bluuebunny/crossref_metadata_2025 huggingface dataset:
Capitalism or information society? The fundamental question of the present structure of society
Authors: Fuchs Christian
Published: November 2012

Theodor W. Adorno asked in 1968: What is the fundamental question of the present structure of society? Do we live in late capitalism or an industrial society? In today’s society, we can reformulate this question: What is the fundamental question of the present structure of society? Do we live in capitalism or an information society? This article deals with these questions. A typology of information society theories is presented. Radical discontinuous information society theories, sceptical views and continuous information society theories are distinguished. Second, an alternative concept that is grounded in Hegelian philosophy and Marxist political economy is presented. The basic argument is that the emergence of transnational informational capitalism is a transformational sublation, but not a radical one, and that informational capitalism is just one of the forms of capitalism that co-exist today. There is a unity of diversity of capitalism(s).
Stereotype awareness development and effective cross-cultural management
Authors: MacNab Brent R , Worthley Reginald
Published: November 2012

Cross-cultural managers who are unaware of their stereotypes risk operating from potentially inaccurate and ineffective cognitive platforms, yet there is a need for more education and training approaches in the area of stereotype awareness. Experiential approaches to social learning that have been proposed as holding high effectiveness and dialectic logic provide a specific avenue for altering perceptions. An experiential approach to stereotype awareness is developed with a multicultural group of over 370 participants. Context influenced participant outcomes in stereotype awareness development indicators and was more significant than individual traits. Participant self-efficacy was found to demonstrate a slight positive moderating influence. Stereotype awareness is established as an important trait for cross-cultural managers; the described experiential approach should be considered as a possible avenue in developing greater effectiveness for managers dealing with diverse groups and cultures. Organizations that can better educate and train people in developing personal stereotype awareness stand to ultimately advance effectiveness in cross-cultural and diversity management.
Not a dirty word: Arts entrepreneurship and higher education
Authors: Bridgstock Ruth
Published: November 2012

While the majority of creative, performing and literary artists are self-employed, relatively few tertiary arts schools attempt to develop capabilities for venture creation and management (and entrepreneurship more broadly) and still fewer do so effectively. This article asks why this is the case. It addresses underlying conceptual and philosophical issues encountered by arts educators, arguing that in all three senses of the term – new venture creation, career self-management, and being enterprising – entrepreneurship is essential to career success in the arts. However, the practice of entrepreneurship in the arts is significantly different from the practice of entrepreneurship in business, in terms of the artist’s drivers and aims, as well as the nature of entrepreneurial opportunities, contexts and processes. These differences mean that entrepreneurship curricula cannot simply be imported from business schools. This article also examines the arts-idiosyncratic challenge of negotiating distinctive and potentially conflicting entrepreneurial aims, using career identity theory. It concludes by suggesting strategies by which adaptive entrepreneurial artist identities can be developed through higher education programs.
Modelling stiffeners of ship hull structures
Authors: Ventura Manuel , Soares C Guedes
Published: November 2012

In this study, the data associated with the definition of stiffeners on plate panels of ship structures are analysed and a data model is described. Then, methods to generate accurate representations of stiffeners as solid models are presented. First, a method is presented to create the parallel trajectory lines of the stiffeners computing geodesic offset paths on free-form parametric surfaces. Next, the generation of the boundary surfaces required to create boundary representation solid models of the stiffeners is described, and finally, this procedure is extended to produce the corresponding accurate edge cut-outs on any plates crossed.
Self-regulation in disability: Migraine management as action research
Authors: Seifert Lauren S
Published: November 2012

Coping with chronic migraine is challenging. Frequently, patients are left with few explanations and little in the way of effective treatment beyond the most popular, current medications. The researcher – an experimental psychologist, who is also a migraine sufferer – proposes that effective migraine management is action research. She utilized participatory action research to manage chronic daily migraine and suggests that others might do the same as they collaborate with stakeholders (e.g. family members, friends, employers, and healthcare specialists) in order to manage their own chronic disease. Ultimately, authentic management of any chronic illness – as action research – is flexible, optimizing, empowering, and liberating.
Meta-analysis of clinical trial safety data in a drug development program: Answers to frequently asked questions
Authors: Berlin Jesse A , Crowe Brenda J , Whalen Edward , Xia H Amy , Koro Carol E , Kuebler Juergen
Published: November 2012

Background

Meta-analyses of clinical trial safety data have risen in importance beyond regulatory submissions. During drug development, sponsors need to recognize safety signals early and adjust the development program accordingly, so as to facilitate the assessment of causality. Once a product is marketed, sponsors add postapproval clinical trial data to the body of information to help understand existing safety concerns or those that arise from other postapproval data sources, such as spontaneous reports.

