Early Methodism on the Pee Dee

Summarizes the growth and development of Methodism along the Pee Dee River, in eastern South Carolina, in the areas of Darlington, Florence, and Marion counties

The Appropriate Clinical Response to Patient Suffering

The starting point of my dissertation is a traditional goal of medicine, the relief of suffering. The central question that I dealt with is the appropriate clinical response to a patient’s suffering. An underlying assumption in the answer that I provide is that a physician’s clinical response must be guided primarily by the principles of beneficence and respect for patient autonomy. I argue that both principles require the physician to respond in a proportionate manner with medically appropriate care, which has the backing of relevant scientific and clinical data, and must be provided in a manner deemed acceptable by the patient. Central to the process of providing medically appropriate care aimed at the relief of suffering is an understanding of suffering itself. To develop that understanding, I studied the works of Freud, Bakan, Frankl, and Cassell. I concluded that suffering is primarily an existential problem associated with the whole person, in contrast to physical pain, which is primarily a neurophysiological problem associated with the body. I define suffering itself as a state of emotion, consisting in an unrelenting tension between hope and despair, caused by a serious and unacceptable disruption in important personal matters. As Frankl put it, when one suffers, one perceives a gap between the way important personal matters are at the moment as compared to how such matters ought to be. The matters are important because they involve something that the sufferer holds dear, while the disruption is unacceptable because the possibility of not overcoming that disruption is potentially devastating. The sufferer’s hope derives from desire and belief v that disruption will be resolved favorably, while the feeling of despair reflects the threat of being overwhelmed by the disruption Although the intensity and duration of suffering vary with subjective factors and the particular circumstances, it follows that relief comes about in one of two ways. Either hope is fulfilled, in which case the sufferer no longer perceives a gap, or relief is a matter of genuine acceptance, as opposed to resignation. Genuine acceptance is the kind possible after adjusting to the death of a loved one, or the consequences of a divorce, or some other personal tragedy. Since some patients hope for relief through physician-assisted suicide, I next examined that issue from the physician’s perspective, and argue that physicians should not agree to such requests. I base my conclusion in part on a requirement defended by Pellegrino and Thomasma, which is that physicians must provide medically appropriate care in a proportionate manner. I developed their principle of proportionality with both a classical and a modern interpretation of that concept. Aquinas provides the basis of a classical interpretation of proportionality, while Gury and Knauer provide the basis of a modern interpretation. Based on a classical version of proportionality, I argue that physician-assisted suicide is morally unacceptable for three reasons. One, it is contrary to the physician’s duty to heal, which does not necessarily mean cure. The healer’s commitment is to care for patients even when cure is not possible, or the patient has a poor quality of life, or death is imminent. This commitment reflects a long-standing legal, medical, and moral tradition that bars the practice of physician-assisted suicide. Two, it is contrary to the public good due to its inherent potential for abuse. I cite evidence from the Netherlands vi and from our own criminal justice system in relation to the death penalty in support of this claim. I also dispute Brock’s claim that safeguards are an effective method of reducing the level of abuse in physician-assisted suicide to a level below that in other end-of-life care strategies. Third, I claim that physician-assisted suicide is contrary to the virtuous practice of medicine because it does not qualify as medically appropriate care. Due to this deficiency, physicians are led to substitute their own personal views about the worth of continued living, which exceeds the limits of their professional expertise. This deviation from established medical protocol goes beyond the particular case to the level of medical principle for all other patients similarly situated, without ethical warrant. Based on a modern interpretation of proportionality, I argue that physicianassisted suicide fails Gury’s version of that principle, which requires a predominance of good in the immediate outcome. Such results cannot be calculated in a case of physicianassisted suicide, because the immediate results of death are known only by the patient, if at all, after death. Physician-assisted suicide also fails Knauer’s version, which requires that the net effect must be measured in the long run and on the whole, which are likewise unknown by the physician. Knauer also requires that there be no less harmful way of securing the value sought, in this case, relief of suffering. In the case of suffering, however, a less onerous method is available, namely, acceptance. Although acceptance is not possible for some patients and not appropriate for others, it is an avenue of relief in all cases of suffering. Because suffering involves the whole person, I draw on the works of Frankl and Cassel to conclude that the appropriate clinical response to a patient’s suffering is a holistic approach to patient care. From the individual’s perspective, Frankl claims that vii resolving suffering depends on the meaning and value that we each give to our experience of suffering. From a clinical perspective, Cassell focuses on suffering as a psychological condition and offers a holistic response, consisting in two primary methods of relief. One is to guide patients to assign meaning to their medical condition, which often resolves the suffering associated with that condition. The other is to assist patients in developing a feeling of transcendence, which helps restore a sense of wholeness after injury to personhood. His approach has three goals. One is to define treatment plans in terms of a sick person, rather than in terms of a disease only. The second is to maximize the patient’s function and not necessarily length of life. The third is to minimize the family\u27s suffering as well as the patient\u27s. In this respect, holistic medicine is centered in community, caring, compassion, and comfort, with a special emphasis on spiritual concerns. Its chief aim is inspire patients to view themselves as persons of value to be cared for, even at end of life when suffering can become unbearable

Performance, physiological, and oculometer evaluation of VTOL landing displays

A methodological approach to measuring workload was investigated for evaluation of new concepts in VTOL aircraft displays. Physiological, visual response, and conventional flight performance measures were recorded for landing approaches performed in the NASA Visual Motion Simulator (VMS). Three displays (two computer graphic and a conventional flight director), three crosswind amplitudes, and two motion base conditions (fixed vs. moving base) were tested in a factorial design. Multivariate discriminant functions were formed from flight performance and/or visual response variables. The flight performance variable discriminant showed maximum differentation between crosswind conditions. The visual response measure discriminant maximized differences between fixed vs. motion base conditions and experimental displays. Physiological variables were used to attempt to predict the discriminant function values for each subject/condition trial. The weights of the physiological variables in these equations showed agreement with previous studies. High muscle tension, light but irregular breathing patterns, and higher heart rate with low amplitude all produced higher scores on this scale and thus represent higher workload levels

