A 1999–2000 national study of U.S. hospitals raised concerns about ethics consultation (EC) practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administered a 105-item survey to “best informants” in a stratified random sample of 600 U.S. general hospitals. This primary article details the methods for the entire study, then focuses on the 16 items from the prior study. Compared with 2000, the estimated number of case consultations performed annually rose by 94% to 68,000. The (...) median number of consults per hospital was unchanged at 3, but more than doubled for hospitals with 400+ beds. The level of education of EC practitioners was unchanged, while the percentage of hospitals formally evaluating their ECS decreased from 28.0% to 19.1%. The gap between large, teaching hospitals and small, nonteaching hospitals widened since the prior study. We suggest targeting future improvement efforts to hospitals where needs are not being met by current approaches to EC. (shrink)

Objective The establishment of patient-centered measures capable of empirically determining meaningful cognitive change after surgery can significantly improve the medical care of epilepsy patients. Thus, this study aimed to develop reliable change indices (RCIs) and standardized regression-based (SRB) change norms for a comprehensive neuropsychological test battery in the German language. Methods Forty-seven consecutive patients with temporal lobe epilepsy underwent neuropsychological assessments, both before and 12 months after surgery. Practice-effect-adjusted RCIs and SRB change norms for each test score were computed. To (...) assess their usefulness, the presented methods were applied to a clinical sample, and binary logistic regression analyses were conducted to model the odds of achieving improvement in quality of life (QOL) after surgery. Results The determined RCIs at 90% confidence intervals and the SRB equations for each test score included in the test battery are provided. Cohen’s kappa analyses revealed a moderate mean agreement between the two measures, varying from slight to almost perfect agreement across test scores. Using these measures, a negative association between improvement in QOL and decline in verbal memory functions after surgery was detected (adjusted odds ratio = 0.09, p = 0.006). Significance To the best of our knowledge, this study is the first to develop RCIs and SRB change norms necessary for the objective determination of neuropsychological change in a comprehensive test battery in the German language, facilitating the individual monitoring of improvement and decline in each patients’ cognitive functioning and psychosocial situations after epilepsy surgery. The application of the described measures revealed a strong negative association between improvement in QOL and decline in verbal memory functions after surgery. (shrink)

Ethical issues arise for nurses involved in all phases of clinical trials regardless of whether they are caregivers, research nurses, trial co-ordinators or principal investigators. Potential problem areas centre on nurses’ moral obligation related to methodological issues as well as the notions of beneficence/non-maleficence and autonomy. These ethical concerns can be highly upsetting to nurses if they are not addressed, so it is imperative that they are discussed fully prior to the initiation of a trial. Failure to resolve these issues (...) can place both the conduct and the results of research in jeopardy. (shrink)

Friedrich Waismann (1896–1959) was one of the most gifted students and collaborators of Moritz Schlick. Accepted as a discussion partner by Wittgenstein from 1927 on, he functioned as spokesman for the latter’s ideas in the Schlick Circle, until Wittgenstein’s contact with this most faithful interpreter was broken off in 1935 and not renewed when exile took Waismann to Cambridge. Nonetheless, at Oxford, where he went in 1939, and eventually became Reader in Philosophy of Mathematics (changing later to Philosophy of Science), (...) Waismann made important and independent contributions to analytic philosophy and philosophy of science (for example in relation to probability, causality and linguistic analysis). The full extent of these only became evident later when the larger (unpublished) part of his writings could be studied. His first posthumous work The Principles of Linguistic Philosophy (1965, 2nd edn.1997; German 1976) and his earlier Einführung in das mathematische Denken (1936) have recently proved of fresh interest to the scientific community. This late flowering and new understanding of Waismann’s position is connected with the fact that he somewhat unfairly fell under the shadow of Wittgenstein, his mentor and predecessor. Central to this book about a life and work familiar to few is unpublished and unknown works on causality and probability. These are commented on in this volume, which will also include a publication of new or previously scattered material and an overview of Waismann’s life. (shrink)

The relation between logic and knowledge has been at the heart of a lively debate since the 1960s. On the one hand, the epistemic approaches based their formal arguments in the mathematics of Brouwer and intuitionistic logic. Following Michael Dummett, they started to call themselves `antirealists'. Others persisted with the formal background of the Frege-Tarski tradition, where Cantorian set theory is linked via model theory to classical logic. Jaakko Hintikka tried to unify both traditions by means of what is now (...) known as `explicit epistemic logic'. Under this view, epistemic contents are introduced into the object language as operators yielding propositions from propositions, rather than as metalogical constraints on the notion of inference. The Realism-Antirealism debate has thus had three players: classical logicians, intuitionists and explicit epistemic logicians. The editors of the present volume believe that in the age of Alternative Logics, where manifold developments in logic happen at a breathtaking pace, this debate should be revisited. Contributors to this volume happily took on this challenge and responded with new approaches to the debate from both the explicit and the implicit epistemic point of view. (shrink)

