Folk teleology drives persistence judgments

Two separate research programs have revealed two different factors that feature in our judgments of whether some entity persists. One program—inspired by Knobe—has found that normative considerations affect persistence judgments. For instance, people are more inclined to view a thing as persisting when the changes it undergoes lead to improvements. The other program—inspired by Kelemen—has found that teleological considerations affect persistence judgments. For instance, people are more inclined to view a thing as persisting when it preserves its purpose. Our goal in this paper is to determine what causes persistence judgments. Across four studies, we pit normative considerations against teleological considerations. And using causal modeling procedures, we find a consistent, robust pattern with teleological and not normative considerations directly causing persistence judgments. Our findings put teleology in the driver’s seat, while at the same time shedding further light on our folk notion of an object

Life in the sun and the deep-freeze

The future effects of climate change will potentially have massive impacts upon society, infrastructure, energy and food supplies. Considerable research is focused upon the development of sophisticated predictive climate models that forecast the implications and effects of climate change over the next few millennia. However, two obvious questions arise. Firstly, how can we test whether these models work? Secondly, are we being short-sighted and not looking far enough into the future? Both of these questions can be examined by looking at analogues from the geological record

AI in space: Past, present, and possible futures

While artificial intelligence (AI) has become increasingly present in recent space applications, new missions being planned will require even more incorporation of AI techniques. In this paper, we survey some of the progress made to date in implementing such programs, some current directions and issues, and speculate about the future of AI in space scenarios. We also provide examples of how thinkers from the realm of science fiction have envisioned AI's role in various aspects of space exploration

Recommendations for phototherapy during the COVID-19 pandemicEnd of Life Considerations in the ECMO Patient - A Case Presentation

Background: Extracorporeal membrane oxygenation (ECMO) is an emerging life-sustaining intervention for patients experiencing critical cardiopulmonary compromise. Despite the promises of this therapy, studies have shown that over 40% of patients receiving ECMO do not survive their hospitalization.1 In light of this, existing research and protocols for weaning ECMO in the setting of medical futility is extremely limited.2,4 Additionally, research suggests that medications may work differently for patients receiving ECMO3, raising questions about the development of future protocols in this patient population. Case Description: Patient is a 60 year-old female with a history of pulmonary sarcoidosis who was hospitalized for acute-on-chronic hypoxic respiratory failure, complicated by in-hospital cardiac arrest. She was ultimately resuscitated and placed on VA-ECMO as a bridge to lung transplantation. She maintained intact neurologic function after several weeks during her hospitalization, however she developed a retroperitoneal hemorrhage and was subsequently informed that she was no longer a candidate for transplantation. The patient and her family made the decision to discontinue life sustaining therapies, including ECMO. Prior to ECMO wean, she received boluses of IV morphine and ativan, and a morphine infusion was initiated. Her ECMO was weaned to 50% settings, and then discontinued altogether as medications were titrated. Despite this, the patient was noted to have evidence of respiratory distress including accessory muscle use. She died approximately 20 minutes after discontinuation of ECMO. Conclusion: ECMO is an emerging life-sustaining therapy for some of the most critically ill patients. Despite the high need for palliative care in this patient population, there exists minimal evidence for protocolization of terminal ECMO weans. This presentation will review clinical challenges in delivering palliative care to an awake patient undergoing a terminal ECMO wean, and aims to identify areas of future research, including relief of symptom burden, and minimizing patient/family distress.https://scholarlycommons.henryford.com/merf2020caserpt/1010/thumbnail.jp

The OneTogether collaborative approach to reduce the risk of surgical site infection: identifying the challenges to assuring best practice

Background: Surgical site infections (SSI) account for 16% of healthcare associated infections, and are associated with considerable morbidity, mortality and increased costs of care. Ensuring evidence-based practice to prevent SSI is incorporated across the patient’s surgical journey is complex. OneTogether is a quality improvement collaborative of infection prevention and operating department specialists, formed to support the spread and adoption of best practice to prevent SSI. This paper describes the findings of an expert workshop on infection prevention in operating departments. Methods: A total of 84 delegates from 75 hospitals attended the workshop, comprising 46 (55%) theatre nurses/operating department practitioners; 16 (19%) infection control practitioners and 22 (26%) other healthcare practitioners. Discussion focused on evidence, policy implementation and barriers to best practice. Responses were synthesised into a narrative review. Results: Delegates reported significant problems in translating evidence-based guidance into everyday practice, lack of local polices and poor compliance. Major barriers were lack of leadership, poorly defined responsibilities, and lack of knowledge/training. Conclusions: This workshop has provided important insights into major challenges in assuring compliance with best practice in relation to the prevention of SSI. The OneTogether partnership aims to support healthcare practitioners to improve the outcomes of patients undergoing surgery by reducing the risk of SSI