What is the value of an early diagnosis of dementia in the absence of effective treatment? There has been a lively scholarly debate over this question, but until now patients have not played a large role in it. Our study supplements biomedical research into innovative diagnostics with an exlporation of its meanings and values according to patients. Based on seven focusgroups with patients and their care-givers, we conclude that stakeholders evaluate early diagnostics with respect to whether and how they expect (...) it to empower their capacity to care. They value it, for instance, with respect to whether it explains experienced complaints, allows to start a process of psychological acceptance and social adaptation to the expected degeneration, contributes to dealing with anxieties, informs adequately about when to start preparing for the end of life, informs the planning of a request for euthanasia, or allows society to deal with a growing amount of dementia patients. Our study suggests that information about disease is considered ‘harmful’ or ‘premature’ when recipients feel unable to act on that information in their care. The results of this research offers input to further ethical research. It invites to adopt a care perspective in evaluation and to seek ways to prevent the ‘harm’ that such diagnostic methods can bring about. (shrink)

Thanks to the exchange of arguments, groups outperform individuals on some tasks, such as solving logical problems. However, these results stem from experiments conducted among Westerners and they could be due to cultural particularities such as tolerance of contradiction and approval of public debate. Other cultures, collectivistic cultures in particular, are said to frown on argumentation. Moreover, some influential intellectual movements, such as Confucianism, disapprove of argumentation. In two experiments, the hypothesis that Easterners might not share the benefits of argumentation (...) was tested. In Experiment 1, Japanese participants had to solve a standard logical problem individually and then in groups. They performed significantly better in groups. In Experiment 2, Japanese participants had to estimate the weight of various animals. They did so individually, then after learning of another participant's estimates, then after discussing these estimates with the other participant, and then indi.. (shrink)

H.B.G. Casimir's life, interests and works are intertwined with the important developments that have taken place in physics during this century. This book was compiled by his friends and admirers in honour of his 80th birthday and concentrates mainly on Casimir's achievements in the field of physics, though without ignoring the peripheral areas of the history and philosophy of physics in which he was greatly interested. The book is divided into four parts. Part I describes Casimir's teachers, Ehrenfest, Bohr and (...) Pauli, and will be of general interest due to the key role which these physicists played in modern developments. The articles do give new facts and provide new insights into the history of modern physics. Part II consists of essays on recent developments in various areas of physics in which Casimir has taken an active interest, such as the modern concept of time, statistical foundations of electrodynamic theory and field theory. The subjects covered in Part III have been selected because of Casimir's efforts in the industrial research area of physics. They cover past, present and future expectations in research. (shrink)

The concept of natural behavior is a key element in current Dutch policy-making on animal welfare. It emphasizes that animals need positive experiences, in addition to minimized suffering. This paper interprets the concept of natural behavior in the context of the scientific framework for welfare assessment. Natural behavior may be defined as behavior that animals have a tendency to exhibit under natural conditions, because these behaviors are pleasurable and promote biological functioning. Animal welfare is the quality of life as perceived (...) by the animal. Animals have evolved cognitive-emotional systems (“welfare needs”) to deal with a variable environment. Animals do not only have so-called physiological needs such as the need for food, water, and thermal comfort. They also need to exercise certain natural behaviors such as rooting or nest-building in pigs, and scratching or dust-bathing in poultry. All needs must be taken into account in order to assess overall welfare. The degree of need satisfaction and frustration can be assessed from scientific information about the intensity, duration, and incidence of (welfare) performance criteria such as measurements of behavior and/or (patho)physiology. Positive welfare value relates to how animals are inclined to behave under natural conditions, in preference tests, and in consumer-demand studies. Negative welfare value relates to stress, frustration, abnormal behavior, aggression, and reduced fitness. Examples are given to illustrate how the need to perform natural behaviors can be assessed following the general principles for welfare assessment, providing a first approximation of how different natural behaviors affect animal welfare. (shrink)

In recent years, the genetic testing and selection of IVF embryos, known as preimplantation genetic testing (PGT), has gained much traction in clinical assisted reproduction for preventing transmission of genetic defects. However, a more recent ethically and morally controversial development in PGT is its possible use in selecting IVF embryos for optimal intelligence quotient (IQ) and other non–disease-related socially desirable traits, such as tallness, fair complexion, athletic ability, and eye and hair colour, based on polygenic risk scores (PRS), in what (...) is referred to as PGT-P. Artificial intelligence (AI) and machine learning–based analysis of big data sets collated from genome sequencing of specific human ethnic populations can be used to estimate an individual embryo’s likelihood of developing such multifactorial traits by analysing the combination of specific genetic variants within its genome. Superficially, this technique appears compliant with Islamic principles and ethics. Because there is no modification of the human genome, there is no tampering with Allah’s creation (_taghyīr khalq Allah_). Nevertheless, a more critical analysis based on the five maxims of Islamic jurisprudence (_qawa'id fiqhiyyah_) that are often utilized in discourses on Islamic bioethics, namely _qaṣd_ (intention), _yaqın̄_ (certainty), _ḍarar_ (injury), _ḍarūra_ (necessity), and _`urf_ (custom), would instead reveal some major ethical and moral flaws of this new medical technology in the selection of non–disease-related socially desirable traits, and its non-compliance with the spirit and essence of Islamic law (shariah). Muslim scholars, jurists, doctors, and biomedical scientists should debate this further and issue a fatwa on this new medical technology platform. (shrink)

