The Problem of Moral Ambivalence: Revisiting Henry Sidgwick's Theory of Rational Benevolence as a Basis for Moral Reasoning, with Reference to Prenatal Ethical Dilemmas

This thesis addresses the conflict traditionally found within moral philosophy between deontological and utilitarian schools of thought. Using the example of the serious moral ambivalence experienced by individuals who are deciding whether to end or continue a difficult pregnancy, it is argued that this ambivalence is the result of both absolute principles (such as the intrinsic value of human life) and outcome based considerations (such as the desire to avoid causing pain and suffering) appearing to be morally reasonable, while also being fundamentally opposed: Each course of action is at once morally defensible on the basis of its own reasonableness, and, conversely, reprehensible due to the reasonableness of the other. This lived experience of moral ambivalence is directly reflected by the tension between deontology and utilitarianism as it occurs at the moral philosophic level, where the deontological emphasis on the unconditional rightness of certain principles is seen to be at irreconcilable odds with the utilitarian emphasis on the attainment of certain ends. The thesis’ central claim is that such ambivalence strongly indicates that human morality is neither exclusively one type or the other, and that both types of moral property are in fact reasonable, and thus have moral value. It is theorised that accounting for this dual reasonableness would lead to the most accurate and helpful representation of the human moral experience – but that the philosophic ‘divide’ between the two types of principle has led to an either/or situation, which has largely prevented this sort of understanding from being developed. The thesis argues that Victorian philosopher Henry Sidgwick developed a view in which neither deontological nor utilitarian principles can be fully realised without reference to the other, precisely on the basis that both can be found to be ultimately rational. This thesis aims to revitalise that theory – represented by the term ‘Rational Benevolence’ - to show that Sidgwick reconciled the divide between absolute and end based principles in such a way that the relationship between them becomes a ‘synthesis’. In this synthesis, deontological and utilitarian concepts are both seen as essential components of morality, that combine to form a dynamic whole in which the value of each principle is both indicated and naturally limited by the value of the other, on account of their respective rationalities. It is argued that this provides a more comprehensive understanding of the reality of the human moral experience, and better moral justification for either course of action in situations of complex and sensitive ethical decision making

Synthesis and coordination chemistry of 2-(di-2-pyridylamino)pyrimidine; structural aspects of spin crossover in an Fe(II) complex

This paper was accepted on February 26 20122-(Di-2-pyridylamino)pyrimidine (L), a potentially ditopic tetradentate ligand, was synthesized from commercially available di-2-pyridylamine and 2-chloropyrimidine. Despite being capable of bridging two metal atoms with bidentate chelation of both metal centres, L prefers to chelate or bridge through the more basic pyridyl donors of the di-2-pyridylamine moiety. Mononuclear trans-[Fe(NCS)2(L)2] and [Cu(L)2(H2O)](BF4)2•H2O complexes, and a discrete [Ag2(L)4](PF6)2 metallomacrocycle were isolated and structurally characterized by X-ray crystallography. A mononuclear palladium complex [PdCl2(L)]•(solvate), where solvate = ½H2O or CH2Cl2, was also readily obtained in 71% yield. One example of the ligand acting as a bis(bidentate) bridging ligand was observed in a dinuclear [(PdCl2)2(L)]•¾H2O complex that was obtained only in very low yield (ca. 3%) from the reaction that produced [PdCl2(L)]•½H2O. trans-[Fe(NCS)2(L)2] undergoes a temperature dependent HS-LS (HS = high spin; LS = low spin) crossover at ca. 205 K that was 2 observed by X-ray crystallography and magnetic measurements and attempts were made to understand the structural basis of this process. Despite efforts to isolate examples of L bridging two iron(II) centres, only the mononuclear trans-[Fe(NCS)2(L)2] species could be obtained.Rachel S. Crees, Boujemma Moubaraki, Keith S. Murray, and Christopher J. Sumb

