The photocycle of visual opsins is essential to maintain the light sensitivity of the retina. The early physical observations of the rhodopsin photocycle by Böll and Kühne in the 1870s inspired over a century's worth of investigations on rhodopsin biochemistry. A single photon isomerizes the Schiff‐base linked 11‐cis‐retinylidene chromophore of rhodopsin, converting it to the all‐trans agonist to elicit phototransduction through photoactivated rhodopsin (Rho*). Schiff base hydrolysis of the agonist is a key step in the photocycle, not only diminishing ongoing (...) phototransduction but also allowing for entry and binding of fresh 11‐cis chromophore to regenerate the rhodopsin pigment and maintain light sensitivity. Many challenges have been encountered in measuring the rate of this hydrolysis, but recent advancements have facilitated studies of the hydrolysis within the native membrane environment of rhodopsin. These techniques can now be applied to study hydrolysis of agonist in other opsin proteins that mediate phototransduction or chromophore turnover. In this review, we discuss the progress that has been made in characterizing the rhodopsin photocycle and the journey to characterize the hydrolysis of its all‐trans‐retinylidene agonist. (shrink)

The complex sensation of vision begins with the relatively simple photoisomerization of the visual pigment chromophore 11-cis-retinal to its all-trans configuration. This event initiates a series of biochemical reactions that are collectively referred to as phototransduction, which ultimately lead to a change in the electrochemical signaling of the photoreceptor cell. To operate in a wide range of light intensities, however, the phototransduction pathway must allow for adjustments to background light. These take place through physiological adaptation processes that rely primarily (...) on Ca2+ ions. While Ca2+ may modulate some activities directly, it is more often the case that Ca2+-binding proteins mediate between transient changes in the concentration of Ca2+ and the adaptation processes that are associated with phototransduction. Recently, combined genetic, physiological, and biochemical analyses have yielded new insights about the properties and functions of many phototransduction-specific components, including some novel Ca2+-binding proteins. Understanding these Ca2+-binding proteins will provide a more complete picture of visual transduction, including the mechanisms associated with adaptation, and of related degenerative diseases. BioEssays 22:337–350, 2000. © 2000 John Wiley & Sons, Inc. (shrink)

This paper mainly studies the communication performance of visible light communication link in fire smoke environment. Compared with the previous studies, this study no longer only considers a single wavelength and considers the influence of smoke and background light noise. Firstly, the variation of background light noise caused by sunlight during a day was analyzed, then signal-to-noise ratio and bit error rate of the visible light communication link in fire smoke environment with different visibility were calculated, and finally, the variation (...) of received power with the angle β between the LED optical axis and the communication link was analyzed. The results show that, during a day from 07:00 to 18:30, background light noise first increases and then decreases, BER changes in the same trend and reaches the maximum at about 13:00, while SNR changes in the opposite trend and reaches the minimum at about 13:00. When visibility is 100 m, the maximum difference of SNR between 7:00 and 13:00 is about 19 dB, and the maximum difference of BER is about 5.3E-10. At 7:00, the maximum difference of SNR is about 13 dB between the visibility of 1 m and the visibility of 100 m, and the maximum difference of BER is about 1.44E − 11, and received power decreases with the increase of β. In addition, SNR increases with visibility of fire smoke environment, and BER changes in the opposite trend. Lastly, in order to enhance the performance of visible light communication in fire smoke environment, this paper gives the transmitting power scheme. (shrink)

Abstract11β‐hydroxysteroid dehydrogenases regulate glucocorticoid concentrations and 17β‐hydroxysteroid dehydrogenases regulate estrogen and androgen concentrations in mammals. Phylogenetic analysis of the sequences from two 11β‐hydroxysteroid dehydrogenases and four mammalian 17β‐hydroxysteroid dehydrogenases indicates unusual evolution in these enzymes. Type 1 11β‐ and 17β‐hydroxysteroid dehydrogenases are on the same branch; Type 2 enzymes cluster on another branch with β‐hydroxybutyrate dehydrogenase, 11‐cis retinol dehydrogenase and retinol dehydrogenase; Type 3 17β‐hydroxysteroid dehydrogenase is on a third branch; while the pig dehydrogenase clusters with a yeast multifunctional enzyme (...) on a fourth branch. Pig 17β‐hydroxysteroid dehydrogenase appears to have evolved independently from the other three 17β‐hydroxysteroid dehydrogenase dehydrogenases; in which case, the evolution of 17β‐hydroxysteroid dehydrogenase activity is an example of functional convergence. The phylogeny also suggests that independent evolution of specificity toward C11 substituents on glucocorticoids and C17 substituents on androgens and estrogens has occurred in Types 1 and 2 11β‐ and 17β‐hydroxysteroid dehydrogenases. (shrink)

La risa caníbal -- Chaplin vs. Hitler : un estudio sobre la parodia -- En el interior de <> -- Sobre el chiste como una de las bellas artes -- La vida privada de los cómicos -- De muñecos y hombres -- El pensamiento cínico o el arte de la performance -- George Bush, o el payaso involuntario -- Prohibir la risa : el 11 de septiembre y la comunidad herida -- El político humorista, el humorista encarcelado: psoverdad, política (...) y humor -- Hombres que se ríen de los dioses -- <> feminista: el caballo en la ciudad sitiada -- Agradecimientos. (shrink)

Vi sono varie forme di impossibilità normativa. Una prima forma si incontra quando un fatto naturale al quale il diritto attribuisce un significato normativo è impossibile. Una seconda consiste nell’impossibilità di un atto o fatto la quale derivi dalla presenza o assenza di una norma. Vi è poi una terza forma di impossibilità normativa che si incontra quando si afferma che da una certa realtà oggetto di normazione derivano necessariamente limiti all’attività di normazione stessa. Di una quarta forma si può (...) parlare quando ci si riferisce a un’impossibilità derivante dalle specifiche relazioni che intercorrono tra norme di un sistema normativo dinamico. Le forme di impossibilità normativa sono indagate, nei contributi raccolti in questo volume, da diverse angolazioni: la filosofia del diritto, la filosofia morale, la logica, la filosofia della conoscenza, la scienza del diritto penale. (shrink)

Depuis les attentats du 11 mars 2004 de Madrid se sont imposées quelques questions qui, d’après notre appréhension continentale de la démocratie, exigent des réponses urgentes. Certaines questions n’ont pas encore été formulées par les intellectuels en Europe et en Espagne. Comment peut-on combattre contre le terrorisme dans une démocratie? Celui-ci est intentionnellement désigné sous le nom de tradition continentale européenne, en opposition à la tradition anglo-saxonne. Cette dernière a de nouveau formulé la question de Hobbes et dans un cas (...) douteux plaide pour la sécurité au détriment de la liberté. Les événements du 11 mars ont prouvé que la scène terroriste est financée par le trafic d’armes et de drogue. Les systèmes démocratiques dont la politique repose sur des mesures d’économie peuvent-ils contrôler le marché noir? Toutes ces questions se rapportent à la vieille question notoire des limites de la liberté. Comment définir la liberté dans une société qui doit se pourvoir d’armes pour lutter contre les actes terroristes arbitraires, contre toute forme de gouvernement autoritaire et contre les différents aspects du fanatisme? (shrink)

Nicolas de Cues (1401-11 août 1464) assume pour l’essentiel la thèse érigénienne et alanienne de l’incognoscibilité de Dieu et de la quiddité des choses. Il développe et approfondit la conscience de la supériorité de la négation sur l’affirmation in divinis qui avait permis au Néoplatonisme Médiéval d’élaborer une théorie sémantique du langage en nette rupture avec le triptyque aristotélicien qui établit la nécessité d’une correspondance entre chose, pensée et signe : pour Nicolas de Cues, l’essence du langage est dans la (...) production d’un sens, et celui-ci peut être entièrement indépendant de la possibilité d’appréhension de son objet. La présente recherche entend démontrer que cette thèse de l’incognoscibilité divine est intimement liée à une autre thèse d’ordre épistémologique qui décrète radicalement que toute affirmation est une conjecture au sujet du réel et que notre esprit est dans l’impossibilité d’atteindre la vérité de façon adéquate. Il n’existe pas de connaissance humaine certaine, car la quiddité des choses qui détermine leurs essences véritables est inaccessible. (shrink)

