OBJECTIVE: To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN: Retrospective descriptive study. SETTING: A cancer clinical trials unit in a large teaching hospital. PATIENTS: From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT: Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. (...) RESULTS: DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS: DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom. (shrink)

This case study details how and why integrating storytelling, empathy, and inclusive practice shifted QSuper, a large Australian finance organisation, from minimal awareness to moral awareness then moral capability in the delivery of services to Indigenous customers. During the Royal Commission into Misconduct in the Banking, Superannuation, and Financial Services Industry, QSuper were recognised for their exemplary service with Indigenous customers (Hayne, Interim report: Royal commission into misconduct in the banking, superannuation and financial services industry, Volume 1. Commonwealth of Australia, (...) 2018; _Transcript of Proceedings, 13 August_, Commonwealth of Australia, 2018). This position was in stark contrast to the inaccessible service offerings of other financial organisations where some used predatory practices to sell unethical financial products to Indigenous Australians (Hayne, Interim report: Royal commission into misconduct in the banking, superannuation and financial services industry, Volume 1. Commonwealth of Australia, 2018; Hayne, Final report: Royal commission into misconduct in the banking, superannuation and financial services industry, Volume 1. Commonwealth of Australia, 2019a). Storytelling garned from visiting customers in remote communities and other meaningful activities involving inclusive practice to facilitate ethical decision-making in finance is different to standard functionalist finance approaches (Schinckus, Int Rev Financ Anal 40:103–106, 2015). Two empathetic questions asked within QSuper complementing the storytelling, were: “What is the right thing to do by the customer?” and “How would I feel if this were my mother?” Exploration into the lived reality of moral capacity is important based on the Commission finding many of the 490,000 finance staff do not know how to provide ethical services to vulnerable customers, in particular remote Indigenous customers (Australian Bureau of Statistics. Labour force, Australia, detailed. ABS. Retrieved from https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-australia-detailed /latest-release, 2021; Hayne, Final report: Royal commission into misconduct in the banking, superannuation and financial services industry, Volume 1. Commonwealth of Australia, 2019a). Furthermore, there is minimal literature on the role of Indigenous storytelling to heighten moral awareness in the finance industry which was found to lead to better ethical outcomes. (shrink)

Knowing the individual skills and competences of one's group members may be important for deciding from whom to learn (social learning), with whom to collaborate and whom to follow. We investigated whether 12 jackdaws could select conspecifics based on their helping skills, which had been exhibited in a previous context. The birds were tested in a blocked-exit-situation, where they could choose between two conspecifics, one of which could be recruited inside. One conspecific had previously displayed the ability to open the (...) exit door whilst the other individual lacked the skill. The subjects showed a significant preference for the skilled conspecific if they had previously directly benefited from this skill. If they had merely observed the skilled (and non-skilled) individual opening (or failing to open) the exit door, they did not preferably choose the skilled conspecific. Taken together, these results suggest that jackdaws are capable of assessing other individuals' competence under certain circumstances. (shrink)

On 5 August 1968, publication of the Harvard Committee’s report on the subject of “irreversible coma” established a standard for diagnosing death on neurological grounds. On the same day, the 22nd World Medical Assembly met in Sydney, Australia, and announced the Declaration of Sydney, a pronouncement on death, which is less often quoted because it was overshadowed by the impact of the Harvard Report. To put those events into present-day perspective, the authors reviewed all papers published on this subject (...) and the World Medical Association web page and documents, and corresponded with Dr A G Romualdez, the son of Dr A Z Romualdez. There was vast neurological expertise among some of the Harvard Committee members, leading to a comprehensible and practical clinical description of the brain death syndrome and the way to diagnose it. This landmark account had a global medical and social impact on the issue of human death, which simultaneously lessened reception of the Declaration of Sydney. Nonetheless, the Declaration of Sydney faced the main conceptual and philosophical issues on human death in a bold and forthright manner. This statement differentiated the meaning of death at the cellular and tissue levels from the death of the person. This was a pioneering view on the discussion of human death, published as early as in 1968, that should be recognised by current and future generations. (shrink)

