Used appropriately, reliance on science distinguishes public health from policymaking driven more by theory and opinion and enhances trust in public health interventions. Evidence-based vaccine policymaking aims to control communicable disease by urging decision makers to base policies on the best available evidence rather than politics or personal views. The results of this approach, such as smallpox eradication, have been dramatic. Historically, mandatory childhood vaccination has been perhaps the most successful evidence-based tool in combating many epidemics. Philosophically, vaccination mandates correspond (...) to the legal system’s dual role in codifying what society deems undesirable behavior and declaring beneficial social norms and values consistent with understandings of the social contract. Despite their effectiveness and philosophical grounding, vaccination mandates present serious legal and ethical questions. Public health policymakers have a continuing responsibility to rely on evidence not only as a basis for generating policy, but also for evaluating and improving elements of its legal design. (shrink)

Obesity is a particularly vexing public health challenge, since it not only underlies much disease and health spending but also largely stems from repeated personal behavioral choices. The newly enacted comprehensive health reform law contains a number of provisions to address obesity. For example, insurance companies are required to provide coverage for preventive-health services, which include obesity screening and nutritional counseling. In addition, employers will soon be able to offer premium discounts to workers who participate in wellness programs that emphasize (...) behavioral choices. These policies presume that government intervention to reduce obesity is necessary and justified. Some people, however, argue that individuals have a compelling interest to pursue their own health and happiness as they see fit, and therefore any government intervention in these areas is an unwarranted intrusion into privacy and one's freedom to eat, drink, and exercise as much or as little as one wants. This paper clarifies the overlapping individual, employer, and social interest in each person's health generally to avoid obesity and its myriad costs in particular. The paper also explores recent evidence on the impact of government interventions on obesity through case studies on food labeling and employer-based anti-obesity interventions. Our analysis suggests a positive role for government intervention to reduce and prevent obesity. At the same time, we discuss criteria that can be used to draw lines between government, employer, and individual responsibility for health, and to derive principles that should guide and limit government interventions on obesity as health reform's various elements (e.g., exchanges, insurance market reforms) are implemented in the coming years. (shrink)

Lachlan observed that any nonzero d.c.e. degree bounds a nonzero c.e. degree. In this paper, we study the c.e. predecessors of d.c.e. degrees, and prove that given a nonzero d.c.e. degree , there is a c.e. degree below and a high d.c.e. degree such that bounds all the c.e. degrees below . This result gives a unified approach to some seemingly unrelated results. In particular, it has the following two known theorems as corollaries: there is a low c.e. degree isolating (...) a high d.c.e. degree [S. Ishmukhametov, G. Wu, Isolation and the high/low hierarchy, Arch. Math. Logic 41 259–266]; there is a high d.c.e. degree bounding no minimal pairs [C.T. Chong, A. Li, Y. Yang, The existence of high nonbounding degrees in the difference hierarchy, Ann. Pure Appl. Logic 138 31–51]. (shrink)

The analysis of a previous paper (see Ref. 1), in which the possibility of a Finslerian generalization of the equations of motion of gravitational field sources was demonstrated, is extended by developing the Finslerian generalization of the gravitational field equations on the basis of the complete contractionK = K lj lj of the Finslerian curvature tensorK l j hk (x, y). The relevant Lagrangian is constructed by the replacement of the directional variabley i inK by a vector fieldy i (x), (...) so that the notion of osculation may be regarded as the key concept on which the approach is based. The introduction of the auxiliary vector fieldy i (x) is shown to be of physical significance, for the field equations refer not only to the proper field variables but also to a special coordinate system associated withy i (x) through the Clebsch representation of the latter. The status of the conservation laws proves to be similar to that in the theory of the Yang-Mills field. By choosing a special Finslerian metric function we elucidate in detail the structure of the field equations in the static case. (shrink)

Purpose of the study is to find out the interdependence of the event as a factor of transformations in the established areas of human life and everyday routine as a way of existence of social being, which cover various types of human activity. Theoretical basis of the research is based on understanding of everyday routine as a form of social reality, a complex and multidimensional object that is constantly evolving, includes new forms of reality, and is influenced by various social (...) changes. The main function of everyday routine is the survival of individual and society, therefore the stable foundations of human existence play a dominant role in every life. In turn the event serves as a way of being existence, has a singular character, an individual expression, identifies elements that do not fit into the usual framework of everyday life. Originality of the obtained results lies in understanding event as the opposition of the phenomena world to the out of experience world of being, unexpected innovation that leads to the emergence of behaviours and structures that are new and unusual for everyday life. Event is not identical to empirical facticity, does not correspond to the usual understanding of phenomena and processes, and leads to a break from the everyday life, as it causes significant changes in human life on the individual and social levels. Unexpected change in everyday life caused by event is a traumatic collision with another dimension of being for an individual, as a result of it new meanings may open. Conclusions. On the background of everyday life, which is able to be in different states, function in a variety of relationships, to be manifested in numerous structures, junctions and connections, the event assumes the prospect of a new reality, contrary to previous representations. From existential point of view, event is always an interruption of everyday life, as for example, love or religious conversion. A large-scale event causes shocks that affect most or all individuals and communities that use multiple ways to react to an event – interpretation, selection, glorification, silence, valuations adjustment, phenomena, facts, celebration of holidays, rituals that are periodically repeated. (shrink)