Final Summary- Prevention of Pressure Injuries

Final Summary- Prevention of Pressure Injuries Our change project highlights the benefits of a turn leader in hospitals to prevent and reduce the occurrences of pressure injuries. The turn leader approach focuses on a designated staff member to monitor, manage, and document the frequent repositioning of patients and prompt reporting of skin breakdown. The turn leader maintains a schedule for repositioning the patients deemed high risk for pressure injuries and ensures pressure is redistributed among high risk areas. They are responsible for noting when the patient was turned, the positioning used, and any changes to skin integrity. To ensure effectiveness, all staff are trained on the turn leader role and pressure injury prevention. A pilot program will be established to track success on one floor and if successful, will be proposed to other floors within the hospital. Regular compliance audits will be implemented along with pre and post implementation comparison, nurse surveys, and direct observation. The goal is to have a 75% reduction in pressure injuries in one year, a decrease in severe pressure injuries, a 100% compliance rate and at least a 90% accurate documentation rate. This will ultimately lead to improved quality of life, reduced infection costs, reduced treatment rates, reduced hospital stays, and fewer readmissions

Examining Turnover Intention: Preparedness, Retention, and Certification Type

A capstone submitted in partial fulfillment of the requirements for the degree of Doctor of Education in the Ernst and Sara Lane Volgenau College of Education at Morehead State University by Rachel H. Addison-Miller and Pamela O. Puryear on April 12, 2024

Needs Versus Expediency: Poverty Reduction and Social Development inPost-Conflict Countries

This chapter explores the issues around the need to strengthen and sustain peace in post-conflict societies. These issues include the amount of focus to be given to absolute poverty reduction versus broader social inclusion, including the reduction of inequality. The chapter sets out a framework that can help country-level policy and action, then moves on to address specific interventions: health, education, livelihoods, and social protection, reviewing the (often limited) evidence available, and drawing out some tentative recommendations for sequencing. This provides the basis for a discussion of the politics of post-conflict inclusion, which delves deeper into the issues around crafting a politics of recovery that also embraces the needs of the poor. A final section concludes that a ‘first best’ outcome for poverty and human development is unlikely, as the political economy of recovery will impose powerful constraints

A quantitative method to measure biofilm removal efficiency from complex biomaterial surfaces using SEM and image analysis

Biofilm accumulation on biomaterial surfaces is a major health concern and significant research efforts are directed towards producing biofilm resistant surfaces and developing biofilm removal techniques. To accurately evaluate biofilm growth and disruption on surfaces, accurate methods which give quantitative information on biofilm area are needed, as current methods are indirect and inaccurate. We demonstrate the use of machine learning algorithms to segment biofilm from scanning electron microscopy images. A case study showing disruption of biofilm from rough dental implant surfaces using cavitation bubbles from an ultrasonic scaler is used to validate the imaging and analysis protocol developed. Streptococcus mutans biofilm was disrupted from sandblasted, acid etched (SLA) Ti discs and polished Ti discs. Significant biofilm removal occurred due to cavitation from ultrasonic scaling (p < 0.001). The mean sensitivity and specificity values for segmentation of the SLA surface images were 0.80 ± 0.18 and 0.62 ± 0.20 respectively and 0.74 ± 0.13 and 0.86 ± 0.09 respectively for polished surfaces. Cavitation has potential to be used as a novel way to clean dental implants. This imaging and analysis method will be of value to other researchers and manufacturers wishing to study biofilm growth and removal

Biofilm formation on bone-anchored hearing aids

AbstractObjective:To investigate microbiological biofilm contamination of retrieved bone-anchored hearing aids.Materials and methods:Nine failed, retrieved bone-anchored hearing aids and 16 internal screws were examined by scanning electron microscopy. A fixture from a failing implant, which had been removed and disassembled under aseptic conditions, was cultured. Finally, an internal screw from a new, unimplanted fixture was examined by scanning electron microscopy.Results:Debris was seen on the fixture and abutment of all bone-anchored hearing aids, and on the heads of the 16 internal screws. On eight screws, biofilm extended down the shaft to the threads, where it was several micrometres thick. Culture of a failing fixture yielded staphylococcus. The new, unimplanted fixture internal screw showed evidence of scratching and metallic debris on the threads, which may interfere with close fitting of the screw and subsequently facilitate microleakage.Conclusion:There may be a link between internal microbial contamination and failure of bone-anchored hearing aids.</jats:sec

