The output feedback controller is designed for a class of stochastic nonlinear systems that satisfy uncertain function growth conditions for the first time. The multivariate function growth condition has greatly relaxed the restrictions on the drift and diffusion terms in the original stochastic nonlinear system. Here, we cleverly handle the problem of uncertain functions in the scaling process through the function maxima theory so that the Ito differential system can achieve output stabilization through Lyapunov function design and the solution (...) of stochastic nonlinear system objects satisfies the existence of uniqueness, ensuring that the system is globally asymptotically stable in the sense of probability. Furthermore, it is concluded that the system is inversely optimally stable in the sense of probability. Finally, we apply the theoretical results to the practical subsea intelligent electroexecution robot control system and obtain good results. (shrink)

This essay explores the experience of suffering in order to see to what extent it can be understood within the context of the human condition without diverting the reality of suffering or denying the meaning of human existence and divine reality. Particular attention is given to describing and interpreting what I call the transcendent dimensions of suffering with the intent of showing that in the experience of suffereing persons come up against the limits of what can be accounted for in (...) ordinary terms and point towards transcendent reality. In religious faith the transcendent dimensions of suffering may be understood to come together with other transcendent dimensions of experience in a more distinctive or focused encounter with transcendent reality. The conception of God that is suggested by the transcendent dimensions of suffering, however, differs from the model of God in western theism as an absolutely transcendent, all powerful, immutable and impassible being. (shrink)

This essay explores the experience of suffering in order to see to what extent it can be understood within the context of the human condition without diverting the reality of suffering or denying the meaning of human existence and divine reality. Particular attention is given to describing and interpreting what I call the transcendent dimensions of suffering with the intent of showing that in the experience of suffereing persons come up against the limits of what can be accounted for in (...) ordinary terms and point towards transcendent reality. In religious faith the transcendent dimensions of suffering may be understood to come together with other transcendent dimensions of experience in a more distinctive or focused encounter with transcendent reality. The conception of God that is suggested by the transcendent dimensions of suffering, however, differs from the model of God in western theism as an absolutely transcendent, all powerful, immutable and impassible being. (shrink)

Luck egalitarianism makes a fundamental distinction between inequalities for which agents are responsible and inequalities stemming from luck. I give several reasons to find luck egalitarianism a compelling view of distributive justice. I then argue that it is an incomplete theory of equality. Luck egalitarianism lacks the normative resources to achieve its ends. It is unable to specify the prior conditions under which persons are situated equivalently such that their choices can bear this tremendous weight. This means that luck (...) egalitarians need to become pluralists who understand equality not merely in terms of choice, luck, and responsibility. After developing my critical argument that luck egalitarianism is incomplete, I sketch a strategy for rehabilitating and filling out the theory. (shrink)

There are various reasons why efforts to promote “support for self-management” have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited and (...) somewhat instrumental views of patients. It tends to: restrict the pursuit of respectful and enabling ‘partnership working’; run the risk of undermining patients’ self-evaluative attitudes ; limit recognition of the supportive value of clinician-patient relationships; and obscure the practical and ethical tensions that clinicians face in the delivery of support for self-management. We suggest that a focus on enabling people to live well with their long-term conditions is a promising starting point for a more adequate conception of support for self-management. We then outline the theoretical advantages that a capabilities approach to thinking about living well can bring to the development of an account of support for self-management, explaining, for example, how it can accommodate the range of what matters to people for living well, help keep the importance of disease control in perspective, recognize social influences on people’s values, behaviours and wellbeing, and illuminate more of the rich potential and practical and ethical challenges of supporting self-management in practice. (shrink)

In this paper, we apply imprinting theory to examine how institutional transformation substantially influences perceptions of corruption that we argue to be incorporated to a varying extent in organizations founded in that period. For this purpose, we compare the effect of a sudden shock (dissolution of the Soviet Union) on the managers' present perceptions to that of a steady transition (EU accession). We consult the 5th round of the Business Environment and Enterprise Performance Survey from 2012 to 2014 analyzing 4715 (...) interviews with managers of organizations from twelve Central and Eastern European countries. Our results reveal striking differences in the present perception of corruption for organizations founded immediately before and immediately after these institutional transitions. The study's results contribute to the research on imprinting theory regarding the relationship between organizations and institutional conditions that constitutes a lasting effect on organizational structures. Thus, applying an institutional perspective that considers less stable periods for organizations yields a promising avenue in research on organizational behavior. (shrink)

Digital communication between a patient and their clinician offers the potential for improved patient care, particularly for young people with long term conditions who are at risk of service disengagement. However, its use raises a number of ethical questions which have not been explored in empirical studies. The objective of this study was to examine, from the patient and clinician perspective, the ethical implications of the use of digital clinical communication in the context of young people living with long-term (...) conditions. A total of 129 semi-structured interviews, 59 with young people and 70 with healthcare professionals, from 20 United Kingdom -based specialist clinics were conducted as part of the LYNC study. Transcripts from five sites were read by a core team to identify explicit and implicit ethical issues and develop descriptive ethical codes. Our subsequent thematic analysis was developed iteratively with reference to professional and ethical norms. Clinician participants saw digital clinical communication as potentially increasing patient empowerment and autonomy; improving trust between patient and healthcare professional; and reducing harm because of rapid access to clinical advice. However, they also described ethical challenges, including: difficulty with defining and maintaining boundaries of confidentiality; uncertainty regarding the level of consent required; and blurring of the limits of a clinician’s duty of care when unlimited access is possible. Paradoxically, the use of digital clinical communication can create dependence rather than promote autonomy in some patients. Patient participants varied in their understanding of, and concern about, confidentiality in the context of digital communication. An overarching theme emerging from the data was a shifting of the boundaries of the patient-clinician relationship and the professional duty of care in the context of use of clinical digital communication. The ethical implications of clinical digital communication are complex and go beyond concerns about confidentiality and consent. Any development of this form of communication should consider its impact on the patient-clinician-relationship, and include appropriate safeguards to ensure that professional ethical obligations are adhered to. (shrink)

