Impairment of the Self has been described in frontal–temporal dementia but little research has been carried out in patients with Alzheimer’s disease. Objective. The aim of this study was to explore changes in the self in patients with AD. Method. Forty-seven patients with mild to moderate AD were examined using a semi-structured scale designed to assess the self-concept along three dimensions, namely, the Material Self, the Social Self and the Spiritual Self. Results. The majority of patients presented impairment of at (...) least one dimension of the Self. When only one dimension was affected, it was always the Social Self. The severity of impairment of the Self was correlated to the impairment of the semantic autobiographical memory and apathy. The Self is impaired in AD and the Social Self dimension appears to be more vulnerable in AD than other dimensions. (shrink)

By now, the general content and format of an English language book on Descartes can usually be predicted: it will be a painstaking reading of the Meditations, especially of the First and Second Meditations. Bernard Williams honors this formula, but only up to a point. He subtitles his book "The Project of Pure Enquiry," announcing his focal concern with the Meditations. To his credit, however, Williams gives more than passing notice to the way Descartes’ scientific project shaped his epistemological theories. (...) For example, Williams has something both convincing and illuminating to say about the distinction between primary and secondary qualities~ and about the place of experiment and observation in the Cartesian theory of knowledge. Indeed, his insights into Descartes’ scientific project are good enough to warrant more space and attention than he gives them. In any case, Williams’s brief side trips into Descartes’ scientific methodology significantly inform his understanding of the "project of pure enquiry.". (shrink)

Purpose. The research is devoted to the analysis of the urgent problem of the information society: the overload of a person with information and, as a result, the impossibility of adequate formation and development of the personality; as well as the problem of "digitization" of human existence and the formation of a new reality of dataism. Theoretical basis. A lot of modern scientific works are devoted to the analysis of the information society, its problems and features. The information society is (...) a logical continuation of the scientific and technological revolution, which led to the rapid growth of scientific knowledge and the technology development. In the 20th century, technologies have touched the sphere of knowledge and information, as a result of which the formation and development of the information society, or "knowledge society", takes place. Information becomes the main resource in it, and, one way or another, a person’s life is inextricably connected with the information space. With the information society formation, the problem of information search and processing becomes one of the most urgent. It turns out that despite the abundance and availability of information, it is very difficult to determine its relevance. A lot of effort is spent on developing information retrieval algorithms. Another problem is related to the person’s inability to process large amounts of data. This situation begins to influence not only the education process and professional activity, but also the formation of a person’s personality. A person is "lost" in the information space and gradually loses his/her "I". Algorithms for data analysis come to the rescue, but gradually, instead of giving a person material for thought, they begin to make decisions on their own, and therefore, live life instead of a person. With the advent of Big Data processing algorithms, a new ideological paradigm appears – dataism, which predicts the merger of a person with the general data flow. Originality. The authors make assumptions that the dataistic future is "natural". A lot of works, including in the framework of philosophy, are focused on the problem of "dissolving" a person in the information space and finding ways to overcome it. But, in our opinion, this process is a completely logical continuation of human evolution. Conclusions. Existence of a person as a data flow is not a problem and a threat, but a new dimension of his/her being, and, therefore, requires a careful study and formulation of the main principles of this form of existence. (shrink)

The clinical introduction of medical devices often occurs with relatively little oversight, regulation and (long-term) follow-up. Some recent controversies underscore the weaknesses of the current regime, such as the complications surrounding the metal-on-metal hip implants and the scandal surrounding the global breast implant scare of silicone implants made by France's Poly Implant Prothese (PIP) Company. The absence of national registries hampered the collection of reliable information on the risks and harms of the PIP breast implants. To warrant long-term safety, a (...) case can be made for mandatory post-marketing surveillance by means of the establishment of compulsory registries. In this edition of Public Health Ethics, Schofield calls for debate on how such a registry system should be initiated and maintained and how it would relate to the ethical requirement of consent. Here we use breast implant registries as a case to discuss whether and when a so-called ‘thick opt-out’ would be an appropriate method to include people in medical device registries. We conclude that a thick opt-out procedure for medical device registries is only justifiable in cases where inclusion does not involve burdens (or very low), when it does not involve a sensitive subject and when the data are stored anonymously (or at least not directly linked to the medical record). Otherwise, inclusion should be sought by means of an opt-in. (shrink)

