Patient-centeredness can be considered a popular, and at the same time “fuzzy”, concept. Scientists have proposed different definitions and models. The present article studies scientific publications that discuss the meaning of patient-centeredness to identify different “discourses” of patient-centeredness. Three discourses are presented; the first is labelled as “caring for patients”, the second as “empowering patients” and the third as “being responsive”. Each of these discourses has different things to say about the why of patient-centeredness; the patient’s identity; the role of (...) the healthcare professional; responsibilities for medical decision-making, and the role of health information. This article compares and contrasts the discourses in ways that allow us to see differences that matter for practitioners in healthcare. On the basis of a relational constructionist philosophy, it is argued that discursive diversity is both an inevitable and a potentially valuable aspect of conversations in healthcare. We are therefore invited to center the challenge of dealing with diversity in productive ways. This article ends with a discussion of the practical implications of the discourse analysis for projects that aim to make healthcare more patient-centered. Debates on patient-centered “Health Information Exchange” are used to explain the need for a recognition of different discourses of patient-centeredness and a reflexive stance towards them. (shrink)

Während der größte Teil der Bevölkerung die kieferorthopädische Therapie, also die Veränderung der Zahn- bzw. Kieferstellung, als eine Behandlung betrachtet, die vor allem auf eine Verbesserung des Erscheinungsbildes zielt, sehen der kieferorthopädische und zahnärztliche Berufsstand sowie auch private und öffentliche Kostenträger in bestimmten Abweichungen von Zahn- oder Kieferstellungen eine Gefährdung der oralen Gesundheit und der Funktionsfähigkeit des Gebisses. Letztere Auffassung bestimmt das ärztliche Handeln in der Kieferorthopädie und begründet auch die Übernahme zumindest bestimmter Leistungen durch die gesetzlichen Krankenkassen. Anhand aktueller (...) wissenschaftlicher Erkenntnisse lassen sich jedoch in vielen Fällen keine (akuten oder potentiellen) gesundheitlichen oder essentiellen funktionellen Beeinträchtigungen und Risiken abweichender Zahnstellungen nachweisen. Ziel dieses Aufsatzes ist es, diesem Widerspruch nachzugehen. Im Folgenden werden wir aufzeigen, welche Faktoren die Anbieter kieferorthopädischer Leistungen beeinflussen, welches die entscheidenden Gründe und Grundlagen für die Behandlung sind und an welchen Kriterien sich die Leistungsübernahme durch die Krankenkassen orientiert. Dabei wird deutlich werden, dass die formalen Kriterien von Behandlung und Kostenübernahme, die tatsächliche Behandlungs- und Kostenerstattungspraxis, die Erwartungen derjenigen, die Behandlungsleistungen in Anspruch nehmen und der aktuelle Stand der Forschung zu erwartbaren Funktionsbeeinträchtigungen durch Zahnstellungsvariationen nicht zwanglos zu vereinbaren sind. Erforderlich erscheint ein interdisziplinärer normativer Diskurs über die Frage, wie die diagnostizierten Spannungen aufzulösen wären. Als Anregung für einen solchen Diskurs werden wir im Ausblick alternative Lösungsstrategien vorstellen. (shrink)

The history of Italian Jews from 1861 to 1938 is often viewed as the period in which they totally assimilated into the Italian nation. This article, however, argues that rather than their assimilation it was a period of their integration into Italian society. Various approaches to this question are presented, including a review of the literature, with a view to reconsidering the relationship between Jewish culture and Italian culture, or rather non-Jewish culture. Italian Jewish history is shown not to be (...) separated from, but to be “internal” to Italian social, cultural, and political history—part of the dynamic process of change that occurred during this period not only in Italy but throughout Europe. (shrink)

In this article I discuss the history of Italian Jews from the Emancipation to the racial laws of 1938 and their present-day attitudes to Judaism and the State of Israel. My aim is to suggest how the policy of social integration enabled Italian Jews to construct a new identity without losing their ancestral heritage. The example of Italian Jewry is relevant to understanding the growing need in today‘s European Union—now comprising 27 countries with different languages, cultures, and values—of revising the (...) concept of national identity and of exploring ways of constructing a new European identity. (shrink)

Jean Paul's novel The Life of Fibel, Author of the Bienrodische Fibel places itself in a specifi c relation to literacy by identifying the alphabet and the spelling-book as a matrix of its own production. Thus, the text refers itself and its sense-effects back to the arbitrariness of its elements and their combinatorics. Moreover, at the margins of the book, it feigns to be abandoned to the contingency of its preliteral physis which is suppressed by sense, authority, authorship and control (...) of the work. (shrink)

Jean Paul's novel The Life of Fibel, Author of the Bienrodische Fibel places itself in a specifi c relation to literacy by identifying the alphabet and the spelling-book as a matrix of its own production. Thus, the text refers itself and its sense-effects back to the arbitrariness of its elements and their combinatorics. Moreover, at the margins of the book, it feigns to be abandoned to the contingency of its preliteral physis which is suppressed by sense, authority, authorship and control (...) of the work. (shrink)

