Historians of medicine generally credit the hospital standardization movement of the early 20th century with establishing the record as a sign of hospital and staff quality. The medical record's role had already been the subject of intense interest at the New York Hospital several decades before, however. In the 1880s malpractice and insurance concerns caused the administration to attempt to supervise record creation, quality, and access, over the objections of physicians. Contemporary concerns about the uses of the medical record were (...) in play well before 1910. (shrink)

Medical records contain important clues about the history of medicine. These documents, which ostensibly describe the course of a patient's illness, are “unique constructions that allow us to observe the social and technical structure of contemporary healing.” As such, the 21st-century hospital medical record reflects the many components of inpatient care: medical interventions, billing, legal documentation, research, and education. It is comprised of a wide array of elements: professionals' notes; vital signs and other descriptive information; laboratory data and test results; (...) demographic information; orders, charges, diagnostic and treatment codes; and other utilization data. It is well understood that many people share and need this information. Current controversies over records involve not control, but computerization, security, and accessibility. Although health professionals offer input, decisions about hospital medical records have been considered largely an administrative responsibility. (shrink)

Includes bibliographical references and index.

When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (n (...) = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p. (shrink)

Experiential evidence shows that pain is associated with common meanings. These include a meaning of threat or danger, which is experienced as immediately distressing or unpleasant; cognitive meanings, which are focused on the long-term consequences of having chronic pain; and existential meanings such as hopelessness, which are more about the person with chronic pain than the pain itself. This interdisciplinary book - the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk - aims to better (...) understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them. The lived experiences of pain described here involve various types of chronic pain, including spinal pain, labour pain, rheumatic pain, diabetic peripheral neuropathic pain, fibromyalgia, complex regional pain syndrome, endometriosis-associated pain, and cancer-related pain. Two chapters provide narrative descriptions of pain, recounted and interpreted by people with pain. Language is important to understanding the meaning of pain since it is the primary tool human beings use to manipulate meaning. As discussed in the book, linguistic meaning may hold clues to understanding some pain-related experiences, including the stigmatisation of people with pain, the dynamics of patient-clinician communication, and other issues, such as relationships between pain, public policy and the law, and attempts to develop a taxonomy of pain that is meaningful for patients. Clinical implications are described in each chapter. This book is intended for people with pain, their family members or caregivers, clinicians, researchers, advocates, and policy makers. (shrink)

RésuméLes propriétés dynamiques de l'amitié requièrent parfois que les amis réévaluent leur relation à la lumière de raisons de réciprocité ou de considérations morales. Les amis maintiennent leur relation en partie en évaluant leurs rapports de réciprocité. Ils doivent aussi considérer parfois l'impact de raisons morales sur leur amidé; il leur faut résoudre d'occasionnelles tensions entre les exigences de l'amitié et certaines considérations rivales d'ordre moral, et ils doivent agir parfois comme surveillants l'un pour l'autre dans l'ordre moral. Je discute (...) ici la façon dont les amis peuvent gérer leur relation sans compromettre la confiance et le respect mutuels qui sont appropriés entre amis. (shrink)

Whether Social Media Companies (hereafter, SMCs) such as Twitter and Facebook limit speech is an empirical question. No one disputes that they do. Whether they “censor” speech is a conceptual question, the answer to which is a matter of dispute. Whether they may do so is a moral question, also a matter of dispute. We address both of these latter questions and hope to illuminate whether it is morally permissible for SMCs to restrict speech on their platforms. This could be (...) part of a larger argument, when we do not explicitly offer here, that states ought not to forbid SMCs from censoring. We do not focus on legal statutes or precedent. We argue that nonstate actors can (as a conceptual matter) and may (as a moral matter) impede the freedoms of others to express themselves. That is, barring rare emergencies, nonstate actors may censor individuals even when states may not. (shrink)

The purpose of this study was to investigate the ways novice social studies teachers perceived difficult discourses in their classrooms. Specifically, we sought to understand what social studies teachers think is difficult about navigating political discourses, and how they describe the nature of those discourses in order to draw conclusions about why some teachers choose to avoid or engage in political or social issues discussions with students. We used a collective case study and a grounded theory analysis of video recorded (...) class sessions and video guided debriefings with teachers to explore this phenomena. We found that the degree to which teachers thought the discourse to be difficult to navigate was shaped by: emotional safety of students, teacher's own ideologies, and the distances of students’ identities from the discourse. (shrink)