Background: More and more quantitative information is becoming available about the risks of complications arising from medical treatment. In everyday practice, this raises the question whether each and every risk, however low, should be disclosed to patients. What could be good reasons for doing or not doing so? This will increasingly become a dilemma for practitioners.Objective: To report doctors’ views on whether to disclose or withhold information on low risks of complications.Methods: In a qualitative study design, 37 respondents were included. (...) Focus group interviews were held with 22 respondents and individual in-depth interviews with 15.Results: Doctors have doubts about disclosing or withholding information on complication risk, especially in a risk range of 1 in 200 to 1 in 10 000. Their considerations on whether to disclose or to withhold information depend on a complicated mix of patient and doctor-associated reasons; on medical and personal considerations; and on the kind and purpose of intervention.Discussion: Even though the degree of a risk is important in a doctor’s considerations, the severity of the possible complications and patients’ wishes and competencies have an important role as well. Respondents said that low risks should always be communicated when there are alternatives for the intervention or when the patient may prevent or mitigate the risk. When the appropriateness of disclosing risks is doubtful, doctors should always tell their patients that no intervention is without risk, give them the opportunity to gather all the information they need or want, and enable them to detect a complication at an early stage. (shrink)

A survey of 106 medical students assessing their interest in and attitudes to medical ethics in the curriculum is reported by the authors. Results indicate that 64 per cent of the students rated the importance of medical ethics to good medical care as high or critical and 66 per cent desired to learn more about the topic. However, in reports of patient encounters identifying ethical issues, less than six per cent of the students reported a frequency of more than one (...) such patient encounter per week. The students also demonstrated a greater awareness of more obvious ethical issues than of more subtle, less publicised issues. When asked how medical ethics should be taught, the students clearly affirmed a desire for an integrated exposure to the subject throughout the medical curriculum. Possible implications of these findings for medical education are discussed. (shrink)

Hypnotic responding might be due to attenuated frontal lobe functioning after the hypnotic induction. Little is known about whether personality traits linked with frontal functioning are associated with responsiveness to hypnotic suggestions. We assessed whether hypnotic suggestibility is related to the traits of self-control and impulsivity in 154 participants who completed the Brief Self-Control Scale, the Self-Regulation Scale, the Barratt Impulsiveness Scale , and the Harvard Group Scale of Hypnotic Susceptibility . BIS-11 non-planning impulsivity correlated positively with HGSHS:A . Furthermore, (...) in the best model emerging from a stepwise multiple regression, both non-planning impulsivity and self-control positively predicted hypnotic suggestibility, and there was an interaction of BIS-11 motor impulsivity with gender. For men only, motor impulsivity tended to predict hypnotic suggestibility. Hypnotic suggestibility is associated with personality traits linked with frontal functioning, and hypnotic responding in men and women might differ. (shrink)

