Pediatric critical careCritical care refers to the health care of children with life-threatening illness or following major surgery or severe injury. This care is offered in different contexts across the globe. In well-resourced environments, critical careCritical care may be provided in pediatric intensive care units, which provide highly complex medical care with advanced, potentially expensive technological devices aimed primarily at sustaining life; whereas in poorly resourced regions, only primary care may be available for critically ill or injured childrenInjured children. Even (...) where PICU facilities are available, they are a scarce and expensive resource. The knowledge and ability to sustain a critically ill or injured child’sInjured children life, potentially with effects on the child and family’s quality of lifeQuality of life and at the expense of other children’s health care, leads to frequent ethical challenges. Ethical issues related to how best to ensure optimal quality of lifeQuality of life and the fair distribution of scarce resources are common. In-depth knowledge and understanding of the individual patient’s medical, scientific and psychosocial context, through interdisciplinary discussion and collaboration; as well as familiarity with the overriding, relevant ethico-legal policiesPolicy and principles is essential for appropriate decision-makingDecision-making. Truthful communicationCommunication with the family is essential, using a shared decision-makingDecision-making process, and the child’s best interestBest interest must be central to every decision. This chapter presents an overview of the recommended approach to, and important considerations for, ethical decision-makingDecision-making in the PICU, using a hypothetical case example. (shrink)

BackgroundThe widespread sharing of biological and biomedical data is recognised as a key element in facilitating translation of scientific discoveries into novel clinical applications and services. At the same time, twenty-first century states are increasingly concerned that this data could also be used for purposes of bioterrorism. There is thus a tension between the desire to promote the sharing of data, as encapsulated by the Open Data movement, and the desire to prevent this data from ‘falling into the wrong hands’ (...) as represented by ‘dual use’ policies. Both frameworks posit a moral duty for life sciences researchers with respect to how they should make their data available. However, Open data and dual use concerns are rarely discussed in concert and their implementation can present scientists with potentially conflicting ethical requirements.DiscussionBoth dual use and Open data policies frame scientific data and data dissemination in particular, though different, ways. As such they contain implicit models for how data is translated. Both approaches are limited by a focus on abstract conceptions of data and data sharing. This works to impede consensus-building between the two ethical frameworks. As an alternative, this paper proposes that an ethics of responsible management of scientific data should be based on a more nuanced understanding of the everyday data practices of life scientists. Responsibility for these ‘micromovements’ of data must consider the needs and duties of scientists as individuals and as collectively-organised groups.SummaryResearchers in the life sciences are faced with conflicting ethical responsibilities to share data as widely as possible, but prevent it being used for bioterrorist purposes. In order to reconcile the responsibilities posed by the Open Data and dual use frameworks, approaches should focus more on the everyday practices of laboratory scientists and less on abstract conceptions of data. (shrink)

Executive functions (EFs) and impulsivity are dimensions of self-regulation that are both related to psychopathology. However, self-report measures of impulsivity and laboratory EF tasks typically display small correlations, and existing research indicates that impulsivity and EFs may tap separate aspects of self-regulation that independently statistically predict psychopathology in adulthood. However, relationships between EFs, impulsivity, and psychopathology may be different in childhood compared to adulthood. Here, we examine whether these patterns hold in the baseline assessment of the Adolescent Brain and Cognitive (...) Development (ABCD) sample, a national sample of over 11,000 children (including 749 twin pairs) ages 9–10 years. We examine the phenotypic and genetic relationships among latent variables for different components of EFs and multiple facets of impulsivity. Additionally, we assess how EFs and impulsivity relate to composite measures and latent variables of psychopathology derived from parent report. EFs were weakly correlated with impulsivity, and the strength varied by impulsivity facet, emphasizing their separability. We did not identify significant genetic and environmental correlations between EFs and impulsivity. Moreover, controlling for their small relationships with each other, both EFs and some facets of impulsivity statistically predicted an Externalizing factor, attention problems, and social problems, and twin analyses suggested these relationships were genetic in origin. These findings indicate that EFs and impulsivity represent phenotypically and genetically separable aspects of self-regulation that are both transdiagnostic correlates of psychopathology in childhood. (shrink)

Professor Kemp Smith in providing a new edition of Hume’s Dialogues Concerning Natural Religion , embodying all the author’s additions and corrections, has given expression to the perennial interest and fascination which this work has possessed for many minds during the odd one hundred and fifty years since it was first published by Hume’s nephew. The editor himself has performed a great service by contributing an Introduction and a clear and concise summary of the Dialogues , in both of which (...) he expounds his own view as to how Hume’s discussion is to be interpreted. Hume employs three characters—Demea, Philo, and Cleanthes; and. (shrink)

How can naïve realism defend itself in face of the illusion of the penny which looks elliptical when it is seen obliquely? Of late many philosophers have tried to deny that a penny looks elliptical when viewed obliquely: they have claimed that it still looks round. It may be true to say this of a small object like a penny, but it cannot be denied that the surfaces of objects in general do look different in shape when viewed from different (...) angles: a large circular object, like a round table, does not look round but elliptical when viewed obliquely. Nevertheless, for convenience, I shall use the example of the penny. The reader may suppose, if he wishes, that the penny is viewed from a considerable distance, say ten feet. (shrink)

It may be most convenient to respond to Dr Andreae’s points in turn. Unless the claim that a child should determine its own genetic characteristics before it is conceived or born is intended to be flippant, it is logically incoherent. Conception is a decision that only a prospective parent can make. The editorial argument is that denial of choice of sex contributes to preventable maternal mortality and morbidity, particularly in developing countries. ….