Equations of state and stability of MgSiO3_3 perovskite and post-perovskite phases from quantum Monte Carlo simulations

We have performed quantum Monte Carlo (QMC) simulations and density functional theory (DFT) calculations to study the equations of state of MgSiO$_3$ perovskite (Pv) and post-perovskite (PPv), up to the pressure and temperature conditions of the base of Earth's lower mantle. The ground state energies were derived using QMC and the temperature dependent Helmholtz free energies were calculated within the quasi-harmonic approximation and density functional perturbation theory. The equations of state for both phases of MgSiO$_3$ agree well with experiments, and better than those from generalized gradient approximation (GGA) calculations. The Pv-PPv phase boundary calculated from our QMC equations of states is also consistent with experiments, and better than previous LDA calculations. We discuss the implications for double crossing of the Pv-PPv boundary in the Earth

NASA Products to Enhance Energy Utility Load Forecasting

Existing energy load forecasting tools rely upon historical load and forecasted weather to predict load within energy company service areas. The shortcomings of load forecasts are often the result of weather forecasts that are not at a fine enough spatial or temporal resolution to capture local-scale weather events. This project aims to improve the performance of load forecasting tools through the integration of high-resolution, weather-related NASA Earth Science Data, such as temperature, relative humidity, and wind speed. Three companies are participating in operational testing one natural gas company, and two electric providers. Operational results comparing load forecasts with and without NASA weather forecasts have been generated since March 2010. We have worked with end users at the three companies to refine selection of weather forecast information and optimize load forecast model performance. The project will conclude in 2012 with transitioning documented improvements from the inclusion of NASA forecasts for sustained use by energy utilities nationwide in a variety of load forecasting tools. In addition, Battelle has consulted with energy companies nationwide to document their information needs for long-term planning, in light of climate change and regulatory impacts

Fast Longwave and Shortwave Radiative Flux (FLASHFlux) Products from CERES and MODIS Measurements

The Clouds and the Earth s Radiant Energy Systems (CERES) project is currently producing world-class climatological data products derived from measurements taken aboard the Terra and Aqua spacecrafts (Wielicki et al., 1996). While of exceptional fidelity, these data products require a considerable amount of processing to assure quality and verify accuracy and precision. Obtaining such high quality assurance, however, means that the CERES data is typically released more than six months after the acquisition of the initial measurements. For climate studies, such delays are of little consequence, especially considering the improved quality of the released data products. There are, however, many uses for the CERES data products on a near real-time basis. These include: CERES instrument calibration and subsystem quality checks, CLOUDSAT operations, seasonal predictions, agricultural and ocean assimilations, support of field campaigns, and outreach programs such as S'Cool. The FLASHflux project was envisioned as a conduit whereby CERES data could be provided to the community within a week of the initial measurements, with the trade-off that some degree of fidelity would be exacted to gain speed. In this paper, we will report on some very encouraging initial results from the FLASHflux project in which we compared the FLASHflux instantaneous surface fluxes to the CERES surface-only flux algorithm data products

El Nino Coupled Tropical Land Surface Hydrologic Response

No abstract availabl

Beyond cognitive deficit: the everyday lived experience of dyslexic students at university

This study explores the lived experiences of three dyslexic university students as they negotiate a number of different learning spaces within their higher education institution. The students completed reflective diaries for a period of three weeks and were subsequently interviewed about the experiences they recorded. The transcribed data from the diaries and interviews were analysed using interpretative phenomenological analysis. The following four themes were constructed following analysis: getting things out of my head; holding back – performance as risk; ever-present inner voices – effort of constant self-monitoring; and not belonging in academic spaces – metaphors of misfit. This study argues that attention to the everyday experiences of students with the dyslexia label is as important as knowledge of cognitive differences in the drive to create a more equitable learning environment in higher education

Compressibility of ferropericlase at high-temperature: evidence for the iron spin crossover in seismic tomography

The iron spin crossover in ferropericlase, the second most abundant mineral in Earth's lower mantle, causes changes in a range of physical properties, including seismic wave velocities. Understanding the effect of temperature on the spin crossover is essential to detect its signature in seismic observations and constrain its occurrence in the mantle. Here, we report the first experimental results on the spin crossover-induced bulk modulus softening at high temperatures, derived directly from time-resolved x-ray diffraction measurements during continuous compression of (Mg0.8Fe0.2)O in a resistive-heated dynamic diamond-anvil cell. We present new theoretical calculations of the spin crossover at mantle temperatures benchmarked by the experiments. Based on our results, we create synthetic seismic tomography models to investigate the signature of the spin crossover in global seismic tomography. A tomographic filter is applied to allow for meaningful comparisons between the synthetic models and data-based seismic tomography models, like SP12RTS. A negative anomaly in the correlation between Vs variations and Vc variations (S-C correlation) is found to be the most suitable measure to detect the presence of the spin crossover in tomographic models. When including the effects of the spin crossover, the misfit between the synthetic model and SP12RTS is reduced by 63%, providing strong evidence for the presence of the spin crossover, and hence ferropericlase, in the lower mantle. Future improvement of seismic resolution may facilitate a detailed mapping of spin state using the S-C correlation, providing constraints on mantle temperatures by taking advantage of the temperature sensitivity of the spin crossover