Le temps est un grand maître en médecine. Il fait évoluer la maladie, le malade et sa relation avec le médecin. Il revient à ce dernier d'en prendre la mesure pour la maîtriser et l'exploiter plutôt que de s'en laisser dominer. C'est ce que l'auteur fait approcher par petites touches au fil d'une cinquantaine de réflexions puisées dans son expérience et ses lectures, alimentés de données parfois dérangeantes. Elles doivent aider à gérer une denrée précieuse, d'une manière simple, mais qui (...) ne va pas toujours de soi et peut contredire un bon sens élémentaire. Il en va de la qualité d'une pratique médicale et des satisfactions que patients comme soignants peuvent en retirer, en choisissant plutôt qu'en subissant. (shrink)

As is the case with most pre‐modern philosophers of India, very little historical information is available about Bhartṛ‐hari. There are many interesting legends, some turned into extensive plays and poems, current about him. However, it is impossible to determine on their basis even whether there was only one philosopher called Bhartṛ‐hari. The appellation “philosopher” could unquestionably be applied to the author or authors of at least two Sanskrit works that are commonly ascribed to Bhartṛ‐hari.

Ḥuqūq al-Islām.--Ḥuqūq al-vālidain.--Ādāb al-maʻ̄ashirat.--Ag̲h̲lāt̤ al-ʻulūm.

The author has made this treatise on Madhva’s realistic school of Ved?nta philosophy convincing to the modern mind by employing western logical apparatus in substantiating Madhva’s ideas. Following the Indian classical tradition, the author has examined the validity of Advaitaved?nta, the Absolute Monism of ?a?kara and Bh?skara as P?rvapak?a, and logically proved its inconsistencies. He has then established the Dvaitasiddh?nta i.e., the Monotheistic Dualism of Madhva. He has successfully brought out the nuances of the realistic school of Indian philosophical thought (...) in this work. A Modern Introduction to M?dhva Philosophy is Prof B H Kotabagi’s posthumous publication. (shrink)

Brian Wormald provides a fundamental reappraisal of one of the most complex and innovative figures of the late-Elizabethan and Jacobean age. In the centuries since his death, Francis Bacon (1561-1626) has been perceived and studied as a promoter and prophet of the philosophy of science--natural science--but he saw himself also as a clarifier and promoter of what he called "policy" or the study and improvement of the structure and function of civil states. Mr. Wormald shows that Bacon was concerned equally (...) with the knowledge of the world of nature and with that of policy. The junction between the two enterprises was effected by his work in history; and in the end it was Bacon's conception and practice of history that provided the answer to his efforts to advance policy and natural philosophy. (shrink)

Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity and death from COVID-19. The social restrictions proved challenging for the residents, their relatives, and the care staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge about how the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethical difficult situations experienced by Norwegian nurses working in nursing homes during the COVID-19 pandemic. Research design and (...) participants: The research design involved semistructured individual interviews conducted with 15 nurses working in 8 nursing homes in 3 health regions in Norway, within both urban and rural areas. Ethical considerations: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Norwegian Centre for Research Data. Findings: Four ethical difficult situations were identified: (a) turning the nursing home into a prison; (b) using medication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact on decision-making. Conclusions: The nurses’ ethical challenges were intertwined with external factors, such as national and local guidelines, and the nurses’ own internalized factors, which were connected to their subjective professionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in a professionally sound and safe manner. (shrink)

Background Informed consent confers upon participants the right to decline or accept participation in a study in equal measure. Consent declines can be used as a potential metric to assess the adequacy of the informed consent process. Limited literature is available on the reporting of consent declines in Clinical Research. We evaluated randomized controlled trials published in three high-impact factor journals for consent declines (four-year period) to assess the extent of exertion of autonomy by research participants. Methods CONSORT flow charts (...) in RCTs published in New England Journal of Medicine (NEJM), The Lancet and Journal of the American Medical Association (JAMA) between 2012 and 2015 were evaluated. The total and per journal proportion of RCTs reporting consent declines was calculated. Percentage of consent declines was also compared based on number of centers (single centric vs. multicentric) and type of setting (developed vs. developing). Between-groups analysis was done using Chi Square, Chi Square for trend and a Crude odds ratio [95% C.I] (cOR) were calculated. Results Only 3.7% (1103/29,825) of the published articles were RCTs. Of the 1103 RCTs, only 532 (48.2%) reported consent declines. JAMA had the highest RCTs reporting consent declines (171/267.64%), the Lancet [129,150/781,924, 16.5%] had the most participants declining consent. Difference was significant using Chi square for linear trend [ p < 0.00001]. Consent decline rate was higher in developed countries relative to developing countries [cOR(95% C.I): 2.27(2.23,2.32), p < 0.000001] and in single centric versus multicentric studies [cOR (95% C.I): 3.63(3.56,3.71), p < 0.0000001]. Conclusion Both authors and journal editors need to ensure better reporting of consent declines. (shrink)

