Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

Increased productivity may have negative impacts on farm animal welfare in modern animal production systems. Efficiency gains in production are primarily thought to be due to the intensification of production, and this has been associated with an increased incidence of production diseases, which can negatively impact upon FAW. While there is a considerable body of research into consumer attitudes towards FAW, the extent to which this relates specifically to a reduction in production diseases in intensive systems, and whether the increased (...) incidence of diseases represents a barrier to consumer acceptance of their increased use, requires further investigation. Therefore a systematic review of public attitudes towards FAW was conducted, with a specific focus on production diseases in intensive systems. Four databases were searched to identify relevant studies. A screening process, using a set of pre-determined inclusion criteria, identified 80 studies, with the strength of evidence and uncertainty assessed for each. A thematic analysis led to the identification of 6 overarching themes constructed from 15 subthemes. The results demonstrate that the public are concerned about FAW in modern production systems. Concern varied in relation to age, gender, education and familiarity with farming. Naturalness and humane treatment were central to what was considered good welfare. An evidence gap was highlighted in relation to attitudes towards specific production diseases, with no studies specifically addressing this. However, the prophylactic use of antibiotics was identified as a concern. A number of dissonance strategies were adopted by consumers to enable guilt free meat consumption. (shrink)

The persistent educational challenges that fractions pose call for developing novel instructional methods to better prepare students for fraction learning. Here, we examined the effects of a 24-session, Cuisenaire rod intervention on a building block for symbolic fraction knowledge, continuous and discrete non-symbolic proportional reasoning, in children who have yet to receive fraction instruction. Participants were 34 second-graders who attended the intervention (intervention group) and 15 children who did not participate in any sessions (control group). As attendance at the intervention (...) sessions was irregular (median = 15.6 sessions, range = 1–24), we specifically examined the effect of the number of sessions completed on their non-symbolic proportional reasoning. Our results showed that children who attended a larger number of sessions increased their ability to compare non-symbolic continuous proportions. However, contrary to our expectations, they also decreased their ability to compare misleading discretized proportions. In contrast, children in the Control group did not show any change in their performance. These results provide further evidence on the malleability of non-symbolic continuous proportional reasoning and highlight the rigidity of counting knowledge interference on discrete proportional reasoning. (shrink)

The bibliography has two main divisions: the first is an alphabetical inventory of materials relating to Al-Färäbï; the second is a break-down of the former into special listings including editions, translations and studies of Al-Färäbï's own works. Although the author has examined a vast amount of materials in many languages, he readily admits that his collection is not complete--the literature by and about the philosopher is inexhaustible. The author also adds that his bibliography is more geared to medieval science and (...) thought than to oriental studies.--A. B. (shrink)

Science naively presupposes the intelligibility of the universe, necessary laws, and a universal truth. The author reflects on these presuppositions to arrive at a demonstration of God's existence. In a vigorous and exclamatory style, he condemns the alternative views of idealism, phenomenology, and philosophies of science which cannot rationally justify their faith in a universal truth. The only rational basis for these presuppositions is a theistic God--the "Vérité mesurante" and "Pensée fondatrice" of scientific reason.--A. B. D.

With this work, the author terminates his trilogy on nationally prominent philosophers in Germany, France, and the United States, respectively. In all three works a deliberate attempt is made to counter the current trend towards linguistic analysis and deal with philosophy in its classical meaning as a body of general truths about the universe as a whole, which the author believes leads to some important consequences of present day relevance. The style of the work, to say the least, is unusual (...) in that it is cast in the form of a series of letters, fourteen in number, of a father to his daughter. Since he admits there are no German, French, or American "philosophies," properly speaking, each letter deals with a particular North American philosopher, beginning with Jonathan Edwards, Benjamin Franklin, and Thomas Paine in Revolutionary days, continuing with Ralph Waldo Emerson, William James, Charles Sanders Peirce, Josiah Royce, John Dewey, and George Herbert Mead as 19th century representatives, and Whitehead, Santayana, and Carnap for the first half of the twentieth. The work concludes with Hans Kelsen and Marcuse, who like Carnap, came to the United States as the result of Hitler’s antisemitism. The tenor of the work lays stress on problems of cultural and political life and, thereby, on the ties of this sort that bind the United States and Europe. The work reads well, and although its tone is more biographical than philosophical, more expository than critical, it could well serve as supplementary reading for a seminar on American philosophy.—A.B.W. (shrink)

A highly ordered universe is described in terms of neutrino and electrino alone as basic particles, and length and time alone as dimensional units. New theories are obtained of particles, nuclides, atomic spectra, general relativity, and gravitation.

Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity and death from COVID-19. The social restrictions proved challenging for the residents, their relatives, and the care staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge about how the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethical difficult situations experienced by Norwegian nurses working in nursing homes during the COVID-19 pandemic. Research design and (...) participants: The research design involved semistructured individual interviews conducted with 15 nurses working in 8 nursing homes in 3 health regions in Norway, within both urban and rural areas. Ethical considerations: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Norwegian Centre for Research Data. Findings: Four ethical difficult situations were identified: (a) turning the nursing home into a prison; (b) using medication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact on decision-making. Conclusions: The nurses’ ethical challenges were intertwined with external factors, such as national and local guidelines, and the nurses’ own internalized factors, which were connected to their subjective professionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in a professionally sound and safe manner. (shrink)

One of the more intriguing figures of the first period of the Successors is Nicanor, the lieutenant and admiral of Cassander. He came into prominence when he assumed command of the Macedonian garrison at Athens, late in 319 B.c. After distinguishing himself there he took a fleet to the Bosporus, where with Antigonus' collaboration he won a decisive victory over Polyperchon's royal navy. Subsequently his aspirations became sufficiently lofty to threaten his patron's security, and Cassander took elaborate precautions to ensure (...) his arrest and condemnation. Nicanor was clearly a figure of considerable importance; yet no source even hints at his origins and family background. Can conjecture go any way to filling the gaps? (shrink)

A new theory of particles proposed in an earlier paper is now applied to explain energy. Having earlier derived the Rydberg formula for atomic spectra without using the Pauli principle, the authors now derive the photoelectric effect, deflection of light by gravitation, and Planck's law for blackbody radiation without using Planck's assumption on energy quanta or Einstein's theory of general relativity.

Concentrating on the thought of Canada's major scientists, philosophers, and clerics - men such as William Dawson and Daniel Wilson, John Watson and W.D. LeSeur, G.M. Grant and Salem Bland - A Disciplined Intelligence begins by reconstructing the central strands of intellectual and moral orthodoxy prevalent in Anglo-Canadian colleges on the eve of the Darwinian revolution. These include Scottish common sense philosophy and the natural theology of William Paley. The destructive impact of evolutionary ideas on that orthodoxy and the major (...) exponents of the new forms of social evolution - Spencerian and Hegelian alike - are examined in detail. By the twentieth century the centre of Anglo-Canadian thought had been transformed by what had become a new, evolutionary orthodoxy. The legacy of this triumphant intellectual movement, British idealism, was immense. It helped to destroy Protestant denominationalism, provide the philosophical core of the social gospel movement, and constitute a major force behind the creation of the United Church of Canada. Throughout the nineteenth century and continuing into the twentieth, however, the moral imperative in Anglo-Canadian thought remained a constant presence. (shrink)

On the life and philosophy of Bhāskarācārya, 8th cent., Vedanta philospher and commentator of Brahmasūtra.

Non-therapeutic ventilation of potential organ donors would increase the supply of kidneys for transplantation. There are no major ethical objections to it. The means of permitting it are forbidden by laws with an ethical basis. A law permitting it would need an ethical basis. Introducing a third legal method of diagnosing death would be unethical. Expanding the power of the advance directive to permit procedures involving minimal harm would be ethical but not helpful. Extending the power of proxies to permit (...) specific non-therapeutic procedures which caused or risked minimal harm to incompetent patients is the best way forward. (shrink)

The physician charter on medical professionalism creates standards of ethical behaviour for physicians and has been endorsed by professional organisations worldwide. It is based on the cardinal principles of the primacy of patient welfare, patient autonomy, and social welfare. There has been little discussion in the bioethics community of the doctrine of the charter and none from a Jewish ethical perspective. In this essay the authors discuss the obligations of the charter from a Jewish ethical viewpoint and call on other (...) cultures to develop their own unique perspectives on this important document. (shrink)

A 4-space formulation of Dirac's equation gives results formally identical to those of the usual Klein paradox. However, some extra physical detail can be inferred, and this suggests that the most extreme case involves pair production within the potential barrier.

The validity of the double effect doctrine is examined in euthanasia and abortion. In these two situations killing is a method of treatment. It is argued that the doctrine cannot apply to the care of the dying. Firstly, doctors are obliged to harm patients in order to do good to them. Secondly, patients should make their own value judgments about being mutilated or killed. Thirdly, there is little intuitive moral difference between direct and indirect killing. Nor can the doctrine apply (...) to abortion. Doctors kill fetuses as a means of treating the mother. They also kill them as an inevitable side effect of other treatment. Drawing a moral distinction between the direct and the indirect killing gives counterintuitive results. It is suggested that pragmatic rules, not ethics, govern practices around euthanasia and cause it to be more restricted than abortion. (shrink)