Significant scientific and technological advances in intensive care have been made. However, patients in the intensive care unit may experience discomfort, loss of control, and surreal experiences. This has generated relevant debates about how to humanize the intensive care units and whether humanization is necessary at all. This paper aimed to explore how humanizing intensive care is described in the literature. A scoping review was performed. Studies published between 01.01.1999 and 02.03.2020 were identified in the CINAHL, Embase, PubMed, and Scopus (...) databases. After removing 185 duplicates, 363 papers were screened by title and abstract. Full-text screening of 116 papers led to the inclusion of 68 papers in the review based on the inclusion criteria; these papers mentioned humanizing or dehumanizing intensive care in the title or abstract. Humanizing care was defined as holistic care, as a general attitude of professionals toward patients and relatives and an organizational ideal encompassing all subjects of the healthcare system. Technology was considered an integral component of intensive care that must be balanced with caring for the patient as a whole and autonomous person. This holistic view of patients and relatives could ameliorate the negative effects of technology. There were geographical differences and the large number of studies from Spain and Brazil reflect the growing interest in humanizing intensive care in these particular countries. In conclusion, a more holistic approach with a greater emphasis on the individual patient, relatives, and social context is the foundation for humanizing intensive care, as reflected in the attitudes of nurses and other healthcare professionals. Demands for mastering technology may dominate nurses’ attention toward patients and relatives; therefore, humanized intensive care requires a holistic attitude from health professionals and organizations toward patients and relatives. Healthcare organizations, society, and regulatory frameworks demanding humanized intensive care may enforce humanized intensive care. (shrink)

Fueled by ever-growing amounts of (digital) data and advances in artificial intelligence, decision-making in contemporary societies is increasingly delegated to automated processes. Drawing from social science theories and from the emerging body of research about algorithmic appreciation and algorithmic perceptions, the current study explores the extent to which personal characteristics can be linked to perceptions of automated decision-making by AI, and the boundary conditions of these perceptions, namely the extent to which such perceptions differ across media, (public) health, and judicial (...) contexts. Data from a scenario-based survey experiment with a national sample (N = 958) show that people are by and large concerned about risks and have mixed opinions about fairness and usefulness of automated decision-making at a societal level, with general attitudes influenced by individual characteristics. Interestingly, decisions taken automatically by AI were often evaluated on par or even better than human experts for specific decisions. Theoretical and societal implications about these findings are discussed. (shrink)

Children, because of age-related reasons, are a vulnerable population, and protecting their health is a social, scientific and emotional priority. The increased susceptibility of children and fetuses to environmental agents has been widely discussed by the scientific community. Children may experience different levels of chemical exposure than adults, and their sensitivity to chemical toxicities may be increased or decreased in comparison with adults. Such considerations also apply to unborn and newborn children. Therefore, research on children is necessary in both clinical (...) and environmental fields, to provide age-specific relevant data regarding the efficacy and safety of medical treatments, and regarding the assessment of risk from unintended environmental exposure. In this context, the stakeholders are many, including children and their parents, physicians and public health researchers, and the society as a whole, with its ethical, regulatory, administrative and political components. The important ethical issues are information of participants and consent to participate. Follow-up and protection of data should be discussed in the context of biobanks, where children obtain individual rights when they become adults. It is important to realise that there are highly variable practices within European countries, which may have, in the past, led to differences in practical aspects of research in children. A number of recommendations are provided for research with children and environmental health. Environmental research with children should be scientifically justified, with sound research questions and valid study protocols of sufficient statistical power, ensuring the autonomy of the child and his/her family at the time of the study and later in life, if data and samples are used for follow-up studies. When children are enrolled, we recommend a consent dyad, including parental informed consent and the child’s assent and/or informed consent from older minors. For evaluation of the studies including children, a paediatrician should always be involved in the research ethics committee. (shrink)