Background Migrant live-in care workers are a main pillar of long-term care in many countries, including Germany. Several studies examining their working and living conditions reveal serious problems. However, a key element of live-in arrangements, namely the relationship between the individuals involved, has not yet been systematically investigated from an ethical perspective. Aim Building on previous socioempirical work that explored and set out the meaning of “care networks”, we start from the premise that live-ins are embedded in a network (...) of relationships which are essential for their employment and living situation. Methods The theoretical analysis draws on a network approach that takes care–ethical considerations into account. Using Joan Tronto’s four care–ethical phases, existing dependencies are described and reflected upon using the corresponding four care–ethical dimensions. The central questions are how dependencies in the live-in arrangement can be characterised based on the existing body of empirical studies and with a focus on the elements of power, dependency and trust in the ethical reflection on care. Results Based on this analysis, it becomes apparent that the ambivalence resulting from the simultaneity of different forms of asymmetry and mutual dependence is omnipresent in live-in arrangements and gives rise to seemingly contradictory forms of relationships and emotions. Responsibilities are vague and are constantly renegotiated on the basis of implicit assumptions and problematic role expectations and are also assigned without negotiation. Conclusions In the future, it will not only be necessary to better understand and clarify responsibilities at the micro level of the individual care arrangement from the various positions and roles and with a view to the changing processes of caring for another, but also to address the pressing ethical questions and problems in live-in arrangements at the meso and macro levels—enriched by care–ethical perspectives. (shrink)

While often presented as promising assistive technologies for motor-impaired users, electroencephalography (EEG)-based Brain-Computer Interfaces (BCIs) remain barely used outside laboratories due to low reliability in real-life conditions. There is thus a need to design long-term reliable BCIs that can be used outside-of-the-lab by end-users, e.g., severely motor-impaired ones. Therefore, we propose and evaluate the design of a multi-class Mental Task (MT)-based BCI for longitudinal training (20 sessions over 3 months) of a tetraplegic user for the CYBATHLON BCI series 2019. (...) In this BCI championship, tetraplegic pilots are mentally driving a virtual car in a racing video game. We aimed at combining a progressive user MT-BCI training with a newly designed machine learning pipeline based on adaptive Riemannian classifiers shown to be promising for real-life applications. We followed a two step training process: the first 11 sessions served to train the user to control a 2-class MT-BCI by performing either two cognitive tasks (REST and MENTAL SUBTRACTION) or two motor-imagery tasks (LEFT-HAND and RIGHT-HAND). The second training step (9 remaining sessions) applied an adaptive, session-independent Riemannian classifier that combined all 4 MT classes used before. Moreover, as our Riemannian classifier was incrementally updated in an unsupervised way it would capture both within and between-session non-stationarity. Experimental evidences confirm the effectiveness of this approach. Namely, the classification accuracy improved by about 30% at the end of the training compared to initial sessions. We also studied the neural correlates of this performance improvement. Using a newly proposed BCI user learning metric, we could show our user learned to improve his BCI control by producing EEG signals matching increasingly more the BCI classifier training data distribution, rather than by improving his EEG class discrimination. However, the resulting improvement was effective only on synchronous (cue-based) BCI and it did not translate into improved CYBATHLON BCI game performances. For the sake of overcoming this in the future, we unveil possible reasons for these limited gaming performances and identify a number of promising future research directions. Importantly, we also report on the evolution of the user's neurophysiological patterns and user experience throughout the BCI training and competition. (shrink)

Person‐specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self‐determination method with people with various long‐term health conditions. It explains the mechanisms of mobilizing relational capacity by including person‐specific evidence in shared decision‐making. Person‐specific self‐insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self‐management challenges. This step paved the way for sharing these (...) insights and challenges in a relationship with a supportive health professional, who could then rely on person‐specific evidence instead of assumptions or a narrow disease perspective for shared decision‐making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person‐specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self‐insights in daily life with other people, decreasing loneliness they experienced in self‐management. Relational capacity, the core of the theory, is mobilized in both people with long‐term health conditions and healthcare professionals. Further research on person‐specific evidence and relational capacity in healthcare is recommended. (shrink)

Long-term potentiation (LTP) is operationally defined as a long-lasting increase in synaptic efficacy following high-frequency stimulation of afferent fibers. Since the first full description of the phenomenon in 1973, exploration of the mechanisms underlying LTP induction has been one of the most active areas of research in neuroscience. Of principal interest to those who study LTP, particularly in the mammalian hippocampus, is its presumed role in the establishment of stable memories, a role consistent with descriptions of memory formation. Other characteristics (...) of LTP, including its rapid induction, persistence, and correlation with natural brain rhythms, provide circumstantial support for this connection to memory storage. Nonetheless, there is little empirical evidence that directly links LTP to the storage of memories. In this target article we review a range of cellular and behavioral characteristics of LTP and evaluate whether they are consistent with the purported role of hippocampal LTP in memory formation. We suggest that much of the present focus on LTP reflects a preconception that LTP is a learning mechanism, although the empirical evidence often suggests that LTP is unsuitable for such a role. As an alternative to serving as a memory storage device, we propose that LTP may serve as a neural equivalent to an arousal or attention device in the brain. Accordingly, LTP may increase in a nonspecific way the effective salience of discrete external stimuli and may thereby facilitate the induction of memories at distant synapses. Other hypotheses regarding the functional utility of this intensely studied mechanism are conceivable; the intent of this target article is not to promote a single hypothesis but rather to stimulate discussion about the neural mechanisms underlying memory storage and to appraise whether LTP can be considered a viable candidate for such a mechanism. (shrink)