Purpose

This article focuses on common questions encountered when designing and performing a meta-analysis of clinical trial safety data. Although far from an exhaustive set of questions, they touch on some basic and often misunderstood features of conducting such meta-analyses.

Methods

The authors reviewed the current literature and used their combined experience with regulatory and other uses of meta-analysis to answer common questions that arise when performing meta-analyses of safety data.

Results

We addressed the following topics: choice of studies to pool, effects of the method of ascertainment, use of patient-level data compared to trial-level data, the need (or not) for multiplicity adjustments, heterogeneity of effects and sources of it, and choice of fixed effects versus random effects.

Limitations

The list of topics is not exhaustive and the opinions offered represent only our perspective; we recognize that there may be other valid perspectives.

Conclusions

Meta-analysis can be a valuable tool for evaluating safety questions, but a number of methodological choices need to be made in designing and conducting any meta-analysis. This article provides advice on some of the more commonly encountered choices.
Evaluation of an alcohol intervention training program for nurses in rural Australia
Authors: Mellor David , McCabe Marita , Ricciardelli Lina A , Brumby Susan , Head Alexandra , Mercer-Grant Catherine , Kennedy Alison
Published: November 2012

Aim

This paper reports on the development, implementation and evaluation of the Alcohol Intervention Training Program (AITP) designed to enhance nurses’ capacity to work with farming men and women who misuse alcohol.

Background

In rural and regional areas where alcohol-related behaviours and problems are relatively elevated, nurses may be the key health professionals dealing with individuals who misuse alcohol. However, they are often ill-equipped to do this, have low confidence in their ability to do so, and perceive numerous barriers. Training is required for these nurses.

Methods

We developed the AITP to enhance nurses’ capacity to work with people with alcohol-related problems. The data were collected during 2010. An intervention group of 15 rural nurses completed the AITP. Nurses’ perceived barriers, attitudes, and perceived performance in working with clients with alcohol problems, and the frequency of engaging with this client group were evaluated. Scores on these measures were compared to those of a control group of 17 nurses’ pre-treatment, post-treatment and at 3-month follow-up.

Results

Participation in the AITP resulted in initial improvements in attitudes to working with alcohol problems, but no change in perceived barriers to doing so. The level of engagement with clients having alcohol-related problems increased, as did perceptions of work performance.

Conclusion

The AITP enhances the ability of rural nurses to address the alcohol and associated health issues of clients in rural and regional areas. However, the program needs refinement and further evaluation.
Action Research and the Educational Doctorate
Authors: Zambo Debby , Isai Shelley
Published: November 2012

This case study reveals the development and action research work of a student in a newly designed educational doctorate aimed at preparing scholarly and influential practitioners. Data were gathered from a research journal, field notes, email correspondence, observation, and dissertation work, and analyzed with a constant comparative approach. Results tell the story of leadership development and action research that discovered the failure of professional development, the importance of teacher efficacy, and ways to build efficacy with knowledge and feedback. Findings from this case have implications for program developers and doctoral students wishing to become action researchers and agents of change.
What Constitutes a Critical Mass? An Investigation of Faculty Staffing Patterns in Educational Leadership Programs
Authors: Hackmann Donald G. , McCarthy Martha M.
Published: November 2012

This study examined faculty staffing patterns in 217 university-based leadership preparation programs, using data collected from an online questionnaire. Units rely on full-time educational leadership faculty, faculty from outside their units, and adjuncts to comprise their instructional core. Findings disclose that research institutions have smaller student–faculty ratios than other institution types, and units with enrollments exceeding 500 students employ significantly more adjuncts than institutions with smaller enrollments. Units are hiring more adjuncts and full-time clinical faculty, while employing fewer tenure-line faculty than reported in previous studies of the professoriate. In addition, full-time faculty numbers are not increasing proportionately with enrollment increases.
Clinical Significance of Leech Therapy in Indian Medicine
Authors: Kumar Syal , Dobos Gustav J. , Rampp Thomas
Published: November 2012

Traditional Indian medicine—ayurveda—could be the oldest medical system in which leech therapy was adopted for treating specific disease conditions of patients. Some of the indications in which leeches are used are in tumors, hemorrhoids, abscess and boils, skin disorders, ulcers, gout, diseases of the eye, headache, herpes zoster, thrombosis, and wounds. The saliva of the leech consists of anesthetic agents, anticoagulant, antiplatelet aggregation factor, antibiotic, anti-inflammatory substances, and gelatinous substances. Leeches suck the excess blood, reduce the swelling in the tissues, and promote healing by allowing fresh oxygenated blood to reach the area until normal circulation can be restored. Clinical studies have been conducted in different parts of the world to observe the scientific action of leech therapy. Studies with leeches have been carried out to observe the healing of complicated varicose veins, pain reduction in osteoarthritis, and other disorders.
Ethical Considerations concerning Screening for Chromosome Aneuploidy: A Response to a 2007 American College of Obstetricians and Gynecologists Practice Bulletin
Authors: Tuohey John , Repenshek Mark
Published: November 2012

