Background: A fair distribution of healthcare services for older patients is an important challenge, but qualitative research exploring clinicians’ consideration in daily clinical prioritisation in healthcare services for the aged is scarce.Objectives: To explore what kind of criteria, values, and other relevant considerations are important in clinical prioritisations in healthcare services for older patients.Design: A semi-structured interview-guide was used to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis and template organising style.Participants: 20 (...) physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway.Results and interpretations: Important dilemmas relate to under-provision of community care and comprehensive approaches, and over-utilisation of certain specialised services. Overt ageism is generally not reported, but the healthcare services for the aged seem to be inadequate due to more subtle processes, for example, dominating considerations and ideals and operating conditions that do not pay sufficient attention to older patients’ needs and considerations of justice. Clinical prioritisations are described as being dominated by adapting traditional biomedical approaches to the operating conditions. Many of the clinicians indicate that there is a potential for improving end of life decisions and for reducing exaggerated use of life-prolonging treatment and hospitalisations.Conclusion: The interviews in this study indicate that considerations of justice and patients’ perspectives should be given more attention to strike a balance between specialised medical approaches and more general and comprehensive approaches in healthcare services for older patients. (shrink)

Background: Although fair distribution of healthcare services for older patients is an important challenge, qualitative research exploring clinicians’ considerations in clinical prioritisation within this field is scarce. Objectives: To explore how clinicians understand their professional role in clinical prioritisations in healthcare services for old patients. Design: A semi-structured interview-guide was employed to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis. Participants: 20 physicians and 25 nurses working in public hospitals and nursing homes (...) in different parts of Norway. Results and interpretations: The clinicians struggle with not being able to attend to the comprehensive needs of older patients, and being unfaithful to professional ideals and expectations. There is a tendency towards lowering the standards and narrowing the role of the clinician. This is done in order to secure the vital needs of the patient, but is at the expense of good practice and holistic role modelling. Increased specialisation, advances and increase in medical interventions, economical incentives, organisational structures, and biomedical paradigms, may all contribute to a narrowing of the clinicians’ role. Conclusion: Distributing healthcare services in a fair way is generally not described as integral to the clinicians’ role in clinical prioritisations. If considerations of justice are not included in clinicians’ role, it is likely that others will shape major parts of their roles and responsibilities in clinical prioritisations. Fair distribution of healthcare services for older patients is possible only if clinicians accept responsibility in these questions. (shrink)

We suggest a new view of secretory and membrane protein folding that emphasizes the role of pathways of biogenesis in generating functional and conformational heterogeneity. In this view, heterogeneity results from action of accessory factors either directly binding specific sequences of the nascent chain, or indirectly, changing the environment in which a particular domain is synthesized. Entrained by signaling pathways, these variables create a combinatorial set of necessary‐but‐not‐sufficient conditions that enhance synthesis and folding of particular alternate, functional, conformational forms. We (...) therefore propose that protein conformation is productively regulated by the cell during translocation across the endoplasmic reticulum (ER), a concept that may account for currently poorly understood aspects of physiological function, natural selection, and disease pathogenesis. BioEssays 24:741–748, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

We present a case study of how mathematicians write for mathematicians. We have conducted interviews with two research mathematicians, the talented PhD student Adam and his experienced supervisor Thomas, about a research paper they wrote together. Over the course of 2 years, Adam and Thomas revised Adam’s very detailed first draft. At the beginning of this collaboration, Adam was very knowledgeable about the subject of the paper and had good presentational skills but, as a new PhD student, did not yet (...) have experience writing research papers for mathematicians. Thus, one main purpose of revising the paper was to make it take into account the intended audience. For this reason, the changes made to the initial draft and the authors’ purpose in making them provide a window for viewing how mathematicians write for mathematicians. We examined how their paper attracts the interest of the reader and prepares their proofs for validation by the reader. Among other findings, we found that their paper prepares the proofs for two types of validation that the reader can easily switch between. (shrink)

