871 resultados para Ethics, Medieval, in literature.


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Montana's oil and gas industries aggregate a gross income of over 12,000,000 annually to the state. Oil and gas fields have been thoroughly discussed in liter­ature as to geology, location, production and future possibilities. The specific object of this report has been to compile a comprehensive study of the production methods as they occur.

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Liquid films, evaporating or non-evaporating, are ubiquitous in nature and technology. The dynamics of evaporating liquid films is a study applicable in several industries such as water recovery, heat exchangers, crystal growth, drug design etc. The theory describing the dynamics of liquid films crosses several fields such as engineering, mathematics, material science, biophysics and volcanology to name a few. Interfacial instabilities typically manifest by the undulation of an interface from a presumed flat state or by the onset of a secondary flow state from a primary quiescent state or both. To study the instabilities affecting liquid films, an evaporating/non-evaporating Newtonian liquid film is subject to a perturbation. Numerical analysis is conducted on configurations of such liquid films being heated on solid surfaces in order to examine the various stabilizing and destabilizing mechanisms that can cause the formation of different convective structures. These convective structures have implications towards heat transfer that occurs via this process. Certain aspects of this research topic have not received attention, as will be obvious from the literature review. Static, horizontal liquid films on solid surfaces are examined for their resistance to long wave type instabilities via linear stability analysis, method of normal modes and finite difference methods. The spatiotemporal evolution equation, available in literature, describing the time evolution of a liquid film heated on a solid surface, is utilized to analyze various stabilizing/destabilizing mechanisms affecting evaporating and non-evaporating liquid films. The impact of these mechanisms on the film stability and structure for both buoyant and non-buoyant films will be examined by the variation of mechanical and thermal boundary conditions. Films evaporating in zero gravity are studied using the evolution equation. It is found that films that are stable to long wave type instabilities in terrestrial gravity are prone to destabilization via long wave instabilities in zero gravity.

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Since 1880, when Wolcott Gibbs made the suggestion that mercury could be used as a cathode in gravimetric electroanalysis, many articles have appeared in literature either criticizing the method or citing successful results which have been obtained by it.

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The accelerated post-war demand for petroleum products with resultant high prices and dwindling reserves has spurred producers to an extensive search for new fields and for ad­ditional production in known fields. Exploration and discov­ery is dependent on the collection and correlation of vast amounts of data both in the field and that found in liter­ature.

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PURPOSE OF REVIEW: Current guidelines for the management of acute coronary syndrome clearly recommend that clopidogrel should be started before diagnostic coronary angiography. If patients undergo coronary artery bypass grafting (CABG) early after clopidogrel loading or during continued exposure, it seems reasonable to expect an increase in bleeding complications. RECENT FINDINGS: Earlier studies may have overestimated the risk of bleeding in patient undergoing CABG with prior clopidogrel exposure (5-10-fold increase). Some conflicting results are reported in literature. As reexploration because of excessive bleeding is concerned, a two to three-fold increase must be expected, which is demonstrated in actual trials properly matched to confounding factors. Discontinuation of clopidogrel for 5-7 days prior to urgent CABG as recommended by guidelines is not well adopted in clinical practice for several reasons. SUMMARY: There is a moderately elevated risk of bleeding complications after CABG due to prior clopidogrel exposure alone. However, in clinical practice this risk is added often to patients who carry already elevated surgical risks (urgent procedures, worse coronary anatomy, history of previous myocardial infarction and prior percutaneous intervention), and after bleeding complications singular patients may suffer from consecutive adverse outcome. Cessation of clopidogrel in patients before CABG clearly prolongs hospitalization time and has an estimated 1% risk of coronary events during the waiting period. Risk and benefit have to be balanced in every individual case.

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Die Verwandlung von der weitgehend souveränen, selbstbestimmten und selbständigen Person zum intensiv abhängigen und sterbenden Menschen wird in der gerontologischen Kategorie des 'vierten Lebensalters' als lebensweltlich und biographisch integrierter Prozess verdeutlicht, der eigene Herausforderungen der Bewältigung bereithält. Die Notwendigkeit der normativen Reflexion dieses Prozesses zeigt sich besonders deutlich an der Problematik eines Würdeverständnisses, das in der Regel unhinterfragt mit den Vorstellungen von Selbstbestimmung und Souveränität verbunden oder gleichgesetzt wird. Der im interdisziplinären Gespräch zwischen Pflege, Medizin und Ethik angelegte Band fragt aus der Perspektive des 'vierten Lebensalters' nach den Konnotationen und Deutungen der Würdekategorie und damit nach den Voraussetzungen, Zielen und Orientierungsmassstäben für den Umgang mit Menschen und notwendige Entscheidungen in dieser Lebensphase, nach dem Konzept einer 'Würde im vierten Lebensalter', das im Kontext von Medizin- und Pflegeethik anwendbar ist.

