Automatized scalable healthcare support solutions allow real-time 24/7 health monitoring of patients, prioritizing medical treatment according to health conditions, reducing medical appointments in clinics and hospitals, and enabling easy exchange of information among healthcare professionals. With recent health safety guidelines due to the COVID-19 pandemic, protecting the elderly has become imperative. However, state-of-the-art health wearable device platforms present limitations in hardware, parameter estimation algorithms, and software architecture. This paper proposes a complete framework for health systems composed of multi-sensor wearable health (...) devices, high-resolution parameter estimation, and real-time monitoring applications. The framework is appropriate for real-time monitoring of elderly patients' health without physical contact with healthcare professionals, maintaining safety standards. The hardware includes sensors for monitoring steps, pulse oximetry, heart rate, and temperature using low-power wireless communication. In terms of parameter estimation, the embedded circuit uses high-resolution signal processing algorithms that result in an improved measure of the HR. The proposed high-resolution signal processing-based approach outperforms state-of-the-art HR estimation measurements using the photoplethysmography sensor. (shrink)

IntroductionThe prefrontal cortex plays a crucial role in cognition, particularly in executive functions. Cortical reactivity measured with Transcranial Magnetic Stimulation combined with Electroencephalography is altered in pathological conditions, and it may also be a marker of cognitive status in middle-aged adults. In this study, we investigated the associations between cognitive measures and TMS evoked EEG reactivity and explored whether the effects of this relationship were related to neurofilament light chain levels, a marker of neuroaxonal damage.MethodsFifty two healthy middle-aged adults from (...) the Barcelona Brain Health Initiative cohort underwent TMS-EEG, a comprehensive neuropsychological assessment, and a blood test for NfL levels. Global and Local Mean-Field Power, two measures of cortical reactivity, were quantified after left prefrontal cortex stimulation, and cognition was set as the outcome of the regression analysis. The left inferior parietal lobe was used as a control stimulation condition.ResultsLocal reactivity was significantly associated with working memory and reasoning only after L-PFC stimulation. No associations were found between NfL and cognition. These specific associations were independent of the status of neuroaxonal damage indexed by the NfL biomarker and remained after adjusting for age, biological sex, and education.ConclusionOur results demonstrate that TMS evoked EEG reactivity at the L-PFC, but not the L-IPL, is related to the cognitive status of middle-aged individuals and independent of NfL levels, and may become a valuable biomarker of frontal lobe-associated cognitive function. (shrink)

Job motivation remains an area of concern among researchers due to the rising issues of poor or lack of motivation among workers. This refers to one’s personal will or drives to perform a task at work. Meanwhile, job satisfaction refers to an employee’s sense of fulfillment with his or her work experience. Therefore, the current study utilized the descriptive- correlational research design to investigate the impact of job motivation on the job satisfaction of accountants. To gather essential data and achieve (...) the objectives of the study, Multidimensional Work Motivational Scale (MWMS) and Minnesota Satisfaction Questionnaire (MSQ) were administered to the target respondents. The collected data were then analyzed using a Multiple Regression Analysis; findings revealed that job motivation has a significant impact on the job satisfaction of accountants. Additionally, the results of this study were carefully evaluated and discussed, and recommendations were made to benefit the stakeholders of the study and contribute to the existing body of knowledge. (shrink)