Nowadays, it is common that newly built hospitals are designed with single‐room accommodation, unlike in the past, where shared accommodation was the favoured standard. Despite this change in hospital design, very little is known about how single‐room accommodation affects nurses' work environment and nursing care. This study evaluates how the single‐room design affects nurses and nursing care in the single‐room hospital design. Nurses working in the single‐room design predominantly work alone with little opportunity for peer training, interaction and reflection. In (...) addition, the single‐room design affects the nurses' work environment due to changes in sensory stimulation and increased walking distances. Furthermore, a change in the discourse, namely, regarding the single room as the patient's home, makes the nurses react to queries, demands and tasks in a new way. Overall, the new hospital design forces the nurses into a more reactive role and affect their way of providing nursing care. Despite this, the nurses find single‐room accommodation beneficial for the patients and their nursing care. (shrink)

Limiting intensive care is paid increasing attention. In the echoing call for physicians’ ethical self‐restriction, it is easily overlooked, however, that ethics needs a critical epistemological analysis before it can suffice as an emergency brake to futile treatment. This analysis is provided by the present essay. The authors suggest that the difficulties of resolving moral dilemmas related to limiting intensive care may just be due to the unclarified epistemological status of moral claims. Even if normative ethics cannot prescribe right decisions, (...) but only draw conclusions from defined premises, the premises may or may not be true. Their intertwined descriptive and normative evidence is endorsed in an academic and political discourse. There will necessarily be various demands for rationality in prudent decisions between physicians, their patients and society. These demands are formulated dialogically through critical questions and justified answers. A good argument is the convincing one that, finally and ideally, leads to the absence of open objections. Thus, in the end the rightness of a given decision does not depend on axiomatic moral principles, but is comparative and conditional, as it is given in an omnilateral argument. Neither is it the democratic process of shared decision making that we should evaluate, but rather the argumentative state itself, when we judge the morality of health politics and clinical practice. (shrink)

Ouija board sessions are illustrious examples of how subjective feelings of control – the Sense of Agency - can be manipulated in real life settings. We present findings from a field experiment at a paranormal conference, where Ouija enthusiasts were equipped with eye trackers while using the Ouija board. Our results show that participants have a significantly lower probability at visually predicting letters in a Ouija board session compared to a condition in which they are instructed to deliberately spell out (...) words with the Ouija board planchette. Our results also show that Ouija board believers report lower SoA compared to sceptic participants. These results support previous research which claim that low sense of agency is caused by a combination of retrospective inference and an inhibition of predictive processes. Our results show that users in Ouija board sessions become increasingly better at predicting letters as responses unfold over time, and that meaningful responses from the Ouija board can only be accounted for when considering interactions that goes on at the participant pair level. These results suggest that meaningful responses from the Ouija board may be an emergent property of interacting and predicting minds that increasingly impose structure on initially random events in Ouija sessions. (shrink)

Mathematicians appear to have quite high standards for when they will rely on testimony. Many mathematicians require that a number of experts testify that they have checked the proof of a result p before they will rely on p in their own proofs without checking the proof of p. We examine why this is. We argue that for each expert who testifies that she has checked the proof of p and found no errors, the likelihood that the proof contains no (...) substantial errors increases because different experts will validate the proof in different ways depending on their background knowledge and individual preferences. If this is correct, there is much to be gained for a mathematician from requiring that a number of experts have checked the proof of p before she will rely on p in her own proofs without checking the proof of p. In this way a mathematician can protect her own work and the work of others from errors. Our argument thus provides an explanation for mathematicians’ attitude towards relying on testimony. (shrink)