Historically, maternal age 35 years or older at the time of delivery has been the marker to identify women with a statistically greater chance for having a child with a chromosome aneuploidy. This article will examine certain aspects of the recommendations made by the American College of Obstetricians and Gynecologists (ACOG) in 2007 to expand aneuploidy screening to all women before 20 weeks gestation. The article will focus on insights within the Catholic moral tradition that help to frame a reexamination of these recommendations.
On Abandoned Embryos
Authors: Collins Timothy P.
Published: November 2012

At this time, the Catholic Church has made no definitive statement regarding the morality of adopting abandoned embryos.

Is it intrinsically evil for a woman to elect to become pregnant, outside of the marital act and with someone else's child?
Current Medical Research Winter 2008–Spring 2009
Authors: Fehring Richard J.
Published: November 2012

Note that the “Current Medical Research” feature focuses on issues relevant to natural family planning and the beginning of life. This piece is complemented by medical reviews published in The National Catholic Bioethics Quarterly, which focus more on other areas of general medical interest including end-of-life issues.—Ed.
Benign Misleading Permissible Deception in Clinical Practice?
Authors: Jaspers Andrew
Published: November 2012

This article considers the ethics of delayed disclosure of the limits of health care to a client. Specifically, it considers the current practice of pro-life crisis pregnancy centers, which imitate abortion providers’ advertising techniques, so as to attract abortion-minded clients. I argue that such advertising is within the limits of truthfulness, and that it may be maintained as a legitimate response to a crisis of terminology in the abortion debate. This conclusion validates similar techniques of “benign misleading” as used by NFP-only or abstinence-only health-care providers.
The Ethics of Ectopic Pregnancy
Authors: Kaczor Christopher
Published: November 2012

Ethicists have continued to debate about two means of treating ectopic pregnancy, namely, the removal of the embryo from the tube (salpingostomy) and the use of methotrexate. This article examines the major arguments in favor of considering salpingostomy intentional killing. The article goes on to evaluate the major arguments in favor of the conclusion that methotrexate is intentional killing or intentional mutilation. The tentative conclusion reached is that both salpingostomy and the use of methotrexate should be considered morally permissible.
Normal Breast Physiology: The Reasons Hormonal Contraceptives and Induced Abortion Increase Breast-Cancer Risk
Authors: Lanfranchi Angela
Published: November 2012

A woman gains protection from breast cancer by completing a full-term pregnancy. In utero, her offspring produce hormones that mature 85 percent of the mother's breast tissue into cancer-resistant breast tissue. If the pregnancy ends through an induced abortion or a premature birth before thirty-two weeks, the mother's breasts will have only partially matured, retaining even more cancer-susceptible breast tissue than when the pregnancy began. This increased amount of immature breast tissue will leave the mother with more sites for cancer initiation, thereby increasing her risk of breast cancer. Hormonal contraceptives increase breast-cancer risk by their proliferative effect on breast tissue and their direct carcinogenic effects on DNA. Hormonal contraceptives include estrogen-progestin combination drugs prescribed in any manner of delivery: orally, transdermally, vaginally, or intrauterine. This article provides the detailed physiology and data that elucidate the mechanisms through which induced abortion and hormonal contraceptives increase breast-cancer risk.
Reflections on the Mucus Symptom
Authors: Norris Charles W.
Published: November 2012

There exists an enormous amount of ignorance on the part of women concerning the mucus symptom of their fertility. At a young age the vast majority of the fair sex teach themselves to ignore those changing mucus sensations. A worthy goal of Catholic physicians would be to do everything in their power to help correct this deep well of ignorance. The Teen STAR program is designed to teach youngsters the meaning of those changing mucus sensations so that they come to a profound respect for their fertility and sexuality. If Catholics, and Catholic physicians especially, do not tell them the truth about their bodies, who will: the media? the drug companies? Planned Parenthood?
Needed, an Ethics Audit of Catholic Sterilization Policies
Authors: Mirkes Sister Renee
Published: November 2012