Essays on a wide range of areas and topics in Asian studies for scholars looking to incorporate Asia into their worldview and teaching. Contributors give contemporary presence to Asian studies through a variety of themes and topics in this multidisciplined and interdisciplinary volume. In an era of globalization, scholars trained in Western traditions increasingly see the need to add materials and perspectives that have been lacking in the past. Accessibly written and void of jargon, this work provides an adaptable entrée (...) to Asia for the integration of topics into courses in the humanities, social sciences, cultural studies, and global studies. Guiding principles, developed at the East-West Center, include noting uncommon differences, the interplay among Asian societies and traditions, the erosion of authenticity and cultural tradition as an Asian phenomenon as well as a Western one, and the possibilities Asian concepts offer for conceiving culture outside Asian contexts. The work ranges from South to Southeast to East Asia. Essays deal with art, aesthetics, popular culture, religion, geopolitical realities, geography, history, and contemporary times. “This volume truly lies at the intersection of scholarship and teaching. Each essay has the potential to help rethink approaches to scholarly issues, and there is a great deal of material for classroom discussion and examples. The book’s breadth—covering India, China, Korea, the Sea of Malay, Bhutan, and other locations—is impressive.” — Robert André LaFleur, Beloit College. (shrink)

This paper reports the social and medical characteristics of women resident in Aberdeen city who were sterilized in 195162 and 197152 women were offered sterilization, the majority being lower social class mothers with five or more children who were sterilized concurrently with abortion; the small number of upper social class women had one or two children and were sterilized for medical or obstetric reasons. By 196172, women themselves requested sterilization, the two–three child family was the norm, the proportion of upper (...) social class women continued to increase, and interval sterilization was gaining ground. (shrink)

Während heute die meisten Menschen keinen Gedanken daran verschwenden, dass sich unser irdischer Wohnort mit mehr als 1000 km/h um die eigene Achse dreht, reichte das Wissen um dieses ständige Bewegtwerden bei den Römern bis in den Alltag: Für Vitruv ist das rotierende Weltall der Prototyp aller mechanischen Einrichtungen. In die römische Lebenswelt gelangte das Wissen über das Raum-Zeit-Modell der griechischen Astronomie, dem Platons Erkenntniseuphorie zu religiösem Charakter verholfen hatte, durch die paideia. Allerdings war der Prozess von der Wissensgewinnung bis (...) zur Wissensrepräsentation keine Einbahnstrasse: Die Deutungsmuster griechischer Welterklärung wurden durch Texte und Artefakte nicht einfach reproduziert, sondern an veränderte Bedürfnisse angepasst. Aus tradierten und neuen wissenschaftlichen Erkenntnissen, religiösen Überzeugungen, politischen Notwendigkeiten und dem Wunsch nach Zurschaustellung des eigenen Kulturkapitals entstand im öffentlichen wie im privaten Bereich ein komplexer Diskurs über Raum und Zeit."--Page 4 of cover. (shrink)

Imperfect efficiency in healthcare delivery is sometimes given as a justification for refusing to ration or even discuss how to pursue fair rationing. This paper aims to clarify the relationship between inefficiency and rationing, and the conditions under which bedside rationing can be justified despite coexisting inefficiency. This paper first clarifies several assumptions that underlie the classification of a clinical practice as being inefficient. We then suggest that rationing is difficult to justify in circumstances where the rationing agent is or (...) should be aware of and contributes to clinical inefficiency. We further explain the different ethical implications of this suggestion for rationing decisions made by clinicians. We argue that rationing is more legitimate when sufficient efforts are undertaken to decrease inefficiency in parallel with efforts to pursue unavoidable but fair rationing. While the qualifier ‘sufficient’ is crucial here, we explain why ‘sufficient efforts’ should be translated into ‘benchmarks of efficiency’ that address specific healthcare activities where clinical inefficiency can be decreased. Referring to recent consensus papers, we consider some examples of specific clinical situations where improving clinical inefficiency has been recommended and consider how benchmarks for efficiency might apply. These benchmarks should state explicitly how much inefficiency shall be reduced in a reasonable time range and why these efforts are ‘sufficient’. Possible strategies for adherence to benchmarks are offered to address the possibility of non-compliance. (shrink)

Based on two workshops held February 1990 in New York and March 1990 in San Francisco. Following the presentation and discussion of three clinical case histories, psychotherapists James F. Masterson, Marian Tolpin, and Peter E. Sifneos compare and contrast developmental, self, and object relations.

