Providing individuals with the information necessary to make informed decisions is now considered an ethical standard for health systems and general practitioners.

Chronic pain is of significant global concern. There is growing evidence that body–mind therapies and psychological approaches can contribute toward changing chronic pain perceptions. This is the first model described in the literature that combines a mindfulness-based approach with dance movement therapy and explores the potential psychological and pain-related changes for this client population. In this paper, the results from the pilot study are presented involving patients with chronic headache recruited in an outpatient rehabilitation setting.Methods: In this pilot study, 29 (...) patients with chronic headache were randomized to either the Mindful-Based Dance Movement Therapy group or the waiting list control group. The MBDMT group was offered 10 sessions in a clinical outpatient rehabilitation setting for 5 weeks. Data were collected pre- and post-intervention and 16 weeks after the intervention was finished. The Hospital Anxiety and Depression Scale, Patient Health Questionnaire−9, Five Facet Mindfulness Questionnaire, and Numeric Rating Scale were used as outcome measures.Results: The working model of MBDMT identifies nine therapeutic mechanisms. Per-protocol analysis reveals statistically significant reduction of pain intensity and depression scores in favor of the MBDMT group, and these improvements were maintained in the follow-up assessment.Conclusions: The results suggest that MBDMT is a feasible and promising therapy approach for chronic pain patients. The pilot study offered sufficient information and preliminary results in the desirable direction to enable the researchers to move to a randomized controlled trial stage in order to establish the efficacy of the intervention.Clinical Trial Registration: The study was registered in the www.researchregistry.com, registry. (shrink)

The use of protocol analysis in the traning of cognitive skills.

Objective To evaluate the questions asked during the informed consent process by adult and adolescent participants as well as their parents in five interventional regulatory studies conducted at our center from 2018 to 2019. Methods The study protocol was approved by Institutional Ethics Committee [EC/OA-116/2019]. Consent narratives in the source documents for the studies were evaluated. Questions asked were classified as per Indian Council of Medical Research’s guidelines. We evaluated total number of questions, nature of questions and whether there (...) was an association between education, gender, phase of trials, physician taking consent and number questions being asked. Results A total of five studies that had N = 297 consent narratives were evaluated. Narratives of n = 284 adult participants/Guardians and of n = 13 children were analysed. A total of 374 questions were asked of which children asked only 10 questions. A total of 131/284 of the participants did not ask any question. Among the participants who asked questions, the majority132/171 participants asked about risks related to investigational products followed by questions related to study procedures 83/171. Participants/guardians with higher education and those who consented for Phase III studies asked significantly more questions. Conclusion A majority of the queries were related to the risks associated with the investigational products. Educational status and the Phase of the trial were found to be significantly associated with the number of questions being asked. (shrink)

A description of the author's application of protocol analysis in the teaching of philosophy.

The philosophical method of conceptual analysis has been criticised on the grounds that empirical psychological research has cast severe doubt on whether concepts exist in the form traditionally assumed, and that conceptual analysis therefore is doomed. This objection may be termed the Charge from Psychology. After a brief characterisation of conceptual analysis, I discuss the Charge from Psychology and argue that it is misdirected.

The central problem which cognitive scientists face in studying thinking is that thinking cannot be observed directly by other people. The traditional solution has been to rely on introspective methods, where individuals observe their own thinking and reflect on its characteristics. In everyday life, the most common technique involves asking people questions about their thinking, knowledge, and strategies. Psychologists have refined the methods for questioning individuals by designing questionnaires and structured interviews. However, these two ways of obtaining information about thinking (...) share two fundamental methodological problems. First, the accuracy of the reports cannot be assessed, because in naturally occurring situations in everyday life the investigator doesn't have any other empirical evidence against which to evaluate the validity of the subjects' reported information. Hence, psychologists are forced to trust the subjects to provide valid information. The second issue concerns whether even those individuals who strive to give accurate reports are able to access and supply valid information on the cognitive processes that mediate their behavior. (shrink)

Sixteen Canadian men and women, part of eight intact couples who had experienced severe and recurrent wife assault, were interviewed individually regarding their worst experience of violence. The self-reports of both spouses of one of these couples is presented and analyzed with a view towards isolating the emerging constituents of their narratives. Additionally, preliminary findings resulting from the analysis of all of the couple's self-reports are presented in the second part of the paper. A gendered reconstruction of their narratives (...) emerges that mirrors the different positions men and women hold in experiences of wife assault. Finally, the main constituents derived from all the participant's selfreports are analyzed and discussed. (shrink)

When we forgive, we do so for reasons. One challenge for forgiveness theorists is to explain which reasons are reasons to forgive and which are not. This paper argues that we forgive in response to a perceived change of heart on the part of the offender. The argument proceeds in four steps. First, I show that we forgive for reasons. Second, I argue that forgiveness requires the right kind of reason. Third, I show that these two points explain a common (...) distinction between forgiving and letting go and, in doing so, solve a problem facing many accounts of forgiveness. Finally, I consider candidate reasons to forgive and argue that all of them are either the wrong kind of reason or are instances of a more general reason of the right kind, namely, a perceived change of heart. (shrink)