Children, because of age-related reasons, are a vulnerable population, and protecting their health is a social, scientific and emotional priority. The increased susceptibility of children and fetuses to environmental agents has been widely discussed by the scientific community. Children may experience different levels of chemical exposure than adults, and their sensitivity to chemical toxicities may be increased or decreased in comparison with adults. Such considerations also apply to unborn and newborn children. Therefore, research on children is necessary in both clinical (...) and environmental fields, to provide age-specific relevant data regarding the efficacy and safety of medical treatments, and regarding the assessment of risk from unintended environmental exposure. In this context, the stakeholders are many, including children and their parents, physicians and public health researchers, and the society as a whole, with its ethical, regulatory, administrative and political components. The important ethical issues are information of participants and consent to participate. Follow-up and protection of data should be discussed in the context of biobanks, where children obtain individual rights when they become adults. It is important to realise that there are highly variable practices within European countries, which may have, in the past, led to differences in practical aspects of research in children. A number of recommendations are provided for research with children and environmental health. Environmental research with children should be scientifically justified, with sound research questions and valid study protocols of sufficient statistical power, ensuring the autonomy of the child and his/her family at the time of the study and later in life, if data and samples are used for follow-up studies. When children are enrolled, we recommend a consent dyad, including parental informed consent and the child’s assent and/or informed consent from older minors. For evaluation of the studies including children, a paediatrician should always be involved in the research ethics committee. (shrink)

About one third of patients with epilepsy have seizures refractory to the medical treatment. Electrical stimulation mapping is the gold standard for the identification of “eloquent” areas prior to resection of epileptogenic tissue. However, it is time-consuming and may cause undesired side effects. Broadband gamma activity recorded with extraoperative electrocorticography during cognitive tasks may be an alternative to ESM but until now has not proven of definitive clinical value. Considering their role in cognition, the alpha and beta bands could further (...) improve the identification of eloquent cortex. We compared gamma, alpha and beta activity, and their combinations for the identification of eloquent cortical areas defined by ESM. Ten patients with intractable focal epilepsy participated in a delayed-match-to-sample task, where syllable sounds were compared to visually presented letters. We used a generalized linear model approach to find the optimal weighting of each band for predicting ESM-defined categories and estimated the diagnostic ability by calculating the area under the receiver operating characteristic curve. Gamma activity increased more in eloquent than in non-eloquent areas, whereas alpha and beta power decreased more in eloquent areas. Diagnostic ability of each band was close to 0.7 for all bands but depended on multiple factors including the time period of the cognitive task, the location of the electrodes and the patient’s degree of attention to the stimulus. We show that diagnostic ability can be increased by 3–5% by combining gamma and alpha and by 7.5–11% when gamma and beta were combined. We then show how ECoG power modulation from cognitive testing can be used to map the probability of eloquence in individual patients and how this probability map can be used in clinical settings to optimize ESM planning. We conclude that the combination of gamma and beta power modulation during cognitive testing can contribute to the identification of eloquent areas prior to ESM in patients with refractory focal epilepsy. (shrink)

Background: Electroconvulsive therapy is one of the most effective treatments for major depressive disorder. Recently, there has been increasing attention to evaluate the effect of ECT on resting-state functional magnetic resonance imaging. This study aims to compare rs-fMRI of depressive disorder patients with healthy participants, investigate whether pre-ECT dynamic functional network connectivity network estimated from patients rs-fMRI is associated with an eventual ECT outcome, and explore the effect of ECT on brain network states.Method: Resting-state functional magnetic resonance imaging data were (...) collected from 119 patients with depression or depressive disorder, and 61 healthy participants, with an age mean of 52.25 years old. The pre-ECT and post-ECT Hamilton Depression Rating Scale were 25.59 ± 6.14 and 11.48 ± 9.07, respectively. Twenty-four independent components from default mode and cognitive control network were extracted, using group-independent component analysis from pre-ECT and post-ECT rs-fMRI. Then, the sliding window approach was used to estimate the pre-and post-ECT dFNC of each subject. Next, k-means clustering was separately applied to pre-ECT dFNC and post-ECT dFNC to assess three distinct states from each participant. We calculated the amount of time each subject spends in each state, which is called “occupancy rate” or OCR. Next, we compared OCR values between HC and DEP participants. We also calculated the partial correlation between pre-ECT OCRs and HDRS change while controlling for age, gender, and site. Finally, we evaluated the effectiveness of ECT by comparing pre- and post-ECT OCR of DEP and HC participants.Results: The main findings include depressive disorder patients had significantly lower OCR values than the HC group in state 2, where connectivity between cognitive control network and default mode network was relatively higher than other states, Pre-ECT OCR of state, with more negative connectivity between CCN and DMN components, is linked with the HDRS changes. This means that those DEP patients who spent less time in this state showed more HDRS change, and The post-ECT OCR analysis suggested that ECT increased the amount of time DEP patients spent in state 2.Conclusion: Our finding suggests that dynamic functional network connectivity features, estimated from CCN and DMN, show promise as a predictive biomarker of the ECT outcome of DEP patients. Also, this study identifies a possible underlying mechanism associated with the ECT effect on DEP patients. (shrink)