The author proposes an ethics audit of Catholic sterilization policies as a way to correct the disparity between the regnant moral directive prohibiting direct sterilization in Catholic health-care facilities and the policy and practice of allowing tubal ligations for “medical” or “therapeutic” purposes. The proposed four-step plan for the ethics audit involves dialogue and collaboration between U.S. bishops who have Catholic health-care facilities in their dioceses and the respective hospitals’ administration, sponsors, and medical staff. First, bishops clarify for Catholic hospital administrators, sponsors, and system leadership the moral distinction between a direct sterilization and one that is therapeutic or indirect. Second, bishops instruct hospital CEOs to abide by directive 53 of the Ethical and Religious Directives for Catholic Health Care Services by providing only indirect sterilizations. Third, bishops encourage hospital leadership and medical/nursing staff to promote directive 53 in tandem with directive 52 and its call for providing natural family planning services within the hospital. And, fourth, bishops collaborate with the hospital or system leadership in conducting ongoing oversight of sterilization policy/procedures to insure that their Catholic health-care institutions practice durable compliance with directives 52 and 53.
Imitating Our Lady's Virtues
Authors: Donoghue John F.
Published: November 2012

Through the experiences of St. Luke, the physician, and his likely relationship with the Blessed Virgin Mary, the virtues of Mary are described, in particular with reference to her seven sorrows. These are related to the ministry of healing of physicians for their patients. A call is given for physicians to imitate the virtues of Mary and, like St. Luke, to be transformed from one who cares only for the body to one who cares for the body and the soul.
“Reproductive Health Care,” the “Demographic Imperative,” and the Real Health Needs of Women in the Developing World (Part One)
Authors: Mosher Steven W.
Published: November 2012

Proponents of “reproductive health care” assert that the 1994 population conference in Cairo marked a watershed between two radically different approaches to reducing the fertility of women in the developing world. They concede that, prior to Cairo, population-control programs were driven solely by a narrow demographic imperative. Following Cairo, however, they maintain that a broad approach to improving reproductive health was adopted that not only encouraged smaller families, but also did so in the context of providing “client-centered” programs that conferred significant health and welfare benefits to their target population. In this two-part article, I will show that these several claims are misleading, if not altogether false.

In the first article, which follows, I document the failure of population-control programs to address women's health needs, as they themselves perceive them. The rationalizations used to support an exclusive focus on contraception and sterilization (“latent demand,” and “unmet need”) are examined, as well as the harm done to women's health by the careless administration of such drugs and devices.

In the second article, I will discuss the post-Cairo conference rhetorical shift to “reproductive health,” and the claims that such programs have reduced maternal mortality, infant mortality, and the absolute number of abortions. I will conclude with a discussion of how the health needs of women in the developing world could be better met by redirecting existing resources to primary health care, including obstetric care.
Current Medical Research Winter 2009–Spring 2010
Authors: Fehring Richard J.
Published: November 2012

Note that the “Current Medical Research” feature focuses on issues relevant to natural family planning and the beginning of life. This piece is complemented by medical reviews published in The National Catholic Bioethics Quarterly, which focus more on other areas of general medical interest including end-of-life issues.—Ed.
Martin Rhonheimer and Some Disputed Issues in Medical Ethics: Masturbation, Condoms, Craniotomies, and Tubal Pregnancies
Authors: May William E.
Published: November 2012

Martin Rhonheimer has written extensively on disputed issues in medical ethics: the use of condoms to prevent HIV, contraception, masturbation to provide semen for analysis, and at length on “vital conflicts” in medical ethics that arise in a pregnancy in which the lives of both the mother and the child are seriously threatened. If nothing is done, both will die, but if a medical intervention is performed, the child will die but the mother has a chance of living. After offering his interpretation of relevant magisterial documents on the difference between “direct” and “indirect” killing and of St. Thomas's teaching on the lawfulness of killing in self-defense and the principle of double effect, Rhonheimer proposes to solve conflicts of this kind by an ethical analysis based on what he calls a “virtue-based ethics” concerned with rendering justice to both mother and child. Using this approach he justifies craniotomy, salpingectomy, and salpingo(s)tomy as morally permissible ways of saving the mother's life without doing any injustice while rejecting use of the drug methotrexate to end a tubal pregnancy. His analysis can be seriously challenged as rooted in a misinterpretation of key magisterial documents and for failing to consider the principle of double effect revised to bring it into harmony with Aquinas's teaching on the distinction between killing as intended and as the unintended although foreseen effect of an act of legitimate self-defense.
Pastoral Care the Chicago Study
Authors: Guinan Patrick , Zabiega Thomas , Zainer Christine
Published: November 2012

