Comparatively little scholarly attention has been given to the question of futility in chronic psychiatric disorders, with the exception of a small body of work on so-called end-stage anorexia nervosa. A review of this literature provides the background for a critical examination of whether the concept of futility has any clinically meaningful, ethically justifiable, and legally defensible application to AN. In this article, the arguments for and against futility judgments in AN are analyzed with special emphasis on determinations of capacity (...) in this serious mental illness. Parallels between the futility disputes in medical and psychiatric disorders, where applicable, will be drawn to further illuminate whether or not the concept that continued psychiatric treatment for AN is ever truly futile. (shrink)

BackgroundStreet-connected children and youth in low- and middle-income countries have multiple vulnerabilities in relation to participation in research. These require additional considerations that are responsive to their needs and the social, cultural, and economic context, while upholding core ethical principles of respect for persons, beneficence, and justice. The objective of this paper is to describe processes and outcomes of adapting ethical guidelines for SCCY’s specific vulnerabilities in LMIC.MethodsAs part of three interrelated research projects in western Kenya, we created procedures to (...) address SCCY’s vulnerabilities related to research participation within the local context. These consisted of identifying ethical considerations and solutions in relation to community engagement, equitable recruitment, informed consent, vulnerability to coercion, and responsibility to report.ResultsSubstantial community engagement provided input on SCCY’s participation in research, recruitment, and consent processes. We designed an assent process to support SCCY to make an informed decision regarding their participation in the research that respected their autonomy and their right to dissent, while safeguarding them in situations where their capacity to make an informed decision was diminished. To address issues related to coercion and access to care, we worked to reduce the unequal power dynamic through street outreach, and provided access to care regardless of research participation.ConclusionsAlthough a vulnerable population, the specific vulnerabilities of SCCY can to some extent be managed using innovative procedures. Engaging SCCY in ethical research is a matter of justice and will assist in reducing inequities and advancing their health and human dignity. (shrink)

BackgroundInformed consent as stipulated in regulatory human research guidelines requires volunteers to be well-informed about what will happen to them in a trial. However, researchers may be faced with the challenge of how to ensure that a volunteer agreeing to take part in a clinical trial is truly informed. This study aimed to find out volunteers’ comprehension of informed consent and voluntary participation in Human Immunodeficiency Virus (HIV) clinical trials during the registration cohort.MethodsWe conducted a qualitative study among volunteers who (...) were enrolled in the registration cohort of HIV clinical trials in Dar es Salaam, Tanzania. A purposive sampling strategy was used to obtain twenty study participants. The data were collected between June and September 2020 using a semi-structured interview guide. In-depth interviews were used to collect the data to obtain deep insights of the individual study participants on the comprehension of informed consent and participation in the clinical trial. A thematic analysis approach was used to analyze the data. Themes and subthemes were supported by the quotes from the participants.ResultsVolunteers described comprehension of informed consent from different perspectives. They reported that various components of the informed consent such as study procedure, confidentiality, risk and benefits were grasped during engagement meetings. Furthermore, the volunteers’ decision to participate in the registration cohort was voluntary. However, trial aspects such as health insurance, free condoms, and medical checkups could have indirectly influenced their reluctance to withdraw from the study.ConclusionEngagement meetings may increase the comprehension of informed consent among potential participants for HIV clinical trials. However, trial incentives may influence participation, and thus future research should focus on the challenges of giving incentives in the study. This will ensure comprehension and voluntary participation in the context of HIV clinical trials. (shrink)

Statistical distributions have great applicability for modeling data in almost every applied sector. Among the available classical distributions, the inverse Weibull distribution has received considerable attention. In the practice of distribution theory, numerous methods have been studied and suggested/introduced to increase the flexibility level of the traditional probability distributions. In this paper, we implement different distribution methods to obtain five new different versions of the inverse Weibull model. The new modifications of the inverse Weibull model are called the logarithm transformed-inverse (...) Weibull, a flexible reduced logarithmic-inverse Weibull, the weighted TX-inverse Weibull, a new generalized-inverse Weibull, and the alpha power transformed extended-inverse Weibull distributions. To illustrate the flexibility and applicability of the new modifications of the inverse Weibull model, a biomedical data set is analyzed. The data set consists of 108 observations and represents the mortality rate of the COVID-19-infected patients. The practical application shows that the new generalized-inverse Weibull is the best modification of the inverse Weibull distribution. (shrink)

