This paper describes the application of eight statistical and machine-learning methods to derive computer models for predicting mortality of hospital patients with pneumonia from their findings at initial presentation. The eight models were each constructed based on 9847 patient cases and they were each evaluated on 4352 additional cases. The primary evaluation metric was the error in predicted survival as a function of the fraction of patients predicted to survive. This metric is useful in assessing a model’s potential to assist (...) a clinician in deciding whether to treat a given patient in the hospital or at home. We examined the error rates of the models when predicting that a given fraction of patients will survive. We examined survival fractions between 0.1 and 0.6. Over this range, each model’s predictive error rate was within 1% of the error rate of every other model. When predicting that approximately 30°K of the patients will survive, all the models have an error rate of less than 1.5%. The models are distinguished more by the number of variables and parameters that they contain than by their error rates; these differences suggest which models may be the most amenable to future implementation as paper-based guidelines. (shrink)

O artigo apresenta e analisa as representações acerca da espiritualidade presentes nos relatos de mulheres usuárias de substâncias que buscam acolhimento em comunidades terapêuticas (CTs) de perfil religioso. Os dados observados são provenientes de entrevistas semiestruturadas realizadas ao longo do segundo semestre de 2020 com mulheres acolhidas em duas CT’s, sendo uma delas de perfil católico carismático e outra vinculada a uma igreja que compõe o protestantismo histórico. As lideranças dessas instituições foram igualmente ouvidas com a intenção de alcançar informações (...) a respeito da maneira como religião e espiritualidade são acionadas e articuladas no método empregado por essas CTs. A principal conclusão desse trabalho indica que as estratégias institucionais aplicadas para afastar essas mulheres do uso de substâncias fundamentam-se em narrativas religiosas que, muitas vezes, são ressignificadas pelas acolhidas por meio de suas próprias experiências subjetivas ao longo da permanência na CT. Ainda, deve-se ressaltar que a espiritualidade vivenciada pelas entrevistadas parece, em algumas situações, confrontar as orientações institucionais. (shrink)

La parution récente en français du livre de M. Denton : “Evolution. Une théorie en crise” , qui traite des theories explicatives actuelles de l'évolution, nous amine à rappeler les caracteres généraux des grandes theories biologiques et à présenter une critique sommaire du livre en question.La science West pas une simple accumulation de connaissances. Le scientifique ne doit pas se contenter de decrire et de mesurer des faits. Son but eat d'essayer de les relier et de construire des théories qui (...) tentent de nous faire comprendre le “reel”, objet de ses recherches.Cependant, la nature du matériel biologique — c'est-à-dire les espèces vivantes et les catégories qu'on y a reconnues, classe ou ordre par exemple — est si complexe qua la biologie actuelle est fort loin encore Wavoir réalisé une synthèse qui ressemble, méme très approximativement, à la classification de Mendéleiev pour les éléments chimiques.Malgré cette complexité, les biologques ont réussi à construire la th6orie du fait de l'evolution et ils proposent aujourd'hui une théorie explicative de cette évolution qui, bien qua critiquée, est incontestablement bien étayee. Nous allons essayer de définir la structure des grandes théories biologiques; ensuite nous analyserons sommairement quelques-unes des critiques qui sont adressees aux theories de l'évolution.Considering the publication in French version of Michael Denton's book, Evolution : A Theory in crisis , in which he critizes the synthetical theory of the biological evolution, we thought it useful to point out the main errors of argumentation contained in that book by first referring to the characteristics of general biological theories.In biology, there exist elementary theories - such as that dealing with the extinction of giant Reptiles - and general theories - such as the chromosomic theory of heredity and the explanatory theory of evolution. The latter generally consist of a group of elementary theories imbricated so that they form a whole like a jig-saw puzzle. An example is provided by the synthetic theory of evolution that can be defined in 20 propositions divided into two categories : the propositions relating to the naturalists' observations - which correspond to descriptive concepts - and those relating to the data of the population genetics - which correspond to explanatory concepts . The general scheme of the theory is formed by a network of relations between the descriptive concepts and the explanatory concepts. There also exist other theories in general biology supported by thousands of minor facts which only together can be of proof of validity. These theories are quite reliable and cannot be questioned by facts still to be explained. Questioning can only happen if they are confronted to well-established data in nearly equal numbers.In his work, Denton does not deny the phenomenon of biological evolution, but he criticizes the syntheticians' ideas by emphasizing that no great evolutive changes can be accounted for by the complex mechanism of random mutations and selection. He goes back to a typological concept of the zoological classification in some way similar to that of Vialleton's. However, Denton agrees with the phenomenon of the biological evolution and accepts the existence of "saltations" among the great zoological groups. The arguments used by Denton merely show that he is not conversant with the complexity of sciences particularly in comparative anatomy and zoology, the teaching of which is being somehow neglected today.By giving as an example the structure of the aortic arches in Amphibians and by a summary of the variations of those structures and the evolution of the blood-circulation in Vertebrates, we proved that the typological argument is of no value. As a matter of fact, a study of the now living beings clearly shows the gradual transition - e.g. a transition by a very large number of feasible stages - from the Lower Vertebrates to the Higher Vertebrates. In particular, there have been several attempts at double circulation and there still exist many species in which the blood of the double circulation is mixed. It seems therefore obvious that the double circulation has been achieved, stage by stage, with many intermediate schemes; we are inclined, therefore, to conclude that this succession of small transformations was produced by a huge mechanism of selected small mutations.Our present-day biological knowledge includes a number of examples large enough to consider the “argument of the impossible” used by Denton is due to inadequate fossil data and not to any mysterious mechanism such as macromutations. Let us say again that the typological structures seem to occur only when the data of comparative anatomy and zoology are over-simplified. (shrink)