The author's aim here is to philosophically analyze the notion of positive mental health. Defining characteristics of positive mental health are described, drawing on modern psychiatric, psychoanalytical, psychological, and philosophical literature. The author finds that it is impossible to draw decisive conclusions about what characteristics constitute positive mental health, and suggests a general theory of health. Lennart Nordenfelt's holistic theory of general health is chosen to guide the rest of the discussion. The author is affiliated with Malmo University, Sweden. This (...) book is based on his PhD thesis in the Department of Health and Society at Linkoping University. Annotation copyrighted by Book News Inc., Portland, OR. (shrink)

The concept of ‘empowerment’ is used frequently in a number of professional areas, from psychotherapy to social work. But even if the same term is used, it is not always clear if the concept denotes the same goals or the same practice in these various fields. The purpose of this paper is to clarify the discussion and to find a plausible and useful definition of the concept that is suitable for work in various professions. Several suggestions are discussed in the (...) paper, for example control over life or health, autonomy, ability, self-efficacy, self-esteem, and freedom, and it is concluded that there are two plausible complementary uses, one as a goal and one as a process or approach. Empowerment as a goal is to have control over the determinants of one’s quality of life, and empowerment as a process is to create a professional relation where the client or community takes control over the change process, determining both the goals of this process and the means to use. (shrink)

One important ethical issue for health promotion and public health work is to determine what the goals for these practices should be. This paper will try to clarify what some of these goals are thought to be, and what they ought to be. It will specifically discuss two different approaches to health promotion, such as, behavior change and empowerment. The general aim of this paper is, thus, to compare the behavior-change approach and the empowerment approach, concerning their immediate goals or (...) aims, and to morally evaluate the strengths and weaknesses of these two goal models, in relation to the ultimate goal of health promotion. The investigation shows that the behavior-change approach has several moral problems. First of all, it is overly paternalistic and often disregards the individual’s or group’s own perception of what is important—something that also increases the risk of failed interventions. Furthermore, it risks leading to ‘victim blaming’ and stigmatization, and to increased inequalities in health, and it puts focus on the ‘wrong’ problems, i.e., behavior instead of the ‘causes of the causes’. It is thereafter shown that the empowerment approach does not have any of these problems. Finally, some specific problems for the empowerment approach are discussed and resolved, such as, the idea that empowering some groups might lead to power over others, the objection that the focus is not primarily on health, and the fact that empowered people might choose to live lives that risk reducing their health. (shrink)

We all intuitively know what a diagram is, and still it is surprisingly difficult to describe it as a semiotic function or type. In this article, we present four groups of hypotheses in view of a clarification. We hypothesize: (1) That diagrams are signs of a distinct type, unknown to classical semiotics; (2) That the elementary graphs of a diagram are all derived fromlines and pointsintopologicalmental spaces. The mind applies these diagrammatic spaces to referential spaces in many ways, but basically (...) through conceptual integration (blending). The mind blends topology and reference, which makes the topology unnoticeable; (3) That elementary diagrammatic graphs constitute a natural, phenomenological, spatiotemporal, figurative and dynamic but informal geometry in the embodied, thinking mind; (4) That diagrammatic signs are the active components of the abstract mental figuration in working memory that accompany perception and deliver the schematizing ideas which invest and connect our categories and construe proper descriptive, narrative, patterns of inferentialthoughtand programs of sensorimotor and social action. (shrink)

The precautionary principle is frequently invoked in environmental law and policy, and the debate around the principle indicates that there is little agreement on what 'taking precautions' means. The purpose of the present paper is to provide an improved conceptual foundation for this debate in the form of an explication of the concept of precaution. Distinctions between precaution and two related concepts, prevention and pessimism, are briefly discussed. The concept of precaution is analysed in terms of precautionary actions. It is (...) argued that precautionary actions are implicitly assumed to be precautionary with respect to something, and that this assumption should be made explicit. A definition of a precautionary action involving three necessary and jointly sufficient conditions (intentionality, uncertainty and reasonableness) is proposed, and the implications of this analysis for the debate on the precautionary principle are discussed. (shrink)

The purpose of the article is to argue for the significance of a clarified goal of health care for the setting of priorities. Three arguments are explored. First, assessment of needs becomes necessary in so far as the principle of need should guide the priority-setting. The concept of health care need includes a goal component. This component should for rational reasons be identical with the goal of health care. Second, in order to use resources efficiently it is necessary to assess (...) the effects of health care. It is not, however, a question of assessing whether there is an effect but a question of assessing whether there is the right effect. And what constitutes the right effect can only be determined in relation to the goal of the enterprise. Third, the health sector involves several groups of actors such as politicians, administrators, doctors, nurses, physiotherapists, occupational therapists, educationists and patients. It is common knowledge that successful teamwork requires an understanding of a common goal. The article ends with an example of a goal chosen from ethics. (shrink)

