Implantable cardioverter defibrillators (ICDs) reduce mortality in selected patients at risk for life-threatening heart arrhythmias, and their use is increasingly common. However, these devices also confer risk for delivery of unexpected painful shocks during the dying process, thus reducing the quality of palliative care at the end of life. This scenario can be avoided by ICD deactivation in appropriate circumstances but patients will remain unaware of this option if not informed about it. It is not known how often end-of-life implications (...) are discussed with patients prior to ICD implantation, when focus is primarily on the short-term potential complications of the device placement procedure itself. We conducted a retrospective chart review to determine how often end-of-life implications were discussed with patients as part of the informed consent process. We evaluated consent forms and related other chart documentation for 91 patients (ranging from age 60 to 89 years) undergoing first-time ICD placement at a mid-western academic medical center from 2006-2008. Only one chart documented any discussion of end-of-life implications, in a case where the issue was raised by a patient who noted that quality of life was their main focus. Consent was provided by a health care surrogate in only four of the 91 cases. In conclusion, patients giving consent for ICD implantation may be uninformed about the device's potential future impact on end-of-life care, the dying process, and the option for device deactivation. Truly informed consent requires that both short- and long-term potential implications be reviewed with patients. (shrink)

This self-contained introduction to natural language semantics addresses the majortheoretical questions in the field. The authors introduce the systematic study of linguistic meaningthrough a sequence of formal tools and their linguistic applications. Starting with propositionalconnectives and truth conditions, the book moves to quantification and binding, intensionality andtense, and so on. To set their approach in a broader perspective, the authors also explore theinteraction of meaning with context and use (the semantics-pragmatics interface) and address some ofthe foundational questions, especially in connection (...) with cognition in general. They also introducea few of the most accessible and interesting ideas from recent research to give the reader a bit ofthe flavor of current work in semantics. The organization of this new edition is modular; after theintroductory chapters, the remaining material can be covered in flexible order. The book presupposesno background in formal logic (an appendix introduces the basic notions of set theory) and only aminimal acquaintance with linguistics. This edition includes a substantial amount of completely newmaterial and has been not only updated but redesigned throughout to enhance itsuser-friendliness. (shrink)

“Female sexual dysfunction” is the type of contested disease that has sparked concern about the role of the pharmaceutical industry in medical science. Many policies have been proposed to manage industry influence without carefully evaluating whether the proposed policies would be successful. We consider a proposal for incorporating citizen stakeholders into scientific research and show, via a detailed case study of the pharmaceutical regulation of flibanserin, that such programs can be co-opted. In closing, we use Holman’s asymmetric arms race framework (...) as a tool for evaluating policies in industry-funded science. (shrink)

For Ordinary Language philosophy, at issue is the use of the expressions of language, not expressions in and of themselves. So, at issue is not, for example, ordinary versus (say) technical words; nor is it a distinction based on the language used in various areas of discourse, for example academic, technical, scientific, or lay, slang or street discourses – ordinary uses of language occur in all discourses. It is sometimes the case that an expression has distinct uses within distinct discourses, (...) for example, the expression ‘empty space’. This may have both a lay and a scientific use, and both uses may count as ordinary; as long as it is quite clear which discourse is in play, and thus which of the distinct uses of the expression is in play. Though connected, the difference in use of the expression in different discourses signals a difference in the sense with which it is used, on the Ordinary Language view. One use, say the use in physics, in which it refers to a vacuum, is distinct from its lay use, in which it refers rather more flexibly to, say, a room with no objects in it, or an expanse of land with no buildings or trees. However, on this view, one sense of the expression, though more precise than the other, would not do as a replacement of the other term; for the lay use of the term is perfectly adequate for the uses it is put to, and the meaning of the term in physics would not allow speakers to express what they mean in these other contexts. (shrink)

Under multistakeholderism, private philanthropic foundations have played an increasingly influential role in global development. As part of which, foundations have promoted what we call “privatization creep” (i.e., mainstreaming market-centric solutions to development). Sidelining redistributive approaches altogether, “privatization creep” favours profit-making over everything else, doing little to “save the world.”.