Catholic health care has, as one of its essential components, the spiritual or pastoral aspects of the care of sick patients. In an effort to assess this aspect of care, the Catholic Physicians' Guild of Chicago sent a questionnaire to the pastoral-care directors of the twenty-one Catholic hospitals in the Archdiocese of Chicago. This questionnaire addressed various topics, such as 1) Catholic identity, 2) Mass, 3) Sacraments, 4) ethics, and 5) natural family planning. In general, the responses indicated that the Chicago archdiocesan hospitals demonstrated strong pastoral-care programs. Health-care counseling appears to be gaining prominence. It is recommended that the sacramental ministry aspect of Catholic care—Mass, the Eucharist, reconciliation, and the anointing of the sick—be reinforced and emphasized.
Can Immunology Corroborate the Two-in-One-Flesh Image in Genesis?
Authors: DeMarco Donald
Published: November 2012

The immune system distinguishes self from nonself permitting protection from invading microorganisms and cancer, but also causing rejection of foreign cells as in allogeneic organ transplantation. However, in sexual reproduction, the man's sperm are not rejected by the woman's immune system. This is based on the presence of a mild immunosuppressant in the seminal fluid, making possible the “two-in-one-flesh” intimacy that results in procreation. The biological consequences of natural sexual intercourse are completely distinct from the unnatural act of anal intercourse, as occurs in homosexual unions. The capacity of spermatozoa to penetrate into the nuclei of cells, coupled with the immunosuppressant in seminal fluid, greatly increases the risk of development of anal cancer. Science, which is immune to political or fashionable trends, thus bears witness to the unique nature of the conjugal bond between a man and a woman.
Changing the Hearts and Minds of those Embracing the Culture of Death a Suggested Strategy
Authors: May William E.
Published: November 2012

It is important to understand why excellent arguments developed by those who propose the “culture of life” are not able to persuade advocates of the “culture of death” to change their minds. Our freely chosen deeds “do not produce a change merely in the state of affairs outside of man but, to the extent that they are deliberate choices, they give moral definition to the very person who performs them, determining his profound spiritual traits.” 1 Those who embrace the culture of death will not accept pro-life arguments because they have freely committed themselves to a way of life that closes their eyes and ears to the truth. They do not want to hear arguments incompatible with their basic commitments. Arguments are presented from Patrick Lee, Mortimer Adler, John Macquarrie, Pope John Paul II, and Pope Benedict XVI that can be used as a conceptual basis for reaching those imbued in the culture of death. This includes pointing out the intrinsic value of human life, the consequences of instituting a hierarchy of individuals based on their “worth” to society, and the yearning of all for the good and the true. These considerations can help persons think more deeply about who they are and their identity as persons, and evoke an “anamnesis” in the minds of some of our contemporaries who disagree with us so greatly on issues regarding the rights of all human beings, born or unborn.
Seminary Formation and Homosexuality Changing Sexual Morality and the Church's Response
Authors: Fernandes Earl K.
Published: November 2012

The article examines recent comments by Pope Benedict XVI in Light of the World regarding the recent Vatican instruction Concerning the Criteria for the Discernment of Vocations with Regard to Persons with Homosexual Tendencies in View of Their Admission to the Seminary and to Holy Orders, which deals with homosexuality and the priesthood. This article demonstrates that Pope Benedict XVI's comments are consistent with the “fractures” in the understanding of sexual morality which he identified in The Ratzinger Report. As sexual mores have changed, attempting to “normalize” homosexuality, gradually the Church has developed norms and guidelines for seminary formators, culminating in the instruction.
On the Psychogenesis of Homosexuality
Authors: van den Aardweg Gerard J.M.
Published: November 2012

The best-established facts in relation to homosexuality point to developmental-psychological, not genetic or physiological, causation. The efforts of the last few decades to find evidence to support a biological theory have made it more doubtful than ever that such evidence will be found. In contrast, many studies have shown that the most significant factor which correlates with homosexuality is “gender nonconformity” or same-sex peer isolation. Another factor closely associated with homosexuality is an imbalance in parent-child interaction, notably forms of over-influence of the opposite-sex parent in combination with a deficient relationship with the same-sex parent. The third well-established correlation is with inherent, rather than discrimination-produced, “neuroticism” or emotional instability/immaturity.