Ethics has been identified as an important factor that potentially affects auditors’ professional skepticism. For example, prior research finds that auditors who are more concerned with professional ethics exhibit greater professional skepticism. Further, the literature suggests that professional skepticism may lead the auditor to more vigilantly resist the client’s position in financial reporting disputes. These reporting disputes are generally resolved through negotiations between the auditor and client to arrive at the final reported amounts. To date, the role that professional skepticism (...) potentially plays in the negotiation process has been relatively unexplored. The literature prior to the enactment of Sarbanes–Oxley (SOX) suggests that auditors are more likely to approve a client position when the matter in dispute is relatively ambiguous and when changing the client’s position will result in the client failing to meet analysts’ expectations. However, changes resulting from SOX have led auditors to be more vigilant and therefore results found in the pre-SOX environment may not hold in the current environment where auditors are held more accountable for their actions. Results from an experiment with experienced audit managers and partners suggest that in the post-SOX climate, auditors’ negotiations do not appear to be substantively influenced by management being able to meet or beat forecasts. Moreover, we find that when auditors exhibit heightened professional skepticism, they are more ethical by being conservative and they stand more resolute than when auditors do not exhibit heightened professional skepticism. Finally, although we do not find a main effect for the influence of earnings forecast, we do find a significant interaction between earnings forecast and heightened professional skepticism. Implications for practice and research are then presented. (shrink)

Maimonides real opinion regarding it. Then, as now, the Aristotelian theory of an eternal material universe seemed more plausible to many people than did the Biblical view of creation exnihilo. While creation is the orthodox view in both Judaism and Christianity, the tension between those two explanatory models goes back a long way. 1 Referring to the heretical views of Elisha ben Abuya, in the early Talmudic period, David Hartman argues as follows.

In the Philosophical Investigations, Wittgenstein is sometimes claimed to hold a redundancy theory of truth. The main evidence to support this view, however, comes from a single passage, number 136, which has been misinterpreted. In this essay I argue for an alternative interpretation of the critical passage in question. The purpose behind Wittgenstein’s remarks is not to provide a general theory of truth, per se. Rather, Wittgenstein uses the section as a way to introduce his notion of fit, a notion (...) that will play a more substantial role in his later arguments on following rules. Furthermore, if Wittgenstein did hold something close to a redundancy theory of truth, such a view would illuminate remarks from the earlier notebooks about a crucial Tractarian view rather than his later view from the Investigations: the so-called “Picture Theory”. (shrink)

Since Durkheim ([1912] 1965), the concept of ritual has held a privileged position in studies of social life because investigators recurrently have treated it as a source of insight into core issues of human sociality, such as the maintenance of social order. Consequently, studies of ritual have typically focused on rituals' function(s), and, specifically, whether ritual begets social integration or fragmentation. In this frame, students of ritual have tended to ignore other, equally fundamental issues, including (1) how actions, or courses (...) of action, constitute a ritual, and (2) whether ritual is best understood as an aspect of all social action or a specific type of it. Drawing on Durkheim's overlooked contemporary, Van Gennep ([1908] 1960), I argue that analyses of ritual must describe how participants enact an occasion as ritual through distinctive activities and sequences of these. Analysts of ritual must attempt to ground the relevance of their descriptions in the participants' demonstrable orientations, an undertaking with more general implications for the study of social action. (shrink)

In metazoans, the extracellular matrix (ECM) provides a dynamic, heterogeneous microenvironment that has important supportive and instructive roles. Although the primary site of action of ECM proteins is extracellular, evidence is emerging for non‐canonical intracellular roles. Examples include osteopontin, thrombospondins, IGF‐binding protein 3 and biglycan, and relate to roles in transcription, cell‐stress responses, autophagy and cancer. These findings pose conceptual problems on how proteins signalled for secretion can be routed to the cytosol or nucleus, or can function in environments with (...) diverse redox, pH and ionic conditions. We review evidence for intracellular locations and functions of ECM proteins, and current knowledge of the mechanisms by which they may enter intracellular compartments. We evaluate the experimental methods that are appropriate to obtain rigorous evidence for intracellular localisation and function. Better insight into this under‐researched topic is needed to decipher the complete spectrum of physiological and pathological roles of ECM proteins. -/- . (shrink)

This book examines the intersection between religious belief, dynastic ambitions, and late Renaissance court culture within the main branches of Germany's most storied ruling house, the Wittelsbach dynasty. Their influence touched many shores from the "coast" of Bohemia to Boston.

