Nurses make an important contribution to the organisation and coordination of patient care but receive little formal educational preparation for this work. This paper builds on Allen's care trajectory management framework to specify evidence‐based and theoretically informed competencies for this component of the nursing role and proposes how these might be incorporated into nursing curricula. This is necessary so that at the point of registration nurses have the expertise to realise their potential as both providers and organisers of patient care (...) and are better able to articulate and develop this aspect of nursing practice. (shrink)

Cross-situational learning is a mechanism for learning the meaning of words across multiple exposures, despite exposure-by-exposure uncertainty as to the word's true meaning. We present experimental evidence showing that humans learn words effectively using cross-situational learning, even at high levels of referential uncertainty. Both overall success rates and the time taken to learn words are affected by the degree of referential uncertainty, with greater referential uncertainty leading to less reliable, slower learning. Words are also learned less successfully and more slowly (...) if they are presented interleaved with occurrences of other words, although this effect is relatively weak. We present additional analyses of participants’ trial-by-trial behavior showing that participants make use of various cross-situational learning strategies, depending on the difficulty of the word-learning task. When referential uncertainty is low, participants generally apply a rigorous eliminative approach to cross-situational learning. When referential uncertainty is high, or exposures to different words are interleaved, participants apply a frequentist approximation to this eliminative approach. We further suggest that these two ways of exploiting cross-situational information reside on a continuum of learning strategies, underpinned by a single simple associative learning mechanism. (shrink)

Humans are experts in cooperating with each other when trying to accomplish tasks they cannot achieve alone. Recent studies of joint action have shown that when performing tasks together people strongly rely on the neurocognitive mechanisms that they also use when performing actions individually, that is, they predict the consequences of their co‐actor’s behavior through internal action simulation. Context‐sensitive action monitoring and action selection processes, however, are relatively underrated but crucial ingredients of joint action. In the present paper, we try (...) to correct the somewhat simplified view on joint action by reviewing recent studies of joint action simulation, monitoring, and selection while emphasizing the intricate interrelationships between these processes. We complement our review by defining the contours of a neurologically plausible computational framework of joint action. (shrink)

The essays in Cultural Pluralism and Moral Knowledge deal with philosophical issues that arise from the existence of a diversity of cultural traditions. The discussions range from broad examinations of the relevance of cultural pluralism to morality, to studies of specific cultural practices. Some essays explore the relationship between pluralism and political theory; some contrast pluralism with relativism or distinguish it from reasonable disagreement. Others propose and defend a set of principles that apply to all societies, forming the foundation of (...) a common moral system. Still others delve into questions of moral psychology, attempting to explain why people hold the values they do. (shrink)

This study aimed to investigate the longitudinal trends in mathematical competencies of Grade 8 students in a public high school located in Zamboanga del Sur, Philippines. The study collected data over a period of six academic years, allowing for a comprehensive analysis of students' performance in 16 distinct mathematical competences of basic education curriculum. These topics include, but are not limited to, special products and factors, factoring, and basic concepts of probability. Using a quantitative research design, the study analyzed both (...) numerical and secondary data to identify patterns or trends in students' mathematical competencies. Trends were analyzed through regression analysis using slopes. The significance of these trends was then evaluated using t-tests for the standard error of slopes. The statistical analysis revealed significant upward trends in certain mathematical topics, indicating an improvement in the students' competencies over the six academic years. However, certain topics displayed downward or stable trends, indicating areas for improvement in the teaching methods used for these topics. The study highlights the importance of flexible and adaptable approaches to mathematics education. It emphasizes the need for constant evaluation and improvement of teaching methods to enhance student learning outcomes. The findings of this study provide valuable insights for educators and policymakers to guide evidence-based decision-making and improve the quality of mathematics education in the new normal setup. Implications and future research directions are incorporated in the study. (shrink)

This text is based on an image that, in some ways, can be understood only in terms of sound. In the lonely darkness of a movie theatre, the audience spends ninety minutes gazing at a single image: that of a rubber dinghy drifting aimlessly on a vast expanse of water.This is the rare challenge posed by German filmmaker Philip Scheffner with his documentary Havarie: viewers are asked to focus on a single image while listening to a variety of sounds – (...) especially the voices of many nameless individuals discussing their own drifting journeys.A few years ago, Scheffner happened “totally by accident” to come across a cellphone video on YouTube lasting three minutes and thirty-six seconds; it was titled simply “refugees”... (shrink)