Alternatives to convenience sampling (CS) are needed for HIV/STI surveillance of most-at-risk populations in Latin America. We compared CS, time space sampling (TSS), and respondent driven sampling (RDS) for recruitment of men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. During concurrent 60-day periods from June-August, 2011, we recruited MSM/TW for epidemiologic surveillance using CS, TSS, and RDS. A total of 748 participants were recruited through CS, 233 through TSS, and 127 through RDS. The (...) TSS sample included the largest proportion of TW (30.7 %) and the lowest percentage of subjects who had previously participated in HIV/STI research (14.9 %). The prevalence of newly diagnosed HIV infection, according to participants' self-reported previous HIV diagnosis, was highest among TSS recruits (17.9 %) compared with RDS (12.6 %) and CS (10.2 %). TSS identified diverse populations of MSM/TW with higher prevalences of HIV/STIs not accessed by other methods. (shrink)

This project continues our interdisciplinary research into computational and cognitive aspects of narrative comprehension. Our ultimate goal is the development of a computational theory of how humans understand narrative texts. The theory will be informed by joint research from the viewpoints of linguistics, cognitive psychology, the study of language acquisition, literary theory, geography, philosophy, and artificial intelligence. The linguists, literary theorists, and geographers in our group are developing theories of narrative language and spatial understanding that are being tested by the (...) cognitive psychologists and language researchers in our group, and a computational model of a reader of narrative text is being developed by the AI researchers, based in part on these theories and results and in part on research on knowledge representation and reasoning. This proposal describes the knowledge-representation and natural-language-processing issues involved in the computational implementation of the theory; discusses a contrast between communicative and narrative uses of language and of the relation of the narrative text to the story world it describes; investigates linguistic, literary, and hermeneutic dimensions of our research; presents a computational investigation of subjective sentences and reference in narrative; studies children’s acquisition of the ability to take third-person perspective in their own storytelling; describes the psychological validation of various linguistic devices; and examines how readers develop an understanding of the geographical space of a story. This report is a longer version of a project description submitted to NSF. This document, produced in May 2007, is a L ATEX version of Technical Report 89-07 (Buffalo: SUNY Buffalo Department of Computer Science, August 1989), with slightly.. (shrink)

When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (n (...) = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p. (shrink)

This article analyses the challenges for the strategies and practices of transformational development in a changing context. This reflection is based on contributions received during the process of dialogues and regional consultations, realised from August 2012 until March 2014, of the ACT Alliance, an international coalition of churches and faith-based organisations working in the areas of humanitarian response, development and advocacy. The main processes that affect the changing development context are addressed, such as the ongoing globalisation as well as (...) the consequences, mainly regarding the shrinking space for civil society. It discusses the concepts of human development and of transformational development, based on a people-centred development vision, a human rights-based approach and advocacy, which addresses the root causes and effects of poverty, inequality and injustice. Transformational development practices, from Latin America, are presented and analysed. The article concludes that the changing development context also offers opportunities, especially regarding regional and global alliances of FBOs, civil society organisations and of social movements. (shrink)

In August 2011, a group of medical doctors, ethicists, academic and medical physicists were asked to debate and reach consensus on the potential need for randomised control trials to test charged particle radiation therapy for treating tumours. The outcome of the meeting was a paper recently published in the Journal of Medical Ethics entitled “Position statement on ethics, equipoise and research on charged particle therapy” by Sheehan et al. However 6 of the 30 meeting participants withdrew from authorship of (...) the ‘position statement’ because their views were not adequately represented. The ‘position statement’ did not state our reasons for withdrawing from the statement, which is a considerable omission. We had two principal objections: the case for the benefits to patients and society of randomized trials to test CPRT was not adequately represented, and the complexities and potential harms of CPRT were not clearly stated. In this response we explain and justify our objections. Patients, doctors and policymakers seeking to make independent judgments about whether equipoise exists for the relative benefits of CPRT should therefore read this document alongside the ‘position’ statement. (shrink)

The impact of COVID-19 on chronic pain in non-infected vulnerable South American subjects is unknown. Healthcare workers are at increased risk for CP. During the pandemic, many HCWs with CP kept working. Knowing how cognition is affected by CP in these subjects is an important subject for work safety. The attention domain has a pivotal role in cognition. Previously, the Continuous Visual Attention Test was applied to detect specific attention deficits in fibromyalgia patients. The present investigation described CP prevalence in (...) non-infected Brazilian HCWs during the pandemic and assessed HCWs’ attentional performance with the aid of the CVAT. This study was carried out at a reference University Hospital in Rio de Janeiro, Brazil. HCWs of both sexes, aged 20 or older, were interviewed from August to December 2020. A 90-second version of the CVAT was performed. The average reaction time to correct responses and the respective intraindividual reaction time variability for correct responses to target was determined. Omission and commission errors were also calculated. Then, for each participant we calculated the Z-scores of the CVAT variables based on the distribution of CVAT performance of 211 healthy subjects. HCWs with Z-scores > 1.64 were classified as significantly impaired. From the 154 selected HCWs, 72 reported CP during the pandemic. Post hoc ANCOVAs showed that the average correct VRT was significantly higher in the CP group than in the non-CP group. The percentage of participants with impaired VRT performance was 30% in the CP group and 16% in the non-CP group. The difference between these two propositions reached significance. As VRT is associated with the sustained-attention subdomain, our data suggest that this subdomain is disrupted in the CP group. (shrink)

