The word τερθρεία, which L. and S.8 derived from τερατεία and translated ‘the use of claptraps’, is perhaps best known from its occurrence in Isocrates , but the new edition has spread the net more widely, citing Philo, Philodemus, Proclus, Galen, Dion. Hal., and giving its meaning as ‘the use of extreme subtlety, hair-splitting, formal pedantry’. This agrees better with the gloss / κενοσπονδία attributed to Orus of Miletus in Et. Mag. 753. 4. Aristotle, Demosthenes, and Plutarch each use τερθρεύομαι (...) once. In the Helen Isocrates, condemning the futile ingenuity of the Sophists in writing encomia on such unworthy objects as salt and humble-bees, holds that such tours de force are immoral, as tending to deceive, representing a literary form of the vice περιεργία. Τερθρεία, then, should take its place, as a recognized term for the idle over-elaboration of a banausic theme, in the vocabulary of Greek literary criticism. It does not, however, appear in Rhys Roberts's ‘Glossary of Greek Rhetoric’ appended to his edition of D.H.'s On Literary Composition. No doubt this is because τερθρεία does not occur in this or any other of D.H.'s Scripta Rhetorica. But D.H. himself uses the word in Antiq. Rom. . Similarly J. F. Lockwood does not discuss the term in his lists in C.Q. xxxi and xxxii, where he collects words which are used metaphorically by D.H. in literary criticism. The metaphor in τερθρεία is certainly not obvious; but the literary sense must have involved some transference of meaning, for it is not to be expected that the word τερθρεία sprang, in full panoply of critical significance, from the brain of the Muse of Rhetoric; and it is part of the purpose of this paper to point the way to an explanation, or at least to set forth some known facts about the word and its possible congeners. (shrink)

Background The COVID-19 pandemic causes moral challenges and moral distress for healthcare professionals and, due to an increased work load, reduces time and opportunities for clinical ethics support services. Nevertheless, healthcare professionals could also identify essential elements to maintain or change in the future, as moral distress and moral challenges can indicate opportunities to strengthen moral resilience of healthcare professionals and organisations. This study describes 1) the experienced moral distress, challenges and ethical climate concerning end-of-life care of Intensive Care Unit (...) staff during the first wave of the COVID-19 pandemic and 2) their positive experiences and lessons learned, which function as directions for future forms of ethics support. Methods A cross-sectional survey combining quantitative and qualitative elements was sent to all healthcare professionals who worked at the Intensive Care Unit of the Amsterdam UMC - Location AMC during the first wave of the COVID-19 pandemic. The survey consisted of 36 items about moral distress (concerning quality of care and emotional stress), team cooperation, ethical climate and (ways of dealing with) end-of-life decisions, and two open questions about positive experiences and suggestions for work improvement. Results All 178 respondents (response rate: 25–32%) showed signs of moral distress, and experienced moral dilemmas in end-of-life decisions, whereas they experienced a relatively positive ethical climate. Nurses scored significantly higher than physicians on most items. Positive experiences were mostly related to ‘team cooperation’, ‘team solidarity’ and ‘work ethic’. Lessons learned were mostly related to ‘quality of care’ and ‘professional qualities’. Conclusions Despite the crisis, positive experiences related to ethical climate, team members and overall work ethic were reported by Intensive Care Unit staff and quality and organisation of care lessons were learned. Ethics support services can be tailored to reflect on morally challenging situations, restore moral resilience, create space for self-care and strengthen team spirit. This can improve healthcare professionals’ dealing of inherent moral challenges and moral distress in order to strengthen both individual and organisational moral resilience. Trial registration The trial was registered on The Netherlands Trial Register, number NL9177. (shrink)

Research involving transgender and gender diverse people (TGD) increased in the last years, mostly concerning healthcare associated to this population. Few studies dedicated their analysis to the impact of parental support on transgender people, even though this is an important aspect in creating a safe environment on which these individuals can build their identity. In addition, the link between family support, TGD identity and homelessness is not completely established. Thus, due to the specificities of the family context of TGD individuals, (...) the aim of this study is to investigate the association between family support and TGD in different moments of the process of gender affirmation. In addition, this study also aims to explore the relationship between a lack of social support and low self-esteem, home abandonment, and dwelling in the street. The survey was designed based on the TransPULSE project and was made available in electronic format. The sample was constituted of 423 TGD residents in two Brazilian states. A Structural Equation Model analysis suggested that the impact of gender affirmation status on homelessness was mediated by parental support, through self-esteem, and the need to move from home. The association between the status of the gender affirmation procedures, family support and self-esteem was significant and indicated that the further TGD individuals advanced in gender affirmation, the more self-esteem and family support they would have. The association between family support and self-esteem indicated that family support was associated with higher self-esteem. Low family support was associated with the willingness to move from home due to one’s TGD status and there was also a significant correlation between low self-esteem and the willingness to move from home due to one’s TGD status. Finally, homelessness was associated with the willingness to move with a large effect size. Limitations include the sample that was constituted by individuals with Internet access and who had more contact with TGD communities. The findings indicate directions for interventions involving TGD people and their families, considering the parental relationship as a critical variable to improve TGD quality of life in the process of gender affirmation. (shrink)