For a little more than a decade, professional organizations and healthcare institutions have attempted to develop guidelines and policies to deal with seemingly intractable conflicts that arise between clinicians and patients (or their proxies) over appropriate use of aggressive life-sustaining therapies in the face of low expectations of medical benefit. This article suggests that, although such efforts at conflict resolution are commendable on many levels, inadequate attention has been given to their potential negative effects upon particular groups of patients/proxies. Based (...) on the well-documented tendency among many African Americans to prefer more aggressive end-of-life medical interventions, it is proposed that the use of institutional policy to break decision making impasse in cases for which aggressive treatment is deemed "medically inappropriate" will fall disproportionately on that group. Finally, it is suggested that the development and application of institutional conflict-resolution policies should be evaluated in the context of historical and current experiences of marginalization and disempowerment, lest such policies exacerbate that experience. (shrink)

In this collection, twelve philosophers, historians, and political philosophers-scholars with a diverse set of disciplinary and political leanings-assess aspects of socialism in light of its recent reversals. Some of the essays consider what made the socialist project seem compelling to its advocates, examining the moral and political values that made socialism appealing to intellectuals. Others evaluate whether there are aspects of socialism that ought to be preserved, such as its quest for equality and community. Some essays examine whether free-market systems (...) need to be further modified in response to ongoing socialist critiques. Several others argue for the continuing validity of socialism in its social democratic incarnation, suggesting ways in which socialism may still have a productive future. Still others condemn the socialist project as inherently misguided in theory, while also portraying 'really existing socialism' as cataclysmic in practice. (shrink)

A central idea in moral and political philosophy, 'autonomy' is generally understood as some form of self-governance or self-direction. Certain Stoics, modern philosophers such as Spinoza, and most importantly, Immanuel Kant, are among the great philosophers who have offered important insights on the concept. Some theorists analyze autonomy in terms of the self being moved by its higher-order desires. Others argue that autonomy must be understood in terms of acting from reason or from a sense of moral duty independent of (...) the passions. Autonomy seems closely related to the notion of freedom, but in what sense: freedom from coercion, freedom from psychological constraints, or freedom from material necessity? Various approaches to these and similar questions yield different implications for public policy. Is capitalism, social democracy or socialism more favorable to autonomy? The essays in this volume address these important questions. (shrink)

Technological innovations and social developments have led to dramatic changes in the practice of medicine and in the way that scientists conduct medical research. Change has brought beneficial consequences, yet these gains have come at a cost, for many modern medical practices raise troubling ethical questions: Should life be sustained mechanically when the brain's functions have ceased? Should potential parents be permitted to manipulate the genetic characteristics of their embryos? Should society ration medical care to control costs? Should fetal stem (...) cells be experimented upon in an effort to eventually palliate or cure debilitating diseases? Bioethicists analyze and assess moral dilemmas raised by medical research and innovative treatments; they also counsel healthcare practitioners, patients, and their families. In this anthology, fifteen philosophers, social scientists, and academic lawyers assess various aspects of this field. (shrink)

The essays in this volume, first published in 2000, explore questions about democracy that are relevant to political philosophy and political theory. Some essays discuss the appropriate ends of government or examine the difficulties involved in determining and carrying out the will of the people. Some address questions relating to the kinds of influence citizens can or should have over their representatives, asking, for example, whether individuals have a duty to vote, or whether inequalities in political influence among citizens can (...) be morally justified. Other essays analyze democratic institutions, discussing what role deliberation should play in the democratic process, and asking whether it is legitimate to use laws and public policies to express approval or disapproval of various kinds of conduct. Still others examine the relationship between democracy and value pluralism, or consider the suitability of democracy as a form of government in non-Western societies. (shrink)

