy—where food insecurity, malnourishment, and significant food poverty are the main concerns. The second part scopes environmental implications—notably greenhouse gas emissions impact, as affected by deforestation and other (indirect) land-use changes. Alongside showing some of the current dilemmas presented by wider land-use changes, arguments are analyzed from two ethical angels: a consequentialist and a deontological. (shrink)
OBJECTIVES: To study the ethical reasoning of nurses and physicians, and to assess whether or not modified focus groups are a valuable tool for this purpose. DESIGN: Discussion of cases in modified focus groups, each consisting of three physicians and three nurses. The discussion was taped and analysed by content analysis. SETTING: Five departments of internal medicine at Danish hospitals. SAMPLE: Seven discussion groups. MAIN MEASUREMENTS: Ethical content of statements, style of statements, time used by each participant. RESULTS: Danish physicians (...) and nurses do not differ in the kind of ethical reasoning they use, but physicians use more of the discussion time than nurses, they use a more assertive style of argumentation, and the solutions chosen are usually first put forward by physicians. CONCLUSION: The results and informal comparisons with similar data from long qualitative interviews indicate that groups of this kind are a useful tool for gathering data on ethical reasoning. (shrink)
Tradicionalmente, “racionalidade” é o exercício da faculdade superior de conhecimento e ação, “razão”, e a propriedade dos produtos resultantes desse exercício, “razões”. Buscar o significado da “racionalidade” pressupõe perscrutá-la “em ação” – não há como “sair fora” do racional para encontrá-la. O valor de face que apresenta é o lado “direito” de sua tessitura. Mas a condição (auto)reguladora da racionalidade demanda que se lhe busque também o “avesso”, lado nem sempre visível das costuras que dão a feitura do “direito”. Em (...) face da contextualidade da racionalidade “em ação”, cabe examinar essa distinção através de dois “casos exemplares”: a visão aristotélica de racionalidade e a argumentação de Charles Darwin na Origem das espécies. De um lado, encontramos uma outra vertente da Retórica aristotélica, mostrando a interpenetração de demonstrar e persuadir no “avesso” da racionalidade; de outro, encontramos no “avesso” da argumentação científica darwiniana a essencialidade de procedimentos ditos “retóricos”. Cruzam-se as fronteiras. Palavras-chave: Racionalidade, argumentação, retórica, ciência, Aristóteles, Charles Darwin. (shrink)
Apresentamos os conceitos de inércia, espaço e tempo na mecânica newtoniana. Analisamos o princípio de Mach, segundo o qual a inércia de qualquer corpo é devida a sua interação com os corpos distantes do universo. Em seguida explicamos porque, em geral, a teoria da gravitação de Einstein não implementa este princípio. Discutimos então o trabalho de Erwin Schrödinger que apresenta uma formulação alternativa para a mecânica baseada numa lei de Weber para a gravitação e que é compatível com as idéias (...) de Mach. (shrink)
New trends in the economic systems management in the context of modern global challenges: collective monograph / scientific edited by M. Bezpartochnyi, in 2 Vol. // VUZF University of Finance, Business and Entrepreneurship. – Sofia: VUZF Publishing House “St. Grigorii Bogoslov”, 2020. – Vol. 1. – 309 p.