A total of 378 mathematics undergraduates (selected for being strong at “systemizing”) and 414 students in other (control) disciplines at Cambridge University were surveyed with two questions: (1) Do you have a diagnosed autism spectrum condition? (2) How many relatives in your immediate family have a diagnosed autism spectrum condition? Results showed seven cases of autism in the math group (or 1.85%) vs one case of autism in the control group (or 0.24%), a ninefold difference that is significant. Controlling for (...) sex and general population sampling, this represents a three- to sevenfold increase for autism spectrum conditions among the mathematicians. There were 7 of 1,405 (or 0.5%) cases of autism in the immediate families of the math group vs 2 of 1,669 (or 0.1%) cases in the immediate families of the control group, which again is a significant difference. These results confirm a link between autism and systemizing, and they suggest this link is genetic given the association between autism and first-degree relatives of mathematicians. (shrink)

With the advent of legalized medical assistance in dying [MAiD] in Canada in 2016, nursing is facing intriguing new ethical and theoretical challenges. Among them is the concept of conscientious objection, which was built into the legislation as a safeguard to protect the rights of healthcare workers who feel they cannot participate in something that feels morally or ethically wrong. In this paper, we consider the ethical complexity that characterizes nurses' participation in MAiD and propose strategies to support nurses' moral (...) reflection and imagination as they seek to make sense of their decision to participate or not. Deconstructing the multiple and sometimes conflicting ethical and professional obligations inherent in nursing in such a context, we consider ways in which nurses can sustain their role as critically reflective moral agents within a context of a relational practice, serving the diverse needs of patients, families, and communities, as Canadian society continues to evolve within this new way of engaging with matters of living and dying. (shrink)

Linear mixed-effect models (LMMs) are being increasingly widely used in psychology to analyse multi-level research designs. This feature allows LMMs to address some of the problems identified by Speelman and McGann ( 2013 ) about the use of mean data, because they do not average across individual responses. However, recent guidelines for using LMM to analyse skewed reaction time (RT) data collected in many cognitive psychological studies recommend the application of non-linear transformations to satisfy assumptions of normality. Uncritical adoption of (...) this recommendation has important theoretical implications which can yield misleading conclusions. For example, Balota et al. ( 2013 ) showed that analyses of raw RT produced additive effects of word frequency and stimulus quality on word identification, which conflicted with the interactive effects observed in analyses of transformed RT. Generalized linear mixed-effect models (GLMM) provide a solution to this problem by satisfying normality assumptions without the need for transformation. This allows differences between individuals to be properly assessed, using the metric most appropriate to the researcher's theoretical context. We outline the major theoretical decisions involved in specifying a GLMM, and illustrate them by reanalysing Balota et al.'s datasets. We then consider the broader benefits of using GLMM to investigate individual differences. (shrink)

Being at Home stimulates careful conversation about some of the most pressing issues facing higher education institutions in South Africa today - race, transformation, and institutional culture. While there are many reasons to be despondent about the current state of affairs in the South African tertiary sector, this book is an invitation for the reader to see these problems as opportunities for rethinking the very idea of what it is to be a university in contemporary South Africa. It is also, (...) more generally, an invitation to think about what it is that the intellectual project should ultimately be about, and to question certain prevalent trends that affect - or, perhaps, infect - the current global academic system. The volume will be of interest to all those who are concerned about the state of the contemporary university, both in South Africa and beyond. [Subject: African Studies, Higher Education]. (shrink)

This anthology of primary materials will help redraw our understanding of the complexity and range of Victorian psychological thought and its relations to the wider cultural framework of the era. Drawing together an unprecedented range of materials from scientific, medical, and cultural sources, it charts changing notions of selfhood and bodily identity in the emerging sciences of psychology and psychiatry. Areas covered include: physiognomy, phrenology, and mesmerism; theories of dreams, memory, and the unconscious; female and masculine sexuality; insanity and nervous (...) disorders; and theories of degeneration. The book illuminates both the diversity and vitality of psychology in the pre-Freudian era and will help correct many of our misconceptions about theories of sexuality and the unconscious at this time. Embodies Selves will be of interest to both specialist and non-specialist audiences in the areas of cultural, literary, historical, and gender studies. (shrink)

