This is a study of the set of the Malitz-completions of a given infinite first-order structure, put in relation with properties of directed sets.

The notion of “ramifiability” , usually applied to cardinals, can be extended to directed sets and is put in relation here with familiar “large cardinal” properties.

This paper explores the ethics of deceased‐directed donation (DDD) and brings a unique perspective to this issue—the relevance of providing family‐centered care and culturally sensitive care to deceased donors, potential recipients, and their families. The significance of providing family‐centered care is becoming increasingly prevalent, specifically in pediatric healthcare settings. Therefore, this topic is especially relevant to those working with and interested in pediatrics. As the world is becoming more diverse with globalization, assessing the cultural aspect of the ethics of (...) DDD is increasingly salient. We provide a brief overview of DDD across the globe, review prominent arguments both for and against DDD, consider family‐centered and culturally specific considerations, and offer considerations for the development of a policy or guideline. We determine that the practice of DDD is ethically defensible in certain circumstances and congruent with providing both family‐centered and culturally sensitive care. Our analysis is relevant to any country with a diverse population and any healthcare provider or institution that operates under a framework of family‐centered care, such as those in pediatric hospitals. (shrink)

§1. I will start with a quick definition of descriptive set theory: It is the study of the structure of definable sets and functions in separable completely metrizable spaces. Such spaces are usually called Polish spaces. Typical examples are ℝn, ℂn, Hilbert space and more generally all separable Banach spaces, the Cantor space 2ℕ, the Baire space ℕℕ, the infinite symmetric group S∞, the unitary group, the group of measure preserving transformations of the unit interval, etc.In this theory sets are (...) classified in hierarchies according to the complexity of their definitions and the structure of sets in each level of these hierarchies is systematically analyzed. In the beginning we have the Borel sets in Polish spaces, obtained by starting with the open sets and closing under the operations of complementation and countable unions, and the corresponding Borel hierarchy. After this come the projective sets, obtained by starting with the Borel sets and closing under the operations of complementation and projection, and the corresponding projective hierarchy.There are also transfinite extensions of the projective hierarchy and even much more complex definable sets studied in descriptive set theory, but I will restrict myself here to Borel and projective sets, in fact just those at the first level of the projective hierarchy, i.e., the Borel (), analytic () and coanalytic () sets. (shrink)

We give a proof of Hechler's theorem that any \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document} $\aleph_1$\end{document}-directed partial order can be embedded via a ccc forcing notion cofinally into \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document} $\omega^\omega$\end{document} ordered by eventual dominance. The proof relies on the standard forcing relation rather than the variant introduced by Hechler.

Diverse possibilities for using Group Spiritual Direction, as taught by Rose Mary Dougherty at Shalem Institute, illustrate ways in which advanced spiritual practices can be introduced to spiritual seekers at many different levels. Group Spiritual Direction can be a core growth process for spiritual directors, clergy, and seekers of deep spiritual community. However, in somewhat modified format, this gem of a spiritual process can offer depth community to church groups, enhance retreats, connect leadership groups in community, provide a depth-formation process (...) for mentor groups, and even be used in family settings with young and old. (shrink)

Background: The Albanian medical system and Albanian health legislation have adopted a paternalistic position with regard to individual decision making. This reflects the practices of a not-so-remote past when state-run facilities and a totalitarian philosophy of medical care were politically imposed. Because of this history, advance directives concerning treatment refusal and do-not-resuscitate decisions are still extremely uncommon in Albania. Medical teams cannot abstain from intervening even when the patient explicitly and repeatedly solicits therapeutic abstinence. The Albanian law on health care (...) has no provisions regarding limits or withdrawal of treatment. This restricts the individual's healthcare choices.DiscussionThe question of 'medically futile' interventions and pointless life-prolonging treatment has been discussed by several authors. Dutch physicians call such interventions 'medisch zinloos' (senseless), and the Netherlands, as one of the first states to legislate on end-of-life situations, actually regulates such issues through appropriate laws. In contrast, leaving an 'advance directive' is not a viable option for Albanian ailing individuals of advanced age. Verbal requests are provided during periods of mental competence, but unfortunately such instructions are rarely taken seriously, and none of them has ever been upheld in a legal or other official forum.SummaryEnd-of-life decisions, treatment refusal and do-not-resuscitate policies are hazardous options in Albania, from the legal point of view. Complying with them involves significant risk on the part of the physician. Culturally, the application of such instructions is influenced from a mixture of religious beliefs, death coping-behaviors and an immense confusion concerning the role of proxies as decision-makers. Nevertheless, Albanian tradition is familiar with the notion of 'amanet', a sort of living will that mainly deals the property and inheritance issues. Such living wills, verbally transmitted, may in certain cases include advance directives regarding end-of-life decisions of the patient including refusal or termination of futile medical treatments. Since these living wills are never formally and legally validated, their application is impossible and treatment refusal remains still non practicable. Tricks to avoid institutional treatment under desperate conditions are used, aiming to provide legal coverage for medical teams and relatives that in extreme situations comply with the advice of withholding senseless treatment. (shrink)

