The complexity of biobank research raises concerns about individuals’ understanding of the information conveyed in the consent process for such research.. We report the results of a qualitative, cognitive interview study with an ethnically, linguistically, and educationally diverse sample of 43 respondents to assess the clarity and utility of a multimedia tool developed for a biobank. Using weighted randomization, respondents were assigned to either view the multimedia tool or read a written consent document . The study illustrates the utility of (...) cognitive interviews for gaining insights from prospective research participants about the clarity of informed consent tools. Findings suggest that a multimedia tool is useful for communicating key messages but should be combined with a written consent document and personal interaction with the study staff. We recommend that the potential value of multimedia tools should be more rigorously tested in a randomized controlled trial. (shrink)

Egg and sperm have, understandably, been the “stars” of mammalian fertilization biology, particularly because artificial reproductive technologies allow for fertilization to occur outside of the female reproductive tract without other apparent contributions from either sex. Yet, recent research, including an exciting new paper, reveals unexpected and important contributions of seminal plasma to fertility. For example, seminal plasma proteins play critical roles in modulating female reproductive physiology, and a new study in mice demonstrates that effects of some of these proteins on (...) the female can even affect the health of her progeny. Furthermore, although several actions of seminal plasma have been conserved across taxa, male accessory glands and their products are diverse – even among mammals. Taken together, these studies suggest that the actions of seminal plasma components are important to understand, and also to consider in future development of assisted reproductive technologies (ART) for humans, farm species and endangered species of mammals. (shrink)

Previous studies examining EEG and LORETA in patients with chronic pain discovered an overactivation of high theta and low beta power in central regions. MEG studies with healthy subjects correlating evoked nociception ratings and source localization described delta and gamma changes according to two music interventions. Using similar music conditions with chronic pain patients, we examined EEG in response to two different music interventions for pain. To study this process in-depth we conducted a mixed-methods case study approach, based on three (...) clinical cases. Effectiveness of personalized music therapy improvisations versus preferred music on chronic pain was examined with 16 participants. Three patients were randomly selected for follow-up EEG sessions three months post-intervention, where they listened to recordings of the music from the interventions provided during the research. To test the difference of EM versus preferred music, recordings were presented in a block design: silence, their own composed EM, preferred music, and a non-participant’s EM as a control. Participants rated their pain before and after the EEG on a 1–10 scale. We conducted a detailed single case analysis to compare all conditions, as well as a group comparison of entrainment-healing condition versus preferred music condition. Power spectrum and according LORETA distributions focused on expected changes in delta, theta, beta, and gamma frequencies, particularly in sensory-motor and central regions. Intentional moment-by-moment attention on the sounds/music rather than on pain and decreased awareness of pain was experienced from one participant. Corresponding EEG analysis showed accompanying power changes in sensory-motor regions and LORETA projection pointed to insula-related changes during entrainment-pain music. LORETA also indicated involvement of visual-spatial, motor, and language/music improvisation processing in response to his personalized EM which may reflect active recollection of creating the EM. Group-wide analysis showed common brain responses to personalized entrainment-healing music in theta and low beta range in right pre- and post-central gyrus. We observed somatosensory changes consistent with processing pain during entrainment-healing music that were not seen during preferred music. These results may depict top–down neural processes associated with active coping for pain. (shrink)

Nearly $2 trillion is spent annually in the U.S. treating chronic illness — yet accessibility to quality health care services in rural communities for the chronically ill and dying remains problematic. Unique barriers present special challenges to a meaningful discussion of and subsequent strategies for addressing these issues in the context of increasingly scarce resources.