Cognitive load theory has been widely used to help understand the process of learning and to design teaching interventions. The Cognitive Load Scale developed by Leppink and colleagues has emerged as one of the most validated and widely used self-report measures of intrinsic load, extraneous load, and germane load. In this paper we investigated an expansion of the CLS by using a multidimensional conceptualization of the EL construct that is relevant for physical and online teaching environments. The Multidimensional Cognitive Load (...) Scale for Physical and Online Lectures goes beyond the CLS's operationalization of EL by expanding the EL component which originally included factors related to instructions/explanations with sub-dimensions including EL stemming from noises, and EL stemming from both media and devices within the environment. Through three studies, we investigated the reliability, and internal and external validity of the MCLS-POL using the Partial Credit Model, Confirmatory Factor Analysis, and differences between students either attending a lecture physically or online. The results of Study 1 provide initial evidence for the validity and reliability of the MCLS-POL within a higher education sample, but also highlighted several potential improvements which could be made to the measure. These changes were made before re-evaluating the validity and reliability of the measure in a new sample of higher education psychology students, and psychological testing students. Together the studies provide evidence for a multidimensional conceptualization cognitive load and provide evidence of the validity, reliability, and sensitivity of the MCLS-POL and provide suggestions for future research directions. (shrink)

This article investigates the role of commonly specified control variables in moderating the relationship between corporate social performance (CSP) and corporate financial performance (CFP). In addition, there are separate measures for positive (strengths) social actions, and for negative (concerns) social actions. The results support the positive relationship between CSP and CFP. The best model, as determined using factorial analysis of variance, is one which has the following control variables: size, industry, risk, and research and development expenditures. In examining the CSP/CFP (...) relationship, researchers must control for these variables, in order to properly specify the model. (shrink)

The “practice turn” in philosophy of science has strengthened the connections between philosophy and scientific practice. Apart from reinvigorating philosophy of science, this also increases the relevance of philosophical research for science, society, and science education. In this paper, we reflect on our extensive experience with teaching mandatory philosophy of science courses to science students from a range of programs at University of Copenhagen. We highlight some of the lessons we have learned in making philosophy of science “fit for teaching” (...) outside of philosophy circles by taking selected cases from the students’ own field as the starting point. We argue for adapting philosophy of science teaching to particular audiences of science students, and discuss the benefits of drawing on research within science education to inform curriculum and course design. This involves reconsidering teaching resources, assumptions about students, intended learning outcomes, and teaching formats. We also argue that to make philosophy of science relevant and engaging to science students, it is important to consider their potential career trajectories. By anticipating future contexts and situations in which methodological, conceptual, and ethical questions could be relevant, philosophy of science can demonstrate its value in the education of science students. (shrink)

The unquestionable achievement of J. G. A. Pocock's The Machiavellian Moment was to describe the retention of pre-modern values in a modern society. Pocock was notoriously accused of decentring Locke and side-lining the Liberal Tradition. A more pertinent critique had it that he failed to articulate how civic humanism in the context of increasingly commercial societies produced more than Jeremiahs or Cassandras. This article explains how Pocock responded to his various critics by inventing the term “commercial humanism” in an effort (...) to clarify the way in which classical virtue was modified in modern commercial contexts, especially by natural jurists and republicans. Commercial humanism proved controversial but stimulated one of the most original scholars working in the history of political thought, István Hont, to undertake a prolonged engagement with Pocock's revisionist ideas, which ultimately allowed him to answer Pocock's critics better than Pocock, whose voice remained too in tune with those whose view of modern political thought he had rejected. For Hont, Pocock's labours in the history of political thought remained less relevant to present politics than they might become, once the depth of eighteenth-century analyses of the relationship between wealth and virtue was recovered. (shrink)

It has been more than sixty years since R. D. Collison Black published his Economic Thought and the Irish Question, a book which ever since has been widely regarded as a classic in the history of e...

This paper examines the reception of Reinhart Koselleck’s Kritik und Krise by the intellectual historian István Hont. Relying on hitherto unpublished manuscripts, it argues that the later work of Hont can be seen as a critical response to Koselleck and his characterisation of the crisis of modern politics as a crisis of political authority.

