Background Randomized controlled trials are central to generating knowledge about effectiveness of interventions as well as risk, protective and prognostic factors related to diseases in emergency newborn care. Whether prospective participants understand the purpose of research, and what they perceive as the influence of the context on their understanding of the informed consent process for RCTs in emergency obstetric and newborn care are not well documented. Methods Conceptual review. Discussion Research is necessary to identify how the illnesses may be prevented, (...) to explore the causes, and to investigate what medications could be used to manage such illness. Voluntary informed consent requires that prospective participants understand the disclose information about the research, and use this to make autonomous informed decision about participation, in line with their preferences and values. Yet the emergency context affects how information may be disclosed to prospective research participants, how much participants may comprehend, and how participants may express their voluntary decision to participate, all of which pose a threat to the validity of the informed consent. I challenge the claim that the ‘understanding’ of research is always necessary for ethical informed consent for research during emergency care. I argue for reconceptualization of the value of understanding, through recognition of other values that may be equally important. I then present a reflective perspective that frames moral reflection about autonomy, beneficence and justice in research in emergency research. Conclusion While participant ‘understanding’ of research is important, it is neither necessary nor sufficient for a valid informed consent, and may compete with other values with which it needs to be considered. (shrink)

BackgroundInformed consent, whose goal is to assure that participants enter research voluntarily after disclosure of potential risks and benefits, may be impossible or impractical in emergency research. In low resource settings, there is limited information on the experiences of the informed consent process for randomized clinical trials in the emergency care context. The objective of this study was to explore the experiences of the informed consent process and factors that motivated participation in two obstetrics and newborn care randomized clinical trials (...) (RCTs).MethodsThis was a qualitative study conducted among former participants of RCTs in the emergency obstetric care context, conducted at Kawempe National Referral Hospital, Uganda. It employed 30 in-depth interviews conducted from June 1, 2019 to August 30, 2019. Issues explored included attitudes about research, the purpose of the research in which they participated, motivations to take part in the study, factors that influenced enrolment decisions, and experiences of the informed consent process.ResultsRespondents felt that research was necessary to investigate the cause, prevention or complications of illness. The decisions to participate were influenced by hope for material or therapeutic benefit, trust in the healthcare system and influence of friends and family members. Many were satisfied with the informed consent process, though they did not understand some aspects of the research.ConclusionRespondents valued participation in RCTs in emergency obstetric and newborn care. Hope for benefit, altruism, desire to further scientific knowledge and trust in the investigators featured prominently in the motivation to participate. Both intrinsic and extrinsic factors were motivators for RCT participation. (shrink)

BackgroundWhereas many adolescents and young people with HIV require the transfer of care from paediatric/adolescent clinics to adult ART clinics, this transition is beset with a multitude of factors that have the potential to hinder or facilitate the process, thereby raising ethical challenges of the transition process. Decisions made regarding therapy, such as when and how to transition to adult HIV care, should consider ethical benefits and risks. Understanding and addressing ethical challenges in the healthcare transition could ensure a smooth (...) and successful transition. The purpose of this study was to analyze the ethical challenges of transitioning HIV care for adolescents into adult HIV clinics.MethodsData presented were derived from 191 adolescents attending nine different health facilities in Uganda, who constituted 18 focus group discussions. In the discussions, facilitators and barriers regarding adolescents transitioning to adult HIV clinics were explored. Guided by the Silences Framework for data interpretation, thematic data analysis was used to analyze the data. The principles of bioethics and the four-boxes ethics framework for clinical care (patient autonomy, medical indications, the context of care, and quality of life) were used to analyze the ethical issues surrounding the transition from adolescent to adult HIV care.ResultsThe key emerging ethical issues were: reduced patient autonomy; increased risk of harm from stigma and loss of privacy and confidentiality; unfriendly adult clinics induce disengagement and disruption of the care continuum; patient preference to transition as a cohort, and contextual factors are critical to a successful transition.ConclusionThe priority outcomes of the healthcare transition for adolescents should address ethical challenges of the healthcare transition such as loss of autonomy, stigma, loss of privacy, and discontinuity of care to ensure retention in HIV care, facilitate long-term self-care, offer ongoing all-inclusive healthcare, promote adolescent health and wellbeing and foster trust in the healthcare system. Identifying and addressing the ethical issues related to what hinders or facilitates successful transitions with targeted interventions for the transition process may ensure adolescents and young people with HIV infection remain healthy across the healthcare transition. (shrink)

