Pupillary responses and associated vergence eye movements were monitored during imagery of objects of differing sizes (“large” or “small”) from varying distances (“near” or “far”). Objects’ imagined size and distance affected oculomotor behavior. Objects visualized as “far” resulted in the larger pupil dilations and smaller visual angle, while small objects imagined “near” were associated with smaller pupils in contrast to relatively larger pupils when imagined as “far” away. Furthermore, near objects resulted in larger visual angle, and particularly, vergence adjustments were (...) observed that were dependent on imagined size and distance of the small objects. The findings are consistent with the idea that imagery emulates perception, also at the embodied level of oculomotor behaviors. (shrink)

This article is intended to raise the question of whether sacrifice can be regarded as constituting a deep ethical structure in the relationship between patient and carer. The significance of sacrifice in a patient-carer relationship cannot, however, be fully understood from the standpoint of the consistently utilitarian ethic that characterizes today’s ethical discourse. Deontological ethics, with its universal principles, also does not provide a suitable point of departure. Ethical recommendations and codices are important and can serve as general sources of (...) knowledge when making decisions, but they should be supplemented by an ethic that takes into consideration contextual and situational factors that make every encounter between patient and carer unique. Caring science research literature presents, on the whole, general agreement on the importance of responsibility and devotion with regard to sense of duty, warmth and genuine engagement in caring. That sacrifice may also constitute an important ethical element in the patient-carer relationship is, however, a contradictory and little considered theme. Caring science literature that deals with sacrifice/self-sacrifice indicates contradictory import. It is nevertheless interesting to notice that both the negative and the positive aspects bring out the importance of the concept for the professional character of caring. The tradition of ideas in medieval Christian mysticism with reference to Lévinas’ ethic of responsibility offers a deeper perspective in which the meaningfulness of sacrifice in the caring relationship can be sought. The theme of sacrifice is not of interest merely as a carer’s ethical outlook, but sacrifice can also be understood as a potential process of transformation towards health. The instinctive or conscious experience of sacrifice on the part of the individual patient can, on a symbolic level, be regarded as analogous to the cultic or religious sacrifice aiming at atonement. Sacrifice appears to the patient as an act of transformation to achieve atonement and healing. Atonement then implies finding meaningfulness in one’s suffering. The concept of sacrifice, understood in a novel way, opens up a deeper dimension in the understanding of suffering and makes caring in ‘the patient’s world’ possible. (shrink)

This article explores the duality of law with regard to the LGBTQ+ community, examining both its historical regulation of non-heteronormative genders and sexualities and its contradictory potential to transcend such regulations over time. Situated within a postcolonial analytical framework, it undertakes a thematic overview and narrative appraisal of research materials, drawn from a diverse array of social science disciplinary intersections, spanning the timeline from 1990 to 2022, that expounds on the intricate and overlapping imbrications between law and the LGBTQ+ community (...) in India. It was observed that the extant academic deliberations on the subject are dispersed across disciplinary boundaries within the larger scope of humanities and social sciences, necessitating an integrative approach. By delving into the historical antecedents of the subject matter, the current findings are situated within four domains, namely: i) the colonial nexus; ii) the postcolonial public redress; and iii) other domains of sustained legal contestation, such as healthcare, workplace, media censorship, and the fraught terrain of identity and legal lexicon. (shrink)

Psychopathology in children cannot be understood without considering developmental processes and transactional relationships, particularly the relationship with caregivers. Time-limited intersubjective child psychotherapy is a developmental and transactional approach aimed at helping children and caregivers get back on healthier developmental trajectories. Core developmental processes, such as self-other-regulation and affect integration, are considered particularly important for healthy function and transactions with caregivers and contexts. Therefore, TIC seeks to strengthen core developmental processes in the child and the caregivers’ ability to scaffold the child’s (...) development. This is achieved through parallel child therapy and parent sessions. The current study is a qualitative study of parents’ experiences of change after TIC. The study explores parents’ perception of change in their child, themselves, and their transactions, and what they experienced as helpful in therapy.Materials and MethodsNine semi-structured qualitative interviews were conducted with parents of nine children aged 9–12 years with internalizing difficulties after completing TIC. The data were analyzed with thematic analysis.ResultsThe parents described positive changes in the children’s ability to understand, regulate and express themselves. The parents also described positive changes in their parenting, and for all nine children the parents reported positive changes in the transactions between themselves and the child. Most parents saw the parallel child and parental sessions as particularly important, while several parents mentioned play and the therapeutic focus.DiscussionParents’ description of changes after TIC indicate that the parents perceived their children as strengthened in core developmental processes important for intersubjective exchanges such as self-regulation and affect integration. In addition, parents saw their children and their own contributions more clearly, and their transactions were described as more supportive and positive.ConclusionThe results from this study give support to TIC as a developmentally supportive approach to therapy, with potential effects on children’s core developmental processes, their parents’ ability to both see and scaffold the child’s development and positive effects on the transactions between children and parents. The positive effects likely result from the integration of the different parts of TIC and the synergies taking place between them, rather than any one component by itself. (shrink)