Structured around this pivotal evidence from statistical as well as clinical research, homosexuality is explained here as a character neurosis. Characteristics of this neurotic character syndrome include personality immaturity, self-victimization, and self-centeredness. This syndrome affects not only the emotional but also the moral and spiritual dimensions of the psyche and if indulged leads to generalized personality deterioration. Therapeutically, a holistic approach, simultaneously addressing the emotional, moral, and spiritual components of the psyche, offers the best opportunity for overcoming homosexuality. De-egocentrization and personality maturity, including the development of mature manhood/womanhood, are the goals of therapy.
The Distinction between Deep-Seated Homosexual Tendencies and Transitory Same-Sex Attractions in Candidates for Seminary and Religious Life
Authors: Kleponis Peter C. , Fitzgibbons Richard P.
Published: November 2012

The sexual abuse crisis in the Church, in which the primary victims were adolescent males, highlights the importance of the 2005 document from the Vatican's Congregation for Catholic Education on the selection of candidates for priesthood and religious life in regard to homosexuality. A thorough in-depth clinical interview that focuses on masculine identity and an evaluation of the development of a positive masculine identity through secure attachment relationships with the father, male peers, and a brother, as well as a positive body image and thorough psychological testing, can distinguish clearly between deep-seated homosexual tendencies and transitory same-sex attractions in candidates for priesthood.

The lack of secure, accepting, and positive relationships with the male peers, the father, and a brother can result in weaknesses in male confidence, sadness, and anger which are major unconscious factors in the development of same-sex attractions. The process of resolving transitory same-sex attractions in candidates and in seminarians is also described in this article. The implementation of this Vatican document is important in the protection of minors from sexual abuse and of the Church from further shame and sorrow.
Current Medical Research Summer–Fall 2010
Authors: Fehring Richard J.
Published: November 2012

Note that the “Current Medical Research” feature focuses on issues relevant to natural family planning and the beginning of life. This piece is complemented by medical reviews published in The National Catholic Bioethics Quarterly, which focus more on other areas of general medical interest including end-of-life issues.—Ed.
The Catholic Physician in an Era of Secular Bioethics
Authors: Pellegrino Edmund D. , D'Arcy Martin C.
Published: November 2012

This essay examines how commitment to the Roman Catholic moral and ethical traditions shapes the process, and content of bioethics and clinical decisions. An essential element of the vocation of Roman Catholic health professionals is to give genuine witness to that tradition in their daily clinical practices. Three questions will be addressed: 1) What is the justification for introducing religious commitments in clinical bioethics in a morally pluralist society? 2) What specifically does the Catholic medical tradition contribute to today's clinical decisions? 3) How are faith and reason to be balanced in clinical ethics? 4) Why are these questions relevant to papal calls for re-evangelization, or “re-proposal” of the faith, especially in the life of the physician?
Utilitarianism Impacting Care of those with Disabilities and those at Life's End
Authors: Hilliard Marie T.
Published: November 2012

Society's understanding of the nature of suffering impacts the development of health-care public policy, having a significant impact on care of the elderly and those with disabilities. With scientific advances comes a societal expectation that one can have “the perfect life,” not just for one's self, but also for one's offspring. Thus extinguishing the imperfect life, at its earliest or later stages through physician-assisted suicide, becomes an accepted recourse. The Catholic tradition is rich in providing meaning to those who suffer and their families, particularly those at the end-of-life or those with disabilities. The Ethical and Religious Directives for Catholic Health Care Services address the importance of advanced directives to assure that the health-care wishes of patients, no longer able to express them, are respected. However, such directives cannot anticipate all of the health-care scenarios that could arise. Thus the role of a health-care agent (surrogate), who through extensive discussions knows the will of the patient and the mind of the Church, is critical. However, increasingly public policies, especially as they pertain to the allocation of costly resources such as health care, are impacting the health-care choices available to patients, their families, and the health-care provider. Consistent with the utilitarian ethic, state sanctioned killing of those deemed to have “lost their dignity” is hailed as a “good.” This essay explores the challenges for all of us who are members of a profession once entrusted with protecting the most vulnerable among us.
Faith in Practice: End-of-Life Care and the Catholic Medical Professional
Authors: Gloth F. Michael
Published: November 2012

Theological discussions on appropriate courses of care for the very ill can be more difficult if information on options and outcomes is lacking. This article provides an historical review of a change in the paradigm of care in the United States and similar developed countries. End-of-life courses can vary based on underlying disease processes and health system resources. The purpose of this article is to help readers to better appreciate the limitations of medicine, and so be able to make a more informed decision about interventions that may be offered at the end of life. While there is also some discussion about ethics and physician-assisted suicide, this is not intended to be a theological treatise on Catholic doctrine related to the sanctity of life. Additionally, the following paragraphs will describe the current state of living and dying in America, contrast this with the way people wish to live until they die, discuss the role of the caregiver, provide insight into physician-assisted suicide and misconceptions about medicine, provide insight into the physician's role in end-of-life care, and explain what medicine can reasonably be expected to provide or prognosticate. Finally, there is an attempt to allay misconceptions about the extent of the effect of medical interventions. Medical intervention is inextricably linked to human fallibility and shortcomings in clinical knowledge and achievement. Recognizing when human intervention can no longer provide cure, prevent decline, or even slow the course of disease is crucial in making end-of-life care decisions.
Condoms and HIV
Authors: Newton William
Published: November 2012

