FISIOLOGIA DO PARTO E DA LACTAÇÃO ANIMAL -/- ANIMAL REPRODUCTION: PHISIOLOGY OF PARTURITION AND ANIMAL LACTATION -/- Emanuel Isaque Cordeiro da Silva Departamento de Zootecnia da UFRPE WhatsApp: (82)98143-8399 -/- 1. INTRODUÇÃO O sucesso biológico do processo de reprodução culmina com a sobrevivência das crias. Durante a gestação, o feto desenvolve-se no útero materno protegido das influências externas, e obtendo os nutrientes e o oxigênio através da mãe. O parto é o processo biológico que marca o fim da gestação e (...) o início da vida extrauterina do animal. Para garantir a sobrevivência do recém-nascido o parto deve ser um processo controlado para que se inicie unicamente quando o feto tiver alcançado desenvolvimento suficiente que lhe permita enfrentar a vida extrauterina. Após o nascimento, a secreção de leite pela glândula mamária proporciona ao neonato tanto os nutrientes necessários para seu desenvolvimento como as defesas (imunoglobulinas) que lhe protegerão contra as possíveis infecções durante as primeiras fases de sua vida. Parto e lactação constituem a última etapa de um ciclo reprodutivo completo nas fêmeas dos animais domésticos, estando ambos os processos regulados e sincronizados por complexas mudanças hormonais na mãe. Estas mudanças são, em última análise, provocadas e governadas pelo próprio feto ou recém-nascido, o qual acomoda as respostas maternas às suas necessidades garantindo a sua sobrevivência. 2. O PARTO O parto é definido como o processo fisiológico pelo qual ocorre a expulsão de um ou mais fetos maduros, bem como das membranas fetais existentes no útero materno. Este processo é desencadeado por uma interação complexa entre as hormonas maternas (fatores maternos) e fetais (fatores fetais). Para que se realize a expulsão do feto é necessário que o útero deixe de ser um órgão quiescente, essencial para a manutenção da gestação, para ser um órgão contrátil. Ao mesmo tempo, o cérvix ou colo uterino, que durante a gestação permanece firmemente fechado para impedir a expulsão prematura do feto e evitar a entrada de agentes infecciosos, relaxa e dilata para facilitar a passagem do feto na hora do parto. Esta modificação na atividade do útero e do colo uterino, ocorrem como consequência das mudanças hormonais que o organismo materno experimenta à medida que a data do parto se aproxima. 2.1 Fatores maternos A gestação dos animais domésticos ocorre com elevada concentração de progesterona que, dependendo da espécie animal, é secretada seja pelo corpo lúteo do ovário (vaca, porca e cabra) ou pela placenta (ovelha e égua). A progesterona desempenha um papel fundamental durante a gestação, inibindo as contrações da musculatura lisa do útero (miométrio), permitindo assim a acomodação do feto durante o seu crescimento. Os estrogênios, estimulantes da atividade contrátil do miométrio, mantêm-se a baixas concentrações durante a maior parte da gestação. À medida que se aproxima o momento do parto, os níveis destes hormônios esteroides modificam-se, produzindo-se a diminuição nos níveis circulantes da progesterona ao mesmo tempo que se incrementam os valores sanguíneos dos estrogênios (figura 1). A redução dos níveis de progesterona suprime a sua ação inibitória sobre a atividade contrátil do miométrio, permitindo que se manifestem os efeitos estimulantes dos estrogênios sobre este órgão. A concentração de estrogênios começa a aumentar geralmente no final da gestação, atingindo os seus valores máximos no momento do parto (figura 1). O aumento da concentração de estrogênios favorece a atividade contrátil espontânea do útero ao: a) estimular a síntese de proteínas contráteis; b) aumentar, sob medida, a sensibilidade do miométrio uterino à ação estimulante das prostaglandinas; c) induzir a formação de receptores de oxitocina no útero. -/- Figura 1. Níveis de progesterona e estrógenos durante a gestação e parto das espécies ovina, caprina, suína e bovina. Fonte: HAFEZ, 2013. Os estrogênios estimulam a síntese e secreção de prostaglandina (PGF2a), que constitui o elemento essencial para o início do parto devido aos efeitos que esta substância provoca. Assim, nas fêmeas, cujos níveis de progesterona gestacional dependem da presença do corpo lúteo, a secreção de PGF, origina a regressão deste (luteólise), com a consequente diminuição da progesterona a níveis basais. Além disso, a PGF2a origina contrações de crescente intensidade no útero sensibilizado pela ação dos estrogênios. Esta ação contrátil da PGF2a deve-se a um aumento da concentração de cálcio intracelular das fibras musculares uterinas. A PGF2a também está envolvida no relaxamento do colo do útero, inibindo a formação de colágeno cervical ao mesmo tempo que estimula a síntese de enzimas (colagenase) que degradam a matriz de colágeno formado no início da gestação. A dilatação do colo do útero está também associada à pressão que o feto exerce sobre o mesmo e, no caso da porca, a relaxina pode também estar envolvida. Esta hormona é também de grande importância para a preparação do parto em todas as espécies animais, uma vez que é responsável pelo relaxamento dos ligamentos e músculos que rodeiam o canal pélvico para favorecer a separação da sínfise púbica durante a expulsão do feto. Nos grandes animais (vaca, égua) as mudanças que ocorrem nos tecidos e ligamentos pélvicos são muito evidentes e constituem um sintoma de parto iminente. O início do parto, ou primeira fase do parto, caracteriza-se pelo aumento das contrações uterinas provocadas pela PGF2a coincidindo com a dilatação do colo uterino para permitir a passagem do feto para o canal do parto, momento em que começa a segunda fase do parto. A distensão vaginal que produz-se para a passagem do feto pelo canal do parto origina um estímulo nervoso que viaja através da medula espinal para o hipotálamo, onde se encontram os neurônios responsáveis pela síntese de oxitocina. As terminações nervosas destes neurónios são projetadas para o lobo posterior da hipófise (neurohipófise), onde a oxitocina é secretada para ser, posteriormente , transportada pela circulação sanguínea. Este reflexo neuroendócrino chamado reflexo de Ferguson determina a secreção súbita de oxitocina, provocando o aumento tanto na intensidade como na frequência das contrações uterinas necessárias para a expulsão final do feto. O papel da oxitocina é ativar a conclusão do processo de expulsão, uma vez que esta hormona não está envolvida no início do parto. A alteração mais significativa entre a gestação e o parto é a alteração na atividade contrátil do miométrio uterino. Esta mudança é devido às alterações hormonais que ocorrem na mãe quando a gestação chegou a fim. No entanto, para que estes mecanismos maternos sejam acionados, é necessário que o feto indique de alguma forma à mãe o seu estado de desenvolvimento, de modo que o nascimento realize-se quando o feto estiver preparado para enfrentar a vida extrauterina. 2.2 Fatores fetais A destruição experimental da hipófise e/ou das glândulas adrenais do feto origina o prolongamento da gestação nos animais domésticos. Pelo contrário, a administração exógena de cortisol (corticosteroides adrenais), ou do seu precursor hipofisário (ACTH), à circulação fetal provoca, em poucas horas, o início do parto. Estes fatos evidenciam a importância do eixo hipófise-adrenal do feto para desencadear o início do parto (figura 2). Figura 2. Mecanismos fetais que controlam o parto em ovelhas. Fonte: LIGGINS et al, 1972. No final da gestação, o feto maduro apresenta um aumento da concentração de corticosteroides plasmáticos devido ao efeito estimulante da hormona adrenocorticotróide (ACVH) secretada pela hipófise fetal sobre as glândulas adrenais do feto. Os corticosteroides fetais por sua vez estimulam as enzimas placentárias para transformar a progesterona em estrogênio. O resultado final é a diminuição dos níveis de progesterona ao mesmo tempo que se eleva a concentração de estrogênios que, por sua vez, estimulam a libertação de PGF2a responsável pelas contrações uterinas. Este raciocínio explica algumas doenças caracterizadas por gestação prolongada em ovelhas, como ocorre na África do Sul, onde estes animais são obrigados, durante as épocas de seca, a ingerir as folhas de um arbusto chamado Salsola tuberculate. O prolongamento da gestação ocorre quando estas folhas são ingeridas durante o último terço da gestação cujos efeitos estão relacionados com a supressão do eixo hipotálamo-hipófise, com o qual as adrenais não recebem o estímulo necessário (ACTH) para a síntese e liberação de corticoides. O efeito contrário é observado nas cabras da raça Angorá, nas quais se produzem, com relativa frequência, partos prematuros que podem estar relacionados com um desenvolvimento precoce das glândulas adrenais. Isto significa que, nos animais domésticos, o feto determina a data do parto. O sinal hormonal que indica à mãe o grau de maturidade do feto é o desenvolvimento do eixo hipotálamo-hipófise-adrenal que origina o aumento na secreção de corticoides fetais que são os responsáveis por desencadear as alterações hormonais no organismo materno necessárias para iniciar o parto. A figura 2 mostra como a remoção da hipófise e as adrenais do feto prolongam a gestação, enquanto a administração exógena de ACTH ou corticoides (cortisol) ao feto originam um parto prematuro. O momento em que ocorre o aumento da concentração plasmática de corticoides no feto varia de acordo com a espécie: de 25 a 30 dias antes do parto na vaca, de 7 a 10 dias na porca e de 2 a 3 dias na ovelha. 2.3 Desenvolvimento e fases do parto O parto inicia-se com o início das contrações peristálticas e regulares do miométrio uterino ao mesmo tempo que o colo do útero se dilata progressivamente. Nas fêmeas que gestam um único feto (monotecas), as contrações começam na extremidade anterior do córneo uterino, enquanto que nas espécies que gestam vários fetos (politocas) as contrações começam pela extremidade cervical para começar a expulsar o feto que se encontra mais próximo do cérvix. Durante o parto são reconhecidas três fases: 1. Fase preparatória - Na qual as contrações uterinas estimulam a rotação do feto (fêmeas monotecas) para adotar a posição dorsal (extremidades anteriores e cabeça forçadas contra o cérvix) que lhe permite oferecer a menor resistência para sua expulsão. A PGF2a provoca as contrações miometriais e a dilatação do cérvix, deslocando o feto contra e através desta estrutura. 2. Fase de expulsão - A passagem do feto através do colo uterino e da vagina causam a completa dilatação destas estruturas, originando a secreção de oxitocina (reflexo de Ferguson), que provoca contrações de maior frequência e intensidade. Por sua vez, estas contrações uterinas são reforçadas pela pressão e contração dos músculos abdominais, chegando estes últimos a ser a força principal (forças de expulsão) envolvida no processo de expulsão do feto. O cordão umbilical rompe-se bem ao levantar-se a mãe ou pelos movimentos do recém-nascido. 3. Fase de expulsão da placenta - Após o parto, as contrações rítmicas do útero continuam a facilitar a expulsão da(s) placenta(s). O tempo necessário para este processo varia de acordo com a espécie animal. Este processo é rápido na égua, já que a separação do corion (membrana fetal) de sua inserção uterina ocorre durante a expulsão do feto, com o qual o parto deve ser concluído rapidamente ou, caso contrário, o potro se asfixiaria. Nos ruminantes, a expulsão da placenta cotiledonaria é um processo mais lento que exige a separação dos cotilédones (membrana fetal) das carúnculas do útero. Por conseguinte, a troca de nutrientes e oxigênio entre a mãe e o feto continua até que este tenha sido totalmente expelido, devido ao cordão umbilical destes animais ser bastante longo. Nas fêmeas politocas, como a porca, geralmente as placentas de vários leitões são expulsadas no final, quando os leitões já foram expelidos, se bem que o último leitão poderá ser expelido durante a expulsão da massa placentária. 3. LACTAÇÃO A lactação constitui o processo que define os mamíferos como classe biológica. O desenvolvimento pós-natal dos mamíferos vai depender, em grande medida, dos nutrientes e defesas fornecidos pela mãe através da secreção de leite (imunoglobulinas). Assim, uma vez concluído o desenvolvimento gestacional do feto, a glândula mamária irá substituir, de certa forma, a função nutritiva e protetora da placenta durante a gestação. 