When people are asked to estimate the probabilities of uncertain events, they often neglect the additivity principle, which requires that the probabilities assigned to an exhaustive set of outcomes should add up to 100%. Previous studies indicate that additivity neglect is dependent on response format, self-generated probability estimates being more coherent than estimates on rating scales. The present study made use of eye-tracking methodology, recording the movement, frequency and duration of fixations during the solution of ten additivity problems and two (...) control tasks. Participants produced more non-additive estimates in the Scale format than in the Self-generated format. Self-generated estimates also led to longer decision time and a higher number of repeated inspections, suggesting a deliberate comparison process. In contrast, the Scale format seemed to encourage a case-based approach where each outcome is evaluated in isolation. (shrink)

The lack of consistency between people’s engagement in ethical issues and their food choices has received considerable attention. Consumption as “choice” dominates this discourse, understood as decision-making at the point of purchase. But ideas concentrating on individual choice are problematic when trying to understand how social and ethical issues emerge and are dealt with in the practices of buying and eating food. I argue in this paper that “consumer choice” is better understood as a political ideology addressing a particular way (...) in which everyday practices can be directed so as to solve social problems. It is a way that makes questions of power particularly challenging. Some assume consumer sovereignty, emphasizing consumer choice as a reflection of neoliberal deregulation and commercialization. Others worry that ongoing changes increase consumers’ powerlessness. None of these seem to capture that there is active regulation, where public as well as commercial and civil actors are making strong efforts to make people do the right thing—voluntarily. Labeling is the key measure. In practice, the individualized and rationalized model of responsibility depends not only on market opportunities, but even political and social expectations and trust. People may lack concrete capabilities and power to follow up on moral calls, but they may also have a different understanding of who is responsible and what is a “good deed,” or their actions may, in a Foucauldian sense, represent resistance. The paper will, with examples from European empirical studies, discuss how mobilization as well as inertia and disinterest emerge within specific political constellations and practical contexts. (shrink)

This study presents findings from an ontological and contextual determination of the concept of dignity. The study had a caritative and caring science perspective and a hermeneutical design. The aim of this study was to increase caring science knowledge of dignity and to gain a determination of dignity as a concept. Eriksson’s model for conceptual determination is made up of five part-studies. The ontological and contextual determination indicates that dignity can be understood as absolute dignity, the spiritual dimension characterized by (...) responsibility, freedom, duty, and service, and relative dignity, characterized by the bodily, external aesthetic dimension and the psychical, inner ethical dimension. Dignity exists in human beings both as absolute and relative dignity. (shrink)

Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these choices, scholars and policy makers have done extensive work on criteria to assess the substantive fairness of health financing policies: their impact on the distribution of rights, duties, benefits and burdens on the path towards UHC. However, less attention has been paid to the procedural fairness of health financing decisions. The Accountability for Reasonableness Framework (A4R), which (...) is widely applied to assess procedural fairness, has primarily been used in priority-setting for purchasing decisions, with revenue mobilization and pooling receiving limited attention. Furthermore, the sufficiency of the A4R framework’s four criteria (publicity, relevance, revisions and appeals, and enforcement) has been questioned. Moreover, research in political theory and public administration (including deliberative democracy), public finance, environmental management, psychology, and health financing has examined the key features of procedural fairness, but these insights have not been synthesized into a comprehensive set of criteria for fair decision-making processes in health financing. A systematic study of how these criteria have been applied in decision-making situations related to health financing and in other areas is also lacking. This paper addresses these gaps through a scoping review. It argues that the literature across many disciplines can be synthesized into 10 core criteria with common philosophical foundations. These go beyond A4R and encompass equality, impartiality, consistency over time, reason-giving, transparency, accuracy of information, participation, inclusiveness, revisability and enforcement. These criteria can be used to evaluate and guide decision-making processes for financing UHC across different country income levels and health financing arrangements. The review also presents examples of how these criteria have been applied to decisions in health financing and other sectors. (shrink)

This World Bank Report offers a new conception of fair decision processes in health financing. It argues that such procedural fairness can contribute to fairer outcomes, strengthen the legitimacy of decision processes, build trust in authorities, and promote the sustainability of reforms on the path to health coverage for all.

