> Wealthy nations must do much more, much faster. The United Nations General Assembly in September 2021 will bring countries together at a critical time for marshalling collective action to tackle the global environmental crisis. They will meet again at the biodiversity summit in Kunming, China, and the climate conference 26) in Glasgow, UK. Ahead of these pivotal meetings, we—the editors of health journals worldwide—call for urgent action to keep average global temperature increases below 1.5°C, halt the destruction of nature (...) and protect health. Health is already being harmed by global temperature increases and the destruction of the natural world, a state of affairs health professionals have been bringing attention to for decades.1 The science is unequivocal; a global increase of 1.5°C above the preindustrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse.2 3 Despite the world’s necessary preoccupation with COVID-19, we cannot wait for the pandemic to pass to rapidly reduce emissions. Reflecting the severity of the moment, this editorial appears in health journals across the world. We are united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory. The risks to health of increases above 1.5°C are now well established.2 Indeed, no temperature rise is ‘safe’. In the past 20 years, heat-related mortality among people aged over 65 has increased by more than 50%.4 Higher temperatures have brought increased dehydration and renal function loss, dermatological malignancies, tropical infections, adverse mental health outcomes, pregnancy complications, allergies, and cardiovascular and pulmonary morbidity and mortality.5 6 Harms disproportionately affect the most vulnerable, including children, older populations, ethnic minorities, poorer communities and those with underlying health problems.2 4 Global heating is also contributing to the decline in …. (shrink)

Background: Black, Asian and minority ethnic groups have a high need for organ transplantation but deceased donation is low. This restricts the availability of well-matched organs and results in relatively long waiting times for transplantation, with increased mortality risks. Objective: To identify barriers to organ donor registration and family consent among the BAME population, and to develop and evaluate a training intervention to enhance communication with ethnic minority families and identify impacts on family consent. Methods: Three-phase programme comprising community-based research (...) involving two systematic reviews examining attitudes and barriers to organ donation and effective interventions followed by 22 focus groups with minority ethnic groups; hospital-based research examining staff practices and influences on family consent through ethics discussion groups with staff, a study on intensive care units and interviews with bereaved ethnic minority families; and development and evaluation of a training package to enhance cultural competence among ICU staff. Setting: Community focus group study in eight London boroughs with high prevalence of ethnic minority populations. Hospital studies at five NHS hospital trusts. Participants: Community studies: 228 focus group participants; hospital studies: 35 nurses, 28 clinicians, 19 hospital chaplains, 25 members of local Organ Donation Committees, 17 bereaved family members; and evaluation: 66 health professionals. Data sources: Focus groups with community residents, systematic reviews, qualitative interviews and observation in ICUs, EDGs with ICU staff, bereaved family interviews and questionnaires for trial evaluation. Review methods: Systematic review and narrative synthesis. Results: Community studies: Organ Donor Register – different ethnic/faith and age groups were at varying points on the ‘pathway’ to organ donor registration, with large numbers lacking knowledge and remaining at a pre-contemplation stage. Key attitudinal barriers were uncertainties regarding religious permissibility, bodily concerns, lack of trust in health professionals and little priority given to registration, with the varying significance of these factors varying by ethnicity/faith and age. National campaigns focusing on ethnic minorities have had limited impact, whereas characteristics of effective educational interventions are being conducted in a familiar environment; addressing the groups’ particular concerns; delivery by trained members of the lay community; and providing immediate access to registration. Interventions are also required to target those at specific stages of the donation pathway. Hospital studies: family consent to donation – many ICU staff, especially junior nurses, described a lack of confidence in communication and supporting ethnic minority families, often reflecting differences in emotional expression, faith and cultural beliefs, and language difficulties. The continuing high proportion of family donation discussions that take place without the collaboration of a specialist nurse for organ donation reflected consultants’ views of their own role in family consent to donation, a lack of trust in SNODs and uncertainties surrounding controlled donations after circulatory death. Hospital chaplains differed in their involvement in ICUs, reflecting their availability/employment status, personal interests and the practices of ICU staff. Evaluation: professional development package – a digital versatile disk-based training package was developed to promote confidence and skills in cross-cultural communication. Initial evaluation produced positive feedback and significant affirmative attitudinal change but no significant difference in consent rate over the short follow-up period with requirements for longer-term evaluation. Limitations: Participants in the focus group study were mainly first-generation migrants of manual socioeconomic groups. It was not permitted to identify non-consenting families for interview with data regarding the consent process were therefore limited to consenting families. Conclusions: The research presents guidance for the effective targeting of donation campaigns focusing on minority ethnic groups and provides the first training package in cultural competence in the NHS. Future work: Greater evaluation is required of community interventions in the UK to enhance knowledge of effective practice and analysis of the experiences of non-consenting ethnic minority families. Funding: The National Institute for Health Research Programme Grants for Applied Research programme. (shrink)