Dealing with soldier enhancement can be challenging for military physicians. As research on the ethics of soldier enhancement is mostly theoretical, this study aims to gain insights into the actual moral issues military physicians encounter, or expect to encounter. To that end, we carried out a qualitative study involving six focus groups of Dutch military physicians (n = 28) in operational roles. The participants voiced their concerns about moral issues concerning soldier enhancement. Based on the group discussions, and using inductive (...) thematic analysis, we ascertained three major themes: (1) Doing no harm in soldier enhancement: uncertainty and high stakes; (2) Dependency relationships and conflicting moral responsibilities; and (3) The risk of ethical slippery slopes. Our findings illustrate that dealing with these moral responsibilities requires considerable skill and acuity to weigh up for all the situated complexities and dependency relationships that go beyond abstract rules or moral principles. A care-ethical approach that acknowledges the contextual and relational aspects of moral complexities along with peer consultation and joint reflective dialogue on moral issues can help military physicians deal with soldier enhancement responsibly. (shrink)

This article shows how the legacy of Hans Christian Ørsted (1777-1851), and his discovery of electromagnetism in 1820, was reconfigured and used by the H.C. english abstracts Ørsted Committee from 1914 before and during the centenary of 1920. Combining Somsen’s (2008) concept of olympic internationalism with uses of the past, I suggest understanding the 1920-centenary as an instance of olympic commemoration [olympisk historiebrug]. I argue that central actors from the committee, e.g. Martin Knudsen (1871-1949) and Kirstine Meyer, née Bjerrum (...) (1861-1941), used Ørsted's nationality to substantiate Denmark’s cultural and scientific achievements. By comparison to pre-twentieth century biographies, I show how the committee re-described Ørsted, i.e. from a scientist [Naturforsker] to being a Danish scientist [dansk Naturforsker]. The committee was deeply concerned with proving the big contributions by the small nation of Denmark, and I show how this relates to cultural politics of the early twentieth century Denmark. (shrink)

Scholars have long been captivated by the parallels between birdsong and human speech and language. In this book, leading scholars draw on the latest research to explore what birdsong can tell us about the biology of human speech and language and the consequences for evolutionary biology. They examine the cognitive and neural similarities between birdsong learning and speech and language acquisition, considering vocal imitation, auditory learning, an early vocalization phase, the structural properties of birdsong and human language, and the striking (...) similarities between the neural organization of learning and vocal production in birdsong and human speech. After outlining the basic issues involved in the study of both language and evolution, the contributors compare birdsong and language in terms of acquisition, recursion, and core structural properties, and then examine the neurobiology of song and speech, genomic factors, and the emergence and evolution of language. Contributors: Hermann Ackermann, Gabriël J.L. Beckers, Robert C. Berwick, Johan J. Bolhuis, Noam Chomsky, Frank Eisner, Martin Everaert, Michale S. Fee, Olga Fehér, Simon E. Fisher, W. Tecumseh Fitch, Jonathan B. Fritz, Sharon M.H. Gobes, Riny Huijbregts, Eric Jarvis, Robert Lachlan, Ann Law, Michael A. Long, Gary F. Marcus, Carolyn McGettigan, Daniel Mietchen, Richard Mooney, Sanne Moorman, Kazuo Okanoya, Christophe Pallier, Irene M. Pepperberg, Jonathan F. Prather, Franck Ramus, Eric Reuland, Constance Scharff, Sophie K. Scott, Neil Smith, Ofer Tchernichovski, Carel ten Cate, Christopher K. Thompson, Frank Wijnen, Moira Yip, Wolfram Ziegler, Willem Zuidema. (shrink)