The American system of long‐term care is disorganized and expensive. Obtaining care for a loved one is a confusing and difficult journey. When it comes to paying for that care, a bit over half who receive care are supported at least partially by insurance, and those with no insurance pay entirely out of pocket. The costs are exorbitant. What makes the system function is reliance on unpaid family members, who care for their loved ones often at considerable cost to (...) themselves.As the baby boom generation ages, this creaky system will become increasingly dysfunctional, and a likely shortage of caregivers will be at the heart of the difficulties. The supply of unpaid family caregivers will become limited, as the ratio of people in the category of ages forty‐five to sixty‐four compared to those who are eighty and older shrinks from just above seven to one in 2010 to just above four to one in 2030. Paid caregivers will be needed to take up the slack, yet they are poorly paid, work under very difficult conditions, and receive little respect from the health care system. In this essay, I discuss the circumstances facing these paid home‐care workers and a possible path forward, illustrating the current problems by drawing on interviews I conducted for a book‐length study published in 2017. (shrink)

Background Professional care workers face ethical issues in long-term care settings (LTCS) for older adults. They need to be independent and responsible, despite limited resources, a shortage of skilled professionals, global and societal changes, and the negative reputation of LTCS work. Research aim Our aim was to describe the care workers’ lived experiences of ethical issues. The findings can be used to gain new perspectives and to guide decision-making to improve the quality of care, occupational well-being and nursing education. Research (...) design Focus group interviews were analyzed using a hermeneutic-phenomenological method. The analysis comprised three steps: naïve reading, structural analysis, and comprehensive understanding. Participants and research context We randomly sampled LTCS service providers in Finland and 53 care workers with different educational backgrounds from seven organizations participated in focus group interviews in 2021. Ethical considerations This was a sensitive study, which was connected to the participants’ individual views of the world, professional ethics and social and health care legislation. The participants' provided informed consent and their anonymity was guaranteed. Findings Care workers spoke about their lived experiences of ethical issues in an emotional way, using practical examples. They talked about how they were experts at caring and advocating for residents, balanced the responsibilities of their different roles, and defended their work to the wider society. The care workers said that ethical aspects of their work were too difficult to solve on their own. There were elements of their working environment and practices that caused unnecessary strain and they needed the commitment of managers, organizations, and society to solve ethical issues in LTCS. Conclusions Ethical issues were related to the well-being of both residents and care workers and reflected both internal and external pressures. Some issues could not be resolved by individuals and needed input from managers, organizations, and society. (shrink)

Team reasoning gives a simple, coherent, and rational explanation for human cooperative behavior. This paper investigates the robustness of team reasoning as an explanation for cooperative behavior, by assessing its long-run viability. We consider an evolutionary game theoretic model in which the population consists of team reasoners and ‘conventional’ individual reasoners. We find that changes in the ludic environment can affect evolutionary outcomes, and that in many circumstances, team reasoning may thrive, even under conditions that, at first glance, may (...) seem unfavorable. We also pursue several extensions that augment the basic account, and conclude that team reasoning is an evolutionarily viable mechanism with the potential to explain behavior in a range of human interactions. (shrink)

Using theoretical analysis of self-consciousness concept and experimental evidence on the brain default mode network (DMN) that constitutes the neural signature of self-referential processes, we hypothesized that the anterior and posterior subnets comprising the DMN should show differences in their integrity as a function of meditation training. Functional connectivity within DMN and its subnets (measured by operational synchrony) has been measured in ten novice meditators using an electroencephalogram (EEG) recording in a pre-/post-meditation intervention design. We have found that while the (...) whole DMN was clearly suppressed, different subnets of DMN responded differently after 4 months of meditation training: The strength of EEG operational synchrony in the right and left posterior modules of the DMN decreased in resting post-meditation condition compared to a pre-meditation condition, whereas the frontal DMN module on the contrary exhibited an increase in the strength of EEG operational synchrony. These findings combined with published data on functional–anatomic heterogeneity within the DMN and on trait subjective experiences commonly found following meditation allow us to propose that the first-person perspective and the sense of agency (the witnessing observer) are presented by the frontal DMN module, while the posterior modules of the DMN are generally responsible for the experience of the continuity of ‘I’ as embodied and localized within bodily space. Significance of these findings is discussed. (shrink)

This paper presents a novel methodological approach of how to design, conduct and analyse robot-assisted play. This approach is inspired by nondirective play therapy. The experimenter participates in the experiments, but the child remains the main leader for play. Besides, beyond inspiration from non-directive play therapy, this approach enables the experimenter to regulate the interaction under specific conditions in order to guide the child or ask her questions about reasoning or affect related to the robot. This approach has been (...) tested in a long-term study with six children with autism in a school setting. An autonomous robot with zoomorphic, dog-like appearance was used in the studies. The children’s progress was analyzed according to three dimensions, namely, Play, Reasoning and Affect. Results from the case-study evaluations have shown the capability of the method to meet each child’s needs and abilities. Children who mainly played solitarily progressively experienced basic imitation games with the experimenter. Children who proactively played socially progressively experienced higher levels of play and constructed more reasoning related to the robot. They also expressed some interest in the robot, including, on occasion, affect. Keywords: Human–Robot Interaction, Robot-Mediated Therapy, Robot-Assisted Play, Non-Directive Play Therapy, Assistive Technology, Autism, Children. (shrink)