ABSTRACT:We combine prior research on ethical decision-making in organizations with a rational choice theory of corporate crime from criminology to develop a model of corporate offending that is tested with a sample of U.S. managers. Despite demands for increased sanctioning of corporate offenders, we find that the threat of legal action does not directly affect the likelihood of misconduct. Managers’ evaluations of the ethics of the act, measured using a multidimensional ethics scale, have a significant effect, as do outcome expectancies (...) that result from being associated with the misconduct but not facing formal sanctions. The threat of formal sanctions appears to operate indirectly, influencing ethical evaluations and outcome expectancies. Obedience to authority also affects illegal intentions, with managers reporting higher prospective offending when they are ordered to engage in misconduct by a supervisor. (shrink)

School effectiveness research together with what is now described as the 'school improvement movement' has captured both the Conservative and New Labour imaginations as a basis for educational planning and policy making in the UK. Internationally school effectiveness enjoys and expanding and enthusiastic audience. This book provides a critique of this research genre, particularly in the light of the recent calls for teaching to go 'back to the basics'. The editors argue that this school effectiveness research is simplistic in its (...) analysis of educational problems. Far from getting to the bottom of the problem of failing students and schools, they argue, these 'movements' are merely scratching at the surface of the problems and coming up with notions for superficial improvements. (shrink)

Research ethics review is an important process, designed to protect participants in medical research. However, it is increasingly criticised for failing to meet its aims. Here, two researchers reflect on their experiences of applying for ethical approval of observational research in clinical settings. They highlight some problems faced by reviewers and researchers and propose a two-stage ethical review process that would alert researchers to the committee's concerns and allow them to give a more considered response.

ABSTRACT:We combine prior research on ethical decision-making in organizations with a rational choice theory of corporate crime from criminology to develop a model of corporate offending that is tested with a sample of U.S. managers. Despite demands for increased sanctioning of corporate offenders, we find that the threat of legal action does not directly affect the likelihood of misconduct. Managers’ evaluations of the ethics of the act, measured using a multidimensional ethics scale, have a significant effect, as do outcome expectancies (...) that result from being associated with the misconduct but not facing formal sanctions. The threat of formal sanctions appears to operate indirectly, influencing ethical evaluations and outcome expectancies. Obedience to authority also affects illegal intentions, with managers reporting higher prospective offending when they are ordered to engage in misconduct by a supervisor. (shrink)

: We criticize a view of maternity that equates the natural with the genetic and biological and show how such a practice overdetermines the maternal body and the maternal experience for women who are mothers through adoption and ART (Assisted Reproductive Technologies). As an alternative, we propose a new framework designed to rethink maternal bodies through the lens of feminist embodiment. Feminist embodied maternity, as we call it, stresses the particularity of experience through subjective embodiment. A feminist embodied maternity emphasizes (...) the physical relations of the subjective lived-body rather than the genetic or biological connections. Instead of universalizing claims about the maternal body, embodied maternity looks to communicable experiences and empathetic understanding. (shrink)

We recognize a paradox of power and promise in the context of legislative and organizational changes in nurse regulation which poses constraints on nursing's capacity to bring voice and influence to pressing matters of healthcare and public policy. The profession is at an important crossroads wherein leaders must be well informed in political, economic and legislative trends to harness the profession's power while also navigating forces that may put at risk its central mission to serve society. We present a critical (...) policy analysis of the impact of recent regulatory trends on what the International Council of Nurses considers nursing's three ‘pillars’ – the profession of nursing, socioeconomic welfare of nurses and nurse regulation. Themes surfacing from this analysis include regulatory discontinuity, a tightening of regulatory control, and an increasingly managerial governance culture. These themes illuminate insights and strategies required to renew and revitalize the social mandate of our profession amidst a climate of urgency in the questioning of nurse scholars with respect to the future of the profession. At this historic juncture, nurses must clearly understand the implications of legislative and organizational regulatory changes to ensure the profession contributes to full capacity in achieving health and health equity globally. (shrink)

