In order to accomplish the transition from avascular to vascular growth, solid tumours secrete a diffusible substance known as tumour angiogenesis factor (TAF) into the surrounding tissue. Endothelial cells which form the lining of neighbouring blood vessels respond to this chemotactic stimulus in a well-ordered sequence of events comprising, at minimum, of a degradation of their basement membrane, migration and proliferation. Capillary sprouts are formed which migrate towards the tumour eventually penetrating it and permitting vascular growth to take place. It (...) is during this stage of growth that the insidious process of invasion of surrounding tissues can and does take place. A model mechanism for angiogenesis is presented which includes the diffusion of the TAF into the surrounding host tissue and the response of the endothelial cells to the chemotactic stimulus. Numerical simulations of the model are shown to compare very well with experimental observations. The subsequent vascular growth of the tumour is discussed with regard to a classical reaction-diffusion pre-pattern model. (shrink)

Background: Black, Asian and minority ethnic groups have a high need for organ transplantation but deceased donation is low. This restricts the availability of well-matched organs and results in relatively long waiting times for transplantation, with increased mortality risks. Objective: To identify barriers to organ donor registration and family consent among the BAME population, and to develop and evaluate a training intervention to enhance communication with ethnic minority families and identify impacts on family consent. Methods: Three-phase programme comprising community-based research (...) involving two systematic reviews examining attitudes and barriers to organ donation and effective interventions followed by 22 focus groups with minority ethnic groups; hospital-based research examining staff practices and influences on family consent through ethics discussion groups with staff, a study on intensive care units and interviews with bereaved ethnic minority families; and development and evaluation of a training package to enhance cultural competence among ICU staff. Setting: Community focus group study in eight London boroughs with high prevalence of ethnic minority populations. Hospital studies at five NHS hospital trusts. Participants: Community studies: 228 focus group participants; hospital studies: 35 nurses, 28 clinicians, 19 hospital chaplains, 25 members of local Organ Donation Committees, 17 bereaved family members; and evaluation: 66 health professionals. Data sources: Focus groups with community residents, systematic reviews, qualitative interviews and observation in ICUs, EDGs with ICU staff, bereaved family interviews and questionnaires for trial evaluation. Review methods: Systematic review and narrative synthesis. Results: Community studies: Organ Donor Register – different ethnic/faith and age groups were at varying points on the ‘pathway’ to organ donor registration, with large numbers lacking knowledge and remaining at a pre-contemplation stage. Key attitudinal barriers were uncertainties regarding religious permissibility, bodily concerns, lack of trust in health professionals and little priority given to registration, with the varying significance of these factors varying by ethnicity/faith and age. National campaigns focusing on ethnic minorities have had limited impact, whereas characteristics of effective educational interventions are being conducted in a familiar environment; addressing the groups’ particular concerns; delivery by trained members of the lay community; and providing immediate access to registration. Interventions are also required to target those at specific stages of the donation pathway. Hospital studies: family consent to donation – many ICU staff, especially junior nurses, described a lack of confidence in communication and supporting ethnic minority families, often reflecting differences in emotional expression, faith and cultural beliefs, and language difficulties. The continuing high proportion of family donation discussions that take place without the collaboration of a specialist nurse for organ donation reflected consultants’ views of their own role in family consent to donation, a lack of trust in SNODs and uncertainties surrounding controlled donations after circulatory death. Hospital chaplains differed in their involvement in ICUs, reflecting their availability/employment status, personal interests and the practices of ICU staff. Evaluation: professional development package – a digital versatile disk-based training package was developed to promote confidence and skills in cross-cultural communication. Initial evaluation produced positive feedback and significant affirmative attitudinal change but no significant difference in consent rate over the short follow-up period with requirements for longer-term evaluation. Limitations: Participants in the focus group study were mainly first-generation migrants of manual socioeconomic groups. It was not permitted to identify non-consenting families for interview with data regarding the consent process were therefore limited to consenting families. Conclusions: The research presents guidance for the effective targeting of donation campaigns focusing on minority ethnic groups and provides the first training package in cultural competence in the NHS. Future work: Greater evaluation is required of community interventions in the UK to enhance knowledge of effective practice and analysis of the experiences of non-consenting ethnic minority families. Funding: The National Institute for Health Research Programme Grants for Applied Research programme. (shrink)