Ce livre part d'une question : pourquoi les gauches ne parviennent-elles pas à faire émerger un projet crédible, en dépit de l'urgence du besoin? Il repose sur urge conviction : un des (nombreux) obstacles réside dans le fait que l'on reste trop souvent sur le terrain de l'adversaire, en ne combattant pas explicitement la forme même de pensée sur laquelle s'appuie l'idéologie dominante et qui la conforte. A l'heure actuelle émerge, à partir des avancées scientifiques, une nouvelle forme de pensée, (...) profondément dialectique, la pensée du complexe, qui peut fournir une aide considérable à l'action politique émancipatrice et nourrir un renouvellement du rationalisme. (shrink)

Professores são acometidos por depressão acima da média populacional. Este estudo buscou identificar quais fatores do contexto trabalho e vivências de prazer e sofrimento no trabalho são preditivos de depressão em professores do ensino privado do Rio Grande do Sul. Realizou-se uma pesquisa quantitativa explicativa com uma amostra de 197 professores com sintomas de depressão de todos os níveis de ensino privado. Os instrumentos utilizados foram a Escala de Indicadores de Prazer e Sofrimento no Trabalho, a Escala de Avaliação do (...) Contexto de Trabalho e o Inventário Beck de Depressão. A coleta de dados foi realizada, inicialmente, online e depois por Correio. Foi realizada análise de regressão linear por método stepwise. Como resultados, identificou-se que as variáveis preditoras de depressão foram: esgotamento emocional e realização socioprofissional. Considerou-se que as vivências de frustração, insegurança e estresse contribuem diretamente para a falta de identificação e de orgulho pelo trabalho docente. (shrink)

ArgumentThe article is based on the controversies relating to conducting experiments and licensing AIDS treatments in France in the 1980s and 1990s. We have identified two political operators, i.e. two issues around which tensions have grown between the different generations of actors involved in these controversies: 1) the way of thinking about patient autonomy, and 2) the way in which objectivity regarding medical decisions is built. The article shows that there are several regimes of objectivity and autonomy, and that it (...) is at the meeting point of the two dimensions that very different political forms of medicine have developed. In the case of AIDS, the article identifies four of these forms (liberal and conservative clinical traditions and therapeutic modernity – enclosed, then participative) and analyzes the dynamics of their emergence and opposition. We discuss an “objectivity/autonomy” diagram as a conceptual framework which enables us (above and beyond AIDS) to think about changes in contemporary medicine. (shrink)

