A gas in a box is perhaps the most important model system studied in thermodynamics and statistical mechanics. Usually, studies focus on the gas, whereas the box merely serves as an idealized confinement. The present article focuses on the box as the central object and develops a thermodynamic theory by treating the geometric degrees of freedom of the box as the degrees of freedom of a thermodynamic system. Applying standard mathematical methods to the thermody- namics of an empty box allows (...) equations with the same structure as those of cosmology and classical and quantum mechanics to be derived. The simple model system of an empty box is shown to have interesting connections to classical mechanics, special relativity, and quantum field theory. (shrink)

Health care policy in the Netherlands has long been guided by the values of solidarity and equality. As a result of several forces, particularly the scarcity of resources, the retreat of the Welfare State and the introduction of market forces in health care, both values are increasingly under strain. Next to solidarity and equality, freedom of choice and financial responsibility are playing an important role in Dutch health care. Consequently, there is a growing division in Dutch heaith care between two (...) tiers, one basic tier giving access to a basic package of services and a luxury tier giving access to a higher quality of care and to services not included in the basic package. The main thesis of the article is that a two-tier system is morally justified on the condition that the basic tier is universally accessible and is based on the value of humanitarian solidarity. Keywords: access to health care, health insurance, resource allocation, solidarity CiteULike Connotea Del.icio.us What's this? (shrink)

This volume powerfully examines divides and mistrust between urban communities and police. The essays challenge readers to contemplate how eroding trust developed, the concerns and challenges facing divided communities, and possible pathways forward considering whose lives matter.

The purpose of this study is to take preliminary steps to unify psychoacoustic techniques with reaction-time methodologies to address the perceptual mechanisms responsible for the detection of one vs. multiple sounds. We measured auditory redundancy gains for auditory detection of pure tones widely spaced in frequency using the tools of Systems Factorial Technology to evince the system architecture and workload capacity in two different scenarios. We adopted an experimental design in which the presence or absence of a target at each (...) of two frequencies was combined factorially with two stimulus levels. Replicating previous work, results did not allow an assessment of system architecture due to a failure to observe factor influence at the level of distribution ordering for dual-target stimuli for both SOFT and LOUD scenarios. All subjects demonstrated very modest redundancy gains for the dual-target compared to the single-target stimuli, and results were similar for both LOUD and SOFT. We propose that these results can be predicted by a mental architecture that falls into the class of integrated subadditive parallel systems, using a well-supported assumption that reaction time is driven by loudness. We demonstrate that modeled loudness of the experimental sounds is highly correlated with mean reaction time, and we provide a proof-of-concept model based on Steven’s Power law that predicts both a failure of distributional ordering for dual-target stimuli and very modest redundancy gains. (shrink)

In a qualitative study, 22 stroke patients undergoing rehabilitation in three nursing homes were interviewed about constraints on and improvements in their autonomy and about approaches of health professionals regarding autonomy. The data were analysed using grounded theory, with a particular focus on the process of regaining autonomy. An approach by the health professionals that was responsive to changes in the patients’ autonomy was found to be helpful for restoration of their autonomy. Two patterns in health professionals’ approach appeared to (...) be facilitatory: (1) from full support on admission through moderate support and supervision, to reduced supervision at discharge; and (2) from paternalism on admission through partial paternalism (regarding treatment) to shared decision making at discharge. The approach experienced by the patients did not always match their desires regarding their autonomy. Support and supervision were reduced over time, but paternalism was often continued too long. Additionally, the patients experienced a lack of information. Tailoring interventions to patients’ progress in autonomy would stimulate their active participation in rehabilitation and in decision making, and would improve patients’ preparation for autonomous living after discharge. (shrink)

This article analyzes the contribution Christian ethics might be able to make to the ethical debate on policy and caregiving in health and social care in the United Kingdom. The article deals particularly with the concepts of solidarity and subsidiarity which are essential in Christian social ethics and health care ethics, and which may be relevant for the ethical debate on health and social caregiving in the United Kingdom. An important argument in the article is that utilitarian and market-driven policies (...) in the National Health Service (NHS) and the social care system have marginalized the position of the elderly and have seriously impoverished the quality of care for the elderly. The neglect of the elderly and other vulnerable groups is also the result of widespread consumerist attitudes among patients and of libertarian models of noninterference which are affirmed by a public ethos of self-sufficiency and counter-dependency. Those who need care dare not make their need known to others and ask for help, while simultaneously those who could help are so intimidated by the public affirmation of privacy and negative rights that they do not dare to offer help except if this is explicitly demanded. This distant and standoffish attitude is in an important way responsible for the fact that the voice of those in need is altogether lost to the public forum. Christian ethics puts much emphasis on responsibility and solidarity with the needy other but is not able to have much impact on the delivery of care in a secularized society and health care system like the NHS. Nonetheless, Christianity still has a powerful and respected voice, by speaking up for those who cannot speak for themselves, such as the elderly and the handicapped. Christians can find allies in the ethics of care and other relational approaches in health care ethics in order to combat libertarianism, consumerism, and utilitarianism. (shrink)

