BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitor...BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitors(PPIs)are considered the referring medications for GERD.Nevertheless,PPIs must be managed carefully because their use,especially chronic,could be linked with some adverse effects.An effective and safe alternative pharmacological tool for GERD is needed.After the identification of potentially new medications to flank PPIs,it is mandatory to revise and improve good clinical practices even through a consensus process.AIM To optimize diagnosis and treatment guidelines for GERD through a consensus based on Delphi method.METHODS The availability of clinical studies describing the action of the multicomponent/multitarget medication Nux vomica-Heel,subject of the consensus,is the basic prerequisite for the consensus itself.A modified Delphi process was used to reach a consensus among a panel of Italian GERD specialists on the overlapping approach PPIs/Nux vomica-Heel as a new intervention model for the management of GERD.The Voting Consensus group was composed of 49 Italian Medical Doctors with different specializations:Gastroenterology,otolaryngology,geriatrics,and general medicine.A scientific committee analyzed the literature,determined areas that required investigation(in agreement with the multiple-choice questionnaire results),and identified two topics of interest:(1)GERD disease;and(2)GERD treatment.Statements for each of these topics were then formulated and validated.The Delphi process involved two rounds of questioning submitted to the panel experts using an online platform.RESULTS According to their routinary GERD practice and current clinical evidence,the panel members provided feedback to each questionnaire statement.The experts evaluated 15 statements and reached consensus on all 15.The statements regarding the GERD disease showed high levels of agreement,with consensus ranging from 70%to 92%.The statements regarding the GERD treatment also showed very high levels of agreement,with consensus ranging from 90%to 100%.This Delphi process was able to reach consensus among physicians in relevant aspects of GERD management,such as the adoption of a new approach to treat patients with GERD based on the overlapping between PPIs and Nux vomica-Heel.The consensus was unanimous among the physicians with different specializations,underlying the uniqueness of the agreement reached to identify in the overlapping approach between PPIs and Nux vomica-Heel a new intervention model for GERD management.The results support that an effective approach to deprescribe PPIs through a progressive decalage timetable(reducing PPIs administration to as-needed use),should be considered.CONCLUSION Nux vomica-Heel appears to be a valid opportunity for GERD treatment to favor the deprescription of PPIs and to maintain low disease activity together with the symptomatology remission.展开更多
Although conceived as a rational deduction,the choice of the principles of justice requires a consensus about the same basic conception of justice since we must consider that there are different comprehensive concepti...Although conceived as a rational deduction,the choice of the principles of justice requires a consensus about the same basic conception of justice since we must consider that there are different comprehensive conceptions of it.That means that is not possible to accomplish such a task within a political strict consensus.We must reach an overlapping consensus grounded in conditions of reciprocity.We then must inquire in what conditions this overlapping consensus may be reached,because we may find a difference between political or constitutional consensus and moral consensus.If the former does not raise many difficulties to be understood,since it deals only with political basic structure of one society,the latter seems to be more problematic.We aim to show that Rawls interpretation of the theory of moral sentiments may be more appropriate for the understanding and justification of the need for an overlapping consensus in the establishment of a just society.For if that could be the case,each citizen will engage the same liberal conception of justice for their one moral reasons.展开更多
I. The Value Tyranny of the Universality of Western Human Rights Discourse From the perspective of history, human rights discourse originating in the West is first of all a kind of special discourse, rather than unive...I. The Value Tyranny of the Universality of Western Human Rights Discourse From the perspective of history, human rights discourse originating in the West is first of all a kind of special discourse, rather than universal words. ＂Human rights discourse is a language of rights, which is a language of Western culture. Therefore, in terms of concept, there is no concept of ＇human rights＇ in traditional Confucianism, not even the concept of ＇rights＇. In this sense, the concept ＇human rights＇ is a product of typical Western culture, although it appeared in modern times and it was the out- come of the development of civil society and democracy.TM Marked by unique Western color, human rights discourse originated from the special Western economic, political, histori- cal and cultural background and has its unique consciousness of problems and practical direction. For example,展开更多
The broad sense overlap concept and types of tree crown overlap were defined in the paper through analping function between the factors of tree crown overlap. The formulas of overlap area and overlap rate were derive...The broad sense overlap concept and types of tree crown overlap were defined in the paper through analping function between the factors of tree crown overlap. The formulas of overlap area and overlap rate were derived from definite integral form. At the same time, many formulas were acquired while the projective figures of tree crown were circle. Application ways of these formulae were illustrated with a concrete caculation process.展开更多
Diversity or pluralism in values has been widely recognized as a major feature of our times both intemationally and domestically, and China is no exception, where this phenomenon is regarded as a major reason for the ...Diversity or pluralism in values has been widely recognized as a major feature of our times both intemationally and domestically, and China is no exception, where this phenomenon is regarded as a major reason for the country＇s efforts to pursue the goal of a “harmonious society” at home and the goal of a “harmonious world” abroad. Against this background, many people show great interest in the idea of “overlapping consensus” proposed by John gawls. On the basis of a careful reading of different interpretations of this idea, or the “overlapping consensus” on the idea of“ overlapping consensus,” we can say that there are three levels of “overlapping consensus. ”At the first level, people with different positions treat each other with the same reasonable attitude. At the second level, people holding different values support the same norms on the basis of their respective values or by taking each other＇s perspectives into the moral discourse. At the third level, people who currently hold different “moral sources”of the shared norms are nonetheless ready to engage in a common leaming process that aims for a “fusion of horizons＂”in the future. Overlapping consensuses at all these levels should not only be discussed in political philosophy, or discovered in political culture, but also constructed in political practice. This means that we should try our best to provide actual conditions for overlapping consensuses in social and institutional reality, and at the same time avoid reducing the validity of any type of overlapping consensus to its facticity.展开更多