This paper provides a case study of an unique initiative in corporate (SME) social responsibility which is too often overlooked in the academic study of “socialresponsibility of business in society” This case focuses on three specific points, 1) the role of an SME in social responsibility, 2) the role of a non-business trained entrepreneur and 3) the adaptation of social responsibility to a new and different socio-economic culture. This case presents the hypothesis that “a good socially responsible initiative provides an (...) excellent insurance policy for the health of a business venture in a new culture internationally. (shrink)

We introduce a natural generalization of Borel's Conjecture. For each infinite cardinal number $\kappa$, let ${\sf BC}_{\kappa}$ denote this generalization. Then ${\sf BC}_{\aleph_0}$ is equivalent to the classical Borel conjecture. Assuming the classical Borel conjecture, $\neg{\sf BC}_{\aleph_1}$ is equivalent to the existence of a Kurepa tree of height $\aleph_1$. Using the connection of ${\sf BC}_{\kappa}$ with a generalization of Kurepa's Hypothesis, we obtain the following consistency results: 1. If it is consistent that there is a 1-inaccessible cardinal then it is (...) consistent that ${\sf BC}_{\aleph_1}$.2. If it is consistent that ${\sf BC}_{\aleph_1}$, then it is consistent that there is an inaccessible cardinal.3. If it is consistent that there is a 1-inaccessible cardinal with $\omega$ inaccessible cardinals above it, then $\neg{\sf BC}_{\aleph_{\omega}} + (\forall n < \omega){\sf BC}_{\aleph_n}$ is consistent.4. If it is consistent that there is a 2-huge cardinal, then it is consistent that ${\sf BC}_{\aleph_{\omega}}$.5. If it is consistent that there is a 3-huge cardinal, then it is consistent that ${\sf BC}_{\kappa}$ for a proper class of cardinals $\kappa$ of countable cofinality. (shrink)

This study examines the role of corporate philanthropy in the management of reputation risk and shareholder value of the top 100 ASX listed Australian firms for the 3 years 2011–2013. The results of this study demonstrate the business case for corporate philanthropy and hence encourage corporate philanthropy by showing increasing firms’ investment in corporate giving as a percentage of profit before tax, increases the likelihood of an increase in shareholder value. However, the proviso is that firms must also manage their (...) reputation risk at the same time. There is a negative association between corporate giving and shareholder value which is mitigated by firms’ management of reputation. The economic significance of this result is that for every cent in the dollar the firm spends on corporate giving, Tobin’s Q will decrease by 0.413 %. In contrast, if the firm increase their reputation by 1 point then Tobin’s Q will increase by 0.267 %. Consequently, the interaction of corporate giving and reputation risk management is positively associated with shareholder value. These results are robust while controlling for potential endogeneity and reverse causality. This paper assists both academics and practitioners by demonstrating that the benefits of corporate philanthropy extend beyond a gesture to improve reputation or an attempt to increase financial performance, to a direct collaboration between all the factors where the benefits far outweigh the costs. (shrink)

Examines the relationship between the question of God and the destiny of metaphysics. Concept of the end of metaphysics; Ambiguous relation between phenomenology and metaphysics; Return of special metaphysics in phenomenology; Phenomenological figure of God. Examines the relationship between the question of God and the destiny of metaphysics. Concept of the end of metaphysics; Ambiguous relation between phenomenology and metaphysics; Return of special metaphysics in phenomenology; Phenomenological figure of God.

The term sustainability can be used so liberally within production industries that it becomes meaningless. There is also recognition that for sustainability to be a useful concept, it must be crafted for the context in which it is deployed. A paradox of sustainability, it seems, lies in the conflict between the practical adoptability and context specificity of programs paired with the need for significant change. One response for those grappling with this sustainability challenge has been to adopt flexible approaches to (...) sustainability through the development of technologies and governance processes that focus on benchmarking, monitoring and ongoing change, rather than hard limits and targets. In this paper we elaborate on this point by evaluating how sustainability programs in a transition context can be seen as deliberative platforms and thus actors in governance processes. Through an analysis of the development of a sustainability program deployed in the wine industry in New Zealand, we argue that a widely adopted and clearly defined program can be an asset to democratic environmental governance, if viewed as a shared project. Drawing on interviews with key personnel in the wine industry and reviews of industry literature and media, we suggest that substantiating sustainability can have benefits for environmental governance through the precipitation of distinction and dialogue. We conclude with some suggestions about how to encourage visionary forms of practice and engagement with sustainability programs in ways that can aid their democratic development and expand the reach of their goals. (shrink)