The primary aim of this study was to investigate the relation between self-perceived executive functions and the school achievement of young adolescents, while controlling for parental education and sex. We specifically focused on executive aspects of daily life behavior and the higher-order EFs, as measured with self-report, rather than on the more basic EFs which have been the primary focus of prior investigations. In two independent samples of sixth graders, students evaluated their EFs on a self-report questionnaire, the Amsterdam Executive (...) Functioning Inventory. School achievement in the domains of mathematics and reading comprehension were evaluated with nationally used, norm-based achievement tests. Results revealed that the self-perceived EFs of young adolescents were significantly correlated with their school achievement in both study samples. School achievement was also correlated with the level of parental education, but the factor sex did not have such influence. In study 1, self-perceived EFs explained additional variance in school achievement, while controlling for parental education and sex. In study 2, this was only the case for the most robust measure of school achievement, i.e., the end-of-primary-school final achievement test. Furthermore, besides the relation with achievement tests, we also found a relation between self-perceived EFs and teacher ratings behavioral problems in the classroom. Together, our findings imply that young students can properly reflect on the effectiveness and appropriateness of their EFs in a way that is relevant to their academic achievement and classroom behavior. The findings underscore the importance of considering the development of EFs and parental education in the evaluation of academic achievements in early adolescence. (shrink)

The study aims to identify the efficiency of the university education performance from the perspective of postgraduate and undergraduate students in international and Palestinian universities. The analytical descriptive approach was used for this purpose and the questionnaire was used as a main tool for data collection. The study community consists of: post graduate students, (23850) graduate students and (146355) undergraduate students. The sample of the study was 378 graduate students and 383 undergraduate students. The random stratified sample was used. The (...) Statistical Package of Social Sciences (SPSS) was also used for data analysis. The study reached a number of results, the most important of which are: The level of efficiency of educational performance in Palestinian and international universities from the point of view of postgraduate and undergraduate students was high. And that there are significant differences between the average views of the sample of the study on the efficiency of educational performance in Palestinian and international universities attributed to the University and to the benefit of international universities. The study concluded many recommendations, the most important of which is the necessity of continuing to develop e-learning strategies that affect the efficiency of educational performance and research commensurate with the university's position in the local and international community, which puts it on the best classification between local and international universities through e-learning. (shrink)

Is what could have happened but never did as real as what did happen? What did happen, but isn't happening now, happened at another time. Analogously, one can say that what could have happened happens in another possible world. Whatever their views about the reality of such things as possible worlds, philosophers need to take this analogy seriously. Adriane Rini and Max Cresswell exhibit, in an easy step-by-step manner, the logical structure of temporal and modal discourse, and show that every (...) temporal construction has an exact parallel that requires a language that can refer to worlds, and vice versa. They make precise, in a way which can be articulated and tested, the claim that the parallel is at work behind even ordinary talk about time and modality. The book gives metaphysicians a sturdy framework for the investigation of time and modality - one that does not presuppose any particular metaphysical view. (shrink)

Over the last decade, numerous interventions and techniques that aim to engender, strengthen, and expand compassion have been created, proliferating an evidence base for the benefits of compassion meditation training. However, to date, little research has been conducted to examine individual variation in the learning, beliefs, practices, and subjective experiences of compassion meditation. This mixed-method study examines changes in novice meditators’ knowledge and contemplative experiences before, during, and after taking an intensive course in CBCT®, a contemplative intervention that is increasingly (...) used for both inter- and intrapersonal flourishing. The participants in this study were Christian healthcare chaplains completing a 1-year residency in Clinical Pastoral Education who learned CBCT as part of their professional chaplaincy training curriculum. Prior to and upon completion of training, we surveyed participants to assess their beliefs about the malleability of compassion, types of engagement in compassion meditation, and perceptions of the impact of taking CBCT. We also conducted in-depth interviews with a subset of participants to gain a qualitative understanding of their subjective experiences of learning and practicing compassion meditation, a key component of CBCT. We found that participants reported increases in the extent to which they believed compassion to be malleable after studying CBCT. We also found high levels of variability of individual ways of practicing and considered the implications of this for the study of contemplative learning processes. This multi-methodological approach yielded novel insights into how compassion practice and compassion-related outcomes interrelate, insights that can inform the basic scientific understanding of the experience of learning and enacting compassion meditation as a means of strengthening compassion itself. (shrink)

Background: Legislation on physician-assisted suicide is being considered in a number of states since the passage of the Oregon Death With Dignity Act in 1994. Opinion assessment surveys have historically assessed particular subsets of physicians.Objective: To determine variables predictive of physicians’ opinions on PAS in a rural state, Vermont, USA.Design: Cross-sectional mailing survey.Participants: 1052 physicians licensed by the state of Vermont.Results: Of the respondents, 38.2% believed PAS should be legalised, 16.0% believed it should be prohibited and 26.0% believed it should (...) not be legislated. 15.7% were undecided. Males were more likely than females to favour legalisation . Physicians who did not care for patients through the end of life were significantly more likely to favour legalisation of PAS than physicians who do care for patients with terminal illness . 30% of the respondents had experienced a request for assistance with suicide.Conclusions: Vermont physicians’ opinions on the legalisation of PAS is sharply polarised. Patient autonomy was a factor strongly associated with opinions in favour of legalisation, whereas the sanctity of the doctor–patient relationship was strongly associated with opinions in favour of not legislating PAS. Those in favour of making PAS illegal overwhelmingly cited moral and ethical beliefs as factors in their opinion. Although opinions on legalisation appear to be based on firmly held beliefs, approximately half of Vermont physicians who responded to the survey agree that there is a need for more education in palliative care and pain management. (shrink)

