This study investigated the perceptions and attitudes of ICU nurses towards the ‘do not resuscitate’ (DNR) decision and changes in their nursing activities after implementation of the DNR decision in South Korea. A data survey was conducted in South Korea between August and October 2008, with a convenience sample of 252 ICU nurses who had more than one year of clinical experience. The data were collected via a self-administered questionnaire. Most of the nurses perceived the necessity of the DNR decision (...) in cases where there would be no chance of patient recovery despite massive efforts. Very few of the nurses' activities changed, either passively or actively, after implementation of the DNR decision. Moreover, the findings of this research provide suggestions for the future direction of the DNR decision and ethical nursing guidelines in South Korea. Further investigations are needed for the development of decision-making skills and intervention guidelines for end-of-life nursing. (shrink)

The establishment of distinct cellular identities was pivotal during the evolution of Metazoa, enabling the emergence of an array of specialized tissues with different functions. In most animals including vertebrates, cell specialization occurs in response to a combination of intrinsic (e.g., cellular ontogeny) and extrinsic (e.g., local environment) factors that drive the acquisition of unique characteristics at the single‐cell level. The first functional organ system to form in vertebrates is the cardiovascular system, which is lined by a network of endothelial (...) cells whose organ‐specific characteristics have long been recognized. Recent genetic analyses at the single‐cell level have revealed that heterogeneity exists not only at the organ level but also between neighboring endothelial cells. Thus, how endothelial heterogeneity is established has become a key question in vascular biology. Drawing upon evidence from multiple organ systems, here we will discuss the role that lineage history may play in establishing endothelial heterogeneity. (shrink)

The acknowledgement of basic human vulnerability in relationships between mental health service users and professionals working in community-based mental health services (in Norway) was a starting point. The purpose was to explore how users of these services describe and make sense of their meetings with other people. The research is collaborative, with researcher and person with experienced-based knowledge cooperating through the research process. Data is derived from 19 interviews with 11 people who depend on mental health services for assistance at (...) least three times a week. Data is analysed according to the Interpretative Phenomenological Analysis (IPA). Results confirm that reciprocity is fundamental for relationships, and that recognizing the individual entails personal involvement. The participants describe a struggle, and recognizing this struggle may help the professional to achieve a deeper understanding of the individual. (shrink)

Background Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat mental disorders and may raise different ethical concerns than other therapies such as medications or talk therapy. Yet little is known about stakeholders’ perceptions of, and ethical concerns related to, these interventions. We aimed to better understand the ethical concerns of a variety of stakeholder groups (patients with depression, caregivers of patients, members of the public, and psychiatrists) regarding four PEIs: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), (...) deep brain stimulation (DBS), and adaptive brain implants (ABI).Methods We conducted a national survey of these four stakeholder groups, using an embedded video vignette experiment depicting a patient with treatment-resistant depression and her psychiatrist discussing the possibility of treatment with one of the four PEIs.Results Participants’ ethical concerns varied by stakeholder group, by PEI, and by the interaction of the two. The three non-clinician groups tended to have similar ethical concerns, but to differ from psychiatrists. Similar concerns were raised with regard to the two implantable technologies, DBS and ABI. Overall, there was relatively little concern about the involuntary use of PEIs, though some expressed concern about the adequacy of information provided during the consent process. There was also significant concern that patients may not receive helpful therapies.Conclusions To our knowledge, this is the first national survey that includes multiple stakeholder groups and multiple PEI modalities. A better understanding of the ethical concerns of stakeholders can help to shape clinical practice and health care policy regarding PEIs. (shrink)

Shoemaker (1996) presenteda prioriarguments against the possibility of ‘self‐blindness’, or the inability of someone, otherwise intelligent and possessed of mental concepts, to introspect any of her concurrent attitude states. Ironically enough, this seems to be a position that Gopnik (1993) and Carruthers (2006, 2008, 2009a,b) have proposed as not only possible, but as the actual human condition generally! According to this ‘Objectivist’ view, supposed introspection of one's attitudes is not ‘direct’, but an ‘inference’ of precisely the sort we make about (...) the attitudes of others, an inference that has the advantage in our own case ofonlyour own sensory data and memories, our behavior, and of the context we are in; i.e. we are all substantially self‐ blind. After sorting out a number of methodological and verbal issues, I argue, first, that thea prioriarguments against Objectivism don't succeed, and that Gopnik and Carruthers are right to regard the issue as an empirical one. On the other hand, I think they seriously underestimate the difficulty of establishing Objectivism. It is unlikely there is an inferential procedure from the data of pure sensation, behavior and context to the relevant self‐attributions that would be as spectacularly reliable as people manifestly seem to be. Moreover, there is a simpler model: the mind very likely consists of a panoply of sub‐routines some of whose outputs are ‘tagged’ for their having been so processed, rather in the way that software ‘documents’ are on standard computers. Introspection plausibly consists in a person's simply attending to distinctive constellations of these tags, even though they may lack phenomenal feels. This draws attention to an important independent fact: that much of phenomenology (or ‘what it's like’ to be in a certain state) may be constituted by facts that are not phenomenal. (shrink)

This work is primarily an interpretation of Indian Logic preserved in China.