Background: Notwithstanding near-universal agreement on the theoretical importance of truthfulness, empirical research has documented gaps between ethical norms and physician behaviors. Although prior research has explored situations in which physicians may not be truthful with patients, it has focused on contexts within specialty practice. In this article, we report on a qualitative study of truthfulness in primary care. Methods: We conducted a qualitative study during December 2014–March 2015 involving both focus groups and in-depth, semistructured interviews with 32 primary care physicians (...) from the Boston, MA, and Baltimore, MD, metro areas in three specialties: internal medicine, family practice, and pediatrics. Interviews and focus groups were led using a semistructured guide, which explored situations in which primary care physicians find it difficult to be honest with patients; factors shaping truthfulness; and rationales for truthful and untruthful communication. Results: While physicians described outright lying to patients as rare, other deviations from truthfulness were not uncommon, including slanting and deliberately withholding information. Physicians described a range of factors as influencing truthfulness, from patient-level characteristics such as educational background to societal considerations including avoiding unnecessary tests and procedures. Physicians described truthfulness as an ethical requirement, deviations from which required further justification. Perceived justifications included promoting patient well-being and avoiding harm. Conclusions: Our results suggest a potential need to augment opportunities for training in “everyday ethics” challenges, such as the appropriateness of deception in response to patient requests for inappropriate tests or pain medications. Furthermore, they indicate that, in various circumstances encountered in primary care, physicians perceive other moral duties as potentially in conflict with the duty of truthfulness. Further ethical analysis should focus on identifying when deviations from complete truthfulness do and do not serve patients' interests, to guide physicians in striking a reasonable balance among principles of medical ethics that may conflict with one another. (shrink)

We give three counterexamples to the folklore claim that in an arbitrary theory, if a complete type p over a set B does not divide over $C\subseteq B$, then no extension of p to a complete type over $\operatorname {acl}(B)$ divides over C. Two of our examples are also the first known theories where all sets are extension bases for nonforking, but forking and dividing differ for complete types (answering a question of Adler). One example is an $\mathrm {NSOP}_1$ theory (...) with a complete type that forks, but does not divide, over a model (answering a question of d’Elbée). Moreover, dividing independence fails to imply M-independence in this example (which refutes another folklore claim). In addition to these counterexamples, we summarize various related properties of dividing that are still true. We also address consequences for previous literature, including an earlier unpublished result about forking and dividing in free amalgamation theories, and some claims about dividing in the theory of generic $K_{m,n}$ -free incidence structures. (shrink)

Wiplinger, F. Metaphysik, Logik, Sprachkritik.--Mück, O. Wahrheit und Verifikation.--Strasser, S. Zur Konsensustheorie der Wahrheit.--Rivera de Ventosa, E. Dialektik und Dialog.--Schöndorfer, U. Ganzheitliche Erkenntnistheorie.--Lotz, J. B. Denken als Vollzug im Ganzen.--Benedikt, M. Orientierung und Architektonik.--Schaff, A. Ein Marxist liest die Integrale Logik.--Ricoeur, P. Wissenschaft und Ideologie.--Kohlenberger, H. Geschichtsprozess als Integration.--Huber, G. Zur Grundproblematik der philosophischen Anthropologie.--Wisser, R. Schöpfung und Schöpfertum in der Philosophie.--Verosta, S. Zum Verhältnis von Ordnung und Macht.--Schneider, H. Politische Ethik in der gegenwärtigen Normenkrise.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Language, Thought, and LogicGabriele PooleLanguage, Thought, and Logic, by John M. Ellis; x & 163 pp. Evanston: Northwestern University Press, 1993, $29.95.It is John Ellis’s contention that notwithstanding the enormous amount of energy that has gone into language studies not very much progress has been achieved and our theory of language remains vastly fragmented and contradictory. Language, Thought, and Logic is presented as an effort to overcome this (...) impasse. Many ideas are discussed, but the fundamental themes are the following four: the priority of categorization over communication, the functional nature of most categories, the attack on the severance of grammar from meaning which characterizes generative grammarians, and the dismissal of the debate on the relationship between language and thought as a meaningless issue.In chapters two and three, Ellis—after having convincingly argued for the logical priority of (language induced) categorization over communication—proceeds to illustrate the difference between “real” and “functional” categories. He states that a few categories, such as chemical classes, have their base in “reality.” Most categories, however, (Ellis uses the example of poison) are not based on intrinsic characteristics of its members (poisons differ widely in chemical structure) but on the collective purposes of the speakers (identifying dangerous substances). The former are “real” categories, the latter functional ones, and on the basis of this opposition Ellis attacks “naive realists” who claim that most linguistic categories are grounded in the extra-linguistic world. Ellis’s dichotomy however is not fully convincing: reality, of course, includes human beings and their interactions with the world. Once we concede that the chemical structure of a given substance is a real fact, then we have to admit that the interaction of a given substance with the human body is equally “real,” and [End Page 142] that a category based on a given type of interaction is grounded in “reality” just as one based on a given type of chemical structure.Chapter five instead is devoted to the traditional question of the relationship between thought and language. Ellis’s contention is that this discussion is in itself logically absurd, since language is an essential part of thought. This “initial logical misstep” inevitably leads thinkers such as John Lyons, Max Black, Eric Lenneberg, and no doubt countless others, to “astonishing” and “bewildering” statements, pseudoproblems,” and “comic” errors (pp. 56–58). In this case, too, Ellis’s position is not particularly convincing, and one wishes that he had devoted some of his unforgiving examination of the logical integrity of other people’s positions to his own arguments. For readers are bound to ask themselves why on earth does the fact that language is part of thought make it “not possible” to speak of the relationship between the two. Is it logically “not possible” to speak of the relationship of the part to the whole? Is it “not possible,” for example, to speak of the relationship of the heart to the rest of the human body?In general, by denying the possibility of discussing the relationship of thought and language, Ellis ends up completely ignoring the tension between the more standardized and collective aspects of language (grammar, and denotation, in particular) and the various ways it becomes articulated within individuals, through its inevitable enmeshment in their different experiences. This is a pity, because in many ways Ellis is trying to carve a commendable path between the Scylla of “deep structures” and the Charybdis of “linguistic determinism,” between the severance of language from meaning, and their absolute identification. It is perhaps inevitable that in shying away from the latter peril he ends up contradicting himself. After having declared the logical impossibility of speaking of the influence of the structure of language on thought, he subsequently states that it is certainly not true that everything in our mental life is completely determined by the structure of our language” (p. 61).Ultimately one is left with the impression that what would have best been offered as a refinement and integration of other positions has been polemically presented as a radical alternative, with the risk of helping to perpetuate the fragmentation of linguistic studies it was meant to overcome. Thus, as far as... (shrink)