The use of tanning beds has been identified as being among the most significant causes of melanoma and non-melanoma skin cancer. Accordingly, the activity is properly seen as one that involves profound harm to self. The article examines paternalistic reasons for restricting sunbed usage. We argue that both so-called soft and hard paternalistic arguments support prohibiting the use of sunbeds. We make the following three arguments: an argument from oppressive patterns of socialization suggesting that the autonomous nature of the conduct (...) in question is questionable; an argument from so-called evaluative delusions in which individuals attach incorrect weights to some of their values; a strictly hard paternalistic argument appealing to the harm in itself pertaining to the use of sunbeds. (shrink)

Context: Distributed language and interactivity are central members of a set of concepts that are rapidly developing into rigorous, exciting additions to 4E cognitive science. Because they share certain assumptions and methodological commitments with enactivism, the two have sometimes been confused; additionally, while enactivism is a well-developed paradigm, interactivity has relied more on methodological development and on a set of focal examples. Problem: The goal of this article is to clarify the core conceptual commitments of both interactivity-based and enactive approaches (...) to cognitive science by contrasting the two and highlighting their differences in assumptions, focus, and explanatory strategies. Method: We begin with the shared commitments of interactivity and enactivism - e.g., antirepresentationalism, naturalism, interdisciplinarity, the importance of biology, etc. We then give an overview of several important varieties of enactivism, including sensorimotor and anti-representationalist enactivism, and then walk through the history of the “core” varieties, taking care to contrast Maturana’s approach with that of Varela and the current researchers following in Varela’s footsteps. We then describe the differences between this latter group and interactivity-based approaches to cognitive science. Results: We argue that enactivism’s core concepts are explanatorily inadequate in two ways. First, they mis-portray the organization of many living systems, which are not operationally closed. Second, they fail to realize that most epistemic activity depends on engagement with non-local resources. Both problems can be dealt with by adopting an interactivity-based perspective, in which agency and cognition are fundamentally distributed and involve integration of non-local resources into the local coupling of organism and environment. Implications: The article’s primary goal is theoretical clarification and exposition; its primary implication is that enactive concepts need to be modified or extended in some way in order to explain fully many aspects of cognition and directed biological activity. Or, read another way, the article’s primary implication is that interactivity already provides a rich set of concepts for doing just that, which, while closely allied with enactivism in several ways, are not enactivist concepts. Constructivist content: The article consists entirely of a comparison between two constructivist fields of theory. Key Words: Interactivity, enactivism, distributed language, radical embodied cognitive science, ecological psychology, autonomy. (shrink)

Upshot: We agree with commenters that enactivism incorporates a broad variety of methodologies, metaphysical stances, concepts, and investigative approaches, and that this is a good thing. However, we remain concerned that autonomy and sense-making are problematic concepts for post-Varelian enactivism, and that they form the foundations of a conceptual framework that may hamper the development of effective explanations for cognitive activity, as well as the paradigmatic aspirations of this particular enactivist approach.

This chapter uncovers a less investigated aspect of the relationship between the two most important scholastic schools of the Renaissance, Thomism and Scotism: the influence of Scotist literature on distinctions as seen in some sixteenth-century Thomists. The chapter has a primary focus on Chrysostomus Javelli’s engagement in his discussion of divine attributes with the Scotist doctrine of distinctions, but also considers other Thomist sources. First, the beginnings of the highly specialised Scotist literature on distinctions are traced back to the start (...) of the fourteenth century; I show how some early followers of Duns Scotus, in particular Francis of Meyronnes and Petrus Thomae, systematised Scotus’ ontology of the various grades of being by compiling lists of subtle distinctions to be applied to various levels of reality. I give some indications as to the later reception of these models of distinctions in the Scotist school. Special attention is paid to Étienne Brulefer, since his summary of Petrus Thomae’s model of seven distinctions was Javelli’s source for the Scotist doctrine. I then investigate how Javelli worked with Brulefer’s summary, and how he sought to integrate the Scotist doctrine into his own discussion of divine attributes. Thomists traditionally allowed only a rational or mental kind of distinction among divine attributes, and between them and the divine essence. Javelli, however, endeavours to show how the Thomist position may be reconciled with the Scotist doctrine of a formal or ex natura rei distinction. He did not always endorse this conciliatory approach; I hypothesise that he changed his mind on the subject over time. Finally, I show how other Renaissance Thomists reacted to the Scotist system of distinctions; in particular, I draw attention to the Thomists Andreas Bodenstein von Karlstadt, Bartolomeo Manzoli, and Mattia Gibboni da Aquario, who all wrote treatises on Thomist distinction theory modelled on the Scotist system of distinctions. In some of this literature, lists of distinctions based on Thomist metaphysics were compiled in order to replace the Scotist system. I argue that Javelli’s approach is more conciliatory and, in fact, has some overlap with the concordist thought of Giovanni Pico della Mirandola, who himself considered Scotus and Aquinas to be in fundamental agreement as regards the distinction between divine attributes. (shrink)

