The number of children with chronic critical illness (CCI) is a growing population in the United States. A defining characteristic of this population is a prolonged hospital stay. Our study assessed the proportion of pediatric patients with chronic critical illness in U.S. hospitals at a specific point in time, and identified a subset of children whose hospital stay lasted for months to years. The potential harms of a prolonged hospitalization for children with CCI, which include over treatment, infection, disruption of (...) family life, and the intensive utilization of resources—combined with the moral distress experienced by the clinicians who care for the children, suggest the need for ethical analysis of this growing issue to identify actions that could be taken at the clinical and health systems levels to reduce the harms associated with prolonged hospital stay.In this article we present three real cases from our study that involved a very long hospital stay. We applied a framework developed by Mackenzie, Rogers, and Dodds to analyze inherent, situational, and pathogenic vulnerabilities to examine the ways that interventions intended to remedy one source of harm for the children in our cohort inadvertently created other harms. We examined the complex ways that children with protracted hospitalization are vulnerable to the choices made by their family and clinicians, as well as by healthcare systems and communities. Finally, we used this analysis to summarize actions and ethical responses to this growing patient population. Such an understanding is essential to making clinical and ethical decisions that arise for children who are at risk for a very long stay in the hospital. (shrink)

Caring for critically ill and dying patients often triggers both professional and personal growth for physician trainees. In pediatrics, the neonatal intensive care unit is among the most distressing settings for trainees. We used longitudinal narrative writing to gain insight into how physician trainees are challenged by and make sense of repetitive, ongoing conflicts experienced as part of caring for very sick and dying babies. The study took place in a 45-bed, university-based NICU in an urban setting in the United (...) States. From November 2009 to June 2010 we enrolled pediatric residents and neonatology fellows at the beginning of their NICU rotations. Participants were asked to engage in individual, longitudinal narrative writing about their “experience in the NICU.” Thematic narrative analysis was performed. Thirty-seven physician trainees participated in the study. The mean number of narratives per trainee was 12; a total of 441 narratives were available for analysis. Conflict was the most pervasive theme in the narratives. Trainees experienced conflicts with families and conflicts with other clinicians. Trainees also described multiple conflicts of identity as members of the neonatology team, as members of the medical profession, as members of their own families, and as members of society. Physician trainees experience significant conflict and distress while learning to care for critically ill and dying infants. These conflicts often led them to question their own morals and their role in the medical profession. Physician trainees should be educated to expect various types of distress during intensive care rotations, encouraged to identify their own sources of distress, and supported in mitigating their effects. (shrink)

People’s comfort with and acceptability of artificial intelligence (AI) instantiations is a topic that has received little systematic study. This is surprising given the topic’s relevance to the design, deployment and even regulation of AI systems. To help fill in our knowledge base, we conducted mixed-methods analysis based on a survey of a representative sample of the US population (_N_ = 2254). Results show that there are two distinct social dimensions to comfort with AI: as a peer and as a (...) superior. For both dimensions, general and technological efficacy traits—locus of control, communication apprehension, robot phobia, and perceived technology competence—are strongly associated with acceptance of AI in various roles. Female and older respondents also were less comfortable with the idea of AI agents in various roles. A qualitative analysis of comments collected from respondents complemented our statistical approach. We conclude by exploring the implications of our research for AI acceptability in society. (shrink)

While the French Jesuits were scandalized at God's moral necessity to elect the best, Des Bosses was right in defending the Théodicée drawing the attention to the contemporary Spanish theology. In fact, Optimism is not the invention of Leibniz', but of the two Sevillan Jesuits' Diego Ruiz de Montoya and Diego Granado . It will be argued that Optimism has two roots, both of them closely connected with the Posttridentinian Theology: 1) the moralization of modal categories, 2) a universe integrating (...) Nature, Grace and Incarnation. In the latter regard, Optimism is a legitimate child of Molinism, viz. in respect to the ,scientia media‘ being the basis of its concept of World, to the ,total decree‘ as a certain mode of this world being realized. As a result, the Théodicée depends on Jesuit theology to an extent which still has to be acknowledged. (shrink)

Yoga is believed to have beneficial effects on cognition, attenuation of emotional intensity and stress reduction. Previous studies were mainly performed on eastern experienced practitioners or unhealthy subjects undergoing concomitant conventional therapies. Further investigation is needed on the effects of yoga per se, as well as its possible preventive benefits on healthy subjects. We investigated the effects of yoga on memory and psychophysiological parameters related to stress, comparing yoga practice and conventional physical exercises in healthy men . Memory tests, salivary (...) cortisol levels and stress, anxiety, and depression inventories were assessed before and after 6 months of practice. Yoga practitioners showed improvement of the memory performance, as well as improvements in psychophysiological parameters. The present results suggest that regular yoga practice can improve aspects of cognition and quality of life for healthy individuals. An indirect influence of emotional state on cognitive improvement promoted by yoga practice can be proposed. (shrink)

Recent work by Wan and McLean has shown that all quantum measurements may be reduced to local position measurements. Using an array of particle detectors as the measuring apparatus we show how a model employing superselection rules and unitary evolution leads to a single detector triggering in each act of measurement. We also present an explicit model of particle detection as a unitary ionization process producing a single ion in the detector, subsequent amplification of which to the visible can be (...) described adequately in classical terms. (shrink)

Popper Proposed the criterion of falsifiability as a solution to the problem of demarcation i.e. of distinguishing science from pseudo-science and not, as many of his contemporaries in the Vienna Circle mistook it to be, a solution to the quite different problem with which they themselves were preoccupied, viz. of providing a criterion of meaning to distinguish the meaningful from the meaningless. While the positivists were concerned to damn metaphysics and exalt science, by identifying the empirically verifiable with the meaningful, (...) Popper was concerned to separate science from scientism, to damn astrology and to extol astronomy. In other words his preoccupation belongs not to the philosophy of language but to the philosophy of science. (shrink)