Background Factors that could potentially act as facilitators and barriers to successful recruitment strategies in perinatal clinical trials are not well documented. The objective was to assess lay persons’ understanding of the informed consent for randomized clinical trial in emergency obstetric and newborn care. Methods This was a qualitative study conducted among survivors of severe obstetric complications who were attending the post-natal clinic of Kawempe National Referral Hospital, Uganda, 6–8 weeks after surviving severe obstetric complications during pregnancy or childbirth. The (...) study that involved 18 in-depth interviews was conducted from June 1, 2019 to July 6, 2019. The issues explored included perceptions of the purpose and necessity to conduct such research how research-related information would be disclosed, and what could be the potential benefits and risks of participation. The data was analyzed by thematic analysis. Results Respondents felt that research was necessary to investigate the cause, prevention or complications of an illness, especially as much was known about some pregnancy and newborn complications. Most believed that the emergency contexts affects whether and what prospective participants may understand if information about research was disclosed. Whereas they did not see the value of procedures like randomization, they felt that if these and any other procedures necessary should be done transparently and fairly. The decisions to participate would significantly be influenced by possibility of risk to the unborn baby or the newborn. Solidarity was an important influence on decision-making. Conclusions Respondents valued participation in RCTs in emergency obstetric and newborn care. However, they expressed concerns and valued openness, transparency and accountability with regard to how clinical trials information is disclosed and the decision-making process for clinical trial participation. While autonomy and solidarity are contradictory values, they complement each other during decision-making for informed consent. (shrink)

BackgroundThe contemporary frameworks for clinical research require informed consent for research participation that includes disclosure of material information, comprehension of disclosed information and voluntary consent to research participation. There is thus an urgent need to test, and an ethical imperative, to test, modify or refine medications or healthcare plans that could reduce patient morbidity, lower healthcare costs or strengthen healthcare systems.MethodsConceptual review.DiscussionAlthough some allocation principles seem better than others, no single moral principle allocates interventions justly, necessitating combining the moral principles (...) into multiprinciple allocation systems. The urgency notwithstanding, navigating ethical challenges related to conducting corona virus disease (COVID-19) clinical trials is mandatory, in order to safeguard the safety and welfare of research participants, ensure autonomy of participants, reduce possibilities for exploitation and ensure opportunities for research participation. The ethical challenges to can be categorized as challenges in allocation of resources for research; challenges of clinical equipoise in relation to the research questions; challenges of understanding disclosed information in potential participants; and challenges in obtaining informed consent.ConclusionTo navigate these challenges, stakeholders need a delicate balance of moral principles during allocation of resources for research. Investigators need to apply information processing theories to aid decision-making about research participation or employ acceptable modifications to improve the informed consent process. Research and ethics committees should strengthen research review and oversight to ensure rigor, responsiveness and transparency. (shrink)

Background There is longstanding consensus on the need to include pregnant women in research. The goal of clinical research is to find highly regulated, carefully controlled, morally responsible ways to generate evidence about how to effectively and safely prevent illness or treat sick people. This manuscripts present a conceptual analysis of the ethicality of clinical trials in 3 scenarios: where the pregnant is involved in clinical trials as a participant during pregnancy for data that addresses pregnancy complications, where the pregnant (...) woman consents to clinical trial participation for an unborn baby that has complications, to generate data on complications at this stage of life, and where the mother may consent for participation of their newborn child in clinical trials. Methods Conceptual analysis. Findings Investigators often choose to exclude pregnant women and newborns from research, even where there is possibility for them to benefit from the study intervention. Objections include vulnerability of pregnant women, altered pharmacokinetics and risk of adverse effects, with a need to balance potential maternal and fetal risks and benefits of research participation. While the objections may be valid, not performing research magnifies what should be a carefully controlled risk during research, pushing this risk into the clinical setting, and subsequently posing a challenge to clinicians who are faced with making treatment decisions for pregnant patients with limited evidence of efficacy and safety. The potential benefits of fair inclusion in clinical trials outweigh the potential risks. Conclusion Research involving pregnant women is necessary to provide women with effective treatment during pregnancy, to promote fetal safety, and to reduce avoidable harm from suboptimal care and to provide pregnant women, their fetuses and newborns. (shrink)