The Norwegian National Committee for Research Ethics inScience and Technology (NENT), collaborating with The NorwegianFisherman''s Association and The Research Council of Norway,started in 1999 a project aiming at an ethical assessment of Norwegian fisheries for the year 2020. The project was to preparethe ground for ethical debate in and of the fishery sector inview of pending important decisions on long term strategies. Thispaper has its focus on the method used for achieving these aims,rather than the substantive results concerning the fisheries. (...) Amethod was developed for this purpose, called the ethicalscenario process. This included the construction of scenarios forthe future of Norwegian fisheries, using an ethical matrix for evaluating strategies, and organizing a ``value workshop'''' whereparticipants from different stakeholder groups came together todo ethical evaluations. The positive achievements and theshortcomings of this method are discussed in this paper. The useof an ethical matrix was meant to combine a participatory approachwith insights from theoretical ethics. The project revealedinherent tensions between these two objectives. Possible ways ofdealing with this tension are indicated, but in general a goodgrasp of the socio-political context might be the best guardianagainst the possible pitfalls involved in such an approach. (shrink)

Some patients who are dependent on extracorporeal membrane oxygenation (ECMO) are alert and retain capacity to participate in decision-making, including decisions regarding whether to continue life...

This study investigated the relationship between supervisor personality and subordinate reports of exposure to bullying and harassment at work. Three research questions were examined: Is there a direct relationship between supervisor personality and reports of workplace bullying? Is there an interaction between supervisor personality and supervisors’ perceived stress as predictors of workplace bullying? Will subordinates who experience bullying at their workplace rate their supervisor’s personality more negatively? The sample consisted of 207 supervisors and employees within 70 Norwegian restaurants. Supervisors low (...) on conscientiousness, high on neuroticism and portraying high levels of exposure to stress were the subject of significantly more reports from subordinates of exposure to workplace bullying. An interaction between agreeableness and stress was found showing that agreeableness is related to bullying under low levels of stress. In addition, subordinates who perceived their supervisor as being low on agreeableness and high on introversion reported significantly more workplace bullying, supporting a negative halo effect hypothesis. (shrink)

As face shields are dusted off and conferences go virtual again, Omicron reminds us how the once-novel coronavirus ruptured our collective idea of medical training. For nearly 2 years, social media...

Although there is a significant amount of research on organizational citizenship behavior and its importance to individual and organizational outcomes, relatively little research has explored the process by which such behavior emerges and is established within an organization. Against this backdrop, we combine the perspectives offered by contextualist inquiry and actor–network theory to propose an integrative framework for investigating how organizational citizenship behavior develops in a large, heterogeneous organization. In order to illustrate the framework, we present a detailed case study (...) of recycling at a large university. Like many other organizations, the university does not have a formal organizational structure to address sustainability concerns and the initiatives are therefore mainly voluntary and emerging in nature, and outcomes are, as a consequence, highly uncertain, and fragile. We argue that contextualist inquiry in combination with actor–network theory provides new and important insights into the emergence and establishment of organizational citizenship behaviors, and that outcomes are contingent upon interactions between the context, process, and content of the behaviors in question and the related networks of human and non-human actors. (shrink)

To explore the limits of quantification as a form of rationalization, we examine a rare case of dequantification: race-based affirmative action in undergraduate admissions at the University of Michigan. Michigan adopted a policy of holistically reviewing undergraduate applications in 2003, after the US Supreme Court ruled unconstitutional its points-based admissions policy. Using archival and ethnographic data, we trace the adoption, evolution, and undoing of Michigan’s quantified system of admissions decision-making between 1964 and 2004. In a context in which opponents of (...) the system had legal avenues to engage a powerful outside authority, we argue that three internal features of the University’s quantified admissions policy contributed to its demise: its transparency, the instability of the categories it quantified, and the existence of qualitative alternatives. Our analysis challenges the presumed durability and inevitability of quantification by identifying its vulnerabilities and suggests that quantification should be understood as a matter of degree rather than a simple binary. (shrink)

ANGUS J, HODNETT E and O’BRIEN-PALLAS L. Nursing Inquiry 2003; 10: 218–228Implementing evidence-based nursing practice: a tale of two intrapartum nursing unitsDespite concerns that the rise of evidence-based practice threatens to transform nursing practice into a performative exercise disciplined by scientific knowledge, others have found that scientific knowledge is by no means the preeminent source of knowledge within the dynamic settings of health-care. We argue that the contexts within which evidence-based innovations are implemented are as influential in the outcomes as (...) the individual practitioners who attempt these changes. A focused ethnography was done in follow-up to an earlier trial that evaluated the effectiveness of a marketing strategy to encourage the adoption of evidence-based intrapartum nursing practice. Bourdieu's (1990, 1991) concepts of habitus, capital and social field were used in our refinement of the analysis of the ethnographic findings. Nursing leadership, interprofessional struggle with physicians, the characteristics of the community and the physical environment were prominent issues at all of the sites. Detailed descriptions of the sociohistorical context and of the experiences at two sites are presented to illustrate the complexities encountered when implementing innovations. (shrink)