BackgroundScientific literature on posttraumatic growth after terrorist attacks has primarily focused on persons who had not been directly exposed to terrorist attacks or persons who had been directly exposed to them, but who were assessed few months or years after the attacks.MethodsWe examined long-term PTG in 210 adults directly exposed to terrorist attacks in Spain a mean of 29.6 years after the attacks. The participants had been injured by a terrorist attack or were first-degree relatives of people who had been (...) killed or injured by a terrorist attack. They completed diagnostic measures of emotional disorders and measures of PTSD and depression symptomatology, optimism, and PTG.ResultsMultiple regression analyses revealed gender differences and a positive linear relationship between PTG and cumulative trauma after the terrorist attack. Some PTG dimensions were significantly associated with PTSD symptomatology, these associations being linear, not curvilinear. However, PTG was not associated with depression symptomatology, diagnosis of emotional disorders, age, elapsed time since the attack, or optimism. In comparison with survivors assessed 18 years after the 1995 Oklahoma City bombing, Spanish victims of terrorism showed higher levels of appreciation of life, but lower levels of relating to others and spiritual change.ConclusionThe findings underscore the influence of gender on PTG and provide support to the hypothesis that some emotional distress may be a necessary condition of PTG. Future studies on PTG after terrorist attacks should take into consideration the characteristics of the terrorist attack itself and the contexts of violence and threat in which it occurred. The political, social, and cultural characteristics of the community affected by it and the profile and characteristics of other traumatic events suffered after the attack should also be taken into account in further research. (shrink)

Nitric oxide (NO) is involved in synaptic long-term potentiation (LTP) by multiple signaling pathways. Here, we show that LTP of synaptic transmission can be explained as a feature of signal transduction—bistable behavior in a chain of biochemical reactions with positive feedback, formed by diffusion of NO to the presynaptic site and facilitating the release of glutamate (Glu). The dynamics of Glu, calcium (Ca2+) and NO is described by a system of nonlinear reaction–diffusion equations with modified Michaelis–Menten (MM) kinetics. Numerical investigation (...) reveals that the chain of biochemical reactions analyzed can exhibit a bistable behavior under physiological conditions when production of Glu is described by MM kinetics and decay of NO is modeled by means of two enzymatic pathways with different kinetic properties. Our finding extends understanding of the role of NO in LTP: a short high-intensity stimulus is “memorized” as a long-lasting elevation of NO concentration. The conclusions obtained by analysis of the chain of biochemical reactions describing LTP can be generalized to other chains of interactions or for creating the logical elements for biological computers. (shrink)

This study examined the effect of an interference task on the consolidation of duration in long-term memory. In a temporal generalization task, the participants performed a learning phase with a reference duration that either was, or was not, followed 30 minutes later by a 15-min interference task. They were then given a memory test, 24h later. Using different participant groups, several reference durations were examined, from several hundred milliseconds (600ms) to several seconds (2.5, 4 and 8s). The results showed that (...) the scalar timing property (i.e. precision proportional to judged duration) was preserved despite the interference task given during the memory consolidation process. However, the interference task increased the variability of time judgment and tended to produce a lengthening effect in all reference duration conditions. The modeling of individual data with parameters derived from scalar expectancy theory suggests that disrupting the memory consolidation of learned reference durations introduces noise in their representation in memory, with time being specifically distorted towards a lengthened duration. (shrink)

From the state to the family: reconfiguring the responsibility for long‐term nursing care at homeThis paper discusses the implications of the shift in the location of the provision of healthcare services from healthcare institutions to the home, which has occurred or is projected to occur in coming years. It is argued that the responsibility for the provision of care and assistance needed by the elderly living at home and people with long‐term conditions living at home has shifted (...) from public services to the family. Studies of care‐givers have shown that in many situations they experience tremendous burdens, financial difficulties and health problems. Their social lives have been confined to the home, and contacts with friends and neighbors have been significantly reduced. This situation needs to be addressed by nurses, who in many cases serve as the bridge between the home and the official healthcare system. Using Foucault’s exploration of power, particularly his idea of governmentality, a genealogy of care‐giving in the home in Iceland’s health‐care has been constructed. The main findings were that, although this is occurring somewhat later than in many other countries, the state is withdrawing from its previously defined responsibility for the health and well‐being of the nation. At the same time the citizen’s responsibility for maintaining health is emphasized. Based on these findings, the argument is made that nurses in Iceland can have a profound influence on policy‐making in relation to the organization of services provided in those homes. Suggestions are made as to how this can be done, which may be of interest to nurses in other countries. (shrink)

Microbial systems biology has made enormous advances in relating microbial physiology to the underlying biochemistry and molecular biology. By meticulously studying model microorganisms, in particular Escherichia coli and Saccharomyces cerevisiae, increasingly comprehensive computational models predict metabolic fluxes, protein expression, and growth. The modeling rationale is that cells are constrained by a limited pool of resources that they allocate optimally to maximize fitness. As a consequence, the expression of particular proteins is at the expense of others, causing trade‐offs between cellular objectives (...) such as instantaneous growth, stress tolerance, and capacity to adapt to new environments. While current computational models are remarkably predictive for E. coli and S. cerevisiae when grown in laboratory environments, this may not hold for other growth conditions and other microorganisms. In this contribution, we therefore discuss the relationship between the instantaneous growth rate, limited resources, and long‐term fitness. We discuss uses and limitations of current computational models, in particular for rapidly changing and adverse environments, and propose to classify microbial growth strategies based on Grimes's CSR framework. (shrink)