This is the first book in welfare economics to be primarily intended for undergraduates and non-specialists. Concepts such as Pareto optimality in a market economy, the compensation criterion, and the social welfare function are explored in detail. Market failures are analysed by using different ways of measuring welfare changes. The book also examines public choice, and the issues of provision of public goods, median voter equilibrium, government failures, efficient and optimal taxation, and intergenerational equity. The three final chapters are devoted (...) to applied welfare economics: methods for revealing people's preferences, cost-benefit analysis, and project evaluation in a risky world. The book is intended for introductory and intermediate courses in welfare economics, microeconomics, and public economics. It will also be suitable for courses in health economics, environmental economics, and cost-benefit analysis, as well as those undertaking project evaluations in government agencies and private firms. (shrink)

The purpose of the present thesis is to apply philosophical methods to the ongoing debate of the precautionary principle, in order to illuminate this debate. The thesis consists of an Introduction and five papers. Paper I con-cerns an objection to the method of conceptual analysis, the Charge from Psychology. After a brief characterisation of conceptual analysis, I argue that the Charge from Psychology is misdirected. In Paper II, the method of conceptual analysis is applied to the concept (...) of precaution which is ana-lysed in terms of precautionary actions. The purpose is explicatory. A definition involving three necessary and jointly sufficient conditions is proposed, and the implications of this analysis for the debate on the pre-cautionary principle are discussed. Paper III attempts to provide an ana-lytical apparatus which may be used for finding improved formulations of the precautionary principle. The approach is lexicographical. Several exist-ing and possible formulations of the precautionary principle are examined, and four common elements and a common structure of the precautionary principle are identified. It is suggested that the analytical apparatus pre-sented can be used in negotiations of the precautionary principle. Paper IV questions the soundness of some arguments against the precautionary prin-ciple. Five common arguments are discussed and rejected. In Paper V, two of these arguments are further discussed. I argue that an attempt at rejec-tion of the precautionary principle delivered by John Harris and Søren Holm is unwarranted, because their arguments against it are based on in-terpretations of the precautionary principle that ignore context. Paper VI deals with the idea of de minimis risk. After a discussion of the distinction between disregarding a risk and accepting it, I examine one way of deter-mining how small a risk ought to be in order to be disregarded, namely the use of natural risk levels as benchmarks. I argue that this approach fails, even if the distinction between what is natural and what is not natural can be upheld. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 36.1 (2003) 39-47 [Access article in PDF] Restraint and Emotion in Cicero's De Oratore Per Fjelstad In De Oratore Cicero has the revered orator Crassus ask, "Who then is the man who gives people a thrill? whom do they stare at in amazement when he speaks? who is interrupted by applause? who is thought to be so to say a god among men?" (1942a, III.53). Crassus, (...) who is asking his companions to think about emotional energy in speech, goes on, "It is those whose speeches are clear, explicit, and full, perspicuous in matter and language, and who in actual delivery achieve a sort of rhythm and cadence—that is, whose style I call 'ornate'."Several things are striking about the passage. First, it resolves its inquiry by invoking the concept of ornatus, a word widely used to translate the Greek idea of kosmos (DiLorenzo 1978). Cicero thus refers to a quality that joins the ideas of cosmic order, physical beauty, and earthly power. Second, the passage is delivered in the midst of Crassus's discussion of the fourth rhetorical canon, that referring to the elaboration of ideas in language, of selecting levels of style and modes of verbal embellishment. Third, the passage ranges across the entire field of rhetorical art, at least as indexed by the scope of the canons. The performative quality directly under discussion, that which gives people a thrill—initially associated with the Theophrastian virtues of style that Crassus has been enumerating, that is, clarity and explicitness—quickly is expanded to include copiousness of invention, perspicuity of language, and energetic beauty in delivery. Cicero's Crassus thus discusses a performative dynamic that appears to govern rhetoric as a whole.As the other characters in the dialogue discuss this quality of speech, which engages listeners emotionally and transforms their experience of the present, they bound beyond the preliminary categories of their analysis and describe a power of speech that is aesthetic and philosophical. As the [End Page 39] narrator of this dialogue, Cicero eventually associates the possibility of emotional transformation with a quality of performance we might identify as graceful or urbane. Cicero suggests that performative style can rise above particular details, conventions, and rules of standard rhetorical instruction. Ornate speech is, in sum, emotionally transformative. In detail, however, how does Cicero theorize this grand ability? What goals, resources, or models does he invoke?This essay argues that Cicero's theory of ornatus insists an orator display emotions relevant to the performance while responding to the need of listeners to hear emotional expression against a backdrop of relative calm. In developing this analysis, I claim that the dialogic format of De Oratore allows insight to emerge from juxtaposed perspectives, that Cicero's ideal of ornatus contains a limiting threshold for performative exuberance, and that his examples of emotional engagement illustrate the importance of context and aesthetic restraint. Theoretical tensions as sources for synthetic insight Theoretical tensions in Cicero's De Oratore are instructive. While Cicero's effort to reconcile Isocratean practice with Aristotelian teleology ultimately makes for a rough fit, the juxtaposition of those understandings within the dialogue also generates new insight, even about limits for rhetorical theory itself. Referring to this mode of theorizing as "ironic eloquence," Michael Leff holds that "through this merger of theory and practice, the rival conceptions of oratory as systematic art and oratory as synthetic practice coalesce within the text, the two perspectives interacting to produce a development that incorporates both" (1986, 323).A similar theoretical tension can be observed in De Oratore regarding the prospects and significance of emotional engagement in oratorical performance. In discussing the practices of emotional oratory Cicero draws on three distinct intellectual sources: a quasi-enthymematic model of emotional engagement, in which an orator need not share or display the sought-after emotional response; a mimetic theory of theatrical performance (that is, a typology of tonal and gestural "moods"); and a latent theory of "authenticity," according to which that which is being theatrically displayed is not "fakely" fictional, but somehow genuine.The conflicting theories suggest... (shrink)

