Nearly one-quarter of Costa Rica's export earnings derive from an expanding tourist sector, one that is increasingly diversified in a mix of tourist niches. Ecotourism is the fastest growing niche and its promises are featured in a range of sites and practices, including the largest multinational hospitality and hotel corporations. These companies promote a vision of sustainability that relies on expanding consumption of ‘environmental' amenities through profit-driven global corporations – a vision that is, to some, antithetical to the very meaning (...) of ecotourism. Our study explores the historical evolution of tourist development in Costa Rica, specifically large-scale coastal development, as a means for national development. Amid pressures to attract foreign direct investment in a neoliberal era, Costa Rica has struggled to maintain its developmentalism, which includes social welfare, environmental protection, and public goods, including coastal preservation and public access. We argue Costa Rica's simult.. (shrink)

BackgroundThe Public Health Service Increased Risk designation identified organ donors at increased risk of transmitting hepatitis B, hepatitis C, and human immunodeficiency virus. Despite clear data demonstrating a low absolute risk of disease transmission from these donors, patients are hesitant to consent to receiving organs from these donors. We hypothesize that patients who consent to receiving offers from these donors have decreased time to transplant and decreased waitlist mortality.MethodsWe performed a single-center retrospective review of all-comers waitlisted for liver transplant from (...) 2013 to 2019. The three competing risk events (transplant, death, and removal from transplant list) were analyzed. 1603 patients were included, of which 1244 (77.6%) consented to offers from increased risk donors.ResultsCompared to those who did not consent, those who did had 2.3 times the rate of transplant (SHR 2.29, 95% CI 1.88–2.79, p < 0.0001), with a median time to transplant of 11 months versus 14 months (p < 0.0001), as well as a 44% decrease in the rate of death on the waitlist (SHR 0.56, 95% CI 0.42–0.74, p < 0.0001). All findings remained significant after controlling for the recipient age, race, gender, blood type, and MELD. Of those who did not consent, 63/359 (17.5%) received a transplant, all of which were from standard criteria donors, and of those who did consent, 615/1244 (49.4%) received a transplant, of which 183/615 (29.8%) were from increased risk donors.ConclusionsThe findings of decreased rates of transplantation and increased risk of death on the waiting list by patients who were unwilling to accept risks of viral transmission of 1/300–1/1000 in the worst case scenarios suggests that this consent process may be harmful especially when involving “trigger” words such as HIV. The rigor of the consent process for the use of these organs was recently changed but a broader discussion about informed consent in similar situations is important. (shrink)

Hojjat Soofi successfully developed a novel dementia-specific model of human flourishing.1 Based on a modified version of Nussbaum’s account of dignity (ie, the theoretical framework of the capabilities approach), and integrated with Kitwood and Bredin’s empirically informed list of indicators of well-being for people with dementia (ie, the field of empirically informed ethics), this model provides guidance on how to actually care for people with dementia in real-life practices, according to the moral requirements of respect for dignity. More specifically, we (...) deem the contributive value of the model to be threefold. (1) It is a successful specification and contextualisation of Nussbaum’s original list of capabilities in the context of dementia care. (2) The table clearly distinguishes between dementia-specific capabilities and their possibly dementia-related progressive deprivation (ie, the internal conditions), and the possible external setbacks or facilitators for human flourishing. (3) The model is proposed as being open to include new and additional insights from further empirical research on what forms of caregiving do (or do not) align with respect for the dignity of people with dementia. In our commentary, we want to focus on the source of dignity, that is, the locus and starting point of our moral requirements on which the author takes an explicit stance. First of all, by being founded on the list of dementia-specific capabilities, Soofi’s model places the source of our moral requirements of respect for the dignity of people with dementia within the persons themselves, ‘having some of the basis capabilities listed’ (p.6). This, in turn, brings classic discussions concerning a …. (shrink)

Cet ouvrage relate l'enquête et le procès menés en 1653 par le Parlement de Provence contre Madeleine Demandolx de la Palud. C'est un récit inspiré des archives conservées à la bibliothèque nationale de France et fort agréable à lire. Délesté de tout appareil scientifique, il est cependant fort instructif, car l'auteur, bon connaisseur du XVIIe siècle provençal (cf. sa thèse, Vivre sa soumission. L'exemple des Ursulines provençales et comtadines (1595-1792), Paris, Publi sud, 1997), me...