文摘BACKGROUND Gastro-esophageal reflux disease(GERD)may affect the upper digestive tract;up to 20%of population in Western nations are affected by GERD.Antacids,histamine H2-receptor antagonists,and Proton Pump Inhibitors(PPIs)are considered the referring medications for GERD.Nevertheless,PPIs must be managed carefully because their use,especially chronic,could be linked with some adverse effects.An effective and safe alternative pharmacological tool for GERD is needed.After the identification of potentially new medications to flank PPIs,it is mandatory to revise and improve good clinical practices even through a consensus process.AIM To optimize diagnosis and treatment guidelines for GERD through a consensus based on Delphi method.METHODS The availability of clinical studies describing the action of the multicomponent/multitarget medication Nux vomica-Heel,subject of the consensus,is the basic prerequisite for the consensus itself.A modified Delphi process was used to reach a consensus among a panel of Italian GERD specialists on the overlapping approach PPIs/Nux vomica-Heel as a new intervention model for the management of GERD.The Voting Consensus group was composed of 49 Italian Medical Doctors with different specializations:Gastroenterology,otolaryngology,geriatrics,and general medicine.A scientific committee analyzed the literature,determined areas that required investigation(in agreement with the multiple-choice questionnaire results),and identified two topics of interest:(1)GERD disease;and(2)GERD treatment.Statements for each of these topics were then formulated and validated.The Delphi process involved two rounds of questioning submitted to the panel experts using an online platform.RESULTS According to their routinary GERD practice and current clinical evidence,the panel members provided feedback to each questionnaire statement.The experts evaluated 15 statements and reached consensus on all 15.The statements regarding the GERD disease showed high levels of agreement,with consensus ranging from 70%to 92%.The statements regarding the GERD treatment also showed very high levels of agreement,with consensus ranging from 90%to 100%.This Delphi process was able to reach consensus among physicians in relevant aspects of GERD management,such as the adoption of a new approach to treat patients with GERD based on the overlapping between PPIs and Nux vomica-Heel.The consensus was unanimous among the physicians with different specializations,underlying the uniqueness of the agreement reached to identify in the overlapping approach between PPIs and Nux vomica-Heel a new intervention model for GERD management.The results support that an effective approach to deprescribe PPIs through a progressive decalage timetable(reducing PPIs administration to as-needed use),should be considered.CONCLUSION Nux vomica-Heel appears to be a valid opportunity for GERD treatment to favor the deprescription of PPIs and to maintain low disease activity together with the symptomatology remission.
文摘Although conceived as a rational deduction,the choice of the principles of justice requires a consensus about the same basic conception of justice since we must consider that there are different comprehensive conceptions of it.That means that is not possible to accomplish such a task within a political strict consensus.We must reach an overlapping consensus grounded in conditions of reciprocity.We then must inquire in what conditions this overlapping consensus may be reached,because we may find a difference between political or constitutional consensus and moral consensus.If the former does not raise many difficulties to be understood,since it deals only with political basic structure of one society,the latter seems to be more problematic.We aim to show that Rawls interpretation of the theory of moral sentiments may be more appropriate for the understanding and justification of the need for an overlapping consensus in the establishment of a just society.For if that could be the case,each citizen will engage the same liberal conception of justice for their one moral reasons.
文摘I. The Value Tyranny of the Universality of Western Human Rights Discourse From the perspective of history, human rights discourse originating in the West is first of all a kind of special discourse, rather than universal words. ＂Human rights discourse is a language of rights, which is a language of Western culture. Therefore, in terms of concept, there is no concept of ＇human rights＇ in traditional Confucianism, not even the concept of ＇rights＇. In this sense, the concept ＇human rights＇ is a product of typical Western culture, although it appeared in modern times and it was the out- come of the development of civil society and democracy.TM Marked by unique Western color, human rights discourse originated from the special Western economic, political, histori- cal and cultural background and has its unique consciousness of problems and practical direction. For example,
文摘The broad sense overlap concept and types of tree crown overlap were defined in the paper through analping function between the factors of tree crown overlap. The formulas of overlap area and overlap rate were derived from definite integral form. At the same time, many formulas were acquired while the projective figures of tree crown were circle. Application ways of these formulae were illustrated with a concrete caculation process.
文摘Diversity or pluralism in values has been widely recognized as a major feature of our times both intemationally and domestically, and China is no exception, where this phenomenon is regarded as a major reason for the country＇s efforts to pursue the goal of a “harmonious society” at home and the goal of a “harmonious world” abroad. Against this background, many people show great interest in the idea of “overlapping consensus” proposed by John gawls. On the basis of a careful reading of different interpretations of this idea, or the “overlapping consensus” on the idea of“ overlapping consensus,” we can say that there are three levels of “overlapping consensus. ”At the first level, people with different positions treat each other with the same reasonable attitude. At the second level, people holding different values support the same norms on the basis of their respective values or by taking each other＇s perspectives into the moral discourse. At the third level, people who currently hold different “moral sources”of the shared norms are nonetheless ready to engage in a common leaming process that aims for a “fusion of horizons＂”in the future. Overlapping consensuses at all these levels should not only be discussed in political philosophy, or discovered in political culture, but also constructed in political practice. This means that we should try our best to provide actual conditions for overlapping consensuses in social and institutional reality, and at the same time avoid reducing the validity of any type of overlapping consensus to its facticity.
