While cancer survivors commonly experience fear and anxiety, a substantial minority experience an enduring and debilitating fear that their cancer will return; a condition commonly referred to as fear of cancer recurrence. Despite recent advances in this area, little is known about FCR among people from Indigenous or other ethnic and racial minority populations. Given the high prevalence and poor outcomes of cancer among people from these populations, a robust understanding of FCR among people from these groups is critical. The (...) current review identified and aggregated existing literature on FCR amongst adult cancer survivors from Indigenous and minority populations. The protocol of this review was registered with PROSPERO in July 2020. A systematic search of bibliographic databases was conducted for relevant articles published from 1997 to November 2019. Data from eligible articles were extracted and appraised for quality by two independent reviewers. Nineteen articles from four countries met the inclusion criteria, including 14 quantitative, 4 qualitative and 1 mixed-methods study. Only one article reported on an Indigenous population. Few studies reported on FCR prevalence or severity. While the variation in tools used to measure FCR hindered a robust estimate of severity, results suggested some differences in FCR severity between minority and dominant populations, although these may have been due to study metholodological differences. Few factors were reported as being associated with FCR in minorities across multiple studies. The qualitative synthesis found five themes associated with the lived experience of FCR: variations in the lived experience of FCR; spirituality and worldview impacting on FCR; the importance of staying positive; complexities around support; and increasing cancer knowledge. The findings of this review highlight differences in FCR across cultures and contexts, which reinforces the need for culturally-specific approaches to this condition. The dearth of research in this area is of concern given the significant burden of cancer in these populations. A deeper understanding of this condition among Indigenous and minority populations is critical to developing and delivering appropriate and effective psychosocial care for cancer survivors from these groups. Systematic Review Registration: identifier [CRD42020161655]. (shrink)

In addition to ensuring that appropriate standards of evidence are employed when attempting to identify adaptations, researchers should investigate all nonevolutionary factors that could potentially explain their results. Evolutionary analyses may be undermined by alternative, non-evolutionary explanations either because not all relevant information is included in an evolutionary analysis, or because inappropriate methods incapable of detecting an adaptation are employed.

Retrospective rule-making has few supporters and many opponents. Defenders of retrospective laws generally do so on the basis that they are a necessary evil in specific or limited circumstances, for example to close tax loopholes, to deal with terrorists or to prosecute fallen tyrants. Yet the reality of retrospective rule making is far more widespread than this, and ranges from ’corrective’ legislation to ’interpretive regulations’ to judicial decision making. The search for a rational justification for retrospective rule-making necessitates a reconsideration (...) of the very nature of the rule of law and the kind of law that can rule, and will provide new insights into the nature of law and the parameters of societal order. This book examines the various ways in which laws may be seen as retrospective and analyses the problems in defining retrospectivity. In his analysis Dr Charles Sampford asserts that the definitive argument against retrospective rule-making is the expectation of individuals that, if their actions today are considered by a future court, the applicable law was discoverable at the time the action was performed. The book goes on to suggest that although the strength of this ’rule of law’ argument should prevail in general, exceptions are sometimes necessary, and that there may even be occasions when analysis of the rule of law may provide the foundation for the application of retrospective laws. (shrink)

AbstractBackgroundEthical challenges constitute an inseparable part of daily decision-making processes in all areas of healthcare. In prehospital emergency medicine, decision-making commonly takes place in everyday life, under time pressure, with limited information about a patient and with few possibilities of consultation with colleagues. This paper explores the ethical challenges experienced by prehospital emergency personnel. MethodsThe study was grounded in the tradition of action research related to interventions in health care. Ethical challenges were explored in three focus groups, each attended by (...) emergency medical technicians, paramedics, and prehospital anaesthesiologists. The participants, 15 in total, were recruited through an internal information network of the emergency services. Focus groups were audio-recorded and transcribed verbatim.ResultsThe participants described ethical challenges arising when clinical guidelines, legal requirements, and clinicians’ professional and personal value systems conflicted and complicated decision-making processes. The challenges centred around treatment at the end of life, intoxicated and non-compliant patients, children as patients—and their guardians, and the collaboration with relatives in various capacities. Other challenges concerned guarding the safety of oneself, colleagues and bystanders, prioritising scarce resources, and staying loyal to colleagues with different value systems. Finally, challenges arose when summoned to situations where other professionals had failed to make a decision or take action when attending to patients whose legitimate needs were not met by the appropriate medical or social services, and when working alongside representatives of authorities with different roles, responsibilities and tasks.ConclusionFrom the perspective of the prehospital emergency personnel, ethical challenges arise in three interrelated contexts: when caring for patients, in the prehospital emergency unit, and during external collaboration. Value conflicts may be identified within these contexts as well as across them. A proposed model of analysis integrating the above contexts can assist in shedding light on ethical challenges and value conflicts in other health care settings. The model emphasises that ethical challenges are experienced from a particular professional perspective, in the context of the task at hand, and in a particular, the organisational setting that includes work schedules, medical guidelines, legal requirements, as well as professional and personal value systems. (shrink)

