bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of Laparoscopy for Identification of Hepatic Disease Before Aortic Surgery
Authors: Huber Thomas S. , Ozaki C. Keith , Flynn Timothy C. , Seeger James M. 
Published: June 2007

Postoperative hepatic failure is a significant yet unpredictable cause of death after elective aortic surgery. Routine preoperative evaluation is frequently insufficient to identify patients at risk. This study was designed to prospectively evaluate the utility of laparoscopy before aortic surgery in patients at a high risk for postoperative hepatic dysfunction. Patients at high risk for postoperative hepatic insufficiency were identified by history, physical examination, and routine blood work. Diagnostic laparoscopy was performed immediately before the planned aortic surgery through a single umbilical incision using standard technique. Liver biopsies were obtained in patients with equivocal findings. The planned operative procedure was undertaken based on the laparoscopic findings. The laparoscopic findings were correlated with those at laparotomy and the postoperative course. Eleven patients scheduled for aortic surgery (indication: aortoiliac occlusive disease [AIOD], five; abdominal aortic aneurysm [AAA], four; renal artery stenosis [RAS], two) were deemed high risk for postoperative hepatic dysfunction owing to alcohol abuse (11 patients), hepatomegaly (1 patient), or laboratory abnormalities (4 patients). Laparoscopy was performed in all patients without complication and required 24 ± 13 minutes (± sd). Laparoscopy revealed a normal liver in three patients, mild liver disease in five, severe cirrhosis in two, and equivocal findings in one patient (frozen section biopsy showed normal liver). The planned aortic procedure (AIOD, aortobiiliac bypass [ABF]; AAA, aortoaorto/aortobiiliac [ABI], RAS, bilateral aortorenal bypass) was performed in nine patients and aborted in the two patients with cirrhosis. The laparoscopic findings correlated reasonably well with those at laparotomy (identical, six patients, lapscope overestimate, two patients, lapscope underestimate, one patient). Postoperative hepatic failure and death occurred after aortic surgery (lapscope, normal liver) in one patient, and transient laboratory abnormalities were seen in two patients (lapscope, mild liver disease). The direct variable and total hospital costs for the laparoscopic study performed as an adjunct to the aortic surgery were $123 and $472 respectively. Diagnostic laparoscopy before aortic surgery is a safe, simple, inexpensive adjunct that may help further identify patients at high risk for postoperative hepatic dysfunction.
The Theological Accoutrements of Anti-Pluralism: The Confused Fate of American Episcopalianism
Authors: Radner Ephraim 
Published: June 2007

ABSTRACTThis article examines the theological and ecclesial tensions that resulted from transplanting the established episcopalian polity and vision of the Church of England within the context of an evolving religious pluralism in America. The theological integralism of Anglican self-understanding as a result was forced to adjust itself in different and still uncomfortable ways within American Episcopalianism, and subsequent limitations on and inner conflicts within Anglican life in the United States (and beyond) are tied in part to these still unresolved tensions.
William Stringfellow's Sacramental Vision
Authors: Dackson Wendy 
Published: June 2007

ABSTRACTWilliam Stringfellow (1929–85) was an Episcopal layman, attorney and social activist. Although much has been written about him since his death, most of it is in the form of personal testimony. Examinations of various doctrinal areas of his theological writings are unusual. Therefore, this article examines Stringfellow's idea of sacramental reality and grounds it in the worship of the Church and Christian engagement with the world. The concluding comments offer a justification for seeing this vision as one of enduring importance for faith and action in a post-Christian society.
Agreeing on a Common Accountability: What Can the Anglican Communion Learn from Ernst Troeltsch?
Authors: Frame Tom 
Published: June 2007

ABSTRACTIn the light of recent theological controversies, the Anglican Communion urgently needs what Archbishop Rowan Williams has described as an ‘agreement over a common accountability’. Such an agreement must differentiate the things that define the essence of the Anglican Church from those that merely imparta distinctive cultural flavour. It will be built on a nuanced theological debate involving questions of self-definition that recognize the social, economic, political and cultural contexts enveloping the Communion's various national churches. In the same way that social structures and economic conditions bear directly upon the shape of religious organizations, it will become apparent that political pressures and cultural mores influence doctrinal commitments. The church-sect-mystic group typology developed by Ernst Troeltsch has the potential to help the Anglican Communion understand the origins of its theological diversity as part of a larger project that seeks to maintain corporate identity and to preserve organizational unity. His attempts to define the ‘essence of Christianity’ in the context of what might otherwise seem random, chaotic and possibly irreconcilable responses to Christ's teaching offers some interpretative insights that will assist Anglicans achieve a consensus on which ‘agreement over a common accountability’ might be based.
Neither Generalism nor Particularism: Ethical Correctness is Located in General Ethical Theories
Authors: Singleton Jane 
Published: June 2007

