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)

Biologically, pain is neither intrinsically good nor bad, but is a communication mechanism designed to serve organismal ends. Pain for any given person at any given time should be evaluated on the basis of “success” (or not) in serving those purposes. Yet, the physiological, psychological, and cultural complexity of the experience makes moral consideration of pain complicated. This is especially the case with infants in pain. The competence of the infant as a “decision maker” cannot, of course, be assumed. Even (...) if the child “thinks” about pain, an epistemological barrier exists in that the child cannot clearly communicate about the pain experience. Furthermore, any expressions of pain from the child may be necessary for diagnosis. Just coercion criteria provide a means of evaluating when and to what extent pain in infants should be controlled under the authority of surrogate decision makers. (shrink)

At the heart of Youth Justice Conferencing, a form of restorative justice aimed at addressing youth crime, is the notion that young persons who have committed an offence should be ‘reintegrated’ into their communities (Braithwaite in Crime, shame and reintegration. Cambridge University Press, Cambridge, 1989). This paper focuses on the role of parents as support persons, in particular the ‘crying mum’, an identity often leveraged by the Convenor when prompting the young person to express remorse to the circle. We explore (...) an Avouchment genre that we have observed whereby support persons vouch for the character of the young person. Our analysis considers the ways in which values are composed (as ideational categories are coupled with evaluative interpersonal ones) and unfold in discourse as invitations for participants to align. In Knight’s (2010) terms, when shared, couplings of ideation and evaluation engender bonds through which participants may commune. (shrink)

To gain an insight into how those entering the teaching profession regard cyberbullying, two focus groups were conducted with nine pre-service teachers. Thematic analytical approach revealed...

It is human nature to try to recognize patterns and to make sense of that which we observe. Unfortunately, our intuition is often wrong, and so there is a need to impose some objectivity on the methods by which observations are converted into knowledge. One definition of biostatistics could be precisely this, the rigorous and objective conversion of medical and/or biological observations into knowledge. Both consumers of biostatistical principles and biostatisticians themselves vary in the extent to which they recognize the (...) need to continue the improvement. Some may not recognize the need for (some or all of) the methods that have already been developed; others may accept these as they find them completely sufficient; still others recognize both the value and the shortcomings of these methods, and seek to develop even better methods to ensure that future medical conclusions are less subject to biases than current ones are. (shrink)

This article demonstrates the benefit of studying a classical version of chromodynamics in order to better understand color charge in quantum chromodynamics. Standard presentations of the conservation and confinement of color charge serve to obscure the Lie-algebra-valued character of the conserved Noether charge. This article shows how we can remove these obscuring factors by studying color charge from the vantage point of classical chromodynamics. This key example of color charge illustrates the larger methodological benefit of this classical vantage point: interpreting (...) classical gauge theories helps to delineate the uniquely quantum features of quantum field theories. (shrink)

Paul Grobstein, Eleanor A. Bliss Professor of Biology at Bryn Mawr College, Pennsylvania, USA passed away Tuesday, June 28, 2011. Since Paul came to Bryn Mawr in 1986, he taught courses ranging from "Introductory Biology" and "Philosophy of Science" to "Evolution of Stories" and "The Brain and Education." Paul founded the Summer Institutes for K-12 Teachers, which brought hundreds of local educators to campus to consider new ways of teaching science and math. He served as chair of the Biology Department (...) and was instrumental in the establishment and success of the Center for Science in Society at Bryn Mawr College. (shrink)

We make two suggestions with regard to Depue & Collins's target article. First, regarding the functioning of MOC13, we provide data indicating that, contrary to D&C's apparent position, this structure is not necessary for instrumental conditioning. Second, we suggest that D&C's approach would be advanced by reference to formal computational theory, in particular the work of Grossberg. We suggest that an integration of Grossberg 's and D&C's models can provide a more complete account of extraversion.