3.1 Anatomia funcional da glândula mamária A estrutura funcional da glândula mamária é muito semelhante em todos os mamíferos, embora o tamanho, forma e número de glândulas varia dependendo da espécie animal. As glândulas mamárias desenvolvem-se como estruturas pares cujo número varia de um par (égua, cabra e ovelha), dois pares (vaca) até sete ou nove (porca). A localização das glândulas também difere sendo inguinal em vaca, égua, cabra e ovelha, enquanto que na porca, cadela e gata se estendem por todo o comprimento do tórax e abdômen. Nos animais domésticos em geral as glândulas mamárias recebem o nome de úberes. Tomando como modelo a vaca, a glândula mamária se organiza em duas estruturas: o estroma, formado por tecido conjuntivo procedente dos ligamentos suspensório medial, localizado entre os dois pares de glândulas, dando suporte à segunda estrutura que é o tecido secretor. Este é formado por acúmulos de células secretoras formando estruturas ocas chamadas alvéolos, que são as unidades fundamentais secretoras de leite. Os alvéolos estão circulados internamente por células epiteliais (secretoras) e rodeados externamente por células mioepiteliais contráteis, cuja contração origina a ejeção do leite (figura 3). O agrupamento de vários alvéolos adjacentes formam um lobo secretor. Figura 3. Diagrama de um agregado de alvéolos na glândula mamária de uma cabra. Fonte: COWIE et al, 1980. Os lobos expelem a secreção através de ductos que, por sua vez, drenam os ductos galactóforas (ductos lácteos) de maior diâmetro, para desembocar em áreas especializadas em armazenar o leite chamadas cisternas (vaca, cabra). Finalmente, a cisterna abre-se para o exterior através do canal papilar da teta. A presença do músculo liso na teta permite-lhe agir como esfíncter para impedir que o leite seja expelido passivamente do interior da glândula. O mamilo/teta é provido de numerosos receptores sensitivos cuja excitação durante a ordenha ou amamentação vai desencadear estímulos nervosos de grande importância para a manutenção da lactação. 3.2 Desenvolvimento da glândula mamária (mamogênese) A glândula mamária difere das demais glândulas do organismo no escasso desenvolvimento que apresenta no nascimento da fêmea, o qual não se inicia até que esta não atinja a puberdade. O início da atividade cíclica do ovário (puberdade) dá origem à síntese de estrogênios (fase folicular do ciclo estral) e progesterona (fase lútea). Os estrogênios originam o alongamento e ramificação dos ductos e a formação de pequenas massas esféricas de células (os futuros alvéolos). Embora este desenvolvimento seja dependente do estrogênio, é também necessária a ação sinérgica da prolactina, hormona do crescimento (GH) e corticoides adrenais, como demonstrado pelos estudos realizados em ratos aos quais foi removida a hipófise, glândulas suprarrenais e ovários (figura 4). A função da progesterona no desenvolvimento da glândula mamária é estimular o crescimento do lobo-alveolar, mas como no caso anterior também requer a ação conjunta dos hormônios acima mencionados. Figura 4. Hormonas relacionadas com o crescimento da glândula mamária e início da secreção de leite na rata hipofisectomizada-adrenoectomizada-ovariectomizada. Fonte: COWIE, 1980. O desenvolvimento da glândula, durante cada ciclo estral, vai depender da duração da fase folicular (níveis elevados de estrogênio), já que nas restantes fases do ciclo, quando os níveis de estrogênio são baixos, os ductos sofrem uma ligeira regressão. Nas espécies com ciclos curtos (rata), em que a fase folicular do ciclo é predominante, enquanto a fase lútea é quase inexistente, verifica-se um grande desenvolvimento dos ductos; enquanto que aquelas que apresentam um corpo lúteo funcional de longa duração (cadela e primatas), além do crescimento dos ductos, mostram um grande desenvolvimento lóbulo-alveolar semelhante ao que ocorre na gestação. É durante a gestação que o sistema alveolar sofre uma hipertrofia considerável, resultando em lobos proeminentes e no desenvolvimento da luz interna dos alvéolos, fato que é evidente na maioria dos animais domésticos por volta da metade do período gestacional. Em algumas espécies, as células que circundam interiormente os alvéolos contêm produtos secretores, indicando que a glândula mamária já está preparada para a fase da lactação. O desenvolvimento glandular durante a gestação deve-se ao efeito conjunto da progesterona e dos estrogênios com as hormonas hipofisárias acima mencionadas: prolactina, hormona do crescimento (GH) e adrenocorticotropina (ACTH). A proporção entre estrogênios e progesterona varia de acordo com a espécie, mas geralmente é necessária uma maior concentração de progesterona (proveniente do corpo lúteo ou da placenta). Quanto às hormonas hipofisárias, a prolactina desempenha um papel fundamental na diferenciação da glândula mamária (mesmo a baixas concentrações) ao estimular o desenvolvimento do epitélio secretor dos alvéolos. A GH favorece o crescimento dos ductos e a ACTH estimula a secreção de corticoides nas adrenais que, por sua vez, favorecem de forma generalizada o crescimento das glândulas. 3.3 Secreção da glândula mamária (lactogênese) A lactogênese, ou o processo pelo qual se produz a síntese e secreção do leite pela glândula mamária, começa no final da gestação coincidindo com o desencadeamento do parto. O primeiro leite formado imediatamente antes ou depois do parto é denominado colostro. No entanto, a lactação não pode desenvolver- se completamente até que se inicie o processo de parto. Isto deve-se ao fato de que o processo de lactação resulta de uma interação complexa de hormonas que preparam a glândula mamária para a secreção do leite. Os requisitos hormonais mínimos para o início da lactogênese são: aumento da secreção de estrogênios, prolactina e corticoides, juntamente com a diminuição da concentração de progesterona, perfis hormonais que estão intimamente relacionados com o desencadeamento do parto. Isto deve-se ao fato de que a progesterona inibe a atividade lactogênica da prolactina bloqueando a formação dos seus receptores na glândula mamária durante a gestação impedindo, assim, a prolactina de sintetizar os componentes fundamentais do leite. Pelo contrário, o aumento da concentração de estrogênios no final da gestação (figura 1, na seção do parto) estimula a síntese, o armazenamento e a secreção hipofisária de prolactina. Assim, apesar da glândula mamária estar preparada para iniciar a secreção de leite, muito antes da data prevista para o parto, a elevada concentração de progesterona (existente durante esse período de gestação) impede a fase láctea (saída do leite pelas tetas) de ocorrer antes da expulsão do feto. Desta forma, o feto poderá beneficiar das vantagens que o fornecimento do colostro materno irá trazer para a sua sobrevivência (imunização, nutrição e favorecimento da exoneração do mecônio). O aumento da concentração de estrogênios nos dias que antecederem o parto resulta num rápido aumento das concentrações plasmáticas de prolactina e corticoides. A prolactina é a hormona lactogênica mais importante na síntese dos componentes do leite. No entanto, para que esta hormona possa exercer a sua função, é necessária a participação dos corticoides, já que os mesmos são os responsáveis pelo desenvolvimento das organelas citoplasmáticas (retículo endoplasmático rugoso e aparelho de Golgi) onde se realiza a síntese do leite. No desenvolvimento da lactogênese, para além da prolactina e dos corticoides, participam também outras hormonas como a insulina, a tiroxina e o hormônio do crescimento. A insulina estimula a proliferação de novas células epiteliais na glândula mamária, enquanto a tiroxina, embora não seja essencial para a lactação, pode influenciar no volume de leite produzido pela fêmea (alta produção leiteira). Por último, a hormona do crescimento favorece, em geral, a lactação, existindo atualmente um interesse considerável no uso desta hormona para promover a produção adicional de leite em vacas através da sua administração exógena (trabalho e projeto desenvolvido pela professora titular e médica-veterinária do IFPB Campus Sousa Marianne Christina Velaqua). 3.3.1 Síntese e secreção dos componentes do leite Os principais constituintes do leite são: proteínas (caseína, alfa-lactalbumina, albumina sérica e imunoglobulinas), açúcares (lactose), gorduras (principalmente sob a forma de triglicerídeos), vitaminas, minerais e citrato (no caso dos ruminantes). As proteínas (caseína e alfa-lactalbumina) são sintetizadas no retículo endoplasmático rugoso e posteriormente embaladas em vesículas secretoras do aparelho de Golgi para serem liberadas da célula para a luz alveolar mediante um processo de exocitose. A lactose é o principal açúcar do leite que, além disso, atua regulando a pressão osmótica do mesmo de modo que o volume de leite que a glândula mamária segrega está diretamente relacionado com a quantidade de lactose presente. A síntese da lactose ocorre no aparelho de Golgi pela condensação de glicose e galactose; esta reação é catalisada por uma enzima (lactose sintetase) presente na membrana do aparelho de Golgi que, por sua vez, é ativada pela proteína alfa-lactalbumina. Esta proteína só aparece na glândula mamária e é essencial para a síntese da lactose, o que demonstra que este açúcar é exclusivamente formado no leite. A lactose é também embalada junto com o cálcio, o fosfato e as proteínas nas vesículas secretoras para ser expulsada ao lúmen alveolar por exocitose. As imunoglobulinas (anticorpos IgA) são formadas pelas células plasmáticas, derivadas dos linfócitos B do sangue, como consequência da exposição da mãe a diferentes microrganismos. Estes anticorpos passam para a glândula mamária por migração dessas células a partir dos tecidos adjacentes. Os triglicerídeos são sintetizados no citoplasma e no retículo endoplasmático liso a partir de ácidos graxos provenientes da circulação sanguínea; em seguida, unem-se formando glóbulos de gordura que se dirigem até o vértice da membrana plasmática para serem finalmente expelidos para a luz do alvéolo, rodeados pela membrana, formando assim uma dispersão de glóbulos de gordura (figura 5). Figura 5. Estrutura de três células alveolares durante a síntese do leite. Fonte: COWIE, 1980. Do ponto de vista quantitativo, a caseína e os triglicerídeos constituem as proteínas e as fontes de energia, respectivamente, mais importantes do leite. Por último, o citrato é um intermediário do metabolismo da glicose que ocorre em grande concentração no leite dos ruminantes. Este composto é também englobado no interior das vesículas secretoras, junto com os outros compostos, para sua expulsão à luz alveolar. A composição do leite varia dependendo da espécie animal, e difere também até entre a mesma espécie. Estas variações estão relacionadas com a raça, idade, estágio de lactação e estado nutricional do animal. O teor de gordura no leite de ovelhas, porcas, cadelas e gatas varia entre 7 e 10%. No gado leiteiro estes valores variam de 3,5 a 5,5%, dependendo da raça. Em relação às cabras, os valores de gordura são muito semelhantes aos das vacas, enquanto o leite das éguas é o que tem menor teor de gordura (tabela 1). Espécie Gordura Proteína Lactosa Cinzas/Cálcio Gata 7,1 10,1 4,2 0,5 Vaca holandesa 3,5 3,1 4,9 0,7 Cadela 9,5 9,3 3,1 1,2 Cabra 3,5 3,1 4,6 0,8 Égua 1,6 2,4 6,1 0,5 Tabela 1. Composição do leite em várias espécies (%). Fonte: JACOBISON, 1984. 3.4 Manutenção da lactação (galactopoiese) A capacidade da glândula mamária de secretar um grande volume de leite começa em/ou imediatamente antes do parto, para aumentar no período pós-parto durante um tempo variável e, posteriormente, diminuir de forma gradual. Em geral, existe um paralelismo entre a atividade secretora da glândula e a procura de leite por parte do lactente. Isto deve-se ao fato de sucção pelo lactente, ou a extração por ordenha, que constituem o fator fundamental para a manutenção da lactação. A sucção estimula a lactação de duas formas: a) reduzindo os efeitos inibitórios da pressão intramamária produzida pela acumulação de leite, e b) estimulando intensamente a secreção de hormonas necessárias para manter a síntese e secreção de leite nos alvéolos. As hormonas que desempenham um papel fundamental na manutenção da lactação são: I) a prolactina, que é responsável pela estimulação da síntese e secreção de leite nas células epiteliais nos alvéolos, e 2) a oxitocina, que provoca a contração das células musculares que circundam externamente os alvéolos e os ductos (células mioepiteliais). A libertação de ambos os hormônios ocorre como resultado de um reflexo neuroendócrino originado pela estimulação do mamilo. 