Stress in health care is affected by moral factors. When people are prevented from doing ‘good’ they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations (...) and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach’s alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: ‘internal demands’ and ‘external demands and restrictions’. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts. (shrink)

When a chimpanzee stockpiles rocks as weapons or when a frog sends out mating calls, we might easily assume these animals know their own motivations--that they use the same psychological mechanisms that we do. But as Beyond the Brain indicates, this is a dangerous assumption because animals have different evolutionary trajectories, ecological niches, and physical attributes. How do these differences influence animal thinking and behavior? Removing our human-centered spectacles, Louise Barrett investigates the mind and brain and offers an alternative (...) approach for understanding animal and human cognition. Drawing on examples from animal behavior, comparative psychology, robotics, artificial life, developmental psychology, and cognitive science, Barrett provides remarkable new insights into how animals and humans depend on their bodies and environment--not just their brains--to behave intelligently. Barrett begins with an overview of human cognitive adaptations and how these color our views of other species, brains, and minds. Considering when it is worth having a big brain--or indeed having a brain at all--she investigates exactly what brains are good at. Showing that the brain's evolutionary function guides action in the world, she looks at how physical structure contributes to cognitive processes, and she demonstrates how these processes employ materials and resources in specific environments. Arguing that thinking and behavior constitute a property of the whole organism, not just the brain, Beyond the Brain illustrates how the body, brain, and cognition are tied to the wider world. (shrink)

Although Gramsci's notions of hegemony and subalternity may seem outdated in this 21st century, a critical examination of the literature shows that these concepts apply in this global pandemic and political context. Racialization is a form of structural violence. In this paper, I also explore Gramsci's’ notion of engaged intellectuals to support the idea of social and political activism in nursing. Nurse scholars call for the decolonization of the discipline. Gramsci's philosophical approach to hegemony can be extended to racialization in (...) nursing. Gramsci's notions of civil society and state can help nurses to see the structures that create racism in nursing and society. (shrink)

For decades, aged care facility residents at risk of pressure ulcers (PUs) have been repositioned at two-hour intervals, twenty-four-hours-a-day, seven-days-a-week (24/7). Yet, PUs still develop. We used a cross-sectional survey of eighty randomly selected medical records of residents aged ≥ 65 years from eight Australian Residential Aged Care Facilities (RACFs) to determine the number of residents at risk of PUs, the use of two-hourly repositioning, and the presence of PUs in the last week of life. Despite 91 per cent (73/80) (...) of residents identified as being at risk of PUs and repositioned two-hourly 24/7, 34 per cent (25/73) died with one or more PUs. Behaviours of concern were noted in 72 per cent (58/80) of residents of whom 38 per cent (22/58) were restrained. Dementia was diagnosed in 70 per cent (56/80) of residents. The prevalence of behaviours of concern displayed by residents with dementia was significantly greater than by residents without dementia (82 per cent v 50 per cent, p = 0.028). The rate of restraining residents with dementia was similar to the rate in residents without dementia. Two-hourly repositioning failed to prevent PUs in a third of at-risk residents and may breach the rights of all residents who were repositioned two-hourly. Repositioning and restraining may be unlawful. Rather than only repositioning residents two-hourly, we recommend every resident be provided with an alternating pressure air mattress. (shrink)

Through its social and political activism goals, postcolonial feminist theoretical approaches not only focus on individual issues that affect health but encompass the examination of the complex interplay between neocolonialism, neoliberalism, and globalization, in mediating the health of non-Western immigrants and refugees. Postcolonial feminism holds the promise to influence nursing research and practice in the 21st century where health remains a goal to achieve and a commitment for humanity. This is especially relevant for nurses, who act as global citizens and (...) as voices for the voiceless. The commitment of nursing to social justice must be further strengthened by relying on postcolonial theories to address issues of health inequities that arise from marginalization and racialization. In using postcolonial feminist theories, nurse researchers locate the inquiry process within a Gramscian philosophy of praxis that represents knowledge in action. (shrink)