'Philosophy arises through misconceptions of grammar', said Wittgenstein. Few people have believed him, and probably none, therefore, working in the area of the philosophy of mathematics. Yet his assertion is most evidently the case in the philosophy of Set Theory, as this paper demonstrates (see also Rodych 2000). The motivation for twentieth century Set Theory has rested on the belief that everything in Mathematics can be defined in terms of sets [Maddy 1994: 4]. But not only are there notable items (...) which cannot be so defined, including numbers and mereological sums, the very notion of a set, as formalized within this tradition, is based on a series of grammatical confusions. (shrink)

P.M.S. Hacker, recounting some of Wittgenstein's views, says : [T]he pervasive conception of behaviour that has informed philosophical psychology for the last three centuries has misrepresented human behaviour as 'bare bodily movement', from which it is supposed we infer, by analogy or inference to best explanation, the inner state and so on from which the behaviour might be thought to arise … But we see the pain in a person's face hear the glee in his chortles, perceive the affection in (...) the looks and gestures of lovers. In this paperIexplain how this can be, before meeting several objections. (shrink)

The history of Athenian relations with Sicily in the fifth century is beset with difficulties; and no part of it, perhaps, is more obscure than the story of what is commonly known as the First Sicilian Expedition, which set sail from Athens in the late summer of 427 under Laches, and was reinforced under Pythodorus, Sophocles and Eurymedon in the winter of 426.

The paper presents and applies Hilbert's Epsilon Calculus, first describing its standard proof theory, and giving it an intensional semantics. These are contrasted with the proof theory of Fregean Predicate Logic, and the traditional (extensional) choice function semantics for the calculus. The semantics provided show that epsilon terms are referring terms in Donnellan's sense, enabling the symbolisation and validation of argument forms involving E-type pronouns, both in extensional and intensional contexts. By providing for transparency in intensional constructions they support a (...) Model Conceptualism to contrast with traditional intensional logic's Modal Realism. But epsilon-terms also symbolise fictions, and through their difference from iota terms enable the solution of a number of outstanding puzzles about Direct Reference and de re beliefs. (shrink)

Two uses of ‘if are discussed which do not involve conditions. The first is illustrated in the example ‘If he's here, I don't see him’, the second in ‘He's not a dunce, if a trifle stupid’. A third non‐conditional use, cognate with the first is also mentioned: it would be illustrated in the example ‘If he's a Dutchman, I'll eat my hat’. It is argued that recent attempts to formulate a logic of conditionals have distorted our understanding of ‘if, by (...) ignoring these uses, sometimes deliberately. Specifically, as a result, many arguments involving ‘if have been misjudged as invalid, because the expectation has been that ‘if expresses a condition. It is suggested that the traditional analysis of ‘necessary and sufficient conditions’ in terms of ‘if and only if, is partly to blame for these misunderstandings. And the proper understanding of ‘if’ which emerges shows it is quite fully captured in the propositional calculus. (shrink)

Concepts of stability and symmetry in irreversible thermodynamics are developed through the analysis of system energy flows. The excess power function, derived from a local energy conservation equation, is shown to yield necessary and sufficient stability criteria for linear and nonlinear irreversible processes. In the absence of symmetry-destroying external forces, the linear range may be characterized by a set of phenomenological coefficient symmetries relating coupled forces and displacements, velocities, and accelerations, whereas rotational phenomena in nonlinear processes may be characterized by (...) skew-symmetric components of the phenomenological coefficients. A physical interpretation of the nature of the skew-symmetric parts is given and the variational principle of minimum dissipation of energy is related to a stability criterion. (shrink)

It is shown that: (i) the Onsager-Machlup postulate applies to nonlinear stochastic processes over a time scale that, while being much longer than the correlation times of the random forces, is still much shorter than the time it takes for the nonlinear distortion to become visible; (ii) these are also the conditions for the validity of the generalized Fokker-Planck equation; and (iii) when the fine details of the space-time structure of the stochastic processes are unimportant, the generalized Fokker-Planck equation can (...) be replaced by the ordinary Fokker-Planck equation. (shrink)

The thermodynamics of averaged motion treats the asymptotic spatiotemporal evolution of nonlinear irreversible processes. Dissipative and conservative actions are associated with short and long spatiotemporal scales, respectively. The motion of asymptotically stable systems is slow, monotonic, and continuous, so that the microscopic state variable description of rapid motion can be supplanted by an analysis of the macroscopic variable equations of motion of amplitude and phase. Rapid motion is associated with instability, and the direction of system motion is determined by thermodynamic (...) criteria, in place of an analysis of the microscopic equations of motion. The characteristic structural configurations, deduced from the extremum principles of partial differential equations, are compared with the thermodynamic criteria. As a result of the nature of asymptotic motion, variational principles exist which characterize the asymptotic states of the system. (shrink)

It seems surprising that this text—or others similar— has been accepted without any serious search for a more meaningful alternative. Even if it be thought that Euripides was capable of adding , in an unusual sense producing an awkward tautology, to , surely this should only be accepted in the absence ofa more credible emendation which departs no further from the manuscripts? Is there such an alternative? In the corresponding last line of the strophe we have : the first syllable (...) of is doubtful; there seems to be no convincing metrical objection to its being a long syllable here. This atonce suggests the maintenance of the manuscripts' to maintain the metrical balance. (shrink)