Background There is longstanding consensus on the need to include pregnant women in research. The goal of clinical research is to find highly regulated, carefully controlled, morally responsible ways to generate evidence about how to effectively and safely prevent illness or treat sick people. This manuscripts present a conceptual analysis of the ethicality of clinical trials in 3 scenarios: where the pregnant is involved in clinical trials as a participant during pregnancy for data that addresses pregnancy complications, where the pregnant (...) woman consents to clinical trial participation for an unborn baby that has complications, to generate data on complications at this stage of life, and where the mother may consent for participation of their newborn child in clinical trials. Methods Conceptual analysis. Findings Investigators often choose to exclude pregnant women and newborns from research, even where there is possibility for them to benefit from the study intervention. Objections include vulnerability of pregnant women, altered pharmacokinetics and risk of adverse effects, with a need to balance potential maternal and fetal risks and benefits of research participation. While the objections may be valid, not performing research magnifies what should be a carefully controlled risk during research, pushing this risk into the clinical setting, and subsequently posing a challenge to clinicians who are faced with making treatment decisions for pregnant patients with limited evidence of efficacy and safety. The potential benefits of fair inclusion in clinical trials outweigh the potential risks. Conclusion Research involving pregnant women is necessary to provide women with effective treatment during pregnancy, to promote fetal safety, and to reduce avoidable harm from suboptimal care and to provide pregnant women, their fetuses and newborns. (shrink)

There is longstanding consensus on the need to include pregnant women in research. The goal of clinical research is to find highly regulated, carefully controlled, morally responsible ways to generate evidence...

There is unanimous agreement regarding the need to ethically conduct research for improving therapy for patients admitted to hospital with acute conditions, including in emergency obstetric care. We present a conceptual analysis of ethical tensions inherent in the informed consent process for randomized clinical trials for emergency obstetric care and suggest ways in which these could be mitigated. A valid consenting process, leading to an informed consent, is a cornerstone of this aspect necessary for preservation and maintenance of respect for (...) autonomy and dignity. In emergency obstetric care research, obtaining informed consent can be problematic, leading to ethical tension between different moral considerations. Potential participants may be vulnerable due to severity of disease, powerlessness or impaired decisional capacity. Time for the consent process is limited, and some interventions have a narrow therapeutic window. These factors create ethical tension in allowing potentially beneficial research while avoiding potential harms and maintaining respect for dignity, human rights, justice and autonomy of the participants. Informed consent in emergency obstetric care in low- and middle-income countries poses numerous ethical challenges. Allowing research on vulnerable populations while maintaining respect for participant dignity and autonomy, protecting participants from potential harms and promoting justice underlie the ethical tensions in the research in emergency obstetric and newborn care. Those involved in research conduct or oversight have a duty of fair inclusion, to avoid denying participants the right to participate and to any potential research benefits. (shrink)

An inspiring collection of the personal philosophies of a fascinating group of individuals Based on the NPR series of the same name, This I Believe features eighty essays penned by the famous and the unknown—completing the thought that the book’s title begins. Each piece compels readers to rethink not only how they have arrived at their own personal beliefs but also the extent to which they share them with others. Featuring a star-studded list of contributors—including Isabel Allende, John Updike, William (...) F. Buckley, Warren Christopher, Penn Jillette, Colin Powell, Rick Moody, and Kay Redfield Jameson—the collection also contains essays by a Brooklyn lawyer; a part-time hospital clerk in Rehoboth, Massachusetts; a woman who sells yellow pages advertising in Fort Worth, Texas; and a man who serves on the state of Rhode Island’s parole board. The result is a stirring, funny, and always provocative trip inside the minds and hearts of a diverse group of Americans whose beliefs—and the incredibly varied ways in which they choose to express them—reveal the American spirit at its best. (shrink)

... Let me start my investigation by taking a brief look at the way in which self-awareness is expressed linguistically, as in the sentences "I am tired" or ...