Innately Expressed Estrogen-Related Receptors in the Skeletal Muscle Are Indispensable for Exercise Fitness

Transcriptional determinants in the skeletal muscle that govern exercise capacity, while poorly defined, could provide molecular insights into how exercise improves fitness. Here, we have elucidated the role of nuclear receptors, estrogen-related receptor alpha and gamma (ERRα/γ) in regulating myofibrillar composition, contractility, and exercise capacity in skeletal muscle. We used muscle-specific single or double (DKO) ERRα/γ knockout mice to investigate the effect of ERRα/γ deletion on muscle and exercise parameters. Individual knockout of ERRα/γ did not have a significant impact on the skeletal muscle. On the other hand, DKO mice exhibit pale muscles compared to wild-type (WT) littermates. RNA-seq analysis revealed a predominant decrease in expression of genes linked to mitochondrial and oxidative metabolism in DKO versus WT muscles. DKO muscles exhibit marked repression of oxidative enzymatic capacity, as well as mitochondrial number and size compared to WT muscles. Mitochondrial function is also impaired in single myofibers isolated from DKO versus WT muscles. In addition, mutant muscles exhibit reduced angiogenic gene expression and decreased capillarity. Consequently, DKO mice have a significantly reduced exercise capacity, further reflected in poor fatigue resistance of DKO mice in in vivo contraction assays. These results show that ERRα and ERRγ together are a critical link between muscle aerobic capacity and exercise tolerance. The ERRα/γ mutant mice could be valuable for understanding the long-term impact of impaired mitochondria and vascular supply on the pathogenesis of muscle-linked disorders

The Antimicrobial Scrub Contamination and Transmission (ASCOT) Trial: A Three-Arm, Blinded, Randomized Controlled Trial With Crossover Design to Determine the Efficacy of Antimicrobial-Impregnated Scrubs in Preventing Healthcare Provider Contamination

OBJECTIVE To determine whether antimicrobial-impregnated textiles decrease the acquisition of pathogens by healthcare provider (HCP) clothing. DESIGN We completed a 3-arm randomized controlled trial to test the efficacy of 2 types of antimicrobial-impregnated clothing compared to standard HCP clothing. Cultures were obtained from each nurse participant, the healthcare environment, and patients during each shift. The primary outcome was the change in total contamination on nurse scrubs, measured as the sum of colony-forming units (CFU) of bacteria. PARTICIPANTS AND SETTING Nurses working in medical and surgical ICUs in a 936-bed tertiary-care hospital. INTERVENTION Nurse subjects wore standard cotton-polyester surgical scrubs (control), scrubs that contained a complex element compound with a silver-alloy embedded in its fibers (Scrub 1), or scrubs impregnated with an organosilane-based quaternary ammonium and a hydrophobic fluoroacrylate copolymer emulsion (Scrub 2). Nurse participants were blinded to scrub type and randomly participated in all 3 arms during 3 consecutive 12-hour shifts in the intensive care unit. RESULTS In total, 40 nurses were enrolled and completed 3 shifts. Analyses of 2,919 cultures from the environment and 2,185 from HCP clothing showed that scrub type was not associated with a change in HCP clothing contamination ( P =.70). Mean difference estimates were 0.118 for the Scrub 1 arm (95% confidence interval [CI], −0.206 to 0.441; P =.48) and 0.009 for the Scrub 2 rm (95% CI, −0.323 to 0.342; P =.96) compared to the control. HCP became newly contaminated with important pathogens during 19 of the 120 shifts (16%). CONCLUSIONS Antimicrobial-impregnated scrubs were not effective at reducing HCP contamination. However, the environment is an important source of HCP clothing contamination. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT 02645214 Infect Control Hosp Epidemiol 2017;38:1147–115