Even among moral theologians who strongly support the Church's teaching on contraception enshrined in Humanae vitae, there is disagreement as to whether condoms might be used when one spouse is infected with HIV. Between 2004 and 2008 there was a vigorous, yet respectful, debate about this question in various Catholic journals, spawned by an article in The Tablet by Fr. Martin Rhonheimer. The aim of this essay is to present the current state of this debate, clarifying the central arguments of each side, what has been achieved through the debate, and what points of difference remain.
Effects of nano-Fe2O3 powder on thermal emission property of microarc oxidation coating on titanium alloy
Authors: Tang H , Wang F
Published: November 2012

A ceramic coating was formed on the titanium alloy by microarc oxidation in an electrolyte containing nano-Fe2O3, emulsifier OP-10 and sodium phosphate. The composition, surface and cross-sectional morphology and the element compositions of the coatings were characterised by X-ray diffraction, scanning electron microscopy and energy dispersive X-ray analysis system. The spectral emissivity of the coatings was measured by a Fourier transform spectrometer apparatus. The bonding strength between the coating and the titanium alloy was studied by tensile strength test. The thermal shock resistance of the coatings was also evaluated. The results showed that nano-Fe2O3 was incorporated into the coating, and the coating had high emission at the wavelength range of 3–20 μm. The bonding strength was 33·2 MPa, and after being subjected to severe thermal shocking for 50 cycles, little peeling-off of the coating occurred.
Striving for scientific stringency: a re-analysis of a randomised controlled trial considering first-time mothers’ obstetric outcomes in relation to birth position
Authors: Thies-Lagergren Li , Kvist Linda J , Christensson Kyllike , Hildingsson Ingegerd
Published: November 2012

Background

The aim of this study was to compare maternal labour and birth outcomes between women who gave birth on a birth seat or in any other position for vaginal birth and further, to study the relationship between synthetic oxytocin augmentation and maternal blood loss, in a stratified sample.

Methods

A re-analysis of a randomized controlled trial in Sweden. An on-treatment analysis was used to study obstetrical outcomes for nulliparous women who gave birth on a birth seat (birth seat group) compared to birth in any other position for vaginal birth (control group). Data were collected between November 2006 and July 2009. The outcome measurements included perineal outcome, post partum blood loss, epidural analgesia, synthetic oxytocin augmentation and duration of labour.

Results

The major findings of this paper were that women giving birth on the birth seat had shorter duration of labour and were significantly less likely to receive synthetic oxytocin for augmentation in the second stage of labour. Significantly more women had an increased blood loss when giving birth on the birth seat, but had no difference in perineal outcomes. Blood loss was increased regardless of birth position if women had been exposed to synthetic oxytocin augmentation during the first stage of labour.

Conclusions

The results of this analysis imply that women with a straightforward birth process may well benefit from giving birth on a birth seat without risk for any adverse obstetrical outcomes. However it is important to bear in mind that, women who received synthetic oxytocin during the first stage of labour may have an increased risk for greater blood loss when giving birth on a birth seat. Finally it is of vital importance to scrutinize the influence of synthetic oxytocin administered during the first stage of labour on blood loss postpartum, since excessive blood loss is a well-documented cause of maternal mortality worldwide and may cause severe maternal morbidity in high-income countries.

Trial registration

Unique Protocol ID: NCT01182038 (http://register.clinicaltrials.gov)
A multiscale and multiparametric approach for modeling the progression of oral cancer
Authors: Exarchos Konstantinos P , Goletsis Yorgos , Fotiadis Dimitrios I
Published: November 2012

Background

In this work, we propose a multilevel and multiparametric approach in order to model the growth and progression of oral squamous cell carcinoma (OSCC) after remission. OSCC constitutes the major neoplasm of the head and neck region, exhibiting a quite aggressive nature, often leading to unfavorable prognosis.

Methods

We formulate a Decision Support System assembling a multitude of heterogeneous data sources (clinical, imaging tissue and blood genomic), aiming to capture all manifestations of the disease. Our primary aim is to identify the factors that dictate OSCC progression and subsequently predict potential relapses of the disease. The discrimination potential of each source of data is initially explored separately, and afterwards the individual predictions are combined to yield a consensus decision achieving complete discrimination between patients with and without a disease relapse. Moreover, we collect and analyze gene expression data from circulating blood cells throughout the follow-up period in consecutive time-slices, in order to model the temporal dimension of the disease. For this purpose a Dynamic Bayesian Network (DBN) is employed which is able to capture in a transparent manner the underlying mechanism dictating the disease evolvement, and employ it for monitoring the status and prognosis of the patients after remission.