It is a commonly raised argument against thefamily resemblance account of concepts that, on thisaccount, there is no limit to a concept's extension.An account of family resemblance which attempts toprovide a solution to this problem by including bothsimilarity among instances and dissimilarity tonon-instances has been developed by the philosopher ofscience Thomas Kuhn. Similar solutions have beenhinted at in the literature on family resemblanceconcepts, but the solution has never received adetailed investigation. I shall provide areconstruction of Kuhn's theory and argue that (...) hissolution necessitates a developmental perspective withbuilds on both the transmission of taxonomies betweengenerations and a progressive development throughhistory. (shrink)

The Golden Age of postwar capitalism has been eclipsed, and with it seemingly also the possibility of harmonizing equality and welfare with efficiency and jobs. Most analyses believe that the emerging postindustrial society is overdetermined by massive, convergent forces, such as tertiarization, new technologies, or globalization, all conspiring to make welfare states unsustainable in the future. Social Foundations of Postindustrial Economies takes a second, more sociological and more institutional, look at the driving forces of economic transformation. What, as a result, (...) stands out is postindustrial diversity, not convergence. Macroscopic, global trends are undoubtedly powerful, yet their influence is easily rivalled by domestic institutional traditions, by the kind of welfare regime that, some generations ago, was put in place. It is, however, especially the family economy that hold the key as to what kind of postindustrial model will emerge, and to how evolving tradeoffs will be managed. Twentieth-century economic analysis depended on a set of sociological assumptions that, now, are invalid. Hence, to better grasp what drives today's economy, we must begin with its social foundations. (shrink)

This paper extends Mori’s (IEEE Robot Autom Mag 19:98–100, 2012) uncanny valley-hypothesis to include technologies that fail its basic criterion that uncanniness arises when the subject experiences a discrepancy in a machine’s human likeness. In so doing, the paper considers Mori’s hypothesis about the uncanny valley as an instance of what Heidegger calls the ‘challenging revealing’ nature of modern technology. It introduces seeming autonomy and heteronomy as phenomenological categories that ground human being-in-the-world including our experience of things and people. It (...) is suggested that this categorical distinction is more foundational than Heidegger’s existential structures and phenomenological categories. Having introduced this novel phenomenological distinction, the paper considers the limits of Mori’s hypothesis by drawing on an example from science fiction that showcases that uncanniness need not only be caused by machines that resemble human beings. In so doing, it explores how the seeming autonomy-heteronomy distinction clarifies (at least some of) the uncanniness that can arise when humans encounter advanced technology which is irreducible to the anthropocentrism that shapes Mori’s original hypothesis. (shrink)

A critical review of Collin Rice's book, Leveraging Distortions: Explanation, Idealization, and Universality in Science.