Over the last century and a half, manners and formalities in the West have become less status-ridden, stiff and rigid. Debates around Norbert Elias' theory of civilising processes gave rise to questions of a change in direction of these patterns. The concept of informalisation, which describes these transformations, was first used to analyse the tumultuous changes of the 1960s and 1970s. This increasing informality, leniency and flexibility, comes hand-in-hand with a growing demand on individuals to self-regulate their emotions. This book (...) will stimulate debate around the changes in the standards of manners and emotion regulation, and will generate new avenues of enquiry that focus on issues involving informalisation. The chapters shed light on a variety of such moral and political issues over the last 150 years, offering a new and broader scope on the present social condition of humanity. Civilisation and Informalisation will be an important addition for students and scholars of figurational process sociology, and of broader interest to academics across sociology, social psychology and social history. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Ethics and the Elderly: The Challenge of Long-Term Care by Sarah M. Moses, and: Loving Later Life: An Ethics of Aging by Frits de LangeDolores L. ChristieEthics and the Elderly: The Challenge of Long-Term Care Sarah M. Moses maryknoll, ny: orbis, 2015. 206 pp. $38.00Loving Later Life: An Ethics of Aging Frits de Lange grand rapids, mi: eerdmans, 2015. 169 pp. $19.00Today many women and men live beyond (...) the so-called third age of life and enter their eighties, the "fourth age," during which the toll of time and the growing incidence of life-limiting conditions wear down even the best-preserved of the human species. Debilitating disease and normal ebbing of human function become more concentrated in this demographic bubble. As people enter their eighties, their world tends to narrow both physically and mentally, creating a need for increasing care. Often the elderly are rendered passive and dependent, forced to cede both autonomy and dignity. They become objects with little voice, requiring greater care and increasing cash. Likewise, as the baby boom generation enters this group, those living in the fourth age make up an increasing percentage of the population. Additionally, modern models of care for the elderly, often based on efficiency and cost-effectiveness, tend to erode their human dignity. Together these factors demonstrate a growing moral problem.What to do? These two books provide valuable road maps for how to proceed. They detail the reality and moral urgency of the situation. Both offer principles from philosophical and religious traditions that outline a good moral model: one of care, compassion, dignity, and community. They draw insights from Augustine and Thomas Aquinas, Karl Barth, and Dietrich Bonhoeffer, among [End Page 214] others. Both reference the Western biblical tradition, which honors the elderly even in the face of their limitations.Although the authors offer wise and thoughtful suggestions to address this growing moral crisis, they approach the serious moral issue very differently. Sarah Moses outlines a compelling case for a new interventional model for elderly living. While her book plays some muted chords that hint at "dissertation," the melody it conveys is strikingly forte and well worth the read.She presents two concrete examples of what good interaction with the elderly might look like. One draws from the international intentional outreach and residential community (the Community of Sant'Egidio), the other is a brick-and-mortar model (the Green House Project). Using both biblical paradigms and church teaching over the centuries, Moses makes the case for treating all persons with dignity and promoting their involvement in decision making as much as possible. The scriptural message she highlights—both our duty to the elderly and the "disappointment and depression" (105) of growing old—is particularly compelling.In her examples of good long-term care, community development is important. In the Sant'Egidio model, volunteers share a common life "through gathering for prayer and various outreach services to the poor" (39). There is motivation to support elderly in their own homes, but the project promotes small, family-like resident facilities when this is not possible. The physical place is less emphasized than the relationship among various age and economic groups.The Green House Project is based in a new vision of homes for the challenged elderly. Results of the project show that not only did staff remain in their jobs longer (nursing home employment turnover is extensive) but visitation by family members increased. Even such a simple thing as a different physical model for the actual building—replacing long halls and routinization with a more home-like environment—has positive results.Moses calls on leadership in church and community to educate, to designate funds for elder care, and to look beyond the caring and the construction of good facilities. She notes how important it is to work politically to change attitudes and actions.She sees care for all dependent people as a responsibility of both the church community and society in general. This includes fostering awareness, encouraging ongoing participation of the elderly in life—including church life—and allocating public resources. Bottom line: she calls for smaller institutions, meaningful opportunities for the... (shrink)

Prior research indicated that resistance to consumption contributes to the achievement of sustainable development goals and is associated with higher well-being. We investigate conditions under which materialists intend to resist consumption. We find that by enhancing self-control and long-term orientation, the intention to resist consumption and the frugality scores of high- and low-materialism individuals increase. These increases are stronger for those who believe that possessions are a source of happiness, but not for those who believe that possessions signal success (...) or for those who believe that acquiring possessions is a central goal in their daily lives. The findings suggest that individuals who believe that possessions are a source of happiness and who are led to feel more self-controlled and long-term oriented become inclined to resist consumption in the short-term to achieve materialistic aspirations in the long-term. Similar findings were not obtained for the other dimensions of materialism because these dimensions do not motivate one to save in the short-term. Overall, these studies demonstrate that the happiness dimension of materialism may also motivate resistance to consumption. Such findings have implications for sustainability, for public policy makers, and for business ethics. (shrink)

Residents with dementia in long-term care facilities (LTCFs) often receive antipsychotic (AP) medications without clear clinical indications. One non-clinical factor influencing the use of APs in LTCFs is low staff levels. Often, using APs is viewed and rationalised by healthcare professionals in LTCFs as a lesser evil option to manage low staff levels. This paper investigates the ethical plausibility of using APs as a lesser of two evils in resource-constrained LTCFs. I examine the practice vis-à-vis the three frequently invoked (...) class='Hi'>conditions of lesser evil justifications as specified in the wider philosophical literature. These conditions include (1) the necessity condition, (2) the condition of sensitivity to both deontic (ie, constraint-based) and non-deontic (ie, outcome-based) considerations and (3) the commensurability condition. I argue that there are considerable difficulties in demonstrating that the practice in question satisfies the conditions of lesser evil justifications. In particular, there are major difficulties in satisfying the condition of sensitivity to deontic and outcome-based considerations, and the commensurability condition. I also argue that the current philosophical debate on lesser-evil justifications is not straightforwardly applicable to the practice of using APs for non-clinical purposes in LTCFs. I contend that caregivers are not so-called ‘generic’ agents, and the assumed rarity of lesser evil cases is questionable. I conclude that until further work is done to resolve these issues, the lesser evil reasoning cannot be, at least routinely, used to formulate robust moral justifications for the practice in question. (shrink)

