BackgroundConsent for data research in acute and critical care is complex as patients become at least temporarily incapacitated or die. Existing guidelines and regulations in the European Union are of limited help and there is a lack of literature about the use of data from this vulnerable group. To aid the creation of a patient-centred framework for responsible data research in the acute setting, we explored views of patients and next-of-kin about the collection, storage, sharing and use of genetic and (...) health-related data for observational research.MethodsWe conducted qualitative interviews (n = 19) with Dutch sudden cardiac arrest survivors who donated clinical and socio-economic data and genetic samples to research. We also interviewed their next-of-kin. Topics were informed by ethics literature and we used scenario-sketches to aid discussion of complex issues.ResultsSudden cardiac arrest survivors displayed limited awareness of their involvement in health data research and of the content of their given consent. We found that preferences regarding disclosure of clinically actionable genetic findings could change over time. When data collection and use were limited to the medical realm, patients trusted researchers to handle data responsibly without concern for privacy or other risks. There was no consensus as to whether deferred consent should be explicitly asked from survivors. If consent is asked, this would ideally be done a few months after the event when cognitive capacities have been regained. Views were divided about the need to obtain proxy consent for research with deceased patients’ data. However, there was general support for the disclosure of potentially relevant post-mortem genetic findings to relatives.ConclusionsSudden cardiac arrest patients’ donation of data for research was grounded in trust in medicine overall, blurring the boundary between research and care. Our findings also highlight questions about the acceptability of a one-time consent and about responsibilities of patients, researchers and ethics committees. Finally, further normative investigation is needed regarding the (continued) use of participants’ data after death, which is of particular importance in this setting. Our findings are thought to be of relevance for other acute and life-threatening illnesses as well. (shrink)

Developments in medical big data analytics may bring societal benefits but are also challenging privacy and other ethical values. At the same time, an overly restrictive data protection regime can form a serious threat to valuable observational studies. Discussions about whether data privacy or data solidarity should be the foundational value of research policies, have remained unresolved. We add to this debate with an empirically informed ethical analysis. First, experiences with the implementation of the General Data Protection Regulation (GDPR) within (...) a European research consortium demonstrate a gap between the aims of the regulation and its effects in practice. Namely, strictly formalised data protection requirements may cause routinisation among researchers instead of substantive ethical reflection, and may crowd out trust between actors in the health data research ecosystem; while harmonisation across Europe and data sharing between countries is hampered by different interpretations of the law, which partly stem from different views about ethical values. Then, building on these observations, we use theory to argue that the concept of trust provides an escape from the privacy-solidarity debate. Lastly, the paper details three aspects of trust that can help to create a responsible research environment and to mitigate the encountered challenges: trust as multi-agent concept; trust as a rational and democratic value; and trust as method for priority setting. Mutual cooperation in research—among researchers and with data subjects—is grounded in trust, which should be more explicitly recognised in the governance of health data research. (shrink)

In this article, we use the theory of Information Ethics to argue that deceased people have a prima facie moral right to privacy in the context of health data research, and that this should be reflected in regulation and guidelines. After death, people are no longer biological subjects but continue to exist as informational entities which can still be harmed/damaged. We find that while the instrumental value of recognising post-mortem privacy lies in the preservation of the social contract for health (...) research, its intrinsic value is grounded in respect for the dignity of the post-mortem informational entity. However, existing guidance on post-mortem data protection is available only in the context of genetic studies. In comparing the characteristics of genetic data and other health-related data, we identify two features of DNA often given as arguments for this genetic exceptionalism: relationality and embodiment. We use these concepts to show that at the appropriate Level of Abstraction, there is no morally relevant distinction between posthumous genetic and other health data. Thus, genetic data should not automatically receive special moral status after death. Instead we make a plea for ‘contextual exceptionalism’. Our analysis concludes by reflecting on a real-world case and providing suggestions for contextual factors that researchers and oversight bodies should take into account when designing and evaluating research projects with health data from deceased subjects. (shrink)