"Neuroscience and Philosophy" begins with an excerpt from "Philosophical Foundations of Neuroscience," in which Maxwell Bennett and Peter Hacker question the ...

While Gabriel Watts and Ainsley Newson argue that diagnostic laboratories do not have a general duty to routinely reinterpret genomic variant classifications, they do formulate several restricted duties to actively reinterpret specific types of classifications.1 They place these duties with laboratories, acknowledging that they are setting aside any responsibilities that might arise for clinicians. Here, we will discuss the implications of this obligation for clinicians and the moral tension it may confront them with. We focus in particular on the (...) consequences of the proposed moral obligation to actively reinterpret variant classifications that carry a higher risk of being false positives. Such reclassification is likely to result in ‘downgrades’: previously pathogenic variants (pathogenic/likely pathogenic, P/LP) reclassified to benign (likely benign/benign, LB/B) or uncertain variants (variant of uncertain significance, VUS). Any laboratory policy to actively reinterpret (specific sets of) classifications will confront the clinician with the question whether the person tested should be recontacted on a reinterpretation of previously reported results. As others have pointed out, recontacting in general comes with challenges, since patients may not want to be recontacted or have forgotten about their genetic test.2 3 Recontacting in case of a downgrade, however, is particularly impactful. Previous studies on the psychosocial impact of reclassification on patients …. (shrink)

The chronic worldwide lack of organs for transplantation and the continuing improvement of strategies for in situ organ preservation have led to renewed interest in elective non-therapeutic ventilation of potential organ donors. Two types of situation may be eligible for elective intensive care: patients definitely evolving towards brain death and patients suitable as controlled non-heart beating organ donors after life-supporting therapies have been assessed as futile and withdrawn. Assessment of the ethical acceptability and the risks of these strategies is essential. (...) We here offer such an ethical assessment using the four principles of medical ethics of Beauchamp and Childress applying them in their broadest sense so as to include patients and their families, their caregivers, other potential recipients of intensive care, and indeed society as a whole. The main ethical problems emerging are the definition of beneficence for the potential organ donor, the dilemma between the duty to respect a dying patient's autonomy and the duty not to harm him/her, and the possible psychological and social harm for families, caregivers other potential recipients of therapeutic intensive care, and society more generally. Caution is expressed about the ethical acceptability of elective non-therapeutic ventilation, along with some proposals for precautionary measures to be taken if it is to be implemented. (shrink)