Advance directives are not a part of the healthcare service in Turkey. This may be related with the fact that paternalism is common among the healthcare professionals in the country, and patients are not yet integrated in the decision‐making process adequately.However, starting from the enactment of the Regulation of Patient Rights in 1998, this situation started to change. While the paternalist tradition still appears to be strong in Turkey, the Ministry of Health has been taking concrete measures in the recent (...) years to ensure that patient rights are implemented in healthcare practice. Therefore, Turkey now seems to be in a transitional period where a move towards a more patient‐autonomy centred approach is being supported by the regulatory authorities, as well as the academic circles and the public at large. In the light of this background, this paper aims to examine the potential benefits of advance directives, particularly with regard to their possible effect in the clinical decision‐making process of Turkey's context. It will be argued that advance directives, if correctly understood and implemented in the right settings, may be beneficial, particularly for improving communication between patients and healthcare professionals and for implementing of the right to refuse treatment. (shrink)

The tree-property and its variants make sense also for directed sets and even for partially ordered sets. A combinatoria approach is developed here, with characterizations and criteria involving adequate families of special substructures of directed sets. These substructures form a natural hierarchy that is also investigated.

Advance directives are not a part of the healthcare service in Turkey. This may be related with the fact that paternalism is common among the healthcare professionals in the country, and patients are not yet integrated in the decision-making process adequately. However, starting from the enactment of the Regulation of Patient Rights in 1998, this situation started to change. While the paternalist tradition still appears to be strong in Turkey, the Ministry of Health has been taking concrete measures in the (...) recent years to ensure that patient rights are implemented in healthcare practice. Therefore, Turkey now seems to be in a transitional period where a move towards a more patient-autonomy centred approach is being supported by the regulatory authorities, as well as the academic circles and the public at large. In the light of this background, this paper aims to examine the potential benefits of advance directives, particularly with regard to their possible effect in the clinical decision-making process of Turkey's context. It will be argued that advance directives, if correctly understood and implemented in the right settings, may be beneficial, particularly for improving communication between patients and healthcare professionals and for implementing of the right to refuse treatment. (shrink)

Arguments against directed altruistic living organ donation are too weak to justify a ban. Potential donors who want to specify the non-related person or group of persons to receive their donated kidney should be accepted. The arguments against, based on considerations of motivation, fairness and (non-)anonymity (e.g. those recently cited by an advisory report of the Dutch Health Council), are presented and discussed, as well as the Dutch Governments response. Whereas the Government argues that individuals have authority with regard (...) to the allocation of their organs, partial considerations have not been sufficiently explored. In addition, it is argued that partial relationships govern human life, are significant and should be valued highly. These relationships are at the core of accepted living kidney donation between relatives (family members, partners, friends). Respecting the particular act of living donation goes beyond respect for autonomy; it touches upon our personal and social identity. Donation, e.g. of a kidney, is not undertaken strictly for the benefit of the recipient, but also to meet the moral standards we wish to set for ourselves. This consideration, rooted in a view of moral identity, provides the basis for many forms of directed donation that are both partial and justified. If the importance of this is not recognized, social policies can be neither adequate nor effective. (shrink)

In this paper, we first review recent arguments about the direct perception of the intentions and emotions of others, emphasizing the role of embodied interaction. We then consider a possible objection to the direct perception hypothesis from social psychology, related to phenomena like ‘dehumanization’ and ‘implicit racial bias’, which manifest themselves on a basic bodily level. On the background of such data, one might object that social perception cannot be direct since it depends on and can in fact be interrupted (...) by a set of cultural beliefs. We argue, however, that far from threatening the idea of direct perception, these findings clearly contradict the idea of hardwired theory of mind modules. More generally, we suggest that in order to further the understanding of social cognition we must take seriously insights about in-group and out-group distinctions and related phenomena, all of which are currently neglected in the mainstream social cognition literature. (shrink)