Il est un point commun de la prise de conscience entre les spécialistes des sciences cognitives et les spécialistes des sciences du droit. Il s'agit d'un point aveugle (ou d'une tache aveugle) correspondant à un trou de l'oeil. Le cerveau ignore en pareille hypothèse la tache aveugle et il va " au-delà de l'information fournie par la rétine en faisant une supposition raisonnable sur l'image qui pouvait être dans la zone aveugle " (Christof Koch). C'est un procédé analogue sur lequel (...) repose régulièrement le droit. Celui-ci utilise la complétion, l'interpolation et le remplissage pour normer des situations de fait. Le droit – à la lumière des sciences cognitives – peut en être profondément bouleversé. (shrink)

1. Xin yi shu chuang zuo lun, Xin yi shu lun ji -- 2. Mian xiang sheng huo, Lun yi shu de ji qiao -- 3. Yi yi dang shi -- 4. Xi wen le jian -- 5. Ge er bu ge -- 6. Lun Feng jie -- 7. Kai xin yue shi -- 8. Bu dao ding dian, Shen mei de min gan -- 9. Zai zai tan suo -- 10. Liao ran yu xin -- 11. Shen mei tan (...) -- 12. Si zeng xiang shi, Yi shen er ren -- 13. Shen mei xin tai -- 14. Hui jian zi ji -- 15. Diao su diao su -- 16. "Fu huo" de fu huo -- 17. Dong fang ji bai -- 18. Shen yu wu you -- 19. Tu na ying hua -- 20. Qu yu wu xie -- 21. Shu xin, ti ci xuan -- 22. Duan jian can pian. (shrink)

BackgroundRespecting patients’ confidentiality is an ethical and legal responsibility for health professionals and the cornerstone of care excellence. This study aims to assess health professionals’ knowledge, attitudes, and associated factors towards patients’ confidentiality in a resource-limited setting.MethodsInstitutional based cross-sectional study was conducted among 423 health professionals. Stratified sampling methods were used to select the participants, and a structured self-administer questionnaire was used for data collection. The data was entered using Epi-data version 4.6 and analyzed using SPSS, version 25. Bi-variable and (...) multivariable binary logistic regression analyses were used to measure the association between the dependent and independent variables. Odds ratio with 95% confidence intervals and P value was calculated to determine the strength of association and to evaluate statistical significance.ResultOut of 410 participants, about 59.8% with [95% CI (54.8–68.8%)] and 49.5% with [95% CI (44.5–54.5%)] had good knowledge and favorable attitude towards patents confidentiality respectively. Being male (AOR = 1.63, 95% CI [1.03–2.59]), taking training on medical ethics (AOR = 1.73, 95% CI = [1.11–2.70]), facing ethical dilemmas (AOR = 3.07, 95% CI [1.07–8.79]) were significantly associated factors for health professional knowledge towards patients’ confidentiality. Likewise, taking training on medical ethics (AOR = 2.30, 95% CI [1.42–3.72]), having direct contact with the patients (AOR = 3.06, 95% CI [1.12–8.34]), visiting more patient (AOR = 4.38, 95% CI [2.46–7.80]), and facing ethical dilemma (AOR = 3.56, 95% CI [1.23–10.26]) were significant factors associated with attitude of health professionals towards patient confidentiality.ConclusionThe findings of this study revealed that health professionals have a limited attitude towards patient confidentiality but have relatively good knowledge. Providing a continuing medical ethics training package for health workers before joining the hospital and in between the working time could be recommended to enhance health professionals’ knowledge and attitude towards patient confidentiality. (shrink)

Robust technology infrastructure is needed to enable learning health care systems to improve quality, access, and cost. Such infrastructure relies on the trust and confidence of individuals to share their health data for healthcare and research. Few studies have addressed consumers’ views on electronic data sharing and fewer still have explored the dual purposes of healthcare and research together. The objective of the study is to explore factors that affect consumers’ willingness to share electronic health information for healthcare and research. (...) This study involved a random-digit dial telephone survey of 800 adult Californians conducted in English and Spanish. Logistic regression was performed using backward selection to test for significant associations of each explanatory variable with the outcome variable. The odds of consent for electronic data sharing for healthcare decreased as Likert scale ratings for EHR impact on privacy worsened, odds ratio = 0.74, 95% CI [0.60, 0.90]; security, OR = 0.80, 95% CI [0.66, 0.98]; and quality, OR = 0.59, 95% CI [0.46–0.75]. The odds of consent for sharing for research was greater for those who think EHR will improve research quality, OR = 11.26, 95% CI [4.13, 30.73]; those who value research benefit over privacy OR = 2.72, 95% CI [1.55, 4.78]; and those who value control over research benefit OR = 0.49, 95% CI [0.26, 0.94]. Consumers’ choices about electronically sharing health information are affected by their attitudes toward EHRs as well as beliefs about research benefit and individual control. Design of person-centered interventions utilizing electronically collected health information, and policies regarding data sharing should address these values of importance to people. Understanding of these perspectives is critical for leveraging health data to support learning health care systems. (shrink)

Dans son dialogue Sur le Bien (19 F = fr. 11 dP), Numénius écrit que le dieu qui est « deuxième et troisième est un ». Par là, il désigne un dieu considéré selon deux aspects qui correspondent à la double orientation de son attention. Dans le second, il est tourné vers le monde et joue le rôle de démiurge. Selon la plupart des chercheurs, ce démiurge serait à identifier à l’âme du monde que les fragments parvenus du dialogue ne (...) mentionnent pas. L’article montre que cette interprétation ne rend peut-être pas compte du propos de Numénius. Il indique les raisons théoriques et polémiques expliquant qu’en réalité, même si le démiurge a la fonction de l’âme du monde, Numénius ne l’identifie pas avec celle-ci. Il veut définir les principes qu’il identifie à l’être, conçu comme incorporel. Le mouvement intrinsèque à l’âme et l’immanence qui la caractérise, d’après la tradition platonicienne que suit Numénius et la tradition stoïcienne à laquelle il s’oppose, interdisent de donner à cette âme le statut de pur intelligible – le lui accorder serait précisément céder à l’immanentisme et au corporalisme stoïciens. Enfin, il n’est pas davantage utile de reconnaître dans le second aspect du deuxième dieu, un moment nommé « troisième dieu » dans le dialogue, le troisième dieu que Numénius aurait identifié au monde d’après le témoignage de Proclus (29 T = fr. 21 dP). Ce troisième dieu-là peut réellement correspondre au monde dont Platon fait un dieu, à condition que ce monde soit considéré comme le produit du seul intellect, ordre (κόσμος) qui comporte certes une âme, et même un intellect en elle, mais qui n’est réduit ni à l’une ni à l’autre. (shrink)

To assess the prevalence of plagiarism in manuscripts submitted for publication in the Croatian Medical Journal (CMJ). All manuscripts submitted in 2009–2010 were analyzed using plagiarism detection software: eTBLAST , CrossCheck, and WCopyfind . Plagiarism was suspected in manuscripts with more than 10% of the text derived from other sources. These manuscripts were checked against the Déjà vu database and manually verified by investigators. Of 754 submitted manuscripts, 105 (14%) were identified by the software as suspicious of plagiarism. Manual verification (...) confirmed that 85 (11%) manuscripts were plagiarized: 63 (8%) were true plagiarism and 22 (3%) were self-plagiarism. Plagiarized manuscripts were mostly submitted from China (21%), Croatia (14%), and Turkey (19%). There was no significant difference in the text similarity rate between plagiarized and self-plagiarized manuscripts (25% [95% CI 22–27%] vs. 28% [95% CI 20–33%]; U = 645.50; P = 0.634). Differences in text similarity rate were found between various sections of self-plagiarized manuscripts (H = 12.65, P = 0.013). The plagiarism rate in the Materials and Methods (61% (95% CI 41–68%) was higher than in the Results (23% [95% CI 17–36%], U = 33.50; P = 0.009) or Discussion (25.5 [95% CI 15–35%]; U = 57.50; P < 0.001) sections. Three authors were identified in the Déjà vu database. Plagiarism detection software combined with manual verification may be used to detect plagiarized manuscripts and prevent their publication. The prevalence of plagiarized manuscripts submitted to the CMJ , a journal dedicated to promoting research integrity, was 11% in the 2-year period 2009–2010. (shrink)