The Institute of Medicine reporting on the quality of health care in America recommends six aims for achieving the health care system we could have. Together with the Institute for Healthcare Improvement Triple Aim initiative, a framework has emerged to challenge providers, educators, and policymakers to remake the health care system according to specific objectives: to provide care that is safe, effective, patient-centered, timely, efficient, and equitable to more people at a price we can afford. Complicating this mission of better (...) prevention and better care at a lower cost is a daunting demographic: January of 2011 marked the month and year that the first of the baby boomers turned 65. The U.S. Census Bureau in May 2010 projected the number of Americans of this age and over to reach 88 million by 2050, more than double the current figure of 40.2 million. Parekh and Barton forecast in stark detail what it will be like to address these burgeoning numbers of older Americans with comorbidities, including the fact that over 20% of the population currently experiences at least two chronic medical conditions. (shrink)

Given any simply consistent formal theory F of the state complexity L(S) of finite binary sequences S as computed by 3-tape-symbol Turing machines, there exists a natural number L(F ) such that L(S) > n is provable in F only if n L(F ). The proof resembles Berry’s..

Taxation policy is driven by many factors, including public opinion, but little research has examined the strength and stability of the public’s taxation preferences. This paper demonstrates one way in which preferences for progressiveness depend on the framing of the question asked. Participants indicated how they would share a fixed tax burden between two individuals who earned different amounts of money, either by adjusting the amount of tax paid by the two individuals, or by adjusting the amount of post-tax income (...) retained. The units in which tax was described — amount of money or percentage tax rate — were manipulated orthogonally. There was a strong metric effect: Participants favored progressiveness more when tax was described as a percentage rather than amount. However, there was also a clear interaction: for amounts, participants favored progressiveness significantly more when considering post-tax money retained rather than tax paid; for percentages, no such effect was found. (shrink)

In discussions of health reform, the increased use of health information technology is a common element of nearly every serious proposal on the table. Health IT includes electronic health records kept by providers, personal health records offered by health insurance plans or owned by consumers, and electronic health information exchanges. Although health reform initiatives being discussed contain little detail regarding health IT, in general they promote health IT to facilitate the electronic sharing of health information to improve individual and population (...) health. During the 2008 presidential campaign, the health care proposals of both President Obama and Senator McCain discussed health IT. President Obama’s proposal invests $50 billion over the next five years to promote the adoption of health IT with privacy safeguards. Senator McCain’s plan also encouraged the adoption of health IT, with an emphasis on coordination. (shrink)

Thinkers committed to an ideal of public reason are suspicious of religiously informed political activity as it undermines democratic political legitimacy. This paper considers Jürgen Habermas’s recent shifts on this question in light of the history of Europe’s religious parties in the late 19th and early 20th centuries. These parties made a real and lasting contribution to Europe’s democratization and their history suggests ways in which Habermas and other defenders of public reason misunderstand the nature of democratic political legitimacy.

This book is a thorough study of John Owen. Owen has become recognized as one of the greatest Reformed theologians Great Britain ever produced, as well as one of the most significant theologians of the Reformed orthodox period. His theological interests were eclectic, exegetically based, and he sought to meet the needs of his times. This volume treats key areas in Owen's thought, including the Trinity, Old Testament exegesis, covenant theology, the law and the gospel, the nature of faith in (...) relation to images of Christ, and prolegomena. The common theme tying them together is that John Owen helps us better understand the development and interrelationship of theology, exegesis, and piety in Reformed orthodox theology. By setting him in his international and cross-confessional contexts, the author seeks to use Owen as a window into the trajectory of Reformed orthodoxy in several key areas. (shrink)

This chapter outlines the intellectual history and conceptual framing that shapes the presentation of ethnographic cases in the subsequent chapters. After a review of the models of music and ethics that informed the author's prior assumptions, the chapter describes a four-cornered conceptual frame-ethics, goods, exchange, and musical meaning-that emerged over the course of fieldwork. Ethics is described as a mode of evaluative thought-feeling that helps members.