Objective: The aim of the current study was to investigate associations, unique and interactive, between mothers’ and children’s histories of childhood sexual abuse (CSA) and children’s psychiatric outcomes using an intergenerational perspective. Further, we were particularly interested in examining whether maternal reflective functioning about their own trauma (T-RF) was associated with lower likelihood of children’s abuse exposure (among children of CSA-exposed mothers). Method: One hundred and eleven children (Mage= 9.53 years; 43 sexual abuse victims) and their mothers (Mage= 37.99; 63 (...) sexual abuse victims) participated in this study. Mothers completed the Parent Development Interview (PDI), which yielded assessments of RF regarding their own experiences of abuse, and also reported on their children’s internalizing and externalizing symptoms. Results: Children of CSA-exposed mothers were more likely to have experienced CSA. A key result was that among CSA-exposed mothers, higher maternal T-RF regarding their own abuse was associated with lower likelihood of child CSA-exposure. Mothers’ and children’s CSA histories predicted children’s internalizing and externalizing symptoms, such that CSA exposure for mother or child was associated with greater symptomatology in children. Conclusions: The findings show that the presence of either maternal or child CSA is associated with more child psychological difficulties. Importantly in terms of identifying potential protective factors, maternal T-RF is associated with lower likelihood of CSA exposure in children of CSA-exposed mothers. We discuss these findings in the context of the need for treatments focusing on increasing Trauma - RF in mothers and children in the context of abuse to facilitate adaptation and reduce the intergenerational risk. (shrink)

Exploring a variety of female superhero narratives, including Wonder Woman comics and television shows like The Secrets of Isis, The Bionic Woman, and Buffy the Vampire Slayer, this book argues that twentieth-century superheroine stories historically depicted education as the path to female liberation and empowerment.

The question of the relationship between mind and body as posed by Descartes, Spinoza, and others remains a fundamental debate for philosophers. In _Damasio’s Error and Descartes’ Truth_, Andrew Gluck constructs a pluralistic response to the work of neurologist Antonio Damasio. Gluck critiques the neutral monistic assertions found in _Descartes’ Error _and _Looking for Spinoza_ from a philosophical perspective, advocating an adaptive theory—physical monism in the natural sciences, dualism in the social sciences, and neutral monism in aesthetics. Gluck’s work (...) is a significant and refreshing take on a historical debate. (shrink)

This article attempts to analyse the ongoing debate regarding open-mindedness as an educational value. The views of Hare, McLaughlin and Gardner are considered. They do not always agree on what open-mindedness is, and the discussion could benefit from a more unified terminology and better counter-examples. The value and limitations of open-mindedness in both science and the humanities are discussed and analysed. It is argued that open-mindedness, while clearly a virtue if not taken to excess, need not be a goal of (...) the educational process. (shrink)

This article attempts to analyse the ongoing debate regarding open-mindedness as an educational value. The views of Hare, McLaughlin and Gardner are considered. They do not always agree on what open-mindedness is, and the discussion could benefit from a more unified terminology and better counter-examples. The value and limitations of open-mindedness in both science and the humanities are discussed and analysed. It is argued that open-mindedness, while clearly a virtue if not taken to excess, need not be a goal of (...) the educational process. (shrink)

This comprehensive and in-depth examination of Aristotle's poetry is focused on his ode for Hermias of Atarneus. The song's relation to earlier poetry is illustrated with unprecedented thoroughness and the remarkable story of its reception is studied in the context of fourth-century politics, religious history, and literary theory.

Do neurosurgical procedures ever result in the patient prior to the procedure not being identical with the individual who wakes up postsurgery in the hospital bed? We address this question by offering an analysis of the persistence of persons that emphasizes narrative, rather than numerical, identity. We argue that a narrative analysis carries the advantage of highlighting what matters to patients in their ordinary lives, explaining the varying degrees of persistence of personal identity, and enhancing our understanding of patients' experiences. (...) We illustrate these points in cases involving temporal lobectomy for treatment of refractory epilepsy and deep brain stimulation for refractory Parkinson's disease. (shrink)