We combine prior research on ethical decision-making in organizations with a rational choice theory of corporate crime from criminology to develop a model of corporate offending that is tested with a sample of U.S. managers. Despite demands for increased sanctioning of corporate offenders, we find that the threat of legal action does not directly affect the likelihood of misconduct. Managers’ evaluations of the ethics of the act, measured using a multidimensional ethics scale, have a significant effect, as do outcome expectancies (...) that result from being associated with the misconduct but not facing formal sanctions. The threat of formalsanctions appears to operate indirectly, influencing ethical evaluations and outcome expectancies. Obedience to authority also affects illegal intentions, with managers reporting higher prospective offending when they are ordered to engage in misconduct by a supervisor. (shrink)

Pearl and Woodward are both well-known advocates of interventionist causation. What is less well-known is the interesting relationship between their respective accounts. In this paper we discuss the different perspectives of causation these two accounts present and show that they are two sides of the same coin. Pearl’s focus is on leveraging global network constraints to correctly identify local causal relations. The rules by which global causal structures are composed from distinct causal relations are precisely defined by the global constraints. (...) Woodward’s focus, however, is on the use of local manipulation to identify single causal relations that then compose into global causal structures. The rules by which this composition takes place emerge as a result of local interventionist constraints. We contend that the complete picture of causality to be found between these two perspectives from the interventionist tradition must recognise both the global constraints of the sort identified by Pearl and the local constraints of the sort identified by Woodward, and the interplay between them: Pearl requires the possibility of local interventions and Woodward requires a global statistical framework within which to build composite causal structures. (shrink)

Influences on the perception of affordances (i.e., opportunities for actions) have been primarily studied by manipulating the functional morphology of the body. However, affordances are not just determined by the functional morphology of the perceiver, but also by the physiological state of the perceiver. States of anxiety have been shown to lead to marked changes in individuals’ physiological state and their behaviour. To assess the influence of emotional state on affordance perception, the perception of action capabilities in near space was (...) examined after participants completed an anxiety-provoking task. Anxiety was induced immediately prior to tasks that assessed participants' perceived reaching ability in Experiment 1, grasping ability in Experiment 2, and the ability to pass their hands through apertures in Experiment 3. Results indicated that those participants who experienced changes in anxiety underestimated their reaching, grasping, and passing ability compared to non-anxious participants. In other words, anxious participants were more conservative in their estimations of their action capabilities. These results suggest that anxiety influences the perception for affordances in near space and are consistent with the notion that anxiety induces withdrawal behaviours. (shrink)

Drawing on Connell's notion of gender projects, the authors assess the degree to which contemporary evangelical ideals of men's headship challenge, as well as reinforce, a hegemonic masculinity. Based on 265 in-depth interviews in 23 states across the country, they find that rather than espousing a traditional gender hierarchy in which women are simply subordinate to men, the majority of contemporary evangelicals hold to symbolic traditionalism and pragmatic egalitarianism. Symbolic male headship provides an ideological tool with which individual evangelicals may (...) maintain a sense of distinctiveness from the broader culture of which they are a part. At the same time, symbolic headship blunts some of the harsher effects of living in a materially rich, but time poor, culture, by defusing an area of potential conflict, creating a safe space within which men can negotiate, and strengthening men's material and emotional ties to their families. (shrink)

Der Band 15 des Internationalen Jahrbuchs des Deutschen Idealismus ist dem Thema Psychologie gewidmet.

How do Dutch people let each other know that they disagree? What do they say when they want to resolve their difference of opinion by way of an argumentative discussion? In what way do they convey that they are convinced by each other’s argumentation? How do they criticize each other’s argumentative moves? Which words and expressions do they use in these endeavors? By answering these questions this short essay provides a brief inventory of the language of argumentation in Dutch.

This paper draws on classical theories of wisdom to explore the organisational impact of nurses on Australian general practice. Between 2004 and 2008, numbers of general practice nurses doubled, the most rapid influx of nurses into any Australian workplace over the decade. Using data from the Australian General Practice Nurses Study, we argue that nurses had a positive impact because they introduced techne at the organisational level and amplified phronesis in clinical activities. In its Hippocratic formulation, techne refers to a (...) field of definable knowledge, which is purposeful and useful and requires mastery of rational principles. Nursing, with its focus on system and accountability, brought techne out of the GP’s consulting room and into the general practice as a whole. Nurses also exemplify phronesis, an Aristotelian virtue connoting a reasoned and honourable capacity to make judgements: the practical wisdom that defines the interaction between clinician and patient in general practice. At a time of significant GP shortage, doctors and nurses began to collaborate around their more complex and time-consuming patients, leading to a deepening of phronesis in the workplace. By bringing techne to bear on the organisation, and complementing and enhancing phronesis, nurses propel organisational wisdom in general practices. (shrink)