3.4.1 Secreção reflexa de prolactina A secreção de prolactina é regulada por dois fatores hipotalâmicos: a dopamina, que inibe a secreção de prolactina e um fator cuja identidade não está bem definida, conhecido como fator liberador de prolactina (PRF)que estimula a liberação deste hormônio. O estímulo sensorial originado como sequência da estimulação do mamilo, pela sucção do lactente, é transportado através da medula espinhal para o hipotálamo, onde atua na inibição da dopamina ou estimulando a secreção do PRF para desencadear a secreção de prolactina da adenohipófise para a circulação sanguínea (figura 6). Figura 6. Reflexos neuroendócrinos secretores de prolactina e oxitocina. Fonte: HAFEZ, 2000. A prolactina estimula a secreção dos componentes do leite para a luz dos alvéolos, afim de repor o volume de leite extraído durante a última ordenha ou sucção. Ao mesmo tempo, a prolactina induz a síntese das proteínas, incluindo a alfa-lactalbumina para estimular novamente a síntese da lactosa, bem como as enzimas necessárias para a produção dos triglicerídeos. Desta forma, a secreção de prolactina originada pelo lactente durante o aleitamento proporciona um mecanismo simples para combinar o volume de produção de leite com as necessidades do lactente. A quantidade de prolactina liberada durante cada período de sucção depende do número de crias, da duração do estímulo e dos intervalos de tempo decorridos entre os períodos de sucção (ou ordenha). No caso das vacas leiteiras, as ordenhas são geralmente realizadas de doze em doze horas, intervalo de tempo suficiente para manter a lactogênese. Os valores plasmáticos de prolactina aumentam imediatamente após o início da ordenha, mas os valores mais elevados são obtidos cerca de meia hora após o início do estímulo (ordenha ou sucção). A secreção de prolactina e a produção de leite são influenciadas de alguma forma pelo fotoperíodo, uma vez que, em alguns animais se comprovou como o aumento do número de horas de exposição à luz dá origem a um aumento da concentração de prolactina circulante, bem como uma maior produção de leite (entre 6 e 10%) (trabalho e projeto elaborado pelos estudantes do curso técnico em agropecuária e da graduação em Medicina Veterinária do IFPB Campus Sousa sob a coordenação e orientação da profa. Me. Esp. Marianne C. Velaqua). 3.4.2 Reflexo da ejeção do leite A sucção do mamilo pelo lactente estimula os receptores sensoriais presentes nesta estrutura, originando a geração de impulsos nervosos que são transmitidos pelas vias nervosas ascendentes da medula espinhal para os corpos celulares produtores de oxitocina no hipotálamo. O estímulo desencadeia a síntese e liberação de um bolo de oxitocina através das terminações nervosas dos núcleos hipotalâmicos para a neurohipófise, da qual é transmitida, através do sangue, para a glândula mamária, provocando a contração das células mioepiteliais que rodeiam os alvéolos (figura 6). Além da estimulação direta do mamilo provocada pela sucção, qualquer estímulo relacionado à ordenha é capaz de gerar o reflexo da ejeção, por exemplo: os estímulos sensoriais auditivos (ruído dos cubos na hora da ordenha), visuais (ambiente da sala de ordenha), táteis (lavagem manual dos mamilos antes da ordenha) e os estímulos olfatórios que se produzem em torno do animal. O desencadeamento do reflexo de ejeção pelos estímulos sensoriais, que não estão diretamente relacionados com a sucção ou ordenha, indica a possível participação de centros superiores do sistema nervoso central para controlar a secreção de oxitocina. Esta teoria é baseada em que os estímulos relacionados com situações de estresse em animais de estimação (medo, ansiedade, frio, etc.) inibem a ejeção do leite. A contração das células mioepiteliais gera um aumento da pressão intra-alveolar mamária, provocando o deslocamento do leite para os ductos maiores da glândula. Este efeito é popularmente conhecido como diminuição do leite e constitui um mecanismo fisiológico muito eficaz para controlar a expulsão do leite para o mamilo, assegurando que a ejeção do leite se realize unicamente quando o lactente o demanda. O efeito estimulante da oxitocina é de grande importância já que a maior parte do leite se encontra nos alvéolos e nos ductos, com o qual, a ausência deste hormônio provocaria um lento movimento do leite para a cisterna do úbere e, portanto, uma menor quantidade de leite. Assim, quando os alvéolos e ductos menores são contraídos, ocorre o relaxamento dos ductos principais, bem como da cisterna (ruminantes) e do mamilo, o que dá origem a um aumento destas estruturas para alojar o volume de leite expelido. Como resultado da volumosa ejeção do leite dos alvéolos e ductos menores, ocorre um aumento da pressão intramamária de modo que o lactente terá que vencer a resistência do esfíncter do mamilo para poder extrair o leite. A produção de leite pela glândula mamária diminui gradualmente à medida que os intervalos de tempo entre os dois períodos de amamentação do lactente diminuem e os estímulos necessários para manter as concentrações de prolactina e oxitocina na circulação sanguínea. A diminuição ou cessação da secreção de leite, geralmente coincide com a mudança na alimentação das crias (desmame) para passar à dieta característica da espécie. 3.5 Colostro O colostro é o primeiro leite que se forma na glândula mamária coincidindo com o parto. A ingestão de colostro por recém-nascidos é de grande importância para a sua sobrevivência, não só pelo seu elevado valor nutritivo, mas também pelo seu teor em imunoglobulinas (IgA) que lhe confere a imunização passiva necessária para o proteger contra patologias. Em algumas espécies (homem, coelho e cobaia) grande parte dos anticorpos passam para a circulação do feto através da placenta durante a gestação. Nos animais domésticos (vaca, égua, ovelha, cabra, porco) as características da placenta (número de camadas entre a circulação materna e fetal) não permitem a passagem destas proteínas. Como resultado, a imunização das crias nestas espécies animais vai depender da transferência das imunoglobulinas através do colostro. O epitélio intestinal dos recém-nascidos permite a passagem destas imunoglobulinas durante as primeiras 24 a 48 horas de vida. Passado este tempo, o epitélio torna-se impermeável à passagem dos anticorpos, fato que põe em evidência a importância que tem para os animais recém-nascidos e desprovidos de defesas a ingestão do colostro durante os primeiros dias. A composição do colostro caracteriza-se (em relação ao leite normal) por um teor mais elevado de proteínas, vitaminas, minerais e uma menor concentração de lactose. A composição do colostro muda gradualmente durante os primeiros três dias após o parto para se transformar em leite normal. 4. RESUMO E PRIMEIRAS CONCLUSÕES O parto, ou processo fisiológico pelo qual se expulsa o feto, é o resultado da maturação sequencial de um sistema de comunicação hormonal. A sequência inicia-se no sistema nervoso central do feto de onde os sinais são transmitidos e amplificados, através da hipófise, para as glândulas adrenais fetais, as quais respondem ao estímulo mediante a secreção de cortisol. O aumento da concentração de cortisol por parte do feto indica que este conseguiu o desenvolvimento necessário para enfrentar a vida extrauterina e, portanto, é hora de interromper a gestação. O cortisol atua sobre a placenta para aumentar a secreção de estrogênios que, por sua vez, estimulam a síntese e a liberação de prostaglandinas. O resultado é a diminuição da progesterona, que é a hormona encarregada de manter a gestação ao inibir as contrações espontâneas do útero, impedindo assim a expulsão prematura do feto. O útero, sob os efeitos da prostaglandina, começa a contrair-se ao mesmo tempo que o colo uterino amolece e dilata progressivamente (fase preparatória do parto). A passagem do feto ao canal do parto origina a secreção reflexa de oxitocina (fase de expulsão), causando contrações de maior frequência e intensidade que culminam com a expulsão do feto. Finalmente, as contrações uterinas continuam durante algum tempo até que finalmente é expulsa a placenta (fase de expulsão da placenta). O desenvolvimento da glândula mamária durante a gestação e a subsequente capacidade desta estrutura para secretar leite, coincidindo com o parto, oferece aos animais pertencentes à classe biológica dos mamíferos a vantagem de alimentar as suas crias para assegurar a sua sobrevivência durante as primeiras fases do seu desenvolvimento e, portanto, a continuidade da espécie. A lactação constitui um dos processos fisiológicos mais complexos em consequência do grande número de hormonas que, segregadas de forma coordenada, controlam as diferentes fases pelo que atravessa este processo: I) mamogênese ou desenvolvimento dos dutos e estruturas lóbulo-alveolares durante a gestação; 2) lactogênese ou síntese láctea por células epiteliais e sua secreção para a luz alveolar coincidindo com o parto, e 3) galactopoiese ou manutenção da síntese e secreção do leite como consequência da sua extração da glândula mamária seja pela sucção da cria ou pela ordenha. -/- Emanuel Isaque Cordeiro da Silva – Departamento de Zootecnia da UFRPE. Recife, 2020. -/- REFERÊNCIAS BIBLIOGRÁFICAS -/- BEIGHLE, D. E. The effect of gestation and lactation on bone calcium, phosphorus and magnesium in dairy cows. Journal of the South African Veterinary Association, v. 70, n. 4, p. 142-146, 1999. BRACKELL, B. G.; JR SEIDEL, G. E.; SEIDEL, S. Avances en zootecnia nuevas técnicas de reproducción animal. Zaragoza: Acribia, 1988. COLE, H. H.; CUPPS, P. T. Reproduction in domestic animals. 1ª ed. Londres: Academic Press, 1977. COWIE, Alfred T.; FORSYTH, Isabel A.; HART, Ian C. Lactation. In: Hormonal control of lactation. Springer, Berlin, Heidelberg, 1980. p. 146-229. CUNNINGHAM, James G. Fisiología veterinaria. São Paulo: Elsevier, 2003. DERIVAUX, Jules; BARNABÉ, Renato Campanarut. Reprodução dos animais domésticos. Zaragoza: Acribia, 1980. DA SILVA, Emanuel Isaque Cordeiro. Definição de Conceitos Básicos na Reprodução Animal: Fertilidade, Fecundidade e Prolificidade-Suínos. Philarchive. Disponível em: -----. Acesso em: Fevereiro de 2020. DA SILVA, Emanuel Isaque Cordeiro. Características Gerais dos Bovinos/General Characteristics of Cattle Bovine. Philarchive. Disponível em: -----. Acesso em: Fevereiro de 2020. DA SILVA, Emanuel Isaque Cordeiro. Reprodução Animal: Fecundação e Gestação. Disponível em: Acervo IFPE. Acesso em: Março de 2020. FERNÁNDEZ ABELLA, Daniel Héctor. Principios de fisiología reproductiva ovina. Montevidéu: Hemisferio Sur1993. GONZÁLEZ, Félix HD. Introdução a endocrinologia reprodutiva veterinária. Porto Alegre: UFRGS, v. 83, 2002. HAFEZ, E. S. E.; HAFEZ, B. Reprodução animal. São Paulo: Manole, 2004. HAFEZ, Elsayed Saad Eldin; HAFEZ, B. (Ed.). Reproduction in farm animals. Nova Jersey: John Wiley & Sons, 2013. HUNTER, R. H. F. Reproducción de los animales de granja. Zaragoza: Acribia, 1987. HUNTER, Ronald Henry Fraser et al. Physiology and technology of reproduction in female domestic animals. Londres: Academic Press, 1980. ILLERA, M. Endocrinología Veterinaria y Fisiología de la Reproducción. Zaragoza: Fareso, 1994. JACOBSON, N. L.; MCGILLIARD, A. D. The mammary gland and lactation. Duke’s Physiology of Domestic Animals. 10th edition. Comstock Publishing Associates, Cornell University Press, Ithaca, New York, USA, p. 863-880, 1984. JAINUDEEN, M. R.; HAFEZ, E. S. E. Gestação, fisiologia pré-natal e parto. Revista Brasileira de Reprodução animal, v. 7, p. 141-142, 2004. LIGGINS, G. C. et al. physiological roles of progesterone, oestradiol-17beta and prostaglandin F2alpha in the control of ovine parturition. J Reprod and Fert Suppl, 1972. PÉREZ PÉREZ, F.; PÉREZ GUTIÉRREZ, F. Reproducción animal, inseminación animal y transplante de embriones. Barcelona: Cientifico-medica, 1985. ROBERTS, Stephen J. Obstetricia veterinaria y patología de la reproducción. Montevidéu: Hemiferio Sur, 1979. SALISBURY, G. W.; VANDERMARK, N. L. Phisiology of the reproduction and artificial insemination of cattle. San Francisco : Freeman e Company, 1961, 630 p. SHILLE, V. M. Fisiologia reprodutiva e endocrinologia da fêmea e do macho. Tratado de medicina interna veterinária. São Paulo: Manole, p. 1857-68, 1992. RUTTER, Bruno; RUSSO, Angel F. Fundamentos de la fisiología de la gestación y el parto de los animales domésticos. Buenos Aires: Eudeba, 2002. UNGERFELD, Rodolfo. Reproducción en los animales domésticos. Montevidéu: Melibea, 2002. (shrink)

