Understanding why patients request euthanasia when it is illegal: a qualitative study in palliative care units on the personal and practical impact of euthanasia requests

Context: Some patients in palliative care units request euthanasia regardless of legislation. Although studies have explored the reasons for these requests, little is known about the subjective, relational, and contextual repercussions for the patient. Objectives: The aim of this study is to understand the purpose of euthanasia requests from the patient’s viewpoint and their personal and practical impact. Methods: We conducted in-depth interviews with patients requesting euthanasia, their family members, and health care providers in 11 French palliative care units. A thematic analysis of the data was performed. Results: In total, 18 patients were interviewed within 48 h of the request being made; 1 week later, 9 patients were interviewed again. Five main themes emerged: assuming the possibility of transgressing the forbidden, a call for unbearable suffering to be recognized, encouragement to change clinical practice, reclaiming a sense of freedom over medical constraints, and imagining a desirable future for oneself. Conclusions: A request for euthanasia appears to be a willful means to remove oneself from the impasse of an existence paralyzed by suffering. It creates a space for discussion, which promotes negotiation with patients on care practices and therapeutics, and strengthens patients’ sense of autonomy. Investigating the relationship between the evolution of euthanasia requests within the palliative care setting could be beneficial. It is important to encourage health care professionals to adopt a readiness to listen by interacting with patients in a way that is not momentarily action-oriented but rather focused on proactive discussion.

The Bumpy Road to Relevance: Croatia, Hungary and Lithuania in Perspective

This chapter examines how has the relevance of political science developed in Croatia, Hungary and Lithuania, that is how is the profession engaged with important audiences, namely the student body, society at large and pragmatic politics. Similar to the Western context the normative and pragmatic understanding of relevance appear in these emerging political science communities while identity formation and the achievement and preservation of legitimacy also define how political science can become relevant. The concept of relevance is built on three dimensions related to three potential fields of engagement: knowledge provision, social presence and practical impact. This chapter highlights that the profession continues to be beset by problems relating to the issue of relevance but differences between the countries are pronounced. Moreover, the three main aspects of relevance have not been achieved to the same level within the same country although we can duly expect a degree of adjustment as the three aspects are interconnected and will influence one another. This chapter argues that the development of relevance is a two-way process: government and university policies act as the external context, while the profession’s interests, commitment and ambitions constitute the internal force marking the way forward.

A qualitative study into the experience of living with acalculia after stroke or acquired brain injury

Acalculia, an acquired disability following a stroke or brain injury, involves difficulty processing numerical information and/ or calculations. Acalculia is not routinely screened for, and as a result there is a lack of understanding about the nature and prevalence and the impact of the condition. This qualitative study was initiated by stroke survivors with a strong interest in acalculia. Sixteen stroke/brain injury survivors with acalculia and seven carers were interviewed using semi-structured online interviews. Participants ranged in age, gender, time post onset, country of residence and numeracy level prior to brain injury. Data were analysed using thematic analysis. Three main themes were identified: Awareness and Diagnosis; Emotional and Practical Impact (independence); Support, Coping Strategies and Self-training. Participants and carers repeatedly referred to the lack of awareness and treatment for acalculia and the impact acalculia has had on their lives and independence. Practical impacts included managing money, making appointments, using timetables, organising social activities and employment, and managing medication. Our results highlight the urgent need to develop suitable assessments and interventions for acalculia and the scope for this to be PCPI-led. The data also reveal useful strategies and suggestions regarding effective timing, targets and approaches for intervention.

Educational chatbots for project-based learning: investigating learning outcomes for a team-based design course

Educational chatbots (ECs) are chatbots designed for pedagogical purposes and are viewed as an Internet of Things (IoT) interface that could revolutionize teaching and learning. These chatbots are strategized to provide personalized learning through the concept of a virtual assistant that replicates humanized conversation. Nevertheless, in the education paradigm, ECs are still novel with challenges in facilitating, deploying, designing, and integrating it as an effective pedagogical tool across multiple fields, and one such area is project-based learning. Therefore, the present study investigates how integrating ECs to facilitate team-based projects for a design course could influence learning outcomes. Based on a mixed-method quasi-experimental approach, ECs were found to improve learning performance and teamwork with a practical impact. Moreover, it was found that ECs facilitated collaboration among team members that indirectly influenced their ability to perform as a team. Nevertheless, affective-motivational learning outcomes such as perception of learning, need for cognition, motivation, and creative self-efficacy were not influenced by ECs. Henceforth, this study aims to add to the current body of knowledge on the design and development of EC by introducing a new collective design strategy and its pedagogical and practical implications.

