The ethical challenges of caring for the chronically ill are of increasing concern to nurses as they attempt to create humanitarian environments for long-term care. This article suggests two ethical perspectives to guide the agenda of the nursing profession to achieve social change in the care of the chronically ill and aging. First, a reemphasis on the public duties of the professions is recommended which extends beyond serving the interests of the nursing profession to recognizing the need to serve the (...) common good. Second, the limitations of the autonomy paradigm are explored and the foundation for the development of a new moral paradigm is analyzed in terms of its' potential usefulness in addressing ethical problems of chronic illness. Several initiatives that nursing must undertake to facilitate the emergence of this paradigm are proposed. (shrink)

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

Introduction: Although deep brain stimulation often improves levodopa-responsive gait symptoms, robust therapies for gait dysfunction from Parkinson's disease remain a major unmet need. Walking speed could represent a simple, integrated tool to assess DBS efficacy but is often not examined systematically or quantitatively during DBS programming. Here we investigate the reliability and functional significance of changes in gait by directional DBS in the subthalamic nucleus.Methods: Nineteen patients underwent unilateral subthalamic nucleus DBS surgery with an eight-contact directional lead in the most (...) severely affected hemisphere. They arrived off dopaminergic medications >12 h preoperatively and for device activation 1 month after surgery. We measured a comfortable walking speed using an instrumented walkway with DBS off and at each of 10 stimulation configurations at the midpoint of the therapeutic window. Repeated measures of ANOVA contrasted preoperative vs. maximum and minimum walking speeds across DBS configurations during device activation. Intraclass correlation coefficients examined walking speed reliability across the four trials within each DBS configuration. We also investigated whether changes in walking speed related to modification of step length vs. cadence with a one-sample t-test.Results: Mean comfortable walking speed improved significantly with DBS on vs. both DBS off and minimum speeds with DBS on. Pairwise comparisons showed no significant difference between DBS off and minimum comfortable walking speed with DBS on. Intraclass correlations were ≥0.949 within each condition. Changes in comfortable walk speed were conferred primarily by changes in step length.Conclusion: Acute assessment of walking speed is a reliable, clinically meaningful measure of gait function during DBS activation. Directional and circular unilateral subthalamic DBS in appropriate configurations elicit acute and clinically significant improvements in gait dysfunction related to PD. Next-generation directional DBS technologies have significant potential to enhance gait by individually tailoring stimulation parameters to optimize efficacy. (shrink)

Cognitive reappraisal is an important emotion regulation strategy that shows considerable developmental change in its use and effectiveness. This paper presents a systematic review of the evidence base regarding the development of cognitive reappraisal from early childhood through adolescence and provides methodological recommendations for future research. We searched Scopus, PsycINFO, and ERIC for empirical papers measuring cognitive reappraisal in normative samples of children and youth between the ages of 3 and 18 years published in peer-reviewed journals through August 9th, 2018. (...) We identified 118 studies that met our inclusion criteria. We first present a quantitative review of the methodologies used to investigate cognitive reappraisal in children and adolescents, with attention to variations in methodologies by the sample age range. We then present a qualitative review of findings with attention to: the age at which children begin to effectively use cognitive reappraisal to regulate their emotions, and developmental changes in cognitive reappraisal from early childhood through adolescence. We consider how methodological differences may contribute to inconsistencies in findings, highlight gaps in the literature that remain to be addressed, and make recommendations for future directions. (shrink)