If one comes to Phénoménologie de la perception after having read Sein und Zeit (or Prolegomena zur Geschichte des Zeitbegriffs) one will be in for a surprise. Both works contain a number of both implicit and explicit references to Husserl, but the presentation they give is so utterly different, that one might occasionally wonder whether they are referring to the same author. Thus nobody can overlook that Merleau-Ponty’s interpretation of Husserl differs significantly from Heidegger’s. It is far more charitable. In (...) fact, when evaluating the merits of respectively Husserl and Heidegger, Merleau-Ponty often goes very much against the standard view. This is not only the case in his notorious remark on the very first page of Phénoménologie de la Perception where he declares that the whole of Sein und Zeit is nothing but an explication of Husserl’s notion of Lifeworld, but also - to give just one further example - in one of his Sorbonne-lectures, where Merleau-Ponty writes that Husserl took the issue of historicity far more seriously than Heidegger. (shrink)

The Oxford Handbook of Contemporary Phenomenology presents twenty-eight essays by some of the leading figures in the field, and gives an authoritative overview of the type of work and range of topics found and discussed in contemporary phenomenology. It is the definitive guide to what is currently going on in phenomenology, and offers a rich source of insight and stimulation for philosophers, students of philosophy, and for people working in other disciplines of the humanities, social sciences, and sciences, who are (...) interested in the state of phenomenology today. The essays explore a diverse range of topics, including intentionality, embodiment, perception, naturalism, temporality, self-consciousness, language, knowledge, ethics, politics, art and religion, and will make it clear that phenomenology, far from being a tradition of the past, is alive and in a position to make valuable contributions to contemporary thought. (shrink)

In this entry, I tackle the phenomenon known as "faultless disagreement", considered by many authors to pose a challenge to the main views on the semantics of subjective expressions. I first present the phenomenon and the challenge, then review the main answers given by contextualist, absolutist and relativist approaches to the expressions in question. I end with signaling two issues that might shape future discussions about the role played by faultless disagreement in semantics.

The Oxford Handbook of the History of Phenomenology contains thirty-seven new essays by leading scholars in the field. The essays all highlight historical influences, connections, and developments and provide an in-depth coverage of the development of phenomenology; one that allows for a better comprehension and assessment of the continuity as well as diversity of the phenomenological tradition. The handbook is divided into three distinct parts. The first part contains chapters that address the way phenomenology has been influenced by earlier periods (...) or figures in the history of philosophy. The second part contains chapters targeting prominent phenomenologists: How was their work affected by earlier figures, how did their own views change over time, and what kind of influence did they exert on subsequent thinkers? The contributions in the third part trace various core topics such as subjectivity, intersubjectivity, embodiment, spatiality, and imagination in the work of different phenomenologists, in order to explore how the notions were transformed, enriched, and expanded up through the century. The handbook will be a source of insight for philosophers, students of philosophy, and for people working in other disciplines of the humanities, social sciences, and sciences, who are interested in the phenomenological tradition. It is an authoritative guide to how phenomenology started, how it developed, and where it is heading. (shrink)

Many times, what we say proves to be wrong. It might turn out that what we took to be a comforting remark was, in fact, making things worse. Or that a joke was inappropriate. Or that yelling out loud was rude. More importantly for this paper, there are plenty of cases in which what we said turns out to be false: we spoke without paying attention, we were misinformed or tricked, or we made a reasoning mistake. -/- A particular instance (...) of this latter phenomenon is when someone changes their perspective and doesn't find their previous assertions true anymore. For example, imagine that you used to like licorice as a child, and that you went around saying things like "Licorice is tasty." But, growing up, you find licorice too strong and quite boring; your tastes have changed. While the taste of licorice itself has not changed, you are not going around anymore uttering "Licorice is tasty." In fact, in certain cases, you might even think that what you said in your childhood was wrong - at least in light of your present preferences. -/- Sometimes we "take back" the assertions we made when we realize they are no longer true. Such speech acts of taking back can be performed in various ways: more formally, as effected in a court of law or when an official speaks to the press, or more informally in our day-by-day interactions. These acts of taking back are known as retraction. Retraction is usually achieved by employing certain linguistic markers ('I was wrong', 'I was mistaken', 'I retract', "Scratch that' etc.) that signal that the retractor takes their previous speech act to be faulty in a certain way. -/- This phenomenon has formed the basis for a popular argument used by relativists about a variety of natural language expressions (predicates of taste, epistemic modals, moral and aesthetic claims etc.) in support of their view. Recently, several considerations (mostly from contextualists about the same expressions), both from the armchair and based on empirical studies, have been offered to undercut the support retraction was thought to provide for relativism. In this paper, I consider and re-evaluate that support in light of both types of considerations, showing that neither of them decisively undermines it. However, to survive the contextualist counterattack, the relativist needs to pay a price: that is, she will be forced to make some concessions or rethink certain claims. I show what I think those concessions should be and what needs to be rethought (and how). The upshot is that, while the support retraction offers relativism is not as strong as initially believed, appeal to retraction remains a legitimate move in the debate. In section 1, I introduce the views in the debate and clarify the phenomenon of retraction and its dialectical role. Armchair data are investigated in section 2, proper experimental studies in section 3, while section 4 summarizes and concludes. (shrink)

