Background: Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Minister for Health reason to commission a study of the role of nurses in medical end-of-life decisions in hospitals, home care and nursing homes.Aim: This paper reports the findings of a study of the role of nurses in euthanasia and physician-assisted suicide, conducted as part of a study of the role of nurses in medical end-of-life decisions. The findings for hospitals, (...) home care and nursing homes are described and compared.Method: A questionnaire was sent to 1509 nurses, employed in 73 hospitals, 55 home care organisations and 63 nursing homes. 1179 responses were suitable for analysis. The questionnaire was pilot-tested among 106 nurses, with a response rate of 85%.Results: In 37.0% of cases, the nurse was the first person with whom patients discussed their request for euthanasia or physician-assisted suicide. Consultation between physicians and nurses during the decision-making process took place quite often in hospitals and nursing homes and less frequently in home care situations . In some cases , nurses administered the euthanatics.Conclusions: The results show substantial differences between the intramural sector and the extramural sector , which are probably linked to the organisational structure of the institutions. Consultation between physicians and nurses during the decision-making process needs improvement, particularly in home care. Some nurses had administered euthanatics, although this task is by law exclusively reserved to physicians. (shrink)

The US neutrino community gathered at the Workshop on the Intermediate Neutrino Program at Brookhaven National Laboratory February 4-6, 2015 to explore opportunities in neutrino physics over the next five to ten years. Scientists from particle, astroparticle and nuclear physics participated in the workshop. The workshop examined promising opportunities for neutrino physics in the intermediate term, including possible new small to mid-scale experiments, US contributions to large experiments, upgrades to existing experiments, R&D plans and theory. The workshop was organized into (...) two sets of parallel working group sessions, divided by physics topics and technology. Physics working groups covered topics on Sterile Neutrinos, Neutrino Mixing, Neutrino Interactions, Neutrino Properties and Astrophysical Neutrinos. Technology sessions were organized into Theory, Short-Baseline Accelerator Neutrinos, Reactor Neutrinos, Detector R&D and Source, Cyclotron and Meson Decay at Rest sessions.This report summarizes discussion and conclusions from the workshop. (shrink)

Electrical resistivity and ac-calorimetric measurements reveal a complex magnetic phase diagram for single crystals of the ferromagnetic Kondo-lattice compound CeAgSb2 at high pressures up to 80 kbar. The ferromagnetic order at TC = 9.6 K at ambient pressure is completely suppressed at a critical pressure PC = 35 kbar. Another magnetic transition, possibly antiferromagnetic, found above 27 kbar, attains a maximum value TN 6 K at 44 kbar and then appears to be completely suppressed by 50 kbar. Thermodynamic and transport (...) measurements in the ferromagnetic state indicate an energy gap Δ 30 K in the spin-wave excitation spectrum at ambient pressure which decreases to Δ 10 K at P = 30 kbar. No superconductivity is observed at ambient pressure above T 0.1 K, under applied pressure in the ferromagnetic state (P = 28.5 kbar), nor in the antiferromagnetic state (P = 33 − 46 kbar) above 0.3 K. © 2003 The American Physical Society. (shrink)

Of the early Roman historians who wrote in Greek, A. Postumius Albinus was not necessarily alone in realizing that his Greek was not the best Greek; while, on the other hand, Cato and those who followed the new fashion of writing in Latin would have resented, we may assume, could they have foreknown, the statement of Q,. Catulus in Cicero's De Oratore that they had no literary or rather ‘oratorical’ merit; though Cato might have approved Catulus' caustic comment on Roman (...) historical writing, ‘Satis est non esse mendacem’. That an historian should not, consciously and deliberately, lie all second-century historians would no doubt have agreed; and they would have endorsed Polybius' condemnation of masquerading as history in a story whose falseness was self-evident, because it assumed, on the part of the young sons of senators at Rome, a gravitas such as no young boy could possibly possess. (shrink)

‘Auctoritas’ was naturally one of Cicero's favourite concepts. In the ideal republic power lay with the people, auctoritas with the Senate . Alternatively, in a balanced state, potestas would lie with the magistrates, libertas with the people, but still auctoritas would be the property of the Senate, ‘in principum consitio’ [De rep. 2. 57).

v. 1. Nicomachean ethics. Politics. The Athenian Constitution. Rhetoric. On Poetics.--v. 2. Logic.--v. 3. Physics. Metaphysics. On the soul. Short physical treaties.--v. 4. On the heavens. On generation and corruption. Meteorology. Biological treatises.