Although activated spinal cord glia contribute importantly to neuropathic pain, how nerve injury activates glia remains controversial. It has recently been proposed, on the basis of genetic approaches, that toll-like receptor 4 may be a key receptor for initiating microglial activation following L5 spinal nerve injury. The present studies extend this idea pharmacologically by showing that TLR4 is key for maintaining neuropathic pain following sciatic nerve chronic constriction injury. Established neuropathic pain was reversed by intrathecally delivered TLR4 receptor antagonists derived (...) from lipopolysaccharide. Additionally, -naltrexone, -naloxone, and -naloxone, which we show here to be TLR4 antagonists in vitro on both stably transfected HEK293-TLR4 and microglial cell lines, suppressed neuropathic pain with complete reversal upon chronic infusion. Immunohistochemical analyses of spinal cords following chronic infusion revealed suppression of CCI-induced microglial activation by -naloxone and -naloxone, paralleling reversal of neuropathic pain. Together, these CCI data support the conclusion that neuron-to-glia signaling through TLR4 is important not only for initiating neuropathic pain, as suggested previously, but also for maintaining established neuropathic pain. Furthermore, these studies suggest that the novel TLR4 antagonists -naloxone and -naloxone can each fully reverse established neuropathic pain upon multi-day administration. This finding with -naloxone is of potential clinical relevance. This is because -naloxone is an antagonist that is inactive at the -opioid selective receptors on neurons that produce analgesia. Thus, these data suggest that -opioid antagonists such as -naloxone may be useful clinically to suppress glial activation, yet -opioid agonists suppress pain. (shrink)

A. R. W. Harrison in The Law of Athens, i , 63–5, argued that the exclusion of bastards from the phratries and the severe restriction of their right of inheritance does not entail their exclusion from Athenian citizenship; and that the form of Pericles' citizenship law, not stating that were to be , and Solon's law restricting the inheritance rights of , both point to the conclusion that bastards were not ipso facto debarred from citizenship. D. M. MacDowell in (...) CQ N.S. 26 , 88–91, rightly finds Harrison's positive arguments inconclusive, but suggests that three texts provide more definite support for this conclusion. (shrink)

This paper is devoted to the study of some subvarieties of the variety Qof Q-Heyting algebras, that is, Heyting algebras with a quantifier. In particular, a deeper investigation is carried out in the variety Q 3 of three-valued Q-Heyting algebras to show that the structure of the lattice of subvarieties of Qis far more complicated that the lattice of subvarieties of Heyting algebras. We determine the simple and subdirectly irreducible algebras in Q 3 and we construct the lattice of subvarieties (...) (Q 3 ) of the variety Q 3. (shrink)

This paper is devoted to the study of some subvarieties of the variety Q of Q-Heyting algebras, that is, Heyting algebras with a quantifier. In particular, a deeper investigation is carried out in the variety Q subscript 3 of three-valued Q-Heyting algebras to show that the structure of the lattice of subvarieties of Q is far more complicated that the lattice of subvarieties of Heyting algebras. We determine the simple and subdirectly irreducible algebras in Q subscript 3 and we construct (...) the lattice of subvarieties lambda (Q subscript 3) of the variety Q subscript 3. (shrink)

First published in 1982, this reissue contains a critical exposition of the views of Frege, Dedekind and Peano on the foundations of arithmetic. The last quarter of the 19th century witnessed a remarkable growth of interest in the foundations of arithmetic. This work analyses both the reasons for this growth of interest within both mathematics and philosophy and the ways in which this study of the foundations of arithmetic led to new insights in philosophy and striking advances in logic. This (...) historical-critical study provides an excellent introduction to the problems of the philosophy of mathematics - problems which have wide implications for philosophy as a whole. This reissue will appeal to students of both mathematics and philosophy who wish to improve their knowledge of logic. (shrink)