Priority setting is inevitable to control expenditure on expensive medicines, but citizen support is often hampered by the workings of the ‘identified victim effect’, that is, the greater willingness to spend resources helping identified victims than helping statistical victims. In this paper we explore a possible cognitive debiasing strategy that is being employed in discussions on healthcare priority setting, which we call ‘empathy counterbalancing’ (EC). EC is the strategy of directing attention to, and eliciting empathy for, those who might be (...) harmed as a result of one-sided empathy for the very ill who needs expensive treatment. We argue that governments have good reasons to attempt EC because the identified victim effect distorts priority setting in ways that undermine procedural fairness. We briefly outline three areas of application for EC and suggest some possible mechanisms that might explain how EC might work, if at all. We then discuss four potential ethical concerns with EC. First, EC might have the counterproductive effect of reducing overall citizen support for public funding of expensive medical treatments, thereby undermining solidarity. Second, EC may give rise to a ‘competition in suffering’, which may have unintended side effects for patients who feature in attempts at EC. Third, there may be doubts about whether EC is effective. Fourth, it may be objected that EC comes down to emotional manipulation, which governments should avoid. We conclude that insofar these concerns are valid they may be adequately addressed, and that EC seems a promising strategy that merits further investigation. (shrink)

The paper investigates inaccessible set axioms and their consistency strength in constructive set theory. In ZFC inaccessible sets are of the form Vκ where κ is a strongly inaccessible cardinal and Vκ denotes the κth level of the von Neumann hierarchy. Inaccessible sets figure prominently in category theory as Grothendieck universes and are related to universes in type theory. The objective of this paper is to show that the consistency strength of inaccessible set axioms heavily depend on the context in (...) which they are embedded. The context here will be the theory CZF− of constructive Zermelo–Fraenkel set theory but without -Induction . Let INAC be the statement that for every set there is an inaccessible set containing it. CZF−+INAC is a mathematically rich theory in which one can easily formalize Bishop style constructive mathematics and a great deal of category theory. CZF−+INAC also has a realizability interpretation in type theory which gives its theorems a direct computational meaning. The main result presented here is that the proof theoretic ordinal of CZF−+INAC is a small ordinal known as the Feferman–Schütte ordinal Γ0. (shrink)

A set of sentential revision operations can be generated in a select-direct way within a new framework for belief change named descriptor revision firstly introduced in Hansson [8]. In this paper, we adopt another constructive approach to these operations, based on a relation \ on sentences named believability relation. Intuitively, \ means that the subject is at least as prone to believe or accept \ as to believe or accept \. We demonstrate that so called H-believability relations and basic believability (...) relations, the second of which the is axiomatically characterized with a set of weak postulates, are faithful alternative models for two typical select-direct sentential revision operations. Then we investigate additional postulates on believability relations that correlate with properties of the generated revision operations. Finally, we show that traditional AGM revision operations can be reconstructed from a strengthened variant of the basic believability relation and there is a close connection between this relation and the standard epistemic entrenchment relation. (shrink)

Research Objective: This study focuses on ADs in the Netherlands and introduces a cross-cultural perspective by comparing it with other countries. Methods: A questionnaire was sent to a panel comprising 1621 people representative of the Dutch population. The response was 86%. Results: 95% of the respondents didn't have an AD, and 24% of these were not familiar with the idea of drawing up an AD. Most of those familiar with ADs knew about the Advanced Euthanasia Directive (AED, 64%). Both low (...) education and the presence of a religious conviction that plays an important role in one's life increase the chance of not wanting to draw up an AD. Also not having experienced a request for euthanasia from someone else, and the inconceivability of asking for euthanasia yourself, increase the chance of not wanting to draw up an AD. Discussion: This study shows that the subjects of palliative care and end-of-life-decision-making were very much dominated by the issue of euthanasia in the Netherlands. The AED was the best known AD; and factors that can be linked to euthanasia play an important role in whether or not people choose to draw up an AD. This differentiates the Netherlands from other countries and, when it comes to ADs, the global differences between countries and cultures are still so large that the highest possible goals, at this moment in time, are observing and possibly learning from other cultural settings. (shrink)

