Doctors and their patients: A context for understanding the wish to hasten death

There is a paucity of research that has directly examined the role of the health professional in dealing with a terminally ill patient's wish to hasten death (WTHD) and the implications of this for the support and services needed in the care for a dying patient. Themes to emerge from a qualitative analysis of interviews conducted on doctors (n = 24) involved in the treatment and care of terminally ill patients were (i) the doctors' experiences in caring for their patients (including themes of emotional demands/expectations, the duration of illness, and the availability of palliative care services); (ii) the doctors' perception of the care provided to their respective patients (comprising themes concerning satisfaction with the care for physical symptoms, for emotional symptoms, or overall care); (iii) the doctors' attitudes to euthanasia and (iv) the doctors' perception of their patients' views/beliefs 'regarding euthanasia and hastened death. When responses were categorised according to the patients' level of a WTHD, the theme concerning the prolonged nature of the patients' illnesses was prominent in the doctor group who had patients with the highest WTHD, whereas there was only a minority of responses concerning support from palliative care services and satisfaction with the level of emotional care in this group. This exploratory study presents a set of descriptive findings identifying themes among a small group of doctors who have been involved in the care of terminally ill cancer patients, to investigate factors that may be associated with the WTHD among these patients. The pattern of findings suggest that research investigating the doctor-patient interaction in this setting may add to our understanding of the problems (for patients and their doctors) that underpins the wish to hasten death in the terminally ill. Copyright (C) 2003 John Wiley Sons, Ltd.

Love, that indispensable supplement: Irigaray and Kant on love and respect

Is love essential to ethical life, or merely a supplement? In Kant's view, respect and love, as duties, are in tension with each other because love involves drawing closer and respect involves drawing away. By contrast, Irigaray says that love and respect do not conflict because love as passion must also involve distancing and we have a responsibility to love. I argue that love, understood as passion and based on respect, is essential to ethics

A OCUPAÇÃO RACIONAL DA ARTE NA EDUCAÇÃO FORMAL: UM ESTUDO DESDE A PERSPECTIVA DA CRIATIVIDADE

A arte e a atividade criativa são alguns dos ingredientes essenciais para o crescimento individual, social e cultural do ser humano e, em consequência, da humanidade. Contudo, desde o século XVI vivemos fortemente influenciados pelos parâmetros da racionalidade cognitivo-instrumental. Particularmente na cultura ocidental tem sido predominante a supervalorização da objetividade, da racionalidade e das ciências duras em detrimento da criação artística. Esta pesquisa examina a ocupação racional da arte e sua influência na limitação da criatividade no ambiente escolar. Assim, analisa as diversas concepções de criatividade, à luz da evolução histórica e as influências herdadas do contexto sóciocultural. Considera ainda o conceito de Arte/Educação em sua relação com as condições históricas da inserção da educação formal no Brasil. Finalmente, esta dissertação identifica as marcas da racionalidade em processos educacionais correntes no Brasil, tendo como referência teorias contemporâneas. As conclusões deste trabalho poderão servir como base para fornecer subsídios à reflexão sobre a necessidade de renovação dos olhares sobre a criatividade, como instrumento de formação intelectual, no ensino de artes no contexto escolar.