Aristotle's endeavor, at least insofar as we can judge from the way it has been transmitted to us and from the titles of the lost works, is often presented as the first work of an encyclopedic nature, as it seems to embrace and order all of the elements of knowledge. Does Aristotle not advance a classification of sciences, in Metaphysics, E, 1, as well as a systematic outline of the “sciences of nature” in his Meteorologica, I, 1? And again, although (...) logic is often presented as not belonging to the system of sciences since it is not counted as a science in Metaphysics, E, 1, is Aristotle not generally considered the inventor of this discipline? The impression is all the stronger in that Andronicus of Rhodes, in the first century b.c., edited Aristotle's works by roughly adopting the threefold division of philosophy into Logic-Physics-Ethics, a division that had become common during the Hellenistic period though more particularly proper to the Stoic system. Since then, all the editions of Aristotle, in every language, have been made to serve the order in which Aristotle's treatises were thus edited. (shrink)

Em A última razão dos reis, Renato Janine Ribeiro se volta para a sociedade e a política do Antigo Regime, buscando entender em que condições algo de novo se pode gerar na aventura humana. Trata-se, aqui, de estudar o passado para verificar o quanto ele nos serve e, inversamente, até que ponto continua a nos governar. Por que uma ética aristocrática é a que melhor convém à fortuna? Por que, no mito de D. Juan, o tema do ateísmo veio (...) a ser posteriormente recalcado, restando apenas o do sedutor? Como e quando teve início a moderna análise de texto? O que existe em comum entre o discurso de um filósofo contemporâneo, Michel Foucault, e o dos moralistas franceses do século XVII? Qual a relação entre uma concepção da história centrada na idéia de novidade e as diversas vertentes da doutrina da soberania surgidas nos séculos XVII e XVIII? O que distingue a revolução socialista da burguesa no Dezoito Brumário de Marx? Questões que o autor analisa neste livro unindo clareza de estilo e erudição, e que interessam às mais variadas áreas, da filosofia à literatura, passando, evidentemente, pela política e pela história. (shrink)

Quais são as causas do descontentamento das pessoas com a política, pergunta-se o filósofo Renato Janine Ribeiro na abertura de O Valor Volta à Política, coletânea de artigos escritos entre 2011 e 2015, num momento de forte otimismo com um país que, após consolidar a democracia, parecia destinado a fortalecê-la e se desenvolver. O retrocesso que o atingiu - assim como a outros países - substituiu a política pelo ódio. Mais que o antipetismo, o maior triunfo desse furor foi (...) a antipolítica. Mas o que aconteceu? Será que a vida política se tronou um efeito da vida econômica? Se a cidadania, em nossos dias, realmente foi substituída pelo consumo, então é a subida ou a queda no nível de vida o principal critério para as pessoas decidirem seus votos? É recorrendo ao tempo longo que Janine vai examinar se o apelo democrático simplesmente se esgotou ou se o que estamos vivendo é uma "reação reacionária" dos ressentidos com um mundo em transformação. Observador atento e afiado, o próprio autor revisita esses anos de efervescência tecendo, em 2021 - portanto após a ascensão da extrema-direita -, comentários aos seus artigos. Dos efeitos da crise financeira de 2008 à contestação da legitimidade das eleições de 2014 - que Janine equivale à abertura de uma caixa de Pandora -, passando pelas manifestações de 2013 e pela ascensão das redes sociais, descortinam-se no fio dos anos visões da política brasileira e os possíveis devires de um passado que perdura no presente. (shrink)

Este volume apresenta uma leitura arrojada das ideias de um dos mais importantes filósofos do século XVII. Ribeiro discorre, principalmente, sobre dois desdobramentos fundamentais do pensamento hobbesiano. O primeiro é o pacto entre os homens para a formação do Estado, por meio do qual transferem todos os direitos ao soberano. Segundo, uma consequência direta dessa concentração de poder: o controle do conhecimento pela autoridade política.