Time and resource constraints, combined with competing priorities, mean that research prioritization is a critical ethical consideration in pandemics and emergencies, given the increased need for relevant research findings to address health needs, and the multiple adverse ways that emergencies can impact capacities to conduct research. At international, national and local levels, careful consideration is needed of which research topics should be prioritized and on what grounds. This needs to take into account the ethically significant considerations that should inform prioritization; (...) existing frameworks to guide prioritization decisions; and the consequences associated with prioritizing or de-prioritizing research. The need to prioritize research that is directly responsive to the pandemic may generate debate about which types of research should be prioritised, and within fields of research, which studies should be continued, paused, or re-oriented. In determining which research proposals may have the greatest likelihood of reducing urgent epidemic health burdens, both the nature and distribution of such burdens are key considerations. Epidemics and pandemics typically disproportionately affect the most disadvantaged and vulnerable people in society, highlighting the necessity of inclusive and responsive approaches, which evaluate not just which research approaches have the greatest potential public health benefit, but also the likelihood that they will help address inequities. Key questions also arise when determining if current studies should be de-escalated or stopped, particularly when this may result in highly compromised results. It is also important to consider what obligations arise for research communities (including funders) to pledge to taking the outcomes of research prioritisation processes into account. The case studies in this chapter prompt consideration of how qualitative research into the impacts of isolation should be prioritised, and whether and how research prioritization measures should be responsive to widespread use of traditional medicine and off-label use of medications. The cases also highlight issues that research teams may face as research priorities are re-evaluated in pandemics, including whether and how to redesign proposed research in response to the logistical challenges posed by the pandemic and evolving pandemic research priorities. (shrink)

In Western societies advance directives are widely recognised as important means to extend patient self-determination under circumstances of incapacity. Following other countries, England and France have adopted legislation aiming to clarify the legal status of advance directives. In this paper, I will explore similarities and differences in both sets of legislation, the arguments employed in the respective debates and the socio-political structures on which these differences are based. The comparison highlights how different legislations express different concepts emphasising different values accorded (...) to the duty to respect autonomy and to protect life, and how these differences are informed by different socio-political contexts. Furthermore each country associates different ethical concerns with ADs which raise doubts about whether these directives are a theoretical idea which is hardly applicable in practice. (shrink)

Partial functions can be easily represented in set theory as certain sets of ordered pairs. However, classical set theory provides no special machinery for reasoning about partial functions. For instance, there is no direct way of handling the application of a function to an argument outside its domain as in partial logic. There is also no utilization of lambda-notation and sorts or types as in type theory. This paper introduces a version of von-Neumann-Bernays-Gödel set theory for reasoning about sets, proper (...) classes, and partial functions represented as classes of ordered pairs. The underlying logic of the system is a partial first-order logic, so class-valued terms may be nondenoting. Functions can be specified using lambda-notation, and reasoning about the application of functions to arguments is facilitated using sorts similar to those employed in the logic of the IMPS Interactive Mathematical Proof System. The set theory is intended to serve as a foundation for mechanized mathematics systems. (shrink)

In the early 1980’s van Inwagen presented the Direct Argument for the incompatibility of determinism with moral responsibility. In the course of the ensuing debate, Fischer, McKenna and Loewenstein have replied, each in their own way, that versions of the Direct Argument do not pose even a prima facie threat to compatibilism. Their grounds were that versions of the Direct Argument all use the “Transfer NR” inference rule in a dialectically problematic way. I rebut these replies here. By so doing, (...) I hope to set the Direct Argument debate on a more fruitful path. (shrink)

There has been much discussion about how to obtain legitimacy at macro-level priority setting in health care by use of fair procedures, but how should we consider priority setting by individual clinicians or health workers at the micro-level? Despite the fact that just health care totally hinges upon their decisions, surprisingly little attention seems being paid to the legitimacy of these decisions. This paper addresses the following question: what are the conditions that have to be met in order to ensure (...) that individual claims on health care are well aligned with an overall concept of just health care? Drawing upon a distinction between individual and aggregated needs, I argue that even though we assume the legitimacy of macro-level guidelines, this legitimacy is not directly transferable to decisions at micro-level simply by adherence to the guidelines’ recommendation. Further, I argue that individual claims are subject to the formal principle of equality and the demands of vertical and horizontal equity in a way that gives context- and patient-related equity concerns precedence over equity concerns captured at the macro-level. I conclude that if we aim to achieve just health care, we need to develop a complementary framework for legitimising individual judgment of patients’ claims on health care resources. Moreover, I suggest the basic structure of such a framework. (shrink)

Background:The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction.Aim:Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway.Research design:A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020.Ethical considerations:Ethical approval granted by the Regional Research Ethics Committee in (...) Western Norway (131421).Findings:Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful.Discussion:By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority.Conclusion:Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms. (shrink)