RATIONALE: The concept of evidence-based medicine is important in providing efficient health care. The process uses research findings as the basis for clinical decision making. Evidence-based practice helps optimize current health care and enables the practitioners to be suitably accountable for the interventions they provide. Little work has been undertaken to examine how allied health professionals change their clinical practice in light of the latest evidence. The use of opinion leaders to disseminate new evidence around the management of low back (...) pain into practice has been proposed. AIMS: The aim of this study was to investigate if physiotherapists' clinical management of patients with low back pain would change following an evidence-based education package, which utilized local opinion leaders and delivered the best evidence. METHOD: Thirty musculoskeletal physiotherapists from a Community Trust in North Staffordshire were cluster randomized by location of work, to two groups. The intervention group received an evidence-based programme on the management of low back pain, including advice regarding increasing activity levels and return to normal activity and challenging patients' fears and beliefs about their pain. The control group received a standard in-service training package on the management of common knee pathologies. The physiotherapists' clinical management of patients with low back pain was measured prior to training and 6 months post training. Outcome measures were based on physiotherapists completing 'discharge summary' questionnaires, which included information relating to the use and importance of therapies for treating their low back pain patients. RESULTS: There were few significant differences in treatment options between the intervention and control groups post training. Whilst there was some indication that physiotherapists were already utilizing aspects of psychosocial management for patients with low back pain, there was little change in what physiotherapists perceived to be important to patient recovery and actual clinical practice following the intervention. CONCLUSIONS: Psychosocial factors have been identified as an important factor in the recovery of patients with low back pain. This project incorporated the latest evidence on the management of low back pain and utilized the theory of opinion leaders to disseminate this evidence into clinical practice. Whilst there were some limitations in the overall size of the study, the results help to give an insight into the challenges faced by the health care system and researchers alike to ensure quality evidence is actually utilized by practitioners for the benefits of patient care. (shrink)

In this fascinating study, the author analyzes the conceptual roots of molecular biology and the social matrix in which it was developed.

When people speak, their words never fully encode what they mean, and the context is always compatible with a variety of interpretations. How can comprehension ever be achieved? Wilson and Sperber argue that comprehension is an inference process guided by precise expectations of relevance. What are the relations between the linguistically encoded meanings studied in semantics and the thoughts that humans are capable of entertaining and conveying? How should we analyse literal meaning, approximations, metaphors and ironies? Is the ability to (...) understand speakers' meanings rooted in a more general human ability to understand other minds? How do these abilities interact in evolution and in cognitive development? MEANING AND RELEVANCE sets out to answer these and other questions, enriching and updating relevance theory and exploring its implications for linguistics, philosophy, cognitive science and literary studies. (shrink)

Recently, there has been a debate focusing on the question of whether groups can literally have beliefs. For the purposes of epistemology, however, the key question is whether groups can have knowledge. More specifi cally, the question is whether “group views” can have the key epistemic features of belief, viz., aiming at truth and being epistemically rational. I argue that, while groups may not have beliefs in the full sense of the word, group views can have these key epistemic features (...) of belief. However, I argue that on Margaret Gilbert's infl uential “plural subject” account of group belief, group views are unlikely to be epistemically rational. (shrink)