Voici un livre important. Ne nous laissons pas abuser par son titre discret et son illustration de couverture idyllique. Mine de rien, il montre, avec une maîtrise exceptionnelle, comment et pourquoi l’histoire des femmes est un moteur puissant de l’histoire tout court. On pourrait croire que l’accouchement sans douleur concerne seulement le confort des parturientes. On découvre ici que cette « révolution oubliée » a bouleversé non seulement l’histoire du corps, de la santé, de la douleur, ma...

BackgroundSelf-prescribing and prescribing to personal contacts is explicitly discouraged by General Medical Council guidelines.AimsThis study examines how widespread the practice of self-prescribing and prescribing to personal contacts is.MethodsA 16-item questionnaire was distributed via an online forum comprising 4445 young medical doctors (representing 20% of all Irish registered doctors), which asked respondents about previous prescribing to themselves, their families, friends and colleagues, including the class of medication prescribed. Demographic details were collected including medical grade and specialty.ResultsA total of 729 responses were (...) obtained, the majority of which were from young non-consultant hospital doctors from a range of specialties. Two-thirds of respondents had self-prescribed, over 70% had prescribed to family, and nearly 60% had prescribed to a friend or colleague. Older doctors were more likely to self-prescribe (χ2=17.51, p<0.001). Interns being less likely to self-prescribe was not unexpected (χ2=69.55, p<0.001), while general practitioners (GPs) and paediatricians were more likely to self-prescribe (χ2=13.33, p<0.001;χ2=11.35, p<0.001). GPs, paediatricians and hospital medicine specialties were more likely to prescribe to family (χ2=5.19, p<0.05;χ2=8.38, p<0.05;χ2=6.17, p<0.05) and surgeons were more likely to prescribe to friends (χ2=15.87, p<0.001). Some 3% to 7% who had self-prescribed had prescribed an opiate, benzodiazepine or psychotropic medication. Male doctors, anaesthetists and surgeons were more likely to self-prescribe opioids (χ2=7.82, p<0.01;χ2=7.31, p<0.01;χ2=4.91, p<0.05), while those in hospital medicine were more likely to self-prescribe psychotropic medications (χ2=5.47, p<0.05).ConclusionPrescribing outside the traditional doctor-patient relationship is widespread despite clear professional guidance advising against it. (shrink)

Voici un livre important. Ne nous laissons pas abuser par son titre discret et son illustration de couverture idyllique. Mine de rien, il montre, avec une maîtrise exceptionnelle, comment et pourquoi l’histoire des femmes est un moteur puissant de l’histoire tout court. On pourrait croire que l’accouchement sans douleur concerne seulement le confort des parturientes. On découvre ici que cette « révolution oubliée » a bouleversé non seulement l’histoire du corps, de la santé, de la douleur, ma...

Il y a comme un hiatus entre le titre et le sous-titre de ce livre. Le titre, Aux origines de l'action sociale, annonce une intention modeste ; en effet l'ouvrage, composé de touches successives, ne se présente pas comme une synthèse historique organisée. Par contre le sous-titre indique un projet précis et construit, un projet d'histoire : L'invention des services sociaux aux chemins de fer. Dans le texte tout se passe comme si les auteurs n'avaient pas voulu (pas su?) choisir (...) entre... (shrink)

Voici un livre important. Ne nous laissons pas abuser par son titre discret et son illustration de couverture idyllique. Mine de rien, il montre, avec une maîtrise exceptionnelle, comment et pourquoi l’histoire des femmes est un moteur puissant de l’histoire tout court. On pourrait croire que l’accouchement sans douleur concerne seulement le confort des parturientes. On découvre ici que cette « révolution oubliée » a bouleversé non seulement l’histoire du corps, de la santé, de la douleur, ma...

Voici un livre important. Ne nous laissons pas abuser par son titre discret et son illustration de couverture idyllique. Mine de rien, il montre, avec une maîtrise exceptionnelle, comment et pourquoi l’histoire des femmes est un moteur puissant de l’histoire tout court. On pourrait croire que l’accouchement sans douleur concerne seulement le confort des parturientes. On découvre ici que cette « révolution oubliée » a bouleversé non seulement l’histoire du corps, de la santé, de la douleur, ma...