Recent studies using functional magnetic resonance imaging of patients in a vegetative state have raised the possibility that such patients retain some degree of consciousness. In this paper, the ethical implications of such findings are outlined, in particular in relation to decisions about withdrawing life-sustaining treatment. It is sometimes assumed that if there is evidence of consciousness, treatment should not be withdrawn. But, paradoxically, the discovery of consciousness in very severely brain-damaged patients may provide more reason to let them die. (...) Although functional neuroimaging is likely to play an increasing role in the assessment of patients in a vegetative state, caution is needed in the interpretation of neuroimaging findings. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Response to David Carr, “The Significance of Music for the Promotion of Moral and Spiritual Value”Iris M. YobDavid Carr has addressed a question that has been lurking in philosophical literature for centuries and, I might add, in our collective intuition as well: Just what is the connection between music and the moral and spiritual life? And as we have come to expect from his work, he brings a (...) new perspective to this perennial question in his answer. First he traces a line of thinking since Plato about music and the ordering of the soul, he touches on the role of music and the other arts in exploring the complexities of the moral imperative as it is lived out in human lives, and returns at the end to give a new take on the old Platonic idea of ordering of the soul. Just maybe, he suggests, the detachment, however temporary, "from the trials and tribulations that beset us in the day to day rough and tumble of human practical affairs" "in the interests of some more balanced perspective" on spiritual and moral matters "might be easier to achieve in the contemplation and appreciation of great works of 'music alone.'"This conclusion does not lay claim to more than what is perfectly reasonable. Allowing oneself to be immersed in a great work of music or art or architecture or dance may very well provide that distance from every day life where one might [End Page 209] re-center and refocus, refresh and renew one's outlook on the world. Such an engagement with an artwork can interrupt the patterns of thinking and acting that might have become increasingly thoughtless and ego-centric. It can be a re-creation in the true sense of the word. Paul Tillich, one of the great twentieth century religious philosophers, tells of an experience he had during the First World War where he served as a chaplain in the German army. On a brief leave from the front he visited Kaiser Friedrich Museum in Berlin and stood entranced before Botticelli's "Madonna and Child with Singing Angels." The moment was spiritually transformative, he tells us, lifting his spirits beyond the mud and grime of the battlefield to contemplate life and meaning on a different plane altogether. The experience enabled him to return to duty with renewed inner strength and calm.1 I believe this is a rather powerful and compelling example of what Carr is talking about.In coming to his conclusion, Carr is relying on the particularly difficult case of "music alone," that is, music that does not have words, title, or any other kind of representative function. In other words his argument does not depend on any didactic nature or morally or spiritually directive intent of the music. Rather, it is centered on music that ostensibly is not about anything. This is musical sound composed and performed for the appreciation of what it is in itself. And yet, in providing distance from the every day world, according to Carr, it can give expression to "realms of spiritual experience that lie beyond the sensual and empirical." Here we enter the world of the metaphorical and symbolic, what Rudolf Otto would call the "irrational" or "superrational," or the realm of the Holy. While Carr does not state this explicitly I would go so far as to say that this realm of the wordless and sacred is where the spiritual and the moral are grounded and from where they draw their power.Against this background, I would like to ask how does "music alone," in the sense intended by Carr and Peter Kivy from whom he borrowed the term bring about this effect? We are unable now to ask Tillich what it was that gave the Botticelli its impact for him, but it is curious that what it did for him it most likely did not do for all the other soldiers from the front who happened upon it the way he did. Tillich would most likely explain its effect by resorting to his theory of symbols, because after all this painting does have a literal meaning that might very well have inspired him. But... (shrink)

Evidence that an animal is capable of some degree of symbolic, human language processing supports the argument that the animal's consciousness is to some degree human-like. In this paper, we reinterpret the findings of Savage- Rumbaugh et al. using the twin tools of Deacon's referential hierarchy and Systemic Functional Linguistics, with a view to providing further corroborative evidence for a Bonobo ape's symbolic processing abilities, and as a result to open a window into the consciousness of at least one non-human (...) primate. (shrink)