Ranging from miniaturized biological robots to organoids, multi-cellular engineered living systems (M-CELS) pose complex ethical and societal challenges. Some of these challenges, such as how to best distribute risks and benefits, are likely to arise in the development of any new technology. Other challenges arise specifically because of the particular characteristics of M-CELS. For example, as an engineered living system becomes increasingly complex, it may provoke societal debate about its moral considerability, perhaps necessitating protection from harm or recognition of positive (...) moral and legal rights, particularly if derived from cells of human origin. The use of emergence-based principles in M-CELS development may also create unique challenges, making the technology difficult to fully control or predict in the laboratory as well as in applied medical or environmental settings. In response to these challenges, we argue that the M-CELS community has an obligation to systematically address the ethical and societal aspects of research and to seek input from and accountability to a broad range of stakeholders and publics. As a newly developing field, M-CELS has a significant opportunity to integrate ethically responsible norms and standards into its research and development practices from the start. With the aim of seizing this opportunity, we identify two general kinds of salient ethical issues arising from M-CELS research, and then present a set of commitments to and strategies for addressing these issues. If adopted, these commitments and strategies would help define M-CELS as not only an innovative field, but also as a model for responsible research and engineering. (shrink)

Forschungen zur verkorperten Intelligenz und zu den symbolischen Vermittlungen des menschlichen Geistes werden bislang zumeist in getrennten Disziplinen betrieben. Die aus der Kulturphilosophie, Kunst- und Bildwissenschaft, Theologie, Medizin, Psychiatrie, Psychologie und Kognitionswissenschaft stammenden Beitrage des Bandes vereint jedoch das gemeinsame Ziel, einen umfassenden Begriff von Verkorperung zu entwickeln, der die Grenzziehung zwischen kulturalistischen und naturalistischen Ansatzen uberwindet.".

The COVID-19 pandemic has forced developmental researchers to rethink their traditional research practices. The growing need to study infant development at a distance has shifted our research paradigm to online and digital monitoring of infants and families, using electronic devices, such as smartphones. In this practical guide, we introduce the Experience Sampling Method – a research method to collect data, in the moment, on multiple occasions over time – for examining infant development at a distance. ESM is highly suited for (...) assessing dynamic processes of infant development and family dynamics, such as parent-infant interactions and parenting practices. It can also be used to track highly fluctuating family dynamics and routines. The aim of the current paper was to provide an overview by explaining what ESM is and for what types of research ESM is best suited. Next, we provide a brief step-by-step guide on how to start and run an ESM study, including preregistration, development of a questionnaire, using wearables and other hardware, planning and design considerations, and examples of possible analysis techniques. Finally, we discuss common pitfalls of ESM research and how to avoid them. (shrink)

In responding to three reviews of Evolution in Four Dimensions (Jablonka and Lamb, 2005, MIT Press), we briefly consider the historical background to the present genecentred view of evolution, especially the way in which Weismann’s theories have influenced it, and discuss the origins of the notion of epigenetic inheritance. We reaffirm our belief that all types of hereditary information—genetic, epigenetic, behavioural and cultural—have contributed to evolutionary change, and outline recent evidence, mainly from epigenetic studies, that suggests that non-DNA heritable variations (...) are not rare and can be quite stable. We describe ways in which such variations may have influenced evolution. The approach we take leads to broader definitions of terms such as ‘units of heredity’, ‘units of evolution’, and ‘units of selection’, and we maintain that ‘information’ can be a useful concept if it is defined in terms of its effects on the receiver. Although we agree that evolutionary theory is not undergoing a Kuhnian revolution, the incorporation of new data and ideas about hereditary variation, and about the role of development in generating it, is leading to a version of Darwinism that is very different from the gene-centred one that dominated evolutionary thinking in the second half of the twentieth century. (shrink)

Most hospitals are considered charities under common law because they were established for the benefit of the public. The law granted them benefits, but also imposed duties. Under the cy-pres doctrine, if a charitable purpose becomes obsolete or incapable of being carried out, the court could modify those purposes to meet current needs of the organization and the community. Modern laws attempt to find a purpose as near as possible to original purposes set up by donors. In the case of (...) hospital conversion, some regulators say assets must be used to support hospital health care, while others say they can be used in the broad sense of health care. That has been a continuing conflict between communities and regulators.Since 1996, 30 conversion statutes have been enacted, covering hospitals, HMOs, and insurers. (shrink)