The chapter presents the prototyping of a thinking routine designed to foster good inference habits in children ages 6 to 11. The prototyping was developed at Ninho, an educational project for children from underprivileged households in Brazil. The thinking routines by Ritchhart and colleagues (2006) served as our starting point. Following a Virtue Education (VE) approach, we supposed that the repeated application would conduce to habituation. In addition, to increase peer-to-peer interactions, the teacher applying the routines worked as a facilitator (...) in a Community of Inquiry (CI). After six months of application, the results were partially successful. We identified that the repeated exposition to the magic question “What makes you say that?” made children more aware of the evidence supporting their assumptions. Furthermore, the interactions between peers made them recognize different perspectives. However, we also identified some shortcomings. Most of them seemed to arise from cognitive biases. At the individual level, belief perseverance kept children too attached to their first assumptions. They preferred self-serving rationalizations instead of accepting a counter-argument. At the group level, we identified problems of social contagion such as information cascades. The effects of a first opinion rhetorically voiced were hard to efface. Since none of the steps on the previous routines addressed these biases, we prototyped a routine to start filling this gap. Following Critical Thinking (CT) theorists, we added a step of structured instruction concerning one specific reasoning technique - the inference to the best explanation. Moreover, the recommendation of cognitive psychologists motivated the inclusion of some extra features to avoid groupthink biases. For instance, a visual table that juxtaposes contrasting arguments should facilitate comparative evaluations. Also, a star-based evaluation scale should help different individuals to discuss their assessments based on a common ground. As described in the end, the prototype with elements from VE, CI and CT presented promising results. (shrink)

ObjectiveThe study is an explorative investigation aimed to assess the differences in acute stress response patterns of health workers facing coronavirus disease 2019 (COVID-19) during Italy’s first lockdown.MethodsA cross-sectional investigation using convenience sampling method was conducted in Italy during April 2020. Eight hundred fifty-eight health workers participated in the research filling out self-report measures including Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI), and Impact of Event Scale–Revised (IES-R).ResultsModerate/severe depression was found in 28.9% (95% CI, 25.8–32.04), (...) moderate/severe anxiety in 55.4% (95% CI, 51.9–58.8), insomnia in 15% (95% CI, 12.5–17.5), and distress in 52.5% (95% CI, 48.5%–56.6) of participants. The 3% of health workers reported frequent suicidal thoughts. Female sex, working for >15 h/week in a COVID-19 unit, and living apart from family were associated with a significantly higher risk of distress, anxiety, insomnia, depression, and functional impairment. Four profiles were identified on the basis of psychopathological measures: Profile_0 included 44% (N= 270); Profile_1, 25.6% (N= 157); Profile_2, 19.1% (N= 117); and Profile_3, 11.3% (N= 69) of participants. Results showed a significant effect for Profiles X IES-R (η2= 0.079;f= 0.29), indicating that in all profiles, except for Profile_0, avoidance scale is lower than hyperarousal and intrusion symptoms scales of the IES-R. This characteristic could be a probable index of the control exerted by the responders to not fly away from their job.ConclusionThe identification of specific profiles could help psychiatrists and emergency psychologists to build specific interventions in terms of both primary and secondary prevention to face future waves of the COVID-19 outbreak. (shrink)

Objective Our study sought to (1) describe the practices and preferences of Colombian adolescents in accessing sexual and reproductive health services: accompanied versus alone; (2) compare actual practices with stated preferences; and (3) determine age and gender differences regarding the practice and these stated preferences. -/- Methods 812 participants aged 11–24 years old answered a survey in two Profamilia clinics in the cities of Medellin and Cali in Colombia. A cross-sectional analysis was performed to compare participants’ answers based on the (...) variables of gender and age. -/- Results A quarter of participants visited the clinic alone (25.4%). Females were more likely to go alone in comparison to males (26.3% vs 14.1%; p = 0.031), and older participants went alone more often than younger participants (p < 0.001). Most participants – 72.7% (95 %CI: 69.3–75.9) – expressed a preference in being accompanied to the clinic, and more than 90% had their preferences met. The preferences of older participants were, however, less likely to be met than those of younger participants (p < 0.001), notably, because they predominantly wanted to be accompanied. -/- Conclusion Contemporary public health and bioethics literature advocates in favor of developing health services that better meet the preferences of adolescents. The present research highlights an apparent blind spot related to the role that others (e.g., parents, friends, partners) can or should play in accompanying adolescent patients when they access sexual and reproductive health services. Respecting adolescents’ preferences, and hence their autonomy, is not simply a matter of ensuring freedom from constraints (e.g., their right and ability to go alone). Rather, it should also consider the liberty to choose whether to be accompanied when accessing SHRS and by whom. (shrink)

Se leggiamo tra le righe del suo lavoro, possiamo scoprire che Varzi prende i mostri molto sul serio. Troviamo, per esempio, mostri mereologici frutto della composizione non ristretta, come l’entità costituita dalla metà sinistra di questa mela e dal bracciolo di quella poltrona.10 Oppure mostri topologici dai quali una teoria mereotopologica delle nicche deve rifuggire, come le curve riempispazio di Peano e Hilbert.11 O, ancora, mostri ontologici come l’antimateria;12 le entità “inesistenti” che, come si sa, non possono esistere, dato che (...) non ci sono cose che non esistono; e le entità “negative”: buchi, mancanze e omissioni, conferenze non date.13 In questo contributo, seguendo il suggerimento di Varzi, parlerò, appunto, di mostri, prendendo l’avvio da alcune creature che popolano il regno della finzione, per poi passare a trattare dei mostri che popolano il nostro mondo. Essendo poco lo spazio e molti i mostri, procederò dapprima proponendone una tassonomia – punto di partenza per ogni generalizzazione che si rispetti – e in seguito cercando di illustrare perché i mostri vadano presi sul serio in metafisica. È d’obbligo precisare che si tratterà di una tassonomia parziale e provvisoria, ma lo è altrettanto ricordare che le tassonomie, quelle biologiche in particolare, lo sono sempre, per due ragioni. In parte, perché la vita è in costante evoluzione, in parte perché le nostre conoscenze e decisioni condizionano la struttura e i contenuti dei nostri sistemi di categorie: basti pensare che la prima edizione del Systema naturae di Linneo contava undici pagine, mentre la tredicesima ben tremila, ripartite in sei volumi. Quando un tassonomo scopre un organismo che ritiene – dopo accurati esami comparativi – essere appartenente a una specie fino ad allora sconosciuta, ne deposita nella letteratura scientifica, insieme al nome binomiale (cioè il nome specifico, composto dall’indicazione del genere e della specie, come Homo sapiens), una descrizione in termini di caratteri fenetici. Quel token è chiamato tipo nomenclaturale, o esemplare-tipo, ed è il portatore del nome della specie di cui viene considerato tipo. Sulla falsariga della procedura appena descritta, riporterò la descrizione di alcuni tipi nomenclaturali per una tassonomia mostruosa che si baserà su tre criteri principali: (1) l’origine, (2) la costituzione genetica, (3) l’aspetto fenotipico. Prima di procedere, vorrei però sottolineare tre rispetti sotto i quali classificare mostri mitologici differisce dal classificare individui “ordinari”. Innanzitutto, nel caso dei mostri mitologici non è possibile, a causa del frequente intervento divino, ricorrere al criterio dell’interfecondità per stabilire se due mostri appartengono alla medesima specie. Ma d’altro canto, tale criterio, benché sia abbastanza affidabile per gli animali, non lo è affatto, per ragioni diverse dai mostri, per molte piante, alghe e funghi. Un’altra peculiarità da segnalare – di cui però non avremo modo di occuparci oltre – è che le entità mitologiche sono frequentemente soggette a trasformazioni sostanziali, mentre la nostra biologia sembra, aristotelicamente, escluderne la possibilità: una tigre non può trasformarsi in un canguro, pena la sua uscita dall’esistenza. Meno paradossalmente, una larva di mosca e la mosca adulta saranno considerate appartenenti alla medesima sorta – la mosca, appunto – benché dall’una all’altra non vi sia praticamente alcuna continuità materiale (nella metamorfosi la larva viene distrutta quasi completamente e l’adulto si genera a partire da pochi aggregati cellulari indifferenziati). Infine, nel caso dei mostri mitologici, parlerò più genericamente di “gruppo tassonomico” anziché di “specie” (e dunque il nome dei tipi nomenclaturali non sarà un nome binomiale) dal momento che, come diverrà chiaro nel corso della lettura, è proprio il concetto di “specie” come diverrà chiaro nel corso della lettura, è proprio il concetto di “specie” come articolazione naturale non oltrepassabile che i mostri che andiamo a classificare ci chiedono di mettere in discussione. (shrink)