Optic neuropathies are conditions that cause disease to the optic nerve, and can result in loss of visual acuity and/or visual field defects. An improved understanding of how these conditions affect the entire visual system is warranted, to better predict and/or restore the visual loss. In this article, we review visually-driven functional magnetic resonance imaging (fMRI) studies of optic neuropathies, including glaucoma and optic neuritis (ON); we also discuss traumatic optic neuropathy (TON). Optic neuropathy-related vision loss results in fMRI deficit (...) within the visual cortex, and is often strongly correlated with clinical severity measures. Using predominantly flickering checkerboard stimuli, glaucoma studies indicated retinotopic-specific cortical alteration with more prominent deficits in advanced than in early glaucoma. Some glaucoma studies indicate a reorganized visual cortex. ON studies have indicated that the impacted cortical areas are briefly hyperactive. For ON, brain deficits are greater in the acute stages of the disease, followed by (near) normalization of responses of the LGN, visual cortex, and the dorsal visual stream, but not the ventral extrastriate cortex. Visually-driven fMRI is sensitive, at least in ON, in discriminating patients from controls, as well as the affected eye from the fellow eye within patients. The use of a greater variety of stimuli beyond checkerboards (e.g., visual motion and object recognition) in recent ON studies is encouraging, and needs to continue to disentangle the results in terms of change over time. Finally, visually-driven fMRI has not yet been applied in TON, although preliminary efforts suggest it may be feasible. Future fMRI studies of optic neuropathies should consider using more complex visual stimuli, and inter-regional analysis methods including functional connectivity. We suggest that a more systematic longitudinal comparison of optic neuropathies with advanced fMRI would provide improved diagnostic and prognostic information. (shrink)

This study investigated potential risk factors (coping, perfectionism and self-regulation) for substantial injuries in contemporary dance students using a prospective cohort design, as high-quality studies focusing on mental risk factors for dance injuries are lacking. Student characteristics (age, sex, BMI, educational program and history of injury) and psychological constructs (coping, perfectionism and self-regulation) were assessed using the Performing artist and Athlete Health Monitor (PAHM), a web-based system. Substantial injuries were measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on (...) Health Problems and recorded on a monthly basis as part of the PAHM system. Univariate and multivariate logistic regression analyses were conducted to test the associations between potential risk factors (i.e. student characteristics and psychological constructs) and substantial injuries. 99 students were included in the analyses. During the academic year 2016-2017, 48 students (48.5%) reported at least one substantial injury. Of all factors included, coping skills (OR: 0.91; 95% CI: 0.84–0.98), age (OR: 0.67; 95% CI: 0.46–0.98) and BMI (OR: 1.38; 95% CI: 1.05–1.80) were identified as significant risk factors in the multivariate analysis. The model explained 24% of the variance in the substantial injury group. Further prospective research into mental risk factors for dance injuries with larger samples sizes is needed to develop preventive strategies. Yet, dance schools could consider including coping skills training as part of injury prevention programs and, perhaps, providing special attention to younger dancers and those with a higher BMI through transitional programs to assist them in managing the stress they experience throughout their (academic) career. (shrink)

Mães exercem papel importante no processo de hospitalização das crianças. As intervenções em psicologia positiva podem contribuir com o fortalecimento dos recursos positivos delas, o que por sua vez auxilia na recuperação da saúde das crianças. Este estudo teve por objetivo apresentar o relato da aplicação e avaliação de uma intervenção em psicologia positiva para mães de crianças hospitalizadas, visando demonstrar evidências de utilidade clínica da intervenção. A intervenção buscou diminuir sintomas de estresse, ansiedade e depressão, aumentar os níveis de (...) bem-estar subjetivo e promover o uso de estratégias de enfrentamento adaptadas ao contexto da hospitalização infantil entre as mães. Os resultados mostraram que o procedimento pode ter auxiliado as mães usarem estratégias favorecedoras durante a hospitalização, bem como alternarem o seu uso conforme a demanda. Além disso, elas puderam vislumbrar elementos positivos presentes e sentirem-se apoiadas. (shrink)

When shared decision making breaks down and parents and medical providers have developed entrenched and conflicting views, ethical frameworks are needed to find a way forward. This article reviews the evolution of thought about the best interest standard and then discusses the advantages of the harm principle (HP) and the zone of parental discretion (ZPD). Applying these frameworks to parental refusals in situations of complexity and uncertainty presents challenges that necessitate concrete substeps to analyze the big picture and identify key (...) questions. I outline and defend a new decision-making tool that includes three parts: identifying the nature of the disagreement, checklists for key elements of the HP and ZPD, and a “think list” of specific questions designed to enhance use of the HP and ZPD in clinical decision making. These tools together will assist those embroiled in complex disagreements to disentangle the issues to find a path to resolution. (shrink)

