An adolescent’s last moment of life is an emotionally and medically complex time. Children may grapple with understanding the things happening to them and with grief of a future lost; caregivers struggle to simultaneously balance deep sorrow, hope, and love; and healthcare providers fight to maintain sound medical and ethical decision making. Increased discussion regarding adolescent end-of-life care is needed so that clinicians may better understand how to engage in ethically based medical management during these events. This holds particularly true (...) in situations where potentially conflicting ideas exist between clinicians and family members. We describe the case of an acutely and terminally ill adolescent who remained cognitively intact but with rapidly advancing multiple organ failure and whose parents requested that he remain uninformed of his critical illness and prognosis. (shrink)

Background: While the solid organ transplant evaluation process is designed to function equitably, discriminatory practices remain, resulting in disparities in access for persons with disabilities. Physical function and frailty status are often-cited factors in establishing transplant, despite limited consensus on their assessment and impact. Objective: The purpose of this study was to describe how transplant healthcare professionals conceptualize the relationship between physical disability and transplant candidacy. Methods: A convenience sample of multidisciplinary transplant was solicited to respond to an electronic survey (...) between February and March 2024. Results: Of the 126 professionals contacted, 43 participants responded, yielding a response rate of 34 %. The majority of participants (88 %) held contradictory views of physical disability as it relates to transplant candidacy (p = 0.049). Men were more likely to endorse awareness of bias when evaluating transplant candidates (p = 0.008). Professional discipline was significantly associated with perception of transplant process fairness, impact of bias, and interpretation of quality of life. Iterative thematic analysis revealed a propensity to conflate frailty with physical disability. Conclusions: Multidisciplinary transplant professionals rarely endorsed overtly ableist sentiments. However, responses highlighted inconsistent, unclear, and at times contradictory conceptions of physical function and physical disability, which may contribute to disparate access to solid organ transplant for individuals with physical disability. (shrink)

The COVID‐19 pandemic has placed extraordinary stress on frontline healthcare providers as they encounter significant challenges and risks while caring for patients at the bedside. This study used qualitative research methods to explore nurses and respiratory therapists' experiences providing direct care to COVID‐19 patients during the first surge of the pandemic at a large academic medical center in the Northeastern United States. The purpose of this study was to explore their experiences as related to changes in staffing models and to (...) consider needs for additional support. Twenty semi‐structured interviews were conducted with sixteen nurses and four respiratory therapists via Zoom or by telephone. Interviews were transcribed verbatim, identifiers were removed, and data was coded and analyzed thematically. Five major themes characterize providers' experiences: a fear of the unknown, concerns about infection, perceived professional unpreparedness, isolation and alienation, and inescapable stress and distress. This manuscript analyzes the relationship between these themes and the concept of moral distress and finds that some, but not all, of the challenges that providers faced during this time align with previous definitions of the concept. This points to the possibility of broadening the conceptual parameters of moral distress to account for providers' experiences of treating patients with novel illnesses while encountering institutional and clinical challenges. (shrink)

[T. 1] Interpretationen zu den frühen und mittleren Dialogen -- T. 2. Das Bild des Dialektikers in Platons späten Dialogen.

TheCulexis now widely recognized as a piece of post-Ovidian, possibly Tiberian, pseudo-juvenilia written by an author impersonating the young Virgil, although it was attached to Virgil's name already in the first centuryc.e., being identified as Virgilian by Statius, Suetonius and Martial. Dedicated to the young Octavian (Octauiin line 1), the poem seems to fill a biographical gap in Virgil's career before his composition of theEclogues. It is introduced as aludus, which Irene Peirano suggests may openly refer to ‘the act of (...) impersonating Virgil’, and, like many of the poems in theAppendix Vergiliana, it seems to have a parodic intent. TheCulexhas been interpreted as a parody of neoteric style and the epyllion, as mock-epic, as Virgil parody (John Henderson called it a ‘spoofAeneidin bucolic drag’), as pointed Augustan satire, as mock Ovidian ‘Weltgedicht’ and as just very bad poetry (Housman's ‘stutterer’). Glenn Most has observed that the poem's three ‘acts’ structurally recapitulate Virgil's three major works in chronological succession. Little attention, however, has been paid to theCulex's final lines, which contain a catalogue of flowers thepastorplaces on the gnat's tomb. Recent scholarship has reintroduced an older interpretation of the gnat's tomb as a political allegory of Augustus’ Mausoleum; in this paper I suggest instead that the tomb and its flowers serve a closural and metapoetic function at the end of the poem. (shrink)

A series of letters between a professor of philosophy and an eleven-year-old girl.