Objective To determine whether presenting delivery room management options as defaults influences decisions to resuscitate extremely premature infants. Materials and methods Adult volunteers recruited from the world wide web were randomised to receive either resuscitation or comfort care as the delivery room management default option for a hypothetical delivery of a 23-week gestation infant. Participants were required to check a box to opt out of the default. The primary outcome measure was the proportion of respondents electing resuscitation. Data were analysed (...) using χ2 tests and multivariate logistic regression. Results Participants who were told the delivery room management default option was resuscitation were more likely to opt for resuscitation (OR 6.54 95% CI 3.85 to 11.11, p<0.001). This effect persisted on multivariate regression analysis (OR 7.00, 95% CI 3.97 to 12.36, p<0.001). Female gender, being married or in a committed relationship, being highly religious, experiences with prematurity, and favouring sanctity of life were significantly associated with decisions to resuscitate. Discussion Presenting delivery room options for extremely premature infants as defaults exert a significant effect on decision makers. The information structure of the choice task may act as a subtle form of manipulation. Further, this effect may operate in ways that a decision maker is not aware of and this raises questions of patient autonomy. Conclusion Presenting delivery room options for extremely premature infants as defaults may compromise autonomous decision-making. (shrink)

Nella problematica generale dei rapporti tra Dio e l'uomo rientra il problema del diritto naturale. Tale problema si e manifestato in modo particolare nel secolo XVII come dimostra lo studio di Ugo Grozio (1583-1645). L'attualita delle sue idee e vivo anche oggi sia in Italia che all'estero; Grozio e ricordato soprattutto dai giuristi, nonostante la sua attivita si sia svolta anche in altri campi come dimostra l'opera bibliografica di Meulen J. Ter e Diermanse. Molti studiosi elogiano le sue impostazioni giuridiche (...) come per esempio G.B. Vico che lo chiama iurisconsultus generis humani. D'altra parte ci sono anche molti critici poco entusiasti del suo pensiero e che anzi lo accusano considerandolo l'iniziatore di una nuova corrente dottrinale che rompe la vera linea del diritto naturale iniziata dai greci, perfezionata dai romani e ripresa dalla scolastica. Da tutto questo appare chiaro che non e facile entrare nel pensiero del giurista di Delft. Questo lavoro vorrebbe dare una risposta al problema del diritto naturale e del suo rapporto con Dio. Si vuol vedere come si puo accordare la famosa affermazione una sola volta nel Prolegomena 11 del De iure belli ac pacis, che le norme del diritto naturale alocum aliquem haberent etiam daremusanon esse Deum, aut non curari a beo negotia humanaa la quale sembra separare il diritto dalla Divinita con la convinzione veramente religiosa di Grozio e con i suoi continui richiami all'autorita delle Sacre Scritture, dei Padri della Chiesa e dei teologi. (shrink)

BackgroundThe effects of psychological interventions on symptoms and psychology of functional dyspepsia remain unclear. We aimed to comprehensively evaluate the effects of psychological interventions on symptoms and psychology of FD.MethodsWe searched the PubMed, Cochrane Library, and Embase electronic databases for randomized controlled trials evaluating the role of psychological interventions in FD patients published before July 2021. Standardized mean differences, risk ratios and 95% confidence intervals were calculated by a random effects model. Subgroup analyses and sensitivity analyses were also performed.ResultsFourteen RCTs (...) with a total of 1,434 FD patients were included. Compared with the control group, psychological interventions were significantly more likely to symptom improvement [RR = 1.74, 95% CI, p = 0.01], relieve gastrointestinal symptoms scores at follow up [SMD = −1.06, 95% CI, p < 0.0001], relieve gastrointestinal symptoms scores at end of treatment [SMD = −0.98, 95% CI, p < 0.001], decrease anxiety [SMD = −0.8, 95% CI, p = 0.006] and depression levels [SMD = −1.11, 95% CI, p < 0.001]. The results of the subgroup analysis showed that psychotherapy was more likely to symptom improvement, relieve gastrointestinal symptoms scores and decreased depression levels compared to the control.ConclusionsPsychological interventions may be effective in alleviating the symptoms and psychology of FD, but the effect appears to be limited to psychotherapy with fewer trials for other psychological interventions. More data from high-quality RCTs are needed to confirm their use in the treatment of FD. (shrink)

Loewe drew attention to the fact that Apuleius is one of the authors drawn upon by the compiler of the Glossary that has come to be known as ‘Abolita’; and Professor Lindsay in his article on this Glossary gives as examples of Apuleius glosses three short batches from the CA-, the CI-, and the CO- sections. These batches are respectively as follows: C.G.L. IV. p. 29, 33 = Met. 7, 12 or 8, 13: 34 = Met. 9, 16: 35 = (...) Met. 11, 16. (shrink)

BackgroundKnowledge development depends on an unbiased representation of the available evidence. Selective citation may distort this representation. Recently, some controversy emerged regarding the possible impact of swimming on childhood asthma, raising the question about the role of selective citation in this field. Our objective was to assess the occurrence and determinants of selective citation in scientific publications on the relationship between swimming in chlorinated pools and childhood asthma.MethodsWe identified scientific journal articles on this relationship via a systematic literature search. The (...) following factors were taken into account: study outcome (authors’ conclusion, data-based conclusion), other content-related article characteristics (article type, sample size, research quality, specificity), content-unrelated article characteristics (language, publication title, funding source, number of authors, number of affiliations, number of references, journal impact factor), author characteristics (gender, country, affiliation), and citation characteristics (time to citation, authority, self-citation). To assess the impact of these factors on citation, we performed a series of univariate and adjusted random-effects logistic regressions, with potential citation path as unit of analysis.ResultsThirty-six articles were identified in this network, consisting of 570 potential citation paths of which 191 (34%) were realized. There was strong evidence that articles with at least one author in common, cited each other more often than articles that had no common authors (odds ratio (OR) 5.2, 95% confidence interval (CI) 3.1–8.8). Similarly, the chance of being cited was higher for articles that were empirical rather than narrative (OR 4.2, CI 2.6–6.7), that reported a large sample size (OR 5.8, CI 2.9–11.6), and that were written by authors with a high authority within the network (OR 4.1, CI 2.1–8.0). Further, there was some evidence for citation bias: articles that confirmed the relation between swimming and asthma were cited more often (OR 1.8, CI 1.1–2.9), but this finding was not robust.ConclusionsThere is clear evidence of selective citation in this research field, but the evidence for citation bias is not very strong. (shrink)

Cet article soutient que Ben. 1, 3-4, une célèbre polémique à l’encontre de l’étymologie chrysippéenne, ne devrait pas être lue comme un rejet « en bloc » d’une étymologie philosophique, mais seulement comme un ensemble de conditions restrictives imposées à celle-ci. Cette interprétation nous permet de considérer les nombreuses étymologies du corpus sénéquien, dont une douzaine sont ici réunies et commentées, comme des réflexions philosophiquement intéressantes sur le langage. L’article se concentre sur la manière dont Sénèque utilise l’étymologie comme une (...) stratégie de traduction (baptisée ancrage étymologique) ayant pour but de rendre acceptables pour le lecteur romain, les aspects les plus contre intuitifs et paradoxaux de la philosophie stoïcienne, domestiquant ainsi la doctrine du Portique. Cette stratégie est comparée à l’approche très semblable de Cicéron dans Tusc. 3, 7-11. (shrink)