Continued concern for animal welfare may be alleviated when welfare would be monitored on farms. Monitoring can be characterized as an information system where various stakeholders periodically exchange relevant information. Stakeholders include producers, consumers, retailers, the government, scientists, and others. Valuating animal welfare in the animal-product market chain is regarded as a key challenge to further improve the welfare of farm animals and information on the welfare of animals must, therefore, be assessed objectively, for instance, through monitoring. Interviews with Dutch (...) stakeholder representatives were conducted to identify their perceptions about the monitoring of animal welfare. Stakeholder perceptions were characterized in relation to the specific perspectives of each stakeholder. While producers tend to perceive welfare from a production point of view, consumers will use visual images derived from traditional farming and from the animals’ natural environments. Scientists’ perceptions of animal welfare are affected by the need to measure welfare with quantifiable parameters. Retailers and governments (policy makers) have views of welfare that are derived from their relationships with producers, consumers, non-governmental organizations (NGOs), and scientists. All interviewed stakeholder representatives stated that animal welfare is important. They varied in the extent to which they weighted economic considerations relative to concern for the animals’ welfare. Many stakeholders emphasized the importance of communication in making a monitoring system work. Overall, the perspectives for the development of a sustainable monitoring system that substantially improves farm animal welfare were assessed as being poor in the short term. However, a reliable system could be initiated under certain conditions, such as integrated chains and with influential and motivated stakeholders. A scheme is described with attention points for the development of sustainable monitoring systems for farm animal welfare in the long term. (shrink)

If we reject τις, which appears only in derivative manuscripts, then the sentence is notable in the following ways. First, the position of τι—not that it separates ἕκαστος from ὑμν, but because we expect it, if present at all, to appear as πρός ὃ τι … and ἓαστός τι in itself is a conspicuously discordant juxtaposition—hence presumably the corruption to ἓαστός τις. Second, the sense: the sentence must surely mean not that each juryman has a criterion, but that each has (...) a different criterion, that he would like to see satisfied. (shrink)

The development of the typical cladomothallus of the red algae Antithaminion plumula (Ellis) Le Jolis [= Pterothamnion plumula (Ellis) Nägcli], (Rhodophyceae, Ceramiales) is simulated with the help of a formal language called L-systems. Two types of uniseriate filaments are distinguished: axial filaments of cladomes with indefinite growth and branching and pleuridia with definite growth and branching. The rythmical acropetal formation of secondary axes with basitonic arrangement contrasts with the intercalary basitonic formation of pleuridia, resulting in an acrotonic arrangement within an (...) axial segment. Five types of cells and two types of cell divisions intervene in the system. In addition, for the graphical representations, some morphological particularities of A. plumula are taken into account: the curvature of axial filaments, the extension of growth zones, variable cell generation times, and segment length variability along an axis. The incidence of these variables on the generated thallus form is emphasized, pointing to the singularities of A. plumula. (shrink)

Objective To determine the attitudes of Egyptian patients regarding their participation in research and with the collection, storage and future use of blood samples for research purposes. Design Cross-sectional survey. Study population Adult Egyptian patients (n=600) at rural and urban hospitals and clinics. Results Less than half of the study population (44.3%) felt that informed consent forms should provide research participants the option to have their blood samples stored for future research. Of these participants, 39.9% thought that consent forms should (...) include the option that future research be restricted to the illness being studied. A slight majority (66.2%) would donate their samples for future genetic research. Respondents were more favourable towards having their blood samples exported to other Arab countries (62.0%) compared with countries in Europe (41.8%, p<0.001) and to the USA (37.2%, p<0.001). Conclusions This study shows that many individuals do not favour the donation of a blood sample for future research. Of those who do approve of such future research, many favour a consent model that includes an option restricting the future research to the illness being studied. Also, many Egyptians were hesitant to have their blood samples donated for genetic research or exported out of the Arab region to the USA and European countries. Further qualitative research should be performed to determine the underlying reasons for many of our results. (shrink)

Various aspects of the integrability of dynamical systems are discussed with the help of the singular point analysis. In particular the connection with the Painlevé property is described. Several examples will serve as illustrations.