Old age often brings with it chronic conditions that make it difficult to handle the activities of daily life. In the United States, unpaid family caregivers, predominantly women, provide most of this care. I explore why this situation has come about and persists and further ground my image of a dystopian future in neoliberalism, the policymaking process, and contemporary politics. I then offer an ethical and policy foundation for an alternative approach to providing needed long-term care services and make (...) provisional suggestions for actions that ought to be taken now and in the near future to avoid this dystopian future. (shrink)

Contemporary Christian ethics encounters the challenge to communicate genuinely Christian normative orientations within the scientific debate in such a way as to render these orientations comprehensible, and to maintain or enhance their plausibility even for non-Christians. This essay, therefore, proceeds from a biblical motif, takes up certain themes from the Christian tradition (in particular the idea of social justice), and connects both with a compelling contemporary approach to ethics by secular moral philosophy, i.e. with Axel Honneth's reception of Hegel, as (...) based on Hegel's theory of recognition. As a first step, elements of an ethics of recognition are developed on the basis of an anthropological recourse to the conditions of intersubjective encounters. These conditions are then brought to bear on the idea of social justice, as developed in the social-Catholic tradition, and as systematically explored in the Pastoral Letter of the United States Conference of Catholic Bishops, Economic Justice For All (1986). Proceeding from this basis, aspects of a Christian ethics of community service with regard to long-term care can be defined. (shrink)

This paper studies long-term norms concerning actions. In Meyer's Propositional Deontic Logic (PDₑL), only immediate duties can be expressed, however, often one has duties of longer durations such as: "Never do that", or "Do this someday". In this paper, we will investigate how to amend (PDₑL) so that such long-term duties can be expressed. This leads to the interesting and suprising consequence that the long-term prohibition and obligation are not interdefinable in our semantics, while there is a duality between these (...) two notions. As a consequence, we have provided a new analysis of the long-term obligation by introducing a new atomic proposition I (indebtedness) to represent the condition that an agent has some unfulfilled obligation. (shrink)

To analyze the influence of the integration of piano art and media on long-term care of the elderly in the aging society, and to improve the living standard and happiness of the elderly, based on educational psychology, several scales of self-compiled personal information, the Ackerson personality inventory, and the memorial university of Newfoundland happiness scale were introduced for statement, and questionnaire method was adopted for information collection. Then, the mechanism of the integration of piano art and media on the happiness (...) of the elderly was summarized. The results showed that there were significant differences in the happiness of the elderly in terms of monthly average income, economic pressure, health status, and living conditions. The happiness of the elderly with a monthly income of more than 5,000 yuan was significantly higher than that of the elderly with a monthly income of <3,000 yuan. The happiness of the elderly with low economic pressure was significantly higher than that of the elderly with high economic pressure. The happiness of the elderly with good living conditions was significantly higher than that of the elderly with ordinary living conditions. The happiness score and positive experience of the elderly with learning over 5 years were significantly higher than those with learning <5 years and the non-piano learning group. The total score of happiness in the piano learning group was significantly positively correlated with positive affection and PE, and negatively correlated with neuroticism and psychosis. It is concluded that the piano art learning process based on educational psychology can improve the subjective well-being of the elderly. In addition, the elderly who have been exposed to piano art for a long time are more active in life. Piano art edification is an important factor affecting the psychological well-being of the elderly. The research has a good guiding significance for improving the happiness of the elderly. (shrink)

Benzodiazepines and antidepressants have been shown to change responses to unfairness; however, the effects of their combined use on unfairness evaluation are unknown. This study examines the effects of concomitant benzodiazepines and antidepressants long-term use on the evaluation of fair and unfair offers. To analyze behavioral changes on responses to unfairness, we compared the performance of medicated participants and healthy controls in the Ultimatum Game, both in the proposer and in the respondent role. The results showed that long-term psychotropic users (...) had the worse economic strategy by accepting less offers than control subjects. However, in the proposer role, the unfair offers made by participants were similar between groups. The present results suggest that long-term use of psychotropic medication, specifically the combination of benzodiazepines and antidepressants, may increase the sensitivity to unfairness, resulting in higher rejection rates in conditions where this strategy is the most disadvantageous. (shrink)

ObjectiveTo investigate the association of pre-existing migraine in patients hospitalised and who recovered from severe acute respiratory syndrome coronavirus 2 infection with the presence of post-coronavirus disease symptoms.BackgroundNo study has investigated the role of migraine as a risk factor for development of post-COVID symptoms.MethodsA case-control study including individuals hospitalised during the first wave of the pandemic was conducted. Patients with confirmed previous diagnosis of migraine were considered cases. Two age- and sex-matched individuals without a history of headache per case were (...) also recruited as controls. Hospitalisation/clinical data were collected from hospital medical records. Patients were scheduled for a telephone interview. A list of post-COVID symptoms was systematically evaluated, but participants were invited to freely report any symptom. The Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index were used to assess anxiety/depressive symptoms and sleep quality. Multivariable conditional logistic regression models were constructed.ResultsOverall, 57 patients with confirmed diagnosis of migraine and 144 non-migraine controls who had recovered from COVID-19 were assessed at 7.3 months after hospital discharge. The number of post-COVID symptoms in the migraine group was significantly greater than in the non-migraine group. Fatigue was significantly more prevalent in the migraine group. However, no between-groups difference in the prevalence of headache as a post-COVID symptom was detected.ConclusionPatients with a history of migraine who recovered from COVID-19 exhibited more long-term fatigue as post-COVID sequelae than those without migraine. Some of the pathophysiological changes associated with migraine could predispose to the occurrence of post-COVID symptoms. (shrink)

