Background Policy instruments based on the working of markets have been introduced to empower consumers of healthcare. However, it is still not easy to become a critical consumer of healthcare. Objectives The aim of this study is to analyse the possibilities of the state to strengthen the position of patients with the aid of a new financial regime, such as personal health budgets. Methods Data were collected through in-depth interviews with executives, managers, professionals and client representatives of six long-term care (...) institutions. Results With the introduction of individual budgets the responsibility for budgetary control has shifted from the organisational level to the individual level in the caregiver-client relationship. Having more luxurious care on offer necessitates a stronger demarcation of regular care because organisations cannot simultaneously offer extra care as part of the standard care package. New financial instruments have an impact on the culture of receiving and giving care. Distributive justice takes on new meaning with the introduction of financial market mechanisms in healthcare; the distributing principle of ‘need’ is transformed into the principle of ‘economic demand’. Conclusion Financial instruments not only act as a countervailing power against providers insufficiently client-oriented, but are also used by providers to reinforce their own positions vis-à-vis demanding clients. Tailor-made finance is not the same as tailor-made care. (shrink)

BackgroundThe emphasis on impact factors and the quantity of publications intensifies competition between researchers. This competition was traditionally considered an incentive to produce high-quality work, but there are unwanted side-effects of this competition like publication pressure. To measure the effect of publication pressure on researchers, the Publication Pressure Questionnaire (PPQ) was developed. Upon using the PPQ, some issues came to light that motivated a revision.MethodWe constructed two new subscales based on work stress models using the facet method. We administered the (...) revised PPQ (PPQr) to a convenience sample together with the Maslach Burnout Inventory (MBI) and the Work Design Questionnaire (WDQ). To assess which items best measured publication pressure, we carried out a principal component analysis (PCA). Reliability was sufficient when Cronbach’s alpha > 0.7. Finally, we administered the PPQr in a larger, independent sample of researchers to check the reliability of the revised version.ResultsThree components were identified as ‘stress’, ‘attitude’, and ‘resources’. We selected 3 × 6 = 18 items with high loadings in the three-component solution. Based on the convenience sample, Cronbach’s alphas were 0.83 for stress, 0.80 for attitude, and 0.76 for resources. We checked the validity of the PPQr by inspecting the correlations with the MBI and the WDQ. Stress correlated 0.62 with MBI’s emotional exhaustion. Resources correlated 0.50 with relevant WDQ subscales. To assess the internal structure of the PPQr in the independent reliability sample, we conducted the principal component analysis. The three-component solution explains 50% of the variance. Cronbach’s alphas were 0.80, 0.78, and 0.75 for stress, attitude, and resources, respectively.ConclusionWe conclude that the PPQr is a valid and reliable instrument to measure publication pressure in academic researchers from all disciplinary fields. The PPQr strongly relates to burnout and could also be beneficial for policy makers and research institutions to assess the degree of publication pressure in their institute. (shrink)

Over the past decades, science funding shows a shift from recurrent block funding towards project funding mechanisms. However, our knowledge of how project funding arrangements influence the organizational and epistemic properties of research is limited. To study this relation, a bridge between science policy studies and science studies is necessary. Recent studies have analyzed the relation between the affordances and constraints of project grants and the epistemic properties of research. However, the potentially very different affordances and constraints of funding arrangements (...) such as awards, prizes and fellowships, have not yet been taken into account. Drawing on eight case studies of funding arrangements in high performing Dutch research groups, this study compares the institutional affordances and constraints of prizes with those of project grants and their effects on organizational and epistemic properties of research. We argue that the prize case studies diverge from project-funded research in three ways: 1) a more flexible use, and adaptation of use, of funds during the research process compared to project grants; 2) investments in the larger organization which have effects beyond the research project itself; and 3), closely related, greater deviation from epistemic and organizational standards. The increasing dominance of project funding arrangements in Western science systems is therefore argued to be problematic in light of epistemic and organizational innovation. Funding arrangements that offer funding without scholars having to submit a project-proposal remain crucial to support researchers and research groups to deviate from epistemic and organizational standards. (shrink)