Entre Islam et Occident, le conflit existe. Il est profond. Et il n'a pas débuté le 11 septembre 2001 car - sans remonter aux Croisades - il oppose deux civilisations dont les valeurs, depuis des siècles, ne sont guère compatibles. Les orientalistes qui le nient se bercent d'illusions. Les partisans de Huntington, qui croient à la mission salvatrice de l'Occident, font tout autant fausse route. Situation d'autant plus grave que, depuis la guerre des Six jours, le conflit en question a (...) pris une forme aiguë, caractérisée d'abord par l'essor du mouvement islamiste, puis par celle d'un terrorisme international dont Al-Qaïda n'est qu'un relais parmi d'autres. Face à ces dangers (dont l'Europe aujourd'hui s'obstine à ignorer l'ampleur), la seule stratégie réaliste me semble consister, pour l'Occident, à opposer un front uni à l'islamisme, tout en laissant celui-ci faire la dure expérience de la réalité dans les pays qui souhaitent le porter au pouvoir car s'il peut être vaincu, ce ne sera pas par la force des armes ni par celle de la rhétorique, mais seulement par l'usure du temps. Ne nous y trompons pas : cette stratégie sera malaisée à mettre en œuvre, car elle devra, d'abord, affronter la passion antiaméricaine, antisioniste et tiers-mondiste qui, chez nous, inspire une grande partie de l'opinion actuelle. Autrement dit, cette maladie que Nietzsche, il y a un siècle déjà, baptisait nihilisme - et dans laquelle il percevait, non sans raison, un écho assourdi de l'antisémitisme chrétien. Comme si la vieille Europe, fatiguée d'avoir trop vécu, était désormais proche d'abdiquer les valeurs des lumières sur lesquelles sa propre culture s'était non sans peine édifiée. (shrink)

Le rapport entre positif et normatif est une question méthodologique et théorique centrale en économie. À ce titre, les débats de la littérature spécialisée réclament une synthèse précise, à défaut de la cartographie exhaustive qui paraît une gageure. Le présent ouvrage le reconnaît volontiers en montrant qu'il est pertinent de revenir sur ces enjeux et qu'il est opportun d'élaborer ou d'ouvrir certaines perspectives jusqu'ici peut-être moins explorées. Le point de vue des coordinateurs de ce volume part du constat que l'étude (...) du rapport entre positif et normatif reste précieuse pour la pensée et la philosophie économiques : l'enquête met en évidence des distinctions essentielles, entre normes, valeurs et faits, ou entre l'activité de description, la prescription et l'évaluation, et concernant des notions comme la causalité dans le champ épistémique, la justice et l'intérêt dans le champ éthique. S'ajoutent des leçons instructives pour penser le rapport entre positif et normatif en défendant la primauté de l'un (le positif, le plus souvent) ou de l'autre (le normatif, plus rarement), ou en les séparant. Force est de constater que les écoles de pensée les plus divergentes peuvent se rejoindre, voire s'accorder sur des positions inattendues. Favoriser le positif, voilà qui réunit des économistes d'écoles de pensée aussi influentes et diverses que les écoles marxiste, autrichienne ou de Chicago : celles-ci, et d'autres, trouvent leur place dans ce volume, ainsi que des approches méthodologiques variées (pragmatisme, bayésianisme, théorie des négociations). S'il semble qu'un consensus valorisant les approches positives en économie y obère la recherche, à quoi est-il dû?? L'histoire de la pensée économique permet-elle de dégager quelques positions venant nuancer cette position?? Des perspectives philosophiques peuvent être adaptées à cet effet et l'importance des pratiques est également à relever, peut-être pour mieux valoriser les approches normatives en économie.Telles sont quelques-unes des approches traitées dans les onze contributions réunies dans cet ouvrage à partir d'un colloque tenu en décembre 2020. Introduction. Le positif, le normatif et la philosophie économique Chapitre 1. Économie normative et économie positive, prescription et théorie : Quesnay et Smith face à la bêtise Chapitre 2. Ni « normativité » ni « positivité » : qu'est-ce qu'une « critique » de l'économie politique? Chapitre 3. Inculquer ou extirper l'esprit du capitalisme? Chapitre 4. L'idéologie allemande. L'idéologie autrichienne Chapitre 5. Questionner la séparation entre le positif et le normatif en économie avec le pragmatisme de John Dewey Chapitre 6. De quelles normativités peut-on parler en économie? Chapitre 7. L'économie politique entre pratiques normatives, normatrices et positives Chapitre 8. Le rôle de la méthode normative dans la théorie néoclassique positive Chapitre 9. L'impossible neutralité des interventions de la Banque centrale européenne sur les marchés financiers Chapitre 10. L'économie normative sans les préférences? Chapitre 11. Aspects positifs et normatifsdu traitement du compromis dans la négociation Index des noms. (shrink)

Ce texte est né de la manifestation du 11 janvier 2015, au cours de laquelle les masses françaises proclamèrent leur adhésion à un contrat social philosophique fondé sur quelques principes essentiels la liberté d'expression, la démocratie, la tolérance, la laïcité, la volonté de vivre ensemble, la lutte contre la barbarie. Des exemplaires du Traité sur la tolérance de Voltaire furent même déposés au pied de la statue de la République, à Paris. La thèse ici défendue est que la plupart des (...) sociétés seraient fondées avant tout sur des idées collectives philosophiques, et non sur des bases matérielles, en particulier économiques. Il n'y a pas de différence de nature entre les idées philosophiques collectives et les idées émises par les philosophes. Cela explique que ceux-ci puissent analyser les idées des groupes sociaux, en tirer des théories, et que Maton, Locke, Montesquieu, Voltaire, Rousseau, Marx ou Nietzsche aient pu influencer massivement des sociétés humaines. Que les idées philosophiques soient vraies et morales, ou fausses et immorales, en elles se joue le destin de l'humanité"--Page 4 of cover. (shrink)

Background Evidence concerning how Japanese physicians think and behave in specific clinical situations that involve withholding or withdrawal of medical interventions for end-of-life or frail elderly patients is yet insufficient. Methods To analyze decisions and actions concerning the withholding/withdrawal of life-support care by Japanese physicians, we conducted cross-sectional web-based internet survey presenting three scenarios involving an elderly comatose patient following a severe stroke. Volunteer physicians were recruited for the survey through mailing lists and medical journals. The respondents answered questions concerning (...) attitudes and behaviors regarding decision-making for the withholding/withdrawal of life-support care, namely, the initiation/withdrawal of tube feeding and respirator attachment. Results Of the 304 responses analyzed, a majority felt that tube feeding should be initiated in these scenarios. Only 18% felt that a respirator should be attached when the patient had severe pneumonia and respiratory failure. Over half the respondents felt that tube feeding should not be withdrawn when the coma extended beyond 6 months. Only 11% responded that they actually withdrew tube feeding. Half the respondents perceived tube feeding in such a patient as a "life-sustaining treatment," whereas the other half disagreed. Physicians seeking clinical ethics consultation supported the withdrawal of tube feeding (OR, 6.4; 95% CI, 2.5–16.3; P < 0.001). Conclusion Physicians tend to harbor greater negative attitudes toward the withdrawal of life-support care than its withholding. On the other hand, they favor withholding invasive life-sustaining treatments such as the attachment of a respirator over less invasive and long-term treatments such as tube feeding. Discrepancies were demonstrated between attitudes and actual behaviors. Physicians may need systematic support for appropriate decision-making for end-of-life care. (shrink)

A geographically stratified cross-sectional survey was conducted in 2002 to investigate household-level factors associated with use of mosquito control measures and self-reported malaria in Malindi, Kenya. A total of 629 households were surveyed. Logistic regressions were used to analyse the data. Half of all households (51%) reported all occupants using an insecticide-treated bed net and at least one additional mosquito control measure such as insecticides or removal of standing water. Forty-nine per cent reported a history of malaria in the household. (...) Of the thirteen household factors analysed, low (OR=0·23, CI 0·11, 0·48) and medium (OR=0·50, CI 0·29, 0·86) education, mudcoral (OR=0·0·39, CI 0·24, 0·66) and mud block–plaster (OR=0·47, CI 0·25, 0·87) wall types, farming (OR=1·38, CI 1·01, 1·90) and travel to rural areas (OR=0·48, CI 0·26, 0·91) were significantly associated with the use of mosquito control, while controlling for other covariates in the model. History of reported malaria was not associated with the use of mosquito control (OR=1·22, CI 0·79, 1·88). Of the thirteen covariates analysed in the second model, only two household factors were associated with history of malaria: being located in the well-drained stratum (OR=0·49, CI 0·26, 0·96) and being bitten while in the house (OR=1·22, CI 0·19, 0·49). These results suggest that high socioeconomic status is associated with increased household-level mosquito control use, although household-level control may not be enough, as many people are exposed to biting mosquitoes while away from the house and in areas that are more likely to harbour mosquitoes. (shrink)

De la Première Guerre mondiale aux attentats du 11 septembre 2001, la manipulation des émotions par le biais des images existe et limite l'esprit critique. L'auteure révèle que les images ont un pouvoir humanisant, et la distance qu'elles créent entre l'homme et ses émotions offre à celui-ci les conditions de sa liberté, à lui de ne pas subir les images, de les refuser.