There are three main metaphysical positions on race. Anti-realists do not believe there are any races. Natural kind approaches find sub-groups of homo sapiens that have scientific importance and label those groups races, generally taking them to be biological categories. This book argues that anti-realism is false, and the groups natural kind theorists point to, if real, are not the groups we care about in ordinary discussions of race. This book defends, instead, a social kind view, which considers races to (...) exist because of contingent social practices. I argue for a social kind view that recognizes that biological features we use to classify people racially do not make races natural kinds. Racial groups could theoretically exist independently of any social constructions, since they are just groups of people, but social constructions single out certain groups of people as races, give them social importance, and allow us to name them as races. This book also identifies several kinds of context-sensitivity in our racial classification and sees that context-sensitivity as central to how racial categorization works. In terms of our moral response to these metaphysical realities, we need racial categories to identify problems in how our racial constructions are formed, including addressing harmful effects, rather than seeking to eliminate the categories in any direct way, but we should also make efforts to change the conditions that generate those problematic elements, with a goal of retaining only the unproblematic aspects. (shrink)

Residents’ councils in Quebec’s residential and long-term care centres have the mandate to promote the improvement of living conditions for residents, to assess their level of satisfaction, and to defend their rights. Based on two studies on the autonomy of councils, we examined how committees can express themselves on topics other than those the management is already aware of, to reveal various previously unknown aspects of the services, and to voice unexpressed concerns. We are especially interested in what makes (...) management receptive, or not, to what the committee members say. The councils’ ability to express them selves is, in fact, inseparable from its capacity to listen to the management teams, and we seek to determine the conditions required to perform this dual capacity. (shrink)

Nigeria agriculture, food security and dietary intake have not been exempted from the disruptions in countless sectors around the world due to the outbreak of COVID-19. The country first experienced the outbreak on February 27, 2020, and the experience since then has shown negative effects not only on the socioeconomic conditions but also on agriculture, food security and dietary intake. Long term in-depth analysis of the effects of this pandemic on food security and dietary intake using quantitative data is (...) still very difficult due to paucity of data and the great level of the improbability of the trajectory of the spread of the Virus. This study is a rapid assessment of the short and long-term potential effects of the disease. It relied on a review of situation reports especially by the Nigeria Centre of Disease Control and other reports around the world on COVID-19, personal observations, and public opinion via mobile telephone survey of Lagos and Oyo States, Nigeria. Findings show that food demand and supply shocks caused by COVID-19 outbreak affect agriculture, food and dietary intake negatively through COVID-19 policies. It leads to a reduction in household income coupled with hike in food prices. Owing to the Nigeria’s crude farming practice, there was a scarcity of hired labour required for production process during 2020 farming season. This implies a high likelihood of low output and further surge in food prices in the future. Food access was also compromised with the accumulation of unsold fresh produce by the smallholder farmers and the low salary earners during movement restrictions and of loss income as a result of international border closure. Food and dietary intake is affected as people are shifting diets to more affordable and low quality foods, while food stability is not guaranteed due to market insecurity, prompting an extraordinary level of indecision. The study concludes that the shock of COVID-19 is not only a demand management problem but a multidimensional crisis requiring monetary, fiscal, and health policy responses with global collaboration and cooperation. (shrink)

To what extent are visual fantasies constrained by our perceptual experience of the real world? Our study exploits the fact that people’s knowledge of the appearance of individuals from the early 20th Century derives predominantly from viewing black-and-white media images. An initial experiment shows that mental imagery for individuals from this period are experienced as significantly less colourful than imagery for individuals from the era of colour media. A second experiment manipulated whether participants were instructed to explicitly imagine using colour (...) or not . Results show that colour manipulation only influences imagery for black-and-white era individuals, with no comparable effect on imagery for colour era individuals. This finding is replicated in a third experiment that includes an additional control condition of imagining generic characters . Again, only imagery for black-and-white era individuals is affected by the colour manipulation. Overall these results provide evidence for long-term perceptual specificity effects in mental imagery. We argue that visual fantasies can be constrained by surface features of underlying representations in memory, even when imagining something we have never directly perceived. (shrink)

PurposeTo explore the mindfulness practice, its long-term effects, facilitators and barriers, in clinical clerkship students 2 years after participation in an 8-week mindfulness-based stress reduction training.MethodA qualitative study was performed by semi-structured in-depth interviews with 16 clinical clerkship students selected by purposive sampling. Students had participated in a MBSR training 2 years before and were asked about their current mindfulness practice, and the long-term effects of the MBSR training. Thematic analysis was conducted using the constant comparison method. Data saturation was (...) reached after 16 interviews.ResultsMost interviewees were still engaged in regular, predominantly informal, mindfulness practice, although some discontinued mindfulness practice and reported an “unchanged lifestyle.” Three main themes came forward; “focused attention and open awareness” during daily activities as core elements of long-term mindfulness practice; “changes in behavior and coping” that resulted from taking a pause, reflecting, recognizing automatic behavioral patterns and making space for a conscious response; “integration in personal and professional life” by enhanced enjoyment of daily activities, improved work-life-balance and making different career choices. Barriers and facilitators in starting and maintaining mindfulness practice were understanding and intention as “pre-conditions”; practical, personal, and professional factors of students in maintaining practice.ConclusionTwo years after participation in a MBSR training, many interviewees were still engaged in mindfulness practice contributing to both personal and professional changes. In light of the high clerkship demands, MBSR training could be a valuable addition to medical curricula, supporting medical students in developing necessary competencies to become well-balanced professionals. (shrink)

Considerable policy and scholarly interest in the treatment of long-term prisoners in conditions of high security existed throughout the 1970s to 1990s, often precipitated by major calamitous events. It has been a major theme of official discourse on the treatment of long-term prisoners since then that ‘a viable life’ and the preservation of dignity are important principles to adhere to in policy and practice. This morality is under threat.