AbstractIn this article I shall be supporting two main claims. The first is that the essence of the difference between particularism and generalism lies in where they locate ethical correctness. The second is that generalism, although to be preferred to particularism, is not the final resting place for ethical correctness. Ultimately, ethical correctness resides in ethical theories that provide the rationale for generalism. Particularism is presented as a theory that allows attention to be paid to specific cases and shows a sensitivity to the particular case. Generalism, with its appeal to moral principles, is supposed to lack this sensitivity to specific cases. I argue that although this might be true of subsumptive generalism, it is not true of what I call judgmental generalism. This latter type of generalism retains an appeal to moral principles whilerequiringsensitivity to the particular case. I consider Kantian ethics as an example of this sort of generalism. Furthermore, I support the claim that this judgmental generalism is to be preferred to particularism. I argue against a prominent form of particularism, put forward by Jonathan Dancy, based on an appeal to the holism of reasons. This doctrine involves the claim that the value of a complex whole is not necessarily identical with the value of its parts. I show that Dancy’s discussion of this involves inconsistencies and also appears to incorporate subsumptive generalism. This statement of particularism is ultimately incoherent.
Taking the Distinction between Persons Seriously
Authors: Laden Anthony 
Published: June 2007

AbstractRawls criticizes utilitarianism for not taking the distinction between persons seriously, and suggests that his own theory: justice as fairness, does. I argue that justice as fairness aims to take the distinction seriously at four levels, ranging from the content of its principles to its conception of political philosophy, and that doing so at each stage is of fundamental importance in working out the basis of a conception of justice for a democratic society. Understanding Rawls’s theory in this way points to a clearer understanding of how to go on doing political philosophy after Rawls.
Rawls and Feminism: What Should Feminists Make of Liberal Neutrality?
Authors: Brake Elizabeth 
Published: June 2007

AbstractI argue that Rawls’s liberalism is compatible with feminist goals. I focus primarily on the issue of liberal neutrality, a topic suggested by the work of Catharine MacKinnon. I discuss two kinds of neutrality: neutrality at the level of justifying liberalism itself, and state neutrality in political decision-making. Both kinds are contentious within liberal theory. Rawls’s argument for justice as fairness has been criticized for non-neutrality at the justificatory level, a problem noted by Rawls himself in Political Liberalism. I will defend a qualified account of neutrality at the justificatory level, taking an epistemic approach to argue for the exclusion of certain doctrines from the justificatory process. I then argue that the justification process I describe offers a justificatory stance supportive of the feminist rejection of state-sponsored gender hierarchy. Further, I argue that liberal neutrality at the level of political decision-making will have surprising implications for gender equality. Once the extent of the state’s involvement in the apparently private spheres of family and civil society is recognized, and the disproportionate influence of a sexist conception of the good on those structures—and concomitant promotion of that ideal—is seen, state neutrality implies substantive change. While—as Susan Moller Okin avowed—Rawls himself may have remained ambiguous on how to address gender inequality, his theory implies that the state must seek to create substantive, not merely formal, equality. I suggest that those substantive changes will not conflict with liberal neutrality but instead be required by it.
Public Reason and the Moral Foundation of Liberalism
Authors: Mahoney Jon 
Published: June 2007

AbstractI argue against Rawls’s freestanding conception of liberalism. On my view, the moral foundation of liberalism can be defended in one of three ways: (1) as a conception one accepts as a result of one’s affirmation of political liberalism, (2) as a conception one must affirm as a presupposition for political liberalism, or (3) as a philosophical truth about practical reason and persons. The first option makes it impossible to distinguish a moral consensus from a modus vivendi. The second renders the moral foundation of liberalism dogmatic because it affirms a moral foundation for which no justification is provided. Since there are good reasons for rejecting (1) and (2), that leaves option (3). I argue that (3) should be the preferred option for liberals who advance liberalism as a political doctrine with a moral foundation.
Self-Realization and the Priority of Fair Equality of Opportunity
Authors: Taylor Robert 
Published: June 2007

AbstractThe lexical priority of fair equality of opportunity in John Rawls’s justice as fairness, which has been sharply criticized by Larry Alexander and Richard Arneson among others, is left almost entirely undefended in Rawls’s works. I argue here that this priority rule can be successfully defended against its critics despite Rawls’s own doubts about it. Using the few textual clues he provides, I speculatively reconstruct his defense of this rule, showing that it can be grounded on our interest in self-realization through work. This reconstructed defense makes liberal use of concepts already present in A Theory of Justice, including the Aristotelian Principle (which motivates the achievement of increasing virtuosity) and the Humboldtian concept of social union (which provides the context for the development of such virtuosity). I also show that this commitment to self-realization, far from violating the priority of right in Rawls’s theory, stems directly from his underlying commitment to autonomy, which is the very foundation of the moral law in his doctrine of right. The reconstituted defense of this priority rule not only strengthens the case for justice as fairness but also has important and controversial implications for public policy.
Good but Not Required?—Assessing the Demands of Kantian Ethics
Authors: Timmermann Jens 
Published: June 2007