Appearing in the “Cairo Declaration on Human Rights in Islam” as an undefined referent for the limits on freedom of expression in Islam, Shariah is still to be chased as an indefinable referent which restricts freedom of the expression in the Islamic Republic of Iran. Iran’s Press Law as well as Constitution unveil Shariah’s referent to be a person: the Jurist-Ruler around whom a cult of personality is legalized in terms of “Imamate” and around whom all the limits on freedom (...) of expression revolve. Interpretation of Shariah is not a solution but part of the problem in Iran. Such problem can be dealt in terms of three modes of self-expression which were invented by the Iranian Reformists to avoid self-censorship. The notion of master-signifier can be the key to unraveling the problem of self-referentiality in freedom of expression and its Reformist solution in Iran’s legal system. (shrink)

Live donor kidney transplantation is the best treatment option for most patients with late-stage chronic kidney disease; however, the rate of living kidney donation has declined in the United States. A consensus conference was held June 5-6, 2014 to identify best practices and knowledge gaps pertaining to live donor kidney transplantation and living kidney donation. Transplant professionals, patients, and other key stakeholders discussed processes for educating transplant candidates and potential living donors about living kidney donation; efficiencies in the living donor (...) evaluation process; disparities in living donation; and financial and systemic barriers to living donation. We summarize the consensus recommendations for best practices in these educational and clinical domains, future research priorities, and possible public policy initiatives to remove barriers to living kidney donation. (shrink)

As previous pandemics, the coronavirus disease 2019 (COVID-19) has direct and indirect effects on mental health and well-being. The purpose of the current study was to examine whether meaning in life mediated the association between coronavirus suffering and satisfaction with life and whether stress-related growth moderated the mediating effect of meaning in life on the association between these variables. Stress-Related Growth Measure (SGM) was also conducted for the purpose of this study. The participants were 402 (66% women) young adults who (...) completed the Suffering Measure During COVID-19, Meaningful Living Measure, Satisfaction With Life Scale, and SGM. The results indicated that the SGM has adequate psychometric properties with unidimensional structure of stress-related growth in the face of adversity. Moderated mediation analysis revealed that coronavirus suffering directly influenced satisfaction with life as well as indirectly by its effect on meaning in life. Additionally, stress-related growth was found as a moderator in the relationship between coronavirus suffering–meaning in life and coronavirus suffering–satisfaction with life. These results suggest that meaning in life mitigates the effect of coronavirus suffering on satisfaction with life, and this mediating effect is moderated by stress-related growth in young adults. While meaning in life helps explain the relationship between coronavirus suffering and satisfaction with life, the stress-related growth functions as a protective factor against the adverse effect of coronavirus experiences. (shrink)

The dynamical equations of relativistic quantum mechanics prescribe the motion of wave packets for sets of events which trace out the world lines of the interacting particles. Electromagnetic theory suggests thatparticle world line densities be constructed from concatenation of event wave packets. These sequences are realized in terms of conserved probability currents. We show that these conserved currents provide a consistent particle and antiparticle interpretation for the asymptotic states in scattering processes. The relation between current conservation and unitarity is used (...) to establish relations between pair production and annihilation amplitudes and scattering. The discrete symmetriesC, T, P are studied and it is shown that no Dirac sea (for fermions where such a construction is possible, or bosons where it is not) is required for consistency of the theory. These currents, furthermore, represent the discrete symmetries in a way consistent with their interpretation as particle currents. (shrink)

We construct a nonlow2 r.e. degree d such that every positive extension of embeddings property that holds below every low2 degree holds below d. Indeed, we can also guarantee the converse so that there is a low r.e. degree c such that that the extension of embeddings properties true below c are exactly the ones true belowd.Moreover, we can also guarantee that no b ≤ d is the base of a nonsplitting pair.