A variety of semiotic resources makes the construction of scientific knowledge possible and meaning-making resources are conveyed by certain semiotic modes. Next, numerous studies have demonstrated the pedagogical importance of gestures in the demonstration of scientific knowledge in the classroom. Drawing on social semiotic systemic functional theory and legitimation code theory, this study explores the types and the role of gestures in the semiotic construction of scientific knowledge in pedagogic semiosis and their pedagogical values for the meaning-making of science content. (...) With this aim, a gesture observation protocol (GOP) is developed to annotate and analyze data. Two science lectures, which are broadcast remotely for middle school students including gifted students, are observed. Systemic Functional Multimodal Discourse Analysis (SF-MDA) method is employed to analyze and evaluate data. Results demonstrated that the deployment of gestures that contributes to the construction of scientific knowledge is low and deployed gestures mostly do not have pedagogical value. It is recommended that teachers should be more conscious and educated about deploying gestures to present scientific knowledge efficiently. (shrink)

Grush's emulation theory comprises both modality-specific and amodal emulators. I suggest that the amodal variety be replaced by multisensory emulators. The key distinction is that multisensory processing retains the characteristics of individual sensory modalities, in contrast to amodal processing. The latter term is better reserved for conceptual and linguistic systems, rather than perception or emulation.

I wish to discuss symbols concerned with the way we feel about the world and the way we conduct our lives in consequence of those feelings. Our conduct is guided by commands and instructions which for some reason we have to obey. We are guided by our knowledge of the world. The symbols I wish to discuss express and excite desires and preferences and that is how they affect our conduct.

The effects of the vacuum electromagnetic fluctuations and the radiation reaction fields on the time development of a simple microscopic system are identified using a new mathematical method. This is done by studying a charged mechanical oscillator (frequency Ω 0)within the realm of stochastic electrodynamics, where the vacuum plays the role of an energy reservoir. According to our approach, which may be regarded as a simple mathematical exercise, we show how the oscillator Liouville equation is transformed into a Schrödinger-like stochastic (...) equation with a free parameter h′ with dimensions of action. The role of the physical Planck's constant h is introduced only through the zero-point vacuum electromagnetic fields. The perturbative and the exact solutions of the stochastic Schrödinger-like equation are presented for h′>0. The exact solutions for which h′<h are called sub-Heisenberg states. These nonperturbative solutions appear in the form of Gaussian, non-Heisenberg states for which the initial classical uncertainty relation takes the form 〈(δx 2)〉〈(δp) 2 〉=(h′/2) 2,which includes the limit of zero indeterminacy (h → 0). We show how the radiation reaction and the vacuum fields govern the evolution of these non-Heisenberg states in phase space, guaranteeing their decay to the stationary state with average energy hΩ 0 /2 and 〈(δx) 2 〉〈(δp) 2 〉=h 2 /4 at zero temperature. Environmental and thermal effects-are briefly discussed and the connection with similar works within the realm of quantum electrodynamics is also presented. We suggest some other applications of the classical non-Heisenberg states introduced in this paper and we also indicate experiments which might give concrete evidence of these states. (shrink)

Open peer commentary on the article “Radical Constructivism and Radical Constructedness: Luhmann’s Sociology of Semantics, Organizations, and Self-Organization” by Loet Leydesdorff. > Upshot: Leydesdorff emphasises the uncertainties involved in the communication of meaning. Luhmann posited three types of media, each of which reduces one type of communicative improbability. The theory of cultural evolution supports Leydesdorff’s emphasis on the uncertainty of communication, and agrees that different media are needed for communication within and across social boundaries. But it highlights the distinction between (...) media and the symbolic codes that give them structure; and it raises the question whether Luhmann’s symbolically generalized communication media are really media at all. (shrink)