Author: Jakubowski Jarosław Title: EN QUOI CONSISTE LA FINITUDE DU CORPS PROPRE? À LA RECHERCHE DE LA RÉPONSE DE PAUL RICOEUR (Na czym polega skończoność ciała własnego? W poszukiwaniu odpowiedzi Paula Ricoeura) Source: Filo-Sofija year: 2010, vol:.11, number: 2010/2, pages: 107-124 Keywords: FINITUDE DU CORPS, RICOEUR, „OUVERTURE”, „FERMETURE DANS L’OUVERTURE”, L’ALTERITE DU CORPS PROPRE Discipline: PHILOSOPHY Language: POLISH Document type: ARTICLE Publication order reference (Primary author’s office address): E-mail: www:L’analyse du problème formulé dans le titre se compose de deux parties (...) thématiques. La première présente la conception du corps propre élaborée par Ricoeur et ses sources philosophiques (Maine de Biran, Husserl, Marcel, Heidegger) les plus importantes. La deuxième partie presénte deux significations fondamentales de la notion de la finitude du corps propre chez Ricoeur. Celui-ci distingue la finitude du corps propre considerée comme une „ouverture” (1) et comme une „fermeture dans l’ouverture” (2). La troisième signification de la notion ci-dessus, mentionnée dans la conclusion de l’article, est liée à une catégorie de l’altérité du corps propre. (shrink)

Les cinq contributions que l’on va lire ont été présentées et discutées lors d’une journée d’étude organisée par Leopoldo Iribarren et André Laks (Centre Léon Robin, UMR 8061) les 11 et 12 février 2011 dans le cadre du programme ANR « Présocratiques Grecs/Présocratiques latins » (ANR Blanc ANR 08‑BLAN‑0063‑01, responsable A. Laks). Couvrant quelques aspects centraux ou représentatifs de la pratique pré‑aristotélicienne de l’analogie et de la réflexion (le plus souvent implicite) dont celle-ci...

RésuméAprès avoir déflni la Psychologie comme la science des personnaliés, de leurs activité au sein des situations qui les confrontent, et de leur développement dans un milieu physique, social et culturel donné, le Dr Murray formule un certain nombre de propositions et conceptions théo‐riques destinées à rendre compte des faits psychiques. Les unes sont ?ordre général, les autres concernent la motivation. Propositions générales. 1. La personnalitéà son siège dans le cerveau.2. Elle dure et se développe dans le temps par suite (...) des opérations qu'elle est amenée à produire.3. Ces opérations sont internes ou externes, et correspondent à des attitudes ?introversion ou ?extroversion. Toutes comportent une dimension temporelle, un début, un déroulement de longueur variable, une fin.4. Les opérations externes sont constituteées ?une série de champs momentanés , le champ lui‐même résultant de la combinaison ?une situation externe et ?un état interne. II importe de distinguer de la situation réelle, la situation telle que la voit le sujet. Cette distinction revêt une importance particulière dans le cas des relations sociales.5. Ľobjet ?étude du Psychologue consiste alors, non pas dans le comportement du seul sujet, mais dans ľinteraction du sujet et de ľobjet. Celle‐ci, avec ses deux aspects complémentaires de besoin et de pression est ce que le Dr Murray à appeié ailleurs un théme.6. Les actions Psychologiques s'ordonnént fréquemment en séquences tendant àľobtention ?un but éioigné. Les démarches intermédiates s'expliquent alors, non pas par ľinfluence des facteurs externes contemporains, mais par celle des facteurs internes antérieurs. Ce sont, non des réactions, mais des proactions. Elles ne sont pas homéostatiques et subor‐données à la restitution ?un équilibre antérieur, mais _HYPERLINK “superstatiqu.es” et visant à la production de quelque chose de neuf. Séquences et proactions composent pour une grande part ľego‐system.7. Ľévolution de la personnalité s'ordonné en périodes relativement longues dont il est possible de prendre au cours de brefs laps de temps une sorte ?échantillonnage.8. La personnalité fait montre ?une intégration variable, perceptible aux niveaux des opérations, des séquences ou des périodes.9. Elle se transforme sans cesse par ľeffet des opérations ou elle est engageée, ces transformations graduelles et insensibles pouvant s'accumuler jusquà déclencher à un moment donné des revirements spectaculaires tels que les conversions.10. Le donné du Psychologue est de deux sortes: faits subjectifs communiqués par le sujet, faits objectifs recueillis par ľobservateur extérieur. II importe ensuite ?expliquer ce donné, autrement dit de construire une représentation hypothétique du psychisme du sujet, qui permette de comprendre ses conduites passées et de prédire ses conduites futures. Ces constructions n'ont pas encore atteint le stade ?une tľpologie satisfaisante. Concepts relatifs à la motivation. Dans la représentation théorique dont il vient ?être parlé, une place éminente revient aux concepts relatifs à la motivation: tendance, instinct, besoin, vecteur psychique concu à la façon de Lewin. La Psychologie américaine à pendant longtemps tendu à restreindre le nombre de ces besoins, et à n'admettre comme tout à fait fondamentaux et originels que ceux qui concernent la nourriture et le sexe. II est impossible de comprendre les actions humaines si ľon ne réserve une place à des tendances, activités et satisfactions ?un ordre plus élevé. Notamment:1. Ľêtre vivant peut dépenser le surplus ?énergie dont il dispose dans des actions spontanées, non déclenchées par un stimulus externe. Ľaction trouve alors sa gratification en elle‐même et non dans le résultat qu'elle procure .2. Un plaisir supplémentaire peut résulter de la manière plus ou moins harmonieuse dont se déroule ľaction, indépendamment de ľeffet où elle arrive.3‐4. Il existe des besoins ?ordre mental oùľesprit cherche sa satisfaction propre et non celle de ľorganisme. On voit alors ľimagination ľemporter sur la perception et le donné s'analyser et se recomposer en créations originales. Ces besoins et les actes qu'ils provoquent procurent les trois sortes de plaisirs distingués plus haut. Leur but n'est pas préala‐blement donné, mais doit être construit pièce par pièce.5‐6. à côté des besoins positifs existent des besoins négatifs qui poussent àéviter, exclure, ou détruire. De même, aux besoins réactifs s'opposent les besoins proactifs, spontanés et créateurs. Les premiers peuvent devenir proréactifs par ľintervention de ľanticipation, les seconds réproactifs sous ľeffet de circonstances inattendues. Ces diverses sortes de conduites peuvent servir à classer les individus ?après la place considérable ou réduite qu'elles occupent dans son comportement.7. Les besoins se spécifient par canalisation ou cathection . Ils peuvent aussi par généralisation sétendre à de nouveaux objets. Ľexcès ou le manque absolu de fixation sont des symptômes ?immaturityé. – Une importance particulière revient, dans le cadre de cette théorie, à la notion freudienne de cathexis. Certains objets et buts sont adoptés à la faveur de circonstances où joue le trial and error. Dautres, purement idéaux àľorigine, sont recherchds par ľindividu sans jamais avoir été rencontrés par lui. Si le trial and error intervient ici, c'est sur le plan de ľimagination. – La Psychologie américaine à restreint en général la notion et le terme ?apprentissage àľacquisition des moyens de satisfaction àľexclusion des fins. De même, la civilisation contemporaine, si elle à prodigieusement développé’ les techniques, à perdu la notion ?un commun idéal humaniste. II importerait de revenir, ?un point de vue théorique non moins que pratique, àľapprentissage des fins, autrement dit au processus par lequel ľindividu, sous la poussée de besoins largement indifférenciés adopte tel nouveau but, s'attache à telle valeur, jugée par lui source de satisfaction.8. Les besoins peuvent être conscients ou inconscients. Dans le dernier cas, ľindividu les refoule sous la pression des impératifs sociaux. Ils se mafestent alors de diverses façons détournées, éventuellement névrotiques, et peuvent se retourner contre le sujet.9‐10. II existe un ordre ?urgence dans la satisfaction des besoins, les plus biologiques réclamant le plus impérieusement satisfaction, les plus Aleves et altruistes ne se faisant sentir qu'ensuite.11. La Psychologic sociale récente à artificiellement dissoci^ les notions ?inUret, attitude et valeur de celle de besoin. Mais la notion de besoin à son tour demande une analľse plus poussee. Le besoin comprend deux composantes : Ľaction à quoi il pousse ou vedeur proprement dit, la valeur ou entite valorisee au benefice de laquelle s'effectue cette action. Toute conduite concrete apparait alors comme un systéme valeur‐uecteur et peut être analľsee de ce double point de vue. (shrink)