This book examines the hypothesis of "direct compositionality", which requires that semantic interpretation proceed in tandem with syntactic combination. Although associated with the dominant view in formal semantics of the 1970s and 1980s, the feasibility of direct compositionality remained unsettled, and more recently the discussion as to whether or not this view can be maintained has receded. The syntax-semantics interaction is now often seen as a process in which the syntax builds representations which, at the abstract level of logical form, (...) are sent for interpretation to the semantics component of the language faculty. In the first extended discussion of the hypothesis of direct compositionality for twenty years, this book considers whether its abandonment might have been premature and whether in fact direct compositionality is not after all a simpler and more effective conception of the grammar than the conventional account of the syntax-semantics interface in generative grammar. It contains contributions from both sides of the debate, locates the debate in the setting of a variety of formal theories, and draws on examples from a range of languages and a range of empirical phenomena. (shrink)

Quasi-set theory has been proposed as a means of handling collections of indiscernible objects. Although the most direct application of the theory is quantum physics, it can be seen per se as a non-classical logic (a non-reflexive logic). In this paper we revise and correct some aspects of quasi-set theory as presented in [12], so as to avoid some misunderstandings and possible misinterpretations about the results achieved by the theory. Some further ideas with regard to quantum field theory are also (...) advanced in this paper. (shrink)

In his account of visual perception, Thomas Reid describes visible figure as both ‘real and external’ to the eye and as the ‘immediate object of sight’. These claims appear to conflict with Reid's direct realism, since if the ‘immediate’ object of vision is also its direct object, then sight would be perceptually indirect due to the role of visible figure as a perceptual intermediary. I argue that this apparent threat to Reid's direct realism may be resolved by understanding visible figure (...) as the set of geometrical properties that holds between an object's visible surfaces and some particular perspective or point of view. On this relational interpretation of visible figure, and once an ambiguity over the use of the term ‘object’ is resolved, Reid's account of vision is both epistemically and perceptually direct, as well as consistent with his account of the other senses and doctrine of signs. (shrink)

This research explores the role of emotions in goal-directed behaviour. A model is provided for an emotional goal system whereby appraisals of the consequences of achieving or not achieving a goal are hypothesised to elicit anticipatory emotions; the anticipatory emotions are expected, in turn, to contribute to volitions in the service of goal pursuit (namely, intentions, plans, and the decision to expend energy); goal-directed behaviours next arise in response to volitions and lead to goal attainment; and the latter (...) then functions as the basis for a new set of appraisals and accompanying goaloutcome emotions. The model was tested in a longitudinal study of the responses of 406 adults (243 women, 163 men) in The Netherlands. The context for the study was the regulation of one's bodyweight via exercising and dieting. (shrink)

This article illustrates some of the difficulties of defining discrimination and briefly sketches the benefits and desiderata of doing so. It then examines and defines generic direct discrimination as an agent treating two groups differently because of the property that defines one of the groups as a group, in a way that is worse for that group, clarifying each of these three conditions in turn. It considers two arguments for further conditions: that an act must target one among a particular (...) set of groups to constitute discrimination, and that an act must be in some sense morally wrong to constitute discrimination. It concludes that while these objections are forceful it may be the case that they illustrate that we employ multiple, partly overlapping concepts of discrimination, and that it may be more important to recognize this heterogeneity than it is to attempt to establish a dominant or unitary definition. (shrink)

A competent person can avoid the onset of dementia by refusing life‐sustaining medical care and by voluntarily stopping eating and drinking, bringing life to an end well before any health crisis. A competent person can also try to limit the duration of dementia by drafting an advance directive that sets bounds on the life‐sustaining care, including artificial nutrition and hydration, that medical caregivers can provide when the person no longer has the capacity to make her own medical decisions. But between (...) these two strategies there can lie a significant gap. A person could live with moderate to severe dementia for a considerable time, no longer able to voluntarily stop eating and drinking yet also not yet requiring the life‐sustaining care forbidden by advance directive.This gap has been much discussed in recent years in the Hastings Center Report. Several years ago (in the May‐June 2014 issue), Paul Menzel and M. Colette Chandler‐Cramer argued for what they described as a moderate correction to the dominant view that food and water should always be offered to a patient with dementia if the patient expresses a desire to eat and drink. The problem is taken up again by the legal scholar Norman L. Cantor in this issue (July‐August 2018), and Cantor, too, tries to find a moderate alternative. (shrink)

