This paper reframes the futility debate, moving away from the question “Who decides when to end what is considered to be a medically inappropriate or futile treatment?” and toward the question “How can society make policy that will best account for the multitude of values and conflicts involved in such decision-making?” It offers a pragmatist moral epistemology that provides us with a clear justification of why it is important to take best standards, norms, and physician judgment seriously and a clear (...) justification of why ample opportunity must be made for patients, families, and society to challenge those standards and norms. (shrink)

This article focuses on the anxiety about whether God loves one or not. In the author's nearly 30-year ministry, this pastoral difficulty continues to perplex and afflict. While the presenting problem is what in theological parlance is 'a lack of assurance', a side difficulty is the poor and incorrect doctrine of God often associated with this. A Baylor University Study in 2006 characterises the kind of God that different groups of Americans believe in. While the phrase 'a lack of assurance' (...) is a part of dogmatic parlance, and has fallen out of use, the feeling of not belonging to God can be overwhelming for people. This feeling may be overwhelming. This makes it a pastoral issue. This article suggests a pastoral response to this issue and a proposal for a clarification in the nature and character of God using the therapeutic theology of 19th-century Scottish minister-theologian John McLeod Campbell. (shrink)

“Clinical ethics consultants” have been practicing in the United States for about 50 years. Most of the earliest consultants—the “pioneers”—were “outsiders” when they first appeared at patients' bedsides and in the clinic. However, if they were outsiders initially, they acclimated to the clinical setting and became “insiders” very quickly. Moreover, there was some tension between traditional academics and those doing applied ethics about whether there was sufficient “critical distance” for appropriate reflection about the complex medical ethics dilemmas of the day (...) if one were involved in the decision making. Again, the pioneers deflected concerns by identifying and instituting safeguards to assure professional objectivity in clinical ethics consultation services. One might suggest that in moving inside and establishing normative practices, the pioneer clinical ethics consultants anticipated adoption of their routines and professionalization of the field. (shrink)

Numerical studies of the Hubbard model and its strong-coupling form, the t-J model, show evidence for antiferromagnetic, $d_{x^{\text{2}} - y^2 } $ -pairing and stripe correlations which remind one of phenomena seen in the layered cuprate materials. Here, we ask what these numerical results imply about various scenarios for the pairing mechanism.

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

The thymus is a unique primary lymphoid organ that supports the production of self‐tolerant T‐cells essential for adaptive immunity. Intrathymic microenvironments are microanatomically compartmentalised, forming defined cortical, and medullary regions each differentially supporting critical aspects of thymus‐dependent T‐cell maturation. Importantly, the specific functional properties of thymic cortical and medullary compartments are defined by highly specialised thymic epithelial cells (TEC). For example, in the medulla heterogenous medullary TEC (mTEC) contribute to the enforcement of central tolerance by supporting deletion of autoreactive T‐cell (...) clones, thereby counterbalancing the potential for random T‐cell receptor generation to contribute to autoimmune disease. Recent advances have further shed light on the pathways and mechanisms that control heterogeneous mTEC development and how differential mTEC functionality contributes to control self‐tolerant T‐cell development. Here we discuss recent findings in relation to mTEC development and highlight examples of how mTEC diversity contribute to thymus medulla function. (shrink)

There is what might be called a ‘majority position’ in the history of Western philosophy according to which causes are sufficient for or ‘necessitate’ their effects. However, there is also a singificant ‘minority position’ according to which causes are necessary relative to their effects. The second/third century A.D. Peripatetic Alexander of Aphrodisias is an ancient representative of the minority position. He attributes his own view — with some justification, I shall suggest – to Aristotle. This paper has two, somewhat loosely (...) connected purposes. The first is to explore the origin of the conception of ‘causes’ as necessary conditions in Aristotle, particularly in On Generation and Corruption 2.11 and Posterior Analytics 2.12, and the development and use of the conception in Alexander's De fato. The second purpose of the paper is to explore and criticize a sophisticated contemporary version of the conception of causes as ‘necessary in the circumstances,’ that of J.L. Mackie. (shrink)

Political corruption imposes substantial costs on shareholders in the U.S. Yet, we understand little about the basic factors that exacerbate or mitigate the value consequences of political corruption. Using federal corruption convictions data, we find that firm-level economic rents and monitoring mechanisms moderate the negative relation between corruption and firm value. The value consequences of political corruption are exacerbated for firms operating in low-rent product markets and mitigated for firms subject to external monitoring by state governments or monitoring induced by (...) disclosure transparency. Our results should inform managers and policymakers of the tradeoffs imposed on firms operating in politically corrupt districts. (shrink)