In the opening sentence of 2.6, which is of key significance, the meanings or references of are disputed, rendering the whole passage difficult. In the most widely established version, while —‘Evidence for the statement that Athens grew morethan other places because of migration is provided by the following, viz. that...’ This is consistent with taking either Athens or the other places as the subject of the infinitive, ‘Athens grew more’ or ‘the other places grew less’. If recapitulates the end of (...) 2.2, appears to refer to those migrations; but since it is a rare word, abnormal in that sense, and is obscure, Ullrich proposed, which makes a straight reference to migration, disposes of the obscurity, and provides an explicit subject for the infinitive. Gomme accepts this. I disagree, but yet believe that the established version, though capable of much improvement, is the best to date. (shrink)

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

It is not easy for an Englishman to acquire a competent knowledge of French philosophy. For one thing there are so many French philosophers writing so many books, and for another the multiplicity of men is matched by the variety of views. In a country where a knowledge of philosophy is expected of any cultivated man, and where the flourishing of philosophy in school and university curricula is regarded as a condition of intellectual freedom, this variety is accepted as part (...) of the cultural background. Professor Bréhier's Transformation de la Philosophie Française must, even so, be of great value to French readers, because of the author's capacity-so admirably shown already in a History of Philosophy that is unquestionably the best now obtainable-to pick out what is essential in a welter of theories, arguments, and mere pronouncements. To English readers, whose knowledge of the background is necessarily limited, this book is particularly valuable, not only for the clarification it brings, but also for a bibliography that is closely related to the text. M. Bréhier observes that French philosophers of the generation that followed and criticized Durkheim, Bergson and Brunschwicg showed themselves acutely conscious of the discontinuities of things, and puritanically averse to the construction of philosophical systems. M. Bréhier, however, does not take this anti-systematic, pluralist tendency at its own valuation. French philosophy, he thinks, is in a phase that makes it comparable to medieval philosophy. It was characteristic of medieval philosophy that it comprised no individually constructed systems like those, for example, of Descartes, Leibniz, Hegel, and Schopenhauer, which have grown up and died away in Europe since the Renaissance. The main reason for this was that Christianity itself provided a common system which was never to be questioned, so that philosophers concerned themselves not with systems, for that would have led to heresy, but with particular problems. Part of M. Bréhier's parallel with modern times is that some Christians and all Marxists aim to produce the same condition. (shrink)

Background: Although fair distribution of healthcare services for older patients is an important challenge, qualitative research exploring clinicians’ considerations in clinical prioritisation within this field is scarce. Objectives: To explore how clinicians understand their professional role in clinical prioritisations in healthcare services for old patients. Design: A semi-structured interview-guide was employed to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis. Participants: 20 physicians and 25 nurses working in public hospitals and nursing homes (...) in different parts of Norway. Results and interpretations: The clinicians struggle with not being able to attend to the comprehensive needs of older patients, and being unfaithful to professional ideals and expectations. There is a tendency towards lowering the standards and narrowing the role of the clinician. This is done in order to secure the vital needs of the patient, but is at the expense of good practice and holistic role modelling. Increased specialisation, advances and increase in medical interventions, economical incentives, organisational structures, and biomedical paradigms, may all contribute to a narrowing of the clinicians’ role. Conclusion: Distributing healthcare services in a fair way is generally not described as integral to the clinicians’ role in clinical prioritisations. If considerations of justice are not included in clinicians’ role, it is likely that others will shape major parts of their roles and responsibilities in clinical prioritisations. Fair distribution of healthcare services for older patients is possible only if clinicians accept responsibility in these questions. (shrink)

Interactive technology assessment (iTA) provides an answer to the ethical problem of normative bias in evaluation research. This normative bias develops when relevant perspectives on the evaluand (the thing being evaluated) are neglected. In iTA this bias is overcome by incorporating different perspectives into the assessment. As a consequence, justification of decisions based on the assessment is provided by stakeholders having achieved agreement. In this article, agreement is identified with wide reflective equilibrium to show that it indeed has the potential (...) of justifying decisions. We work out several conditions for this agreement to be achievable and just. (shrink)

Background: A fair distribution of healthcare services for older patients is an important challenge, but qualitative research exploring clinicians’ consideration in daily clinical prioritisation in healthcare services for the aged is scarce.Objectives: To explore what kind of criteria, values, and other relevant considerations are important in clinical prioritisations in healthcare services for older patients.Design: A semi-structured interview-guide was used to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis and template organising style.Participants: 20 (...) physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway.Results and interpretations: Important dilemmas relate to under-provision of community care and comprehensive approaches, and over-utilisation of certain specialised services. Overt ageism is generally not reported, but the healthcare services for the aged seem to be inadequate due to more subtle processes, for example, dominating considerations and ideals and operating conditions that do not pay sufficient attention to older patients’ needs and considerations of justice. Clinical prioritisations are described as being dominated by adapting traditional biomedical approaches to the operating conditions. Many of the clinicians indicate that there is a potential for improving end of life decisions and for reducing exaggerated use of life-prolonging treatment and hospitalisations.Conclusion: The interviews in this study indicate that considerations of justice and patients’ perspectives should be given more attention to strike a balance between specialised medical approaches and more general and comprehensive approaches in healthcare services for older patients. (shrink)

This chapter describes the potential far‐reaching consequences of contemplative higher education for the fields of science and medicine.