Algorithmic biases, or algorithmic unfairness, have been a topic of public and scientific scrutiny for the past years, as increasing evidence suggests the pervasive assimilation of human cognitive biases and stereotypes in such systems. This research is specifically concerned with analyzing the presence of discursive biases in the text generated by GPT-3, an NLPM which has been praised in recent years for resembling human language so closely that it is becoming difficult to differentiate between the human and the algorithm. The (...) pertinence of this research object is substantiated by the identification of race, gender and religious biases in the model’s completions in recent research, suggesting that the model is indeed heavily influenced by human cognitive biases. To this end, this research inquires: How does the Natural Language Processing Model GPT-3 replicate existing social biases?. This question is addressed through the scrutiny of GPT-3’s completions using Critical Discourse Analysis (CDA), a method which has been deemed as amply valuable for this research as it is aimed at uncovering power asymmetries in language. As such, the analysis is specifically centered around the analysis of gender and race biases in the model’s generated text. Research findings suggest that GPT-3’s language generation model significantly exacerbates existing social biases while replicating dangerous ideologies akin to white supremacy and hegemonic masculinity as factual knowledge. (shrink)

Deformation quantisation is applied to ordinary Quantum Mechanics by introducing the star product in a configuration space combining a Riemannian structure with a Poisson one. A Hilbert space compatible with such a configuration space is designed. The dynamics is expressed by a Hermitian Hamiltonian containing a scalar potential and a one-form potential. As a simple illustration, it is shown how a particular type of non-commutativity of the star product is interpretable as generating the Zeeman effect of ordinary Quantum Mechanics.

Classical mechanics is presented so as to render the new formulation valid for an arbitrary temporal variable, as opposed to Newton’s Absolute Time only. Newton’s theory then becomes formally identical (in a precise sense) to relativity, albeit in a three-dimensional manifold. (The ultimate difference between the two dynamics is traced to the existence of the relativistic ‘mass-shell’ condition.) A classical Lagrangian is provided for our formulation of the equations of motion and it is related to one of the known forms (...) of the corresponding relativistic Lagrangian, which is the analogue of the Polyakov Lagrangian of string theory. (shrink)

The starting point of my analysis is the complexity of contemporary society. Complexity here refers more in particular to social complexity: the type of complexity that emerges from the relationships between human beings and the myriad of options and possibilities that exist in our society. A systems theoretical account of complexity elicits that this 'social abundance' necessitates selections. One way of enabling selections, and hence the reduction of complexity, is the formulation of norms. The central thesis of this account follows (...) from this observation: social complexity is a source of normativity, in the sense that social complexity generates – among others – normativity. Dealing with social complexity requires selections and a considerable range of selections, at their turn, require norms. From a somewhat different angle, we could say that social complexity entails both freedom of choice and force of choice. It is this combination of freedom and force that confronts our society with a profound problem. It translates, so to speak, social complexity into uncertainty: how to deal with all these options and possibilities, how to shape our interactions? An important aspect of the problem is the abundance of colliding heteronymous norms and a simultaneous lack of ethical norms that do not compromise our individual autonomy. The analysis of this ethical state of affairs draws upon the work of Zygmunt Bauman. The paper tentatively seeks to outline the social theoretical requirements of an ethic that takes issue with the uncertainty of choice. (shrink)

We study the existence of weak solutions for the coupled system of functional integral equations of Urysohn-Stieltjes type in the reflexive Banach spaceE. As an application, the coupled system of Hammerstien-Stieltjes functional integral equations is also studied.