There is what might be called a ‘majority position’ in the history of Western philosophy according to which causes are sufficient for or ‘necessitate’ their effects. However, there is also a singificant ‘minority position’ according to which causes are necessary relative to their effects. The second/third century A.D. Peripatetic Alexander of Aphrodisias is an ancient representative of the minority position. He attributes his own view — with some justification, I shall suggest – to Aristotle. This paper has two, somewhat loosely (...) connected purposes. The first is to explore the origin of the conception of ‘causes’ as necessary conditions in Aristotle, particularly in On Generation and Corruption 2.11 and Posterior Analytics 2.12, and the development and use of the conception in Alexander's De fato. The second purpose of the paper is to explore and criticize a sophisticated contemporary version of the conception of causes as ‘necessary in the circumstances,’ that of J.L. Mackie. (shrink)

During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift—to some degree—from a usual clinical ethic, focused on the well-being of individual patients, to a public health ethic, focused on population health. Many triage policies exist that fall under the legal protections afforded by “crisis standards of care,” but they have key differences. We critically appraise one of the most fundamental differences among policies, namely the use of criteria to categorically exclude (...) certain patients from eligibility for otherwise standard medical services. We examine these categorical exclusion criteria from ethical, legal, disability, and implementation perspectives. Focusing our analysis on the most common type of exclusion criteria, which are disease-specific, we conclude that optimal policies for critical care resource allocation and the use of cardiopulmonary resuscitation (CPR) should not use categorical exclusions. We argue that the avoidance of categorical exclusions is often practically feasible, consistent with public health norms, and mitigates discrimination against persons with disabilities. (shrink)

Nature contact has associations with emotional ill-being and well-being. However, the mechanisms underlying these associations are not fully understood. We hypothesised that increased adaptive and decreased maladaptive emotion regulation strategies would be a pathway linking nature contact to ill-being and well-being. Using data from a survey of 600 U.S.-based adults administered online in 2022, we conducted structural equation modelling to test our hypotheses. We found that (1) frequency of nature contact was significantly associated with lesser emotional ill-being and greater emotional (...) well-being, (2) effective emotion regulation was significantly associated with lesser emotional ill-being and greater emotional well-being, and (3) the associations of higher frequency of nature contact with these benefits were partly explained via emotion regulation. Moreover, we found a nonlinear relationship for the associations of duration of nature contact with some outcomes, with a rise in benefits up to certain amounts of time, and a levelling off after these points. These findings support and extend previous work that demonstrates that the associations of nature contact with emotional ill-being and well-being may be partly explained by changes in emotion regulation. (shrink)

This book provides practical and research-based chapters that offer greater clarity about the particular kinds of teacher reflection that matter and avoids talking about teacher reflection generically, which implies that all kinds of reflection are of equal value.

In 1885, during initial discussions of J. C. Maxwell's celebrated thermodynamic demon, Whiting (1) observed that the demon-like velocity selection of molecules can occur in a gravitationally bound gas. Recently, a gravitational Maxwell demon has been proposed which makes use of this observation [D. P. Sheehan, J. Glick, and J. D. Means, Found. Phys. 30, 1227 (2000)]. Here we report on numerical simulations that detail its microscopic phase space structure. Results verify the previously hypothesized mechanism of its paradoxical behavior. This (...) system appears to be the only example of a fully classical mechanical Maxwell demon that has not been resolved in favor of the second law of thermodynamics. (shrink)

Bertie Ahern, the incumbent Taoiseach or Prime Minister of Ireland, was elected to a third term in the general election of 24 May 2007. While Ahern's party, Fianna F il, was able to retain its governing coalition, the level of support of some of the other parties changed dramatically. Fine Gael, the principal opposition party, saw its number of seats in the parliament, D il ireann, increase by nineteen. Some of the minor parties did less well than expected or compared (...) to previous elections. Only the Greens maintained their six representatives. As a result, they were rewarded with a share in the new government. This election suggests that, while Irish society is changing rapidly, the political system is changing more slowly and subtly. This article examines the election results in terms of the fate of the political parties and focuses on one constituency, Tipperary South, to illustrate trends in Irish electoral politics. (shrink)