There has been considerable interest in the literature about how professions operate in both the private and public interest. This paper examines this issue in the context of the enforcement of the professional code of conduct of a particular professional accounting association. The paper explores whether certain enforcement actions of the association suggest behaviour motivated at least partially by private interest. It then considers whether the consequences of such behaviour or practices are troubling.

‘Gender’, understood as the social construction of sex, is a key concept for feminists working at the interface of theory and policy. This article examines challenges to the concept which emerged from different groups at the UN Fourth World Conference on Women in Beijing, September 1995, an important arena for struggles over feminist public policies. The first half of the article explores contradictory uses of the concept in the field of gender and development. Viewpoints from some southern activist women at (...) the NGO Forum of the Beijing Conference are presented, Some of them argued that the way ‘gender’ has been deployed in development institutions has led to a depoliticization of the term, where feminist policy ambitions are sacrificed to the imperative of ease of institutionalization. ‘Gender’ becomes a synonym for ‘women’, rather than a form of shorthand for gender difference and conflict and the project of transformation in gender relations. ‘Gender sensitivity’ can be interpreted by non-feminists as encouragement to use gender-disaggregated statistics for development planning, but without consideration of relational aspects of gender, of power and ideology, and of how patterns of subordination are reproduced. A completely different attack on ‘gender’ came from right-wing groups and was battled out over the text of the Platform for Action agreed at the official conference. Six months prior to the conference, conservative groups had tried to bracket for possible removal the term ‘gender’ in this document, out of opposition to the notion of socially constructed, and hence mutable, gender identity. Conservative views on gender as the ‘deconstruction of woman’ are discussed here. The article points out certain contradictions and inconsistencies in feminist thinking on gender which are raised by the conservative backlash attack on feminism and the term ‘gender’. (shrink)

This research focuses on women in corporate positions “above the glass ceiling” and explores their perceptions on corporate mobility and strategies for success in elite positions. Through interviews with 16 men and women corporate presidents and chief executive officers in Southern California, it is found that while white men promote the dominant ideology of individualism and patriarchal gender ideology as explanations of corporate mobility and success, white women emphasize alternative perspectives by confirming the importance of social networks and peer similarities (...) for succeeding in elite positions. These women strategically attempt to increase their cultural capital to negotiate male-dominated networks and maintain their high-status positions through such measures as obtaining advanced educational degrees or modifying speech and behavior. (shrink)

In this debate-format book, four philosophers--Joshua Glasgow, Sally Haslanger, Chike Jeffers, and Quayshawn Spencer--articulate contrasting views on race. Each author presents a distinct viewpoint on what race is, and then replies to the others, offering theories that are clear and accessible to undergraduates, lay readers, and non-specialists, as well as other philosophers of race.

Canadian nursing practice has been profoundly influenced by the legalization of medical assistance in dying in 2016, requiring that nurses navigate new and sometimes highly challenging experiences. Findings from our longitudinal studies of nurses' experiences suggest that these include deep emotional responses to medical assistance in dying, an urgency in orchestrating the perfect death, and a high degree of relational impact, both professionally and personally. Here we propose a theoretical explanation for these experiences based upon a relational ontology. Drawing upon (...) the work of Wildman, we understand a relational ontology to be one in which relationships are more fundamentally central than the conceptual entities that provide the context to practice. It is in a relationship that conceptual entities, and their affiliated values, are created and recreated. Seen as causal, relationships have ontological status, with important implications for how we consider the concepts of death, suffering, and time in this context. From a conceptual perspective, suffering is primarily self‐defined based upon personal histories, time reflects the potential remaining until death, and death is primarily biological and amoral, although social discourses of a good and bad death surround the death trajectory. However, within a relational ontology of medical assistance in dying, these understandings shift. Death becomes primarily social rather than biological, suffering is shared, and time until death is now clearly delimited. Accordingly, nurses assume a profound responsibility for influencing outcomes that are authentically person‐centered. These understandings provide important insights into nurses' experiences, enabling us to recognize the causal effects, both intended and unintended, of nurses' relational practices amidst the complexities of assisted death. Drawing on such a perspective, we find implications for how we provide spaces for nurses to reflect on, and have conversations about, their experiences with some of the greatest mysteries of life—death, suffering, and time. (shrink)