The aim of this study was to investigate patients' experiences of not being treated well in medical health care in Stockholm County, Sweden. The study was conducted by implementing qualitative content analysis using categorization of empirical material for 2006 and 2007 provided by the Patients' Advisory Committee (Patientnämnden) in Stockholm. Complaints about not being treated well accounted for 13% of all complaints to the Patients' Advisory Committee. A sample of those who complained about their medical treatment shows that about 30% (...) of these complaints also involved experiences of being badly received. Categorization of the complaints about being badly treated resulted in the following 11 categories: (1) rude, aggressive or arrogant behaviour; (2) being ignored; (3) being denied examinations or treatments; (4) lack of empathy among personnel; (5) lack of respect for personal integrity; (6) lack of time/waiting time; (7) personnel not separating private issues from their professional role; (8) injustice and discrimination; (9) sexual harassment; (10) coercion and violence and (11) unspecified bad treatment. In relation to the total number of patients, women were over-represented in all categories. In conclusion, what patients react most strongly against is when health-care personnel treat them disrespectfully by not abiding by established social norms. The results indicate that the combination of failure in medical treatment and not receiving an apology often leads patients to complain to the Patients' Advisory Committee. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:What Did the Romans Know? An Inquiry into Science and Worldmaking by Daryn LehouxJohn M. OksanishDaryn Lehoux. What Did the Romans Know? An Inquiry into Science and Worldmaking. Chicago, Ill.: University of Chicago Press, 2012. xii + 275 pp. 10 black-and-white figs., 2 tables. Cloth, $45.“Have we ever been modern?” Thus author Daryn Lehoux expresses one of the fundamental questions underlying the book under review, which seeks to (...) present a historicizing account of the various lenses through which elite Romans in the late Republic and early Empire understood and, importantly, expressed their understanding of our world. I say “our” world because, as Lehoux makes clear from the beginning of this fascinating, if sometimes challenging, monograph, continuity with our scientific forebears is as fundamental a key to accessing their ambitions, limits, and scope, as are our divergences from them. In this sense, What Did the Romans Know? provides a kind of study in the reception of Roman sciences, whose plurality, interdependence, and context-specific viability are emphasized throughout. For although (1) physical realities have per se not [End Page 343] changed since antiquity, and (2) how we regard and describe them has, Lehoux insinuates that our own laws of nature remain limited by specific ontological and rhetorical constraints—“blind spots”—that render our modern science in some ways comparable with the sciences that operated in antiquity. By first emphasizing various contexts (epistemological, ontological, etc.) and showing readers how the ancient sciences operated within them, Lehoux effectively shows us that ancient sciences did indeed work, even astrology. However, Lehoux ultimately reveals himself as a scientific realist: the contextual viability of the ancient sciences notwithstanding, he does not believe in a Lucretian “swerve” but in atoms, electrons, and other phenomena that he has never seen directly. That he waits until the ninth chapter (200) for this admission to materialize fully is surely purposeful, but it can sometimes make for disorienting reading. Equally disorienting is the book’s tendency to present ancient scientific terms with little or no explanation (e.g., equant, 68; synodic anomaly, 69), while terms whose specific valences will be well-known to many readers of this journal (e.g., religio, 26; pietas, 27) are glossed, sometimes simplistically. Despite this and a few other caveats, however, Lehoux has broadly succeeded at a very difficult task, i.e., presenting ancient science in a manner that is accessible and interesting to Classicists of various stripes, while simultaneously delivering classical texts to historians of science through an essentially new historicist lens.The first three chapters provide examples from and discussions of selected texts that show the Romans making links between nature and law in science, religion (especially divination), and in legal theories. We quickly learn that Lehoux’s is not a book about Romans who merely applied Greek theories in the interest of technology or about the ways in which slave-power made an ancient industrial revolution unnecessary at Rome (the so-called blocage question, discussed by Serafina Cuomo in Technology and Culture in Greek and Roman Antiquity [Cambridge, 2007]). Rather, this is a book about science as a reflection of, and participant in, the creation of Roman ideology and society. Any good discussion of Roman-ness at the end of the Republic inevitably involves a good deal of Cicero, who conveniently, and thus perhaps problematically, provides ample discussion of the kinds of topics in which Lehoux is interested, especially divination. Cicero’s apparently contradictory positions on the practice (Leg. 2.32 and Div. 2.74) are noted, as is the movement in the past thirty years away from the “naive” reading of De Divinatione as a “vigorous rationalistic protest” against a national superstition. Divination, for Lehoux’s Cicero, is neither an intellectual offense nor a politically expedient fiction; rather, it is a thoroughly Roman way of both seeing the world and doing business. Some of what is found here will not be new to classicists, and the chapter overall seems less interested in breaking new ground than in establishing, in deliberate fashion, the book’s foundational interest in seeing nature, law, and religion as legitimately connected. Divination and other phenomena reflect a Roman interest in a kind... (shrink)