When do organizations decide to ‘adopt’ a given social issue such that they come to acknowledge it in their patterns of action and communication? Traditional answers to this question have focused either on the characteristics of the issue itself, or on the traits of the focal organization. In many cases, however, a firm’s decision to adopt or ignore an issue is not a straightforward function of firm or issue characteristics. Instead, we view issue adoption as a socially constructed process of (...) information exchange between parties that are involved in the emergence and evolution of the issue, mediated by third-party organizations. We refer to this process as the infomediary process and these latter organizations as ‘infomediaries,’ after the information mediation and brokerage roles they play in the social processes linking social issues to organizational impact. We present a concise theoretical model of how infomediaries establish credible linkages between focal organizations and social issues. The thrust of the model is that the infomediation process, rather than the issue or firm characteristics, is what really drives firm-level issue adoption decisions. (shrink)

The majority of Dutch physicians feel pressure when dealing with a request for euthanasia or physician-assisted suicide. This study aimed to explore the content of this pressure as experienced by general practitioners. We conducted semistructured in-depth interviews with 15 Dutch GPs, focusing on actual cases. The interviews were transcribed and analysed with use of the framework method. Six categories of pressure GPs experienced in dealing with EAS requests were revealed: emotional blackmail, control and direction by others, doubts about fulfilling the (...) criteria, counterpressure by patient’s relatives, time pressure around referred patients and organisational pressure. We conclude that the pressure can be attributable to the patient–physician relationship and/or the relationship between the physician and the patient’s relative, the inherent complexity of the decision itself and the circumstances under which the decision has to be made. To prevent physicians to cross their personal boundaries in dealing with EAS request all these different sources of pressure will have to be taken into account. (shrink)

Background:Surveillance technology such as tag and tracking systems and video surveillance could increase the freedom of movement and consequently autonomy of clients in long-term residential care settings, but is also perceived as an intrusion on autonomy including privacy.Objective:To explore how clients in residential care experience surveillance technology in order to assess how surveillance technology might influence autonomy.Setting:Two long-term residential care facilities: a nursing home for people with dementia and a care facility for people with intellectual disabilities.Methods:Ethnographic field study.Ethical considerations:The boards (...) representing clients and relatives/proxies of the clients were informed of the study and gave their written consent. The clients’ assent was sought through a special information leaflet. At any time clients and/or proxy were given the option to withdraw from the study. The research protocol was also reviewed by a medical ethics committee.Findings:Our findings show a pattern of two themes: (1) coping with new spaces which entailed clients: wandering around, getting lost, being triggered, and retreating to new spaces and (2) resisting the surveillance technology measure because clients feel stigmatized, missed the company, and do not like being “watched.”Conclusion:Client experiences of surveillance technology appear to entail a certain ambivalence. This is in part due to the variety in surveillance technology devices, with each device bringing its own connotations and experiences. But it also lies in the devices’ presupposition of an ideal user, which is at odds with the actual user who is inherently vulnerable. Surveillance technology can contribute to the autonomy of clients in long-term care, but only if it is set in a truly person-centered approach. (shrink)

Background As our society is ageing, nursing homes are finding it increasingly difficult to deal with an expanding population of patients with dementia and a decreasing workforce. A potential answer to this problem might lie in the use of technology. However, the use and application of surveillance technology in dementia care has led to considerable ethical debate among healthcare professionals and ethicists, with no clear consensus to date. Aim To explore how surveillance technology is viewed by care professionals and ethicists (...) working in the field, by investigating the ideal application of surveillance technology in the residential care of people with dementia. Methods Use was made of the concept mapping method, a computer-assisted procedure consisting of five steps: brainstorming, prioritising, clustering, processing by the computer and analysis. Various participants (ranging from ethicists to physicians and nurses) were invited on the basis of their professional background. Results The views generated are grouped into six categories ranging from the need for a right balance between freedom and security, to be beneficial and tailored to the resident, and clearly defined procedures to competent and caring personnel, active monitoring and clear normative guidance. The results are presented in the form of a graphic chart. Conclusions There appears to be an inherent duality in the views on using surveillance technology which is rooted in the moral conflict between safety and freedom. Elaboration of this ethical issue has proved to be very difficult. (shrink)