Of Peter Abelard's logical writings, the fruit of thirty-five years of his activity as a teacher and dialectician, there have been to date only four editions worthy of note: that of Cousin in 1836, of Geyer in 1919 and 1936, of Dal Pra in 1954, and lastly the critical reconstruction of Abelard's literal glosses by L. M. Rijk in 1956. With this handsome second edition of minor but relevant glosses of Abelard, Dal Pra aims to fill the gap still existing (...) in the previous collections. His volume includes Abelard's writings found in the Paris BN manuscripts n. 13.368 and 7493. Chronologically the former belongs to the period when Abelard was given the chair of dialectic at the University of Paris in 1114 and the latter to Abelard's more mature period when he began original speculations on the logical status of propositions in 1121. Dal Pra argues at great length that the glosses in the first manuscript are to be read as the best and only introduction to Abelard's own work on dialectic. Hence he suggests against Rijk the title Introductiones Dialecticae rather than Introductiones Parvulorum. He assembles them according to what he believes was Abelard's intellectual development at the time. They are: the glosses to Porphyrius, to Aristotle's Categories, to the De Interpretatione, and to Boethius' De Devisione. [[sic]] The second section of the volume contains the glosses Super Topica where Abelard discusses among other subjects his first position on the problem of universals. Against Geyer who had consigned these works to the literal glosses of Abelard, Dal Pra offers strong evidence for locating them in the bulk of Abelard's De Ingredientibus precisely between the De Interpretatione and the De Syllogismo Hypothetico. The modernity of Abelard's logical theory is well known among contemporary logicians. Dal Pra's finely planned and handsomely executed edition makes an excellent contribution to the history of medieval logic as well as to contemporary logical theories on names and propositions.--L. M. P. (shrink)

Some people have supposed that utility is good in itself, non-in-strumentally good, as distinct from good because conducive to other good things. And in modern versions of this view, utility often means want-satisfaction, as distinct from pleasure or happiness. For your want that p to be satisfied, is it necessary that you know or believe that p, or sufficient merely that p is true? However that question is answered, there are problems with the view that want-satisfaction is a non-instrumental good. (...) What if you want something only because you have a false belief? What if the time at which you want that p is fifty or five hundred years before the time to which p itself refers? To meet these difficulties, qualifications have to be introduced, and much has been written about how exactly these qualifications are to be framed.1 There is however what may be a rather more serious objection to the view that want-satisfaction is a non-instrumental good, or rather to the combination of that view with the principle that it is sufficient for your want that p to be satisfied simply that p is true. The objection is that this combination forces you to give undue weight to the mere acquisition of desires when you come to make judgements about changes in the value of things. It forces you to say that for any true proposition p, which initially you do not want to be true, your mere acquisition of a desire that p will, other things being equal, make the world better. Non-instrumental value can be increased merely by multiplying desires, even though everything else remains the same. Surely, however, improving the world is not as easy as that. (shrink)

Humanitarian health care practitioners working outside familiar settings, and without familiar supports, encounter ethical challenges both familiar and distinct. The ethical guidance they rely upon ought to reflect this. Using data from empirical studies, we explore the strengths and weaknesses of two ethical models that could serve as resources for understanding ethical challenges in humanitarian health care: clinical ethics and public health ethics. The qualitative interviews demonstrate the degree to which traditional teaching and values of clinical health ethics seem insufficient (...) for addressing all the realities of health care practice during humanitarian missions. They equally suggest that greater good orientations of public health ethics can thwart the best intentions of health care professionals wanting to attend to the interests of individual patients. Even though neither is complete on its own for helping guide health professionals on field missions, taken together these models have much to offer. At the same time, the narratives of the humanitarian health care workers illustrate how some of the crucial differences between public health ethics and clinical ethics generate tensions in humanitarian health practice. We offer an analysis of some of the complexities this creates for humanitarian health care ethics, and consider ways of adjudicating between the two models. (shrink)

Background: The Declaration of Helsinki, the World Medical Association’s statement of ethical guidelines regarding medical research, is published in the three official languages of the WMA: English, French and Spanish.Methods: A detailed comparison of the three official language versions was carried out to determine ways in which they differed and ways in which the wording of the three versions might illuminate the interpretation of the document.Results: There were many minor linguistic differences between the three versions. However, in paragraphs 1, 6, (...) 29, 30 and in the note of clarification to paragraph 29, there were differences that could be considered potentially significant in their ethical relevance.Interpretation: Given the global status of the Declaration of Helsinki and the fact that it is translated from its official versions into many other languages for application to the ethical conduct of research, the differences identified are of concern. It would be best if such differences could be eliminated but, at the very least, a commentary to explain any differences that are unavoidable on the basis of language or culture should accompany the Declaration of Helsinki. This evidence further strengthens the case for international surveillance of medical research ethics as has been proposed by the WMA. (shrink)