Personal narratives have become one of the most potent vehicles for advancing human rights claims across the world. Human Rights and Narrated Lives explores what happens when autobiographical narratives are produced, received, and circulated in the field of human rights. It asks how personal narratives emerge in local settings how international rights discourse enables and constrains individual and collective subjectivities in narration how personal narratives circulate and take on new meanings in new contexts and how and under what conditions they (...) feed into, affect, and are affected by the reorganization of politics in post-cold war, postcolonial, globalizing human rights contexts. (shrink)

In this paper I take up a critical position in regard to the theme of debility around which this collection is framed. I argue that theorisations of ‘debility’ do little to progress theory and policy in regard to disability and share many of the problems inherent to the social model. I also suggest that the theorisation of debility is rooted in and reinforces ablebodied privilege. I begin with a critical analysis of the social model of disability and explore the dualisms (...) by which it either negates the body altogether or can only conceive the disabled body in negative terms. I then go on to explore how Puar's work on debility continues this negation of the disabled body. From this position I use the work of Inahara to excavate the foundations of ablebodied privilege. In Inahara's work gender is the analytic starting point, but for me white privilege is a much more effective mechanism through which to understand the impact and reproduction of ablebodied privilege— what McRuer refers to as ‘compulsory ablebodiedness'—which I argue underpins Puar's work. I conclude with some reflections upon how a critical analysis of ablebodied privilege might function and I reiterate its importance for a critical theory that goes beyond the mere repetition of binary structures of ablebodiedness and disability. (shrink)

The doctrine of double effect, together with other moral principles that appeal to the intentions of moral agents, has come under attack from many directions in recent years, as have a variety of rationales that have been given in favor of it. In this paper, our aim is to develop, defend, and provide a new theoretical rationale for a secular version of the doctrine. Following Quinn (1989), we distinguish between Harmful Direct Agency and Harmful Indirect Agency. We propose the following (...) version of the doctrine: that in cases in which harm must come to some in order to achieve a good (and is the least costly of possible harms necessary), the agent foresees the harm, and all other things are equal, a stronger case is needed to justify Harmful Direct Agency than to justify Harmful Indirect Agency. We distinguish between two Kantian rationales that might be given for the doctrine, a “dependent right” rationale, defended by Quinn, and an “independent right” rationale, which we defend. We argue that the doctrine and the “independent right” rationale for it are not vulnerable to counterexamples or counterproposals, and conclude by drawing implications for the larger debate over whether agents' intentions are in any way relevant to permissibility and obligation. (shrink)

In this paper, I explore a range of existent and possible ameliorative semantic theories of gender terms: invariantism, according to which gender terms are not context-sensitive, contextualism, according to which the meaning of gender terms is established in the context of use, and relativism, according to which the meaning of gender terms is established in the context of assessment. I show that none of these views is adequate with respect to the plight of trans people to use their term of (...) choice to self-identify and be referred to accordingly. I then consider an invariantist view based on self-identification and explore some of its challenges. (shrink)

The work reported in this monograph was begun in the winter of 1967 in a graduate seminar at Berkeley. Many of the basic data were gathered by members of the seminar and the theoretical framework presented here was initially developed in the context of the seminar discussions. Much has been discovered since1969, the date of original publication, regarding the psychophysical and neurophysical determinants of universal, cross-linguistic constraints on the shape of basic color lexicons, and something, albeit less, can now also (...) be said with some confidence regarding the constraining effects of these language-independent processes of color perception and conceptualization on the direction of evolution of basic color term lexicons. (shrink)