Part I: WHAT IS ETHICS? Plato: Socratic Morality: Crito. Suggestions for Further Reading. Part II: ETHICAL RELATIVISM VERSUS ETHICAL OBJECTIVISM. Herodotus: Custom is King. Thomas Aquinas: Objectivism: Natural Law. Ruth Benedict: A Defense of Ethical Relativism. Louis Pojman: A Critique of Ethical Relativism. Gilbert Harman: Moral Relativism Defended. Alan Gewirth: The Objective Status of Human Rights. Suggestions for Further Reading. Part III: MORALITY, SELF-INTEREST AND FUTURE SELVES. Plato: Why Be Moral? Richard Taylor: On the Socratic Dilemma. David Gauthier: Morality and (...) Advantage. Gregory Kavka: A Reconciliation Project. Derek Parfit: Later Selves and Moral Principles. Bernard Williams: Persons, Character, and Morality. Suggestions for Further Reading. Part IV: VALUE. Jeremy Bentham: Classical Hedonism. Robert Nozick: The Experience Machine. Richard Taylor: Value and the Origin of Right and Wrong. Friedrich Nietzsche: The Transvaluation of Values. Derek Parfit: What Makes Someone’s Life Go Best? Thomas Nagel: Value: The View from Nowhere. Suggestions for Further Reading. Part V: UTILITARIANISM AND CONSEQUENTIALISM. John Stuart Mill: Utilitarianism. J.J.C. Smart: Extreme and Restricted Utilitarianism. Kai Nielsen: Against Moral Conservatism. Bernard Williams: Against Utilitarianism. John Hospers: Rule-Utilitarianism. Robert Nozick: Side Constraints. Peter Singer: Famine, Affluence and Morality. Suggestions for Further Reading. Part VI: KANTIAN AND DEONTOLOGICAL SYSTEMS. Immanuel Kant: Foundation for the Metaphysic of Morals. W. D. Ross: What Makes Right Acts Right? Onora O’Neill: Kantian Formula of the End in Itself and World Hunger. Thomas Nagel: Moral Luck. Philippa Foot: Morality as a System of Hypothetical Imperatives. Judith Jarvis Thomson: Killing, Letting Die, and the Trolley Problem. Suggestions for Further Reading. Part VII: CONTRACTARIAN ETHICAL SYSTEMS. Thomas Hobbes: The Leviathan. David Gauthier: Why Contractarianism? John Rawls: Contractualism: Justice as Fairness. T.M. Scanlon: Contractualism and Utilitarianism. Suggestions for Further Reading. Part VIII: VIRTUE-BASED ETHICAL SYSTEMS. Aristotle: The Ethics of Virtue. Bernard Mayo: Virtue and the Moral Life. William Frankena: A Critique of Virtue-Based Ethics. Walter Schaller: Are Virtues No More than Dispositions to Obey Moral Rules? Alasdair MacIntyre: The Nature of the Virtues. Susan Wolf: Moral Saints. Louis P. Pojman: In Defense of Moral Saints. Suggestions for Further Reading. Part IX: THE FACT/VALUE PROBLEM: METAETHICS IN THE TWENTIETH CENTURY. David Hume: On Reason and the Emotions: The Fact/Value Distinction. G. E. Moore: Non-Naturalism. A. J. Ayer: Emotivism. R. M. Hare: Prescriptivism: The Structure of Ethics and Morals. Geoffrey Warnock: The Object of Morality. Suggestions for Further Reading. Part X: MORAL REALISM AND THE CHALLENGE OF SKEPTICISM. J.L. Mackie: The Subjectivity of Values. Jonathan Harrison: A Critique of Mackie’s Error Theory. Gilbert Harman: Moral Nihilism. Nicholas Sturgeon: Moral Explanations. Bernard Williams: Ethics and the Limits of Philosophy. Bruce Russell: Two Forms of Ethical Skepticism. Michael Smith: A Defense of Moral Realism. Suggestions for Further Reading. Part XI: RELIGION AND ETHICS. Plato: Morality and Religion. Immanuel Kant: God and Immortality as Necessary Postulates of Morality. George Mavrodes: Religious and the Queerness of Morality. Kai Nielson: Ethics Without God. Suggestions for Further Reading. Part XII: CONTEMPORARY CHALLENGES TO CLASSICAL ETHICAL THEORY. Part A. Sociobiology and the Question of Moral Responsibility. Charles Darwin: Ethics and the Descent of Man. E.O.Wilson: Sociobiology and Ethics. Michael Ruse: Evolution and Ethics: The Sociobiological Approach. Elliot Sober: Prospects for an Evolutionary Ethics. J.L. Mackie: The Law of the Jungle, Evolution and Morality. Suggestions for Further Readingon Sociobiology. Part B. The Challenge of Determinism to Moral Responsibility and Desert. Galen Strawson: The Impossibility of Moral Responsibility. Louis Pojman: Free Will, Determinism, and Moral Responsibility:A Response to Galen Strawson. Richard Taylor: A Libertarian Defense of Free Will and Responsibility. Suggestions for Further Reading on Moral Responsibility. Glossary of Ethical Terms. (shrink)