Traditionally, the consequences of employees' behavior (teleology) and the norms attributed to the behavior (deontology) have been two familiar determinants of ethical decision making (EDM). More recently, emotions have also gained considerable attention for their ability to affect EDM. Marketing ethics literature overlooks how emotions are related with norms and consequences. Hence, this study investigates how normative, consequentialist, and emotional factors interactively influence EDM in a sales ethics context. Using scenarios with a 2 × 2 between-groups factorial design, we collected (...) data online from 303 sales professionals. Then we used independent samples t tests and hierarchical regression models to analyze the hypothesized relationships. Results indicate that violation of and obedience to deontological norms stimulate negative and positive anticipated emotions, respectively, leading to stronger EDM. However, to a lesser extent, when violation of and obedience to deontological norms do not stimulate anticipated emotions, those emotions lead to weaker EDM. Moreover, consequences do not stimulate any anticipated emotions. Instead, consequences moderate the relationship between anticipated emotions and EDM. In addition, deontological and teleological evaluations mediate the relationship between anticipated emotions and EDM. These findings highlight the importance of considering the interplay between normative, consequentialist, and emotional factors in the formation of ethical judgments and intentions. The article discusses the implications of these results for sales professionals and organizations and suggests future research directions. (shrink)

Recently implemented Chinese health insurance schemes have failed to achieve a Chinese health care system that is family-oriented, family-based, family-friendly, or even financially sustainable. With this diagnosis in hand, the authors argue that a financially and morally sustainable Chinese health care system should have as its core family health savings accounts supplemented by appropriate health insurance plans. This essay’s arguments are set in the context of Confucian moral commitments that still shape the background culture of contemporary China.

Tüm dünyayı etkisi altına alan koronavirüs pandemisinin siyasi tutumlarla ilişkisini öğrenmek ve siyasetin kriz durumlarında halkın tutum ve davranışlarını yönlendirip yönlendirmediğini öğrenmek amacıyla 767 kişiyle çevrimiçi anket yapılmıştır. Yapılan nicel araştırma sonucunda, alınan önleyici tedbirlere uymanın, bu tedbirlerin yerinde oluşuna/haklılığına olan tutumun, aşı olma niyetinin ve aşının koruyuculuğuna olan inancın siyasi görüşlere göre farklılaştığı bulunmuştur. Ayrıca katılımcıların yapılan Covid-19 açıklamaları bakımından siyasi partilerine, parti temsilcilerinden daha çok güvendikleri, alınan önlem ve tedbirleri kısmen yerinde/haklı buldukları ve çok büyük çoğunluğun bu önlemlere (...) uyduğu görülmüştür. Araştırma sonucunda virüsün kökenine yönelik inançlar bakımından virüsün gerçek olduğuna inanıldığı, ortaya çıkış nedeni bakımından ise ülkelerin ekonomilerini kötüleştirmek ve dünya nüfusunu azaltmak için ortaya çıktığına inanıldığı görülmüştür. Araştırmadan çıkan bir başka sonuç ise katılımcıların televizyon, dergi ve gazetelerin ideolojik nedenlerle ve siyasi yanlılıklarına bağlı olarak virüs haberlerini halka farklı yansıttığını düşündükleridir. Sosyal medyadaki haberlerin ise yanıltıcı, yanlış olduğu görüşündelerdir. Bu çalışma sonucunda salgın hastalık, afet, savaş, ekonomik krizler gibi olağanüstü durumlarda siyasetin, siyasi görüşlerin dikkate alınmasının hem krizin üstesinden gelmede hem de toplumun tüm üyelerini kapsamada önemli bir rol oynayacağı vurgulanmaktadır. (shrink)

Since the publication of J. A. Hobson’s (1858–1940) Imperialism: A Study in 1902, the text has been studied—even celebrated—as a liberal or proto-Marxist critique of modern empires. This reputation stands in some tension with the text itself, which defends various forms of imperial domination. While scholars have addressed this tension, they remain divided over how best to understand Hobson’s imperial commitments. Offering a new response to this debate, I argue that a key dimension of Imperialism has been overlooked—namely, Hobson’s conception (...) of humanity as stratified into a hierarchy of racial “souls.” This deeply committed view of human difference undergirded Hobson’s arguments about the moral and practical limits of Western imperial power. This article shows how Hobson articulated imperialism as the “parasitic” rule of whites over the nonwhite world—the solution to which was not the rejection of empire but the reform of white imperial power in accordance with his normative vision of global racial hierarchy. This recovery reveals the redemptive critique at the core of Imperialism and enables us to more readily grasp the text as a form of imperial apologetics. The article concludes with the suggestion that Hobson is better understood not as a liberal- or socialist-imperialist but as a proponent of racial capitalism on a global scale. (shrink)

Geçmişten günümüze Yahudi mistisizmi, Sabetay Sevi ve Sabetaycılık ile ilgili birçok eser yazılmıştır. Bu eserler arasında en fazla dikkat çeken, Kabala’yı akademik alanda çalışılan ve bilimsel metotlarla incelenen bir konu haline getiren Gershom Scholem’in çalışmasıdır. Goldish ise Sabetay Sevi ile ilgili geleneksel bakış açısına karşı tarihi perspektiften yaklaşmaktadır.