Canadian and international nursing educators are increasingly concerned with the quality of university nursing education. Contemporary nursing education is fraught by a growing anti‐intellectualism coupled with the dominance of neoliberalism and corporate university business culture. Amid these challenges, nursing schools must prepare nurses to provide care in an era compounded by social and health inequities. The purpose of this paper was to explore the philosophical and contextual factors influencing anti‐intellectualism in nursing education. We use John Henry Newman's view of the (...) purpose of a university education as a heuristic perspective to examine anti‐intellectualism in nursing. We contend that the ideological worship of technological advances, a culture of consumerism, quality improvement and risk management, the primacy of doing over thinking, competency‐based curricula and business models rooted in neoliberal financial policies reinforce anti‐intellectualism in nursing. Anti‐intellectualism is a complex issue to address within the corporate university culture. We propose multiple strategies at the disciplinary, university and sociopolitical levels to decrease anti‐intellectualism. Counteracting anti‐intellectualism requires critical thinking, praxis and emancipation. Nurses should critically examine this anti‐intellectual trend as it limits the advancement of the discipline and marginalizes its contributions within the academy. If nurses do not address this challenge, the survival of nursing as an academic discipline may be jeopardized. (shrink)

This paper explores the nature of trust in nurse–patient relationships from the perspective of the patient's trust in the nurse and what might be said to then render such a relationship trustworthy, from the patient's point of view. The paper commences with a general examination of the nature of trust, followed by consideration of the nature of professional–patient relationships in healthcare, with emphasis on nurse– patient relationships in particular. The nature of this relationship is used to provide grounds for arguing, (...) both morally and conceptually, that the nature of patients’ trust in those who nurse them is generally such that for the nurse to respond in a trustworthy way, she must care about her patients, not just for them. In arriving at this conclusion, the paper deliberately restricts its focus to nurse–patient encounters where patients are adults and a relationship, as opposed to a brief engagement between two people, can be said to have taken place. The context for this focus is public sector health care in the United Kingdom. In the text, gendered pronouns referring to doctors, nurses and patients are meant to be inclusive of both sexes. (shrink)

Whatever the answer to Molyneux's question is, it is certainly not obvious that the answer is ‘yes’. In contrast, it seems clear that we should answer affirmatively a temporal variation on Molyneux's question, introduced by Gareth Evans. I offer a phenomenological explanation of this asymmetry in our responses to the two questions. This explanation appeals to the modality-specific spatial structure of perceptual experience and its amodal temporal structure. On this explanation, there are differences in the perception of spatial properties in (...) different modalities, but these differences do not stand in the way of the objectivity of perceptual experience. (shrink)

Using multisource data and multilevel analysis, we propose that the ethical stance of supervisors influences subordinates’ perceptions of corporate social responsibility which in turn influences subordinates’ trust in the organization resulting in their taking increased personal social responsibility and engagement in organizational citizenship behaviors oriented toward both the organization and other individuals. Using a multilevel model, we assessed the extent to which ethical leadership and CSR at the work unit level impacts subordinates’ behaviors mediated by organizational trust at the individual (...) level. We employed a sample of 71 work unit supervisors and 308 subordinates from five businesses of a conglomerate company located in mainland China. Subordinates were asked to rate supervisory ethical leadership practices, CSR, and their extent of organizational trust. Supervisors were asked to rate the personal social responsibility taking and OCB of their respective subordinates. A multilevel path analysis revealed that ethical leadership has a positive effect on CSR at the work unit level and that CSR has a positive cross-level effect on organizational trust at the individual level, which in turn significantly and positively impacts OCB through the mediating effect of taking personal social responsibility. Results are discussed in the context of China’s manufacturing sector. (shrink)

Shaun Gallagher applies enactivist thinking to a staggeringly wide range of topics in philosophy of mind and cognitive science, even venturing into the realms of biological anthropology. One prominent point Gallagher makes that the holistic approach of enactivism makes it less amenable to scientific investigation than the cognitivist framework it seeks to replace, and should be seen as a “philosophy of nature” rather than a scientific research program. Gallagher also gives truth to the saying that “if you want new ideas, (...) read old books”, showing how the insights of the American pragmatists, particularly Dewey and Mead, offer a variety of resources and tools that can be brought to bear on modern day enactivism. Here, I suggest that the adoption of enactivist thinking would undermine the assumptions of certain scientific positions, requiring their abandonment, rather than simply making it more difficult to conduct research within an enactivist framework. I then discuss how Mead’s work has been used previously as a “pragmatist intervention” to help resolve problems in a related 4E endeavour, Gibson’s ecological psychology, and make a case for the inclusion of radical behaviorism as another pragmatist resource for 4E cognition. I conclude with a plea for further enactivist intervention in studies of comparative cognition. (shrink)