BackgroundThe emergence of artificial intelligence (AI) in medicine has prompted the development of numerous ethical guidelines, while the involvement of patients in the creation of these documents lags behind. As part of the European PROFID project we explore patient perspectives on the ethical implications of AI in care for patients at increased risk of sudden cardiac death (SCD).AimExplore perspectives of patients on the ethical use of AI, particularly in clinical decision-making regarding the implantation of an implantable cardioverter-defibrillator (ICD).MethodsSemi-structured, future scenario-based (...) interviews were conducted among patients who had either an ICD and/or a heart condition with increased risk of SCD in Germany (n = 9) and the Netherlands (n = 15). We used the principles of the European Commission’s Ethics Guidelines for Trustworthy AI to structure the interviews.ResultsSix themes arose from the interviews: the ability of AI to rectify human doctors’ limitations; the objectivity of data; whether AI can serve as second opinion; AI explainability and patient trust; the importance of the ‘human touch’; and the personalization of care. Overall, our results reveal a strong desire among patients for more personalized and patient-centered care in the context of ICD implantation. Participants in our study express significant concerns about the further loss of the ‘human touch’ in healthcare when AI is introduced in clinical settings. They believe that this aspect of care is currently inadequately recognized in clinical practice. Participants attribute to doctors the responsibility of evaluating AI recommendations for clinical relevance and aligning them with patients’ individual contexts and values, in consultation with the patient.ConclusionThe ‘human touch’ patients exclusively ascribe to human medical practitioners extends beyond sympathy and kindness, and has clinical relevance in medical decision-making. Because this cannot be replaced by AI, we suggest that normative research into the ‘right to a human doctor’ is needed. Furthermore, policies on patient-centered AI integration in clinical practice should encompass the ethics of everyday practice rather than only principle-based ethics. We suggest that an empirical ethics approach grounded in ethnographic research is exceptionally well-suited to pave the way forward. (shrink)

A definition is given for formulae $A_1,\ldots,A_n$ in some theory $T$ which is formalized in a propositional calculus $S$ to be (in)dependent with respect to $S$. It is shown that, for intuitionistic propositional logic $\mathbf{IPC}$, dependency (with respect to $\mathbf{IPC}$ itself) is decidable. This is an almost immediate consequence of Pitts' uniform interpolation theorem for $\mathbf{IPC}$. A reasonably simple infinite sequence of $\mathbf{IPC}$-formulae $F_n(p, q)$ is given such that $\mathbf{IPC}$-formulae $A$ and $B$ are dependent if and only if at least (...) on the $F_n(A, B)$ is provable. (shrink)

Euthanasia and physician-assisted suicide (PAS) by request and/or based on an advance directive are legal in The Netherlands under strict conditions, thus providing options for patients with Huntington's disease (HD) and other neurodegenerative diseases to stay in control and choose their end of life. HD is an inherited progressive disease characterised by chorea and hypokinesia, psychiatric symptoms and dementia. From a qualitative study based on interviews with 15 physicians experienced in treating HD, several ethical issues emerged. Consideration of these aspects (...) leads to a discussion about the professional role of a physician in relation to the personal autonomy of a patient. Such a discussion can raise awareness that talking about end-of-life wishes with an HD patient is part of the legal, professional and moral responsibility of the physician, and that a letter of intent on behalf of the physician can improve active participation in the process. Discussion of these issues can help to advance the debate on euthanasia and PAS in HD and other neurodegenerative diseases. (shrink)

Programmed cell death (PCD) or apoptosis is a broadly conserved phenomenon in metazoans, whereby activation of canonical signal pathways induces an ordered dismantling and death of a cell. Paradoxically, the constituent proteins and pathways of PCD (most notably the metacaspase/caspase protease mediated signal pathways) have been demonstrated to retain non‐death functions across all phyla including yeast, nematodes, drosophila, and mammals. The ancient conservation of both death and non‐death functions of PCD proteins raises an interesting evolutionary conundrum: was the primordial intent (...) of these factors to induce cell death or to regulate other cellular adaptations? Here, we propose the hypothesis that apoptotic behavior of PCD proteins evolved or were co‐opted from core non‐death functions. (shrink)

First published in 1912, and originally intended as a textbook for students in secondary school, this book gives an overview of the human and physical geography of the occupied areas of the earth's surface. The text is richly illustrated with diagrams, tables, and contemporary photographs of places of interest. Although in general Dicks manages to rise above the colonial viewpoint prevalent at the time, certain aspects of the text are reflective of racial attitudes during this period of the twentieth century. (...) This book will be of value to anyone with an interest in the history of education. (shrink)

Semantic Automata Johan van Ben them. INTRODUCTION An attractive, but never very central idea in modern semantics has been to regard linguistic expressions ...