A total of 80 authors working in a variety of scientific disciplines commented on the theoretical model of CLimate, Aggression, and Self-control in Humans (CLASH). The commentaries cover a wide range of issues, including the logic and assumptions of CLASH, the evidence in support of CLASH, and other possible causes of aggression and violence (e.g., wealth, income inequality, political circumstances, historic circumstances, pathogen stress). Some commentaries also provide data relevant to CLASH. Here we clarify the logic and assumptions of CLASH (...) and discusses its extensions and boundary conditions. We also offer suggestions for future research. Regardless of whether none, some, or all of CLASH is found to be true, we hope it will stimulate future research on the link between climate and human behavior. Climate is one of the most presing issues of our time. (shrink)

Residency training in the Netherlands is to be restructured over the coming years. To this end a general competence profile for medical specialists has been introduced. This profile is nearly the same as the Canadian CanMEDS 2000 model, which describes seven general areas of medical specialist competence, one of which is professionalism. In order to establish a training programme for residents and their instructors based on this competence, it is necessary to develop a vision that does justice to everyday medical (...) practice. The two most prevailing views of professionalism—as personal, or as a behavioural characteristic—fall short of this. Only when professionalism is understood as reflective professionalism does it encompass the fundamental contextuality of medical treatment. This means that the focus of training and assessment must be shifted to accountability for treatment. (shrink)

The study aimed to identify E- Learning strategies and their relation to the efficiency of research performance in foreign and Palestinian universities (University of Ottawa, Munster, Suez Canal, Al-Azhar, Islamic, Al-Aqsa). The analytical descriptive approach was used for this purpose, and relying on the questionnaire as a main tool for data collection. The study society is from the senior management, where the number of senior management in the universities in question is 206. The random stratified sample was selected and (SPSS) (...) was used for statistical data analysis. The study found a significant relationship between E- Learning strategies and the efficiency of research performance in universities. It also reached the participation of senior management in the research that develops the university performance in the Palestinian universities. The senior management indicated that they do not care to follow the policies of implementing the development of scientific research. While the senior management in foreign universities indicated that they are interested in following up the policies of implementing the development of scientific research. The study also showed that senior management in Palestinian universities does not care about providing the appropriate budget for E- Learning. The study recommended that the senior management of Palestinian universities should provide an E- Learning budget and encourage employees to continue using E- Learning strategies. The administration in the Palestinian universities should adopt and support outstanding research, and the need to encourage interest in the implementation of policies for the development of scientific research. (shrink)

We consider the problem of mixing in the f 0(980)–a 0(980) system when width effects are taken into account. By explicit calculation we show that two mixing angles are necessary to describe the phenomenon.

Bell's theorem is expounded as an analysis in Bayesian probabilistic inference. Assume that the result of a spin measurement on a spin-1/2 particle is governed by a variable internal to the particle (local, “hidden”), and examine pairs of particles having zero combined angular momentum so that their internal variables are correlated: knowing something about the internal variable of one tells us something about that of the other. By measuring the spin of one particle, we infer something about its internal variable; (...) through the correlation, about the internal variable of the second particle, which may be arbitrarily distant and is by hypothesis unchanged by this measurement (locality); and make (probabilistic) prediction of spin observations on the second particle. Each link in this chain has a counterpart in the Bayesian analysis of the situation. Irrespective of the details of the internal variable description, such prediction is violated by measurements on many particle pairs, so that locality—effectively the only physics invoked—fails. The time ordering of the two measurements is not Lorentz-invariant, implying acausality. Quantum mechanics is irrelevant to this reasoning, although its correct predictions of the statistics of the results imply it has a nonlocal—acausal interpretation; one such, the “transactional” interpretation, is presented to demonstrable advantage, and some misconceptions about quantum theory are pursued. The “unobservability” loophole in photonic Bell experiments is proven to be closed. It is shown that this mechanism cannot be used for signalling; signalling would become possible only if the hidden variables, which we insist must underlie the statistical character of the observations (the alternative is to give up), are uncovered in deviations from quantum predictions. Their reticence is understood as a consequence of their nonlocality: it is not easy to isolate and measure something nonlocal. Once the hidden variables are found, all the problems of quantum field theory and of quantum gravity might melt away. (shrink)

At the turn of the century Idealism was perhaps the leading school of philosophy in the English-speaking world. By the 1960s the situation was very different. There had occurred during the previous two generations what has been described as 'a revolution in philosophy', one consequence of which had been the almost total eclipse of Idealism. Originally published in 1962, this book is a critical study of certain aspects of the work of four Idealist philosophers: F. H. Bradley, T. H. Green, (...) Bernard Bosanquet and Josiah Royce. It deals mainly with their social philosophy, but some consideration is also given to their metaphysics. It is the thesis of this book that there is a valid and significant form of Idealism to be found in the work of these philosophers, but that they did not succeed in developing it fully and consistently. (shrink)