This paper, looking over the life and the texts of the greek philosophers and analyzing the Pythagorean harmony, the two stories of Thales, the outstanding personality of Xenophanes, the humorous sense of Democritus and the Socratic irony, shows that philosophy in the beginning was understood not like an abstract reflection, but like a joyful search of the excellence in the human life.

This Handbook documents the main trends in current research between logic and language, including its broader influence in computer science, linguistic theory and cognitive science. The history of the combined study of Logic and Linguistics goes back a long way, at least to the work of the scholastic philosophers in the Middle Ages. At the beginning of this century, the subject was revitalized through the pioneering efforts of Gottlob Frege, Bertrand Russell, and Polish philosophical logicians such as Kazimierz Ajdukiewicz. Around (...) 1970, the landmark achievements of Richard Montague established a junction between state-of-the-art mathematical logic and generative linguistic theory. Over the subsequent decades, this enterprise of Montague Grammar has flourished and diversified into a number of research programs with empirical and theoretical substance. This appears to be the first Handbook to bring logic-language interface to the fore. Both aspects of the interaction between logic and language are demonstrated in the book i.e. firstly, how logical systems are designed and modified in response to linguistic needs and secondly, how mathematical theory arises in this process and how it affects subsequent linguistic theory. The Handbook presents concise, impartial accounts of the topics covered. Where possible, an author and a commentator have cooperated to ensure the proper breadth and technical content of the papers. The Handbook is self-contained, and individual articles are of the highest quality. (shrink)

The question of whether old age should or should not play a role in medical decision-making for the elderly patient is regularly debated in ethics and medicine. In this paper we investigate exactly how age influences the decision-making process. To explore the normative argumentation in the decisions regarding an elderly patient we make use of the argumentation model advanced by Toulmin. By expanding the model in order to identify normative components in the argumentation process it is possible to analyse the (...) way that age-related value judgements influence the medical decision-making process. We apply the model to practice descriptions made by medical students after they had attended consultations and meetings in medical practice during their clinical training. Our results show the pervasive character of age-related value judgements. They influence the physician’s decision in several ways and at several points in the decision-making process. Such explicit value judgements were not exclusively used for arguments against further diagnosis or treatment of older patients. We found no systematic “ageist” pattern in the clinical decisions by physicians. Since age plays such an important, yet hidden role in the medical decision-making process, we make a plea for revealing such normative argumentation in order to gain transparency and accountability in this process. An explicit deliberative approach will make the medical decision-making process more transparent and improve the physician–patient relationship, creating confidence and trust, which are at the heart of medical practice. (shrink)

This article reports the findings of a study into the role of Dutch nurses in the alleviation of pain and symptoms with a life-shortening intention, conducted as part of a study into the role of nurses in medical end-of-life decisions. A questionnaire survey was carried out using a population of 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The response rate was 82.0%; 78.1% (1179) were suitable for analysis. The results show that in about half (...) of the cases (55.8%) nurses were involved in the decision making by the physician and that nurses were frequently (81.5%) involved in administering the medication. The authors' conclusion is that alleviation of pain and symptoms with a life-shortening intention represents a `grey' area, in which physicians and nurses act on the basis of personal ethical norms rather than legal rules, professional guidelines or shared moral values. (shrink)