Cyclic adenosine monophosphate (cAMP) and cAMP‐dependent protein kinase A (PKA) are evolutionary conserved molecules with a well‐established position in the complex network of signal transduction pathways. cAMP/PKA‐mediated signaling pathways are implicated in many biological processes that cooperate in organ development including the motility, survival, proliferation and differentiation of epithelial cells. Cell surface polarity, here defined as the anisotropic organisation of cellular membranes, is a critical parameter for most of these processes. Changes in the activity of cAMP/PKA elicit a variety of (...) effects on intracellular membrane dynamics, including membrane sorting and trafficking. One of the most intriguing aspects of cAMP/PKA signaling is its evolutionary conserved abundance on the one hand and its precise spatial–temporal actions on the other. Here, we review recent developments with regard to the role of cAMP/PKA in the regulation of intracellular membrane trafficking in relation to the dynamics of epithelial surface domains. BioEssays 30:146–155, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

The issue of the relation between financial derivatives, money and crisis remains one of on-going debate within Marxism. This paper takes issue with a recent contribution to this debate by Tony Norfield. We contend that the relationship between financial derivatives and the concept of ‘money’ needs to be framed in the context of a changing understanding of liquidity, and that issues of crisis and renewed accumulation are better understood though this path than via debates about speculative versus real investment and (...) productive versus unproductive capital. Indeed these latter taxonomies are being superseded by current developments within finance, and Marxian analysis needs to be attuned to these current developments. (shrink)

Patient-reported outcomes are frequently used for medical decision making, at the levels of both individual patient care and healthcare policy. Evidence increasingly shows that PROs may be influenced by patients’ response shifts and dispositions. We identify how response shifts and dispositions may influence medical decisions on both the levels of individual patient care and health policy. We provide examples of these influences and analyse the consequences from the perspectives of ethical principles and theories of just distribution. If influences of response (...) shift and disposition on PROs and consequently medical decision making are not considered, patients may not receive optimal treatment and health insurance packages may include treatments that are not the most effective or cost-effective. We call on healthcare practitioners, researchers, policy makers, health insurers, and other stakeholders to critically reflect on why and how such patient reports are used. (shrink)

In this rethinking of Marxism and its blind spots, Dick Howard argues that the collapse of European communism in 1989 should not be identified with a victory for capitalism and makes possible a wholesale reevaluation of democratic politics in the U.S. and abroad. The author turns to the American and French Revolutions to uncover what was truly "revolutionary" about those events, arguing that two distinct styles of democratic life emerged, the implications of which were misinterpreted in light of the (...) rise of communism. Howard uses a critical rereading of Marx as a theorist of democracy to offer his audience a new way to think about this political ideal. He argues that it is democracy, rather than Marxism, that is radical and revolutionary, and that Marx could have seen this but did not. In Part I, Howard explores the attraction Marxism held for intellectuals, particularly French intellectuals, and he demonstrates how the critique of totalitarianism from a Marxist viewpoint allowed these intellectuals to see the radical nature of democracy. Part II examines two hundred years of democratic political life--comparing America's experience as a democracy to that of France. Part III offers a rethinking of Marx's contribution to democratic politics. Howard concludes that Marx was attempting a "philosophy by other means," and that paradoxically, just because he was such an astute philosopher, Marx was unable to see the radical political implications of his own analyses. The philosophically justified "revolution" turns out to be the basis of an anti-politics whose end was foreshadowed by the fall of European communism in 1989. (shrink)

