Background and AimsEnd-of-life discussions can be difficult for seriously ill adolescents and young adults. Researchers aimed to determine whether completing Voicing My CHOiCES —a research-informed advance care planning guide—increased communication with family, friends, or health care providers, and to evaluate the experience of those with whom VMC was shared.MethodsFamily, friends, or HCPs who the AYAs had shared their completed VMC with were administered structured interviews to assess their perception of the ACP discussion, changes in their relationship, conversation quality, and whether (...) the discussion prompted changes in care. Open-ended responses underwent thematic analysis.ResultsOne-month post-completion, 65.1% of AYA had shared VMC completion with a family member, 22.6% with a friend, and 8.9% with an HCP. Among a sample of respondents, family and friends reported a positive change in their relationship with the AYA. Participant descriptions of the experience fell into five themes: positive experience, difficult experience, appreciated a guide to facilitate discussion, provided relief, and created worry/anxiety. Only 1 HCP noted a treatment change. Family, friends, and HCP did not think the AYA would have discussed EoL preferences without completing VMC.ConclusionsVMC has potential to enhance communication about ACP between AYA and their family and friends, though less frequently with HCPs. Participants reported a positive change in their relationship with the AYA after discussing VMC, and described experiencing the conversation as favorable, even when also emotionally difficult. (shrink)

I first provide an interpretation of the doctrine of creatio ex nihilo based on the Fourth Lateran Council, according to which God creates from nothing if and only if God creates everything except God Himself. I then show that this doctrine entails the modal problem that it is both possible and not possible that there is nothing at all except God, or alternatively, that it is both necessary and not necessary that there is something else besides God. I proceed to (...) examine several proposals to solve the problem, and find them all inadequate. Therefore, I conclude that creatio ex nihilo violates modal logic and is necessarily false. (shrink)

Plotinus' mysticism of henosis, <I>unification with the One, is a highly controversial topic in Plotinian scholarship. This book presents a careful reading of the Enneads and suggests that Plotinus' mysticism be understood as mystical teaching that offers practical guidance concerning henosis. It is further argued that a rational interpretation thereof should be based on Plotinus' metaphysics, according to which the One transcends all beings but is immanent in them. The main thesis of this book is that Plotinus' mystical teaching does (...) not help man attain henosis on his own, but serves to remind man that he fails to attain henosis because it already pertains to his original condition. Plotinus' mysticism seeks to change man's misconception about henosis, rather than his finite nature. (shrink)

L S Penrose’s Limit Theorem – which is implicit in Penrose [7, p. 72] and for which he gave no rigorous proof – says that, in simple weighted voting games, if the number of voters increases indefinitely and the relative quota is pegged, then – under certain conditions – the ratio between the voting powers of any two voters converges to the ratio between their weights. Lindner and Machover [4] prove some special cases of Penrose’s Limit Theorem. They give a (...) simple counter-example showing that the theorem does not hold in general even under the conditions assumed by Penrose; but they conjecture, in effect, that under rather general conditions it holds ‘almost always’ – that is with probability 1 – for large classes of weighted voting games, for various values of the quota, and with respect to several measures of voting power. We use simulation to test this conjecture. It is corroborated with respect to the Penrose–Banzhaf index for a quota of 50% but not for other values; with respect to the Shapley–Shubik index the conjecture is corroborated for all values of the quota. (shrink)

In this desolate ancient country, which is a semicolony, all activities [seemed to have] stopped. People's lives have also become meaningless. The warm breeze blown from other countries stirred the curiosity of youth. Go! Let us go to the free world. And so, many people left the motherland for France in Europe, as if even workers there were happier than gentlemen here. But what was the reality? They were unable to do very hard work like the average workers. So their (...) idealized country became the target of their curses. (shrink)

Hsun K'uang was an outstanding thinker of the newly-emerging landlord class in Chinese history. Through the analytical critique, he established a simple materialist ideological system as the theoretical foundation of the later feudal centralism. In the historical development of materialism, his ideological system encompassed the essence of thought advanced before and after him. His combative proposition on the "decrees of Heaven" is an especially epoch-making achievement in ancient materialist theory. However, his world outlook, a metaphysical theory of cycles, recognized change (...) and cycles but not evolution and development. (shrink)

