A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients’ perception of material risks, by trained interviewers. Patients’ demographics were obtained. Mann–Whitney U (...) test and Kruskal-Wallis one-way analysis of variance was used. Statistical significance was taken at p < 0.05. Four hundred fourteen patients were eligible of which 26 refused to participate and 24 were excluded due to language barrier. 364 patients were recruited. A higher level of education, being employed and younger age group are factors identified in patients who wanted greater participation in medical decisions. Gender, marital status, type of surgery, and previous surgical history did not affect their level of participation. The complications most patients knew about were Nausea, Drowsiness and Surgical Wound Pain. Patients ranked Heart Attack, Death and Stroke as the most significant risks that they wanted to be informed about in greater detail. Most patients wanted to make a joint decision with the anaesthetist, instead of letting the doctor decide or deciding for themselves. Discussion with the anaesthetist is the preferred medium of communication compared to reading a pamphlet or watching a video. Age and educational level can influence medical decision-making. Despite the digital age, most patients still prefer a clinic consult instead of audio-visual multimedia for pre-operative anaesthetic counselling. The local population appears to place greater importance on rare but serious complications compared to common complications. This illustrates the need to contextualize information provided during informed consent to strengthen the doctor-patient relationship. (shrink)

Peter Kivy argues that Handel was the first composer to be regarded as a genius and that only in the eighteenth century was the philosophical apparatus in place that would enable any composer to be conceived of as a musical genius. According to Kivy, a Longinian conception of genius transformed Handel into a genius. A Platonic conception of genius was used to classify Mozart as a genius. Then Kant adopted a Longinian conception of genius and this shaped the perception of (...) Beethoven. Kivy is wrong on all counts. Composers were thought to be geniuses long before Handel. The emergence of philosophical aesthetics in the eighteenth century did little to shape conceptions of musical genius. More specifically, Kivy misrepresents Kant's conception of genius and the role that it plays in the recognition of Beethoven as a musical genius. (shrink)

Jian Zhou,* Weiqiang Ju,* Xiaopeng Yuan, Xiaofeng Zhu, Dongping Wang, Xiaoshun HeOrgan Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China *These authors contributed equally to this work: Hyperosmolar nonketotic hyperglycemic coma is a serious, rare complication induced by methylprednisolone pulse therapy for acute rejection after orthotopic liver transplantation. Herein, we report an unusual case of a 58-year-old woman who experienced acute rejection at 30 months after OLT, only one case in which HNKHC resulted in MP (...) pulse therapy for acute rejection in all 913 recipients in our center. The general morbidity of HNKHC was 1.09‰ in this study. HNKHC is characterized by rapid onset, rapid progression, and a lack of specific clinical manifestations. High-dose MP management was a clear risk factor. The principle of treatment included rapid rehydration, low-dose insulin infusion, and correcting disorders of electrolytes and acidosis. In conclusion, clinicians considering MP pulse therapy after OLT should be alert to the occurrence of HNKHC. Keywords: liver transplantation, complications, hyperosmolar nonketotic hyperglycemic coma, methylprednisolone pulse therapy, principle of treatment. (shrink)

This paper addresses the definition and the operational use of intuitions in philosophical methods in the form of a research study encompassing several regions of the globe, involving 282 philosophers from a wide array of academic backgrounds and areas of specialisation. The authors tested whether philosophers agree on the conceptual definition and the operational use of intuitions, and investigated whether specific demographic variables and philosophical specialisation influence how philosophers define and use intuitions. The results obtained point to a number of (...) significant findings, including that philosophers distinguish between intuitions used to formulate (discovery) and to test (justification) philosophical theory. The survey results suggest that strategies implemented to characterise philosophical intuition are not well motivated since, even though philosophers do not agree on a single account of intuition, they fail to capture a preferred usage of intuitions as aspects of discovery. The quantitative summary of survey findings informs the debate on this topic, and advances more defined routes for subsequent approaches to the study of intuitions. (shrink)

This article traces the multiple enactments of sex in clinical practices of transgender medicine to argue against the presumed singularity of ‘transexuality’. Using autoethnography to analyse my own experience as a trans patient, I describe my clinical encounters with doctors, psychiatrists and surgeons in order to theorise sex as multiple. Following recent developments in science and technology studies (STS) that advance the work of Judith Butler on sex as performatively reproduced, I use a praxiographic approach to argue that treatment practices (...) produce particular iterations of what sex (and transexuality) ‘is’ and how these processes limit and foreclose other trans possibilities. I consider the ethical, political and material-discursive implications of treatment practices and offer a series of reflections about the effects and effectiveness of current clinical practices and the possibilities for intervening in such processes in order that, following Annemarie Mol, we might (re)make sex (and transexuality) differently. (shrink)

At some distance from a high-rate source in an elastic half-space, the dominant wave motion at the free surface is a Rayleigh surface wave. The calculation of surface waves generated by a concentrated force in a half-space is a basic problem in elastodynamics. By straightforward manipulations, the result can be used to obtain surface waves for other kinds of wave-generating body-force arrangements. For example, appropriate combinations of double-forces (or dipoles) can be used to represent the surface loading due to laser (...) irradiation, or due to acoustic emission from the opening of a sub-surface crack or from sliding over a fault surface. The surface wave motion is usually obtained by the application of integral transform techniques and the subsequent extraction of the surface waves as the contributions from poles in the integral for the inverse transform. In this paper, we use a much simpler approach based on the elastodynamic reciprocity theorem. We consider a transversely isotropic solid whose axis of symmetry is normal to the surface of the half-space. Surface wave pulses generated by a single force, by irradiation from a laser source, and by opening of a crack, have been determined. (shrink)

We give a unified account of some results in the development of Polyadic Inductive Logic in the last decade with particular reference to the Principle of Spectrum Exchangeability, its consequences for Instantial Relevance, Language Invariance and Johnson's Sufficientness Principle, and the corresponding de Finetti style representation theorems.

The remarkable modern speculations concerning non-Euclidean sorts of space, of which Prof. Helmholtz gave some account in No. III. of MIND, are likely to be hailed as one of the chief difficulties with which the Kantian theory of space will have to deal. Digital edition compiled by Gabriele Dörflinger. Heidelberg University Library.

The Third Covenant explores the work of Pierre Teilhard de Chardin, Thomas Berry, and Albert LaChance, revealing through the lens of spirituality, science, and ecology, their understanding of human origin and evolution. Pierre Teilhard de Chardin, an early twentieth century geologist and priest, devoted his life as a scientist, clergyman, and mystic, to reuniting the artificial fracture between science and religion. Thomas Berry, a follower of Teilhard de Chardin and a highly respected cultural historian, furthered this reunification by repositioning the (...) human in the unfolding of an evolving universe, integrated and interdependent with the rest of the life systems of the planet. Albert LaChance, himself a six-year, face-to-face student of Berry, brought this new paradigm into his work as a poet, psychologist, addiction recovery professional, and most importantly, as a mystic and scholar of religion. Along with his daughter, Rebecca LaChance Goodwin, LaChance explores the development of this crucial shift in human understanding and its implications for the future. Parts I and II explore the elements of polarized thinking that makes us believe that we are separate from each other and the life systems of the planet. Thomas Berry's list of twelve principles for understanding the universe and the role of the human in the universe process describes the creative unfolding of our place in the universe. Part III introduces practical steps for achieving personal, familial, and cultural change. LaChance outlines his Twelve Steps of Ecological Spirituality to help us move from powerlessness and isolation to a state of reawakening to self, to humanity, to all species, to the planet, and to the universe. (shrink)