Cognitive semio-linguistics studies the relations between signs and language, between semiological and linguistic structures, as expressions of, and as causes of, the cognitive activities involved in thinking, here called epistemic activities. This short essay displays a leveled analysis of the relations holding between semio-linguistic and epistemic structures active in the human mind.

During the last decade, the populist radical nationalist party, the Sweden Democrats, has gone from being a minor party to become Sweden’s third largest party in parliament. In this article, the author shows how the category of Christianity has come to play a pivotal role in the party’s political identification. Drawing on Ernesto Laclau’s analysis of populism, the author argues that Christianity should be understood as a projection surface for fantasies of an ethnically and culturally superior homogenous nation vis-à-vis (...) constructed national others. In a populist logic, Christianity has thus become a way to distinguish the SD from its articulated external and internal political foes. By appropriating Christianity, the SD articulates itself as the guardian of true Christianity, the future savior of a Church allegedly hijacked by external and internal foes, and in the long run, the Swedish nation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 36.1 (2003) 39-47 [Access article in PDF] Restraint and Emotion in Cicero's De Oratore Per Fjelstad In De Oratore Cicero has the revered orator Crassus ask, "Who then is the man who gives people a thrill? whom do they stare at in amazement when he speaks? who is interrupted by applause? who is thought to be so to say a god among men?" (1942a, III.53). Crassus, (...) who is asking his companions to think about emotional energy in speech, goes on, "It is those whose speeches are clear, explicit, and full, perspicuous in matter and language, and who in actual delivery achieve a sort of rhythm and cadence—that is, whose style I call 'ornate'."Several things are striking about the passage. First, it resolves its inquiry by invoking the concept of ornatus, a word widely used to translate the Greek idea of kosmos (DiLorenzo 1978). Cicero thus refers to a quality that joins the ideas of cosmic order, physical beauty, and earthly power. Second, the passage is delivered in the midst of Crassus's discussion of the fourth rhetorical canon, that referring to the elaboration of ideas in language, of selecting levels of style and modes of verbal embellishment. Third, the passage ranges across the entire field of rhetorical art, at least as indexed by the scope of the canons. The performative quality directly under discussion, that which gives people a thrill—initially associated with the Theophrastian virtues of style that Crassus has been enumerating, that is, clarity and explicitness—quickly is expanded to include copiousness of invention, perspicuity of language, and energetic beauty in delivery. Cicero's Crassus thus discusses a performative dynamic that appears to govern rhetoric as a whole.As the other characters in the dialogue discuss this quality of speech, which engages listeners emotionally and transforms their experience of the present, they bound beyond the preliminary categories of their analysis and describe a power of speech that is aesthetic and philosophical. As the [End Page 39] narrator of this dialogue, Cicero eventually associates the possibility of emotional transformation with a quality of performance we might identify as graceful or urbane. Cicero suggests that performative style can rise above particular details, conventions, and rules of standard rhetorical instruction. Ornate speech is, in sum, emotionally transformative. In detail, however, how does Cicero theorize this grand ability? What goals, resources, or models does he invoke?This essay argues that Cicero's theory of ornatus insists an orator display emotions relevant to the performance while responding to the need of listeners to hear emotional expression against a backdrop of relative calm. In developing this analysis, I claim that the dialogic format of De Oratore allows insight to emerge from juxtaposed perspectives, that Cicero's ideal of ornatus contains a limiting threshold for performative exuberance, and that his examples of emotional engagement illustrate the importance of context and aesthetic restraint. Theoretical tensions as sources for synthetic insight Theoretical tensions in Cicero's De Oratore are instructive. While Cicero's effort to reconcile Isocratean practice with Aristotelian teleology ultimately makes for a rough fit, the juxtaposition of those understandings within the dialogue also generates new insight, even about limits for rhetorical theory itself. Referring to this mode of theorizing as "ironic eloquence," Michael Leff holds that "through this merger of theory and practice, the rival conceptions of oratory as systematic art and oratory as synthetic practice coalesce within the text, the two perspectives interacting to produce a development that incorporates both" (1986, 323).A similar theoretical tension can be observed in De Oratore regarding the prospects and significance of emotional engagement in oratorical performance. In discussing the practices of emotional oratory Cicero draws on three distinct intellectual sources: a quasi-enthymematic model of emotional engagement, in which an orator need not share or display the sought-after emotional response; a mimetic theory of theatrical performance (that is, a typology of tonal and gestural "moods"); and a latent theory of "authenticity," according to which that which is being theatrically displayed is not "fakely" fictional, but somehow genuine.The conflicting theories suggest... (shrink)