A central question in contemporary ethics and political philosophy concerns which entities have moral status. In this article, I provide a detailed analysis of the view that moral status comes in degrees. I argue that degrees of moral status can be specified along two dimensions: (i) the weight of the reason to protect an entity’s morally significant rights and interests; and/or (ii) the rights and interests that are considered morally significant. And I explore some of the complexities that arise when (...) we link degrees of moral status to the weight of reasons to protect bundles and/or the content and size of these bundles, in particular regarding the attribution of moral status to nonparadigmatic entities (e.g. people with severe cognitive disabilities, children, embryos and foetuses, robots, non-human animals, ecosystems, and rivers). (shrink)

In this article, I assess the prospects for the limitarian thesis that someone has too much wealth if they exceed a specific wealth threshold. Limitarianism claims that there are good political and/or ethical reasons to prevent people from having such ‘surplus wealth’, for example, because it has no moral value for the holder or because allowing people to have surplus wealth has less moral value than redistributing it. Drawing on recent literature on distributive justice, I defend two types of limitarian (...) principles of justice. First, limitarian midlevel principles draw on the limitarian thesis to specify normative commitments for guiding institutional design and individual actions. Second, the limitarian presumption draws on that thesis to specify what a just allocation of wealth requires under epistemic constraints. Such a presumption says that without substantive reasons to the contrary, we should regard a distribution as unjust if some people’s wealth exceeds the limitarian threshold. Furthermore, I will argue that we must reject a possible but implausible interpretation of limitarianism as an ideal distributive pattern. Yet both as a midlevel principle and as a presumption, limitarianism can play an important role in theorizing about justice in the real world. (shrink)

In this paper, I argue that limitarian policies are a good means to further political equality. Limitarianism, which is a view coined and defended by Robeyns, is a partial view in distributive justice which claims that under non-ideal circumstances it is morally impermissible to be rich. In a recent paper, Volacu and Dumitru level two arguments against Robeyns’ Democratic Argument for limitarianism. The Democratic Argument states that limitarianism is called for given the undermining influence current inequalities in income and wealth (...) have for the value of democracy and political equality. Volacu and Dumitru’s Incentive Objection holds that limitarianism places an excessive and inefficient burden on the rich in ensuring political equality. The Efficacy Objection holds that even if limitarianism limits excessive wealth it still fails to ensure the preservation of political equality. In this paper, I will argue that both of these objections fail, but on separate grounds. I argue that the Incentive objection fails because one could appeal to limitarian policies that are different from the ones discussed by Volacu and Dumitru and which escape the problem of reduced productivity. I argue against the Efficacy Objection that limitarian policies are a partial but highly valuable step towards establishing political equality, and that they can and should complement or be complemented by other strategies. (shrink)

Recent instances of corporate misconduct and examples of blatant leader self-serving behavior have rekindled interest in leader personality traits as antecedents of negative leader behavior. The current research builds upon that work, and examines the relationship between leader psychopathy and leader self-serving behavior. Moreover, we investigate whether follower self-esteem affects the occurrence of self-serving behavior in leaders with psychopathic tendencies. We predict that self-serving behaviors by psychopathic leaders are more likely to occur in the interaction with followers low in self-esteem. (...) We first conducted an experimental study (N = 156), in which we manipulated follower self-esteem, measured leader psychopathy, and assessed their combined effect on leader self-serving behavior using an ultimatum game. We then conducted a multi-source field study (N = 124 leader-follower dyads) using questionnaires to assess leader psychopathy, follower self-esteem, and perceived leader self-serving behavior. Across both studies, we found that leader psychopathy was positively related to their self-serving behavior, but only when followers had low rather than high self-esteem. As expected, our studies showed that the degree to which (perceived) psychopathic traits of leaders are reflected in their behavior depends on the characteristics of their followers. Apparently, the behavioral expression of negative leader traits is not only a matter of the trait strength, but instead is the result of the interplay between leader and follower in a certain context. (shrink)

One of the new ways used by companies to demonstrate their social responsibility is to encourage employee volunteering, whereby employees engage in socially beneficial activities on company time, while being paid by the company. The reasoning is that it is good for employee motivation (internal effects) and good for the company reputation (external effects). This article reports an empirical investigation of the internal effects of employee volunteering conducted amongst employees of the Dutch ABN-AMRO bank. The study showed that (a) socio-demographic (...) characteristics from employee volunteers markedly differ from those of non-volunteers and community volunteers and (b) employee volunteering seems to have positive effects on attitudes and behavior towards the organization. (shrink)