Objectives—To assess perceptions of the informed consent process in patients undergoing urgent abdominal surgery.Design—A prospective observational study was carried out using structured questionnaire-based interviews. Patients who had undergone urgent abdominal surgery were interviewed in the postoperative period to ascertain their perceptions of the informed consent process. Replies were compared to responses obtained from a control group undergoing elective surgery, to identify factors common to the surgical process and those specific to urgent surgery. Patients' perceptions of received information were also compared (...) to the information perceived to have been provided by the consent obtainers. Setting—Gastrointestinal surgical service of a university teaching hospital.Patients—Seventy-four consecutive patients undergoing urgent abdominal surgery and 80 control patients undergoing elective surgery. Main measurements—Principal outcome measures were patients' perceptions of factors interfering with the ability to give informed consent, assessment of the quality of informed consent and the degree of discussion of the expected outcomes. Results—Forty-nine of the seventy-four (66%) patients undergoing urgent surgery perceived that pain did not affect their ability to give informed consent. Twenty-seven reported an adverse effect of analgesia on the ability to give informed consent. Only 22% of patients undergoing urgent surgery perceived that there had been any discussion of potential side effects and complications of surgery. Conclusion–The majority of patients in this series with acute intra-abdominal surgical conditions perceive that they retain the ability to give informed consent for surgery. There is a need for improved discussion of therapeutic options and likely outcomes. (shrink)

Phosphatidylinositol 3‐phosphate (PtdIns3P) is generated on the cytosolic leaflet of cellular membranes, primarily by phosphorylation of phosphatidylinositol by class II and class III phosphatidylinositol 3‐kinases. The bulk of this lipid is found on the limiting and intraluminal membranes of endosomes, but it can also be detected in domains of phagosomes, autophagosome precursors, cytokinetic bridges, the plasma membrane and the nucleus. PtdIns3P controls cellular functions through recruitment of specific protein effectors, many of which contain FYVE or PX domains. Cellular processes known (...) to be controlled by PtdIns3P and its effectors include endosomal fusion, sorting and motility, autophagy, cytokinesis, regulated exocytosis and signal transduction. Here we discuss how Ptdins3P is generated on specific cellular membranes, how its localizations and functions can be studied, and how its effectors serve to control cellular functions.Editor's suggested further reading in BioEssays:Phosphatidylinositol 4,5‐bisphosphate: Targeted production and signalingAbstractHow does SHIP1/2 balance PtdIns(3,4)P2 and does it signal independently of its phosphatase activity?AbstractPhosphatidylinositol‐3,4,5‐trisphosphate: Tool of choice for class I PI 3‐kinasesAbstractPhosphatidylinositol‐4‐phosphate: The Golgi and beyondAbstract. (shrink)

Sociology and Animals : Beginnings -- Animals and Biology as Destiny -- Animals, Social Inequalities and Oppression -- Animals, Crime and Abuse -- Town and Country : Animals, Space and Place -- Consumption of the Animal -- Animals, Leisure and Culture -- Animal Experiments and Animal Rights -- Conclusion: Sociology for Other Animals.

Sandplay is a growing field of interest for Jungian and other psychotherapists. _Sandplay - Silent Workshop of the Psyche_ by Kay Bradway and Barbara McCoard, provides an introduction to sandplay as well as extensive new material for those already using this form of therapy. Based on the authors' wide-ranging clinical work, it includes: in-depth sandplay case histories material from a wide range of adults and children over 90 illustrations in black and white and colour detailed notes on interpretation of sand (...) trays an examination of symbols and concepts used in sandplay. Clearly written and soundly based in theory, this book provides historical background for understanding sandplay as well as helpful discussion of how it works in a clinical context. Kay Bradway and Barbara McCoard bring their indispensable personal experience to the subject to stress the healing potential of sandplay. They also reflect on the nature of a therapy where the psyche works largely in silence. (shrink)

This paper starts by investigating Ackermann's interpretation of finite set theory in the natural numbers. We give a formal version of this interpretation from Peano arithmetic (PA) to Zermelo-Fraenkel set theory with the infinity axiom negated (ZF−inf) and provide an inverse interpretation going the other way. In particular, we emphasize the precise axiomatization of our set theory that is required and point out the necessity of the axiom of transitive containment or (equivalently) the axiom scheme of ∈-induction. This clarifies the (...) nature of the equivalence of PA and ZF−inf and corrects some errors in the literature. We also survey the restrictions of the Ackermann interpretation and its inverse to subsystems of PA and ZF−inf, where full induction, replacement, or separation is not assumed. The paper concludes with a discussion on the problems one faces when the totality of exponentiation fails, or when the existence of unordered pairs or power sets is not guaranteed. (shrink)