In a previous article we have shown that Kuhn's theory of concepts is independently supported by recent research in cognitive psychology. In this paper we propose a cognitive re-reading of Kuhn's cyclical model of scientific revolutions: all of the important features of the model may now be seen as consequences of a more fundamental account of the nature of concepts and their dynamics. We begin by examining incommensurability, the central theme of Kuhn's theory of scientific revolutions, according to two different (...) cognitive models of concept representation. We provide new support for Kuhn 's mature views that incommensurability can be caused by changes in only a few concepts, that even incommensurable conceptual systems can be rationally compared, and that scientific change of the most radical sort—the type labeled revolutionary in earlier studies—does not have to occur holistically and abruptly, but can be achieved by a historically more plausible accumulation of smaller changes. We go on to suggest that the parallel accounts of concepts found in Kuhn and in cognitive science lead to a new understanding of the nature of normal science, of the transition from normal science to crisis, and of scientific revolutions. The same account enables us to understand how scientific communities split to create groups supporting new paradigms, and to resolve various outstanding problems. In particular, we can identify the kind of change needed to create a revolution rather precisely. This new analysis also suggests reasons for the unidirectionality of scientific change. (shrink)

Language is infused with materiality and should therefore not be considered as an abstract system that is isolated from socio-material reality. Expressions materialise language in social practices, thus providing the necessary basis for languaging activities. For this reason, it makes sense to challenge proponents of orthodox linguistics and others who hold that language can be studied in isolation from its concrete manifestations. By exploring the relation between materiality and linguistic activity, the article extends Malafouris’ Material Engagement Theory while clarifying the (...) phenomenon of ‘linguistic denotation’. In so doing, it critiques orthodox approaches to language which trace denotation to abstract meanings and/or mental representations. The article shows how the denotative aspects of language can be cashed out in non-representational terms and, furthermore, that the interrelation of denotation and materiality is crucial to human material culture in that it allows for material engagements to transcend localised contexts. These engagements become global in Latour’s sense and, in so doing, denotation ceases to demand descriptions in terms of representations. (shrink)

The paper reviews the current state of play around anti-representationalist attempts at countering Clark and Toribio’s representation-hunger thesis. It introduces a distinction between different approaches to Chemero’s Radical embodied cognition thesis in the form of, on the one hand, those pushing a hard line and, on the other, those who are more relaxed about their anti-representationalist commitments. In terms of overcoming Clark and Toribio’s thesis, hardliners seek to avoid any mentioning of mental content in the activity they purport to explain. (...) Yet, the paper argues, adopting a hard line complicates this endeavor considerably and unnecessarily. Those promoting a relaxed REC, however, are better off in that they have no problem in recognizing that some types of cognition are hybrid. By turning to Hutto and Myin’s Radical Enactivism as a prime example of a relaxed approach to the REC thesis, the paper points towards the lack of continuity between covariant information and informational content as the gap that would necessarily have to be closed in order for RECers to, once and for all, be able to dismiss Clark and Toribio’s hypothesis that certain kinds of cognition are per definition off-limits to anti-representationalism. (shrink)

It is a well-established fact in representationalist cognitive science that concrete concepts influence human perception. In radical, anti-representationalist cognitive science, however, the case is far from clear. One reason for this is that proponents of Radical Enactivism yet have to clarify whether perceptual activity involving concepts is bound to rely on mental content or if it instantiates basic, contentfree cognition. The purpose of this paper is to show that concept-involving perception instantiates REC-style basic cognition. The paper begins by considering ‘cognitive (...) projection’ as the term is introduced by Distributed Cognition research. Although being introduced as a means for exploring concept-based perception in non-representationalist terms, I argue that ‘cognitive projection’ comes with mentalist overtones and unclarities concerning its linguistic basis. With the purpose of overcoming these shortcomings, I unfold a REC-friendly reading of Wittgenstein’s writings on aspect perception, arguing that basic concept-involving perception is an instantiation of basic cognition. Concludingly, with the aim of ensuring compatibility, I make a connection between conceptual aspect perception and the REC notion of attentional anchors. The latter has been introduced to explore the role of material artefacts in the context of science, technology, engineering, and mathematics educational design but has, I submit, the potential for being extended to other practical contexts. (shrink)