Combining in-depth analysis with strikingly apt examples of the role that courage plays in the life of human beings, this major contribution to moral philosophy argues that courage is necessary to personal achievement as well as to the common good of a civic community. Bauhn insists that courage is necessary for reinforcing people's understanding of themselves as autonomous agents, which is in turn necessary for countering widespread feelings of alienation and depression. He defines courage as the ability to confront (...) fear, but crucially distinguishes a variety of fears that give rise to different types of courage. (shrink)

Gilbert Ryle's book The Concept of Mind was published in 1949. According to Ryle, his "destructive purpose" was to show that "a family of radical category mistakes" is the source of the "official doctrine," that is, a "double-life theory," according to which "with the doubtful exception of idiots and infants in arms every human being has both a body and a mind." By numerous examples, Ryle showed quite forcefully how psychology and philosophy at the time were misled into asking the (...) wrong kinds of questions. More than 50 years have elapsed since the original publication of Gilbert Ryle's book and, as Ullin T. Place wrote shortly before passing away, Ryle's conceptual analysis is now due, if not overdue, for a comeback. The purpose of this paper is to discuss the persistent relevance of category mistakes to current problems in the analysis of behavior. (shrink)

This thesis in an invistigation into the concept of "harm" and its moral relevance. A common view is that an analysis of harm should include a counterfactual condition: an act harms a person iff it makes that person worse off. A common objection to the moral relevance of harm, thus understood, is the non-identity problem. -/- This thesis criticises the counterfactual condition, argues for an alternative analysis and that harm plays two important normative roles. -/- The main ground (...) for rejecting the counterfactual condition is that it has unacceptable consequences in cases of overdetermination and pre-emption. Several modifications to the condition are considered but all fail to solve this problem. -/- According to the alternative analysis to do harm is to perform an act which is responsible for the obtaining of a state of affairs which makes a person’s life go worse. It is argued that should be understood in terms of counterfactual dependence. This claim is defended against counterexamples based on redundant causation. An analysis of is also provided using the notion of a well-being function. It is argued that by introducing this notion it is possible to analyse contributive value without making use of counterfactual comparisons and to solve the non-identity problem. -/- Regarding the normative importance of harm, a popular intuition is that there is an asymmetry in our obligations to future people: that a person would have a life worth living were she to exist is not a reason in favour of creating that person while that a person would have a life not worth living is a reason against creating that person. It is argued that the asymmetry can be classified as a moral option grounded in autonomy. Central to this defence is the suggestion that harm is relevant to understanding autonomy. Autonomy involves partly the freedom to pursue one’s own aims as long as one does no harm. (shrink)

Human gait is a complex activity that requires high coordination between the central nervous system, the limb, and the musculoskeletal system. More research is needed to understand the latter coordination's complexity in designing better and more effective rehabilitation strategies for gait disorders. Electroencephalogram and functional near-infrared spectroscopy are among the most used technologies for monitoring brain activities due to portability, non-invasiveness, and relatively low cost compared to others. Fusing EEG and fNIRS is a well-known and established methodology proven to enhance (...) brain–computer interface performance in terms of classification accuracy, number of control commands, and response time. Although there has been significant research exploring hybrid BCI involving both EEG and fNIRS for different types of tasks and human activities, human gait remains still underinvestigated. In this article, we aim to shed light on the recent development in the analysis of human gait using a hybrid EEG-fNIRS-based BCI system. The current review has followed guidelines of preferred reporting items for systematic reviews and meta-Analyses during the data collection and selection phase. In this review, we put a particular focus on the commonly used signal processing and machine learning algorithms, as well as survey the potential applications of gait analysis. We distill some of the critical findings of this survey as follows. First, hardware specifications and experimental paradigms should be carefully considered because of their direct impact on the quality of gait assessment. Second, since both modalities, EEG and fNIRS, are sensitive to motion artifacts, instrumental, and physiological noises, there is a quest for more robust and sophisticated signal processing algorithms. Third, hybrid temporal and spatial features, obtained by virtue of fusing EEG and fNIRS and associated with cortical activation, can help better identify the correlation between brain activation and gait. In conclusion, hBCI system is not yet much explored for the lower limb due to its complexity compared to the higher limb. Existing BCI systems for gait monitoring tend to only focus on one modality. We foresee a vast potential in adopting hBCI in gait analysis. Imminent technical breakthroughs are expected using hybrid EEG-fNIRS-based BCI for gait to control assistive devices and Monitor neuro-plasticity in neuro-rehabilitation. However, although those hybrid systems perform well in a controlled experimental environment when it comes to adopting them as a certified medical device in real-life clinical applications, there is still a long way to go. (shrink)