This paper argues that current iterations of lesbian, gay, bisexual, transgender and intersex rights are limited by an overreliance on particular representations of sexuality, in which homosexuality is defined negatively through a binary of homosexual/heterosexual. The limits of these representations are explored in order to unpick the possibility of engaging in a form of sexuality politics that is grounded in difference rather than in sameness or opposition. The paper seeks to respond to Braidotti’s call for an “affirmative politics” that is (...) open to forms of creative, future-oriented action and that might serve to answer some of the more common criticisms of current LGBTI rights activism. (shrink)

Adult playfulness describes individual differences in framing everyday situations as personally interesting, and/or entertaining, and/or intellectually stimulating. We aimed at extending initial evidence on the interconnectedness between language use and adult playfulness by asking 264 participants to provide written descriptions of their understanding of playfulness and collected self-reports of their playfulness. We used the Linguistic Inquiry and Word Count methodology to quantitatively analyze the language use in these descriptions and tested the associations with individual differences in participants’ age, gender, and (...) playfulness. While higher expressions in all measures of playfulness did go along with writing more content when describing playfulness, facet-wise analyses revealed differential findings ; but the effects were small. We found that being a women and younger age were related to writing longer texts, and we discovered additional associations between certain LIWC categories and age and gender. Our study expands the knowledge about adult playfulness and its manifestations in natural language use. We embed our findings into previous research and discuss limitations and potential approaches for replication studies. (shrink)

This pioneering study is one of the first English-language books to address Jewish theology from a postmodern perspective, probing the question of how it has the potential to survive the postmodern onslaught that some see as heralding the collapse of religion. Basing her arguments on both philosophical and theological scholarship, the author shows how postmodernism might actually be a resource for rejuvenating religion. Her response to the conception of theology and postmodernism as competing systems of thought is based on a (...) close critical study of Rav Shagar (Shimon Gershon Rosenberg) and Tamar Ross. She analyzes their writings through the lens of the most radical continental postmodern philosophers and cultural critics in order to offer a compelling theology compatible with their world-view. Whether the reader considers postmodernism to be inherently problematic or merely inconsequential, this study demonstrates why reconsidering these preconceptions is one of the most pressing issues in contemporary Jewish thought. (shrink)

This book is a collection of essays by a variety of specialists with a particular interest in palliative care. It contains seven chapters by six different authors. The first chapter Why is the study of ethics important? is by Patricia Webb, a lecturer in palliative care with a background in nursing. She tells us that studying ethics encourages logical reasoned thinking in the face of difficult decisions such as allocation of resources, access to services, best care, clinical research, and rights (...) to life. Webb reminds us that clinical guidelines may not be much help in the face of an ethical dilemma with no clear right or wrong answer. The chapter called Care versus cure by David Jeffrey, a consultant in palliative medicine and writer on medical ethics, reminds us that care is concerned as much with the subjective feelings of the patient as with the physical disease, and aims …. (shrink)

In this paper we present an equivalence between the category of commutative regular rings and the category of Boolean-valued fields, i.e., Boolean-valued sets for which the field axioms are true. The author used this equivalence in [12] to develop a Galois theory for commutative regular rings. Here we apply the equivalence to give an alternative construction of an algebraic closure for any commutative regular ring.Boolean-valued sets were developed in 1965 by Scott and Solovay [10] to simplify independence proofs in set (...) theory. They later were applied by Takeuti [13] to obtain results on Hilbert and Banach spaces. Ellentuck [3] and Weispfenning [14] considered Boolean-valued rings which consisted of rings and associated Boolean-valued relations. To the author's knowledge, the present work is the first to employ the Boolean-valued sets of Scott and Solovay to obtain results in algebra.The idea that commutative regular rings can be studied by examining the properties of related fields is not new. For several years algebraists and logicians have investigated commutative regular rings by representing a commutative regular ring as a subdirect product of fields or as the ring of global sections of a sheaf of fields over a Boolean space. These representations depend, as does the work presented here, on the fact that the set of central idempotents of any ring with identity forms a Boolean algebra. The advantage of the Boolean-valued set approach is that the axioms of classical logic and set theory are true in the Boolean universe. Therefore, if the axioms for a field are true for a Boolean-valued set, then other properties of the set can be deduced immediately from field theory. (shrink)