Aim:This study explores experiences of patients suffering from Korsakoff’s syndrome. It contributes to improved reflection on the value of patient knowledge.Background:An ethics of care perspective states the importance of moving to patients in their vulnerable state of being, and to figure out patients’ individual needs necessary to provide good care. The information given by patients suffering from Korsakoff’s syndrome might be mistaken, invented and even not true. The value of these patients’ experiences and knowledge had not been researched to date.Method:Data (...) from six in-depth interviews were analysed concurrently through the constant comparative method.Ethical considerations:The principles of voluntariness, confidentiality and anonymity were respected during the research process.Findings:Four important themes within patients’ knowledge emerged: health condition, involuntary admission into the nursing home, the daily routine and interpretation of the caring abilities of healthcare professionals. The findings show that our respondents were able to provide a window into their inner perspective.Conclusion:This study deepens our understanding of the value of patient knowledge in situations where patients see the world in a different manner as do healthcare professionals. The conversations revealed personal subjective knowledge which our respondents create and live by. Healthcare professionals are encouraged to discover and affirm the understandings of these patients, and not be prepossessed due to the diagnosis or general nursing home rules. Understanding patients’ unique knowledge through appreciation of the complexity and richness of different views on the situation can assist to give a more humane response to individual needs and pain. Health staff in healthcare institutions are encouraged to evaluate the – unintended – effect of rigidly applied nursing home rules, and the government is challenged to rethink its policy about care, and provide more resources permitting relational care that nurtures the dignity of patients suffering from Korsakoff’s syndrome. (shrink)

This book surveys the major thinking about Christian ethics as found in books published or distributed in the United States from the mid-sixties to the end of the seventies. In the first half of the book, Professor Long updates the analysis he first expounded in 1967 in his widely praised study, A Survey of Christian Ethics. Part one examines the literature dealing with moral reasoning, thinking about laws and codes, and ethics done in terms of situations and relationships. Part two (...) examines published work that stress the importance of institutions, politics in operational terms, and efforts to think of Christian fidelity as expressed in special communities outside or opposed to the civic mainstream. In part three Professor Long examines works concerned with the nature and function of the moral agent, covering such topics as attention to virtue and character, the nature and role of conscience, and thinking about the implications of moral development theory. Part four describes three new frameworks for doing ethics that have been developed during the last fifteen years: vocational ethics and policy studies; liberation theology; and comparative religious ethics. (shrink)

Evolution has shaped all living organisms on Earth, although many details of this process are shrouded in time. However, it is possible to see, with one's own eyes, evolution as it happens by performing experiments in defined laboratory conditions with microbes that have suitably fast generations. The longest‐running microbial evolution experiment was started in 1988, at which time twelve populations were founded by the same strain ofEscherichia coli. Since then, the populations have been serially propagated and have evolved for (...) tens of thousands of generations in the same environment. The populations show numerous parallel phenotypic changes, and such parallelism is a hallmark of adaptive evolution. Many genetic targets of natural selection have been identified, revealing a high level of genetic parallelism as well. Beneficial mutations affect all levels of gene regulation in the cells including individual genes and operons all the way to global regulatory networks. Of particular interest, two highly interconnected networks—governing DNA superhelicity and the stringent response—have been demonstrated to be deeply involved in the phenotypic and genetic adaptation of these experimental populations. BioEssays 29:846–860, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

The aim of the experiment was to evaluate the adaptive responses of biomechanical and electromyographic parameters to vertical unloading when walking during the 4-month isolation experiment SIRIUS-19 in the ground-based space station model. The study involved 6 healthy international crew members of the SIRIUS-19 project aged 34 ± 6.2 years. Body Weight Unloading conditions was created by the h/p/cosmos airwalk system. The locomotor test included walking with a sequential change of BWU modes: 5-min walking with 0% BWU, 5-min walking (...) with 65% BWU and 5-min walking with 85% BWU. Ground Reaction Force was recorded by the h/p/cosmos treadmill device. Muscle Lab Model 4000e device was used to record the electromyographic signals of the hip and shin muscles. The locomotor test was performed twice before GBI, monthly during GBI and 1 week after leaving isolation. The results obtained before GBI demonstrate that the changes of support and proprioceptive afferentation signals play significant role in reorganizing of the biomechanical structure of motor acts and the development of new movement patterns. The results of the study are consistent with the previously obtained results of other studies in this direction. Despite the fact that during the GBI the participants of the experiment performed regular physical training, a decrease in the performance indicators values was detected, especially pronounced after 100 days of GBI. This is probably due to limited space of a space station model, as well as the development of a special motor stereotype in it. Noteworthy are the results obtained after the 4th session of the experiment, indicating the effect of sensorimotor learning. We think that the data obtained in this study will be useful in research both in gravitational physiology and in clinical medicine. (shrink)

With a history dating back at least 3000 years, the philosophical tradition of India is one of the oldest to continue to thrive today. Encompassing a wide variety of worldviews, Indian philosophy includes perspectives that have ongoing relevance to contemporary issues such as the nature of consciousness, the relationship between philosophy and the good life, the existence of a divine reality, and the meaning of happiness. Contrary to widespread stereotypes, Indian philosophy is not simply an extension of Indian religion. Scepticism (...) is a pervasive feature of this discourse, and there is even a school of thought which affirms materialism. The idea of a divine reality is debated extensively, not only in terms of the existence of such a reality-"Is there a God?"-but also in terms of its nature-"What is God?" This book, drawing upon some of the latest research in the field, traces the history of the Indian philosophical tradition from ancient times to the present, outlining the views and major thinkers of such schools of thought as Vedanta, Jainism, Buddhism, and many more. Jeffery D. Long treats each system, however, not simply as an historical artifact, but as a living reality with important insights to offer our world today. It is essential reading for anyone interested in world philosophies and how they address the 'big questions' that have always engaged human beings. (shrink)