Does the capacity to think require the capacity to sense? A lively debate on this topic runs throughout the history of philosophy and now animates discussions of artificial intelligence. Many have argued that AI systems such as large language models cannot think and understand if they lack sensory grounding. I argue that thought does not require sensory grounding: there can be pure thinkers who can think without any sensory capacities. As a result, the absence of sensory grounding does not entail (...) that large language models cannot think or understand. I also consider to what extent quasi-sensory grounding can at least boost the performance of a language model. (shrink)

Artificial agents (AAs), particularly but not only those in Cyberspace, extend the class of entities that can be involved in moral situations. For they can be conceived of as moral patients (as entities that can be acted upon for good or evil) and also as moral agents (as entities that can perform actions, again for good or evil). In this paper, we clarify the concept of agent and go on to separate the concerns of morality and responsibility of agents (most (...) interestingly for us, of AAs). We conclude that there is substantial and important scope, particularly in Computer Ethics, for the concept of moral agent not necessarily exhibiting free will, mental states or responsibility. This complements the more traditional approach, common at least since Montaigne and Descartes, which considers whether or not (artificial) agents have mental states, feelings, emotions and so on. By focussing directly on mind-less morality we are able to avoid that question and also many of the concerns of Artificial Intelligence. A vital component in our approach is the Method of Abstraction for analysing the level of abstraction (LoA) at which an agent is considered to act. The LoA is determined by the way in which one chooses to describe, analyse and discuss a system and its context. The Method of Abstraction is explained in terms of an interface or set of features or observables at a given LoA. Agenthood, and in particular moral agenthood, depends on a LoA. Our guidelines for agenthood are: interactivity (response to stimulus by change of state), autonomy (ability to change state without stimulus) and adaptability (ability to change the transition rules by which state is changed) at a given LoA. Morality may be thought of as a threshold defined on the observables in the interface determining the LoA under consideration. An agent is morally good if its actions all respect that threshold; and it is morally evil if some action violates it. That view is particularly informative when the agent constitutes a software or digital system, and the observables are numerical. Finally we review the consequences for Computer Ethics of our approach. In conclusion, this approach facilitates the discussion of the morality of agents not only in Cyberspace but also in the biosphere, where animals can be considered moral agents without their having to display free will, emotions or mental states, and in social contexts, where systems like organizations can play the role of moral agents. The primary cost of this facility is the extension of the class of agents and moral agents to embrace AAs. (shrink)