Support from grandparents plays a role in mothers’ perinatal mental health. However, previous research on maternal mental health has mainly focused on influences of partner support or general social support and neglected the roles of grandparents. In this narrative review and meta-analysis, the scientific evidence on the association between grandparental support and maternal perinatal mental health is reviewed. Searches in PubMed, EMBASE, MEDLINE, Scopus, and PsycINFO yielded 11 empirical studies on N = 3381 participants, reporting on 35 effect sizes. A (...) multilevel approach to meta-analysis was applied to test the association between grandparental support and maternal mental health. The results showed a small, statistically significant association (r =.16; 95% CI: 0.09–0.25). A moderator test indicated that the association was stronger for studies reporting on support from the maternal grandmother in particular (r =.23; 95% CI: 0.06–0.29). Our findings suggest that involved grandparents, in particular mother’s own mother, constitute a protective factor for the development of maternal postpartum mental health problems. These findings have clear implications for interventions. Future studies should examine whether stimulating high-quality support from grandparents is a fruitful avenue for enhancing maternal postpartum mental health. (shrink)

There is growing interest in examining dark personality traits, to better explain malevolent and self-serving behaviour patterns commonly observed in clinical and non-clinical settings. Recently, taxonomies of dark personalities have been developed, along with psychometric tools to measure and delineate between traits including psychopathy, Machiavellianism and narcissism. The extent to which these constructs are distinct or overlapping remains controversial. Psychophysiological research can improve understanding of biological mechanisms contributing to personality that may help to evaluate taxonomies. This study investigated diurnal variations (...) in salivary cortisol (on waking, cortisol awakening response, and at bedtime, over two days) and their relationship to personality traits (Short Dark Triad Scale and IPIP Mini), psychopathology (Depression, Anxiety and Stress Scale; DASS) and quality of life (WHOQOL-BREF) in a non-clinical sample (N=45, 26 females, 19 males, 18-59 years). Dark personality traits correlated with low bedtime cortisol, reduced sleep, depression and poorer quality of life. Hierarchical linear regressions analyses indicated that bedtime cortisol levels significantly accounted for variance in Psychopathy (F(1,39)=5.55, p=.02, R=.52, B=-1.81, 95% CI [-3.37-(-.26)], β=-.33, sr2=.10) and reduced sleep uniquely accounted for variance Machiavellianism (F(2,40)=5.99, p=.01, R=.48, B=1.01, 95% CI [.16-2.02], β=.34, sr2=.11). These data provide preliminary evidence that supports the cortisol hypoarousal hypothesis of Psychopathy and has identified a link between Machiavellianism, sleep-wake cycles, and chronotype. The hypoarousal hypothesis of Psychopathy contends that the hypothalamic-pituitary-adrenal axis is unresponsive to the stress of social engagement. Machiavellianism was predicted by longer days with evidence for an evening chronotype. These findings indicated that the Dark Triad traits have different underlying biological mechanisms that require further exploration. (shrink)

This study aims to assess the level and determinants of the general public's willingness to organ donation. We conducted a population-based cross-sectional study of 4261 participants in China. The primary outcome was the willingness to donate organs. Logistic regression modelling was used to determine the factors that affect willingness to donate organs. Overall, the proportion of participants who showed a willingness to donate organs was 47.45% (95%CI: 0.46, 0.49) in this study. Logistic regression modelling showed participants from Western (OR = (...) 1.33, 95%CI = 1.11-1.59) and Eastern China (OR = 1.40, 95%CI = 1.19-1.65) were more willing to donate organs compared with those from Central China. The odds of being willing to donate organs was higher in females than males (OR = 1.35, 95%CI = 1.17-1.55); and was higher in those participants with experience of organ donation (OR = 1.58, 95%CI = 1.13-2.21), experience of caring for organ transplant patients (OR = 1.45, 95%CI = 1.01-2.07), and those undertaking related voluntary activities (OR = 1.67, 95%CI = 1.45-1.94), than those without. The general public's level of willingness to organ donation was not high in this study. Geographical region, gender, experience of organ donation related activities, taking care of organ transplant patients and volunteering in related activities were independently associated with participants' willingness to donate organs. (shrink)

This study aims to assess the level and determinants of the general public's willingness to organ donation. We conducted a population-based cross-sectional study of 4261 participants in China. The primary outcome was the willingness to donate organs. Logistic regression modelling was used to determine the factors that affect willingness to donate organs. Overall, the proportion of participants who showed a willingness to donate organs was 47.45% (95%CI: 0.46, 0.49) in this study. Logistic regression modelling showed participants from Western (OR = (...) 1.33, 95%CI = 1.11-1.59) and Eastern China (OR = 1.40, 95%CI = 1.19-1.65) were more willing to donate organs compared with those from Central China. The odds of being willing to donate organs was higher in females than males (OR = 1.35, 95%CI = 1.17-1.55); and was higher in those participants with experience of organ donation (OR = 1.58, 95%CI = 1.13-2.21), experience of caring for organ transplant patients (OR = 1.45, 95%CI = 1.01-2.07), and those undertaking related voluntary activities (OR = 1.67, 95%CI = 1.45-1.94), than those without. The general public's level of willingness to organ donation was not high in this study. Geographical region, gender, experience of organ donation related activities, taking care of organ transplant patients and volunteering in related activities were independently associated with participants' willingness to donate organs. (shrink)

This study aims to assess the level and determinants of the general public's willingness to organ donation. We conducted a population-based cross-sectional study of 4261 participants in China. The primary outcome was the willingness to donate organs. Logistic regression modelling was used to determine the factors that affect willingness to donate organs. Overall, the proportion of participants who showed a willingness to donate organs was 47.45% (95%CI: 0.46, 0.49) in this study. Logistic regression modelling showed participants from Western (OR = (...) 1.33, 95%CI = 1.11-1.59) and Eastern China (OR = 1.40, 95%CI = 1.19-1.65) were more willing to donate organs compared with those from Central China. The odds of being willing to donate organs was higher in females than males (OR = 1.35, 95%CI = 1.17-1.55); and was higher in those participants with experience of organ donation (OR = 1.58, 95%CI = 1.13-2.21), experience of caring for organ transplant patients (OR = 1.45, 95%CI = 1.01-2.07), and those undertaking related voluntary activities (OR = 1.67, 95%CI = 1.45-1.94), than those without. The general public's level of willingness to organ donation was not high in this study. Geographical region, gender, experience of organ donation related activities, taking care of organ transplant patients and volunteering in related activities were independently associated with participants' willingness to donate organs. (shrink)

Background: Chinese Taoist cognitive therapy (CTCT), a culture-oriented psychological therapy for Chinese mental well-being, has been proposed for decades. However, the evidence for its effects is unclear. This study aimed to systematically assess the effect of this therapy on symptoms of depression and anxiety in Chinese adults. Methods: Relevant studies were searched from major electronic databases through November 2018 without language limits. Several search terms used include “anxiety” OR “depression” AND “Taoism” OR “Daoism” OR “Chinese Taoist Cognitive Therapy”. A total (...) of 11 clinical trials focusing on CTCT were included in this meta-analysis. Random-effects meta-analytical models were conducted. Heterogeneity and publication bias were also explored. Results: Eight clinical trials for 580 subjects were included. The majority of these studies explored samples with depressive symptoms. Overall, CTCT significantly reduced depressive symptoms with a small positive effect (SMD = 0.16, 95% CI: -0.36-0.68). Medium-to-large effect sizes were observed across individuals with clinical or nonclinical depression and chronic physical diseases (SMD = 0.70, 95%CI: 0.27-1.13 and SMD = 0.72, 95%CI: 0.09-1.35, respectively). However, the effectiveness for anxiety symptoms remains debatable. Conclusions: Our findings hold promise that CTCT can help reduce depressive symptoms in Chinese adults, including patients with chronic physical diseases and clinical or nonclinical depression. Our findings may be generalized to Chinese communities in other countries. (shrink)