In lieu of an abstract, here is a brief excerpt of the content:69 WILLIAM ROBERTSON AND DAVID HUME: THREE LETTERS The relationship between David Hume and his fellow Scottish historian William Robertson has always seemed one-sided. Despite the existence of fifteen letters to Robertson in the standard volumes of Hume's correspondence,1 Hume scholars have long had reason to regret the lack of a single extant letter from Robertson to Hume. None are to be found, for example, where one would most (...) expect them to be — in the Royal Society of Edinburgh, alongside the letters to Hume from various other Moderate clergymen and literati in Robertson's circle, such as Hugh Blair and Adam Ferguson. Fortunately, however, two of Robertson's letters to Hume (numbered II and III below) have now turned up where one would not expect them to be — among Robertson's own correspondence in the Robertson2 Macdonald Papers, National Library of Scotland. They are not mere drafts, such as one is accustomed to find among an author's private papers; rather, they are autograph signed letters that appear to have actually been posted. How and when they found their way back to Robertson's personal papers, and what became of the rest of Robertson's letters to Hume, are questions open to speculation. For the moment we are grateful for the letters we now have, neither of which is known to have been published before in whole or in part. Nor has Hume been identified before as the recipient of either of these letters, though internal evidence makes it clear that he was. Both letters date from the late 1760s, when Hume was living in London and Robertson was at the peak of his multi-faceted career in Edinburgh as university principal, parish minister, ecclesiastical leader, and man of letters. The first of them, dated 27 March 1767, was sent to Hume in his capacity as under- 70 secretary of state in the Northern Department (an office he held from February 1767 to January 1768). It is plainly a reply to a letter of 19 March, in which Hume had discussed three topics to which Robertson was 5 responding: Robertson's efforts to secure a military chaplaincy for a certain Scottish minister (evidently named Brodie); Conway's role in the famous dispute between Hume and Rousseau; and the public response to Adam Ferguson's newly published Essay on the History of Civil Society. In addition Robertson addresses a matter that Hume had apparently broached with him at some earlier time: the attempt to find a suitable Scottish church to which Hume might obtain a crown presentation for his nephews' tutor, the Rev. Christopher Tait. The letter concludes on a note of admiration that is characteristic not only of Robertson but of most of Hume's other "Protestant Pastors" in Scotland. The second letter to Hume, dated 31 January 1769, is chiefly concerned with the forthcoming publication of Robertson's History of Charles V and the French translation of it by J.-B.-A. Suard — subjects that had been treated in two letters from Hume to 7 Robertson of autumn 1768. It also contains a strong recommendation for a bright young Scottish writer (in both the legal and literary senses of that term) who would one day become Robertson's most vitriolic critic: Gilbert Stuart. On the personal side, there is encouragement for the now unemployed Hume to return to Edinburgh, as he was then threatening to do, after his "great glut of society" at Paris and London, and there are allusions in the closing paragraph to Hume's part in introducing his friend to polite society when Robertson had visited London to arrange the publication of Charles V in the spring of 1768. 71 To these two letters from Robertson we have prefixed a third from earlier in the same decade, one Q not actually addressed to Hume but largely about him. Robertson wrote it to their common friend Gilbert Elliot (later Sir Gilbert Elliot) on 8 March 1762, two days before the Town Council elected Robertson principal of Edinburgh University. The first paragraph deals with the principalship and relates to Hume only indirectly, as we point out in a footnote. The second paragraph, however, contains interesting... (shrink)

In Chinese scholarship, Xunzi is often regarded as an eclectic Confucian master who accepted some form of utilitarian thoughts (e.g. Fung Yu-lan, Mou Zongsan and Xu Fuguan). This characteristic was also observed by some western scholars such as Benjamin I. Schwartz. In a recent study, I argued that the basic character of Xunzi’s philosophy is utilitarianism in a broad sense based on an examination on his intellectual criticism and political criticism. Xunzi asserts that humans are innately driven by self-interested desires, (...) and he evaluates all intellectual works and political behaviours by their utility. However, he does not limit utility to only basic animal desires such as food and sex. In Xunzi’s view, humans also have innate emotions; hence, these emotions should also be accounted for in their utility. This is similar to John Stuart Mill’s redefinition of Bentham’s concept of utility. Are Xunzi’s and Mill’s concepts of utility exactly the same? This question has yet to be examined. This article is a comparative study between utilitarianism and Xunzi’s philosophy which especially explores the compatibility of these two philosophies. (shrink)