(1991). Grant‐maintained schools: Making a difference without being really different 1 . British Journal of Educational Studies: Vol. 39, No. 4, pp. 409-424.

Preface and acknowledgments -- Prelude -- 1. Gender, sexuality, and meaning: An overview -- Part I. Politics and scholarship: 2. Language and gender -- 3. Feminism in linguistics -- 4. Difference and language: A linguist's perspective -- Part II. Social practice, social meanings, and selves: 5. Communities of practice: Where language, gender, and power all live -- 6. Intonation in a man's world -- 7. Constructing meaning, constructing selves: Snapshots of language, gender, and class from Belten High -- Part III. (...) Constructing content in discourse: 8. The sexual reproduction of meaning: A discourse-based theory -- 9. Prototypes, pronouns, and persons -- 10. What's in a name?: Social labeling and gender practices -- 11. Queering semantics: Definitional struggles -- Coda: 12. Breaking through the 'glass ceiling': Can linguistic awareness help? (shrink)

BackgroundMoral distress (MD) is an emotional and psychological response to morally challenging dilemmas. Moral distress is experienced frequently by nurses in the intensive care unit (ICU) and can result in emotional anguish, work dissatisfaction, poor patient outcomes, and high levels of nurse turnover. Opportunities to discuss ethically challenging situations may lessen MD and its associated sequela.ObjectiveThe purpose of this project was to develop, implement, and evaluate the impact of nursing ethics huddles on participants’ MD, clinical ethics knowledge, work satisfaction, and (...) patient care among ICU nurses.Sample and SettingThe sample, 32 nurses from three ICU settings in an 800-bed tertiary academic medical center, participated in six nursing ethics huddles over a two-month period.MethodsAlvita K. Nathaniel’s Theory of Moral Reckoning guided development of the nursing ethics huddle process.1 The Moral Distress Thermometer was administered at three data points: baseline level of MD, and pre- and post-huddle to determine changes in the subjects’ level of MD.2 Focused content analysis was used to analyze qualitative responses from questionnaires about the subjects’ perception of the effect of the huddles on work satisfaction and patient care. Knowledge attainment was evaluated via open-ended short-answer questions.ResultsOverall, use of nurse-ethicist-led nursing ethics huddles was associated with improved quality of work life, patient care, and clinical ethics knowledge. The change in pre- and post-nursing ethics huddles MD scores was statistically significant (p < 0.0001). (shrink)

Of all the changes to the Human Fertilisation and Embryology Act 1990 that were introduced in 2008 by legislation of the same name, foremost to excite media attention and popular controversy was the amendment of the so-called welfare clause. This clause forms part of the licensing conditions which must be met by any clinic before offering those treatment services covered by the legislation. The 2008 Act deleted the statutory requirement that clinicians consider the need for a father of any potential (...) child before offering a woman treatment, substituting for it a requirement that clinicians must henceforth consider the child’s need for “supportive parenting”. In this paper, we first briefly recall the history of the introduction of s 13(5) in the 1990 Act, before going on to track discussion of its amendment through the lengthy reform process that preceded the introduction of the 2008 Act. We then discuss the meaning of the phrase “supportive parenting” with reference to guidance regarding its interpretation offered by the Human Fertilisation and Embryology Authority. While the changes to s 13(5) have been represented as suggesting a major change in the law, we suggest that the reworded section does not represent a significant break from the previous law as it had been interpreted in practice. This raises the question of why it was that an amendment that is likely to make very little difference to clinical practice tended to excite such attention (and with such polarising force). To this end, we locate debates regarding s 13(5) within a broader context of popular anxieties regarding the use of reproductive technologies and, specifically, what they mean for the position of men within the family. (shrink)