Children with autism spectrum disorder show marked difficulties in reading comprehension, a complex cognitive skill fundamental to successful daily functioning that is associated with core executive functions. However, the neurophysiological mechanisms underlying reading comprehension deficits in these children remain elusive. Twenty-one right-handed males with high-functioning ASD and 23 age-, IQ-, educational level-, sex- and handedness-matched typically developing individuals underwent a reading comprehension test and the semantic verbal fluency test that tapped core executive functions underlying reading comprehension during concurrent prefrontal functional (...) near-infrared spectroscopy measurement. Participants’ information processing efficiency was also assessed. High-functioning ASD children exhibited general reading comprehension [main effect of group: F = 7.58, p = 0.009], selective verbal fluency deficits [Group × category interaction: F = 4.90, p = 0.032] and slower processing speed. Regarding the hemodynamics of the prefrontal cortex, although ASD individuals showed comparable patterns of PFC brain activation to their healthy counterparts, lower PFC intrahemispheric [main effect of group: F = 11.36, p = 0.002] and interhemispheric [main effect of group: F = 7.79, p = 0.008] functional connectivity were evident during the semantic verbal fluency test. At the whole-group level, poorer reading comprehension performance was associated with poorer performance in the semantic verbal fluency test. Moreover, poorer semantic verbal fluency test performance was associated with slower information processing speed, which is associated with reduced left medial PFC functional connectivity. Abnormal intrahemispheric and interhemispheric prefrontal hypoconnectivity is associated with deficits in executive processes essential for reading comprehension in ASD. Our study has provided important implications for the neuropsychological and neurophysiological mechanisms underlying reading comprehension deficits in ASD. (shrink)

Yvonne Knibiehler continue son histoire des mères commencée il y a quelques années et arrêtée au seuil des ses propres enfantements, comme elle le rappelle dans l'introduction. L'entreprise n'est pourtant pas aisée. Non pas que le sujet déborderait trop sur l'intime de la chercheuse. L'égo-histoire, qui ne rime décidément pas avec l'histoire tout court, ne dépasse pas les premières pages de l'ouvrage. Mais le sujet est miné, piégé de l'intérieur par une charge idéologique hors du commu..

À une époque où l'on constate la présence massive des femmes dans le monde public, féminisant la culture, Yvonne Knibiehler lance son défi provocant : comment les femmes peuvent-t-elles contribuer à faire avancer la réflexion sur les questions de la sexualité, notamment en ce qui concerne les relations entre les sexes et l'éducation sexuelle des jeunes, alors que la fête libératrice de la Révolution sexuelle est finie? Comment construire au présent une éducation des jeunes à la sexual...

Voici un livre à deux voix, où s’entrelacent en un dialogue (rendu sensible par des typographies contrastées) les réflexions d’une grande historienne de la maternité et celles d’un gynécologue obstétricien d’aujourd’hui. Il s’agit de comprendre les profondes transformations de la procréation et de la naissance dans nos sociétés en revenant sur l’histoire longue des croyances et des pratiques autour de la grossesse et de l’accouchement. Même s’il n’est pas question de proposer un retour à l’an...

Les textes réunis dans cet ouvrage pluridisciplinaire, issus de communications données au colloque de La Rochelle (2 octobre 2001) ainsi qu’au colloque international de Toulouse « Recherches francophones. Ruptures, résistances, utopies (17-22 septembre 2002) », sont articulés autour d’un argument commun : redonner sa place, au sein de débats actuellement dominés par la notion de « parentalité », à un questionnement axé sur la redéfinition contemporaine de la maternité. Forgé dans le creuset d...

Cet ouvrage reprend sous forme remaniée les actes du colloque « Germaine Poinso-Chapuis, témoin de son temps » organisé à Marseille par l'association Les Femmes et la Ville (20-22 novembre 1997). Il répare heureusement l'oubli injuste d'une figure majeure de l'histoire de l'après-guerre. Moins connue que les femmes sous-secrétaires d'État du Front populaire alors qu'elle est la première femme ministre de plein exercice, moins populaire que Simone Veil alors qu'elle a été députée pendan...