AbstractThere seems to be a strong sentiment in pre-philosophical moral thought that actions can be morally valuable without at the same time being morally required. Yet Kant, who takes great pride in developing an ethical system .rmly grounded in common moral thought, makes no provision for any such extraordinary acts of virtue. Rather, he supports a classi.cation of actions as either obligatory, permissible or prohibited, which in the eyes of his critics makes it totally inadequate to the facts of morality. The related idea of uncommonly grand and noble deeds is frequently dismissed by Kant as high-.own emotional nonsense. Such considerations give rise to the fear that actions intuitively classed as morally commendable but not required must be re-classi.ed as commands of duty by Kant, making his ethical theory as unbearably demanding as direct utilitarianism. The paper divides into three sections: (1) an examination of the nature of moral goodness from a meta-ethical angle that introduces some passages from Kant's writings presenting strong theoretical evidence against the case for supererogatory action; (2) a critique of Thomas Hill's suggestion that within the category of wide duty we can accommodate some of the main features of actions classi.ed as supererogatory in other ethical systems; concluding that,contraHill, there are no actions of wide duty that can be so characterized in any signi.cant sense; and (3) a .nal discussion of the problem of how demanding the requirements of Kantian ethical theory really are.
Legal Reasons: Between Universalism and Particularism
Authors: Redondo María 
Published: June 2007

AbstractThe first part of this work analyses the universalist and the particularist conceptions of reasons. The second part projects this analysis to the legal domain. The author stresses that universalism and particularism regarding reasons are mutually exclusive theories linked to incompatible conceptions of norms, i.e. norms as strict universal conditionals and norms as defeasible conditionals. In giving an account of this tenet, different meanings of universality and defeasibility are explored. A parallel debate regarding reasons can be found in the legal domain, where two contrasting categories of norms are usually distinguished: rules and principles. On this issue the author argues that the conception of legal reasons depends on the way in which this contrast between different kinds of legal norms is shaped.
Keeping Our Distance in Compassion-Based Social Relations
Authors: Smith Steven 
Published: June 2007

AbstractAlthough responding to ‘bad luck’ through instituting appropriate redistributive principles is a proper part of what justice entails, these principles must also paradoxically include the possibility of an agent-based response to misfortune that transforms adverse contingencies, such that the initial ‘bad luck’ becomes a positive part of the ‘sufferer's’ identity. This neo-Kantian accommodation within theories of justice signifies a ‘deep’ egalitarian empathic connectedness between persons, based on an equal respect for persons as agents (and not simply as passive victims of misfortune). Moreover, it is an accommodation that (a) can promote equality as ‘an end in itself’ rather than as merely a means to the end of enhancing a teleological conception of ‘well-being’ and ‘human flourishing’ and (b) can underpin a more robust Rawlsian conception of ‘justice as reciprocity’ than is usually allowed.
Chronically ill rural women: self-identified management problems and solutions
Authors: Cudney Shirley , Sullivan Therese , Winters Charlene A. , Paul Lynn , Oriet Pat 
Published: June 2007

Objective: To add to the knowledge base of illness management of chronically ill, rural women by describing the self-identified problems and solutions reported by women participants in the online health-education segment of the Women to Women (WTW) computer outreach project. Methods: WTW is a research-based computer intervention providing health education and online peer support for rural women with chronic diseases. Messages posted to the online chat room were examined to determine the women's self-management problems and solutions. Results: The self-identified problems were: (1) difficulties in carrying through on self-management programmes; (2) negative fears and feelings; (3) poor communication with care providers; and (4) disturbed relationships with family and friends. The self-identified solutions to these problems included problem-solving techniques that were tailored to the rural lifestyle. Although not all problems were `solvable', they could be `lived with' if the women's prescriptions for self-management were used. Discussion: Glimpses into the women's day-to-day experiences of living with chronic illness gleaned from the interactive health-education discussions will give health professionals insights into the women's efforts to manage their illnesses. The data provide health professionals with information to heighten their sensitivity to their clients' day-to-day care and educational needs.
The personal impact of rheumatoid arthritis on patients' identity: a qualitative study
Authors: Lempp Heidi , Scott David , Kingsley Gabrielle 
Published: June 2007