The American Journal of Bioethics, Volume 11, Issue 8, Page W4-W6, August 2011.

Aworkshop was held August 26–28, 2015, by the Earth- Life Science Institute (ELSI) Origins Network (EON, see Appendix I) at the Tokyo Institute of Technology. This meeting gathered a diverse group of around 40 scholars researching the origins of life (OoL) from various perspectives with the intent to find common ground, identify key questions and investigations for progress, and guide EON by suggesting a roadmap of activities. Specific challenges that the attendees were encouraged to address included the following: What (...) key questions, ideas, and investigations should the OoL research community address in the near and long term? How can this community better organize itself and prioritize its efforts? What roles can particular subfields play, and what can ELSI and EON do to facilitate research progress? (See also Appendix II.) The present document is a product of that workshop; a white paper that serves as a record of the discussion that took place and a guide and stimulus to the solution of the most urgent and important issues in the study of the OoL. This paper is not intended to be comprehensive or a balanced representation of the opinions of the entire OoL research community. It is intended to present a number of important position statements that contain many aspirational goals and suggestions as to how progress can be made in understanding the OoL. The key role played in the field by current societies and recurring meetings over the past many decades is fully acknowledged, including the International Society for the Study of the Origin of Life (ISSOL) and its official journal Origins of Life and Evolution of Biospheres, as well as the International Society for Artificial Life (ISAL). (shrink)

Volume 20, Issue 8, August 2020, Page W12-W13.

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded (...) in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

This is a description of an avian-shaped feature that rests below a network of cellular structures found on a mound within the Argyre Basin of Mars in Mars Global Surveyor image M14-02185, acquired on April 30, 2000, and released to the public on April 4, 2001. The area examined is located near 48.0° South, 55.1° West. The formation is approximately 2,400 meters long from the tip of its beak to the tip of its farthest tail feather. There is a minimum (...) of six different variations in appearance of the surface material over this small area. Utilizing the public targeting request form provided on the Mars Global Surveyor (MGS) website, co-author Miller secured a second image of the area that was obtained on July 3, 2006, showing this feature under different conditions S20-00165. The new image was then released to the public on August 11, 2006. A third image of the formation identified as MGS S13-01480 was acquired on December 15, 2005, and although officially processed on June 20, 2006, it was not made available to the public until August 22, 2009, on NASA’s Planetary Data System (PDS) website. All three of the MGS images reveal defining aspects of this avian feature, including a head, beak, body, eye, leg, foot, toes, wing, and feathers. When taken together, these components induce the visual impression of an avian-shaped formation that exhibits a unique set of proportional features. Adjoining this formation is a composite of complex cellular features that form a compartmentalized infrastructure. The three authors who are veterinarians provide a critical analysis of the avian features, and the geologist and geoscientist authors examine natural mechanisms that could contribute to the formation of this feature. An extensive search of comparable regions within and beyond the area of the Argyre Basin was conducted. A list of these sites is provided, and terrestrial comparisons are also offered. (shrink)

The Constitution of the Athenians ascribed to Xenophon the orator.--The Politeia of the Spartans by Xenophon.--The Boeotian Constitution from the Oxyrhynchus historian.--The Constitution of Athens by Aristotle.