In the wake of the most recent financial crisis, corporations have been criticized as being self-interested and unmindful of their relationship to society. Indeed, the blame is sometimes placed on the corporate legal form, which can exacerbate the tension between duties to shareholders and interests of stakeholders. In comparison, the Benefit Corporation (BC) is a new legal business entity that is obligated to pursue public benefit in addition to the responsibility to return profits to shareholders. It is legally a for-profit, (...) socially obligated, corporate form of business, with all the traditional corporate characteristics combined with societal responsibilities. Considering the history and perception of shareholder primacy in United States law, it is argued that this new business structure is an ethical step toward empowering socially committed commercial entities. The contribution of this research is to provide a fundamental base of knowledge about the new legal form of business, the BC, upon which further study may rely. First, the legal history of the corporation is briefly reviewed in order to provide context to the relationship of the corporate form to society, including exploration of the premise that shareholder wealth maximization is its best and only purpose. Second, the BC is described in detail, and state statutes are compared. Third, the BC is placed within the context of corporate social responsibility. Finally, opportunities for future research are discussed. (shrink)

En prenant pour exemple mon parcours personnel allant du travail de la cure à celui de l’écriture, des violences politiques reflétées dans celles de la famille à la douleur de leurs inscriptions psychiques et textuelles, la première partie de l’exposé montrera en quoi le travail d’élaboration et d’écriture que doit effectuer un descendant de survivants, s’il cherche à psychiser, historiciser et inscrire le trauma de ses ascendants, constitue une démarche violente et transgressive. La seconde partie dégagera quelques aspects des déterminants (...) psychiques qui affectent les descendants de survivants : le caractère double du vécu traumatique, l’expérience d’une délocalisation psychique en l’absence d’image narcissisante, le souvenir de la terreur dans le rapport aux autres, la mutilation ou l’incapacité d’être. (shrink)

This paper examines the impact of integrated reporting on the integration of environmental, social, and governance issues into the business model and the related economic and ESG performance changes. To investigate these internal and external transformational effects of IR, important differences between IR and alternative ESG reporting strategies are worked out. Using three matched samples of companies from around the world for the sample period 2002–2011, IR companies are matched with companies applying no ESG reporting, stand-alone ESG reporting, or ESG (...) reporting in the annual report. The results suggest that IR is a superior mechanism only for the integration of ESG issues into the core business model when comparing IR with the ESG reporting strategies of no ESG reporting and ESG reporting in annual reports. In comparison with, stand-alone ESG reporting, the results indicate that IR is negatively associated with the ESG integration level and with the economic and ESG performance. Moreover, this negative impact is lower for companies that have already implemented ESG management tools prior to the initiation of IR and is stronger for companies residing in countries with legal requirements for the disclosure of ESG information. A separate change analysis reveals that companies do not benefit from a switch from stand-alone ESG reporting to IR. Thus, this paper provides empirical evidence that contradicts the general notion of IR as a superior reporting mechanism, as the benefits of IR are driven by several factors. (shrink)

Stories of young children who make up exaggerated stories provide questions for a discussion about lying.

For most of us, learning to communicate is as effortless as breathing, and like air, communication skills are elemental; integral to our human existence in this world. Our communicative competencies might be seen as a bridge, facilitating our relationship with the world we are immersed in. But what happens when a child has difficulty learning to communicate effectively? What happens when their most basic messages of hunger or thirst fail to be understood or they are unable to jointly share in (...) everyday experiences of curiosity, joy, frustration, or anger? In these situations, it is the role of the Speech-Language Pathologist (SLP) to span the distance between a child and their family, a child and the world, building a route for life experiences and understandings to cross over. An SLP often begins with assessment and after a brief interaction, an SLP may come to a ‘naming’ such as delay or disorder. While the caring professional may intend this naming to be helpful in better understanding a child or facilitating access to valuable support, this naming may also place an immeasurable weight upon the child and their family. The act of naming is therefore an ethical concern. Through observation and interviews, this paper presentation explores SLP’s experiences of coming to a diagnosis through the human lens of phenomenological inquiry. It seeks to enhance thoughtful and conscientious practice by considering the ‘ethical experience of caring responsibility’ as applied to SLP (van Manen, 2016). (shrink)