Background When anti-cancer treatments have been given market authorization, but are not (yet) reimbursed within a healthcare system, physicians are confronted with ethical dilemmas. Arranging access through other channels, e.g., hospital budgets or out-of-pocket payments by patients, may benefit patients, but leads to unequal access. Until now, little is known about the perspectives of physicians on access to non-reimbursed treatments. This interview study maps the experiences and moral views of Dutch oncologists and hematologists.Methods A diverse sample of oncologists and hematologists (...) (n = 22) were interviewed. Interviews were analyzed thematically using Nvivo 12 qualitative data software.Results This study reveals stark differences between physicians’ experiences and moral views on access to anti-cancer treatments that are not (yet) reimbursed: some physicians try to arrange other ways of access and some physicians do not. Some physicians inform patients about anti-cancer treatments that are not yet reimbursed, while others wait for reimbursement. Some physicians have principled moral objections to out-of-pocket payment, while others do not.Conclusion Oncologists and hematologists in the Netherlands differ greatly in their perspectives on access to expensive anti-cancer treatments that are not (yet) reimbursed. As a result, they may act differently when confronted with dilemmas in the consultation room. Physicians working in different healthcare systems may face similar dilemmas. (shrink)

Taxometric analyses were applied to the construct of psychopathy (as measured by the Psychopathy Checklist) and to several variables reflecting antisocial childhood, adult criminality, and criminal recidivism. Subjects were 653 serious offenders assessed or treated in a maximum-security institution. Results supported the existence of a taxon underlying psychopathy. Childhood problem behaviors provided convergent evidence for the existence of the taxon. Adult criminal history variables were continuously distributed and were insufficient in themselves to detect the taxon.

I have not seen the papyrus, but if β and μ are correctly reported, and if the space between would admit three letters, I tentatively suggest . sed haec quidem uituperatio.

The Stepford Wives, a novel by Ira Levin, provides the theme for this allegory. The men of Stepford belong to the Men’s Association. Their wives are “perfect”, in that they do nothing other than clean, cook, preen, and provide satisfaction without argument for their husbands. They are, furthermore, content with their lot, and believe that their previous interests and freedoms were self indulgent. Levin never informs his readers how the men came to obtain total mastery over their “Stepford wives”, although (...) there is the suggestion that the real wives have been replaced by robotic lookalikes. (shrink)

Aristotle argued that you need some wealth to live well. The Stoics argued that you could live well with or without wealth. But the Cynics argued that wealth is a hinderance. For the Cynics, a good life consists in self-sufficiency, or being able to rule and help yourself. You accomplish this by living simply and naturally, and by subjecting yourself to rigorous philosophical exercises. Cynics confronted people to get them to abandon extraneous possessions and positions of power to live better. (...) And while the Cynics were experts in living in this way, their ascetic lifestyles made their message curious to some audiences. This paper reflects on Cynic ascetic practices and the ways others perceived them. (shrink)

The provision of health care service in resource-poor settings is associated with a broad set of ethical issues. Devakumar's case discusses the ethical issues related to the inability to treat in a cholera clinic patients who do not have cholera. This paper gives a closer look on the context in which Devakumar's case took place. It also analyses the potential local and organizational factors that gives rise to ethical dilemmas and aggravate them. It also proposes a framework to help in (...) the proactive handling of the factors that leads to ethical dilemmas and resolving the ethical issues as they appear. It adopts the four principles of autonomy, beneficence, non-maleficence and justice as universal and prima facie principles, but with the inclusion of a local understanding of what of each of these principles means. It is based on a collaborative approach that involves the beneficiaries and other partners in the field to help share information and resources, as well as adopting the provision of a wider service to the whole community. This is done by asking three basic questions: (a) who are the relevant stakeholders? (b) what ought to be the ethical principles in place? and (c) how should we take, implement and follow the decision about service provision? (shrink)

Programming practice suggests a notion of general iteration corresponding to the while-do construct. This leads to new characterizations of general computable unary functions usable in computer science.