If the world itself is metaphysically indeterminate in a specified respect, what follows? In this paper, we develop a theory of metaphysical indeterminacy answering this question.

One challenge to the rationality of religious commitment has it that faith is unreasonable because it involves believing on insufficient evidence. However, this challenge and influential attempts to reply depend on assumptions about what it is to have faith that are open to question. I distinguish between three conceptions of faith each of which can claim some plausible grounding in the Judaeo-Christian tradition. Questions about the rationality or justification of religious commitment and the extent of compatibility with doubt look different (...) on accounts of faith in which trust or hope, rather than belief, are the primary basis for the commitments. On such accounts, while the person of faith has a stake in the truth of the content, practical as well as epistemic considerations can legitimately figure in normative appraisals. Trust and hope can be appropriate in situations of recognized risk, need not involve self-deception, and are compatible with the idea that one's purely epistemic opinions should be responsive only to evidence.Send article to KindleTo send this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.Authentic faith and acknowledged risk: dissolving the problem of faith and reasonVolume 49, Issue 1DANIEL J. MCKAUGHAN DOI: https://doi.org/10.1017/S0034412512000200Your Kindle email address Please provide your Kindle [email protected]@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. Authentic faith and acknowledged risk: dissolving the problem of faith and reasonVolume 49, Issue 1DANIEL J. MCKAUGHAN DOI: https://doi.org/10.1017/S0034412512000200Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. Authentic faith and acknowledged risk: dissolving the problem of faith and reasonVolume 49, Issue 1DANIEL J. MCKAUGHAN DOI: https://doi.org/10.1017/S0034412512000200Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation Request permission. (shrink)

Feminist socially constitutive conceptions of autonomy make the presence of idealized social conditions necessary for autonomy. I argue that such conceptions cannot, when applied under nonideal conditions, play two key feminist theoretical roles for autonomy: the roles of anti-oppressive character ideal and paternalism-limiting concept. Instead, they prescribe action that reinforces oppression. Treated as character ideals, socially constitutive conceptions of autonomy ask agents living under nonideal ones to engage in self-harm or self-subordination. Moreover, conceptions of autonomy that make idealized social conditions (...) a requirement of autonomy yield the conclusion that oppressed agents are appropriate objects of paternalism. (shrink)

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as tirzepatide, have been found to be effective for treating obesity and diabetes, significantly reducing weight and the risk or predicted risk of adverse cardiovascular events. There is a global shortage of these medications that could last several years and raises questions about how limited supplies should be allocated. We propose a fair-allocation framework that enables evaluation of the ethics of current (...) practices and could guide governments, professional societies, and physicians in allocation decisions. (shrink)

In computer science, Artificial Intelligence (AI), sometimes called machine intelligence, is intelligence demonstrated by machines, in contrast to the natural intelligence displayed by humans and other animals. Computer science defines AI research as the study of "intelligent agents": any device that perceives its environment and takes actions that maximize its chance of successfully achieving its goals. Deep Learning is a new field of research. One of the branches of Artificial Intelligence Science deals with the creation of theories and algorithms that (...) allow the machine to learn by simulating neurons in the human body. Most in-depth learning research focuses on finding high-level methods. The strippers analyze a large data set using linear and nonlinear transformations. The method of deep learning is used in the detection of several diseases including blood cell diseases and their classification using the radiography of blood cells to help decision makers to know the type of blood cell and its associated diseases and the results will be presented in detail and discussed. This thesis is using python language and deep learning to detect blood cell diseases and their classifications. The proposed deep learning model was trained, validated and the tested. The accuracy of proposed model was 98.00%. (shrink)

Virtue epistemology is among the dominant influences in mainstream epistemology today. An important commitment of one strand of virtue epistemology – responsibilist virtue epistemology (e.g., Montmarquet 1993; Zagzebski 1996; Battaly 2006; Baehr 2011) – is that it must provide regulative normative guidance for good thinking. Recently, a number of virtue epistemologists (most notably Baehr, 2013) have held that virtue epistemology not only can provide regulative normative guidance, but moreover that we should reconceive the primary epistemic aim of all education as (...) the inculcation of the intellectual virtues. Baehr’s picture contrasts with another well-known position – that the primary aim of education is the promotion of critical thinking (Scheffler 1989; Siegel 1988; 1997; 2017). In this paper – that we hold makes a contribution to both philosophy of education and epistemology and, a fortiori, epistemology of education – we challenge this picture. We outline three criteria that any putative aim of education must meet and hold that it is the aim of critical thinking, rather than the aim of instilling intellectual virtue, that best meets these criteria. On this basis, we propose a new challenge for intellectual virtue epistemology, next to the well-known empirically-driven ‘situationist challenge’. What we call the ‘pedagogical challenge’ maintains that the intellectual virtues approach does not have available a suitably effective pedagogy to qualify the acquisition of intellectual virtue as the primary aim of education. This is because the pedagogic model of the intellectual virtues approach (borrowed largely from exemplarist thinking) is not properly action-guiding. Instead, we hold that, without much further development in virtue-based theory, logic and critical thinking must still play the primary role in the epistemology of education. (shrink)

Robert Audi’s Seeing, Knowing, and Doing argues that knowledge does not entail justification, given a broadly externalist conception of knowledge and an access internalist conception of justification, where justification requires the ability to cite one’s grounds or reasons. On this view, animals and small children can have knowledge while lacking justification. About cases like these and others, Audi concludes that knowledge does not entail justification. But the access internalist sense of “justification” is but one of at least two ordinary senses (...) of the term. On a broader or looser sense, “justification” means “being in the right” where that involves meeting a standard or norm. I argue that the beliefs of animals and small children can then meet standards or norms associated with truth and knowledge such that their beliefs may count as justified in this broader or looser sense. I then question whether knowledge fails to entail justification on this broader sense. (shrink)

A familiar interpretation of quantum mechanics (one of a number of views sometimes labeled the "Copenhagen interpretation'"), takes its empirical apparatus at face value, holding that the quantum wave function evolves by the Schrödinger equation except on certain occasions of measurement, when it collapses into a new state according to the Born rule. This interpretation is widely rejected, primarily because it faces the measurement problem: "measurement" is too imprecise for use in a fundamental physical theory. We argue that this is (...) a weak objection, as there may be many ways of making "measurement" precise. However, measurement-collapse interpretations face a more serious objection: a dilemma tied to the quantum Zeno effect. Is measurement itself an observable that can enter superpositions? If yes, then the standard measurement-collapse dynamics is ill-defined. If no, then (at least if measurement is an observable), measurements can never start or finish. The best way out is to deny that measurement is an observable, but this leads to strong and revisionary consequences. This reinforces the view that there is no nonrevisionary interpretation of quantum mechanics. (shrink)

A prominent view holds that perception and memory are distinguished at least partly by their temporal orientation: Perception functions to represent the present, while memory functions to represent the past. Call this view perceptual presentism. This chapter critically examines perceptual presentism in light of contemporary perception science. I adduce evidence for three forms of perceptual sensitivity to the past: (i) shaping perception by past stimulus exposure, (ii) recruitment of mnemonic representations in perceptual processing, and (iii) perceptual representation of present objects (...) as possessing past properties. I argue that forms (i) and (ii) are consistent with perceptual presentism, while form (iii) poses a genuine threat to the view. While the empirical case for form (iii) remains inconclusive, I suggest that the most serious challenges to perceptual presentism derive from representations that integrate mnemonic and present-tensed elements in the performance of canonical perceptual functions, such as perceiving object continuity over time. (shrink)

In this paper I argue that there would be no obligatory maxims if the only standards for assessing maxims were Kant’s universalizability tests. The paper is divided into five sections. In the first, I clarify my thesis: I define my terms and disambiguate my thesis from other related theses for which one might argue. In the second, I confront the view that says that if a maxim passes the universalizability tests, then there is a positive duty to adopt that maxim; (...) I also confront a close relative of this view. In the third, I confront the view that says that if a maxim does not pass the universalizability tests, then there is a positive duty to adopt the contradictory of that maxim. In the fourth, I confront two variations of the view that says that if a maxim does not pass the universalizability tests and an agent is deliberating about the action in the maxim, then the agent has a positive duty to adopt the contrary of that maxim. In the fifth, I confront the view that says that if an agent has adopted a maxim of ends, then the agent has a positive duty to universalize that end. I then wrap up the paper with some concluding remarks. (shrink)

In this article, we aim to map out the complexities which characterise debates about the ethics of vaccine distribution, particularly those surrounding the distribution of the COVID-19 vaccine. In doing so, we distinguish three general principles which might be used to distribute goods and two ambiguities in how one might wish to spell them out. We then argue that we can understand actual debates around the COVID-19 vaccine – including those over prioritising vaccinating the most vulnerable – as reflecting disagreements (...) over these principles. Finally, we shift our attention away from traditional discussions of distributive justice, highlighting the importance of concerns about risk imposition, special duties, and social roles in explaining debates over the COVID-19 vaccine. We conclude that the normative complexity this article highlights deepens the need for decision-making bodies to be sensitive to public input. (shrink)

In the early twentieth century, many philosophers in America thought that time should be taken seriously in one way or another. George P. Adams (1882-1961) argued that the past, present and future are all real but only the present is actual. I call this theory ‘actualist eternalism’. In this paper, I articulate his novel brand of eternalism as one piece of his metaphysical system and I explain how he argued for the view in light of the best explanations of temporal (...) experience and the present. I argue that his exploitation of analogies between time and modality offer some lessons for current debates about time such as the importance of providing a temporal epistemology. I also extract what I call the temporal boundary problem and argue that it gives rise to an unaddressed challenge for presentists and growing block theorists. (shrink)

This article argues that if panpsychism is true, then there are grounds for thinking that digitally-based artificial intelligence may be incapable of having coherent macrophenomenal conscious experiences. Section 1 briefly surveys research indicating that neural function and phenomenal consciousness may be both analog in nature. We show that physical and phenomenal magnitudes—such as rates of neural firing and the phenomenally experienced loudness of sounds—appear to covary monotonically with the physical stimuli they represent, forming the basis for an analog relationship between (...) the three. Section 2 then argues that if this is true and micropsychism—the panpsychist view that phenomenal consciousness or its precursors exist at a microphysical level of reality—is also true, then human brains must somehow manipulate fundamental microphysical-phenomenal magnitudes in an analog manner that renders them phenomenally coherent at a macro level. However, Sect. 3 argues that because digital computation abstracts away from microphysical-phenomenal magnitudes—representing cognitive functions non-monotonically in terms of digits—digital computation may be inherently incapable of realizing coherent macroconscious experience. Thus, if panpsychism is true, digital AI may be incapable of achieving phenomenal coherence. Finally, Sect. 4 briefly examines our argument’s implications for Tononi’s Integrated Information Theory theory of consciousness, which we contend may need to be supplanted by a theory of macroconsciousness as analog microphysical-phenomenal information integration. (shrink)

The Oxford Handbook of Metaphysics offers the most authoritative and compelling guide to this diverse and fertile field of philosophy. Twenty-four of the world's most distinguished specialists provide brand-new essays about 'what there is': what kinds of things there are, and what relations hold among entities falling under various categories. They give the latest word on such topics as identity, modality, time, causation, persons and minds, freedom, and vagueness. The Handbook's unrivaled breadth and depth make it the definitive reference work (...) for students and academics across the philosophical spectrum. (shrink)

In this paper I examine Grace A. de Laguna’s theory of universals in its historical context and in relation to contemporary debates in analytic metaphysics. I explain the central features of her theory, arguing that her theory should be classified as a form of immanent realism and as a powers ontology. I then show in what ways her theory affords a theory of modality in terms of potentialities and discuss some of its consequences along the way.