The objective of the study was to investigate the relationship between childhood IQ of parents and characteristics of their adult offspring. It was a prospective family cohort study linked to a mental ability survey of the parents and set in Renfrew and Paisley in Scotland. Participants were 1921-born men and women who took part in the Scottish Mental Survey in 1932 and the Renfrew/Paisley study in the 1970s, and whose offspring took part in the Midspan Family study in 1996. There (...) were 286 offspring from 179 families. Parental IQ was related to some, but not all characteristics of offspring. Greater parental IQ was associated with taller offspring. Parental IQ was inversely related to number of cigarettes smoked by offspring. Higher parental IQ was associated with better education, offspring social class and offspring deprivation category. There were no significant relationships between parental IQ and offspring systolic blood pressure, diastolic blood pressure, cholesterol, glucose, lung function, weight, body mass index, waist hip ratio, housing, alcohol consumption, marital status, car use and exercise. Structural equation modelling showed parental IQ associated with offspring education directly and mediated via parental social class. Offspring education was associated with offspring smoking and social class. The smoking finding may have implications for targeting of health education. (shrink)

New trends in the economic systems management in the context of modern global challenges: collective monograph / scientific edited by M. Bezpartochnyi, in 2 Vol. // VUZF University of Finance, Business and Entrepreneurship. – Sofia: VUZF Publishing House “St. Grigorii Bogoslov”, 2020. – Vol. 1. – 309 p.

Using the Job Demands-Resources model literature and the life-span theory as scholarly frameworks, we examined the effects of job demands and job resources as mediators in the relationship between bundles of used HRM practices and employee outcomes. In addition, we tested for age differences in our research model. Findings confirmed the hypothesized original 2-factor structure representing maintenance and development HRM practices. Structural Equation Modeling analyses showed that the maintenance HRM bundle related directly and negatively to employee outcomes, without moderating effects (...) of age. However, job resources appeared to mediate this relationship in a positive way as it also did for the development HRM bundle. Whereas this study showed the ‘ driving power’ of the actual use of HRM bundles through job resources, regardless of the employee’s age, this study also suggests a ‘ dark side’ of HRM. In particular, we found that development HRM bundles may also increase job demands, which, in turn, may result in lower levels of beneficial employee outcomes. These empirical outcomes demonstrate the strength of the driving power eliciting from job resources preceded by any HRM bundle. Moreover, this effect appears to apply to employees of all ages. Our moderated-mediation model appeared robust for several control variables. Overall, this study provides an extension of the well-known Job Demands-Resources model by including maintenance and development bundles of HRM practices used by employees that have a differential effect on job demands and job resources which in turn have an impact on employee outcomes. (shrink)

Le but de cet article est une critique de la philosophie politique de M. Eric Weil. Par opposition à M. Weil, l'auteur définit la „politique" ici comme l'art du réalisable, à préciser comme : l'art d'arriver à court terme à une organisation de la société qu'on estime meilleure, et cela en employant tous les moyens permis. L'homme politique n'est pas, ainsi que l'affirme M. Weil, un „saint de Vtmiversel”, qui, en ce qui concerne l'emploi de la violence, se trouve au-dessus (...) de la loi. Ce „politicien-éducateur” est en vérité l'appui des régimes totalitaires et est d'ailleurs inconcevable en dehors de ceux-ci. En outre la théorie de M. Weil contient un certain nombre de contradictions internes et, si on la mesure à la pratique, elle se trouve être déficiente à beaucoup d'égards. Contre la conception platonicienne de M. Weil l'auteur défend la thèse que la politique n'est pas une infraction, regrettable mais inévitable, à „la morale”. C'est la tâche de l'homme politique de supprimer toutes les absurdités, inconséquences et injustices qui entachent les structures de la société. Ce qui, concrètement, est absurde, inconséquent ou injuste n'est pas déterminé par „la morale”, mais par la conscience du droit et par le sentiment moral d'une époque donnée. Les „certitudes” d'où part l'homme politique ne sont pas des Idées platoniciennes, mais des hypothèses de travail, qui dérivent leur contenu non pas de la contemplation des Idées, mais d'une notion de ce qui est juste et désirable, notion qui est déterminée par les conditions matérielles et spirituelles et qui se trouve dans un changement continuel. (shrink)

