Mandevillian vices.

Bernard Mandeville argued that traits that have traditionally been seen as detrimental or reprehensible, such as greed, ambition, vanity, and the willingness to deceive, can produce significant social goods. He went so far as to suggest that a society composed of individuals who embody these vices would, under certain constraints, be better off than one composed only of those who embody the virtues of self-restraint. In the twentieth century, Mandeville's insights were taken up in economics by John Maynard Keynes, among others. More recently, philosophers have drawn analogies to Mandeville's ideas in the domains of epistemology and morality, arguing that traits that are typically understood as epistemic or moral vices (e.g. closed-mindedness, vindictiveness) can lead to beneficial outcomes for the groups in which individuals cooperate, deliberate, and decide, for instance by propitiously dividing the cognitive labor involved in critical inquiry and introducing transient diversity. We argue that mandevillian virtues have a negative counterpart, mandevillian vices, which are traits that are beneficial to or admirable in their individual possessor, but are or can be systematically detrimental to the group to which that individual belongs. Whilst virtue ethics and epistemology prescribe character traits that are good for every moral and epistemic agent, and ideally across all situations, mandevillian virtues show that group dynamics can complicate this picture. In this paper, we provide a unifying explanation of the main mechanism responsible for mandevillian traits in general and motivate the case for the opposite of mandevillian virtues, namely mandevillian vices.

Assessment of the potential impact of embedded radioactive fragments following the use of a crude radiological dispersal device ('dirty bomb').

This work was undertaken to understand what would happen if a high-activity radioactive fragment became embedded in an individual following the use of a crude radiological dispersal device ('dirty bomb'). Two areas were addressed: how would a high-activity fragment be viewed on modern digital x-ray imaging systems; and, what would be the impact on medical management for the patient? A set of experimental trials were undertaken using an iridium-192 source and a DRagon mobile x-ray set equipped with a Canon CXDI-50G portable flat panel digital detector plate. In addition, the potential doses to a surgical team were calculated and potential doses to a patient were assessed using a Monte Carlo code, in which a radioactive point source of nil volume was located within a limb of an anthropomorphic voxel phantom. Three distinct effects on the digital imaging systems were observed, referred to in this paper as a localised 'bloom' effect, a 'discontinuity' effect towards the middle of the image and 'fogging' across the entire image. The first two of these effects were unexpected, and possible reasons for their appearance are discussed. The Monte Carlo modelling showed that the patient exposure can potentially lead to very high localised absorbed doses, which may result in symptoms associated with acute radiation syndrome. While the dose clearly depends upon the activity of the fragment and the length of time that the fragment is present inside the patient, it is clear that radiation necrosis of bone, muscle and other tissues may threaten the medium term viability of the limb. The dose rates associated with high-activity fragments may also restrict the time a surgeon has to operate, leading to challenging ethical and surgical decisions. Low-activity fragments allow for conventional surgical management to be considered with appropriate control measures.

Chemical, biological, radiological and nuclear considerations in a major incident.

Chemical, biological, radiological and nuclear (CBRN) incidents have a disproportionate effect on all aspects of efficient management of casualties. The immediate risks to rescue and healthcare staff, along with damage and threats to existing infrastructure, make CBRN incidents an important consideration to plan and train for, even if the likelihood of encountering them is remote. In addition to the generic 'all hazards' approach shared with all major incident planning, CBRN incident management has a number of specific treatments and interventions which require early identification of the agent involved, and thus a high degree of specialist knowledge among responders.

Delineation of the proximal 3q microdeletion syndrome.

Interstitial deletions of the proximal long arm of chromosome 3 are very rare and a defined clinical phenotype is not established yet. We report on the clinical, cytogenetic and molecular findings of a 20-month-old Hispanic male with a 2.5 Mb de novo deletion on q13.11q13.12. Up to now, this is the smallest deletion reported among patients with the proximal 3q microdeletion syndrome. The patient has distinct facial features including brachycephaly, broad and prominent forehead, flat nasal bridge, prominent ears, anteverted nose, tetralogy of Fallot, bilateral cryptorchidism, and peripheral skeletal abnormalities. To further delineate the proximal 3q deletion syndrome, the phenotype of our patient was compared with 10 other patients previously described. We found that ALCAM and CBLB are the only genes deleted in our patient and based on previously published data, we propose that the CBLB gene is responsible for the craniofacial phenotype in patients with deletions of proximal 3q region.

Temperature--the forgotten vital sign.

OBJECTIVE: To improve the measurement of core body temperature in the resuscitation room. METHOD: This work was undertaken in the Emergency Department (ED) of a large District General Hospital. The clinical notes for all admissions to the resuscitation suite during a 2 month period were reviewed to establish the frequency of temperature measurement. Following a simple educational program, performance was re-audited using the same methodology. RESULTS: Of the first cohort 13.4% had had their temperature recorded. This improved to 71.6%. CONCLUSIONS: The measurement of body temperature in the resuscitation room is important as hypothermia has profound effects on the cardiovascular, pulmonary, neurological and haemostatic systems. Clinical audit highlights poor current performance and enables improvement of practice through simple education.