The ability to memorize changes in the environment is present at all biological levels, from social groups and individuals, down to single cells. Trans‐generational memory is embedded subcellularly through genetic and epigenetic mechanisms. Evidence that cells process and remember features of the immediate environment using protein sensors is reviewed. It is argued that this mnemonic ability is encapsulated within the protein conformational space and lasts throughout its lifetime, which can overlap with the lifespan of the organism. Means to determine diachronic (...) changes in protein activity are presented. (shrink)

There is a growing tendency to hyperbolize the U.S.-Mexican borderlands as a “dystopian zone of terror.” Dystopian borderlands hyperbole is double-edged. It can be used to create virulently racist mischaracterizations of borderlands life, and it can be used critically, as Alicia Gaspar de Alba and Sayak Valencia use it in Desert Blood and Capitalismo gore, to draw attention to structural forms of violence that imperil the borderlands on a daily basis. Desert Blood and Capitalismo gore exemplify a tendency in borderlands (...) literature to hyperbolically magnify borderlands crises of violence, misogyny, exploitation, and racism to all-encompassing dimensions. That magnification serves to highlight historical and structural conditions that have created and perpetuated those crises. The borderlands in Desert Blood and Capitalismo gore are hyperbolically reimagined as dystopias of neoliberal patriarchal violence. Gaspar de Alba and Valencia hyperbolize those dystopias to critique and ultimately abolish them. (shrink)

Since the early 1980’s, with the clinical advent of in vitro fertilization resulting in so-called “test tube babies,” a wide array of ethical considerations and concerns regarding artificial womb technology (AWT) have been described. Recent breakthroughs in the development of extracorporeal neonatal life support by means of AWT have reinitiated ethical interest about this topic with a sense of urgency. Most of the recent ethical literature on the topic, however, pertains not to the more imminent scenario of a physiologically improved (...) method of neonatal care through AWT, but instead to the remote scenario of “complete ectogenesis” that imagines human gestation occurring entirely outside of the womb. This scoping review of the ethical literature on AWT spans from more abstract concerns about complete ectogenesis to more immediate concerns about the soon-to-be-expected clinical life support of what we term the fetal neonate or fetonate. Within an organizing framework of different stages of human gestational development, from conception to the viable premature infant, we discuss both already identified and newly emerging ethical considerations and concerns regarding AWT and the care of the fetonate. (shrink)

The analysis of the measurement of gravitational fields leads to the Rosenfeld inequalities. They say that, as an implication of the equivalence of the inertial and passive gravitational masses of the test body, the metric cannot be attributed to an operator that is defined in the frame of a local canonical quantum field theory. This is true for any theory containing a metric, independently of the geometric framework under consideration and the way one introduces the metric in it. Thus, to (...) establish a local quantum field theory of gravity one has to transit to non-Riemann geometry that contains (beside or instead of the metric) other geometric quantities. From this view, we discuss a Riemann–Cartan and an affine model of gravity and show them to be promising candidates of a theory of canonical quantum gravity. (shrink)

This article sets out key contributions to the long-running debate about mental disorder from the ordinary language philosophy of the ‘Oxford School’. The distinction between definition and use of concepts underpinning ordinary language philosophy reframes the debate as a debate not just about mental disorder but about disorder in general, bodily as well as mental. The field work of ordinary language philosophy (focusing on the use of concepts as a guide to their meanings) shows that, attempts at elimination notwithstanding, there (...) is an essential evaluative element in the meaning of disorder, bodily as well as mental. The concept of disorder in the debate thus reframed presents a double challenge for analysis: to explain why disorder has evaluative connotations used of mental conditions but descriptive connotations used of bodily conditions. Philosophical value theory, derived by applying ordinary language philosophy to the language of values, provides a rich resource of ideas for meeting this double challenge. It meets the double challenge at the level of theory by allowing both aspects of the double challenge of disorder to be derived from a logical property that disorder shares with all other value terms. It meets the double challenge at the level of practice by supporting the development of a new approach to working with values alongside evidence in healthcare called values-based practice. Ordinary language philosophy, notwithstanding these several contributions, is no panacea. It helps us to make a start, no more and no less, in understanding mental disorder. (shrink)