Clifford, Dick The world outlook is rather grim. Greece is bankrupt, the efforts to cure the problem by making new loans to the banks and cutting living standards is likely only to postpone the date when bankruptcy is declared. Italy and Spain are in a similar position. Britain, Europe and the USA are loaded with debt, only a few countries like Iceland are adopting methods which are the reverse of what conventional economics requires and seem to be recovering from (...) their problems slowly. (shrink)

Carl Knight argues that lexical sufficientarianism, which holds that sufficientarian concerns should have lexical priority over other distributive goals, is ‘excessive’ in many distinct ways and that sufficientarians should either defend weighted sufficientarianism or become prioritarians. In this article, I distinguish three types of weighted sufficientarianism and propose a weighted sufficientarian view that meets the excessiveness objection and is preferable to both Knight’s proposal and prioritarianism. More specifically, I defend a multi-threshold view which gives weighted priority to benefits directly above (...) and below its thresholds, but gives benefits below the lowest threshold lexical priority over benefits above the highest threshold. (shrink)

Despite the prominence of thresholds in theories of distributive justice, there is no general account of what sort of role is played by the idea of a threshold within such theories. This has allowed an ongoing lack of clarity and misunderstanding around views that employ thresholds. In this article, I develop an account of the concept of thresholds in distributive justice. I argue that this concept contains three elements, which threshold views deploy when ranking possible distributions. These elements are (i) (...) the level of the threshold, (ii) what constitutes the value of the threshold, and (iii) how benefits above and below the threshold must be allocated. I highlight three contributions that this particular account of thresholds makes: it clarifies the nature of the shift that occurs at the threshold; it resolves a common misunderstanding about headcount principles; and it shows how the arbitrariness objection can be met. (shrink)

In this rethinking of Marxism and its blind spots, Dick Howard argues that the collapse of European communism in 1989 should not be identified with a victory for capitalism and makes possible a wholesale reevaluation of democratic politics in the U.S. and abroad. The author turns to the American and French Revolutions to uncover what was truly "revolutionary" about those events, arguing that two distinct styles of democratic life emerged, the implications of which were misinterpreted in light of the (...) rise of communism. Howard uses a critical rereading of Marx as a theorist of democracy to offer his audience a new way to think about this political ideal. He argues that it is democracy, rather than Marxism, that is radical and revolutionary, and that Marx could have seen this but did not. In Part I, Howard explores the attraction Marxism held for intellectuals, particularly French intellectuals, and he demonstrates how the critique of totalitarianism from a Marxist viewpoint allowed these intellectuals to see the radical nature of democracy. Part II examines two hundred years of democratic political life -- comparing America's experience as a democracy to that of France. Part III offers a rethinking of Marx's contribution to democratic politics. Howard concludes that Marx was attempting a "philosophy by other means," and that paradoxically, just because he was such an astute philosopher, Marx was unable to see the radical political implications of his own analyses. The philosophically justified "revolution" turns out to be the basis of an anti-politics whose end was foreshadowed by the fall of European communism in 1989. (shrink)

The modal completeness proofs of Guaspari and Solovay (1979) for their systems R and R – are improved and the relationship between R and R – is clarified.

Background In the ethical and clinical literature, cases of parents who want treatment for their child to be withdrawn against the views of the medical team have not received much attention. Yet resolution of such conflicts demands much effort of both the medical team and parents. Objective To discuss who can best protect a child9s interests, which often becomes a central issue, putting considerable pressure on mutual trust and partnership. Methods We describe the case of a 3-year-old boy with acquired (...) brain damage due to autoimmune-mediated encephalitis whose parents wanted to stop treatment. By comparing this case with relevant literature, we systematically explored the pros and cons of sharing end-of-life decisions with parents in cases where treatment is considered futile by parents and not (yet) by physicians. Conclusions Sharing end-of-life decisions with parents is a more important duty for physicians than protecting parents from guilt or doubt. Moreover, a request from parents on behalf of their child to discontinue treatment is, and should be, hard to over-rule in cases with significant prognostic uncertainty and/or in cases with divergent opinions within the medical team. (shrink)