In this article, we present findings from a qualitative study examining how young women experience being long‐term bedridden with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), during childhood and adolescence. The aim is to explore how young women who fell ill with ME/CFS during childhood and adolescence look back on their lived experience of being long‐term bedridden from the vantage point of being fully or partially recovered. Informed by a phenomenological theoretical perspective, the researchers applied a narrative (...) methodological approach involving the analysis of interviews with 13 women, aged 16–29 years at the time of the interview. Attention was particularly paid to how participants structured their narratives and to the events (telling moments) they identified as important. Four major storylines were developed: Ambivalent responses to the presence of others; A body on the edge of life; An eternity in the dark; and Recasting painful memories of being bedridden and alone. Based on our findings, we argue that the experience of being long‐term bedridden with ME/CFS during childhood and adolescence can be understood and communicated as a plot in which individuals find themselves pushed to the extreme limit of suffering and loneliness. (shrink)

Hermeneutics and narration: a way to deal with qualitative data This article focuses a hermeneutic approach on the interpretation of narratives. It is based on the French philosopher Paul Ricoeur's theory of interpretation but modified and used within a caring science paradigm. The article begins with a presentation of the theoretical underpinnings of hermeneutic philosophy and narration, as well as Ricoeur's theory of interpretation, before going on to describe the interpretation process as modified by the authors. The interpretation process, which (...) consists of several stages, is exemplified and discussed using a single case from a larger study on suffering. The results of that study indicate that the struggle of suffering is perceived as a struggle formed between shame and dignity, and that nurses must engage in the process of preserving and restoring the dignity of their suffering patients. The authors suggest that Ricoeur's theory of interpretation is useful when trying to understand narrative data if the researcher realises that the process of distanciation, although central in Ricoeur's thinking, is not the goal of the process but rather a means to deal with the researcher's pre‐understandings. According to Ricoeur, distanciation is accomplished by putting the context aside and dealing with the text ‘as text’ and thereby explaining its meaning. Explanation thus becomes the dialectic counterpart to understanding in the interpretation process. The researchers further argue that distanciation must be followed by reflection, where the interpretations are linked back to the empirical context. (shrink)

In 2017, Ukraine’s Parliament passed legislation establishing a single health benefit package for the entire population called the Programme of Medical Guarantees,‎ financed through general taxes and administered by a single national purchasing agency. This legislation was in line with key principles for financing universal health coverage. However, health professionals and some policymakers have been critical of elements of the reform, including its reliance on general taxes as the source of funding. Using qualitative methods and drawing on deliberative democratic theory (...) and criteria for procedural fairness, this study argues that the acceptance and sustainability of these reforms could have been strengthened by making the decision-making process fairer. It suggests that three factors limited the extent of stakeholders’ participation in this process: first, a perception among reformers that fast-paced decision-making was required because there was only a short political window for much needed reforms; second, a lack of trust among reformers in the motives, representativeness, and knowledge of some stakeholders; and third, an under-appreciation of the importance of dialogic engagement with the public. These findings highlight a profound challenge for policymakers. In retrospect, some of those involved in the reform’s design and implementation believe that a more meaningful engagement with the public and stakeholders who opposed the reform might have strengthened its legitimacy and durability. At the same time, the study shows how difficult it is to have an inclusive process in settings where some actors may be driven by unconstrained self-interest or lack the capacity to be representative or knowledgeable interlocutors. It suggests that investments in deliberative capital (the attitudes and behaviours that facilitate good deliberation) and in civil society capacity may help overcome this difficulty. (shrink)

Paul Ricoeur's hermeneutic phenomenology has proved to be very helpful in guiding nursing researchers’ qualitative analysis of interview transcripts. Modifying Ricoeur's philosophy, a number of nursing researchers have developed their own interpretive methods and shared them, along with their experience, with research community. Major contributors who published papers directly presenting their modifications of Ricoeur's theory include Rene Geanellos (2000), Lena Wiklund, Lisbet Lindholm and Unni Å. Lindström (2002), Anders Lindseth and Astrid Norberg (2004) and Pia Sander Dreyer and Birthe (...) D Pedersen (2009). The aim of this article was to delineate differences among these methods. Descriptive presentation of each method side by side makes clear the differences among them. In addition, Ricoeur's hermeneutic theory is portrayed and compared with the modifications. It is believed that differences that are found can stimulate further thoughts on how to apply Ricoeur's theory in qualitative research in nursing. (shrink)