Introduction: The concept of ” work ability” is central for many sciences, especially for those related to working life and to rehabilitation. It is one of the important concepts in legislation regulating sickness insurance. How the concept is defined therefore has important normative implications. The concept is, however, often not sufficiently well defined. Aim and Method: The objective of this paper is to clarify, through conceptual analysis, what the concept can and should mean, and to propose a useful definition (...) for scientific and practical work. Results: Several of the defining characteristics found in the literature are critically scrutinized and discussed, namely health, basic standard competence, occupational competence, occupational virtues, and motivation. These characteristics are related to the work tasks and the work environment. One conclusion is that we need two definitions of work ability, one for specific jobs that require special training or education, and one for jobs that most people can manage given a short period of practice. Having work ability, in the first sense, means having the occupational competence, the health required for the competence, and the occupational virtues that are required for managing the work tasks, assuming that the tasks are reasonable and that the work environment is acceptable. In the second sense, having work ability is having the health, the basic standard competence and the relevant occupational virtues required for managing some kind of job, assuming that the work tasks are reasonable and that the work environment is acceptable. Conclusion: These definitions give us tools for understanding and discussing the complex, holistic and dynamic aspects of work ability, and they can lay the foundations for the creation of instruments for evaluating work ability, as well as help formulate strategies for rehabilitation. (shrink)

The terms “health promotion” and “disease prevention” refer to professional activities. But a “health promoter” has also come to denote a profession, with an alternative agenda compared to that of traditional public health work, work that by some is seen to be too medically oriented, too reliant upon prevention, risk-elimination and health-care. But is there really a sharp distinction between these activities and professions? The main aim of the paper is to investigate if these concepts are logically different, or if (...) they are just two extremes of one dimension. The central concepts, health promotion and disease prevention, are defined, and it is concluded that health promotion and disease prevention are logically distinct concepts, although they are conceptually related through a causal connection. Thus, logically, it is possible to promote health without preventing disease, even if this is not so common, in practice, but it is not possible to prevent disease without promoting health. Finally, most health promoting interventions target basic health, not manifest health, and often also thereby reduce future disease. (shrink)

It appears that there are two distinct practices within public health, namely health promotion and disease prevention, leading to different goals. But does the distinction hold? Can we promote health without preventing disease, and vice versa? The aim of the paper is to answer these questions. First, the central concepts are defined and the logical relations between them are spelt out. A preliminary conclusion is that there is a logical difference between health and disease, which makes health promotion and disease (...) prevention two distinct endeavours. However, since disease is defined in relation to health, as those kinds of internal processes and states that typically lead to ill health, the difference is smaller than it might appear. Second, in order to answer the practical question whether it is possible to promote health without preventing disease, and vice versa, several kinds of public health interventions are discussed. The conclusion is that while health promotion and disease prevention can be distinguished conceptually, they can hardly be distinguished in practice. Most general measures do both at the same time. (shrink)

Although most theorists of healthcare rationing argue that rationing, including rationing that takes place in the physician–patient relationship is unavoidable, some health professionals strongly disagree. In a recent essay, Vegard Bruun Wyller argues that bedside rationing is immoral and thoroughly at odds with a sound view of the physician–patient relationship. We take Wyller to be an articulate exponent of the reluctance to participate in rationing found among some clinicians. Our essay attempts to refute the five crucial premises of his argument (...) yet build on his genuine insights. In our analysis, Wyller’s critique of bedside rationing is instructive both for harbouring some very common misconceptions that must be exposed and refuted, but also for offering important words of caution. In particular, bedside rationing must be performed in ways that do not harm the physician–patient relationship. Read irenically, Wyller’s critique is a reminder of what must not be lost in our painful endeavour to update the ethics of medicine to encompass the unavoidability of rationing. (shrink)

The standard interpretation of cognitive reflection tests assumes that correct responses are reflective and lured responses are unreflective. However, prior process-tracing of mathematical reflection tests has cast doubt on this interpretation. In two studies (N = 201), we deployed a validated think-aloud protocol in-person and online to test how this assumption is satisfied by the new, validated, less familiar, and less mathematical verbal Cognitive Reflection Test (vCRT). Importantly, thinking aloud did not disrupt test performance compared to a control group. (...) Moreover, verbalized thoughts in both studies revealed that most (but not all) correct responses involved reflection and that most (but not all) lured responses lacked reflection. These data suggest that the vCRT usually satisfies the standard interpretation of the reflection tests (albeit not without exceptions) and that the vCRT can be a good measure of the construct theorized by the two-factor explication of ‘reflection’ (as deliberate and conscious). (shrink)

This paper highlights the dark side of power imbalance regarding its consequences in agri-food supplier–buyer relationships. We report on findings from two studies. The first study is based on a sample of 105 key informants, while study 2 is based on a sample of 444 key informants, all from the cocoa agri-food supply market of Ghana. While the first study focuses on the antecedents of power imbalance and its consequences, the second study explores the role of cooperatives/collective action in minimizing (...) supplier exploitation. Data from these studies were analysed using the partial least squares technique. Analysis of these findings shows switching costs’ impact on power imbalance to be curvilinear, while power imbalance has a curvilinear relationship with opportunism. The negative consequences of power imbalance are further exacerbated by dependency and the lack of joint action. Furthermore, we found the negative impact of power imbalance on financial performance to be stronger for non-cooperative members than for cooperative members, while, counterintuitively, we found the positive impact of economic satisfaction on financial performance to be stronger for non-cooperative members than for cooperative members. (shrink)