Back from the future:the second chance in the past of aller + infinitive

Typological studies (Bybee et al. 1994, Dahl 2000, Bourdin 2008 among many others) have shown a tendency for spatial elements (such as movement verbs) to grammaticalise into temporal expressions. The periphrasis made of aller + infinitive has been very productive in Romance languages. If in French, Spanish or Portuguese, it refers to future, it refers to a simple past in Catalan. fr.: je vais aller au cinéma esp.: voy a ir al cine pt. Vou ira o cine cat.: vaig anar al cine Barceló & Bres (2005:168) indicate that, In French, «vers le XVIème siècle, […] la périphrase a brièvement fonctionné comme un temps du passé (alors même que l’emploi comme temps du futur émergeait)»: (1) Sur ces propos, firent leur accord et, en regardant le lieu le plus propre pour faire cette belle œuvre, elle va dire qu’elle n’en savait point de meilleure ni plus loin de tout soupçon, qu’une petite maison qui était dedans le parc, où il y avait chambre et lit tout à propos. (Marguerite de Navarre, L’Heptaméron) The future value took over so much so that Damourette & Pichon (1911-1936 :117) claimed the past value had disappeared»: Un second tour, encore plus aberrant, n’a plus, que nous sachions, aucune position en pays d’Oui. Nous voulons parler de l’expression d’un passé au moyen de l’auxiliaire aller, suivi de l’infinitif. Ce tour a eu une grande fortune dans le provençal ancien et le catalan […] En français, on n’en trouve que des traces, notamment du XIVe au XVIe siècles . Ex.:[…] Adoncques s’arrêtèrent le conte et Raimondin soubz un grand arbre ; lors va dire le conte à Raimondin: […]. Et Raimondin va lui dire : Sire, ce qu’il vous plaira. That allegedly extinct use is nonetheless alive and kicking in Contemporary French. Larreya (2005:349)notes that it is « très courant dans les récits – en particulier dans les récits oraux» and it is also found in newspaper language as shown by this except from an obituary for Loulou Gasté (Le Monde 1995): (2) Celle-ci se déroule aux Editions Micro, où il a un bureau. Séduit par la jeune interprète, il commence à lui écrire des chansons sur mesure et leur complicité va mettre cinq ans à se transformer en amour. Au début de leur rencontre, Loulou est neurasthénique parce qu’il vient de divorcer et la future Line, exclusivement préoccupée par son métier, ne songe à rien d’autre. Line et Loulou vont rattraper le temps perdu et créer ensemble un millier de petites chansons dont la plupart sont devenues immortelles. Jusqu’à ces derniers mois, il ne va pas se passer une journée sans que Loulou s’empare de sa guitare pour créer un refrain. Would we be witnessing a linguistic resurrection? The same structure seems therefore to have grammaticalised in diverging and even diametrically opposite ways in different Romance languages. In this talk, we shall try to explain how the phrase aller + infinitive is able to function both as a future and a past. We will especially concentrate on the case of contemporary French where, while the future interpretation has obtained the status of tense as futur proche or périphrastique, a past interpretation is now commonplace. Our reflection will be supported by a personal corpus of authentic examples.

Oxygen, pH and calcium dynamics and fluxes at the thallus surface under ambient (8.1) and low (7.8) seawater pH and across a range of irradiances

Presently, an incomplete mechanistic understanding of tropical reef macroalgae photosynthesis and calcification restricts predictions of how these important autotrophs will respond to global change. Therefore, we investigated the mechanistic link between inorganic carbon uptake pathways, photosynthesis and calcification in a tropical crustose coralline alga (CCA) using microsensors. We measured pH, oxygen (O2), and calcium (Ca2+) dynamics and fluxes at the thallus surface under ambient (8.1) and low (7.8) seawater pH (pHSW) and across a range of irradiances. Acetazolamide (AZ) was used to inhibit extracellular carbonic anhydrase (CAext), which mediates hydrolysis of HCO3-, and 4,4' diisothiocyanatostilbene-2,2'-disulphonate (DIDS) that blocks direct HCO3- uptake by anion exchange transport. Both inhibited photosynthesis, suggesting both diffusive uptake of CO2 via HCO3- hydrolysis to CO2 and direct HCO3- ion transport are important in this CCA. Surface pH was raised approximately 0.3 units at saturating irradiance, but less when CAext was inhibited. Surface pH was lower at pHSW 7.8 than pHSW 8.1 in the dark, but not in the light. The Ca2+ fluxes were large, complex and temporally variable, but revealed net Ca2+ uptake under all conditions. The temporal variability in Ca2+ dynamics was potentially related to localized dissolution during epithallial cell sloughing, a strategy of CCA to remove epiphytes. Simultaneous Ca2+ and pH dynamics suggest the presence of Ca2+/H+ exchange. Rapid light-induced H+ surface dynamics that continued after inhibition of photosynthesis revealed the presence of a light-mediated, but photosynthesis-independent, proton pump. Thus, the study indicates metabolic control of surface pH can occur in CCA through photosynthesis and light-inducible H+ pumps. Our results suggest that complex light-induced ion pumps play an important role in biological processes related to inorganic carbon uptake and calcification in CCA.