Results

By feeding as input to the DBN data from the baseline visit we achieve accuracy of 86%, which is further improved to complete discrimination when data from the first follow-up visit are also employed.

Conclusions

Knowing in advance the progression of the disease, i.e. identifying groups of patients with higher/lower risk of reoccurrence, we are able to determine the subsequent treatment protocol in a more personalized manner.
Finding malaria hot-spots in northern Angola: the role of individual, household and environmental factors within a meso-endemic area
Authors: Magalhães Ricardo J Soares , Langa Antonio , Sousa-Figueiredo José Carlos , Clements Archie CA , Nery Susana Vaz
Published: November 2012

Background

Identifying and targeting hyper-endemic communities within meso-endemic areas constitutes an important challenge in malaria control in endemic countries such like Angola. Recent national and global predictive maps of malaria allow the identification and quantification of the population at risk of malaria infection in Angola, but their small-scale accuracy is surrounded by large uncertainties. To observe the need to develop higher resolution malaria endemicity maps a predictive risk map of malaria infection for the municipality of Dande (a malaria endemic area in Northern Angola) was developed and compared to existing national and global maps, the role of individual, household and environmental risk factors for malaria endemicity was quantified and the spatial variation in the number of children at-risk of malaria was estimated.

Methods

Bayesian geostatistical models were developed to predict small-scale spatial variation using data collected during a parasitological survey conducted from May to August 2010. Maps of the posterior distributions of predicted prevalence were constructed in a geographical information system.

Results

Malaria infection was significantly associated with maternal malaria awareness, households with canvas roofing, distance to health care centre and distance to rivers. The predictive map showed remarkable spatial heterogeneity in malaria risk across the Dande municipality in contrast to previous national and global spatial risk models; large high-risk areas of malaria infection (prevalence >50%) were found in the northern and most eastern areas of the municipality, in line with the observed prevalence.

Conclusions

There is remarkable spatial heterogeneity of malaria burden which previous national and global spatial modelling studies failed to identify suggesting that the identification of malaria hot-spots within seemingly mesoendemic areas may require the generation of high resolution malaria maps. Individual, household and hydrological factors play an important role in the small-scale geographical variation of malaria risk in northern Angola. The results presented in this study can be used by provincial malaria control programme managers to help target the delivery of malaria control resources to priority areas in the Dande municipality.
Apps for asthma self-management: a systematic assessment of content and tools
Authors: Huckvale Kit , Car Mate , Morrison Cecily , Car Josip
Published: November 2012

Background

Apps have been enthusiastically adopted by the general public. They are increasingly recognized by policy-makers as a potential medium for supporting self-management of long-term conditions. We assessed the degree to which current smartphone and tablet apps for people with asthma offer content and tools of appropriate quality to support asthma self-management.

Methods

We adapted systematic review methodology to the assessment of apps. We identified English-language asthma apps for all ages through a systematic search of official app stores. We systematically assessed app content using criteria derived from international guidelines and systematic review of strategies for asthma self-management. We covered three domains: comprehensiveness of asthma information, consistency of advice with evidence and compliance with health information best practice principles.

Results

We identified 103 apps for asthma in English, of which 56 were sources of information about the condition and 47 provided tools for the management of asthma. No apps offered both types of functionality. Only three information apps approached our definition of comprehensiveness of information about asthma. No apps provided advice on lay management of acute asthma that included details of appropriate reliever medication use. In 32 of 72 instances, apps made unequivocal recommendations about strategies for asthma control or prophylaxis that were unsupported by current evidence. Although 90% of apps stated a clear purpose, compliance with other best practice principles for health information was variable. Contact details were located for 55%, funding source for 18% and confidentiality policy for 17%.

Conclusions

No apps for people with asthma combined reliable, comprehensive information about the condition with supportive tools for self-management. Healthcare professionals considering recommending apps to patients as part of asthma self-management should exercise caution, recognizing that some apps like calculators may be unsafe; that no current app will meet the need of every patient; and that ways of working must be adapted if apps are to be introduced, supported and sustained in routine care. Policy-makers need to consider the potential role for assurance mechanisms in relation to apps. There remains much to be done if apps are to find broad use in clinical practice; clinicians cannot recommend tools that are inaccurate, unsafe or lack an evidence base.