Set theory is an autonomous and sophisticated field of mathematics, enormously successful not only at its continuing development of its historical heritage but also at analyzing mathematical propositions cast in set-theoretic terms and gauging their consistency strength. But set theory is also distinguished by having begun intertwined with pronounced metaphysical attitudes, and these have even been regarded as crucial by some of its great developers. This has encouraged the exaggeration of crises in foundations and of metaphysical doctrines in general. However, (...) set theory has proceeded in the opposite direction, from a web of intensions to a theory of extensionpar excellence, and like other fields of mathematics its vitality and progress have depended on a steadily growing core of mathematical structures and methods, problems and results. There is also the stronger contention that from the beginning set theory actually developed through a progression ofmathematicalmoves, whatever and sometimes in spite of what has been claimed on its behalf.What follows is an account of the development of set theory from its beginnings through the creation of forcing based on these contentions, with an avowedly Whiggish emphasis on the heritage that has been retained and developed by current set theory. The whole transfinite landscape can be viewed as the result of Cantor's attempt to articulate and solve the Continuum Problem. (shrink)

Background Transcranial direct current stimulation (tDCS) is a brain stimulation technique currently being researched as an alternative or complimentary treatment for various neurological disorders. There is little knowledge about experiences of the participants of tDCS clinical research, especially from pediatric studies. Methods An interview study with typically developing minors (n = 19, mean age 13,66 years) participating in a tDCS study, and their parents (n = 18) was conducted to explore their views and experiences and inform the ethical analysis. Results (...) Children (10–13 years old) and adolescents (14–18 years old) reported good experiences with the stimulation. Next to financial incentives, main motives to participate in the study were curiosity and the possibility to help develop treatments for children affected by neurological disorders. They could also see a potential of using tDCS in a non-medical setting, especially regarding the provision of equal opportunity, e.g. in education. Parents also presented a positive attitude towards tDCS and their children participation in the basic research study. Nevertheless, their understanding of tDCS was rather poor. Even though many of them understood the techniques, they often did not see the link between the (current) lack of side effects and an absence of longitudinal studies. Parents were also cautious about using tDCS for non-medical/enhancement purposes. Conclusions The study findings show a need for more transparent information about the state of the art of tDCS, its function and what it might be able to offer, especially considering the good acceptability of tDCS. (shrink)

Every set can been thought of as a directed graph whose edge relation is ∈. We show that many natural examples of directed graphs of this kind are indivisible: for every infinite κ, for every indecomposable λ, and every countable model of set theory. All of the countable digraphs we consider are orientations of the countable random graph. In this way we find indivisible well‐founded orientations of the random graph that are distinct up to isomorphism, and ℵ1 that (...) are distinct up to siblinghood. (shrink)

In the maximal form of indirect development found in many taxa of marine invertebrates, embryonic cell lineages of fixed fate and limited division capacity give rise to the larval structures. The adult arises from set‐aside cells in the larva that are held out from the early embryonic specification processes, and that retain extensive proliferative capacity. We review the locations and fates of set‐aside cells in two protostomes, a lophophorate and a deuterostome. The distinct adult body plans of many phyla develop (...) from homologous set‐aside cells within homologous larvae. We argue that the stocks from which these phyla arose utilized these respective larvae, and the diversity of their adult body plans reflects diverse pattern formation processes executed in their set‐aside cell populations. Chordates and arthropods develop directly, but share adult characters with indirectly developing phyla. Thus the deuterostome and protostome stocks that were ancestral to chordates and arthropods, respectively, also utilized maximal indirect development. (shrink)

Basic to all motile life is a differential approach/avoid response to perceived features of environment. The stages of response are initial reflexive noticing and orienting to the stimulus, preparation, and execution of response. Preparation involves a coordination of many aspects of the organism: muscle tone, posture, breathing, autonomic functions, motivational/emotional state, attentional orientation and expectations. The organism organizes itself in relation to the challenge. We propose to call this the “preparatory set” (PS). We suggest that the concept of the PS (...) can offer a more nuanced and flexible perspective on the stress response than do current theories. We also hypothesize that the mechanisms of bodymind therapeutic and educational systems (BTES) can be understood through the PS framework. We suggest that the BTES, including meditative movement, meditation, somatic education, and the body-oriented psychotherapies, are approaches that use interventions on the PS to remedy stress and trauma. We discuss how the PS can be adaptive or maladaptive, how BTES interventions may restore adaptive PS, and how these concepts offer a broader and more flexible view of the phenomena of stress and trauma. We offer supportive evidence for our hypotheses, and suggest directions for future research. We believe that the PS framework will point to ways of improving the management of stress and trauma, and that it will suggest directions of research into the mechanisms of action of BTES. (shrink)