The self is one of the perennial topics in philosophy, and also one of the most debated. Its existence has been both defended and contested in equal measure by philosophers including Descartes and Hume. A Map of Selves: Beyond Philosophy of Mind proposes an original and compelling defense of selfhood. N. M. L. Nathan argues that the self is an enduring substance with a unique quality not shared with any other substance. He criticizes the panpsychist theory that material objects are (...) composed of selves analogous to ours and argues for the existence of at least one transcendent self, whose activity explains both our own existence and the existence of the natural world. He concludes by considering how the world would be for us if such selves did not exist, and we were, as some philosophers think we are, not selves, but, e.g., brains or simply sequences of mental events. A radical and innovative philosophical theory of the self, A Map of Selves: Beyond Philosophy of Mind will be of interest to those working on the philosophy of self and personal identity, philosophy of mind and metaphysics. (shrink)

Although activated spinal cord glia contribute importantly to neuropathic pain, how nerve injury activates glia remains controversial. It has recently been proposed, on the basis of genetic approaches, that toll-like receptor 4 may be a key receptor for initiating microglial activation following L5 spinal nerve injury. The present studies extend this idea pharmacologically by showing that TLR4 is key for maintaining neuropathic pain following sciatic nerve chronic constriction injury. Established neuropathic pain was reversed by intrathecally delivered TLR4 receptor antagonists derived (...) from lipopolysaccharide. Additionally, -naltrexone, -naloxone, and -naloxone, which we show here to be TLR4 antagonists in vitro on both stably transfected HEK293-TLR4 and microglial cell lines, suppressed neuropathic pain with complete reversal upon chronic infusion. Immunohistochemical analyses of spinal cords following chronic infusion revealed suppression of CCI-induced microglial activation by -naloxone and -naloxone, paralleling reversal of neuropathic pain. Together, these CCI data support the conclusion that neuron-to-glia signaling through TLR4 is important not only for initiating neuropathic pain, as suggested previously, but also for maintaining established neuropathic pain. Furthermore, these studies suggest that the novel TLR4 antagonists -naloxone and -naloxone can each fully reverse established neuropathic pain upon multi-day administration. This finding with -naloxone is of potential clinical relevance. This is because -naloxone is an antagonist that is inactive at the -opioid selective receptors on neurons that produce analgesia. Thus, these data suggest that -opioid antagonists such as -naloxone may be useful clinically to suppress glial activation, yet -opioid agonists suppress pain. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

A systematic study of rational or justified belief, which throws fresh light on current debates about foundations and coherence theories of knowledge, the validation of induction and moral scepticism. Dr Nathan focuses attention on the largely unsatisfiable desires for active and self-conscious assurance of truth liable to be engendered by philosophical reflection about total belief-systems and the sources of knowledge. He extracts a kernel of truth from the doctrine that a regress of justification is both necessary and impossible, contrasts the (...) resultant scepticism with more familiar complaints about the inapplicability of supposedly essential cognitive concepts and explores the feasibility of non-Humean modes of consolation. This is an original and carefully constructed book, which will interest professional philosophers and advanced students of epistemology. (shrink)