This book is the second volume of an interdisciplinary study, chiefly one of philosophy and psychology, which concerns personality, especially the abnormal in terms of states of aloneness, primarily that of the negative emotional isolation customarily known as loneliness. Other states of aloneness investigated include solitude, reclusiveness, seclusion, desolation, isolation, and what the author terms “aloneliness,” “alonism,” “lonism,” and “lonerism.” Insofar as this study most explicitly focuses on abnormal personalities, it employs the general and specific definitions of personality aberrations as (...) formulated by the American Psychiatric Association in its latest edition of the _Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)_. The author views personality as preeminently comprised of the individual's interpersonal relationships. Unlike the _DSM-IV_, he proposes that people with personality disorders not only possibly but necessarily manifest deviancy regarding interpersonal functioning via serious shortcomings in shared inwardness, paramountly reciprocated intimacy. This work also engages in an analysis of five social factors that are conducive to predisposing, precipitating, and maintaining negative kinds of personality and aloneness. The author has formed these factors into an acronym titled _SCRAM_ since when they are present, intimacy scurries away and in its absence, loneliness and other sorts of unwanted aloneness scamper in and fill the person with unhappiness via, for instance, sadness and self-worthlessness. The constituents of SCRAM are the following social illnesses: _S_uccessitis (for example, the fixation on fame and fortune), _C_apitalitis (greed-driven, unfettered capitalism), _R_ivalitis (competitivitis), _A_tomitis (hyper-individualism), and _M_aterialitis (for example, the anti-spirituality of consumeritis). In sum, this book provides a different perspective on personality via the lenses of various types of aloneness and their lack of public and private intimacy, especially love. (shrink)

Originally published in 1944, this book was originally intended as a continuation of the 1943 publication Nautical Mathematics, which is also reissued in this series. In it, the principles set out in Nautical Mathematics are given practical applications, and the text is supplied with exercises to test and clarify the lessons. This book will be of value to anyone with an interest in the history of education in the forces during WWII.

Next SectionBackground: Physicians face ethical difficulties daily, yet they seek ethics consultation infrequently. To date, no systematic data have been collected on the strategies they use to resolve such difficulties when they do so without the help of ethics consultation. Thus, our understanding of ethical decision making in day to day medical practice is poor. We report findings from the qualitative analysis of 310 ethically difficult situations described to us by physicians who encountered them in their practice. When facing such (...) situations, the physicians sought to avoid conflict, obtain assistance, and protect the integrity of their conscience and reputation, as well as the integrity of the group of people who participated in the decisions. These goals could conflict with each other, or with ethical goals, in problematic ways. Being aware of these potentially conflicting goals may help physicians to resolve ethical difficulties more effectively. This awareness should also contribute to informing the practice of ethics consultation. Objective: To identify strategies used by physicians in dealing with ethical difficulties in their practice. Design, setting, and participants: National survey of internists, oncologists, and intensive care specialists by computer assisted telephone interviews (n = 344, response rate = 64%). As part of this survey, we asked physicians to tell us about a recent ethical dilemma they had encountered in their medical practice. Transcripts of their open-ended responses were analysed using coding and analytical elements of the grounded theory approach. Main measurements: Strategies and approaches reported by respondents as part of their account of a recent ethical difficulty they had encountered in their practice. Results: When faced with ethical difficulties, the physicians avoided conflict and looked for assistance, which contributed to protecting, or attempting to protect, the integrity of their conscience and reputation, as well as the integrity of the group of people who participated in the decisions. These efforts sometimes reinforced ethical goals, such as following patients’ wishes or their best interests, but they sometimes competed with them. The goals of avoiding conflict, obtaining assistance, and protecting the respondent’s integrity and that of the group of decision makers could also compete with each other. Conclusion: In resolving ethical difficulties in medical practice, internists entertained competing goals that they did not always successfully achieve. Additionally, the means employed were not always the most likely to achieve those aims. Understanding these aspects of ethical decision making in medical practice is important both for physicians themselves as they struggle with ethical difficulties and for the ethics consultants who wish to help them in this process. (shrink)

Background: Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services.Methods: A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case (...) and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK.Results: Survey respondents ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision-making capacity , disagreement among caregivers and limitation of treatment at the end of life . The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct , someone capable of providing specific advice , help in weighing outcomes and clarification of the issues . Few of the types of help expected to be useful varied among countries.Conclusion: Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. (shrink)