In this article, I assess the prospects for the limitarian thesis that someone has too much wealth if they exceed a specific wealth threshold. Limitarianism claims that there are good political and/or ethical reasons to prevent people from having such ‘surplus wealth’, for example, because it has no moral value for the holder or because allowing people to have surplus wealth has less moral value than redistributing it. Drawing on recent literature on distributive justice, I defend two types of limitarian (...) principles of justice. First, limitarian midlevel principles draw on the limitarian thesis to specify normative commitments for guiding institutional design and individual actions. Second, the limitarian presumption draws on that thesis to specify what a just allocation of wealth requires under epistemic constraints. Such a presumption says that without substantive reasons to the contrary, we should regard a distribution as unjust if some people’s wealth exceeds the limitarian threshold. Furthermore, I will argue that we must reject a possible but implausible interpretation of limitarianism as an ideal distributive pattern. Yet both as a midlevel principle and as a presumption, limitarianism can play an important role in theorizing about justice in the real world. (shrink)

In The March of Unreason, Dick Taverne expresses his concern that irrationality is on the rise in Western society, and argues that public opinion is increasingly dominated by unreflecting prejudice and an unwillingness to engage with factual evidence. Discussing topics such as genetically modified crops and foods, organic farming, the MMR vaccine, environmentalism, the precautionary principle, and the new anti-capitalist and anti-globalization movements, he argues that the rejection of the evidence-based approach nurtures a culture of suspicion, distrust, and cynicism, (...) and leads to dogmatic assertion and intolerance. Science, with all the benefits it brings, is an essential part of a civilized and democratic society: it offers the most hopeful future for humankind. (shrink)

In chapter 1 of Sovereign Virtue Ronald Dworkin argues against the claim that insofar as we care about distributive equality (equality in the distribution of resources to be privately owned), what we should care about is equality of welfare. This says that a distribution of resources in a society is equal just in case it results in all members of society having the same level of welfare (utility, well-being, personal good).

In this article, I propose a novel characterization of sufficientarianism. I argue that sufficientarianism combines three claims: a priority claim that we have non-instrumental reasons to prioritize benefits in certain ranges over benefits in other ranges; a continuum claim that at least two of those ranges are on one continuum; and a deficiency claim that the lower a range on a continuum, the more priority benefits in that range have. This characterization of sufficientarianism sheds new light on two long-standing philosophical (...) debates, namely about the distinctiveness of sufficientarianism as a distributive principle and about the common objections to sufficientarianism. (shrink)

Solovay's 1976 completeness result for modal provability logic employs the recursion theorem in its proof. It is shown that the uses of the recursion theorem can in this proof be replaced by the diagonalization lemma for arithmetic and that, in effect, the proof neatly fits the framework of another, enriched, system of modal logic (the so-called Rosser logic of Gauspari-Solovay, 1979) so that any arithmetical system for which this logic is sound is strong enough to carry out the proof, in (...) particular I0+EXP. The method is adapted to obtain a similar completeness result for the Rosser logic. (shrink)

The American Indian Movement, founded in 1968 in Minneapolis, burst into that turbulent time with passion, anger, and radical acts of resistance. Spurred by the Civil Rights movement, Native people began to protest the decades--centuries--of corruption, racism, and abuse they had endured. They argued for political, social, and cultural change, and they got attention. The photographs of activist Dick Bancroft, a key documentarian of AIM, provide a stunningly intimate view of this major piece of American history from 1970 to (...) 1981. Veteran journalist Laura Waterman Wittstock, who participated in events in Washington, DC, has interviewed a host of surviving participants to tell the stories behind the images. The words of Russell Means, Dennis Banks, Clyde Bellecourt, Eddie Benton Banai, Pat Bellanger, Elaine Salinas, Winona LaDuke, Bill Means, Ken Tilsen, Larry Leventhal, Jose Barreiro, and others tell the stories: the takeovers of federal buildings and the Winter Dam in Wisconsin, the founding of survival schools in the Twin Cities, the Wounded Knee trials, international conferences for indigenous rights, the Trail of Broken Treaties Caravan and the Longest Walk for Survival, powwows and camps and United Nations actions. This is the inside record of a movement that began to change a nation. Dick Bancroft has been the unofficial photographer for the American Indian Movement since 1970. He has traveled the world to take these photographs. Laura Waterman Wittstock, a writer and media consultant, covered the early years of the American Indian Movement as a journalist. Rigoberta Menchú Tum, recipient of the 1992 Nobel Peace Prize, is an activist for indigenous rights in Guatemala. (shrink)