ABSTRACT Real-time graphical interval logic is a modal logic for reasoning about time in which the basic modality is the interval. The logic differs from other logics in that it has a natural intuitive graphical representation that resembles the timing diagrams drawn by system designers. We have developed an automted deduction system for the logic, which includes a theorem prover and a user interface. The theorem prover checks the validity of proofs in the logic and produces counterexamples to invalid proofs. (...) The user interface includes a graphical editor that enables the user to create graphical formulas on a workstation display, and a database and proof manager that tracks proof dependencies and allows graphical formulas to be stored and retrieved. In this paper we describe the logic, the automated deduction system, and an application to robotics. (shrink)

The name of the third author was incorrect in the initial online publication. The original article has been corrected.

In this exploratory study, we present findings from semi-structured interviews with 11 self-identified lesbian and gay (LG) humanitarian aid workers of Doctors without Borders (MSF). We investigate their perceptions of workplace inclusion in terms of perceived satisfaction of their needs for authenticity and belonging within two organizational settings, namely office and field. Through our combined deductive and inductive approach, based on grounded theory, we find that perceptions of their colleagues’ and supervisors’ attitudes and behaviors, as well as organizational inclusiveness practices (...) play a role in LGs’ perceived authenticity, but not belonging, in the workplace. However, these organization-level characteristics do not account for between-participant differences in perceived authenticity. Therefore, we inductively construct a typology of three groups, which we coined conscious first-missioners, authentic realists, and idealistic activists, based on how LG humanitarian aid workers assess and deal with not being able to be their authentic selves when they are in the field, because homosexuality is illegal in many project countries. Conscious first-missioners are separated from the other two groups based on having gone to the field once, whereby they felt in control over the decision on how to manage their sexuality. Alternatively, authentic realists and idealistic activists alike felt they did not really have a choice in how to manage their sexuality, but handled that differently. We find the importance of one’s sexuality as well as adherence to the overarching organizational mission relevant individual-level factors herein. Furthermore, we find disclosure of sexual identity to be strongly context-dependent, as participants are ‘out of the closet’ in the office, but go back into the closet when they enter the field, with different country contexts even leading to different decisions concerning self-disclosure, thus demonstrating the importance of careful sexual identity management. This so-called disclosure dilemma, we find, may not be merely an individual choice, but rather a shared dilemma involving multiple stakeholders, such as the organization and fellow team members. We discuss the findings’ contributions to existing literature on LGs’ workplace experiences and implications for future research on inclusion of sexual and other invisible minorities in the workplace. (shrink)

The expansion of livestock production throughout the world has led to increased demand for high protein animal feed. This expansion has created economic benefits for livestock farmers and other actors in the chain, but also resulted in environmental and social side effects. This study aims to identify a set of sustainability issues that cover the environmental, economic and social dimensions of soymeal and beef production chains. The method applied combines the results of multiple studies, including a literature review and stakeholder (...) surveys. Stakeholder surveys were conducted for three different interest groups and two geographical regions . Our results reveal that the selection of issues in most sustainability assessment studies is a relatively arbitrary decision, while the literature also states that identifying issues is an important step in a sustainability assessment. Defining sustainability issues from a whole chain perspective is important, as issues of sustainability emerge at various stages along the production chain, and are found to vary across stakeholders’ interests. Business stakeholders, for example, perceived economic issues to be more important, whereas the majority of consumer stakeholders and other stakeholders perceived social and environmental issues, respectively, to be more important. Different education levels, knowledge, and living patterns in various geographical regions can affect the stakeholders’ perceptions. The combination of a heterogeneous group of stakeholders and the consideration of multiple chain stages constitutes a useful approach to identify sustainability issues along food chains. (shrink)