This article reports a follow-up study of Norwegian nursing students entitled ‘The helping motive -an important goal for choosing nursing education’. It presents and discusses a significant ambiguity within the altruistic helping motive of 301 nursing students in the light of classical and modern virtue ethics. A quantitative longitudinal survey design was used to study socialization and building professional identity. The follow-up study began after respondents had completed more than two-and-a-half years of the three-year educational programme. Data were collected using (...) a questionnaire with closed questions, supplemented by 18 semi-structured, in-depth, audiotaped interviews. A motive such as ‘desire for human contact/to help others’ appeared to be highly significant. The research questions employed were: What motivates nursing students at the end of their studies to help other people? What does helping others mean for nursing students? Factor analysis revealed two factors. Factor 1 can be expressed as an altruism factor and factor 2 can be interpreted as an ‘acknowledgement-from-the-patient factor’ that in fact indicates an ambiguity within the helping motive itself. Findings from the interviews also reveal ambiguous helping motives. On one hand the students want to be altruistic and on the other they wish to receive positive feedback from patients when giving help. The findings indicate that this positive feedback is essential to the students in order for them to provide altruistic care. (shrink)

Standard tools used in societal risk management such as probabilistic risk analysis or cost–benefit analysis typically define risks in terms of only probabilities and consequences and assume a utilitarian approach to ethics that aims to maximize expected utility. The philosopher Carl F. Cranor has argued against this view by devising a list of plausible aspects of the acceptability of risks that points towards a non-consequentialist ethical theory of societal risk management. This paper revisits Cranor’s list to argue that (...) the alternative ethical theory responsibility-catering prioritarianism can accommodate the aspects identified by Cranor and that the elements in the list can be used to inform the details of how to view risks within this theory. An approach towards operationalizing the theory is proposed based on a prioritarian social welfare function that operates on responsibility-adjusted utilities. A responsibility-catering prioritarian ethical approach towards managing risks is a promising alternative to standard tools such as cost–benefit analysis. (shrink)

Meanings of living at home on a ventilator Nine adults were interviewed in order to illuminate the meanings of being dependent on a ventilator and living at home. The data were analysed using a phenomenological‐hermeneutic method inspired by the philosophy of Ricoeur. Five main themes emerged through the analysis: experiencing home as a safe and comfortable space from which to reach out, experiencing the body as being frail, brave and resilient, striving to live in the present, surrendering oneself to (...) and trusting others, and experiencing technology as a burden and a relief to the lived body. Meanings of being home on a ventilator were interpreted as maintaining autonomy and persistence in interaction with the ventilator and other human beings and being able to rise above yourself and your personal boundaries in order to live a good life. These meanings indicate that aesthetic and ethical values impact on the lived body. They are bound up with experiencing a vital force and interdependency, bringing safety and courage into daily life. (shrink)

In previous work, we introduced a version of distributed temporal logic that is well-suited both for verifying security protocols and as a metalogic for reasoning about, and relating, different security protocol models. In this paper, we formally investigate the relationship between our approach and strand spaces, which is one of the most successful and widespread formalisms for analyzing security protocols. We define translations between models in our logic and strand-space models of security protocols, and we compare the results obtained (...) with respect to the level of abstraction that is inherent in each of the formalisms. This allows us to clarify different aspects of strand spaces that are often left implicit, as well as pave the way to transfer results, techniques and tools across the two approaches. (shrink)

Arthur Norman Prior (1914-69) was a logician and philosopher from New Zealand who contributed crucially to the development of ‘non-standard’ logics, especially of the modal variety. His greatest achievement was the invention of modern temporal logic, worked out in close connection with modal logic. However, his work in logic had a much broader scope. He was also the founder of hybrid logic, and he made important contributions to deontic logic, modal logic, the theory of quantification, the nature of propositions and (...) the history of logic. In addition, he discussed questions of ethics, free will, and general theology. Prior’s philosophical works comprise about 200 titles. His earliest articles center on philosophical theology and historical studies of Scottish Reformed Theology. This led on to the publication of his first influential work on ethics: Logic and The Basis of Ethics (1949). With the invention of tense-logic in the early 1950s, his focus shifted to investigations into the syntax of tempo-modal logic leading to his seminal Time and Modality (1957), a volume derived from his John Locke Lectures in Oxford in 1956. Furthermore Prior, together with the Irish mathematician and logician C.A. Meredith (1904-76), made important early contributions to the semantics of possible worlds. Prior’s tense-logic provided a strong conceptual framework for problems pertaining to the philosophy of time. In Time and Modality, Prior discussed the philosophical implications of Ruth Barcan’s famous formulae for tense-logic, and in the 1960s he worked on the notion of the present. The most persistent problem running through Prior’s work is his study of the questions surrounding human freedom and divine foreknowledge, and more general philosophical problems emerging from this classical theological question. His thorough analysis of this problem, with the conceptual tools of tense-logic, received a crucial impetus from his correspondence with the young Saul Kripke, when the latter suggested the semantic tool of branching time to Prior. Prior’s development of two solutions based on branching time for the problem of future contingency, the Peircean and the Ockham solution, was most thoroughly developed in Past, Present and Future (1967), the most important work published by Prior. Characteristically for Prior’s methodological approach, the development of these two solutions were at the same time a development of two new systems of tense logic, and vice versa. One of Prior’s significant contributions to logic was his work on world propositions and instant propositions. In the course of developing these notions he also made one of the earliest formulations of hybrid logic. In Papers on Time and Tense (1968), he presented this idea in a more detailed manner in the context of his four grades of tense-logical involvement. (shrink)