The cucumber is a creeping vine that roots in the ground and grows up trellises or other supporting frames, wrapping around supports with thin, spiraling tendrils. The plant may also root in a soilless medium, whereby it will sprawl along the ground in lieu of a supporting structure. The vine has large leaves that form a canopy over the fruits. Among these common diseases, we single out the diseases that affect the cucumber, which is affected by about 22 diseases, with (...) different symptoms for each disease. Today, technology is facilitating human life in all areas of life, and among these facilities are expert systems that have become an integral part of human life as they contain several systems and areas, for example: Artificial Intelligence (AI), which refers to systems or devices that simulate Human intelligence to perform tasks that can improve itself based on some human information, and other areas, and with reference to expert systems and their importance to humans, an integrated expert system has been created in the agricultural field that diagnoses cucumber diseases using CLIPS Expert System language Delphi language. The system was used to design and implement the proposed expert system. The system facilitates the diagnosis of cucumber-related diseases. There is no doubt that this expert system will help farmers and those involved in the agricultural field to diagnose cucumber-related diseases. Objectives: is to help farmers diagnose pear diseases in the correct way and how to treat these diseases. Method: The system contains a program that diagnoses 22 diseases that affect cucumber. Results: The expert system was evaluated by farmers and praised for helping them with it. Conclusion: The expert system for diagnosing cucumber diseases is effective and usable. (shrink)

Moral reasoning traditionally distinguishes two types of evil:moral (ME) and natural (NE). The standard view is that ME is the product of human agency and so includes phenomena such as war,torture and psychological cruelty; that NE is the product of nonhuman agency, and so includes natural disasters such as earthquakes, floods, disease and famine; and finally, that more complex cases are appropriately analysed as a combination of ME and NE. Recently, as a result of developments in autonomous agents in cyberspace, (...) a new class of interesting and important examples of hybrid evil has come to light. In this paper, it is called artificial evil (AE) and a case is made for considering it to complement ME and NE to produce a more adequate taxonomy. By isolating the features that have led to the appearance of AE, cyberspace is characterised as a self-contained environment that forms the essential component in any foundation of the emerging field of Computer Ethics (CE). It is argued that this goes someway towards providing a methodological explanation of why cyberspace is central to so many of CE's concerns; and it is shown how notions of good and evil can be formulated in cyberspace. Of considerable interest is how the propensity for an agent's action to be morally good or evil can be determined even in the absence of biologically sentient participants and thus allows artificial agents not only to perpetrate evil (and fort that matter good) but conversely to `receive' or `suffer from' it. The thesis defended is that the notion of entropy structure, which encapsulates human value judgement concerning cyberspace in a formal mathematical definition, is sufficient to achieve this purpose and, moreover, that the concept of AE can be determined formally, by mathematical methods. A consequence of this approach is that the debate on whether CE should be considered unique, and hence developed as a Macroethics, may be viewed, constructively,in an alternative manner. The case is made that whilst CE issues are not uncontroversially unique, they are sufficiently novel to render inadequate the approach of standard Macroethics such as Utilitarianism and Deontologism and hence to prompt the search for a robust ethical theory that can deal with them successfully. The name Information Ethics (IE) is proposed for that theory. Itis argued that the uniqueness of IE is justified by its being non-biologically biased and patient-oriented: IE is an Environmental Macroethics based on the concept of data entity rather than life. It follows that the novelty of CE issues such as AE can be appreciated properly because IE provides a new perspective (though not vice versa). In light of the discussion provided in this paper, it is concluded that Computer Ethics is worthy of independent study because it requires its own application-specific knowledge and is capable of supporting a methodological foundation, Information Ethics. (shrink)

Nietzsche’s favourable comments about science and the senses have recently been taken as evidence of naturalism. Others focus on his falsification thesis: our beliefs are falsifying interpretations of reality. Clark argues that Nietzsche eventually rejects this thesis. This article utilizes the multiple ways of being science friendly in Nietzsche’s context by focussing on Mach’s neutral monism. Mach’s positivism is a natural development of neo-Kantian positions Nietzsche was reacting to. Section 15 of Beyond Good and Evil is crucial to Clark’s interpretation. (...) The presented interpretation makes better sense of this passage and shows that Nietzsche can accept both falsification and empiricism. (shrink)

We argue that the ethical case for instituting vaccine benefit programs is justified by 2 widely recognized values: (1) reducing overall harm from COVID-19 and (2) protecting disadvantaged individuals. We then explain why they do not coerce, exploit, wrongfully distort decision-making, corrupt vaccination's moral significance, wrong those who have already been vaccinated, or destroy willingness to become vaccinated. However, their cost impacts and their effects on public perception of vaccines should be evaluated.

While many aspects of cognition have been shown to be shared between humans and non-human animals, there remains controversy regarding whether the capacity to mentally time travel is a uniquely human one. In this paper, we argue that there are four ways of representing when some event happened: four kinds of temporal representation. Distinguishing these four kinds of temporal representation has five benefits. First, it puts us in a position to determine the particular benefits these distinct temporal representations afford an (...) organism. Second, it provides the conceptual resources to foster a discussion about which of these representations is necessary for an organism to count as having the capacity to mentally time travel. Third, it enables us to distinguish stricter from more liberal views of mental time travel that differ regarding which kind(s) of temporal representation is taken to be necessary for mental time travel. Fourth, it allows us to determine the benefits of taking a stricter or more liberal view of mental time travel. Finally, it ensures that disagreement about whether some species can mentally time travel is not merely the product of unrecognised disagreement about which temporal representation is necessary for mental time travel. We argue for a more liberal view, on the grounds that it allows us to view mental time travel as an evolutionarily continuous phenomenon, and to recognise that differences in the ways that organisms mentally time travel might reflect different temporal representations, or combinations thereof, that they employ. Our ultimate aim, however, is to create the conceptual framework for further discussion regarding what sorts of temporal representations are required for mental time travel. (shrink)

I argue that the theory of chance proposed by David Lewis has three problems: (i) it is time asymmetric in a manner incompatible with some of the chance theories of physics, (ii) it is incompatible with statistical mechanical chances, and (iii) the content of Lewis's Principal Principle depends on how admissibility is cashed out, but there is no agreement as to what admissible evidence should be. I proposes two modifications of Lewis's theory which resolve these difficulties. I conclude by tentatively (...) proposing a third modification of Lewis's theory, one which explains many of the common features shared by the chance theories of physics. (shrink)

We discuss some implications of the Holocaust for moral philosophy. Our thesis is that morality became distorted in the Third Reich at the level of its social articulation. We explore this thesis in application to several front-line perpetrators who maintained false moral self-conceptions. We conclude that more than a priori moral reasoning is required to correct such distortions.

According to the character condition, a person is morally responsible for an action A only if a character trait of hers non-accidentally motivates her performing A. But that condition is untenable according to the out of character objection because people can be morally responsible for acting out of character. We reassess this common objection. Of the seven accounts of acting out of character that we outline, only one is even a prima facie counterexample to the character condition. And it is (...) not obvious that people act out of character in that sense. We argue that whether the out of character objection succeeds ultimately depends on the unnoticed methodological commitment that cases that may not resemble human life provide good data for theorizing about moral responsibility. But even if such cases provide good data, the forcefulness of the objection is at least deflated given that its persuasive power is supposed to come from clear real-life cases. (shrink)

Despite the end of the Cold War and the ascendancy of liberal democracy celebrated by Francis Fukuyama as “the end of history”, a growing number of scholars and political activists point to its inherent shortcomings. However, they have tended to dismiss it on the basis of one or two of its salient weaknesses. While this is a justifiable way to proceed, it denies the searching reader an opportunity to see the broad basis for the growing rejection of liberal democracy among (...) African political theorists. Consequently, in this article, I argue that from an African perspective, the almost hegemonic status of liberal democracy can be challenged on at least five grounds, namely, logical inconsistency, impracticability due to the largely communalistic outlook of many africans, inconsistency between affirmation and action, violation of the right to ethnic identity, and the moral imperative to assert the right to cultural emancipation. -/- I conclude by calling upon African and Africanist political theorists to utilise indigenous African political thought, coupled with emancipatory aspects of political thought from other parts of the world, to design practicable models of democracy for contemporary African states. I further conclude that in order to promote genuine inter-cultural dialogue on democratisation, people from Western cultures ought to acknowledge the equality of all cultures, and to recognise that systems of governance are part and parcel of those cultures. (shrink)