Studies have shown that children vary in the trajectories of their language development after cochlear implant (CI) activation. The aim of the present study is to assess the preverbal and lexical development of a group of 20 Italian-speaking children observed longitudinally before CI activation and at three, 6 and 12 months after CI surgery (mean age at the first session: 17.5 months; SD: 8.3; and range: 10–35). The group of children with CIs (G-CI) was compared with two groups of normally-hearing (...) (NH) children, one age-matched (G-NHA; mean age at the first session: 17.4 months; SD: 8.0; and range: 10–34) and one language-matched (G-NHL;n= 20; mean age at the first session: 11.2 months; SD: 0.4; and range: 11–12). The spontaneous interactions between children and their mothers during free-play were transcribed. Preverbal babbling production and first words were considered for each child. Data analysis showed significant differences in babbling and word production between groups, with a lower production of words in children with CIs compared to the G-NHA group and a higher production of babbling compared to the G-NHL children. Word production 1 year after activation was significantly lower for the children with CIs than for language-matched children only when maternal education was controlled for. Furthermore, latent class growth analysis showed that children with CIs belonged mainly to classes that exhibited a low level of initial production but also progressive increases over time. Babbling production had a statistically significant effect on lexical growth but not on class membership, and only for groups showing slower and constant increases. Results highlight the importance of preverbal vocal patterns for later lexical development and may support families and speech therapists in the early identification of risk and protective factors for language delay in children with CIs. (shrink)

Dans les débats sur la situation des religions en Europe, la pensée de Jürgen Habermas reste incontournable. Depuis le choc de 11 septembre 2001, celle-ci a largement évolué pour accorder une place plus grande aux demandes de reconnaissance des religions dans l’espace public. Pour autant, l’éthique de la discussion doit aujourd’hui être interrogée à nouveaux frais face aux recrudescences des fondamentalismes religieux et laïcistes.

BackgroundWe examine the incidence of medical tribunal decisions and disciplinary actions (DAs) against healthcare professionals (HCPs). In addition, we studied whether an intimate relationship between an HCP and patient as part of the medical tribunal decision is associated with an increased likelihood of disciplinary actions.MethodsWe conducted a nationwide cohort analysis on the downloadable medical tribunal decisions from a medical disciplinary tribunal in the Netherlands from 2010 to 2017.ResultsWe found that 117 (2.8%) of the 4,046 medical tribunal decisions involved an alleged (...) intimate relationship between an HCP and patient. In these medical tribunal decisions the likelihood of a disciplinary action was significantly increased (odds ratio [OR] 12.97, 95% Confidence Interval [95% CI] 7.11–23.64). In addition, we found that nurses and psychiatrists are more frequently accused of and receive disciplinary actions due to intimate relationships than other HCP groups.ConclusionsWe found a limited number of medical tribunal decisions involving an intimate relationship. Especially given the total number of medical tribunal decisions and the number of yearly HCP-patient interactions, the number appears small. Furthermore, an alleged intimate relationship or inappropriate sexual conduct is associated with an increased likelihood of disciplinary action. Future research should obtain statistics on the number of intimate relationships that actually start between HCPs and patients. (shrink)

BackgroundThe Public Health Service Increased Risk designation identified organ donors at increased risk of transmitting hepatitis B, hepatitis C, and human immunodeficiency virus. Despite clear data demonstrating a low absolute risk of disease transmission from these donors, patients are hesitant to consent to receiving organs from these donors. We hypothesize that patients who consent to receiving offers from these donors have decreased time to transplant and decreased waitlist mortality.MethodsWe performed a single-center retrospective review of all-comers waitlisted for liver transplant from (...) 2013 to 2019. The three competing risk events (transplant, death, and removal from transplant list) were analyzed. 1603 patients were included, of which 1244 (77.6%) consented to offers from increased risk donors.ResultsCompared to those who did not consent, those who did had 2.3 times the rate of transplant (SHR 2.29, 95% CI 1.88–2.79, p < 0.0001), with a median time to transplant of 11 months versus 14 months (p < 0.0001), as well as a 44% decrease in the rate of death on the waitlist (SHR 0.56, 95% CI 0.42–0.74, p < 0.0001). All findings remained significant after controlling for the recipient age, race, gender, blood type, and MELD. Of those who did not consent, 63/359 (17.5%) received a transplant, all of which were from standard criteria donors, and of those who did consent, 615/1244 (49.4%) received a transplant, of which 183/615 (29.8%) were from increased risk donors.ConclusionsThe findings of decreased rates of transplantation and increased risk of death on the waiting list by patients who were unwilling to accept risks of viral transmission of 1/300–1/1000 in the worst case scenarios suggests that this consent process may be harmful especially when involving “trigger” words such as HIV. The rigor of the consent process for the use of these organs was recently changed but a broader discussion about informed consent in similar situations is important. (shrink)

Professeure d’histoire à l’université de Wisconsin (États-Unis), Mary Louise Roberts est l’auteure du classique Civilization without Sexes : reconstructing gender in Postwar France, 1917-1927, paru en 1994. Passant du premier au deuxième après-guerre, elle livre aujourd’hui une analyse de la sexualité des GIs dans la France libérée de 1944 où elle s’attache à démontrer le caractère profondément politique de leur vie sexuelle (p. 11). Car pour elle, loin d’être une affaire privée, celle-ci a é...

Background Although medical ethicists and educators emphasise patient-centred decision-making, previous studies suggest that patients often prefer their doctors to make the clinical decisions. Objective To examine the associations between a preference for physician-directed decision-making and patient health status and sociodemographic characteristics. Methods Sociodemographic and clinical information from all consenting general internal medicine patients at the University of Chicago Medical Center were examined. The primary objectives were to (1) assess the extent to which patients prefer an active role in clinical decision-making, (...) and (2) determine whether religious service attendance, the importance of religion, self-rated spirituality, Charlson Comorbidity Index, self-reported health, Vulnerable Elder Score and several demographic characteristics were associated with these preferences. Results Data were collected from 8308 of 11 620 possible participants. Ninety-seven per cent of respondents wanted doctors to offer them choices and to consider their opinions. However, two out of three (67%) preferred to leave medical decisions to the doctor. In multiple regression analyses, preferring to leave decisions to the doctor was associated with older age (per year, OR=1.019, 95% CI 1.003 to 1.036) and frequently attending religious services (OR=1.5, 95% CI 1.1 to 2.1, compared with never), and it was inversely associated with female sex (OR=0.6, 95% CI 0.5 to 0.8), university education (OR=0.6, 95% CI 0.4 to 0.9, compared with no high school diploma) and poor health (OR=0.6, 95% CI 0.3 to 0.9). Conclusions Almost all patients want doctors to offer them choices and to consider their opinions, but most prefer to leave medical decisions to the doctor. Patients who are male, less educated, more religious and healthier are more likely to want to leave decisions to their doctors, but effects are small. (shrink)

Objective: To estimate the level of complementary feeding pattern (CFP) among children aged between 6 to 23 months and to identify the determinants in individual, household and community level in Bangladesh. Methods: From secondary data of Bangladesh Demographic Health Survey (BDHS) 2011 was used in this study. A total of 2,373 children aged between 6 to 23 months were selected. To estimate the level of CFP dimension index and the “score of the index” was used as dependent variables. Statistical analyses (...) and tests were guided by the nature of the variables. Multivariable logistic regression analyses were performed to identify the significant determinants of CFP. Results: The overall level of CFP among children aged between 6 to 23 months was low. More than 95% of the children experienced inadequate (92.7%) CFP level. The mean levels of CFP as well as percentages of no or inadequate (94.1%) CFP were significantly lower among children of the youngest age group (06 months), uneducated parents, unemployed/laborer fathers, socio-economically poor families, food insecure families and rural areas. However, only few variables remained significant for adequate CFP in the multivariable logistic regression analysis. Adequate CFP was significantly lower among the children aged between 6 to 23 months (OR: 0.22, 95% CI: 0.10-0.47), children of illiterate fathers (OR: 0.32, 95% CI: 0.11-0.95) and socio-economically middle-class families (OR: 0.28, 95% CI: 0.09-0.86) as compared to their reference categories. Conclusion: Inappropriate and inadequate CFP may cause serious health hazards among children of 6 to 23 months in Bangladesh. It is ethical to take effective interventions and strategies by the government and other concerned stakeholders to improve the overall situation of CFP in Bangladesh. (shrink)