ABSTRACT Research ethics is the most developed aspect of bioethics in Africa. Most African countries have set up Institutional Review Boards (IRBs) to provide guidelines for research and to comply with international norms. However, bioethics has not been responsive to local needs and values in the rest of the continent. A new direction is needed in African bioethics. This new direction promotes the development of a locally‐grounded bioethics, shaped by a dynamic understanding of local cultures and informed by structural and (...) institutional problems that impact the public's health, as well as cognisant of the salient contribution of social sciences and social epidemiology which can bring a lasting impact on African local communities. In today's post‐Structural Adjustment Africa, where healthcare has been liberalized and its cost increased, a bioethics agenda that focuses essentially on disease management and clinical work remains blind in the face of a structural marginalization of the masses of poor. Instead, the multidimensional public health crisis, with which most African countries are confronted, calls for a bioethics agenda that focuses primarily, but not exclusively, on health promotion and advocacy. Such an approach to bioethics reckons with the macro‐determinants of health and well‐being and places clinical and research ethics in the broader context of population's health. The same approach underscores the need to become political, not only by addressing health policymaking processes and procedures, but also by becoming an advocacy forum that includes other constituencies equipped with the potentialities to impact the population's health. (shrink)

Data on advance directives in Brazil are lacking. This study aims to assess the understanding of oncologists regarding advance directives and the frequency with which they discuss advance directives and advance care planning with their patients in Brazil. This is an observational, descriptive and cross-sectional study, conducted with cclinical oncologists associated with the Brazilian Society of Clinical Oncology. Participants were invited to answer a questionnaire prepared by the authors. In total, 72 physicians answered the questionnaire, of which 73% were under (...) 45 years old and 56% worked in oncology for less than 10 years. Regarding the limits of intervention and end-of-life care during treatment, 54.2% of respondents reported not discussing it. Although 67% of oncologists know the term advance directives, they do not develop them with their patients and 57.2% do not perform advance care planning. Most oncologists in this study do not set advance care planning and advance directives for most patients. (shrink)

In this paper we suggest that differing approaches to the science of social cognition mirror the arguments between radical embodied and traditional approaches to cognition. We contrast the use in social cognition of theoretical inference and mental simulation mechanisms with approaches emphasizing a direct perception of others’ mental states. We build from a recent integrative framework unifying these divergent perspectives through the use of dual-process theory and supporting social neuroscience research. Our elaboration considers two complementary notions of direct perception: one (...) primarily stemming from ecological psychology and the other from enactive cognition theory. We use this as the foundation from which to offer an account of the informational basis for social information and assert a set of research propositions to further the science of social cognition. In doing so, we point out how perception of the minds of others can be supported in some cases by lawful information, supporting direct perception of social affordances and perhaps, mental states, and in other cases by cues that support indirect perceptual inference. Our goal is to extend accounts of social cognition by integrating advances across disciplines to provide a multi-level and multi-theoretic description that can advance this field and offer a means through which to reconcile radical embodied and traditional approaches to cognitive neuroscience. (shrink)

Grounded in long-term ethnographic fieldwork in New Delhi’s fashion industry, this article explores the pressing question on the designer’s mind, namely: how do I align the desires of others with my -desire? This question points us towards an investigation of how people’s affects are mobilized and directed through commercial rituals such as fashion shows set within hyper-designed theatrical play-spheres. Translating the invisible or covert mobilization of affects into profit has been on the mind of advertisers for the last decade. (...) However, analysing such deliberately covert strategies of capture employed in two cases – JJ Valaya’s haute couture shows and Nitin Bal Chauhan’s youth brand – we realize that it is precisely their failure at being covert that makes them effective; clients know full well about them. Robert Pfaller’s theory of ‘illusions without owners’ can throw some light here on why clients passionately embrace the desire of capital precisely against their better knowledge. (shrink)

The fourth amendment to the German Medicinal Products Act (Arzneimittelgesetz) states that nontherapeutic research in incompetent populations is permissible under the condition that potential research participants expressly declare their wish to participate in scientific research in an advance research directive. This article explores the implementation of advance research directives in Germany against the background of the international legal and ethical framework for biomedical research. In particular, it addresses a practical problem that arises from the disclosure requirement for advance research directives. (...) We show that, if the disclosure standard for advance research directives is set at a token level, nontherapeutic research in incompetent populations becomes practically impossible. To resolve this issue, we suggest the disclosure standard be set at a type level. (shrink)