In 'Een handvol filosofen' staan de filosofen centraal die sinds de oprichting van de Vrije Universiteit in 1880 aan deze instelling verbonden zijn geweest. Het gaat hierbij niet alleen om de inhoud van hun werk, maar ook om de personen zelf. Er waren filosofiedocenten die zich met de universiteit identificeerden en zich volledig konden ontplooien. Er waren er echter ook voor wie dit niet gold, die geïsoleerd of in gewetensnood raakten. Veel filosofiestudenten waren actief betrokken bij wat er in hun (...) faculteit gebeurde. Zij namen initiatieven, protesteerden soms tegen de gang van zaken en kozen partij in conflictsituaties. Sinds het eind van de jaren zestig van de twintigste eeuw verloor de Vrije Universiteit geleidelijk haar christelijk karakter. Tegenwoordig werken alle stafleden vanuit hun eigen motivatie mee aan een hoofdzakelijk seculier geworden universiteit, die ruimte biedt voor religieuze en levensbeschouwelijke diversiteit. (shrink)

A promise to do some action seems to create a binding obligation to do that action. And yet, paradoxically, an obligation seems not to be a fact that we can create or bring into existence; we can create an obligation only by creating or bringing into existence something else. The only way to avoid the paradox is to show that the act of promising creates something other than an obligation, which nonetheless binds us to perform the action in question. After (...) considering and rejecting various options such as the promisee's expectation and the promisor's resolve, Prichard locates the bindingness of a promise in a prior general promise, which allows the noises we make when promising to generate an obligation to perform the promised action. (shrink)

Currently, there is widespread skepticism that higher cognitive processes, given their apparent flexibility and globality, could be carried out by specialized computational devices, or modules. This skepticism is largely due to Fodor's influential definition of modularity. From the rather flexible catalogue of possible modular features that Fodor originally proposed has emerged a widely held notion of modules as rigid, informationally encapsulated devices that accept highly local inputs and whose operations are insensitive to context. It is a mistake, however, to equate (...) such features with computational devices in general and therefore to assume, as Fodor does, that higher cognitive processes must be non‐computational. Of the many possible non‐Fodorean architectures, one is explored here that offers possible solutions to computational problems faced by conventional modular systems: an ‘enzymatic’ architecture. Enzymes are computational devices that use lock‐and‐key template matching to identify relevant information (substrates), which is then operated upon and returned to a common pool for possible processing by other devices. Highly specialized enzymes can operate together in a common pool of information that is not pre‐sorted by information type. Moreover, enzymes can use molecular ‘tags’ to regulate the operations of other devices and to change how particular substrates are construed and operated upon, allowing for highly interactive, context‐specific processing. This model shows how specialized, modular processing can occur in an open system, and suggests that skepticism about modularity may largely be due to failure to consider alternatives to the standard model. (shrink)

Dion is a human person, Lefty is his left foot, and Theon is Lefty-Complement, a proper part of Dion. Lefty is annihilated and Dion survives left-footless. After Lefty’s annihilation Theon, if he survives, occupies the same region as Dion. I suggest that this scenario be understood as a fusion case in which Dion and Theon, initially overlapping but distinct, are identical after Lefty’s annihilation and propose an account of proper names that allows us to say that Dion and Theon have (...) ‘become identical’ without commitment to occasional identity or other controversial metaphysical doctrines. The proposed solution employs the semantics developed by Wolfgang Schwarz to address the ‘paradox of occasional identity’, posed by puzzle cases of fission, to deal with the problem of Dion and Theon, a body-minus puzzle. (shrink)

I bogen "Den store humor" undersøger Harald Høffding humoren som livsanskuelse. "Den store humor" er ifølge Høffding en etisk livsholdning, som et menneske kan leve sit liv efter. Inspireret af filosoffen Søren Kierkegaards stadieteori karakteriserer Harald Høffding humoren som et etisk standpunkt, der nægter at anerkende den kristnes tragiske syn på livet. I stedet formår humoristen, at balancere livets lyse og skyggefulde sider. Humoristen lever sit liv med åbne øjne og har derfor blik for såvel verdens komik som tragik. Harald (...) Høffding (1843-1931) var teolog og filosof og virkede gennem 30 år som professor ved Københavns Universitet. I løbet af sin karriere opnåede han en central position i det danske videns- og kulturliv og nød stor anerkendelse både i og udenfor Danmark. Høffding var yderst virksom hele sit liv, og tankegodset i hans bøger er stadig relevant i dag. Udover værkerne om etik, filosofihistorie og psykologi kendes han for monografier om Søren Kierkegaard, Jean-Jacques Rousseau og Baruch Spinoza. (shrink)