The Holocaust takes on a riveting immediacy in these true stories of the everyday, understated heroism that saved thousands of Jews from annihilation at the hands of the Third Reich. Combining personal interviews with contemporary and vintage photographs, To Save a Life pairs the stories of a handful of rescuers with those of people they saved. Ellen Land-Weber creates a moving, multidimensional picture of the evasive strategies and heartstopping close calls that filled the years of the Holocaust for both (...) rescuers and rescued. In paperback for the first time, the rescues narrate their growing awareness of the tightening circle of Nazi terror, their experiences in hiding, often being shunted from one safehouse to another, and their hair's-breadth separation from friends and family who did not escape. Promotional Information: Life-saving acts of heroism by ordinary people in the face of Nazi tyranny. (shrink)

The promises of precision medicine are often heralded in the medical and lay literature, but routine integration of genomics in clinical practice is still limited. While the “last mile” infrastructure to bring genomics to the bedside has been demonstrated in some healthcare settings, a number of challenges remain — both in the receptivity of today's health system and in its technical and educational readiness to respond to this evolution in care. To improve the impact of genomics on health and disease (...) management, we will need to integrate both new knowledge and new care processes into existing workflows. This change will be onerous and time-consuming, but hopefully valuable to the provision of high quality, economically feasible care worldwide. (shrink)

A History of Women Philosophers, Volume I: Ancient Women Philoophers, 600 B.C. - 500 A.D., edited by Mary Ellen Waithe, is an important but somewhat frustrating book. It is filled with tantalizing glimpses into the lives and thoughts of some of our earliest philosophical foremothers. Yet it lacks a clear unifying theme, and the abrupt transitions from one philosopher and period to the next are sometimes disconcerting. The overall effect is not unlike that of viewing an expansive landscape, illuminated (...) only by a few tiny spotlights. (shrink)

This article describes the ethical conflicts that a sample of US nurse utilization reviewers faced in their work, and also each nurse’s self-reported ethical orientation that was used to resolve the dilemmas. Data were collected from a sample of 97 registered nurses who were working at least 20 hours per week as utilization reviewers. Respondents were recruited from three managed care organizations that conduct utilization reviews in a large midwestern city. A cross-sectional survey design was used to collect demographic data (...) and to ask closed-response, short-answer and open-ended questions. Ethical conflicts reported by nurses were similar across utilization review settings and many were justice orientated. Self-reported ethical orientations were similar across organizations, with beneficence dominating. Implications of these findings are discussed. (shrink)

Sociology has long recognized the centrality of the body in the reciprocal construction of individuals and society, and recent research has explored the influence of a variety of social institutions on the body. Significant research has established the influence of social class, child-rearing practices, and variable language forms in families and children. Less well understood is the influence of children's social class status on their gestures, comportment, and other bodily techniques. In this essay Sue Ellen Henry brings these two (...) areas of study together to explore how working-class children's bodies are shaped by the child-rearing practices associated with their social class status, and the potential effects these bodily techniques have on their experience in schools. (shrink)

We explore how the Sarbanes–Oxley Act of 2002 created pressure for firms to take more visible and costly corrective action following the announcement of an earnings restatement. Building on theory about focusing events, the institutional effects of legislative change, and the agenda-setting role of the media, we propose that Sarbanes–Oxley created reactive normative pressure on firms that announce earnings restatements, increasing the likelihood of CEO replacement in their aftermath. We theorize that Sarbanes–Oxley changed the meaning—and therefore the impact—of media coverage (...) of earnings restatements. Our findings show that firm behavior after Sarbanes–Oxley did change in ways that are consistent with the intent of the legislation: to increase executives’ accountability for the reliability of their firms’ financial statements. Moreover, we show this change is a result both of the direct effect of the legislation on increasing CEO accountability as well as through intensifying the effect of the media spotlight on misconduct. (shrink)