Anne Cova s'est emparée d'un sujet central pour l'histoire des femmes : la maternité. En 1977, Catherine Fouquet et Yvonne Knibiehler avaient publié la première synthèse, Histoire des mères du Moyen Age à nos jours. Élisabeth Badinter, en 1980, attirait elle aussi, avec L'Amour en plus, l'attention du public sur l'historicité du sentiment maternel, soulignant la mutation survenue au XVIIIe siècle : début de la limitation des naissances, rapprochement de la mère et de l'enfant, valorisa..

The desire to see a sign phenomenon in different ways always has a reason to interpret it in an unbiased, panoramic way, and in some places - even allowing for contradictions in its understanding by different participants in the interpretative process. For modern humanities, this disposition is quite understandable, since it follows from its very postmodern nature, thereby defining the semantic semantic fields of the leading humanities. True, it is not so wide-spread, but instead, it is evident that Ukrainian religious (...) thinkers of the Middle Ages and Baroque have interpreted the iconic phenomena more deeply. In the story of Petro Mohyla "On the Wonderful Elder Grigory Mezhyhirsky" the metropolitan Mohyla clearly expresses the need to build before the thinking gaze of the reader his own, immanently religious-philosophical conception of the Divine, which every time would present him not just as an act of manifestation, otherwise he appears before the person, while remaining alone. The contemporary study of this issue in order to integrate its leading concepts in the religious-philosophical and general cultural discourse of the postmodern era has largely determined the relevance of the proposed article. The study of the phenomenon of "leaving" by itself in changing forms of the phenomenon of the Divine is also one of the key ones in the proposed studio, because it expresses the very meaning of the Divine as a religious, and therefore a cultural phenomenon. (shrink)

Given a physical system, one knows that there is a logical duality between its properties and its states. In this paper, we choose its states as the undefined notions of our axiomatic construction. In fact, by means of well-motivated assumptions expressed in terms of a transition probability function defined on the set of all pure states of the system, we construct a system of elementary propositions, i.e., a complete orthomodular atomic lattice satisfying the covering law. We also study in this (...) framework the important notion of compatibility of propositions, and we define the superpositions and the mixtures of the states of the physical system. (shrink)

Richard Taylor was born in Charlotte, Michigan on 5 November 1919. He received his A. B. from the University of illinois in 1941, his M. A. from Oberlin College in 1947, and his Ph. D. from Brown University in 1951. He has been William H. P. Faunce Professor of Philosophy at Brown University, Professor of Philosophy (Graduate Faculties) at Columbia University, and Professor of Philosophy at the University of Rochester. He is the author of about fifty articles and of five (...) philosophical books. This volume consists of essays presented to Richard Taylor on the occa sion of his sixtieth birthday. Some of the contributors have been Taylor'S students; some have been his colleagues; and all have been, and continue to be, his admirers. I have made several attempts to articulate what it is I (I would not presume to speak for anyone else) admire about Richard Taylor: (1) There is a particular 'flavor' to Taylor's philosophical writing and con versation that is wholly delightful. Like any other flavor, it can be tasted and enjoyed and remembered but never adequately described. (If there should be someone who has picked up this book who does not know what I mean, I recommend that he read the chapter on 'God' in Taylor's Metaphysics. ) (2) Taylor is a masterful dialectician. (shrink)

P.M.S. Hacker 1. _The problems of Intentionality_ The problems of intentionality have exercised philosophers since the dawn of their subject. In the last century they were brought afresh into the limelight by Brentano. Famously he remarked that.

‘To Gödel via Babel’, MIND, July 1966.In (1), the last clause should read: ‘then the GN of the resulting P-sentence is x100.y’ In (21), the expression in Roman numerals should read: ‘$$Y.\frac{\hbox{ L }Y}{\hbox{ XIX }}$$’ In (25) and (27), the expression in Roman numerals should read: ‘$${(\hbox{ C }}^{\hbox{ XVII }}.\hbox{ D })\hbox{ . }\frac{\hbox{ L }\left({\hbox{ C }}^{\hbox{ XVII }}.\hbox{ D }\right)}{\hbox{ XIX }}$$’.