Recent studies support a model in which the progeny of SOX9+ epithelial progenitors at the distal tip of lung branches undergo cell allocation and differentiation sequentially along the distal‐to‐proximal axis. Concomitant with the elongation and ramification of lung branches, the descendants of the distal SOX9+ progenitors are distributed proximally, express SOX2, and differentiate into cell types in the conducting airways. Amid subsequent sacculation, the distal SOX9+ progenitors generate alveolar epithelial cells to form alveoli. Sequential cell allocation and differentiation are integrated (...) with the branching process to generate a functional branching organ. This review focuses on the roles of SOX9+ cells as precursors for new branches, as the source of various cell types in the conducting airways, and as progenitors of the alveolar epithelium. All of these processes are controlled by multiple signaling pathways. Many mouse mutants with defective lung branching contain underlying defects in one or more steps of cell allocation and differentiation of SOX9+ progenitors. This model provides a framework to understand the molecular basis of lung phenotypes and to elucidate the molecular mechanisms of lung patterning. It builds a foundation on which comparing and contrasting the mechanisms employed by different branching organs in diverse species can be made. (shrink)

Background Ethical dilemmas that arise in the clinical setting often require the collaboration of multiple disciplines to be resolved. However, medical and nursing curricula do not prioritize communication among disciplines regarding this issue. A common teaching strategy, problem-based learning, could be used to enhance communication among disciplines. Therefore, a university in southern Taiwan developed an interprofessional ethics education program based on problem-based learning strategies. This study described tutors’ experience teaching in this program. Aim To explore the phenomenon of teaching and (...) learning in interprofessional ethics education for medical and nursing students from the perspectives of tutors. Design Phenomenological qualitative research. Methods Medical and nursing students completed a 6-week interprofessional ethics education program moderated by either physician or nurse tutors. At the conclusion of the ethics education program, all 14 tutors were invited to participate in focus group interviews. Among them, six tutors (three nursing tutors and three physician tutors) participated in additional individual interviews. All of the contents from the focus group interviews and individual interviews were recorded and transcribed. Using the phenomenological approach, the phenomenon of teaching and learning in interprofessional ethics education were generated. Ethical consideration The study was approved by the Institutional Review Board. Findings Three themes emerged from the tutors' teaching perspectives, including the instructor’s motivation to teach, the use of narrative case scenarios, and the emphasis on improving interprofessional ethics communication. Discussion Problem-based learning creates an interprofessional communication platform in interprofessional ethics education. The phenomenon of value convergence between tutors and students, between different students’ professions, and between different students’ professional maturities is observed. Conclusion Problem-based learning is an effective teaching strategy for creating a communication platform for interprofessional ethics education. Ethic curriculum should emphasize motivating instructor, use narrative case scenarios, and focus on interprofessional communication. (shrink)

This essay defends a reading of Hegel as a metametaphysical antirealist. Metametaphysical antirealism is a denial that metaphysics has as its subject matter answers to theoretical questions about the mind-independent world. Hence, on this view, metaphysical questions are not, in principle, knowledge transcendent. I hold that Hegel presents a version of metaphysical antirealism in the Science of Logic because he pursues his project by suspending reference to all supposed objects of metaphysical theory as practiced before him. Hegel introduces reference in (...) his theory only by the self-reference of thought to itself in the Doctrine of the Concept. I motivate the relevance of Hegel’s approach to metaphysics by comparing it to Kit Fine’s concept of ‘naïve metaphysics’. I argue that Hegel’s theory results from a comprehensively naïve metaphysics. (shrink)

Objetiva-se apresentar, aqui, alguns elementos da trajetória de integração da escola Pão dos Pobres com a comunidade porto alegrense, sobretudo no que concerne à manutenção de suas bases materiais, de modo a levantar alguns indícios iniciais da inserção desta instituição ao hoje denominado terceiro setor, fenômeno vinculado à promoção de solidariedade social e cidadania.

Volume 20, Issue 7, July 2020, Page 150-152.