Empirical evidence advancing the theory of anthropogenic climate change and resultant policy action has been framed through the perspectives of scientists, economists and politicians; the ultimate objective being to minimise the risk of dangerous climate change through the reduction of GHG emissions. However, policies designed to reduce carbon pollution have utilised cost benefit analysis , largely ignoring ethical implications of such actions. This has resulted in a climate debate that sidelines the moral and social considerations of the suggested actions designed (...) to reduce the impact of dangerous climate change. Special interest groups have focussed on subjective interpretations of objective statistics, resulting in an extreme polarisation of viewpoints, pitting climate change deniers against politico-economic rationalists, with climate scientists largely sitting on the sidelines. There has, however, been a recent shift in the science of climate change acknowledging that, “many profound ethical questions are hidden in scientific and economic arguments about various climate change policy proposals” ‘White Paper on the Ethical Dimensions of Climate Change’, Rock Ethics Institute, Penn State University). We wish to promote an inter-disciplinary approach to the ethical considerations of climate change and situate the debate within a ‘real world’ context to enable people to link evidence and resultant policy to their own moral responsibility as ‘global citizens’. By placing reliable scientific information within a holistic framework, scientific outcomes with a high level of certainty may be conveyed within a wider perspective that includes ethical and social considerations, resulting in a stronger claim for practical outcomes with respect to climate change solutions. This can be used to support policies that are practical as well as moral. (shrink)

SummaryThis paper develops a semantical account of sentences containing performative principal verbs in which these verbs are analyzed as indexical expressions: the proposition picked out by a sentence containing a performative verb depends on aspects of the context of use of the sentence; and these same aspects of context of use also determine the truth value of the proposition picked out. A two‐dimensional modal operator is utilized in analyzing non‐ performative sentences that contain principal verb which, in other contexts, have (...) performative uses. Thus, the analysis developed accounts for the performative — non‐performative distinction within a formal semantic‐pragmatic framework; the more common approach of relegating the distinction to the somewhat vague realm of ‘language use’ is avoided.RésuméCet article développe un traitement sémantique des phrases contenant un verbe principal performatif. Ces verbes sont analysés comme des expressions indicées: la proposition sélectionnée par une phrase contenant un verbe performatif dépend du contexte d'usage de cette phrase; et ces mêmes aspects du contexte d'usage déterminent également la valeur de vérité de la proposition sélectionnée. Un opérateur modal à deux dimensions est utilisé pour l'analyse de phrases non‐performatives contenant un verbe principal performatif dans d'autres contextes. L'analyse développée rend ainsi compte de la distinction performatif — non‐performatif dans un cadre sémantico‐pragmatique; on évite ainsi la solution habituelle consistant à reléguer cette distinction dans le domaine plutôt vague de l'usage linguistique.ZusammenfassungEs wird eine semantische Darstellung von Sätzen entwickelt, die performative Hauptverben enthalten, indem diese Verben als indexikale Ausdrücke analysiert werden: die Proposition, die durch einen Satz mit einem performativen Verb bezeichnet wird, hängt von Aspekten des Gebrauchskontextes des Satzes ab; und gerade diese Aspekte bestimmen auch den Wahrheitswert der Proposition. Ein zweidimensionaler Modaloperator wird verwendet, um nicht‐performative Sätze zu analysieren, die Hauptverben enthalten, welche — in andern Kontexten — einen performativen Gebrauch haben. Auf diese Weise gibt die entwickelte Analyse innerhalb eines formalen semantisch‐syntaktischen Rahmenwerkes Rechenschaft über die Unterscheidung performativ — nicht‐performativ; man vermeidet dadurch das übliche Vorgehen, die Unterscheidung in den etwas vagen Bereich des sog. 〈Sprachgebrauchs〉 abzuschieben. (shrink)

Phonemes have variant pronunciations depending on context. For instance, in American English, the [t] in pat [pæt] and the [d] in pad [pæd] are both realized with a tap [ɾ] when the –ing suffix is attached, [pæɾɪŋ]. We show that despite greater distributional and acoustic support for the [t]-tap alternation, 12-month-olds successfully relate taps to stems with a perceptually-similar final [d], not the dissimilar final-[t]. Thus, distributional learning of phonological alternations is constrained by infants' preference for the alternation of perceptually-similar (...) segments. Further, the ability to relate variant surface forms emerges between 8- and 12-months. Our findings of biased learning provide further empirical support for a role for perceptual similarity in the acquisition of linguistically-relevant categories. We discuss the implications of our findings for phonological theory, language acquisition and models of the mental lexicon. (shrink)