In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume 29, Number 2, November 2003, pp. 223-266 A Diplomatic Transcription of Hume's "volunteer pamphlet" for Archibald Stewart: Political Whigs, Religious Whigs, and Jacobites M. A. BOX, DAVID HARVEY, AND MICHAEL SILVERTHORNE Many scholars interested in David Hume will have encountered his defense of the beleaguered Archibald Stewart as it appears in an appendix in John Valdimir Price's The Ironic Hume (Austin: University of Texas Press, 1965). (...) Additionally they might know of Price's discussion for The Biblioteck of 1973 of a copy with manuscript markings. A reason for revisiting this pamphlet is that the National Library of Scotland has graciously given permission to reproduce a copy (shelfmark NE.10.e.4) featuring a preface and significant markings in manuscript not in the copy that Price reproduced in his book. As Hume assumes considerable familiarity with the events to which he alludes, we have annotated the text to make it fully intelligible to readers two and half centuries after its composition. The rudimentary bibliographic facts and mysteries are as follows. Two editions survive to us, an octavo (in fours) and a rare duodecimo. Although there is no reason to regard the duodecimo as a second edition correcting or augmenting a first edition, it probably was manufactured after, and was textually derivative from, the octavo. We know nothing of the publishing of M. A. Box is Associate Professor of English, University of Alaska, Fairbanks, PO Box 755720, Fairbanks, AK 99775-5720, USA. David Harvey is at the Classics Department, University of Exeter, Queen's Building, Queen's Drive, Exeter EX4 4QH, UK. Michael Silverthorne is Associate Professor of History, McGiIl University, Stephen Leacock Building, 855 Sherbrooke St. West, Montreal H3A 2T7, Canada, e-mail: [email protected] 224 M. A. Box, David Harvey, and Michael Silverthorne the duodecimo, and doubtless that is as its producers intended. Its title page indicates, like that of the octavo, that the printing was done "for M. Cooper" in 1748, but William Strahan's ledgers register the printing in December 1747 of only the octavo in an edition of 1000 copies.1 The job is listed under bookseller Andrew Millar's account, not Mary Cooper's, probably for the reason that Cooper was a front whose role was to screen the true producers. It is possible that Millar hired someone other than Strahan to print the duodecimo, but it is also possible that someone other than Millar had it printed to mimic the octavo and take the opportunity it offered for concealment.2 A different editorial judgment is evinced in the duodecimo in that cosmetic measures are taken in it to obscure the identities of two military men ridiculed. For example, "Fowke" is rendered as "F—" and "John Cope" as "J-C-----." A digression on Mary Cooper is in order. This remarkable woman (died 1761) took over her husband Thomas's business upon his death 9 February 1743. That business had a history of "publishing" pamphlets and therefore made a plausible front for Millar, who in at least thirty-six other instances, none requiring courage, was willing to have his name appear on a title page with "M. Cooper." (This figure derives from a search by imprints using the English Short-Title Catalogue.) Until Thomas Cooper died, his name appeared on editions of John Armstrong's The Oeconomy of Love (1736 and thereafter) though only Millar's name is listed in the Stationers' Register (Foxon, English Verse A303-A311), and Mary's name is on the title page of the 1753 edition for which Strahan charged Millar (Strahan Papers, Add. MS 48800, s.v. August 1753). It was perhaps in this pattern that the second edition of Hume's heterodox Philosophical Essays (1750) would be reissued in 1751 with a new title page replacing Millar's name with Cooper's. That book was made temporarily a more alarming property by the superstitious panic of the London populace following the winter earthquakes in 1750, presaged by a bloody cloud. Within that year Bishop Thomas Sherlock caused a stir with a pastoral letter (A Letter from the Lord Bishop of London) blaming the earthquakes on several iniquities, "particularly heretical books" (Walpole, Correspondence 20... (shrink)

In this 1974 book a practising scientist and gifted expositor sets forth an exciting point of view on the nature of science and how it works.

BLWith new text and full apparatus criticus The Eudemian Ethics was one of two ethical treatises which Aristotle wrote on the subject of ethica or `matters to do with character'. Although the two works cover much the same ground, the Nicomachean Ethics is better known; the poor manuscript tradition of the Eudemian Ethics has made correct translation and interpretation of the text extremely difficult. The subject of the work is the choice of a certain means of conduct, made by a (...) `man of practical wisdom', between two extremes of behaviour: asceticism and yielding to uncontrolled impulses. Aristotle also stresses the notion of moral intention and the importance of virtue of character. This new Oxford Classical Text of the Eudemian Ethics is the result of many years of work. After Sir David Ross's death, his original text was substantially reworked and revised by his friend and colleague R. R. Walzer, who was aided in the revision by his former pupil Mrs Jean Mingay, who continued his work after his death in 1974. Mrs Mingay was fortunate in being able to make use of previously unpublished contributions from D. J. Allan after his death in the late seventies, and more recently has been helped in her work by the suggestions of Professor D. A. Russell, David Robinson, and Christopher Rowe. (shrink)