In this book, S. A. Lloyd provides a radical interpretation of Hobbes' laws of nature, revealing them to be not egoistic precepts of personal prudence but rather moral instructions for obtaining the common good. This account of Hobbes' moral philosophy stands in contrast to both divine command and rational choice interpretations. Drawing from the core notion of reciprocity, Lloyd explains Hobbes' system of 'cases in the law of nature' and situates Hobbes' moral philosophy in the broader context of his political (...) philosophy and views on religion. Offering ingenious new arguments, Lloyd defends a reciprocity interpretation of the laws of nature through which humanity's common good is secured. (shrink)

In an international survey of rationing we have found that European physicians encounter scarcity-related ethical difficulties, and are dissatified with the resolution of many of these cases. Here we further examine survey results to explore whether ethics support services would be potentially useful in addressing scarcity related ethical dilemmas. Results indicate that while the type of help offered by ethics support services was considered helpful by physicians, they rarely referred difficulties regarding scarcity to ethics consultation. We propose that ethics consultants (...) could assist physicians by making the process less difficult, and by contributing to decisions being more ethically justifiable. Expertise in bringing considerations of justice to bear on real cases could also be useful in recognising an unjust limit, as opposed to a merely frustrating limit. Though these situations are unlikely to be among the most frequently referred to ethics support services, ethics consultants should be prepared to address them. (shrink)

S. A. Lloyd proposes a radically new interpretation of Hobbes's Leviathan that shows transcendent interests - interests that override the fear of death - to be crucial to both Hobbes's analysis of social disorder and his proposed remedy to it. Most previous commentators in the analytic philosophical tradition have argued that Hobbes thought that credible threats of physical force could be sufficient to deter people from political insurrection. Professor Lloyd convincingly shows that because Hobbes took the transcendence of religious and (...) moral interests seriously, he never believed that mere physical force could ensure social order. Lloyd's interpretation demonstrates the ineliminability of that half of Leviathan devoted to religion, and attributes to Hobbes a much more plausible conception of human nature than the narrow psychological egoism traditionally attributed to Hobbes. (shrink)

Collection of 10 Jaina philosophical tracts.

Concept of Avidyā in the Vedānta philosophy of Śaṅkarācārya; a study.

Работа предназначена для ученых и специалистов, преподавателей, аспирантов, слушателей, студентов, а также всех интересующихся рассматриваемой темой.

On philosophy; transcript of the 1978-1979 Śāradā-vyākhyāna-mālā lecture, under the auspices of Sri Lal Bahadur Shastri Rashtriya Vidyapeeth, New Delhi.

Environmentalist philosophers often paint a holistic picture, stressing such things as the continuity of humanity with wider nature and our membership of the 'natural community' . The implication seems to be that a non-anthropocentric philosophy requires that we strongly identify ourselves with nature and therefore that we downplay any human/non-human distinction. An alternative view, I think more interesting and plausible, stresses the distinction between humanity and a nature valued precisely for its otherness. In this article I discuss some of its (...) main elements, and some of the difficulties involved with keeping nature's otherness in focus. Firstly (in sections 1-5), I try to clarify what I take to be the otherness-based position by distinguishing it from the apparently similar views of John Passmore, Robert Elliott and Keekok Lee, and some opposed holistic views, especially of J. Baird Callicott. Then, in the second half of the article (sections 6-7), I argue that if nature is valued in virtue of its otherness, this value is best thought of as an extrinsic, final and objective good, where 'objectivity' is a 'method of understanding', in Thomas Nagel's sense. Although I give some reasons for preferring an otherness account to certain alternative positions, I make no overall attempt to 'prove' that nature is valuable for its otherness. My aim is to show that, if it is, then this seems the best way to understand that value. (shrink)

Study of Yogasūtra of Patañjali with Yogabhāṣya of Vyāsa and philosophy of Osho on Yoga philosophy.

In this book, S. A. Lloyd offers a radically new interpretation of Hobbes's laws of nature, revealing them to be not egoistic precepts of personal prudence but rather moral instructions for obtaining the common good.

Background: In 2014, companies began covering the costs of egg freezing for their employees. The adoption of this benefit was highly contentious. Some argued that it offered women more reproductive...