The formal structure of practical rationality

The concept of rationality is strongly normative. Indeed, qualifying an action as rational implies demarcating spaces of inclusion and exclusion that have a practical impact. However, the notion of rationality is not fully explained. In this article I intend to clarify the constitutive elements of the formal structure of practical rationality in order to facilitate its conceptualisation.

Reflections on kernelizing and computing unrooted agreement forests

Phylogenetic trees are leaf-labelled trees used to model the evolution of species. Here we explore the practical impact of kernelization (i.e. data reduction) on the NP-hard problem of computing the TBR distance between two unrooted binary phylogenetic trees. This problem is better-known in the literature as the maximum agreement forest problem, where the goal is to partition the two trees into a minimum number of common, non-overlapping subtrees. We have implemented two well-known reduction rules, the subtree and chain reduction, and five more recent, theoretically stronger reduction rules, and compare the reduction achieved with and without the stronger rules. We find that the new rules yield smaller reduced instances and thus have clear practical added value. In many cases they also cause the TBR distance to decrease in a controlled fashion, which can further facilitate solving the problem in practice. Next, we compare the achieved reduction to the known worst-case theoretical bounds of $$15k-9$$ 15 k - 9 and $$11k-9$$ 11 k - 9 respectively, on the number of leaves of the two reduced trees, where k is the TBR distance, observing in both cases a far larger reduction in practice. As a by-product of our experimental framework we obtain a number of new insights into the actual computation of TBR distance. We find, for example, that very strong lower bounds on TBR distance can be obtained efficiently by randomly sampling certain carefully constructed partitions of the leaf labels, and identify instances which seem particularly challenging to solve exactly. The reduction rules have been implemented within our new solver Tubro which combines kernelization with an Integer Linear Programming (ILP) approach. Tubro also incorporates a number of additional features, such as a cluster reduction and a practical upper-bounding heuristic, and it can leverage combinatorial insights emerging from the proofs of correctness of the reduction rules to simplify the ILP.

The Hardiness Profile of Islamic Boarding School Student in Indonesian

The primary goal of this study is to evaluate the hardiness profile of students in Islamic boarding schools and determine whether or not hardiness has a practical impact on students through Islamic boarding schools, with the top indicators being challenge, control, and commitment. Every shift brings with it a new set of challenges, which can be challenging to adjust to. This research employs quantitative methods to demonstrate this. For the 2020/2021 academic year, student boarding school students in Jakarta served as the study's subject population. As a result, 76 participants were chosen at random using a purposive selection method. It is possible to get data using the santri hardiness instrument as the method of gathering information. The hypothetical mean approach is utilized in this study to determine the optimal score, the minimal score, the standard deviation, and the theoretical mean. The score range is obtained in order to determine the category, which will be as follows: X 129.3 indicates a high category, 103.7 129.3 indicates a medium category, and X 103.7 indicates a low category. It is possible to conclude from these estimates that the hardiness profile of boarding school kids falls into the middle category. The result is that most students have attitudes and skills that are not yet optimal for coping with life difficulties in Islamic boarding schools.

KAJIAN HERMENEUTIK FRASA “MEMBENCI ESAU” BERDASARKAN MALEAKHI 1:2-3 DAN IMPLIKASINYA BAGI ORANG KRISTEN MASA KINI

Hermeneutic Study of the Phrase “Hate Esau” Based on Malachi 1:2-3 and Its Implications for Christians Today. This research is focused on hermeneutical studies to find the meaning of the phrase “Hate Esau” based on Malachi 1:2-3 and its implications for Christians today. This study uses a qualitative research with exegesis hermeneutic method in which the researcher exegises the phrase “Hate Esau” based on Malachi 1:2-3. Based on the results of the exposition of the book of Malachi 1:2-3, the researchers found the meaning of the phrase "Hate Esau" as well as its theological impact and its practical impact on Christians today.

Research on the Path of China's Rural Green Development under the Governance System of "Three Integration Governance"

The governance system of "three integration governance" reflects the organic relationship of mutual supplement and restriction among autonomy, rule of law and rule of virtue. The governance system of "three integration governance" is not only the inevitable requirement of China's modern rural development, but also an important path to realize China's rural green development. The governance system of "three integration governance" provides multiple subject forces, legal system guarantee and spiritual and cultural power for the smooth implementation of China's rural green development. Discussing China's rural green development from the "three governance integration" rural governance system not only has important theoretical value, but also has a far-reaching practical impact on solving the practical problems faced by China's rural green development.