BackgroundThe preferable position of Deep Brain Stimulation electrodes is proposed to be located in the dorsolateral subthalamic nucleus to improve general motor performance. The optimal DBS electrode localization for the post-operative improvement of balance and gait is unknown.MethodsIn this single-center, retrospective analyses, 66 Parkinson’s disease patients were assessed pre- and post-operatively by using MDS-UPDRS, freezing of gait score, Giladi’s gait and falls questionnaire and Berg balance scale. The clinical outcome was related to the DBS electrode coordinates in x, y, z (...) plane as revealed by image-based reconstruction. Binomial generalized linear mixed models with fixed-effect variables electrode asymmetry, parkinsonian subtype, medication, age class and clinical DBS induced changes were analyzed.ResultsSubthalamic nucleus-deep brain stimulation improved all motor, balance and FoG scores in MED OFF condition, however there were heterogeneous results in MED ON condition. DBS electrode reconstructed coordinates impacted the responsiveness of axial symptoms. FoG and balance responders showed slightly more medially located STN electrode coordinates and less medio-lateral asymmetry of the electrode reconstructed coordinates across hemispheres compared to non-responders.ConclusionDeep brain stimulation electrode reconstructed coordinates, particularly electrode asymmetry on the medio-lateral axis affected the post-operative responsiveness of balance and FoG symptoms in PD patients. (shrink)
Este artigo analisa a situação de diversidade de religiões em que o mundo se encontra hoje, e o caminho que a Igreja encontrou para o diálogo, a partir do impulso dado pelo Vaticano II, e agora assumido também pela V Conferência Geral do Episcopado Latino-Americano e do Caribe, realizada em Aparecida.
Partimos da afirmação de K.-O. Apel, repetida por João Maria André, de que "[...] é na ‘mística' do ‘logos' e na teologia negativa do Pseudo-Dionísio que, de modo determinante, Nicolau de Cusa irá beber os traços fundamentais da sua filosofia da linguagem". Com base no De filiatione Dei propomo-nos refletir sobre a relação fundamental e constitutiva entre o verbo mental humano e o Verbo ou Logos eterno. A importância desse texto, no âmbito do problema da linguagem em Nicolau de Cusa, (...) é reconhecida por Casarella justamente por sua inflexão cristológica em relação aos primeiros sermões, pois, em oposição à reflexão intratrinitária dos sermões, a imagem humanamente visível de Cristo torna-se o espelho da linguagem, ou seja, em Cristo, vemos de modo perfeito o que pode ser expresso por meio da linguagem. O texto cusano é uma meditação sobre Jo, I, 12: "Mas a todos que o receberam deu o poder de se tornarem filhos de Deus: aos que creem em seu nome". Interessa-nos principalmente a meditação sobre os exemplos aduzidos por Nicolau de Cusa para explicitar de que modo colhemos a unidade divina intelectualmente, pois serão nesses exemplos ou enigmas que o autor pensará a relação constitutiva entre o verbo mental humano e o verbo mental inefável. We begin with the statement of K.-O. Apel, repeated by João Maria André, that "[…] it is in the ‘mystic' of the ‘logos' and in the negative theology of pseudo-Dionysus that, in a determinate manner, Cusa would receive the fundamental features of his philosophy of language". Based on De filiatione Dei, we reflect on the fundamental and constitutive relationship between the mental human word and the eternal Word or Logos. The importance of this text in the context of the problem of language in Cusa is recognized by Casarella, specifically for its Christological inflection in relation to Cusa's first sermons. In opposition to the intra-Trinitarian reflection of the sermons, in De filiatione Dei the humanly visible image of Christ becomes the mirror of language; that is, it is in Christ that we see the perfect mode that can be expressed by means of language. Cusa's text is a meditation on John 1:12: "But as many as received him, to them gave he power to become the sons of God, even to them that believe on his name". Of principal interest to us are the examples adduced by Cusa that make explicit the way in which we intellectually receive the divine unity, as it is in these examples or enigmas that the author reflects on the constitutive relation between the mental human word and the ineffable mental word. (shrink)
_In _Challenging the One Best System_, a team of leading education scholars offers a rich comparative analysis of the set of urban education governance reforms collectively known as the “portfolio management model.”_ They investigate the degree to which this model—a system of schools operating under different types of governance and with different degrees of autonomy—challenges the standard structure of district governance famously characterized by David Tyack as “the one best system.” The authors examine the design and enactment of the portfolio (...) management model in three major cities: New Orleans, Los Angeles, and Denver. They identify the five interlocking mechanisms at the core of the model—planning and oversight, choice, autonomy, human capital, and school supports—and show how these are implemented differently in each city. Using rich qualitative data from extensive interviews, the authors trace the internal tensions and tradeoffs that characterize these systems and highlight the influence of historical and contextual factors as well. Most importantly, they question whether the portfolio management model represents a fundamental restructuring of education governance or more incremental change, and whether it points in the direction of meaningful improvement in school practices. Drawing on a rigorous, multimethod study, _Challenging the One Best System_ represents a significant contribution to our understanding of system-level change in education. (shrink)
Obstetrics and gynaecology always has reputation for being a highly litigious. The field of obstetrics and gynaecology is surrounded by different circumstances that stimulate the doctors to practice defensive..