The Test of Basic Auditory Capabilities is a battery of auditory-discrimination tasks and speech-identification tasks that has been normed on several hundred young normal-hearing adults. Previous research with the TBAC suggested that cognitive function may impact the performance of older adults. Here, we examined differences in performance on several TBAC tasks between a group of 34 young adults with a mean age of 22.5 years and a group of 115 older adults with a mean age of 69.2 years recruited from (...) the local community. Performance of the young adults was consistent with prior norms for this age group. Not surprisingly, the two groups differed significantly in hearing loss and working memory with the older adults having more hearing loss and poorer working memory than the young adults. The two age groups also differed significantly in performance on six of the nine measures extracted from the TBAC with the older adults consistently performing worse than the young adults. However, when these age-group comparisons were repeated with working memory and hearing loss as covariates, the groups differed in performance on only one of the nine auditory measures from the TBAC. For eight of the nine TBAC measures, working memory was a significant covariate and hearing loss never emerged as a significant factor. Thus, the age-group deficits observed initially on the TBAC most often appeared to be mediated by age-related differences in working memory rather than deficits in auditory processing. The results of these analyses of age-group differences were supported further by linear-regression analyses with each of the 9 TBAC scores serving as the dependent measure and age, hearing loss, and working memory as the predictors. Regression analyses were conducted for the full set of 149 adults and for just the 115 older adults. Working memory again emerged as the predominant factor impacting TBAC performance. It is concluded that working memory should be considered when comparing the performance of young and older adults on auditory tasks, including the TBAC. (shrink)

Research integrity is fundamental to the validity and reliability of scientific findings, and for ethical conduct of research. As part of PRINTEGER (Promoting Integrity as an Integral Dimension of Excellence in Research), this study explores the views of researchers, research managers, administrators, and governance advisors in Estonia, Italy, Norway and UK, focusing specifically on their understanding of institutional and organisational influences on research integrity.A total of 16 focus groups were conducted. Thematic analysis of the data revealed that competition is pervasive (...) and appeared in most themes relating to integrity. The structural frameworks for research such as funding, evaluation and publication were thought to both protect and, more commonly, undermine integrity. In addition, institutional systems, including workload and research governance, shaped participants’ day-to-day work environment, also affecting research integrity. Participants also provided ideas for promoting research integrity, including training, and creating conditions that would be supportive of research integrity.These findings support a shift away from individual blame and towards the need for structural and institutional changes, including organisations in the wider research environment, for example funding bodies and publishing companies. (shrink)

Previous research has demonstrated that trait self-control is related to a range of positive romantic relationship processes, suggesting that trait self-control should be positively and robustly linked to relationship satisfaction in both partners in a romantic relationship. However, the existing empirical evidence is limited and mixed, especially regarding partner effects. With three datasets of heterosexual couples, the present pre-registered studies examined: the dyadic associations between trait self-control and relationship satisfaction both cross-sectionally and longitudinally, and whether these effects hold when controlling (...) for both partners’ relationship commitment. The results indicated a cross-sectional positive actor effect, some support for a positive cross-sectional partner effect, and only little support for a longitudinal actor effect. After controlling for relationship commitment, all effects of trait self-control on satisfaction diminished except for a longitudinal actor effect among women in Study 2. Potential explanations for the current results, and implications for theory and practice, are discussed. (shrink)

Background: Issues concerning legislation and regulation with respect to the role of nurses in euthanasia and physician-assisted suicide gave the Minister for Health reason to commission a study of the role of nurses in medical end-of-life decisions in hospitals, home care and nursing homes.Aim: This paper reports the findings of a study of the role of nurses in euthanasia and physician-assisted suicide, conducted as part of a study of the role of nurses in medical end-of-life decisions. The findings for hospitals, (...) home care and nursing homes are described and compared.Method: A questionnaire was sent to 1509 nurses, employed in 73 hospitals, 55 home care organisations and 63 nursing homes. 1179 responses were suitable for analysis. The questionnaire was pilot-tested among 106 nurses, with a response rate of 85%.Results: In 37.0% of cases, the nurse was the first person with whom patients discussed their request for euthanasia or physician-assisted suicide. Consultation between physicians and nurses during the decision-making process took place quite often in hospitals and nursing homes and less frequently in home care situations . In some cases , nurses administered the euthanatics.Conclusions: The results show substantial differences between the intramural sector and the extramural sector , which are probably linked to the organisational structure of the institutions. Consultation between physicians and nurses during the decision-making process needs improvement, particularly in home care. Some nurses had administered euthanatics, although this task is by law exclusively reserved to physicians. (shrink)

The current study investigates whether self-talk phrases can influence behavior in Ultimatum Games. In our three self-talk treatments, participants were instructed to tell themselves (i) to keep their own interests in mind, (ii) to also think of the other person, or (iii) to take some time to contemplate their decision. We investigate how such so-called experimenter-determined strategic self-talk phrases affect behavior and emotions in comparison to a control treatment without instructed self-talk. The results demonstrate that other-focused self-talk can nudge proposers (...) towards fair behavior, as offers were higher in this group than in the other conditions. For responders, self-talk tended to increase acceptance rates of unfair offers as compared to the condition without self-talk. This effect is significant for both other-focused and contemplation-inducing self-talk but not for self-focused self-talk. In the self-focused condition, responders were most dissatisfied with unfair offers. These findings suggest that use of self-talk can increase acceptance rates in responders, and that focusing on personal interests can undermine this effect as it negatively impacts the responders’ emotional experience. In sum, our study shows that strategic self-talk interventions can be used to affect behavior in bargaining situations. (shrink)