An extensive literature overlapping economics, statistical decision theory and finance, contrasts expected utility [EU] with the more recent framework of mean–variance (MV). A basic proposition is that MV follows from EU under the assumption of quadratic utility. A less recognized proposition, first raised by Markowitz, is that MV is fully justified under EU, if and only if utility is quadratic. The existing proof of this proposition relies on an assumption from EU, described here as “Buridan’s axiom” after the French philosopher’s (...) fable of the ass that starved out of indifference between two bales of hay. To satisfy this axiom, MV must represent not only “pure” strategies, but also their probability mixtures, as points in the (σ, μ) plane. Markowitz and others have argued that probability mixtures are represented sufficiently by (σ, μ) only under quadratic utility, and hence that MV, interpreted as a mathematical re-expression of EU, implies quadratic utility. We prove a stronger form of this theorem, not involving or contradicting Buridan’s axiom, nor any more fundamental axiom of utility theory. (shrink)

1. The Commentariolum Petitionis is not in the Codex Mediceus of Cicero's correspondence with his brother Quintus, but it appears at the end of the letters to Quintus in the other manuscripts. It starts in the normal manner of a letter and is, or purports to be, a collection of tips on canvassing set in the particular context of M. Cicero's consular candidature in 64: a composition of his brother Quintus. It is printed as no. 12 in Tyrrell and Purser's (...) collection of Cicero's Letters. (shrink)

The problems of the tolal energy and quasilocalenergy density or an isolated spherically symmetric static system in general relativity (GR) are considered with examples of some exact suintions. The field formulation of GR dereloped earlier hy L. P. Grishchuk. el al. (1984). in ihe framework of which all the dynamical fields, including the gravitation field, are considered in a fixed background spacetime is used intensively. The exact Schwarzschild and Reissner Nordstrom solutions are investigated in detail, and the results are compared (...) with those in the recent work by J. D. Brown and J. W. York. Jr. (1993) as well as discussed with respect to the principle of nonlocalization of the gravitational energy in GR. Those examples are illustrative and simple because the background is selected as Minkowski spacetime and, in fact, the field configurations are studied in the framework of special relativity. It is shown that some problems of the Schwarzschild solution which are difficult to resolve in the standard geometrical framework of GR are resolved in the framework of the field formulation. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

© 2015 Elsevier Inc.Postnatal organogenesis occurs in an immune competent environment and is tightly controlled by interplay between positive and negative regulators. Innate immune cells have beneficial roles in postnatal tissue remodeling, but roles for the adaptive immune system are currently unexplored. Here we show that adaptive immune responses participate in the normal postnatal development of a non-lymphoid epithelial tissue. Since the mammary gland is the only organ developing predominantly after birth, we utilized it as a powerful system to study (...) adaptive immune regulation of organogenesis. We found that antigen-mediated interactions between mammary antigen-presenting cells and interferon-γ -producing CD4+ T helper 1 cells participate in MG postnatal organogenesis as negative regulators, locally orchestrating epithelial rearrangement. IFNγ then affects luminal lineage differentiation. This function of adaptive immune responses, regulating normal development, changes the paradigm for studying players of postnatal organogenesis and provides insights into immune surveillance and cancer transformation. Plaks et al. (shrink)

This commentary explores biological models of analogical and associative learning in support of Illusion 1 and Illusion 4 in D. Noble’s target article. The intent is to support Noble’s theses of emergent higher level functionality from lower level stochastic dynamics and his etiological claim that “there is no privileged level of causation” through a biosemiotic lens. Upon these arguments, a case for creative agency via higher-dimensional constraints will also be made in support of Noble’s claim that organismic behavior is actively (...) directed by an agent. (shrink)

While outcomes for children with T-cell acute lymphoblastic leukemia have improved dramatically, survival rates for patients with relapsed/refractory disease remain dismal. Prior studies indicate that glucocorticoid resistance is more common than resistance to other chemotherapies at relapse. In addition, failure to clear peripheral blasts during a prednisone prophase correlates with an elevated risk of relapse in newly diagnosed patients. Here we show that intrinsic GC resistance is present at diagnosis in early thymic precursor T-ALLs as well as in a subset (...) of non-ETP T-ALLs. GC-resistant non-ETP T-ALLs are characterized by strong induction of JAK/STAT signaling in response to interleukin-7 stimulation. Removing IL7 or inhibiting JAK/STAT signaling sensitizes these T-ALLs, and a subset of ETP T-ALLs, to GCs. The combination of the GC dexamethasone and the JAK1/2 inhibitor ruxolitinib altered the balance between pro- and anti-apoptotic factors in samples with IL7-dependent GC resistance, but not in samples with IL7-independent GC resistance. Together, these data suggest that the addition of ruxolitinib or other inhibitors of IL7 receptor/JAK/STAT signaling may enhance the efficacy of GCs in a biologically defined subset of T-ALL.Leukemia advance online publication, 30 May 2017; doi:10.1038/leu.2017.136. (shrink)

New trends in the economic systems management in the context of modern global challenges: collective monograph / scientific edited by M. Bezpartochnyi, in 2 Vol. // VUZF University of Finance, Business and Entrepreneurship. – Sofia: VUZF Publishing House “St. Grigorii Bogoslov”, 2020. – Vol. 1. – 309 p.