ABSTRACTResearch Objective: This study focuses on ADs in the Netherlands and introduces a cross‐cultural perspective by comparing it with other countries.Methods: A questionnaire was sent to a panel comprising 1621 people representative of the Dutch population. The response was 86%.Results: 95% of the respondents didn't have an AD, and 24% of these were not familiar with the idea of drawing up an AD. Most of those familiar with ADs knew about the Advanced Euthanasia Directive . Both low education and the (...) presence of a religious conviction that plays an important role in one's life increase the chance of not wanting to draw up an AD. Also not having experienced a request for euthanasia from someone else, and the inconceivability of asking for euthanasia yourself, increase the chance of not wanting to draw up an AD.Discussion: This study shows that the subjects of palliative care and end‐of‐life‐decision‐making were very much dominated by the issue of euthanasia in the Netherlands. The AED was the best known AD; and factors that can be linked to euthanasia play an important role in whether or not people choose to draw up an AD. This differentiates the Netherlands from other countries and, when it comes to ADs, the global differences between countries and cultures are still so large that the highest possible goals, at this moment in time, are observing and possibly learning from other cultural settings. (shrink)

In New Zealand an advance directive can be either an oral statement or a written document. Such directives give individuals the opportunity to make choices about future medical treatment in the event they are cognitively impaired or otherwise unable to make their preferences known. All consumers of health care have the right to make an advance directive in accordance with the common law. When we consider New Zealand's rapidly ageing population, the fact that more people now live with and die (...) of chronic rather than acute conditions, the importance given to respecting autonomous decision-making, increasing numbers of individuals who require long-term residential care, and financial pressures in the allocation of medical resources, there would seem to be a number of compelling reasons to encourage individuals to write or verbalise an advance directive. Indeed the promotion of advance directives is encouraged. However, caution should be exercised in promoting advance directives to older people, especially in light of several factors: ageist attitudes and stereotypes towards them, challenges in the primary healthcare setting, and the way in which advance directives are currently focused and formulated. This paper considers some of the specific challenges that need to be addressed if the promotion of advance directives are to improve outcomes of patient treatment and care near the end of life. (shrink)

This article aims to explore how epistemic status is negotiated during talk about the life memories of one speaker. Direct questions which foreground ‘remembering’ can lead to troubled sequences of talk. However, interlocutors sometimes frame their first parts as ‘co-rememberings’, and the sequential positioning of these can be crucial to the outcome of the talk. We draw on almost 10 hours of video data from dementia settings, where memory is a talked-about matter. Our focus is on 30 sequences which are (...) initiated with a question or other first part taking a K-stance, selecting one person as next speaker, and topically relating to the recipient’s past life. We show how type 2 knowables can be used alongside markers of tentativeness, to jointly construct the recipient’s epistemic primacy. (shrink)

Harreà’s positioning theory posits discourse as the concrete context within which selves are produced, but accentuates the dissociation between the physical engagement in a conversation and ‘location’ in a conceptual interpersonal space. The thesis that positioning involves selective attention, and that selected positions express ongoing transformations in the hearer’s experiential realm is expanded here initially by reference to Gibson’s direct-perception theory. The concepts of indexical and symbolic affordances are introduced to describe the function of utterances in setting parameters for hearer’s (...) behavioural and social-relational engagement, respectively. This implicates a construct of ‘psychological value’ , as proposed by C. G. Jung. The essay draws attention to the idea of symbol forming as a process whereby abstract self/world relations are articulated in one’s actions and thoughts, and in which context the ‘reception’ of others’ actions and utterances as having positioning implications may be understood. (shrink)

setting, are warranted. This article details a descriptive study in which patients were interviewed, during hospital stays, about their beliefs and understanding of advanced directions, as well as the processes used in completing them. The study was undertaken in a community hospital located in a rural area in the Midwest. Findings show that many patients were able to clearly articulate what an AD means in terms of making their choices known. However, misconceptions were found in patients' understanding of ADs and (...) only 46% reported discussing their ADs with a physician. Strategies for effective implementation of education programs related to ADs are detailed here. © 1999 Lippincott Williams & Wilkins, Inc.... (shrink)

A transitive model M of ZFC is called a ground if the universe V is a set forcing extension of M. We show that the grounds ofV are downward set-directed. Consequently, we establish some fundamental theorems on the forcing method and the set-theoretic geology. For instance, the mantle, the intersection of all grounds, must be a model of ZFC. V has only set many grounds if and only if the mantle is a ground. We also show that if the (...) universe has some very large cardinal, then the mantle must be a ground. (shrink)