Although it is commonly believed that the concept of brain death was developed to benefit organ transplants, it evolved independently. Transplantation owed its development to advances in surgery and immunosuppressive treatment; BD owed its origin to the development of intensive care. The first autotransplant was achieved in the early 1900s, when studies of increased intracranial pressure causing respiratory arrest with preserved heartbeat were reported. Between 1902 and 1950, the BD concept was supported by the discovery of EEG, Crile’s definition of (...) death, the use of EEG to demonstrate abolition of brain potentials after ischaemia, and Crafoord’s statement that death was due to cessation of blood flow. Transplantation saw the first xenotransplant in humans and the first unsuccessful kidney transplant from a cadaver. In the 1950s, circulatory arrest in coma was identified by angiography, and the death of the nervous system and coma dépassé were described. Murray performed the first successful kidney transplant. In the 1960s, the BD concept and organ transplants were instantly linked when the first kidney transplant using a brain-dead donor was performed; Schwab proposed to use EEG in BD; the Harvard Committee report and the Sydney Declaration appeared; the first successful kidney, lung and pancreas transplants using cadaveric donors were achieved; Barnard performed the first human heart transplant. This historical review demonstrates that the BD concept and organ transplantation arose separately and advanced in parallel, and only began to progress together in the late 1960s. Therefore, the BD concept did not evolve to benefit transplantation. (shrink)

The pull to coordinate with other individuals is fundamental, serving as the basis for our social connectedness to others. Discussed is a dynamical and ecological perspective to joint action, an approach that embeds the individual’s mind in a body and the body in a niche, a physical and social environment. Research on uninstructed coordination of simple incidental rhythmic movement, along with research on goal‐directed, embodied cooperation, is reviewed. Finally, recent research is discussed that extends the coordination and cooperation studies, examining (...) how synchronizing with another, and how emergent social units of perceiving and acting are reflected in people’s feelings of connection to others. (shrink)

Background: During the COVID-19 pandemic, frontline workers faced a series of challenges balancing family and work responsibilities. These challenges included making decisions about how to reduce COVID-19 exposure to their families while still carrying out their employment duties and caring for their children. We sought to understand how frontline workers made these decisions and how these decisions impacted their experiences.Methods: Between October 2020 and May 2021, we conducted 61 semi-structured interviews in English or Spanish, with individuals who continued to work (...) outside of the home during the pandemic and had children living at home. Interviews were recorded, transcribed verbatim, and analyzed using abductive methods.Results: Frontline workers experienced moral distress, the inability to act in accordance with their values and obligations because of internal or external constraints. Their moral distress was a result of the tensions they felt as workers and parents, which sometimes led them to feel like they had to compromise on either or both responsibilities. Individuals felt morally conflicted because 1) their COVID-19 work exposures presented risk that often jeopardized their family’s health; 2) their work hours often conflicted with their increased childcare responsibilities; and 3) they felt a duty to their colleagues, patients/customers, and communities to continue to show-up to work.Conclusions: Our findings point to a need to expand the concept of moral distress to include the perspectives of frontline workers outside of the healthcare professions and the fraught decisions that workers make outside of work that may impact their moral distress. Expanding the concept of moral distress also allows for a justice-based framing that can focus attention on the disparities inherent in much frontline work and can justify programmatic recommendations, like increasing paid childcare opportunities, to alleviate moral distress. (shrink)

Background: Discussing treatment risks has become increasingly important in medical communication. Still, despite regulations, physicians must decide how much and what kind of information to present. Objective: To investigate patients’ preference for information about a small risk of a complication of colonoscopy, and whether medical and personal factors contribute to such preference. To propose a disclosure policy related to our results. Design: Vignettes study. Setting: Department of Gastroenterology, Academic Medical Centre, the Netherlands. Patients: 810 consecutive colonoscopy patients. Intervention: A home-sent (...) questionnaire containing three vignettes. Vignettes varied in the indication for colonoscopy, complication severity and level of risk. Patients were invited to indicate their wish to be informed and the importance of such information. In addition, sociodemograhic, illness-related and psychological characteristics were assessed. Main outcome measurements: Wish to be informed and importance of information. Results: Of 810 questionnaires, 68% were returned. Patients generally wished to be informed about low-risk complications, regardless of the indication for colonoscopy or the severity of the complication. The level of risk did matter, though (OR = 2.48, SE = 0.28, p = 0.001). The information was considered less important if done for population screening purposes or diagnosis of colon cancer, if the complication was less severe (bleeding) and if the risk was smaller (0.01% and 0.1%). Patients’ information preference was also related to age, mood and coping style. Limitations: Difficulty of vignettes. Conclusions: Patients generally wish to be informed about all possible risks. However, this might become uninformative. A stepwise approach is suggested. (shrink)