AimWhite matter changes in individuals at ultra-high risk for psychosis (UHR) may be involved in the transition to psychosis. Sleep-wake disturbances commonly precede the first psychotic episode and predict development of psychosis. We examined associations between white matter microstructure and sleep-wake disturbances in UHR individuals compared to healthy controls (HC), as well as explored the confounding effect of medication, substance use, and level of psychopathology.MethodsSixty-four UHR individuals and 35 HC underwent clinical interviews and diffusion weighted imaging. Group differences on (...) global and callosal mean fractional anisotropy (FA) was tested using general linear modeling. Sleep-wake disturbances were evaluated using the subjective measures disturbed sleep index (DSI) and disturbed awakening index (AWI) from the Karolinska Sleep Questionnaire, supported by objective sleep measures from one-night actigraphy. The primary analyses comprised partial correlation analyses between global FA/callosal FA and sleep-wake measures. Secondary analyses investigated multivariate patterns of covariance between measures of sleep-wake disturbances and FA in 48 white matter regions of interest using partial least square correlations.ResultsUltra-high risk for psychosis individuals displayed lower global FA (F = 14.56, p < 0.001) and lower callosal FA (F = 11.34, p = 0.001) compared to HC. Subjective sleep-wake disturbances were significantly higher among the UHR individuals (DSI: F = 27.59, p < 0.001, AWI: F = 36.42, p < 0.001). Lower callosal FA was correlated with increased wake after sleep onset (r = −0.34, p = 0.011) and increased sleep fragmentation index (r = −0.31, p = 0.019) in UHR individuals. Multivariate analyses identified a pattern of covariance in regional FA which were associated with DSI and AWI in UHR individuals (p = 0.028), but not in HC. Substance use, sleep medication and antipsychotic medication did not significantly confound these associations. The association with objective sleep-wake measures was sustained when controlling for level of depressive and UHR symptoms, but symptom level confounded the covariation between FA and subjective sleep-wake measures in the multivariate analyses.ConclusionCompromised callosal microstructure in UHR individuals was related to objectively observed disruptions in sleep-wake functioning. Lower FA in ventrally located regions was associated with subjectively measured sleep-wake disturbances and was partly explained by psychopathology. These findings call for further investigation of sleep disturbances as a potential treatment target. (shrink)

In 1885, during initial discussions of J. C. Maxwell's celebrated thermodynamic demon, Whiting(1) observed that the demon-like velocity selection of molecules can occur in a gravitationally bound gas. Recently, a gravitational Maxwell demon has been proposed which makes use of this observation [D. P. Sheehan, J. Glick, and J. D. Means, Found. Phys. 30, 1227 (2000)]. Here we report on numerical simulations that detail its microscopic phase space structure. Results verify the previously hypothesized mechanism of its paradoxical behavior. This system (...) appears to be the only example of a fully classical mechanical Maxwell demon that has not been resolved in favor of the second law of thermodynamics. (shrink)

Starting in early childhood, children are socialized to be honest. However, they are also expected to avoid telling the truth in sensitive situations if doing so could be seen as inappropriate or impolite. Across two studies (total N = 358), the reasoning of 3‐ to 5‐year‐old children in such a scenario was investigated by manipulating whether the information in question would be helpful to the recipient. The studies used a reverse rouge paradigm, in which a confederate with a highly salient (...) red mark on her nose asked children whether she looked okay prior to having her picture taken. In Study 1, children tended to tell the truth only if they were able to observe that the mark was temporary and the confederate did not know it was there. In Study 2, children tended to tell the truth only if they were able to observe that the mark could be concealed with makeup. These findings show that for children as young as age 3, decisions about whether to tell the truth are influenced by the likelihood that the information would be helpful to the recipient. (shrink)

Previous research has found that funding disparities are driven by applications’ final impact scores and that only a portion of the black/white funding gap can be explained by bibliometrics and topic choice. Using National Institutes of Health R01 applications for council years 2014–2016, we examine assigned reviewers’ preliminary overall impact and criterion scores to evaluate whether racial disparities in impact scores can be explained by application and applicant characteristics. We hypothesize that differences in commensuration—the process of combining criterion scores (...) into overall impact scores—disadvantage black applicants. Using multilevel models and matching on key variables including career stage, gender, and area of science, we find little evidence for racial disparities emerging in the process of combining preliminary criterion scores into preliminary overall impact scores. Instead, preliminary criterion scores fully account for racial disparities—yet do not explain all of the variability—in preliminary overall impact scores. (shrink)

Books reviewed in this article:Roger Crisp and Brad Hooker (eds), Well–being and Morality: essays in honour of James GriffinJames Griffin, Value JudgementJohn O’Neill, The Market: ethics, knowledge and politicsE. F. Paul, F. D. Miller and J. Paul (eds), Human FlourishingJoseph Raz, Engaging ReasonL. W. Sumner, Welfare, Happiness and Ethics.