Constitutional and judicial law-making is increasingly beginning to find its reflection not only in the Anglo-Saxon, but also in the Romano-Germanic legal family. However, the prerequisites for the use of this legal instrument are different, which determines the relevance of conducting a comparative analysis regarding the provision of such a mechanism in the USA and Kazakhstan. The purpose of the research is to identify common and distinctive features in the process of implementation of constitutional and judicial law-making in countries belonging (...) to different legal systems. The article uses the methods of analysis, synthesis, comparison, deduction and generalization. As a result, the specificity of ensuring the mechanism of constitutional law-making in the USA was expressed, taking into account various forms of law-making activity. It has been established that the development of constitutional provisions in the United States takes place with the help of the constitutional doctrines of the Supreme Court of the United States, which provide for the introduction of amendments to constitutional provisions without a formal procedure. As a result of the study of the experience of Kazakhstan, it was established that special priority was given to the role of precedent, in particular, the decision of the Supreme Court of the Republic of Kazakhstan. This is explained by the integrative nature of the Romano-Germanic legal system, which allows effective development of national legislation as a whole and its provisions. The obtained results can be used during the professional training of judges in the Republic of Kazakhstan. (shrink)

Die Teilhabe an der lateinischen res publica litterarum der frühneuzeitlichen Fakultäten und Universitäten wurde mittels gemeinsamer literarischer Ausdrucksformen reguliert - zuweilen in Gestalt feingeistiger philologischer Kontroverse, zuweilen als wüste Polemik oder tosender Jubel. In Fallstudien zu Humanisten aus drei Jahrhunderten geht der Band der Frage nach, wie kollegiale Beziehungen literarisch inszeniert und innerhalb der Gelehrtengemeinschaft instrumentalisiert wurden. Diskursregeln und Kommunikationsbedingungen kommen dabei ebenso zur Sprache wie die Anwendung literarischer Modelle aus antiker und nachantiker Invektive, Satire und Panegyrik.

The analysis of the measurement of gravitational fields leads to the Rosenfeld inequalities. They say that, as an implication of the equivalence of the inertial and passive gravitational masses of the test body, the metric cannot be attributed to an operator that is defined in the frame of a local canonical quantum field theory. This is true for any theory containing a metric, independently of the geometric framework under consideration and the way one introduces the metric in it. Thus, to (...) establish a local quantum field theory of gravity one has to transit to non-Riemann geometry that contains (beside or instead of the metric) other geometric quantities. From this view, we discuss a Riemann–Cartan and an affine model of gravity and show them to be promising candidates of a theory of canonical quantum gravity. (shrink)

Our Odyssey is shaped by oral poetics but also by storytelling techniques developed to attract and hold audiences’ attention. From Odysseus’s first appearance, episodes consistently bring to mind his revenge plot against the suitors and test the qualities and skills he will need to carry it out. These episodes offer reassuring evidence that Odysseus will defeat the suitors balanced by doubt-inducing signs that he will fail. Taken together, these episodes elicit hope and fear, the constituent elements of suspense, regarding Odysseus’s (...) chances of succeeding. The consistency with which these episodes appear and the balance they strike between reassurance and doubt suggest that the generation of suspense played a significant role in the composition of the Odyssey as we have it. (shrink)

Durante las últimas dos décadas las culturas de los pueblos originarios del país quedan inscritas en el corazón de las movilizaciones étnicas y de la política indígena de los recientes gobiernos democráticos y, con ello, experimentan una nueva dinámica e importantes transformaciones. La cultura es a la vez el fundamento y objeto estratégico de acción en la emergencia indígena desarrollada en el periodo. Su conformación como sujetos colectivos se establece desde el recurso a la cultura propia, que les otorga especificidad. (...) También se constituye en objeto de una política cultural y de diversos cursos de acción. Participan de ello agentes culturales indígenas, agencias públicas especializadas y grupos e instituciones de la sociedad civil. De su concurrencia se gesta un proceso nuevo de construcción social de lo cultural indígena, cuya estructuración toma la forma de un dominio o campo de lo cultural indígena en Chile. Cultural issues in Chile are undergoing new dynamics and important transformations. During the past two decades, Chilean indigenous people’s cultures have been circumscribed in the core of ethnical mobilizations and indigenous policies deployed by recent democratic governments. Cultural issues are both the basics and the strategic action object within the indigenous ethnogenesis developed during this period. Their formation as collective subjects rises up from access to their culture, which bestows upon them specificity. It also set itself up as an object of cultural policy and diverse ways of action. Indigenous cultural agents, specialized public agencies and civil society groups and institutions participate in this phenomenon. From this concurrence, a new process of social construction of indigenous cultural issues rises. Its structure takes the shape of a scope or a field of indigenous cultural issues in Chile. (shrink)