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Sickle cell anemia (SCA) is a hemolytic disease characterized by the production of abnormal hemoglobin chains and distorted red blood cell morphology or sickling. "Sickle cell crisis" includes vaso-occlusive crisis, a plastic crisis, sequestration crisis, haemolytic crisis and often culminating in serious complications, organ damage and even sudden death. Post-mortem computed tomography (PMCT) findings of sickle cell disease have never been reported in literature. This case of sudden death from acute hemolytic crisis in SCA where post-mortem computed tomography (PMCT) and autopsy findings complemented each other, both revealing findings invisible to the other and both crucial to the case.

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Spousal loss is an inevitable critical life event for most individuals in old age, mostly associated with a negative impact on various well-being measures, ie. lower life satisfaction, higher rates of loneliness and depressive symptoms compared to married peers. While the negative effects on well-being are well documented in literature, the modifying factors accounting for the large variability in adaptation to loss are discussed controversially. The potential relevance of personality in the adaptation process has rarely been examined and findings regarding the role of time since loss are contradictory. Based on a vulnerability-stress-model this contribution aims a) to compare psychological well-being of bereaved individuals with married counterparts and b) to investigate the protective effects of different personality traits (Big Five, resilience), and the role of time since loss for adaptation in terms of life satisfaction, loneliness and depression. Data from a questionnaire study about the loss of a spouse in middle and old age in the German- and French-speaking parts of Switzerland are reported. The study is part of the Swiss National Centre of Competence in Research LIVES (Swiss National Science Foundation). The sample consists of 351 widowed persons (39% men, widowed since 0 - 5 years), and 605 married controls (50% men), aged 60 - 89 years. Group comparisons reveal the detrimental effect of spousal bereavement on all indicators of psychological adaptation. Results from hierarchical regression analyses show furthermore, that the effect of spousal loss on all psychological outcomes is moderated by personality traits. Separate analyses with the group of bereaved individuals suggest, that the protective effect of personality varies by the time passed since loss. Our results contribute to a better understanding of the variability in psychological adaptation to spousal loss in old age and give hints for counselling practice.

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Background: Semantic memory processes have been well described in literature. However, the available findings are mostly based on relatively young subjects and concrete word material (e.g. tree). Comparatively little information exists about semantic memory for abstract words (e.g. mind) and possible age related changes in semantic retrieval. In this respect, we developed a paradigm that is useful to investigate the implicit (i.e. attentionindependent) access to concrete and abstract semantic memory. These processes were then compared between young and elderly healthy subjects. Methods: A well established tool for investigating semantic memory processes is the semantic priming paradigm, which consists both of semantically unrelated and related word pairs. In our behavioral task these noun-noun word pairs were further divided into concrete, abstract and matched pronounceable non-word conditions. With this premise, the young and elderly participants performed a lexical decision task: they were asked to press a choice of two buttons as an indication for whether the word pair contained a non-word or not. In order to minimize controlled (i.e. attention-dependent) retrieval strategies, a short stimulus onset asynchrony (SOA) of 150ms was set. Reaction time (RT) changes and accuracy to related and unrelated words (priming effect) in the abstract vs. concrete condition (concreteness effect) were the dependent variables of interest. Results and Discussion: Statistical analysis confirmed both a significant priming effect (i.e. shorter RTs in semantically related compared to unrelated words) and a concreteness effect (i.e. RT decrease for concrete compared to abstract words) in the young and elderly subjects. There was no age difference in accuracy. The only age effect was a commonly known general slowing in RT over all conditions. In conclusion, age is not a critical factor in the implicit access to abstract and concrete semantic memory.