Benthic organic carbon flux and oxygen penetration depth in the Southern Ocean

For the investigation of organic carbon fluxes reaching the seafloor, oxygen microprofiles were measured at 145 sites in different sub-regions of the Southern Ocean. At eleven sites, an in situ oxygen microprofiler was deployed for the measurement of oxygen profiles and the calculation of organic carbon fluxes. At four sites, both in situ and ex situ data were determined for high latitudes. Based on this dataset as well as on previous published data, a relationship was established for the estimation of fluxes derived by ex situ measured O2 profiles. The fluxes of labile organic matter range from 0.5 to 37.1 mgC m**2/day. The high values determined by in situ measurements were observed in the Polar Front region (water depth of more than 4290 m) and are comparable to organic matter fluxes observed for high-productivity, upwelling areas like off West Africa. The oxygen penetration depth, which reflects the long-term organic matter flux to the sediment, was correlated with assemblages of key diatom species. In the Scotia Sea (~3000 m water depth), oxygen penetration depths of less than 15 cm were observed, indicating high benthic organic carbon fluxes. In contrast, the oxic zone extends down to several decimeters in abyssal sediments of the Weddell Sea and the southeastern South Atlantic. The regional pattern of organic carbon fluxes derived from micro-sensor data suggest that episodic and seasonal sedimentation pulses are important for the carbon supply to the seafloor of the deep Southern Ocean.

Interpretational variability of structural traps : implications for exploration risk and volume uncertainty

We would like to acknowledge and thank Frank Peel and Seb Turner for taking time to review this paper. Also thanks to Marguerite Fleming for perpetual encouragement. From: Richards, F. L., Richardson, N. J., Rippington, S. J., Wilson, R. W. & Bond, C. E. (eds) 2015. Industrial Structural Geology: Principles, Techniques and Integration. Geological Society, London,

Interpretational variability of structural traps : implications for exploration risk and volume uncertainty

We would like to acknowledge and thank Frank Peel and Seb Turner for taking time to review this paper. Also thanks to Marguerite Fleming for perpetual encouragement. From: Richards, F. L., Richardson, N. J., Rippington, S. J., Wilson, R. W. & Bond, C. E. (eds) 2015. Industrial Structural Geology: Principles, Techniques and Integration. Geological Society, London,

Dynamiques familiales de la communauté hindoue de Montréal : contrer la violence intrafamiliale

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Dynamiques familiales de la communauté hindoue de Montréal : contrer la violence intrafamiliale

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Trace element composition of IODP Site 304-U1309 and 305-U1309 (Table A2)

IODP Site U1309 was drilled at Atlantis Massif, an oceanic core complex, at 30°N on the Mid-Atlantic Ridge (MAR). We present the results of a bulk rock geochemical study (major and trace elements) carried out on 228 samples representative of the different lithologies sampled at this location. Over 96% of Hole U1309D is made up of gabbroic rocks. Diabases and basalts cross-cut the upper part of the section; they have depleted MORB compositions similar to basalts sampled at MAR 30°N. Relics of mantle were recovered at shallow depth. Mantle peridotites show petrographic and geochemical evidence of extensive melt-rock interactions. Gabbroic rocks comprise: olivine-rich troctolites (> 70% modal olivine) and troctolites having high Mg# (82-89), high Ni (up to 2300 ppm) and depleted trace element compositions (Yb 0.06-0.8 ppm); olivine gabbros and gabbros (including gabbronorites) with Mg# of 60-86 and low trace element contents (Yb 0.125-2.5 ppm); and oxide gabbros and leucocratic dykes with low Mg# (< 50), low Ni (~65 ppm) and high trace element contents (Yb up to 26 ppm). Troctolites and gabbros are amongst the most primitive and depleted oceanic gabbroic rocks. The main geochemical characteristics of Site U1309 gabbroic rocks are consistent with a formation as a cumulate sequence after a common parental MORB melt, although (lack of systematic) downhole variations indicate that the gabbroic series were built by multiple magma injections. In detail, textural and geochemical variations in olivine-rich troctolites and gabbronorites suggest chemical interaction (assimilation?) between the parental melt and the intruded lithosphere. Site U1309 gabbroic rocks do not represent the complementary magmatic product of 30°N volcanics, although they sample the same mantle source. The bulk trace element composition of Site U1309 gabbroic rocks is similar to primitive MORB melt compositions; this implies that there was no large scale removal of melts from this gabbro section. The occurrence of such a large magmatic sequence implies that a high magmatic activity is associated with the formation of Atlantis Massif. Our results suggest that almost all melts feeding this magmatic system stays trapped into the intruded lithosphere.