This essay engages Mary Shelley’s Frankenstein or The Modern Prometheus as a salient intervention into modern political theory. I analyze the work as a cipher for the tensions inhabiting Euro-modernity’s stitched together fictions of racial determinism and racial dynamism legible in slavery, assimilationist projects and White fears reverberating throughout. Adapting the mythical ancient Prometheus as one who steals fire from the gods to create humans and civilization, Frankenstein dramatizes the risks and monstrous results of White imperial masculinity as a Euro-colonial (...) Promethean project of subject formation and race-making. Viewed through the prism of the Modern Prometheus, modernity in general and liberal humanism in particular are recast as monster-making projects. The European “discovery” of Indigenous peoples amplified Promethean aspirations to create subjects through civilizational processes of religious conversion, the infusion of Enlightenment rationality, and assimilation into whiteness. Politically, the Promethean capacity to engineer humans and proto-humans using Native peoples as raw material allowed progressives to argue against outright extermination in favor of cultural genocide. Seeking to create a subserviant species, Victor Frankenstein confronts a revolting insurrection of his own making—a Creature who refuses slavery, claims mastery over his creator and demands a female companion. Yet Frankenstein’s fear of creating “a race of devils” betrays a terror of what Whites know, but refuse to acknowledge, about themselves and racial others. (shrink)

The article is concerned with the question of how legal institutions are structured with the use of constitutive, institutive, consequential, and terminative rules. To that end, the regulation of international treaties as laid down in the Vienna Convention on the Law of Treaties of 1969 is analysed. This leads to the discovery of two additional categories of rules: content rules and invalidating rules. Finally, the special status of unique legal institutions is investigated. Unique legal institutions – for example, heads of (...) state, parliaments, and supreme courts – enjoy validity in a legal system to the exclusion of the validity of any other legal institution of the same category in that system. (shrink)

In the Ukrainian reality of the twenty-first century. The search for the dominant spiritual and national identity is one of the leading places. The dialogue between Catholicism, which is represented by the spiritual phenomenon of the Vatican, and by Ukraine, one of the countries not only of the Greek Catholic, but also of the Orthodox tradition, with a distinct national-cultural specificity, is, in our opinion, the semiosphere where the answers to many challenges of the present and the future. But such (...) answers are difficult to find if the sine era et studio does not analyze the key trends in the development of the Ukrainian Orthodox Church by examining it, without looking back at the stereotypes of the identification of Ukrainian spiritual thinking and being with the imperially secular tradition. The most suitable method for this task is the comparative methodology, which examines the basic ideological characteristics of the ideological world of Orthodox thinkers - from Ivan Vyshensky and to thinkers and spiritual prophets of the Second Cathedral of the UAOC. (shrink)

Actuality of the usage of the food safety knowledge-based technologies is shown. The food safety stakeholders and information objects are presented. The set of ontologies and context areas which are described decision –making tasks and processes are shown. The basic ontology is presented as a means of conceptual representation of the field of food safety. The usage of decision-making is considered. Modern food processing technologies, food safety requirements, food safety requirements etc. are characterized by the need for complex and rational (...) solutions. It is necessary to consider different aspects of decision-making in food safety, which can be based not only on the knowledge of a particular subject area. The use of information and knowledge is a key task in any problem area related to the production and dissemination of knowledge, especially new types of unique content that are useful and accessible. The paper aim is to conceptually present an ontological system based on the use of context and ontologies and aimed at supporting decision making in the food safety management system. Food safety knowledge, which used in decision-making processes, is considered as the context knowledge and the knowledge that describes the content. The paper presents food safety stakeholders and provides information objects. The information and knowledge includes various aspects such as knowledge and information on the production and processing industry; and the food safety aspects. For this purpose, an interconnected set of ontologies is used, which is a multilevel associative structure: meta-ontology; basic ontology; context ontology; set of domain ontologies; realization ontology; user presentation and interaction ontology; model of inference machine. Implementation of food safety processes and integration of the components of decision-making is based on the presentation of the multi-level system of management and decision-making in it through a model of a context. The context framework takes into account different context domains, such as: purpose/result, actor, process/action, object, environment, facility, tools, presentation, location, and time. The ontology implementation builds an inter connected system of preparation and choice of solutions, both for the given problem and for interaction with other complexes of problems and tasks, allows to make decisions taking into account the consequences of their implementation. (shrink)