Results of studies that cast doubt on the safety of genetically modified crops have been published since the first GM crop approval for commercial release. These ‘alarming studies’ challenge the dominant view about the adequacy of current risk assessment practice for genetically modified organisms. Subsequent debates follow a similar and recurring pattern, in which those involved cannot agree on the significance of the results and the attached consequences. The standard response from the government—a reassessment by scientific advisory bodies—seems insufficient to (...) bring the debate to a satisfactory closure. The recurrence of the same debate every time an alarming study is published shows that science alone cannot solve the problem. We believe that further analysis is needed to investigate if and how we can prevent this repetitive cycle that creates frustration amongst all stakeholders. In this paper, we analyse the dynamics behind discussions which occur following alarming studies. We will use a selection of representative alarming GMO case studies to underpin our claim that it is likely that there will be a permanent difference in view of opinion that cannot be solved with more data or new facts. The current strategy of more research is a pitfall that is unlikely to solve this issue. Instead, the focus of the GM crop discussion should shift towards managing permanent different viewpoints and providing a platform for a broader conversation on agriculture and food production. (shrink)

Standard tools used in societal risk management such as probabilistic risk analysis or cost–benefit analysis typically define risks in terms of only probabilities and consequences and assume a utilitarian approach to ethics that aims to maximize expected utility. The philosopher Carl F. Cranor has argued against this view by devising a list of plausible aspects of the acceptability of risks that points towards a non-consequentialist ethical theory of societal risk management. This paper revisits Cranor’s list to argue that (...) the alternative ethical theory responsibility-catering prioritarianism can accommodate the aspects identified by Cranor and that the elements in the list can be used to inform the details of how to view risks within this theory. An approach towards operationalizing the theory is proposed based on a prioritarian social welfare function that operates on responsibility-adjusted utilities. A responsibility-catering prioritarian ethical approach towards managing risks is a promising alternative to standard tools such as cost–benefit analysis. (shrink)

While in vitro animal meat is not yet commercially available, the public has already begun to form opinions of IVM as a result of news stories and events drawing attention to its development. As such, we can discern public perceptions of the ethics of IVM before its commercial release. This affords advocates of environmentally sustainable, healthy, and just diets with a unique opportunity to reflect on the social desirability of the development of IVM. This work draws upon an analysis (...) of ethical perceptions of IVM in 814 US news blog comments related to the August 2013 tasting of the world’s first IVM hamburger. Specifically, I address three primary questions: How does the public perceive the ethics of IVM development? How acceptable is IVM to the public relative to alternative approaches to reducing animal meat consumption? and What should all of this mean for the ongoing development and promotion of IVM? Ultimately, it is argued that there is a strong need for facilitation of public dialogue around IVM, as well as further research comparing the acceptability of IVM to other alternatives. (shrink)

Our aim with this descriptive phenomenological study was to identify and describe the essential meaning structure in the experience of postpartum depression . We interviewed four women diagnosed with major depression and analyzed the data with Giorgi’s descriptive phenomenological method. Our analysis revealed two essential meaning structures of PPD. The first structure describes the mother as thrown into a looming, dangerous world, coupled with a restricted, heavy body that hindered her attunement to her baby. Tormented by anxiety, guilt and (...) shame, she tried to deal with her pain by analytical reflection and social isolation. The second structure describes sudden lapses into intense feelings of alienation from the self, the baby, and from the social and material world. With a distorted primordial self-awareness, the mother no longer felt that she existed as herself in the world. We reflect on these findings using the insights of Fuchs, Van den Berg, Heidegger and Merleau-Ponty. (shrink)

The aim of this article is twofold. First, it is a theoretical and empirically based contribution to the branch of research that studies enabling conditions of human sense-making. It demonstrates the value of a coherent ecological framework, based on dialogism and interactivity for the study of sense-making, problem-solving and task performance in naturalistic contexts. Second, it presents a promising method for the analysis of cognitive activities, Cognitive Event Analysis, with which we investigate real-life medical interactions, especially the emergence (...) of insights in procedural task performance in emergency medicine. We show how sense-making and insights are accomplished by medical teams when they integrate cultural expertise, professional skills, inter-bodily dynamics, material constraints and affordances within the environment, i.e. when local co-action is embedded in socio-cultural patterns of behaviour. (shrink)