This paper discusses some of the anthropological andphilosophical features of the use of self-managementplans by patients with a chronic disease, focusing onpatients with asthma. Characteristics of thistechnologically mediated form of self-care arecontrasted with the work of Mauss and Foucault on bodytechniques and techniques of self. The similaritiesand differences between self-management of asthma andFoucault's technologies of self highlight some of theways in which self-management contributes tomodifications in the definitions of patients andphysicians. Patients, in measuring their lungfunction, first come to rely on (...) measurements more thanon felt disturbances, but next, felt disturbancesbecome modified by previous measurements. Physicians,on the other hand, see their role changed from expertto being a participant in a joint treatment. It isargued that the concept of agency is more appropriatefor describing the advantage of self-management forpatients than autonomy. (shrink)

Animals in Disasters is a comprehensive book on animal rescue written by Dr. Dick Green who shares his experiences, best practices and lessons learned from well over 125 domestic and international disasters. It provides a step-by-step process for communities and states to more effectively address animal issues and enhance their animal response capabilities. Sections include an overview of the history of animal rescue, where we are today, and the steps needed to better prepare for tomorrow. This how-to book for (...) emergency managers who want to develop programs, craft policy, and build response capability/capacity is an ideal companion to their work. Clearly identifies the components of building a resilient community Introduces the Community Preparedness Checklist Helps readers develop and deliver effective animal response training. (shrink)

The problem of Uniqueness and Explicit Definability of Fixed Points for Interpretability Logic is considered. It turns out that Uniqueness is an immediate corollary of a theorem of Smoryski.

RESUMO O pensamento de Bakhtin, dos primeiros e dos últimos textos, se concentrou nas imagens do corpo humano. Entende-se o corpo ao contemplá-lo: ver é saber. Esse “contemplar” não tem nenhuma das qualidades objetivantes do que hoje é conhecido como “olhar”. A filosofia inicial de Bakhtin é baseada em um compromisso compassivo pelo qual uma pessoa ajuda a outra a ver e a se conhecer como um todo e, além disso, como um todo amado. Por mais limitante que seja, argumentarei (...) que sua concepção inicial de corpo ainda tem muito valor. O argumento então se volta para as imagens posteriores e muito mais familiares de Bakhtin sobre o corpo grotesco. Enquanto, inicialmente, suas ideias voltam-se para um corpo estático, agora vemos o corpo envolvido em uma interação tumultuada e interminável com seu ambiente social e natural. Seria essa uma alegoria antissoviética ou uma visão alternativa do corpo humano que remonta à pré-história? Ofereço duas ilustrações em defesa da ideia de que esta era, na verdade, uma filosofia do corpo. ABSTRACT Bakhtin's thinking, early and late focused upon images of the human body. A body is a thing understood by looking at it: to see is to know. This 'looking' has nothing of the objectivising qualities of what is known today as the 'gaze'. Bakhtin's early philosophy is based on a compassionate engagement whereby one person helps another see and know themselves as a whole, and moreover, as a loved whole. As limiting as it is, I shall argue his early conception of the body still has much value. The argument then turns to Bakhtin's later and much more familiar images of the grotesque body. While his early body is static, now we see the body engaged in a tumultuous and unending interaction with its social and natural environment. Was this an anti-Soviet allegory, or an alternative vision of the human body that reaches back into pre-history? I offer two illustrations in defence of the idea that this was indeed a philosophy of the body. (shrink)