This article unfolds in three stages. First, it locates the emergence of modern conceptions of social justice in industrializing Europe, and especially in the discovery of the “social,” which provided a particular idiom for the liberal democratic politics for most of the twentieth century. Second, the article links this particular conception of the social to the political rationalities of the postwar welfare state and the identity of the social citizen. Finally, the article discusses the myriad ways in which this legacy (...) of the social and social justice has been disrupted, although not yet fully displaced, by the economic orthodoxies and individualization that inform the contemporary neoliberal governing project in Canada. The result, the article concludes, has been the institutionalization of insecurity, which demands the renewal of a social way of seeing and a politics of social justice on local and global scales. (shrink)

Reports of children participating in hunger strikes while detained in offshore detention centres raise interrelated ethical issues and recognizable challenges for the medical decision-makers at these sites. A composite case study, informed by reports in the public domain, is employed to explore the unique challenges of consent and decision-making in these circumstances and the perennial issues inherent in adolescents’ developing capacity and autonomy. We present an amalgamated case of a fourteen-year-old adolescent who refused to consent to medical reversal of her (...) hunger strike protest. The medical team became the final arbiter when her parents, who were also in detention, could not agree with each other even after mediation. The case explores the complexity of evaluating the adolescent’s capacity to provide informed consent while influenced by the opinions of co-detainees in this extreme setting. We argue that the parents and the child had compromised decisional capacity due to the effects of detention. The challenges to the medical team are recognized and discussed. The team members faced a difficult dilemma and considered the competing values of the multiple cultural and ethical factors. Each team member integrated his or her own roles, duties, and discipline-specific professional guidelines with the primary goal of mitigating potential harms. (shrink)

The dominant theory of elite power, grounded in Weberian bureaucracy, has analyzed elites in terms of stable positions at the top of enduring institutions. Today, many conditions that spawned these stable ‘command posts’ no longer prevail, and elite power thus warrants rethinking. This article advances an argument about contemporary ‘influence elites’. The way they are organized and the modus operandi they employ to wield influence enable them to evade public accountability, a hallmark of a democratic society. Three cases are presented, (...) first to investigate changes in how elites operate and, second, to examine varying configurations in which the new elites are organized. The cases demonstrate that influence elites intermesh hierarchies and networks, serve as connectors, and coordinate influence from multiple, moving perches, inside and outside official structures. Their flexible and multi-positioned organizing modes call for reconsidering elite theory and grappling with the implications of these elites for democratic society. (shrink)

The Administration of Buddhism in China: A Study and Translation of Zanning and the Topical Compendium of the Buddhist Clergy, by Albert Welter. Cambria Press, 2018. 722pp., Hb. $154.99. ISBN-13: 9781604979428.

Authentic Replicas: Buddhist Art in Medieval China by Hsueh-man Shen. Honolulu: University of Hawai‘i Press 2019. 352 pp.; 132 illustrations, 113 in colour. Hb $72 ISBN-13: 9780824867058.

This paper examines whether and to what extent the overall business strategy influences the firm’s mismanagement of sustainability. Specifically, an empirical measure for the mismanagement of sustainability is developed by exploiting the newly available materiality guidelines for US firms to define industry-specific material sustainability issues. Using this measure, this paper shows that mismanagement of sustainability can represent unethical business behavior when firms intentionally perform better on immaterial issues than on material issues by diverting stakeholders’ attention from the firm’s low overall (...) sustainability performance. This paper assumes that the right business strategy can prevent such unethical actions. Based on Miles and Snow’s organizational theory, this paper distinguishes between Prospector and Defender business strategies. By employing multiple firm-level panel regressions, the findings suggest that Prospector-type firms are more likely to mismanage sustainability issues compared to Defender-type firms intentionally. The results give implications for researchers, regulators and standard setters, auditors, sustainability practitioners, and scholars. (shrink)