I. We know fairly well how the City Dionysia at Athens was celebrated in classical times. But although the numerous dramatic festivals of the Hellenistic period were in many respects modelled on the Athenian Dionysia, it is not clear how the performances at these festivals were organized. The difficulty arises from the fact that apart from a few great centres which may have had their own theatre production, playwrights, actors, etc., the majority of cities depended on the travelling of Dionysos’.1 (...) It seems that the of Dionysiac artists were formed early in the third century. Three major Dionysiac associations—the Athenian, the Isthmian and Nemean, and the Ionian and Hellespontian—operated in Greece, Asia Minor, and the islands in Hellenistic times. The question is how these associations functioned. Were they theatrical companies as well as professional guilds? Did they undertake the organization of musical and dramatic performances at various festivals? Was there a division of territories between the and were certain festivals dominated by certain guilds? (shrink)

Individual and Society in Buddhism. W. G. Weeraratne. Metro Printers Ltd., Colombo. 101pp £2.

This short note considers the formulation of Full Intuitionistic Linear Logic given by Hyland and de Paiva . Unfortunately the formulation is not closed under the process of cut elimination. This note proposes an alternative formulation based on the notion of patterns.

Az értelmiségi mint történelmi probléma -- Dic cur hic -- Van-e a filozófiának múltja? (hiszen örök) -- A német kontraszt -- Beszéd a félelem nélküli beszédről -- Öt tanács a hazának -- Utolsó feljegyzések -- Felhívás a Bürök című folyóirat megalapítására -- Jegyzetek -- Életrajzi kísérlet.

Impartiality is primarily a feature of normative or evaluative deliberation – deliberation about what ought to be done or about something's goodness or badness. An initial description is this: such deliberation is impartial when it is not unduly influenced by the deliberator's own interests, preferences, or loyalties. Derivatively, impartiality can be attributed to actions that are guided by deliberation with this feature, or persons who characteristically deliberate or act in this way.

Este trabajo presenta una propuesta para la investigación y la enseñanza de la parasitología. La Metodología de los Programas de Investigación Científica está basada en la metodología de Imre Lakatos. El “núcleo tenaz” del programa en parasitología es “las características de comportamiento alimenticio de los hospedadores explica y predice la fauna de endoparásitos que ellos albergan “. Las hipótesis auxiliares del cinturón protector son: i) hipótesis de los ciclos biológicos y ii) hipótesis del desarrollo de comunidades de parásitos. Las pre-condiciones (...) iniciales necesarias para el establecimiento de la relación parásitohospedador son: a) existencia del parásito potencial, b) existencia del hospedador potencial y c) existencia del biotopo potencial. Se discute el papel de las anomalías y se sugieren modificaciones al tratamiento hecho por Lakatos. Creemos que las anomalías no deben archivarse y acumularse hasta que la comunidad científica comience a dudar y cuestionar el núcleo tenaz. Es mejor que el científico resuelva cada anomalía a medida que se le van presentando, pudiedo resultar en el futuro en caminos insospechables para el trabajo teórico y empírico, y de esta manera aumentar el poder predictivo y explicativo del programa. En definitiva esto estará aumentando el “contenido experimental” del programa.This paper presents a theoretical methodological proposal for research and teaching in parasitology. The Methodology of Scientific Research Program, , presented here is based on I. Lakatos’ methodology. The “hard core” in parasitology is: the characteristics of the trophic behavior of hosts explain and forecast the parasitic fauna which they harbour. The following hypotheses form the hard core’s safety belt of the auxiliary hypotheses: 1. the hypothesis of the biological cycles; 2. the hypothesis of parasite community development. The necessary initial physical pre-conditions for the establishment of a host-parasite relation are: a.- the existence of a potential parasite; b- the existence of a potential host, and c - the existence of a potential biotope. The role of anomalies in the development of any MSRP is discussed and a modification of Lakatos’ treatment is suggested. We believe that anomalies should not be set aside until they accumulate to the point where the scientific community begins to doubt their basic hard core. It is better for the scientist to resolve each controversial event as soon as it emerges since these events, may, in the future, give rise to unsuspected paths of theoretical and empiricalwork, or even improve and widen the predictive and explicative power of the MSRP itself. This, in brief, would deepen the “experimental content” of the program. (shrink)