Objective: To provide a detailed understanding of the direct personal experiences of living with rheumatoid arthritis (RA) and the impact of the illness upon patients' lives, to inform the improvement of clinical care and training. Method: A qualitative study was performed using data from semi-structured interviews with 26 patients who live with RA, recruited at two outpatient clinics in south-east England. Results: In addition to the physical impact of RA on patients' lives, their accounts gave detailed descriptions of how their identity was affected in relation to: (1) their private lives (e.g. difficulties in their relationships, or caring for others); (2) their public roles and responsibilities (e.g. in their paid work and in experiences of stigmatization or discrimination); and (3) their private and public domains (e.g. perceived change of physical appearance, alteration of self-image, and change or loss of social roles). Young patients (25—45 years) did report some differences in their chronic illness experiences, but patients from black and ethnic minorities did not. Discussion: The study highlights new findings which can facilitate more open communication between staff and patients on the personal impact of RA, on patients' coping strategies, and on the effects on their identity both in private and in public. This will allow multidisciplinary outpatient services to provide care more closely matched to the difficulties that are directly experienced by patients.
`When I am together with them I feel more ill.' The stigma of multiple sclerosis experienced in social relationships
Authors: Grytten Nina , Måseide Per 
Published: June 2007

Objectives: We explored the stigma that people with multiple sclerosis (MS) experienced in social relationships. Informed by the symbolic integrationist paradigm, this sociological study focuses on the creation of personal identity through interaction with others. The symbolic interactionist account of stigma examines the meaning and reality being negotiated in communication with others. Methods: Fourteen people with MS and their relatives were interviewed. The unstructured interviews were tape-recorded, transcribed and coded in accordance with the procedure of grounded theory. Results: Informants reported being ignored or, in contrast, having people overemphasize MS in interpersonal encounters. Although people tried to act tactfully, these acts were experienced as crucial stigmatizing. Informants were coping to counteract stigmatizing experiences in social relationships. Discussion: People with MS perceive that their bodily performance and impression management is being judged in interpersonal encounters. Being ignored or perceiving that MS is overemphasized indicates the dilemma of managing stigma in social networks. Consequently, during interaction and in social relationships, people with MS experience a sense of `feeling more ill'. This paper describes strategies of networking to affirm self and identity.
Remaking the future: contemplating a life with chronic widespread pain
Authors: Richardson Jane C. , Bie Nio Ong  , Sim Julius 
Published: June 2007

Objectives: This paper reports findings from a larger study that aimed to explore how people with chronic widespread pain experience, understand and make meaning of their `condition', and attempt to influence or exert control over their pain. This included an exploration of sufferers' understanding of the past and future as well as of their present situation. Methods: A combination of data generation methods was used, including lifegrid interviews, diaries and diary interviews, with eight people with chronic widespread pain. Five family members also participated in interviews. Analytical methods were based on interpretative phenomenological analysis (IPA). Results: With regard to their views about the future, participants could be categorized into those who were `optimistic' (`things can only get better'), those who were pessimistic (`things will get worse'), and those who were overwhelmed with uncertainty about the future. Uncertainty was a dominant feature in all the accounts of the future. Discussion: The pervading uncertainty of chronic widespread pain, in which there is no framework for the trajectory of the condition, affects perceptions of the future and makes planning for the future difficult. The findings also raise the question of how this makes chronic widespread pain different from other chronic conditions in terms of understanding of chronicity, time and future, and hence `acceptance'.
Social support and self-management of type 2 diabetes among immigrant Australian women
Authors: Kokanovic Renata , Manderson Lenore 
Published: June 2007

Objective: To elucidate the social meanings and interpretations that immigrant women attach to the diagnosis of type 2 diabetes, and the social support and professional advice that they receive following this diagnosis. Methods: In-depth interviews were conducted with 16 immigrant women living in Melbourne, Australia, from communities with a higher than average incidence of type 2 diabetes. Women were recruited purposively through general practitioners and community organizations. The women's initial reaction to the diagnosis of diabetes, understandings of the behavioural changes required to control symptoms and prevent complications and the nature of the social and professional supports were discussed. Interviews were audio-taped, transcribed, coded and analysed thematically by both authors. Results: Some women were critical of their doctors but also manipulated their encounters to avoid receiving unwelcome information about the progress of the disease and consequent required changes in management. Social interactions influenced women's adjustments to diagnosis and informed their communication and adaptation of their lives. Choice of support varied by cultural background, but many respondents reflected on the thin line between support and interference. All women found most understanding from others living with diabetes. Discussion: The social context of people with type 2 diabetes is important in facilitating or inhibiting the management of the condition. Variations in attitudes to family and professionals influenced adherence to advice and emphasized the need for appropriate support to women to sustain behavioural change.