O propósito deste artigo é analisar o olhar feminino através da narração e do mis-en-scène da série The Handmaid’s Tale, em português, O Conto da Aia (2017). A série se passa em uma sociedade distópica, regida à base da teonomia totalitária e fundamentalista cristã. As mulheres dessa sociedade perderam suas vozes, são desumanizadas, devido ao seu gênero, e tornadas objetos férteis nas mãos de seus comendadores; a narrativa e o desenvolvimento das personagens fazem alusão ao empoderamento feminino e suas lutas (...) pelos direitos civis que vêm acontecendo desde o fim século XIX. A busca por suas vozes torna-se evidente a partir da narração que ajuda a compreender a representatividade da mulher na série.Palavras-chave: The Handmaid’s Tale. Feminismo. Identidade. Narrativa. Série. (shrink)

The plot thickens--in novels and our lives--forcing us from the fairy tale into a bewildering, even heartbreaking narrative. We look at the god we're holding, and find it too fragile, too brittle to meet reality. Cling tighter? Move on godless? In fact, rejecting a god image (or as C. S. Lewis puts it, allowing God to smash our limited god) opens space for deeper faith in the midst of painful life experience. In OMG, Mary Ellen Ashcroft invites readers to (...) look over her shoulder as she traces her god growth, beginning with a capricious childhood god. The loving savior who embraced her when she was eighteen, followed her into strict fundamentalism, while the god she met in an Anglican seminary shocked her by caring more about poverty than a seven-day creation, but then called her to a South Africa tipping toward revolution. An interweaving of narrative theology and creative nonfiction, OMG invites readers to grow into deeper faith, retelling their stories in the light of the biblical one, dropping inadequate gods to grasp a mysterious, awesome one. (shrink)

Neuropalliative care developed to address the needs of patients living with life‐limiting neurologic disease. One critical consideration is that disease‐related changes to cognition, communication, and function challenge illness experiences and care practices. We conducted an ethnography to understand neuropalliative care as a phenomenon; how it was experienced, provided, conceptualized. Personhood served as our conceptual framework; with its long philosophical history and important place in nursing theory, we examined the extent to which it captured neuropalliative experiences and concerns. Personhood contextualized complex (...) losses, aligning the impact of functional and relational changes. Cognition, communication, and functional alterations stretched conceptions of personhood, insinuating it can be relational, fluid, adaptive. Although normative conceptions of personhood guided research and decision‐making, ethical considerations suggested personhood could be transformed, remade. We consider the implications of our findings through three themes. First, we examine how literature on illness experience fails to integrate the realities of people living with and dying from neurologic disease; we counter this by interrogating the concept of experience. Second, we turn to Ricoeur's work on recognition to illuminate relational conceptions of personhood to inform care practices. Finally, we reflect on how personhood can bridge the gap left by functional changes, enhance relational engagement, and promote dignity at the end of life. (shrink)

ABSTRACT The Daodejing (DDJ) is an ancient Chinese text traditionally taken as a representative Daoist classic expressing a distinctive philosophy from the Warring States Period (403–221 BCE). This essay explicates the ethical dimensions of the DDJ paying attention to issues related to war and peace. The discussion consists of four parts: (1) “naturalness” as an onto‐cosmological argument for a philosophy of harmony, balance, and peace; (2) war as a sign of the disruption of the natural pattern of things initiated by (...) the proliferation of desire; (3) defensive war and appropriate war conduct required when one has to be involved in warfare; and (4) the natural and spontaneous way of living that would prevent war from happening in the first place. This essay attempts to show that what makes the DDJ different from other military texts, or what is called the “art of war corpus” in China is that the discourse of war and warfare in the DDJ is presented via its unique understanding of peace at the personal and social levels. The DDJ is meant to be an inquiry into an effective method to prevent war from happening amid a world full of selfish interests and excessive desires. It proposes that peace is not only a condition in which there is freedom from war and overt violence, but a state of harmony that marks human life and its betterment. (shrink)

While cancer rates continue to increase, therapy has dramatically decreased the mortality rates. The increased efficacy of current therapies may unfortunately have profound toxic effects on gamete function in both adolescent and reproductive age groups, with infertility as an expected consequence of cancer therapy. Significant progress in the advancement of fertility preservation therapies provides realistic options for future fertility in cancer survivors. However, a number of challenging issues need to be considered when presenting fertility preservation options. This overview highlights some (...) of these considerations including religious-cultural-ethical values, access to care and cost of services, developmental capacity and consent, and posthumous reproduction. (shrink)