Abstract: In this paper I offer an account of a particular variety of perception of absence, namely, visual perception of empty space. In so doing, I aim to make explicit the role that seeing empty space has, implicitly, in Mike Martin's account of the visual field. I suggest we should make sense of the claim that vision has a field—in Martin's sense—in terms of our being aware of its limitations or boundaries. I argue that the limits of the visual field (...) are our own sensory limitations, and that we are aware of them as such. Seeing empty space, I argue, involves a structural feature of experience that constitutes our awareness of our visual sensory limitations, and thus, in virtue of which vision has a field. (shrink)

RACINE L and PERRON A. Nursing Inquiry 2012; 19: 190–201 Unmasking the predicament of cultural voyeurism: a postcolonial analysis of international nursing placementsThe growing interest in international nursing placements cannot be left unnoticed. After 11 years into this twenty‐first century, violations of human rights and freedom of speech, environmental disasters, and armed conflicts still create dire living conditions for men and women around the world. Nurses have an ethical duty to address issues of social justice and global health as a (...) means to fulfil nursing’s social mandate. However, international placements raise some concerns. Drawing on the works of postcolonial theorists in nursing and social sciences, we examine the risk of replicating colonialist practices and discourses of health in international clinical placements. Referring to Bakhtin’s notions of dialogism and unfinalizability, we envision a culturally safe nursing practice arising from dialogical encounters between the Self as an Other and with the Other as an Other. We suggest that exploring the intricacies of cultural and race relations in everyday nursing practice are the premises upon which nurses can understand the broader historic, racial, gendered, political and economic contexts of global health issues. Finally, we make suggestions for developing culturally safe learning opportunities at the international level without minimizing the impact of dialogical cultural encounters occurring at the local and community levels. (shrink)

BackgroundDealing with end of life is challenging for patients and health professionals alike. The situation becomes even more challenging when a patient requests a legally permitted medical service that a health professional is unable to provide due to a conflict of conscience. Such a scenario arises when Victorian health professionals, with a conscientious objection (CO) to voluntary assisted dying (VAD), are presented with patients who request VAD or merely ask about VAD. The Voluntary Assisted Dying Act 2017 (Vic) recognizes the (...) inherent conflict of conscience that may arise for some health professionals when asked to provide VAD and responds by affording broad protection to conscientious objectors who wish to refuse to take part in the VAD process.MethodsSeventeen semi-structured qualitative interviews were conducted with Victorian health professionals with a self-identified CO to VAD in the lead-up to the implementation of VAD in Victoria. Interviews explored how participants anticipated they would manage their CO in practice. Interviews were transcribed verbatim and analyzed thematically.ResultsOur results reveal that the way in which health professionals claimed they would approach CO conversations is variable and was dependant on the strength of their opposition to VAD. We categorized conscientious objectors according to their approach as either dissuasive non-referrers, passive non-referrers, facilitators or negotiators. Our study also explores the perceived difficulties of exercising one’s CO as identified by our participants.ConclusionThe broad protection offered by the Voluntary Assisted Dying Act 2017 (Vic) encourages a range of behaviors from conscientious objectors, due to the minimal obligations imposed. In order to assist conscientious objectors, more policy, institutional guidance, and education needs to be available to conscientious objectors explicitly addressing how to effectively manage one’s CO. Such guidance is imperative to ensuring that their moral integrity is preserved and that they are exercising their CO appropriately. (shrink)

We argue that claims of racial progress rest upon untenable teleological assumptions founded in Enlightenment discourse. We examine the theoretical and methodological focus on progress and its historical roots. We argue research should examine the concrete mechanisms that produce racial stability and change, and we offer three alternative frameworks for interpreting longitudinal racial data and phenomena. The first sees racism as a “fundamental cause,” arguing that race remains a “master category” of social differentiation. The second builds on Glenn’s “settler colonialism (...) as structure” framework to describe race relations as a mutually constituted and place-based system of resource allocation. The third framework draws attention to racialized agency. (shrink)

