The purpose of this article is to investigate how cultural meanings associated with the left ventricular assist device inform acceptance and experience of this innovative technology when it is used as a destination therapy. We conducted open-ended, semistructured interviews with family caregivers and patients who had undergone LVAD-DT procedures at six U.S. hospitals. A grounded theory approach was used for the analysis. Thirty-nine patients and 42 caregivers participated. Participants described a sense of obligation to undergo the procedure because of its (...) promise for salvation. However, once the device was implanted, patients described being placed into a liminal state of being neither sick nor healthy, with no culturally scripted role. Consideration of end-of-life decisions was complicated by the uncertainties about how patients with LVADs die. Pre-implantation communications among patient, family, and clinicians should take into account the impact of the technology on meaning, identity, and patient experience. (shrink)
Lors d’un entretien récent Natalie Zemon Davis soulignait opportunément : « […] the study of the past provides rewards for moral sensibility and tools for critical understanding. No matter how evil the times, no matter how immense the cruelty, some elements of opposition or kindness and godness emerge. No matter how bleak and constrained the situation, some forms of improvisation and coping take place. No matter what happens, people go on telling stories about it and bequeath them to the futu..
Though many argue over root causes, few dispute the existence of gender disparities across our societal landscape. Patriarchal norms consistently obstruct the flourishing of those who identify themselves as women, those who are identified by others as women, and generally those who gender-identify in ways that challenge the norms of heterosexual cis-gender male privilege. Acknowledging the limits of our analysis, here we focus on some of the disparities faced by women in particular.1 From the persistent wage gap despite women's steadily (...) increasing participation in the workforce, to the perplexing paucity of women occupying C-suite positions in business or tenured professorships in academia despite efforts to... (shrink)
The dimension of spatial representations can be assessed by above-chance performance in novel shortcut or spatial reasoning tasks independent of accuracy levels, systematic biases, mosaic/segmentation across space, separate coding of individual dimensions, and reference frames. Based on this criterion, humans and some other animals exhibited sufficient evidence for the existence of three-dimensional and/or four-dimensional spatial representations.
Outside France the epistemology of G. Bachelard is unknown ; in France his influence is considerable, especially on philosophers like L. Althusser, M. Foucault, G. Canguilhem, J. Hyppolite, M. Serres, G. G. Granger, D. Lecourt and many others. Bachelard occupies a strategic point on the crossroads of all theoretical debates concerning science. The fact that he seems to give satisfactory answers on the problems which have risen after the breakdown of the logical-positivistic philosophy of science, justifies an exposition and evaluation (...) of his original contribution to philosophy. The author distinguishes the following items. 1. The determination of Bachelards philosophy as a scientific philosophy which is wedded to a history of the sciences, especially the natural sciences. 2. The 'systematicity' as the criterium of science against other, traditional, criteria like empiricalness, logical deducibility, correspondence with reality and so on. 3. The rectification-principle : the formation of a scientific system cannot be conceived otherwise than as the restructuring or reorganisation of the ruling system or system-sets. 4. The transformation of scientific knowledge shows many discontinuities in all its phases and branches. Bachelard calls them ruptures. 5. The translation of a theory into another, more coherent and comprehensive one, is baptised as a 'dialectisation' of the concept. By a dialectisation a system is both generalised and specified. Formal logic, which is based on identity and the principle of the excluded middle, is not able to interprete this dynamic aspect of scientific thinking. 6. Central in Bachelards philosophy is also the concept of recurrence. Each new organisation of the scientific system (global or partial) sheds new light on their history and their logical foundations. History has to be rewritten after each progress. Recurrence, however, also has systematic implications. Science always desimplifies its own evidences. 7. The scientist has to demolish the obstacles which he made himself by surcharging the content of the concepts not in use and by not assimilating them in the system. 8. Bachelards philosophy of science is both idealistic and realistic ; the phenomenology becomes phenomenotechnique under the hands and in the brains of the scientist. 9. He always denies (negativity) the earlier theories and objects by incorporating them in new relationships. 10. This constructive aspect of theory formation is the same in natural science and mathematics. Bachelard opposes the logical-positivistic idea that these are methodically dissimilar. In a critical commentary the author discusses the question of 'dialectical logic' in the sciences, in relation to some recent research in this field by I. Lakatos en Errol E. Harris. In his opinion the epistemology of Bachelard affords a creative renewal of the understanding of science, although further research is needed in many aspects. (shrink)
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