Much progress has been made in the Soviet Union and a number of other socialist countries in studying and advancing the heritage of Marx and Engels in esthetics. The enrichment of our notions of the views of the founders of Marxism with respect to esthetics and literary criticism has promoted the further development of the discipline of esthetics. The progress achieved is the result and continuation of the work done by the older generation of Soviet philosophers, critics, and students of (...) literature fully thirty and thirty-five years ago in studying and elaborating the heritage of Marx and Engels. (shrink)

This is a brief, clear, and vigorous reinterpretation of Bergson's philosophy. The author attempts to prove that, far from being an irrationalist, Bergson is a systematic metaphysician firmly committed to the concept of final cause.

This article presents a study on the ethical dilemma of whistleblowing in physical therapy, and suggests some lines for further research on this topic as well as ways for integrating it in the physical therapy curriculum. The study examines the self-reported willingness of physical therapy students to report misconduct, whether internally or externally, to protect the patient's interests. Internal disclosure entails reporting the wrongdoing to an authority within the organisation. External disclosure entails reporting the offence to an outside agency, such (...) as the police, professional organisation, or press. The findings indicate that the students view the acts that are detrimental or cause injustice to the patient in a very serious light. In dilemma situations such as these, the students reported a willingness to act. The students also report considerably greater likelihood of whistleblowing internally than externally. The pattern reveals a desire to correct the misconduct coupled with a marked decline in the willingness to blow the whistle as this act moved from the workplace to an external authority. (shrink)

El ensayo constituye una interpretación de la herencia de M. Heidegger en las filosofías de M. Foucault y G. Deleuze. Tal interpretación se hace desde una perspectiva precisa y selectiva. Se trata de analizar el modo en que la diferencia óntico-ontológica heideggeriana es transformada en el núcleo del pensamiento de estos dos pensadores. El autor parte de la tesis según la cual Heidegger conserva restos del pensamiento identitario en su concepción del ser, al caracterizarlo simultáneamente como acontecimiento diferencial y como (...) lo Mismo. Es esta dificultad la que intenta ser resuelta, de un modo semejante, en las filosofías de Foucault y de Deleuze. El ensayo sostiene que en estas últimas la mismidad es disuelta en favor de una «multiplicidad acontecimental en estado naciente». (shrink)

Gli autori di Politica, morale e fortuna, volume che celebra il cinquantesimo anniversario della scrittura de Il principe di Machiavelli, propongono letture aggiornate di questo classico che ci permettono di rinnovare la prospettiva con cui lo affrontiamo. In questi articoli si instaurano dialoghi tra Machiavelli e altri autori di epoche diverse che consentono ancora una volta di ricostruire e problematizzare l'inesauribile opera del fiorentino, avvicinandola ai temi d'attualità. La novità che raccolgono le diverse prospettive è una lettura che riconosce nel (...) Principe il primo trattato filosofico-politico propriamente moderno. (shrink)

This study investigated the differences between past and future temporal discounting in terms of neural activity in relation to temporal distance. Results show that brain regions are engaged differently in past and future temporal discounting. This is likely because past temporal discounting requires memory reconstruction, whereas future temporal discounting requires the processing of uncertainty about the future. In past temporal discounting, neural activity differed only when preferences were made between rewards received one hour prior and rewards received further in the (...) past. The peak amplitudes of P2 and P3 varied as the temporal distance increased from 2 weeks to 50 years. In future temporal discounting, neural activity differed only when preferences were evaluated between two delayed rewards. The delay conditions and had a significant influence on P2 and N2. Findings indicate the existence of different decision-making systems operating in past and future temporal discounting. (shrink)

Background and objectives Conscientious refusal of abortion has been discussed widely by medical ethicists but little information on practitioners' opinions exists. The American College of Obstetricians and Gynecologists (ACOG) issued recommendations about conscientious refusal. We used a vignette experiment to examine obstetrician-gynecologists' (OB/GYN) support for the recommendations. Design A national survey of OB/GYN physicians contained a vignette experiment in which an OB/GYN doctor refused a requested elective abortion. The vignette varied two issues recently addressed by the ACOG ethics committee—whether the (...) doctor referred and whether the doctor disclosed their objection to the abortion. Participants and setting 1800 OB/GYN randomly selected physicians were asked to complete a mail survey containing the vignette. The response rate was 66% (n=1154) after excluding 40 ineligible cases. Measurement Physicians indicated their approval for the vignette doctor's decision. Main results Overall, 43% of OB/GYN physicians responded that the conscientious refusal exercised by the vignette physician was appropriate. 70% rated the vignette doctor as acting appropriately when a referral was made. This dropped to 51% when the doctor disclosed objections to the patient, and to 12% when the doctor disclosed objections and refused to make a referral. Consistent with previous research, males were more likely to support disclosure and refusal to refer. Highly religious physicians supported non-referral but not disclosure. Conclusion OB/GYN physicians are less likely to support conscientious refusal of abortion if physicians disclose their objections to patients. This is at odds with ACOG recommendations and with some models of the doctor–patient relationship. (shrink)