Translations, whether in the form of text, illustration, or interpretive analysis, served knowledge-making in multiple ways. It offered a refuge, severed contexts, and concealed the various workers that created it. Over the course of the seventeenth century, European naturalists in Istanbul, such as Luigi Ferdinando Marsigli (1658–1730), procured illustrations of Ottoman nature as fundamental resources to identify, collect, and compare indigenous plants and newly bred varieties. Despite maintaining an actual mediation for cross-cultural interactions, these sources of virtual communication remain largely (...) forgotten in modern scholarship. This article argues that this curious yet invisible corpus was not a nonagentive medium in an alienated leisure of a gentleman-scholar; instead, these illustrations were designed to call upon the viewer’s constant attention in self-motivated scientific labor. Such handy tools responded and contributed to early modern scholars’ modes of working, and in exchange they determined these sources’ own function, position, and visibility – either as a by-product or as a derivative. It is therefore only when integrated into the labor history of science that the degrees of invisibility pertaining to both Ottoman nature studies and self-directed labor can come into a granular view. (shrink)

If a hereditary predisposition to colorectal cancer or breast cancer is diagnosed, most guidelines state that clinical geneticists should request index patients to inform their at-risk relatives about the existence of this condition in their family, thus enabling them to consider presymptomatic genetic testing. Those identified as mutation carriers can undertake strategies to reduce their risk of developing the disease or to facilitate early diagnosis. This procedure of informing relatives through the index patient has been criticised, as it results in (...) relatively few requests for genetic testing, conceivably because a certain number of relatives remain uninformed. This pilot study explored attitudes toward informing family members and relevant practices among clinical geneticists. In general, clinical geneticists consider it to be in the interests of family members to be informed and acknowledge that this goal is not accomplished by current procedures. The reasons given for maintaining present practices despite this include clinical ‘mores’, uncertainty about the legal right of doctors to inform family members themselves, and, importantly, a lack of resources. We discuss these reasons from an ethical point of view and conclude that they are partly uninformed and inconsistent. If informing relatives is considered to be in their best interests, clinical geneticists should consider informing relatives themselves. In the common situation in which index patients do not object to informing relatives, no legal obstacles prevent geneticists from doing so. An evaluation of these findings among professionals may lead to a more active approach in clinical practice. (shrink)

Nurse practitioners can ease increased pressure on primary care shortage while providing a cost-effective and high-quality alternative to certain physician services. However, scope-of-practice laws are restrictive and their modification remains a source of controversy. Clearly, there is a need for new thinking around the scope of practice debate. This article conducted a review of literature and laws concerning the nursing scope of practice, as well as the outcomes of nurse-led care coordination models. It also examined different manifestations of the controversy (...) that arises in scope of practice debates. We argue that improved care coordination is necessary to improve outcomes and “bend the cost curve downward.” Allowing nurse practitioners and other providers to practice to the full extent of their licenses will result in improved care coordination. This can be accomplished by expanding nursing and other providers' scopes of practice. But any health care reform strategy, particularly with respect to chronic care management, must also serve to activate the patient herself as the keystone in the coordinated care process. Focusing first on the patient's need for coordinated care may be what is necessary to move beyond the existing impasse between physicians and nurses on scope of practice expansion. (shrink)

Recent developments in the health care industry have precipitated a new wave of interest in expanding the scope of practice for nursing. This is because the Patient Protection and Affordable Care Act, broadly designed to increase access to health insurance, will inevitably result in increased demand for primary care providers. And with compensation for primary care physicians already lagging far behind that of specialists, the role of nurse practitioners is once again receiving increased attention as a viable means by which (...) to ease the pressure for access to health care.But the economics of this trade-off are controversial. On one hand, it sets primary care physicians at odds with specialists; namely, if the ultimate goal is to “bend the cost curve downward,” should specialist compensation be reduced in order to increase spending on primary care? (shrink)

New targets for brain tumor therapies may be identified by mutations that cause hereditary microcephaly. Brain growth depends on the repeated proliferation of stem and progenitor cells. Microcephaly syndromes result from mutations that specifically impair the ability of brain progenitor or stem cells to proliferate, by inducing either premature differentiation or apoptosis. Brain tumors that derive from brain progenitor or stem cells may share many of the specific requirements of their cells of origin. These tumors may therefore be susceptible to (...) disruptions of the protein products of genes that are mutated in microcephaly. The potential for the products of microcephaly genes to be therapeutic targets in brain tumors are highlighted hereby reviewing research on EG5, KIF14, ASPM, CDK6, and ATR. Treatments that disrupt these proteins may open new avenues for brain tumor therapy that have increased efficacy and decreased toxicity. -/- . (shrink)