We isolate two abstract determinacy theorems for games of length $\omega_1$ from work of Neeman and use them to conclude, from large-cardinal assumptions and an iterability hypothesis in the region of measurable Woodin cardinals thatif the Continuum Hypothesis holds, then all games of length $\omega_1$ which are provably $\Delta_1$ -definable from a universally Baire parameter are determined;all games of length $\omega_1$ with payoff constructible relative to the play are determined; andif the Continuum Hypothesis holds, then there is a model of (...) ${\mathsf{ZFC}}$ containing all reals in which all games of length $\omega_1$ definable from real and ordinal parameters are determined. (shrink)

In their thought-provoking article, Sedlakova and Trachsel (2023) defend the view that the status—both epistemic and ethical—of Conversational Artificial Intelligence (CAI) used in psychotherapy is complicated. While therapeutic CAI seems to be more than a mere tool implementing particular therapeutic techniques, it falls short of being a “digital therapist.” One of the main arguments supporting the latter claim is that even though “the interaction with CAI happens in the course of conversation… the conversation is profoundly different from a conversation with (...) a human therapist” (Sedlakova and Trachsel 2023, 8). In particular, unlike a human therapist, CAI cannot help its users gain new insight and self-understanding (Sedlakova and Trachsel 2023). We agree that currently available therapeutic CAI cannot be considered a “digital therapist,” however, we think that the issue surrounding the acquisition of new self-understanding in the interaction with therapeutic CAI is more complicated than Sedlakova and Trachsel suggest. (shrink)

Despite Vancil’s (1979) proclamation over twenty years ago that topoi have been abandoned in argument theory, this essay contends that topoi should have a vital role in contemporary argumentation theory. Four key areas are identified where topoi are (or can be) essential tools for argumentation: Locating argument, building argument, development of critical thinking, and argument pedagogy. As a result, teachers and students of argument can both benefit from a (re)discovery of topoi.

It is shown that the determinacy of $G_{\delta \sigma }$ games of length $\omega ^2$ is equivalent to the existence of a transitive model of ${\mathsf {KP}} + {\mathsf {AD}} + \Pi _1\textrm {-MI}_{\mathbb {R}}$ containing $\mathbb {R}$. Here, $\Pi _1\textrm {-MI}_{\mathbb {R}}$ is the axiom asserting that every monotone $\Pi _1$ operator on the real numbers has an inductive fixpoint.

We characterize the determinacy of $F_\sigma $ games of length $\omega ^2$ in terms of determinacy assertions for short games. Specifically, we show that $F_\sigma $ games of length $\omega ^2$ are determined if, and only if, there is a transitive model of ${\mathsf {KP}}+{\mathsf {AD}}$ containing $\mathbb {R}$ and reflecting $\Pi _1$ facts about the next admissible set.As a consequence, one obtains that, over the base theory ${\mathsf {KP}} + {\mathsf {DC}} + ``\mathbb {R}$ exists,” determinacy for $F_\sigma $ (...) games of length $\omega ^2$ is stronger than ${\mathsf {AD}}$, but weaker than ${\mathsf {AD}} + \Sigma _1$ -separation. (shrink)

The use of tensed language and the metaphor of set ‘formation’ found in informal descriptions of the iterative conception of set are seldom taken at all seriously. Both are eliminated in the nonmodal stage theories that formalise this account. To avoid the paradoxes, such accounts deny the Maximality thesis, the compelling thesis that any sets can form a set. This paper seeks to save the Maximality thesis by taking the tense more seriously than has been customary (although not literally). A (...) modal stage theory, MST, is developed in a bimodal language, governed by a tenselike logic. Such a language permits a very natural axiomatisation of the iterative conception, which upholds the Maximality thesis. It is argued that the modal approach is consonant with mathematical practice and a plausible metaphysics of sets and shown that MST interprets a natural extension of Zermelo set theory less the axiom of Infinity and, when extended with a further axiom concerning the extent of the hierarchy, interprets Zermelo–Fraenkel set theory. (shrink)