‘Gender disappointment’ is regularly reported by those whose child’s sex does not match the sex that they, the parent, desired. With symptoms ranging from mere fleeting sadness to documented cases of serious depression, alienation from one’s child, and emotional suffering, it is clear that so-called ‘gender disappointment’ is a serious issue, that has, as yet, seen little philosophical attention (though see Hendl and Browne 2020). In this chapter I explore gender disappointment, not from the perspective of a parent who ended (...) up with the child of the wrong sex at birth, but rather, from the perspective of a different kind of gender disappointment: the transgender person who grew up and only then disappointed their parents by turning out to be the ‘wrong’ gender. This perspective, I argue, reveals a great deal about the shared gender essentialism at the heart of patriarchal and cissexist ideology. Moreover, I will argue that it reveals the underlying propertarian relationship of parents to their children under contemporary capitalism – a troubling relationship that legitimates the treatment of children as objects to be designed and controlled as commodities at the whims of parents. In this way I disagree with Whyman when he writes that “a preference for having a child of one sex over the other should be considered one of those irrational things of which some sense can nevertheless be made – like aesthetic taste” (Whyman 2021, 113-114). I argue, to the contrary, that the desire for a child of one particular gender is not akin to a mere unproblematic aesthetic preference. Instead, and following the rich feminist tradition of thinking about the patriarchal origins of sexual desire, I argue that we must see these desires as troubling reflections of dominant patriarchal and cissexist ideology, underwritten by a particular neoliberal capitalist mode of production. Moreover, we can seek to change those desires. (shrink)

This paper investigates the connection between temporal attitudes (attitudes characterised by a concern (or lack thereof) about future and past events), beliefs about temporal ontology (beliefs about the existence of future and past events) and temporal preferences (preferences regarding where in time events are located). Our aim is to probe the connection between these preferences, attitudes, and beliefs, in order to better evaluate the normative status of these preferences. We investigate the hypothesis that there is a three-way association between (a) (...) being present-biased (that is, preferring that positive events are located in the present, and negative events are located in the non-present), (b) believing that past and future events do not exist and (c) tending to have present-focused rather than non-present-focused temporal attitudes. We find no such association. This suggests that insofar as temporal preferences and temporal attitudes are connected to the ways we represent time, they are not connected to the ways we represent temporal ontology; rather, they are more likely connected to the ways we represent relative movement in, or of, time. This has important consequences for, first, explaining why we exhibit these preferences and, second, for their normative evaluation. (shrink)

This paper aims to identify computerized management information systems resources and their relationship to the development of performance in the Electricity Distribution Company in Gaza. This research used two dimensions. The first dimension is computerized management information systems and the second dimension the Development of Performance. The control sample was (063). (360) questioners were distributed and (306) were retrieved back with a percentage of (85%). Several statistical tools were used for data analysis and hypotheses testing, including reliability correlation using Cronbach’s (...) alpha, “ANOVA”, Simple Linear Regression and Step Wise Regression. The overall findings of the current study suggested the presence of a statistically significant relationship between resources (physical, software, and human and organizational) for the computerized management information systems and the development of performance in the Electricity Distribution Company in Gaza. The study recommended the following: The need to strengthen the company's management interest in the potential of computerized management information systems and using them in the computerization of all the company's activities. And the need to involve workers and users in the design of computerized management information systems and assessment and development process. And strengthen the relationship between users and information systems personnel in the department responsible for the system. And it is essential that the company is developing the infrastructure for information technology in general, and computerized management information systems, in particular for the development of performance. And increase interest in providing resources (physical, software, and human and organizational) for the computerized management information systems. The current study is unique by the virtue of its nature, scope and way of implied investigation, as it is the first study at Electricity Distribution Company in Gaza resources explores the status of Computerized management information systems and their relationship to the development of performance in the Electricity Distribution Company in Gaza increasing interest in Computerized management information systems through continuity, keeping pace with technological means and modern techniques. (shrink)

Fictionalism has recently returned as a standard response to ontologically problematic domains. This article assesses moral fictionalism. It argues (i) that a correct understanding of the dialectical situation in contemporary metaethics shows that fictionalism is only an interesting new alternative if it can provide a new account of normative content: what is it that I am thinking or saying when I think or say that I ought to do something; and (ii) that fictionalism, qua fictionalism, does not provide us with (...) any new resources for providing such an account. (shrink)

Default logic has been a very active research topic in artificial intelligence since the early 1980s, but has not received as much attention in the philosophical literature thus far. This paper shows one way in which the technical tools of artificial intelligence can be applied in contemporary epistemology by modeling a paradigmatic case of deep disagreement using default logic. In §1 model-building viewed as a kind of philosophical progress is briefly motivated, while §2 introduces the case of deep disagreement we (...) aim to model. On the heels of this, §3 defines our formal framework, viz., a refined Horty-style default logic. §4 then uses the framework to model deep disagreement, and finally §5 provides a critical discussion of the result. (shrink)

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

The maturing of metaethics has been accompanied by widespread, but relatively unarticulated, discontent that mainstream metaethics is fundamentally on the wrong track. The malcontents we have in mind do not simply champion a competitor to the likes of noncognitivism or realism; they disapprove of the supposed presuppositions of the existing debate. Their aim is not to generate a new theory within metaethics, but to go beyond metaethics and to transcend the distinctions it draws between metaethics and normative ethics and between (...) cognitivism and non-cognitivism. In our experience, the differences with traditional metaethics go deep enough that it can feel as if two different paradigms are talking past each other. We attempt to bring clarity and focus to this rather inchoate debate by simultaneously articulating the general issues involved and engaging in a detailed case study of one of the prominent representatives of this discontent, Christine Korsgaard. We argue that Korsgaard fails to go beyond metaethics–indeed, fails even to provide a theory within metaethics. Our strategy for showing this is to argue that her claims are compatible with both cognitivism and non-cognitivism. We have argued elsewhere that her distinctive claims are compatible with realism. Here we focus on the crucial role that claims about agency and the will seem to play her in work and, according to our interpretation, in her attempts to go beyond mainstream metaethics. We show in detail that these claims are actually compatible with non-cognitivism. Though our discussion often focuses on her work in particular, it has clear implications for other attempts to obviate the debates of traditional metaethics. (shrink)

This article examines a fundamental question of justice in global health. Is it ethically preferable to provide a larger number of people with cheaper treatments that are less effective (or more toxic), or to restrict treatments to a smaller group to provide a more expensive but more effective or less toxic alternative? We argue that choosing to provide less effective or more toxic interventions to a larger number of people is favored by the principles of utility, equality, and priority for (...) those worst-off. Advocates are mistaken to demand that medical care provided in low-income and middle-income countries should be the same as in high-income countries. (shrink)

Our aim in this paper is to bring the woefully neglected literature on predictive modeling to bear on some central questions in the philosophy of science. The lesson of this literature is straightforward: For a very wide range of prediction problems, statistical prediction rules (SPRs), often rules that are very easy to implement, make predictions than are as reliable as, and typically more reliable than, human experts. We will argue that the success of SPRs forces us to reconsider our views (...) about what is involved in understanding, explanation, good reasoning, and about how we ought to do philosophy of science. (shrink)

The study aimed to identify the creative environment of the technical colleges operating in Gaza Strip. The analytical descriptive method was used through a questionnaire which was randomly distributed to 289 employees of the technical colleges in Gaza Strip with a total number of (1168) employees and a response rate equal to (79.2%) of the sample study. The results confirmed the existence of a high degree of approval for the dimensions of the creative environment with a relative weight of (75.19%) (...) according to the perspective of the employees of the technical colleges in Gaza Strip. The results of the study showed a high level of creative environment (fluency, flexibility, originality, sensitivity to problems) in the technical colleges in Gaza Strip, where the field (fluency) ranked first and relative weight (76.86%), in the second place came the area (sense of problems) and relative weight (74.89%). The field of elasticity came in third place with a relative weight of (74.59%). Finally, the field of originality came in fourth and final rank with a relative weight of (74.41%). The results showed that there are differences between the technical colleges in the principles of the creative environment in all fields and the overall degree except for the field of flexibility. The most available colleges in these principles were the university college of applied sciences, and that was the least of the Faculty of Al-Aqsa Society. The results showed that there were differences according to the age variable in the areas of creative environment only in the sense of problems for age groups (less than 30 years) and (from 40 to 50 years). The researchers suggested a number of recommendations, the need to enhance the dimensions of the creative environment in technical colleges by working to improve the faculties of fluency, flexibility, originality and sensitivity to problems. The need to work on continuity and improve aspects of the creative environment of the colleges and the creation of new and innovative ways to support and develop and support these aspects combined. Necessity of technical colleges to continue to develop the creative environment (fluency, flexibility, originality, sensitivity to problems) for employees by engaging them in specialized training courses for creative thinking and problem solving. Developing work procedures with new innovative methods that will accomplish the various tasks quickly and accurately, and provide the effort, time and costs. The researchers urged more future studies that address the same variables of the current study in the field of creative environment and applied to other sectors. (shrink)

Various psychopathologies of self-awareness, such as somatoparaphrenia and thought insertion in schizophrenia, might seem to threaten the viability of the higher-order thought (HOT) theory of consciousness since it requires a HOT about one’s own mental state to accompany every conscious state. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that there is a HOT to the effect that “I am in mental state M” (Rosenthal 2005, Gennaro 2012). In a previous publication (...) (Gennaro 2015), I argued that a HOT theorist can adequately respond to this concern with respect to somatoparaphrenia. Somatoparaphrenia is a “depersonalization disorder” which is characterized by the sense of alienation from parts of one’s body. It is a bizarre type of body delusion where one denies ownership of a limb or an entire side of one’s body. My focus in the chapter, however, is on “inserted thoughts” which is a common symptom of schizophrenia, although it will also be useful to contrast it with somatoparaphrenia. Schizophrenia is a mental disorder which most commonly manifests itself through auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking. Thought insertion is the delusion that some thoughts are not “one’s own” in some sense or are somehow being inserted into one’s mind by someone else. Graham and Stephens (2000), for example, have suggested that thought insertion should be understood as alienated self-consciousness or meta-representation. I argue that HOT theory has nothing to fear from this phenomenon either and can consistently explain what happens in this admittedly unusual case. (shrink)