This article reports the findings of a study into the role of Dutch nurses in the alleviation of pain and symptoms with a life-shortening intention, conducted as part of a study into the role of nurses in medical end-of-life decisions. A questionnaire survey was carried out using a population of 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The response rate was 82.0%; 78.1% were suitable for analysis. The results show that in about half of (...) the cases nurses were involved in the decision making by the physician and that nurses were frequently involved in administering the medication. The authors' conclusion is that alleviation of pain and symptoms with a life-shortening intention represents a `grey' area, in which physicians and nurses act on the basis of personal ethical norms rather than legal rules, professional guidelines or shared moral values. (shrink)

BackgroundObtaining informed consent for intravenous thrombolysis in acute ischemic stroke can be challenging, and little is known about if and how the informed consent procedure is performed by neurologists in clinical practice. This study examines the procedure of informed consent for intravenous thrombolysis in acute ischemic stroke in high-volume stroke centers in the Netherlands.MethodsIn four high volume stroke centers, neurology residents and attending neurologists received an online questionnaire concerning informed consent for thrombolysis with tissue-type plasminogen activator (tPA). The respondents were (...) asked to report their usual informed consent practice for tPA treatment and their considerations on whether informed consent should be obtained.ResultsFrom the 203 invited clinicians, 50% (n = 101) completed the questionnaire. One-third of the neurology residents (n = 21) and 21% of the neurologists (n = 8) reported that they always obtain informed consent for tPA treatment. If a patient is not capable of providing informed consent, 30% of the residents (n = 19) reported that they start tPA treatment without informed consent. In these circumstances, 53% of the neurologists (n = 20) reported that the resident under their supervision would start tPA treatment without informed consent. Most neurologists (n = 21; 55%) and neurology residents (n = 45; 72%) obtained informed consent within one minute. None of the respondents used more than five minutes for informed consent. Important themes regarding obtaining informed consent for treatment were patients’ capacity, and medical, ethical and legal considerations.ConclusionThe current practice of informed consent for thrombolysis in acute ischemic stroke varies among neurologists and neurology residents. If informed consent is obtained, most clinicians stated to obtain informed consent within one minute. In the future, a shortened information provision process may be applied, making a shift from informed consent to informed refusal, while still considering the patient’s capacity, stroke severity, and possible treatment delays. (shrink)

REFERENCES Barwise, J. & R. Cooper (1981) — 'Generalized Quantifiers and Natural Language', Linguistics and Philosophy 4:2159-219. Van Benthem, J. (1983a) — ' Five Easy Pieces', in Ter Meulen (ed.), 1-17. Van Benthem, J. (1983b) ...

The brief coda devoted to the Trinity in Schleiermacher's The Christian Faith does not intend to marginalize the doctrine. It indicates that the doctrine, though at present still to be completed, is the recapitulation of the entire scheme of redemption. The central structuring concept in that scheme is that of the genuine union between the divine existence of the infinite creator and human nature in Christ, a pattern replicated in the coming of the Holy Spirit as the inauguration of a (...) second, strictly analogous union of God and humanity. The subtle way in which Schleiermacher conceives these unions in line with his rigorous understanding of radical causality of divine creation requires careful unpacking. Only such an analysis brings to light the architecture of the doctrine of the Trinity, and its function as a kind of meta-doctrine, connecting and coordinating different elements in the doctrine of grace. (shrink)

s div class="title" a terTwo Notions of Being: Entity and Essence s /div a ter - Volume 62 - E. J. Lowe.