This study examines public health nurses’ perceptions and concerns about the implications of Japan’s new long-term care insurance law concerning care provision for elderly people and their families. Respondents voiced their primary concern about this law as access to services for all elderly people needing care, and defined their major responsibility as strengthening health promotion and illness prevention programmes. Although wanting to expand their roles to meet the health care, social and public policy advocacy needs of elderly persons and their (...) families, respondents also stated their concern for the possible lack of enough resources for this expansion to support family caregivers adequately. They viewed their first function as developing collaborative relationships with local government officials to help to assure sufficient resources to provide the necessary foundation for long-term care programmes to deliver services to all those in need. These concerns fall within the larger ethical issue of distributive justice in a society based on the obligations of the state to citizens and the family to its members, especially elderly relatives, who, according to traditional Japanese values, retain respect. (shrink)

Courses in the history of philosophy which exclude contributions made by women cannot legitimately claim to teach this history. This is true, not merely because those histories are incomplete, but rather because they give a biased account. I sketch the difficulties thus posed for the profession, and offer suggestions for developing a less biased, more accurate understanding of the history of philosophy.

Arid Waters is a photographic response to the growing crisis of water scarcity, which exists because our culture thinks of water as a commodity, or an abstract legal right, rather than the most basic physical source of life. The Water in the West Project began as a collaborative effort designed to present an artistic response to water as a social issue. Photography historian Ellen Manchester and the photographers - Mark Klett, Terry Evans, Laurie Brown, Peter Goin, Robert Dawson, Martin (...) Stupich, Gregory Conniff, and Wanda Hammerbeck - address the question: How can photography contribute to the urgent public debate over water use and allocation? Project members prepared an exhibition of their work, defining it as a laboratory and emphasizing the process of working through ideas. Contact prints and numerous work prints were displayed on the walls of the Sheppard Fine Art Gallery at the University of Nevada, Reno, and simultaneously the Nevada Humanities Committee sponsored a conference entitled "Water in the Arid West." Participants included historians, writers, ranchers, politicians, lawyers, students, and community members. Arid Waters documents the evolution of the Water in the West Project from its inception as a group collaboration to the foundation of an archive. Ellen Manchester, codirector of the Water in the West Project, has written an informative introduction that provides a historical perspective for the collaboration. Including 59 photographs from the eight photographers, Arid Waters is a testimony to the role photography has played in western history. (shrink)

This article examines the Dobsonian Telescope as an object of material culture, showing how starting with the materiality of a scientific instrument opens up new perspectives that are lost by focusing purely on its instrumentality. It argues that the simple design and homely materials of the Dobsonian telescope, as well as the gestures that it requires from its users, are at the core of its significance to the popularization of amateur astronomy and amateur telescope making.

In this issue of American Journal of Bioethics, Childress et al. address one of the most challenging modern clinical ethical dilemmas: the awake, competent patient dependent on extracorporeal membr...

Difficulty engaging in reciprocal social interactions is a core characteristic of autism spectrum disorder. The mechanisms supporting effective dynamic real-time social exchanges are not yet well understood. This proof-of-concept hyperscanning electroencephalography study examined neural synchrony as the mechanism supporting interpersonal social interaction in 34 adolescents with autism spectrum disorder, age 10–16 years, paired with neurotypical confederates of similar age. The degree of brain-to-brain neural synchrony was quantified at temporo-parietal scalp locations as the circular correlation of oscillatory amplitudes in theta, alpha, (...) and beta frequency bands while the participants engaged in a friendly conversation. In line with the hypotheses, interpersonal neural synchrony was significantly greater during the social interaction compared to the baseline. Lower levels of synchrony were associated with increased behavioral symptoms of social difficulties. With regard to sex differences, we found evidence for stronger interpersonal neural synchrony during conversation than baseline in females with autism, but not in male participants, for whom such condition differences did not reach statistical significance. This study established the feasibility of hyperscanning during real-time social interactions as an informative approach to examine social competence in autism, demonstrated that neural coordination of activity between the interacting brains may contribute to social behavior, and offered new insights into sex-related variability in social functioning in individuals with autism spectrum disorders. (shrink)