Responding to a major pandemic and planning for allocation of scarce resources under crisis standards of care requires coordination and cooperation across federal, state and local governments in tandem with the larger societal infrastructure. Maryland remains one of the few states with no state-endorsed ASR plan, despite having a plan published in 2017 that was informed by public forums across the state. In this article, we review strengths and weaknesses of Maryland’s response to COVID-19 and the role of (...) the Maryland Healthcare Ethics Committee Network in bridging gaps in the state’s response to prepare health care facilities for potential implementation of ASR plans. Identified “lessons learned” include: Deliberative Democracy Provided a Strong Foundation for Maryland’s ASR Framework; Community Consensus is Informative, Not Normative; Hearing Community Voices Has Inherent Value; Lack of Transparency & Political Leadership Gaps Generate a Fragmented Response; Pandemic Politics Requires Diplomacy & Persistence; Strong Leadership is Needed to Avoid Implementing ASR … And to Plan for ASR; An Effective Pandemic Response Requires Coordination and Information-Sharing Beyond the Acute Care Hospital; and The Ability to Correct Course is Crucial: Reconsidering No-visitor Policies. (shrink)

Pao-Shen Ho attempts to argue that the Christian doctrine of _creatio ex nihilo_ violates modal logic and is necessarily false. More precisely, Ho argues that, if God creates the universe out of nothing, then the non-existence of the universe is both possible and impossible, which is logically incoherent. I point out, however, that Ho commits the modal scope fallacy by confusing the scope of necessity in the argument and, therefore, Ho's argument is unsound.

The Genetic Privacy Act is a comprehensive effort to protect individuals from unauthorized analysis of their DNA and from unauthorized disclosure of information resulting from genetic analysis. Irrespective of merit, every bill must survive legislative scrutiny. This is a considerable challenge, particularly for a bill as complex and far-reaching as the GPA. To illustrate my point, I describe the fate of two bills introduced into the Maryland Senate in 1995 by Senator Jennie Forehand. The first, also entitled the Genetic (...) Privacy Act, was a slightly modified version of the model legislation prepared by Annas, Glantz, and Roche. After a hearing, the bill received a 9-2 unfavorable vote from the Economic and Environmental Affairs Committee. The second was a much shorter bill, DNA Testing – Informed Consent and Confidentiality, which simply stated that “DNA analysis may only be performed with the informed consent of the person being analyzed” and that the results of such analysis “are the exclusive property of the person tested, are confidential, and may not be disclosed without the consent of the person being tested.” This bill had a hearing but was never put to a vote by the Judicial Proceedings Committee. My principal aim is to examine the testimony on these bills. I will conclude with some suggestions about accomplishing the goals of genetic privacy legislation. (shrink)

O presente artigo tem como objetivo verificar as principais concepções relativas à construção das dimensões de cidadão e cidadania desenvolvidos pelo Orfanotrófio Pão dos Pobres, na década de 20, através da análise do impresso da escola - Boletim Pão dos Pobres -· bem como a sua relação com a realidade social da época, a fim de demonstrar como essas iniciativas procuravam atender às necessidades do novo contexto social emergente.

Since the turn of the century, the number of small-scale farmers in the U.S. and farmlands they owned have declined very sharply (structural change). Although the decrease in number is generally true for both white and Black farm operators, it has been more significant for Blackfarm operators than whites. The declining trend in the number of Blackfarm operators in the country is derived from individual state experiences that resulted from a combination of various political and economic factors. Using the census (...) of agriculture data from 1900 to 1987, this paper gives a brief historical overview of Black farm operators in Maryland. The census data for the study period shows that at their peak number in 1910, there were 6,382 Blackfarmers in the state of Maryland. However, by 1987, only 371 of that number remained, representing a loss of 94 percent since 1910. According to the 1987 census data almost all Black operated farms in Maryland were not only small-scale but also in the lower sales class, less than $20,000 a year. Their household net family income is below that of non-metropolitan median household income. This concentration of Blacks in the lower economic class of farm operators in the state, for the most part, is closely related to their resource endowments, patterns of tenure, type of farm enterprises, and government farm programs and policies. On the average, Blackfarmers in Maryland have less land, capital and management skills than their white counterparts. Government policies and programs had, and continue to have, a devastating effect on Maryland Black farmers because they were tied to productive resources rather than farm income needs. Under conditions of low income, years of neglect by federal and state programs and policies, and limited resources Blackfarmers were unable to adopt capital intensive production practices and expand their farm operations. This resulted in most of them leaving agriculture, in the past and today, at a faster rate than whites. To avert or at least lessen the unfortunate situation of Black farm operators, projections and possible solutions are offered. This includes how the 1890 Land-Grant institutions because of their tradition, expertise and experience of research, teaching and outreach can take the leadership role in shaping the future direction of these farmers and their operations. (shrink)