The vast majority of contributions to the literature on spirituality in nursing make extravagant claims about transcendence, eternity, the numinous, higher powers, higher levels of existence, invisible forces, cosmic unity, the essence of humanity, or other supernatural concepts. Typically, these assertions are made without the support of argument or evidence; and, as a consequence, alternative ways of theorizing ‘spirituality’ have been closed off, while the lack of consistent scholarship has turned the topic into a metaphysical backwater. In this paper, I (...) adopt a different premise, rejecting unsupported claims, and surveying the ‘spirituality’ terrain from a naturalistic and reductionist perspective. I argue that, if we rid ourselves of non‐naturalistic assumptions, we will discover theoretical and clinical resources in health psychology, social psychology, neuropsychology, and pharmacopsychology – resources which confirm that it is possible to conceptualize the study of existential concerns, and how health professionals might respond to them, in a properly scientific manner. In order to illustrate the potential usefulness of these resources, I will take palliative care as an example. (shrink)

Introduction : a divided discipline -- A genealogy of agency -- Reforming a paradigm : constructivism to rational constructivism -- A rational constructivist theory of identity and strategy -- Jerusalem : the unsubstitutable core value -- Jihad for Jerusalem : Israel the tiger 1967-1997 -- Jihad for Jerusalem : Iran the cub 1967-1997 -- Jihad for Jerusalem : Saudi Arabia the paper tiger 1967-1997 -- Jihad for Jerusalem : Jordan the mouse 1967-1997 -- Conclusion : the future of Jerusalem.

Purpose. The purpose of this paper is to study the behaviour of women in extreme conditions, to establish various social roles of women, ways of their adaptation to extreme conditions on the example of Ukrainian anti-Nazi underground during Second World War. Theoretical basis. The authors derive from the fact that historical anhropology is a leading and promising area of historical research. Originality. For the first time, the authors have shown that in conditions of constant stress state and direct threat to (...) life and health, the behaviour of underground women was determined by adequate survival strategies, i.e. by the life circumstances and personal qualities of the underground members. Conclusions. Permanent existence on the verge of life and death often led women to emotional actions, deviant forms of behaviour. Their actions could be controversial, and the motives – confusing. At the same time, the majority of women left in the Soviet underground chose as a strategy of survival the path of confrontation with occupiers, held true to their choices, often showed courage, ingenuity and self-sacrifice. (shrink)

In the present essay we attempt to reconstruct Newtonian mechanics under the guidance of logical principles and of a constructive approach related to the genetic epistemology of Piaget and García. Instead of addressing Newton’s equations as a set of axioms, ultimately given by the revelation of a prodigious mind, we search for the fundamental knowledge, beliefs and provisional assumptions that can produce classical mechanics. We start by developing our main tool: the no arbitrariness principle, that we present in a form (...) that is apt for a mathematical theory as classical mechanics. Subsequently, we introduce the presence of the observer, analysing then the relation objective–subjective and seeking objectivity going across subjectivity. We take special care of establishing the precedence among all contributions to mechanics, something that can be better appreciated by considering the consequences of removing them: the consequence of renouncing logic and the laws of understanding is not being able to understand the world, renouncing the early elaborations of primary concepts such as time and space leads to a dissociation between everyday life and physics, the latter becoming entirely pragmatic and justified a-posteriori, changing our temporary beliefs has no real cost other than effort. Finally, we exemplify the present approach by reconsidering the constancy of the velocity of light. It is shown that it is a result of Newtonian mechanics, rather than being in contradiction with it. We also indicate the hidden assumption that leads to the contradiction. (shrink)

Open peer commentary on the article “Constructivist Model Building: Empirical Examples From Mathematics Education” by Catherine Ulrich, Erik S. Tillema, Amy J. Hackenberg & Anderson Norton. Upshot: I comment on the nature and exemplification of second-order models in Ulrich et. al. I discuss what I see as the theoretical gap between second-order models and mathematics pedagogy. Finally, I share work we are doing to contribute towards filling that theoretical gap.