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OBJECTIVES To compare noninferiority margins defined in study protocols and trial registry records with margins reported in subsequent publications. STUDY DESIGN AND SETTING Comparison of protocols of noninferiority trials submitted 2001 to 2005 to ethics committees in Switzerland and The Netherlands with corresponding publications and registry records. We searched MEDLINE via PubMed, the Cochrane Controlled Trials Register (Cochrane Library issue 01/2012), and Google Scholar in September 2013 to identify published reports, and the International Clinical Trials Registry Platform of the World Health Organization in March 2013 to identify registry records. Two readers recorded the noninferiority margin and other data using a standardized data-abstraction form. RESULTS The margin was identical in study protocol and publication in 43 (80%) of 54 pairs of study protocols and articles. In the remaining pairs, reporting was inconsistent (five pairs, 9%), or the noninferiority margin was either not reported in the publication (five pairs, 9%) or not defined in the study protocol (one pair). The confidence interval or the exact P-value required to judge whether the result was compatible with noninferior, inferior, or superior efficacy was reported in 43 (80%) publications. Complete and consistent reporting of both noninferiority margin and confidence interval (or exact P-value) was present in 39 (72%) protocol-publication pairs. Twenty-nine trials (54%) were registered in trial registries, but only one registry record included the noninferiority margin. CONCLUSION The reporting of noninferiority margins was incomplete and inconsistent with study protocols in a substantial proportion of published trials, and margins were rarely reported in trial registries.

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IMPORTANCE The discontinuation of randomized clinical trials (RCTs) raises ethical concerns and often wastes scarce research resources. The epidemiology of discontinued RCTs, however, remains unclear. OBJECTIVES To determine the prevalence, characteristics, and publication history of discontinued RCTs and to investigate factors associated with RCT discontinuation due to poor recruitment and with nonpublication. DESIGN AND SETTING Retrospective cohort of RCTs based on archived protocols approved by 6 research ethics committees in Switzerland, Germany, and Canada between 2000 and 2003. We recorded trial characteristics and planned recruitment from included protocols. Last follow-up of RCTs was April 27, 2013. MAIN OUTCOMES AND MEASURES Completion status, reported reasons for discontinuation, and publication status of RCTs as determined by correspondence with the research ethics committees, literature searches, and investigator surveys. RESULTS After a median follow-up of 11.6 years (range, 8.8-12.6 years), 253 of 1017 included RCTs were discontinued (24.9% [95% CI, 22.3%-27.6%]). Only 96 of 253 discontinuations (37.9% [95% CI, 32.0%-44.3%]) were reported to ethics committees. The most frequent reason for discontinuation was poor recruitment (101/1017; 9.9% [95% CI, 8.2%-12.0%]). In multivariable analysis, industry sponsorship vs investigator sponsorship (8.4% vs 26.5%; odds ratio [OR], 0.25 [95% CI, 0.15-0.43]; P < .001) and a larger planned sample size in increments of 100 (-0.7%; OR, 0.96 [95% CI, 0.92-1.00]; P = .04) were associated with lower rates of discontinuation due to poor recruitment. Discontinued trials were more likely to remain unpublished than completed trials (55.1% vs 33.6%; OR, 3.19 [95% CI, 2.29-4.43]; P < .001). CONCLUSIONS AND RELEVANCE In this sample of trials based on RCT protocols from 6 research ethics committees, discontinuation was common, with poor recruitment being the most frequently reported reason. Greater efforts are needed to ensure the reporting of trial discontinuation to research ethics committees and the publication of results of discontinued trials.

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OBJECTIVE To investigate the planning of subgroup analyses in protocols of randomised controlled trials and the agreement with corresponding full journal publications. DESIGN Cohort of protocols of randomised controlled trial and subsequent full journal publications. SETTING Six research ethics committees in Switzerland, Germany, and Canada. DATA SOURCES 894 protocols of randomised controlled trial involving patients approved by participating research ethics committees between 2000 and 2003 and 515 subsequent full journal publications. RESULTS Of 894 protocols of randomised controlled trials, 252 (28.2%) included one or more planned subgroup analyses. Of those, 17 (6.7%) provided a clear hypothesis for at least one subgroup analysis, 10 (4.0%) anticipated the direction of a subgroup effect, and 87 (34.5%) planned a statistical test for interaction. Industry sponsored trials more often planned subgroup analyses compared with investigator sponsored trials (195/551 (35.4%) v 57/343 (16.6%), P<0.001). Of 515 identified journal publications, 246 (47.8%) reported at least one subgroup analysis. In 81 (32.9%) of the 246 publications reporting subgroup analyses, authors stated that subgroup analyses were prespecified, but this was not supported by 28 (34.6%) corresponding protocols. In 86 publications, authors claimed a subgroup effect, but only 36 (41.9%) corresponding protocols reported a planned subgroup analysis. CONCLUSIONS Subgroup analyses are insufficiently described in the protocols of randomised controlled trials submitted to research ethics committees, and investigators rarely specify the anticipated direction of subgroup effects. More than one third of statements in publications of randomised controlled trials about subgroup prespecification had no documentation in the corresponding protocols. Definitive judgments regarding credibility of claimed subgroup effects are not possible without access to protocols and analysis plans of randomised controlled trials.