This collection brings together fourteen contributions by authors from around the globe. Each of the contributions engages with questions about how local and global bioethical issues are made to be comparable, in the hope of redressing basic needs and demands for justice. These works demonstrate the significant conceptual contributions that can be made through feminists' attention to debates in a range of interrelated fields, especially as they formulate appropriate responses to developments in medical technology, global economics, population shifts, and poverty.
The collection presents a variety of promising new directions in Royce scholarship from an international group of scholars, including historical reinterpretations, explorations of Royce's ethics of loyalty and religious philosophy, and contemporary applications of his ideas in psychology, the problem of reference, neo-pragmatism, and literary aesthetics.
6. Seeing With the Mind ’ s Eye 1 : The Puzzle of Mental Imagery 6. 1 What is the puzzle about mental imagery? 6. 2 Content, form and substance of representations 6. 3 What is responsible for the pattern of results obtained in imagery studies?
High-spin states have been studied in Pr-135(59), populated through the Cd-116(Na-23,4n) reaction at 115 MeV, using the Gammasphere gamma-ray spectrometer. The negative-parity yrast band has been significantly extended to spin similar to 45 (h) over bar and excitation energy 21.5 MeV, showing evidence for several rotational alignments. The positive-parity yrast band of Ce-135(58), populated through the p4n channel of this reaction, was also populated to spin similar to 38 (h) over bar and excitation energy 18 MeV. Cranking calculations indicate that (...) these nuclei are soft with respect to the triaxiality parameter gamma and that several competing nuclear shapes occur at high spin. (shrink)
At any given time, an individual has certain beliefs and certain procedures or methods for modifying those beliefs. In The Realm of Reason, as in his previous book, Being Known (1999), Christopher Peacocke is concerned with the elusive question of what it is for someone to be “entitled” to a given belief or procedure.1..
BackgroundObstetrics and gynaecology always has reputation for being a highly litigious. The field of obstetrics and gynaecology is surrounded by different circumstances that stimulate the doctors to practice defensive medicine.MethodsThis study was directed to assess the extent and the possible effect of defensive medicine phenomenon on medical decision making among different grades of obstetric and gynaecologic Sudanese doctors, and to determine any experience of medical litigations with respect to sources and factors associated with it.ResultsA total of 117 doctors were approached, (...) their distribution according to job description was as follow: consultants registrars and specialists. The majority 89.7 % had the impression that litigation against doctors are increasing and 27.6 % had a direct experience of litigation. In this study less than one half of the surveyed doctors knew the concept of defensive medicine and 71.8 % reported practicing one or another form of defensive medicine. The different sources of the litigations reported by the doctors included: maternal death, perinatal death, other {misdiagnosis, intra-uterine fetal death, uterine perforation, rupture uterus}, fetal distress, injury to viscera and shoulder dystocia. In this study the experience of medical litigation was significantly observed among those who worked in area of blame culture. In logistic regression model, there was no significant difference between those who knew the concept of defence medicine and those who didn’t.ConclusionThere should be strategic plan to reduce the practice of defensive medicine and medical litigation against doctors. (shrink)
Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are (...) extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity. (shrink)