According to tranditional philosophical terminology and to most interpretations of Cartesianism, Descartes is a dualist. This dualism is expressed in his fundamental distinction between two substances—mind and matter—and, though admitted to be full of difficulties and by many to be untenable, it has very generally been regarded as at least a clearly intelligible doctrine, consistently held by Descartes. That this is not so has been shown by Professor Boyce Gibson in his able and careful analysis of Cartesianism. The aim of (...) the present essay is to draw attention to another difficulty that has not been sufficiently noticed; whether it is an actual one or only an apparent one due to a misunderstanding of Descartes is a question that may be left to those who read him differently and who may be able to remove one more charge of inconsistency. The general contention is that Descartes—and this point is conceded in expositions of Descartes—seeks to prove that there are material bodies, that material bodies are necessary for his own account of the physical universe, and that yet his own theory of matter as extension, even combined with motion, makes the existence of bodies impossible and hence any proof of such existence impossible. In fact, the employment of the idea of motion only serves to emphasize the difficulty and inconsistency of the theory. (shrink)

THE question which I am to raise for discussion is one which has long been debated by philosophers, and consequently I consider it doubtful whether anything very new can be said on the matter. But it may be profitable to review once more the present position of the controversy and to have in mind the reasons which at present make the question of interest and of importance.

David Hume , a member of the well-known Border family of Home, was born on April 26, 1711. After a period of preparatory training he matriculated at Edinburgh College in 1723, although he may have entered earlier. His course during this period is obscure; according to his own statement the curriculum was mainly literary; on leaving College he records that his interests lay predominantly in this direction, and, being left to his own choice, he was able to indulge his inclinations. (...) An attempt to train him for a legal career ended in failure; and he continued to live at his ancestral home of Ninewells, to the west of Berwick, for some years, devoting himself. (shrink)

The title of this article might quite well be given the more hackneyed form, Has Kant answered Hume? Much of the discussion pertains to this latter question, but as the aim is also to emphasize some points concerned with Kant himself a deviation in title may be permissible.

No one who is interested in the problem of value and attempts to read through the literature on the subject can fail to be struck by the extraordinary diversity of opinion. Some of this difference of view is traceable to ambiguities in language; there are various terms employed, each of which, of course, may or may not express anyvalid idea—terms like value, values, kinds of value, sorts of things that have value, value-objects, things that have value. The terms value and (...) values are subject to and lead to much confusion, even on the part of those who are aware of the existence of such a danger. Much of the difference may probably be due to two other importantfactors: first, the education and training in earlier years whereby emotional reactions to words instead of intelligent understanding of their meaning and validity are induced, and, second, the continual reliance upon moral experience, which reliance may seem to be necessary, but which may be invalidated by the consideration, generally overlooked and unappraised, that moral, like social, experience might not be what it is if certain views were not entertainedand did not prevail. The latter possibility would put moral and social studies on a plane quite different from that of physical investigations, for the moral and social inquirer would always have to bear in mind that the facts with which he is confronted, and to which he seeks to appeal, may exist to confront him and his fellowmen only in the sense that they arise from the acceptance and effectuation of a belief or theory, and would not be but for the effectuation of the belief or theory. The other factor, that of the influence of education and training upon emotional reactions, is also important in relation to a study of value, for it is necessary to be on guard against confusing reactions to words and reactions to objects, things, or situations. (shrink)

The article presents an approach to the formation of a decision support system in the management of energy consumption of production technological systems. Such systems allow the company to detect and respond in a timely manner to the appearance of hidden energy losses, to carry out organizational measures aimed at energy saving and to optimize the timing and scope of repair and restoration work. The approach is based on the modeling of stationary sections of energy consumption, presented in the form (...) of precedents, their accumulation and subsequent analysis in the space of influential technological parameters. In addition to the base of precedents, the system includes software modules for assessment and formation of the profile of hidden energy losses, modules of technical condition, forecast and formation of precedents. The analysis of precedents consists in the selection of similar cases of energy consumption, the formation of efficient energy consumption functions and the calculation of energy losses with its help. Hidden energy losses can be calculated in real time for all technological systems of the enterprise. This allows you to build a profile of energy losses of the enterprise. The advantage of this approach in comparison with the known ones is that it allows to adapt to technological systems with different energy sources. The article emphasizes that the method can work with the energy manager with both linear and nonlinear dependence of energy consumption on process parameters. However, the limitations of this approach are noted. Thus, the determination of latent energy losses and technical condition of the equipment requires the participation of qualified specialists of the enterprise, who must be able to analyze the results and propose measures to eliminate energy losses. (shrink)