Discussions of what minds are and what they do is a contentious issue. This is particularly so when considering non‐human animals, for here the questions become: do they have minds at all? And if so, what kinds of minds are they? Alternatives to Cartesian or computational models of mind open up a whole new space of possibility for how we should conceive of animal minds, while also highlighting how Skinner's pragmatist‐inspired radical behaviourism has much more to offer than most researchers (...) in animal cognition would like to admit. Pragmatism, or ‘American Naturalism' is also highlighted by Chemero as the alternative for human cognition. The challenge, then, is to build an understanding of mind along pragmatist lines in a way that does justice to both human and non‐human animals. A clear understanding of embodiment, and commitment to a radical form of enactivism, can, perhaps, begin to generate a better kind of continuity. (shrink)

The Social Intelligence or Social Brain Hypothesis is an influential theory that aims to explain the evolution of brain size and cognitive complexity among the primates. This has shaped work in both primate behavioural ecology and comparative psychology in deep and far-reaching ways. Yet, it not only perpetuates many of the conceptual confusions that have plagued psychology since its inception, but amplifies them, generating an overly intellectual view of what it means to be a competent and successful social primate. Here, (...) I present an analysis of the Social Intelligence/Brain hypothesis highlighting how its anthropocentric origins have led us to be held captive by a picture of what social life involves and the kind of mind needed to navigate the social landscape. I go on to consider how experimental work in this vein either does not test what it claims to be testing, or introduces impossible problems regarding animal minds that cannot be solved, but only dissolved. What we need, in other words, is the application of “Wittgenstein's razor” and the reinvention of primatology along his enactivist lines. (shrink)

The way in which educators choose to engage with learners and to offer opportunities to share knowledge of both the physical world and the world of ideas is an ongoing area of international research interest but remains diffuse and difficult to systematise. This idiosyncratic quality underscores the privileged position of teachers as creative professionals. By exploring Claude Lévi-Strauss’s conception of how and for what purpose we share knowledge within society, this paper explores the relationship between perceptions of teachers’ professional role (...) and the challenges they face working within formal education systems. The artisan quality of teachers’ practice, gained through experience, association and personal commitment, makes possible a visualisation of teacher professionalism as bricolage that, when read alongside theories of teacher agency, generates an affirmative picture of how teacher professionalism may be reframed as creative and responsive rather than homogenous and mechanistic. (shrink)

Presents a set-theoretic version of the analysis of "there be" as predicating instantiation of a property, a property-theoretic version of which was developed in McNally 1992. This paper provides a solution to the criticism that McNally 1992's analysis could not account for sentences in which postverbal nominal contains a monotone decreasing or nonmonotonic determiner.

‘Vulnerability’ is a key concept used to understand the ethical implications of conducting refugee-focused research. This case study illustrates the need to follow Luna’s call for a shift fr...

Objective: Illness perceptions are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors and examine the impacts of IP on perceived stress and preventive behaviors.Methods: This was a time-series-cross-section study of 7,032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed (...) considering the date of participation and the date recoded to account the epidemiological evolution of each country. The outcomes considered were perceived stress and COVID-19 preventive behaviors.Results: There were significant trends, over time, for several IP, suggesting a small decrease in negativity in the perception of COVID-19 in the community. Age, gender, and education level related to some, but not all, IP. Considering the self-regulation model, perceptions consistently predicted general stress and were less consistently related to preventive behaviors. Country showed no effect in the predictive model, suggesting that national differences may have little relevance for IP, in this context.Conclusion: The present study provides a comprehensive picture of COVID-19 IP in Europe in an early stage of the pandemic. The results shed light on the process of IP formation with implications for health-related outcomes and their evolution. (shrink)

L’article porte sur un mouchoir décoré par des femmes de l’Armée Républicaine Irlandaise (IRA) pendant leur incarcération à la prison d’Armagh, en 1976. Il s’intéresse aux aspects concrets d’un objet genré et politisé. En effet, le tracé, le remplissage à la couleur, la signature et l’échange de ce tissu prennent place à la fin de la première phase du conflit en Irlande du Nord caractérisée par les emprisonnements politiques. Dans les années 1970, les prisonniers républicains adaptent une activité féminine, la (...) broderie. Illustrant cette pratique, le mouchoir d’Armagh passe pour un exemple de tissu, certes hétérogène et marqué d’emprunts, mais qui conserve ses qualités liées au genre. Cet article s’intéresse donc aussi à la signification même du tissu. (shrink)