Betrayal trauma theory suggests that psychogenic amnesia is an adaptive response to childhood abuse. When a parent or other powerful figure violates a fundamental ethic of human relationships, victims may need to remain unaware of the trauma not to reduce suffering but rather to promote survival. Amnesia enables the child to maintain an attachment with a figure vital to survival, development, and thriving. Analysis of evolutionary pressures, mental modules, social cognitions, and developmental needs suggests that the degree to which the (...) most fundamental human ethics are violated can influence the nature, form, and processes of trauma and responses to trauma. (shrink)

Countermeasures for mpox (formerly known as monkeypox), primarily vaccines, have been in limited supply in many countries during outbreaks. Equitable allocation of scarce resources during public health emergencies is a complex challenge. Identifying the objectives and core values for the allocation of mpox countermeasures, using those values to provide guidance for priority groups and prioritisation tiers, and optimising allocation implementation are important. The fundamental values for the allocation of mpox countermeasures are: preventing death and illness; reducing the association between death (...) or illness and unjust disparities; prioritising those who prevent harm or mitigate disparities; recognising contributions to combating an outbreak; and treating similar individuals similarly. Ethically and equitably marshalling available countermeasures requires articulating these fundamental objectives, identifying priority tiers, and recognising trade-offs between prioritising the people at the highest risk of infection and the people at the highest risk of harm if infected. These five values can provide guidance on preferable priority categories for a more ethically sound response and suggest methods for optimising allocation of countermeasures for mpox and other diseases for which countermeasures are in short supply. Properly marshalling available countermeasures will be crucial for future effective and equitable national responses to outbreaks. (shrink)

The proposition that digital innovations can put people in charge of their health has been accompanied by prolific talk of empowerment. In this paper we consider ethical challenges and opportunities of trying to achieve justice and empowerment using digital health initiatives. The language of empowerment can misleadingly suggest that by using technology, people can control their health and take responsibility for health outcomes to a greater degree than is realistic or fair. Also, digital health empowerment often primarily reaches people who (...) already have high technological and health literacy, leaving others behind. We critically investigate whether the concept of health empowerment could be re-engineered to mean something different, namely the process of improving the health literacy and access of those who least possess it, in line with recent proposals for conceptual engineering in the service of justice. We settle on the weaker conclusion that underlying ethical values including justice should be used to interpret the existing concept of empowerment. To conclude, we take a high-level view of various strategies for achieving the ethical value associated with digital health empowerment. (shrink)

Abstract The values of the healthcare sector are fairly ubiquitous across the globe, focusing on caring and respect, patient health, excellence in care delivery, and multi-stakeholder collaboration. Many individual pharmacists embrace these core values. But their ability to honor these values is significantly determined by the nature of the system they work in. -/- The paper starts with a model of the prevailing pharmacist workforce model in Scotland, in which core roles are predominantly separated into hierarchically disaggregated jobs focused on (...) one professional ‘pillar’: Clinician /Practice Provider; Educator; Leader/Manager; and Researcher. This is the ‘Atomistic’ Model. This skills-segregation yields a workforce of individuals working in isolation rather than collaborating together, and lacking a shared information flow, purpose and identity. Key strategic flaws include suboptimal responsiveness to population and subpopulation needs, inconsistency and inequity of care, an erosion of professional agency, and lower job satisfaction. It is conjectured that this results from a lack of congruence between values, professional ethos, and organizational structure. ‘Atomism’ culminates in a syndrome of widespread professional-level cognitive dissonance. -/- The paper contrasts this with a new emerging workforce vision, The Collaborative Care Model. This new model defines a systems-first-approach, built on the principle that all jobs must include all four professional ‘pillars’. Vertical skills integration, involving education and task sharing, will support sustainability and succession planning. Horizontal skills integration (across practice, leadership and research) is included to improve responsiveness to population need and individual professional agency. The working conditions, supportive ethos, and career structure needed to make the model work are described. Moral theory and workforce theory are used to justify why the model may be more effective for population health, delivering greater job satisfaction for individuals and ultimately helping systematically realize and honor healthcare values. Finally, the paper sketches the first steps needed to implement the model at the national level, starting with the operationalization of new multi-pillar professional curricula across the career spectrum. Potential pitfalls and challenges are also discussed. -/- Co-Authors: 1. Paul Forsyth (PF) Lead Pharmacist Clinical Cardiology, Pharmacy, NHS Greater Glasgow & Clyde. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Writing - original draft (lead author), Writing - review & editing (lead author) 2. Andrew Radley (AR), Consultant in Public Health Pharmacy, NHS Tayside. Contribution: Conceptualization; Model curation; Model Theory; Writing - review & editing 3. Gordon Rushworth (GR), MPharm MSc FFRPS FRPharmS (Consultant). Programme Director, Highland Pharmacy Education & Research Centre, NHS Highland, Inverness. Contribution: Model curation; Writing - review & editing 4. Fiona Marra (FM) National Lead Clinician Scottish Infection and Immunology Network (SPAIIN) / Advanced Pharmacist HCV / HIV, NHS Greater Glasgow & Clyde. Contribution: Model curation; Writing - review & editing 5. Susan Roberts (SR) Associate Postgraduate Pharmacy Dean, NHS Education for Scotland. Contribution: Model curation; Writing - review & editing 6. Roisin O’Hare (RO) Lead Teacher Practitioner Pharmacist, Northern Ireland University Network, Southern Health and Social Care Trust. Contribution: Model curation; Writing - review & editing 7. Catherine Duggan (CD) Chief Executive Officer, International Pharmaceutical Federation (FIP). Contribution: Model curation; Writing - review & editing 8. Barry Maguire (BM) Senior Lecturer, School of Philosophy, Psychology and Life Sciences, The University of Edinburgh. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Supervision; Writing - original draft (senior academic supervisor), Writing - review & editing (senior academic supervisor) -/- . (shrink)

The biological sciences study (bio)complex living systems. Research directed at the mechanistic explanation of the "live" state truly requires a pluralist research program, i.e. BioComplexity research. The program should apply multiple intra-level and inter-level theories and methodologies. We substantiate this thesis with analysis of BioComplexity: metabolic and modular control analysis of metabolic pathways, emergence of oscillations, and the analysis of the functioning of glycolysis.

Commentary on: Olaf Blanke, Thomas Metzinger, Full-body illusions and minimal phenomenal selfhood, Trends in Cognitive Sciences, Volume 13, Issue 1, January 2009, Pages 7-13, ISSN 1364-6613, DOI: 10.1016/j.tics.2008.10.003.

Three decades after Chalmers named it, the ‘hard problem’ remains. I suggest a parsimonious solution. Biological dynamic systems interact according to simple rules (while the environment provides simple constraints) and thus self-organize to become a new, more complex dynamic system at the next level. This spiral repeats several times generating a hierarchy of levels. A leap to the next level is frequently creative and surprising. From ants, themselves self-organized according to physical/chemical laws, may emerge an ant colony self-organized according to (...) eusocial laws. A dynamic system need not be material. A living language (immaterial) is a complex adaptive system. Body/brain are material but the next level of complexity, a psychological dynamic system, a thought, feeling, image or ideal, is less material. From several psychological dynamic systems emerges the next level, narrative (immaterial), and from multiple narratives emerges personality. Concrete evidence explains how an early narrative emerges from body-and-brain. Evidence also shows that personality emerges from narrative. Even an objective narrative captures subjectivity since the teller’s choice of content is subjective. I argue that the ‘stream-of-consciousness’ story (movie) you are currently telling yourself (watching) is your conscious experience, ‘what it is like’ for you to be conscious. Adriana Cavarero’s arguments support this. Each level of a hierarchy of dynamic systems must necessarily be homeostatic, at that level. McDowell et al. (2023: submitted, in revision) reported evidence that a dream (a narrative) supports personality homeostatically. Perhaps the evolutionary advantage of conscious experience, also a narrative, has always been that it too supports personality homeostatically. Personality and body/brain, a chimera of symbiotic life-forms, constitute interactionist duality. (shrink)

In his pithy indictments of democracy, Churchill captured a feeling prevalent among intellectuals in the first half of the twentieth century; a feeling that government-by-the-people warranted, at best, a limited or half-hearted faith; a feeling that might be described as the “majoritarian creed.” This creed can be characterized by the following propositions. A believer-inthe-democratic-faith defends majoritarian methods—such as popular votes, polls and representation—as the best available means to signal the people’s collective political preferences.

I argue for the thesis (UL) that there are certain logical abilities that any rational creature must have. Opposition to UL comes from naturalized epistemologists who hold that it is a purely empirical question which logical abilities a rational creature has. I provide arguments that any creatures meeting certain conditions—plausible necessary conditions on rationality—must have certain specific logical concepts and be able to use them in certain specific ways. For example, I argue that any creature able to grasp theories must (...) have a concept of conjunction subject to the usual introduction and elimination rules. I also deal with disjunction, conditionality and negation. Finally, I put UL to work in showing how it could be used to define a notion of logical obviousness that would be well suited to certain contexts—e.g. radical translation and epistemic logic—in which a concept of obviousness is often invoked. (shrink)

This paper aims to determine knowledge management (KM) factors which have strong impact on high performance. Also, the study aims to compare KMM between intermediate colleges. This study was applied on three intermediate colleges in Gaza strip, Palestine. Asian productivity organization model was applied to measure KMM. Second dimension which assess high performance was developed by the authors. The controlled sample was 190. Several statistical tools were used for data analysis and hypotheses testing, including reliability correlation using Cronbach’s alpha, “ANOVA”, (...) simple linear regression and step wise regression and LSD test. The overall findings of the current study show that maturity level is in the second level. Findings also support the main hypothesis and its sub- hypotheses. The most important factors effecting high performance are the processes, KM leadership, people and KM outcomes. In addition, there are differences in high performance for college (PTC). Furthermore, the current study is unique by the virtue of its nature, scope and way of implied investigation, as it is the first comparative study between intermediate colleges in Palestine that explores the status of KMM using the Asian productivity model. Research limitations was that the survey findings were based on intermediate colleges in Gaza Strip. (shrink)