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Nowell-Smith reasoned that an event which deviates from what is currently known about regularities in nature, such as a miracle, principally remains an event which may still be explained by science one day. However, if on the basis of available evidence, the existence of miracles could be proved at all, it can never be concluded that God could be the efficient cause as this claim is beyond any form of verification. Diamond echoed this criticism by arguing that the recognition of a miracle would totally ignore the scientific method, which makes it unacceptable to maintain the true occurrence of such an event. All these arguments against miracles are of a logical nature, not because miracles could never happen in principal, but for the reason that the assumed supernatural causation of 83 Flew, A. As we have seen, in this debate Hume refers regularly to the testimony of someone who claims, against all odds, to have seen a miracle. However, he uses probalistic theory to show the exact opposite of what Hume claimed to point out, namely that biblical miracles most probably did take place.

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At the same time, the last years of the 1780s and the Washington administration saw an enormous increase in the maritime commerce of the United States. It started a valuable triangular commerce: New England manufacturers to the northwest Indians, their furs to China, and then China tea to Boston. The next year the first woolen factory followed at Hartford, with a fi1,28o capital raised on the open market in fi10 shares. Steam was coming and in 1789, already, John Fitch was experimenting in Philadelphia with a working steamship. Washington did not want America to become a manufacturing country like Britain any more than Jefferson did, and for the same 156 reasons, but he was a realist and knew it was coming. He was also a military man who knew how important it was for the United States to have modern military equipment, including the latest warships and cannon, and how closely this was linked to military capacity. Washington gave a public valediction to the American people by means of a farewell address, the text which filled an entire page of the American Daily Advertiser on September 19, 1796. Washington wrote a rough draft of his declaration, intended as his political testament and considered advice to the nation, in May, and sent it to Hamilton for his approval.

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The following are all relevant: Royal College of Radiologists Standards for patient consent particular to radiology (2012). By safeguarding high standards of care and seeking to continuously improve its quality, it ensures that health care provision is patientcentred which is central to the concept. The main components of a clinical governance framework can be summarised as follows: 3 i) Risk management ii) Clinical audit iii) Education, training and Continuous Professional Development iv) Patient and carer experience and involvement v) Staffing and staff management An example of published Trust information on clinical governance can be found at. This will include audit of ultrasound examinations and reports: participation in multi-disciplinary team meetings and radiology discrepancy meetings would be further examples; ii) Communication and consent: (ref: section 1. This is of particular importance following the publication of the Francis Report in 2013 4 (ref: section 1. The National Ultrasound Steering Group was a short-term sub-group of the National Imaging Board. Web links Standards for the provision of an ultrasound service (2014). The on-line training sessions enhance traditional learning, support existing teaching methods and provide a valuable reference point. They are designed and built to be engaging and interactive, using quality images, video, audio 20 and animation to help trainees learn and retain knowledge. In order to access the e-learning sessions, is it necessary to first register with the programme portal. If anyone is interested in applying to become an assessor please contact. Most quality assurance protocols focus on the consistency of specific features of image quality over time. The acceptability of image quality may not be apparent from measurable changes in the parameters tested. The issue of what constitutes unacceptable equipment performance is still very difficult to assess objectively. All healthcare professionals have a professional duty to report concerns they may have about the safety of patients and of service delivery. Employers will have available advice and policies as to the pathways that ultrasound practitioners are required to follow.

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Introduction In Luxembourg, in terms of the number of years of life lost due to premature death, cardiovascular diseases were the highest ranking causes in 2010, the principal cause of acquired longterm disabilities and the leading cause of death (Organisation mondiale de la Sante, 2012; Institute for Health Metrics and Evaluation, 2010). Risk markers such as age, male gender, race/ethnicity, and genetic factors, lifestyle, smoking behaviour, alcohol consumption and cultural or economic circumstances may cause the different impairment deficiencies profiles. Cardiovascular long-term disabilities are not exclusively physical, but also psychological distress, familial repercussions on daily life, restrictions in routine, leisure and work activities, and substantial socioeconomic impacts. Indeed, cardiovascular risk management, lifestyle changes, secondary prevention of relapses among known patients and treatment of heart attacks are well documented to lead decreases in the originally very high case fatality of myocardial infarctions (Eurostat, 2013). Study design, sample and recruitment this survey was a retrospective health record audit from the Institut National de Chirurgie Cardiaque et de Cardiologie Interventionnelle in Luxembourg, involving all cardiovascular patients (3632 survivors by excluding wrong addresses and those deceased) who underwent coronary angiography between 2008 and 2009. They were contacted in 2013-2014 by a letter that contained information about the aims of the survey. Instruments and their translation As Luxembourg is multilingual and very culturally diverse (more than 170 different nationalities), each patient was invited to complete a self-questionnaire in the language of their choice: Portuguese, French or German. Ethical Restriction the protocol was approved by the National Committee of Research Ethics and notified to the Committee for Data Protection of Luxembourg. Collected on age, sex, living in couple (yes/no), Luxembourgish (yes/no); educational level (primary, secondary, tertiary), professional status (manual worker, employee, executive, other), retired (yes/no), and total annual income (euros) (low, low middle, high middle, and high). Data on those who suffered in the last 5 years from myocardial infarction or angina pectoris. Changes of tobacco consumption, physical inactivity and eating habits were recorded. This model was adjusted with sex, age and income; the other variables were introduced one by one. Among health-related issues, the knowledge of the respective roles of main preventive behaviours such as physical exercise may be useful for policy interventions aimed at improving the health and daily life of patients (Institute for Health Metrics and Evaluation, 2010). Previous work suggests that angina is a strong predictor of future cardiovascular events, but other investigations of psychological factors and coronary heart disease find that conventional risk factors explain little of the observed association (Kubzansky & Thurston, 2007). Health promotion or therapeutic education programs would benefit by targeting factors that moderate the unfavourable intention-behaviour relationship. Cardiovascular diseases affect health in combination with social, psychological and material factors. Some of these associations, such as income and living in couple, exist for the general population and are well-documented in the literature (Eurofound, 2012). Life satisfaction two-years after stroke onset: the effects of gender, occupational status, memory function and quality of life among stroke patients (Newsqol) and their family caregivers (Whoqol-bref) in Luxembourg.

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