The paper proposes to integrate literary studies in consciousness research to develop a strong ethical and existential dimension in the field. More specifically, it considers the value of fictional narrative for developing concepts of selfhood and personal identity that cohere with the reductionist explanations of human consciousness and self in modern empirical consciousness research. My central claim is that looking to the literary representations of human consciousness and existence that reject or are free from conventional essentialist ideas of self, agency, (...) and anthropocentrism can help 'normalize' the reductionist scientific descriptions of humans and reduce their psychologically and socio-culturally disruptive impact. The paper uses Virginia Woolf's The Waves as an example, showing how the novel's non-anthropocentric and non-essentialist conceptions of self and consciousness overlap with materialist theories in neuroscience and -philosophy but present these in a distinctive narrative framework and poetic terms that bring out the inherent emancipatory potential of the materialist explanation of human existence and offer the reader the possibility of relating to these experientially and emotionally. (shrink)

Many people are worried about the harmful effects of climate change but nevertheless enjoy some activities that contribute to the emission of greenhouse gas (driving, flying, eating meat, etc.), the main cause of climate change. How should such people make choices between engaging in and refraining from enjoyable greenhouse-gas-emitting activities? In this chapter, we look at the answer provided by decision theory. Some scholars think that the right answer is given by interactive decision theory, or game theory; and moreover think (...) that since private climate decisions are instances of the prisoner’s dilemma, one rationally should engage in these activities provided that one enjoys them. Others think that the right answer is given by expected utility theory, the best-known version of individual decision theory under risk and uncertainty. In this chapter, we review these different answers, with a special focus on the latter answer and the debate it has generated. (shrink)

The impact of digital media and technology on performance arts is evident when digital visual effects (VFX) filming techniques are introduced on a film set. Digital technologies influence the film actor’s approach to be congruent to and authentic within the circumstances of the scene. Actors require an effective skillset and strategies to successfully deliver an embodied performance aligning with the various digital VFX techniques. Focusing on imagination, action and emotion that would facilitate such an embodied performance, we drew on relevant (...) neuroscientific notions such as neuron reactivation, conceptual blending, as-if body states and affordances. Additionally, we incorporated relevant embodied performance concepts from Stanislavski, Laban/Bartenieff Movement Studies, Effector Patterns including the Emotional Body Approach and Lessac Kinesensics to the development of a digital acting programme, advancing the actor’s required skills and providing on-set digital acting strategies to support congruency with digital VFX and authenticity within the diegetic reality. The efficacy of this programme was determined by assessing pre- and post-intervention recordings of both a control and an experimental group of trained actors. Reflection-on-action journals from participants supplemented the assessment. The assessments and journals indicate that the acquired skillset and on-set digital acting strategies effectively improve the actor’s performance with digital VFX filming technology. (shrink)

Classical treatise on the fundamentals of Nyaya philosophy with commentaries; critical edition.

This is a reproduction of the original artefact. Generally these books are created from careful scans of the original. This allows us to preserve the book accurately and present it in the way the author intended. Since the original versions are generally quite old, there may occasionally be certain imperfections within these reproductions. We're happy to make these classics available again for future generations to enjoy!

This is the first sustained, whole-Bible treatment on the theme of meeting God face to face. Starting with Genesis and ending with Revelation, the author systematically covers the major events in salvation history, all of which reveal the beauty of encountering God's grace in abundance.

In this book, Phillip Wiebe examines religious, spiritual, and mystical experiences, assessing how these experiences appear to implicate a spiritual order. Despite the current prevalence of naturalism and atheism, he argues that experiences purporting to have a religious or spiritual significance deserve close empirical investigation. Wiebe surveys the broad scope of religious experience and considers different types of evidence that might give rise to a belief in phenomena such as spirits, paranormal events, God, and an afterlife. He demonstrates that there (...) are different explanations and interpretations of religious experiences, both because they are typically personal accounts, and they suggest a reality that is often unobservable. Wiebe also addresses how to evaluate evidence for theories that postulate unobservables in general, and a Theory of Spirits in particular. Calling for more rigorous investigation of these phenomena, Wiebe frames the study of religious experience among other accepted social sciences that seek to understand religion. (shrink)