"Erscheinen und Verschwinden sind als Auf und Abtreten physische und symbolische Operationen, die sich auf die den Schauplatz abscheidend konstituierenden Grenze zwischen on-stage und backstage beziehen, aus dem das Geschehen auf der Bühne sich speist. Auftreten ist derart als ein riskanter und instabiler Vorgang zwischen Erscheinen und Verschwinden zu kennzeichnen. Am Beispiel zeitgenössischer Auseinandersetzungen mit den Bedingungen des Theaters, die die Bühne als Gefüge diverser Darstellungs-Flächen und -Räume nutzen, bekommt die Verwiesenheit der theatralen Präsentation auf das Anderswo einen spezifischen Witz (...) für das Verschwinden: was hier ›verschwindet‹ ist irgendwo anders. As entrances and exits, appearance and disappearance are physical and symbolic operations, which refer to the border between onstage and backstage that constitutes the scene and with it the action on stage. To make an entrance is thus a risky and unstable operation between appearance and disappearance. Using the example of contemporary explorations of the conditions of theater that use the stage as a structure of various presentation areas and -spaces, the dependence of the theatrical presentation on an Elsewhere produces a specific pun on disappearance: that which ›disappears‹ here is somewhere else.". (shrink)

?Starting from the literary translations and reflections on the theory of translation of Christoph Martin Wieland, this book deals with different modalities and methods of translating and transmitting? not only from language to language, but also between literary genres, epochs, knowledge formations and nations. Wieland is portrayed as an author and editor who devoted himself? with experimental openness? to a project of mediating and resolving dichotomies such as cosmopolitism and nation.".

Artikelen vanuit verschillende invalshoeken over het wezen en de oorsprong van het kwaad en de omgang ermee in verschillende culturen.

Hume's Reception in Early America: Expanded Edition brings together the original American responses to one of Britain's greatest men of letters, David Hume. Now available as a single volume paperback, this new edition includes updated further readings suggestions and dozens of additional primary sources gathered together in a completely new concluding section. From complete pamphlets and booklets, to poems, reviews, and letters, to extracts from newspapers, religious magazines and literary and political journals, this book's contents come from a wide variety (...) of sources published in colonial America and the early United States between 1758 and 1850. As well as classics by Thomas Jefferson, John Adams and Alexander Hamilton, it contains scores of unknown and hard-to-locate items, many of which have not been reprinted since their original publication. These responses are divided into four parts covering Hume's Essays; his Philosophical Writings; his History of England; and his Character and Death. Each of those parts has a separate introductory essay, and every selection is introduced by a short headnote that sets the piece in its historical context and provides bibliographical references. Packed with new insights into Hume and American thought and culture, Hume's Reception in Early America reveals the relevance and impact of Hume on American political, philosophical, historical, religious, and aesthetic debates. (shrink)

Biological evolution is a complex blend of ever changing structural stability, variability and emergence of new phe- notypes, niches, ecosystems. We wish to argue that the evo- lution of life marks the end of a physics world view of law entailed dynamics. Our considerations depend upon dis- cussing the variability of the very ”contexts of life”: the in- teractions between organisms, biological niches and ecosys- tems. These are ever changing, intrinsically indeterminate and even unprestatable: we do not know ahead of (...) time the ”niches” which constitute the boundary conditions on selec- tion. More generally, by the mathematical unprestatability of the ”phase space”, no laws of mo- tion can be formulated for evolution. We call this radical emergence, from life to life. The purpose of this paper is the integration of variation and diversity in a sound concep- tual frame and situate unpredictability at a novel theoretical level, that of the very phase space. Our argument will be carried on in close comparisons with physics and the mathematical constructions of phase spaces in that discipline. The role of symmetries as invariant preserving transformations will allow us to under- stand the nature of physical phase spaces and to stress the differences required for a sound biological theoretizing. In this frame, we discuss the novel notion of ”enablement”. Life lives in a web of enablement and radical emergence. This will restrict causal analyses to differential cases. Mutations or other causal differ- ences will allow us to stress that ”non conservation princi- ples” are at the core of evolution, in contrast to physical dynamics, largely based on conservation principles as sym- metries. Critical transitions, the main locus of symmetry changes in physics, will be discussed, and lead to ”extended criticality” as a conceptual frame for a better understanding of the living state of matter. (shrink)

This is a welcome reprint of a book that continues to grow in importance.

This entirely new work guides the reader through the most basic systems of modal propositional logic up to systems of modal predicate with identity, dealing with both technical developments and discussing philosophical applications.

Throughout his career, Schelling assigns knowledge of the absolute first principle of philosophy to intellectual intuition. Schelling's doctrine of intellectual intuition raises two important questions for interpreters. First, given that his doctrine undergoes several changes before and after his identity philosophy, to what extent can he be said to “hold onto” the same “sense” of it by the 1830s, as he claims? Second, given that his doctrine of intellectual intuition restricts absolute idealism to what he calls a “science of reason”, (...) which he says cannot prove the absolute’s existence, what other doctrine does he require in order to prove this? I will answer these questions by tracing the shifts in Schelling’s doctrine of intellectual intuition from the 1790s to the 1830s and drawing out its evolving methodological role within his science of intelligibility. (shrink)