Computer vision research involving street and road detection methods usually focuses on driving assistance and autonomous vehicle systems. In this context, street segmentation occurs in real-time, based on images centered on the street. This work, on the other hand, uses street segmentation for urban planning research to classify pavement types of a city or region, which is particularly important for developing countries. For this application, it is needed a dataset with images from various locations for each street. These images are (...) not necessarily centered on the street and include challenges that are not common in street segmentation datasets, such as mixed pavement types and the presence of faults and holes on the street. We implemented a multi-class version of a state-of-the-art segmentation algorithm and adapted it to perform street pavement classification, handling navigation along streets and angle variation to increase the accuracy of the classification. A data augmentation approach is also proposed to use preliminary results from the test instances as new ground truth and increase the amount of training data. A dataset with more than 300,000 images from 773 streets from a Brazilian city was built. Our approach achieved a precision of 0.93, showing the feasibility of the proposed application. (shrink)

Any theory of information needs to comply with what we call the implementation, formalization, and representation constraints. These constraints are justified by basic considerations concerning scientific modelling and methodology. In the first part of this paper, we argue that the implementation and formalization constraints cannot be satisfied because the relation between Shannon information and IIT must be clarified. In the second part of the paper, we focus on the representation constraint. We argue that IIT cannot succeed in satisfying this constraint (...) for semantic contents without offering models for concepts, conceptual roles, and context sensitivity. In the final part of the paper, further complications are raised with respect to the distinction between consciousness and attention, which apply more specifically to the representation constraint. We conclude with some recommendations as to how IIT may succeed in solving these problems, highlighting the advantages and enormous potential of IIT as a scientific theory. (shrink)

A cultural icon of the fin de siècle, the New Woman was not one figure, but several. In the guise of a bicycling, cigarette-smoking Amazon, the New Woman romped through the pages of Punch and popular fiction; as a neurasthenic victim of social oppression, she suffered in the pages of New Woman novels such as Sarah Grand's hugely successful The Heavenly Twins. The New Woman in Fiction and Fact marks a radically new departure in nineteenth-century scholarship to explore the polyvocal (...) nature of the late Victorian debates around gender, motherhood, class, race and imperialism which converged in the name of the New Woman. (shrink)

Electrophysiology deals with apparatus applied in a stimulus response situation. This technique is partly concerned with physical problems, partly with biological ones. The failure to appreciate differences in these problems leads to assumptions which require critical examination. Assumptions stating the constancy of objective stimuli, the meaning of inter and intra-individual variation, and the stability of the so-called “resting level” are examined.Some experiments are cited which reveal complications by the apperception of the patient and which have a significant influence on electrophysiological (...) data. The evocation of stress reactions by routine laboratory procedures is discussed and a suggestion is made of the way in which the validity of electro-physiological measurements may be improved.Dans la science de l'électro-physiologie on se sert des instruments pour mesurer des processus de réaction d'une objet stimulée.La méthodique dans cette science est dérivée partiellement de la science biologique et partiellement de la science physicale.Une des difficultées est d'apprécier justement des differences dans les problèmes de mesure dans les deux terraines scientifiques, ce que mène à des assumptions douteuses, qui a besoin d'une examination scrupuleuze.Des assumptions concernant la constance de stimulations objectives, la significance des variations inter- et intra-individuelles et la stabilité du niveau, dit „resting level”, sont examinés.Quelques experiments, révelant des complexités dans l'apperception des patients ayant une influence importante sur les données électro-physiologiques, sont cités.L'évocation des réactions de tension, par des procedures routinières en laboratoire sont discutés et une suggestion afin d'améliorer la validité des données de mesure électrophysiologique est donnée.In der Elektrophysiologie ist man beschäftigt mit Instrumentarium, waraus die Zusammenhang zwischen Reiz und Reaktion untersucht wird. In diesen Untersuchungen werden Methoden angewandt, welche teils aus der biologischen, teils aus der physikalischen Wissenschaft stammen. Es kommt vor, dass Unterschiede in Messungsprobleme innerhalb jedem Fachgebiet nicht richtig gewertet werden, was zu Annahmen führt, welche eine kritische Analyse bedürfen.Annahmen was betrifft, die Konstanz von objective Reize, die Bedeutung von inter- und intra-individuellen Variationen und die Konstanz des sogenannten „resting level”, wurden einer Analyse unterzogen.Einige Experimenten sind zitiert, die eine erhebliche Komplexität in der Wahrnehmungsempfindung des Patienten nachweisen und die eine bedeutungsvolle Einfluss haben auf den elektro-physiologischen Angaben. Das Hervorrufen Spannungsreaktionen durch Routine-vorgänge im Laboratorium wurde diskutiert und eine Weise um mit möglicherweise zuverlassigem Erfolg elektro-physiologischen Messungen aus zu führen wurde vorgeschlagen. (shrink)