I tried to analyse the proceedings of heredity, methodologically separating the factors of “irritation and the reaction” upon it on the part of the living substance. The question was, to investigate the development of the hereditarily directed growth of the cells by “formative irritation” according to the conception of H.Driesch, that is to say in their homogeneousness with the biological reaction upon irritation on the part of the nutritive substances. It so became evident, that mechanism and vitalism have to co-operate (...) in separate sections of investigation: the first towards the substancially conceivable side, the latter towards an irrational order of ideas, as vitalism lays them down in “Entelechy“.Practically the same idea is expressed inSpemann's “Regenerations” by looking on the “Organisatoren” as substancial bearers of hereditary immaterial factors. The same thing results in all probability from an analysis ofPawlow's “conditioned Teflexes”.From all this results, that mechanism and vitalism ought to supplement one another in acting conjointly as to the conception of “totality” in the organic structure. In his “Holism”,Adolf Meyer, going beyond mechanism and vitalism, placed his conceptions of totality at the head and by “simplification” deducted the simple from the complicated.Hans Schmalfuss says: simplifying and complicating have each of them three sides, a substancial one, a planning-one and one constructed by thought. The planning side is the connecting link between the substancial side and the one constructed by thought and cannot be separated from either. He proves this by thorough argument in his “Substance and Life”. He is able to include naturallyvon Uexküll's “Planlehre”.All this corresponds to the adaptation of all that is living to the environment as belonging to a harmonious life of the individual. Even here the extreme mechanists suppose themselves able to draw upon the future and therefore remain implacable adversaries of vitalism. Perhaps there might be a reconciliation even here, if the order of ideas about an “All-life” as well as an “All-plan” combined with “Holism” should prove indispensable in scientifically enlightening the mystery of life.There follow a few words concerning the problem of heredity of qualities acquired, “erworbene Eigenschaften” .J'ai essayé d'analyser les procédés de l'hérédité en séparant méthodologiquement les facteurs de „l'irritation et ceux de la réaction” de la part de la substance vivante. Il s'agit ici du développement de la croissance des cellules par „l'irritation formative” d'après la conception de H.Driesch, cela veut dire d'après leur homogénéité avec la réaction biologique de la substance nutritive. Il se montra ainsi, que le mécanisme et le vitalisme doivent coopérer: le premier du côté substantiellement concevable, le dernier du côté de l'ordre des idées irrationelles telles que le vitalisme les expose dans „l'entéléchie”.Pratiquement, la même idée est exposée dans les „Régénérations” deSpemann, en regardant les „Organisatoren” comme porteurs des facteurs héréditaires et immatériels. Le même résultat se montre avec probabilité dans une analyse des „réflexes conditionels” dePawlow.De tout cela résulte, que le mécanisme et le vitalisme devraient suppléer l'un l'autre dans un travail commun quant à la notion de „totalité” dans la croissance organique. Dans son „Holisme”,Adolf Meyer, allant au delà du mécanisme et du vitalisme, a mis à la tête la conception de „totalité” et par la simplification il a déduit le simple du compliqué.Hans Schmalfuss dit: la simplification et la complication ont chacune trois côtés, un côté substantiel, un côté „planlich” et un côté provenant de la pensée. Le côté „planlich” est le lien entre le côté substantiel et celui provenant de la pensée et ne peut être séparé d'aucun des deux. Il prouve cela par un argument profond dans son livre „la Substance et la Vie”. Il inclut tout naturellement la „Planlehre” devon Uexküll.Tout cela correspond à l'adaptation de tout ce qui est vivant à son milieu, faisant ainsi part de la vie harmonieuse de l'individu. Il est vrai, que les extrêmes mécanistes croient pouvoir tirer sur l'avenir et c'est pour cette raison, qu'ils restent des adversaires implacables du vitalisme. Peut-être y aura-t-il une réconciliation si les ordres d'idées d'un „All-Leben” ainsi que d'un „All-Plan” combinés avec le „Holisme” se trouvent être indispensables à l'éclaircissement du mystère de la vie selon la science.Quelques mots suivent concernant le problème de l'hérédité des qualités acquises, „erworbene Eigenschaften”. (shrink)