After defining, for each many-sorted signature Σ = (S, Σ), the category Ter ( Σ ), of generalized terms for Σ (which is the dual of the Kleisli category for , the monad in Set S determined by the adjunction from Set S to Alg ( Σ ), the category of Σ -algebras), we assign, to a signature morphism d from Σ to Λ , the functor from Ter ( Σ ) to Ter ( Λ ). Once defined the mappings (...) that assign, respectively, to a many-sorted signature the corresponding category of generalized terms and to a signature morphism the functor between the associated categories of generalized terms, we state that both mappings are actually the components of a pseudo-functor Ter from Sig to the 2-category Cat . Next we prove that there is a functor Tr Σ , of realization of generalized terms as term operations, from Alg ( Σ ) × Ter ( Σ ) to Set , that simultaneously formalizes the procedure of realization of generalized terms and its naturalness (by taking into account the variation of the algebras through the homomorphisms between them). We remark that from this fact we will get the invariance of the relation of satisfaction under signature change. Moreover, we prove that, for each signature morphism d from Σ to Λ , there exists a natural isomorphism θ d from the functor to the functor , both from the category Alg ( Λ ) × Ter ( Σ ) to the category Set , where d * is the value at d of the arrow mapping of a contravariant functor Alg from Sig to Cat , that shows the invariant character of the procedure of realization of generalized terms under signature change. Finally, we construct the many-sorted term institution by combining adequately the above components (and, in a derived way, the many-sorted specification institution), but for a strict generalization of the standard notion of institution. (shrink)

Após a obrigatoriedade da educação sexual (ES) nas escolas portuguesas em 2009, pretendemos conhecer que perspectiva têm os professores ( N = 307) sobre a ES. Através de um questionário on-line , analisado através de estatística descritiva e de análise factorial e inferencial, avaliámos as atitudes gerais sobre a ES, o conhecimento, o conforto e a disponibilidade para a ensinar, a importância atribuída a diversos tópicos de ES e o nível de escolaridade em que devem ser introduzidos. Os professores revelaram (...) atitudes ainda mais positivas do que em estudos anteriores. Consideraram ter um conhecimento, um conforto e uma disponibilidade moderados, realidade que se mantém inalterada na última década. Ao contrário de estudos anteriores, o início da ES foi proposto mais precocemente, entre o pré-escolar e o 5º ano.1 A perspectiva de ES defendida revela um modelo médico-preventivo, valorizando-se mais a saúde sexual e menos o comportamento sexual e as questões de género. A percepção de formação considerada suficiente, a erotofilia e pontualmente o sexo feminino destacam-se na adopção de uma perspectiva abrangente de ES. A análise de resultados foi, sempre que possível, comparada com resultados de estudos similares realizados no Brasil. (shrink)

After defining, for each many-sorted signature Σ = (S, Σ), the category Ter(Σ), of generalized terms for Σ (which is the dual of the Kleisli category for $${\mathbb {T}_{\bf \Sigma}}$$, the monad in Set S determined by the adjunction $${{\bf T}_{\bf \Sigma} \dashv {\rm G}_{\bf \Sigma}}$$ from Set S to Alg(Σ), the category of Σ-algebras), we assign, to a signature morphism d from Σ to Λ, the functor $${{\bf d}_\diamond}$$ from Ter(Σ) to Ter(Λ). Once defined the mappings that assign, respectively, (...) to a many-sorted signature the corresponding category of generalized terms and to a signature morphism the functor between the associated categories of generalized terms, we state that both mappings are actually the components of a pseudo-functor Ter from Sig to the 2-category Cat. Next we prove that there is a functor TrΣ, of realization of generalized terms as term operations, from Alg(Σ) × Ter(Σ) to Set, that simultaneously formalizes the procedure of realization of generalized terms and its naturalness (by taking into account the variation of the algebras through the homomorphisms between them). We remark that from this fact we will get the invariance of the relation of satisfaction under signature change. Moreover, we prove that, for each signature morphism d from Σ to Λ, there exists a natural isomorphism θ d from the functor $${{{\rm Tr}^{\bf {\bf \Lambda}} \circ ({\rm Id} \times {\bf d}_\diamond)}}$$ to the functor $${{\rm Tr}^{\bf \Sigma} \circ ({\bf d}^* \times {\rm Id})}$$, both from the category Alg(Λ) × Ter(Σ) to the category Set, where d* is the value at d of the arrow mapping of a contravariant functor Alg from Sig to Cat, that shows the invariant character of the procedure of realization of generalized terms under signature change. Finally, we construct the many-sorted term institution by combining adequately the above components (and, in a derived way, the many-sorted specification institution), but for a strict generalization of the standard notion of institution. (shrink)

There is a special need for solidarity at the global level to address global health disparities. Ter Meulen argues that solidarity must complement justice, and is, in fact, more fundamental than justice to the arrangement of health care practices. We argue that PG/SHG, though a theory of justice, is fundamentally synergistic with solidarity. We relate PG/SHG to Jodi Dean’s conceptual work on reflective solidarity, contrasted with conventional solidarity, as an approach to transnational solidarity that dovetails with PG/SHG. We argue that (...) PG/SHG meets both the need for solidarity at the global level and the need for solidarity within theories of the arrangement of health care practices. (shrink)