De la moral del sacrificio a la conciencia de la precariedad. Un análisis cualitativo de los discursos sobre la evolución de la crisis en España

La larga crisis económica que padece España está teniendo importantes consecuencias sociales. La más comentada por académicos, mass media y parte del arco político es la fractura social que se está abriendo en el país, ante el aumento de las desigualdades económicas que generan el enorme desempleo y las duras políticas de ajuste del gasto público. Sin embargo, más allá de cuestiones económicas la crisis está haciendo mella de forma muy profunda en el imaginario social del país en relación a las razones y consecuencias de la crisis, tanto a corto como a largo plazo. El objetivo de este artículo es el realizar una valoración de esas percepciones sociales de la ciudadanía en relación con la crisis, centrándonos en un aspecto como es el de la relación de la población española con el consumo de bienes y servicios públicos, en un escenario de hegemonía de la austeridad como única receta anti-crisis. Para ello, realizaremos un análisis de los discursos recogidos en una investigación cualitativa realizada en el año 2014 mediante grupos de discusión. Los resultados muestran un pesimismo enorme de la población en relación al futuro del Estado del Bienestar y de la propia clase media española, junto a una frustración que puede anunciar futuros ciclos de movilización social.

Olivella Columellaris: un caracol de la Playa de Los Blancos

En la playa los Blancos del Estero de Jaltepeque en El Salvador existe siempre un fuerte oleaje que revuelve su suelo profundamente arenoso.Cada una de las oleadas causa además,particularmente en su contracorriente,una fuerte desviación de la arena hacia el occidente.Dentro de la zona del oleaje toda la arena de la playa esta en un movimiento continuo debido a las mareas,esta zona sufre fuertes movimientos del suelo cada doce horas,en que se mueven distintas fajas de las costas hacia adelante y atrás.Durante la marea alta un fuerte oleaje revuelve la playa y pocas horas después ya no se encuentra una gota de agua en la superficie de la arena.Durante el día su arena oscura se calienta rápida e intensamente.Una región tal que sufre primeramente un fuerte movimiento perpetuo y segundo un cambio microclimático tan fuerte y en breve plazo,ofrece condiciones bastante duras para la existencia de los más variados organismos,en particular para los animales de la macrofauna.Por otra parte la arena se mueve tan fuertemente que ejerce una fuerte presión en organismos soterrados.Sin embargo,existen algunos animales que según su constitución y su manera de vivir son capaces de existir en un ambiente semejante.Entre ellos se encuentra el caracol prosobranquial Olivella Columellaris que vive en la playa de los Blancos en grandes cantidades,este vive enterrado en la arena en la zona de los rompientes de las mareas.Su cubierta protege su cuerpo blando contra la fricción de la arena.

Princesses et duchesses bibliophiles à la cour de René d'Anjou

De nombreuses dames de la cour d'Anjou ont exercé un mécénat littéraire et bibliophilique important à la cour d'Anjou. Parmi elles se trouvent Marie de Blois (v. 1340-1404), Yolande d'Aragon (1381-1442), Isabelle de Lorraine (v. 1400-1453), Jeanne de Laval (1433-1498) et Marie de Clèves (1426-1487). Le mécénat de ces femmes, parentes, épouses ou amies de René d'Anjou, est ici abordé à travers les documents d'archives et les manuscrits conservés qui attestent d'un intérêtréel et constant pour l'art du livre et de l'enluminure et pour la littérature en vogue à la cour. Une attention toute particulière est réservée au Pèlerinage de Vie humaine de Guillaume de Digulleville dont la version rimée, et plus tard la version en prose commandée par Jeanne de Laval, n'a cessé de captiver le lectorat féminin et notamment Marguerite d'Anjou, Blanche d'Anjou et Guyonne de Beauvau