Emergency care in large urban hospitals across the country is in the midst of major redesign intended to deliver quality care through improved access, decreased wait times, and maximum efficiency. The central argument in this paper is that the conceptualization of quality including the documentary facts and figures produced to substantiate quality emergency care is socially organized within a powerful ruling discourse that inserts the interests of politics and economics into nurses' work. The Canadian Triage and Acuity Scale figures prominently (...) in the analysis as a high‐level organizer of triage work and knowledge production that underpins the way those who administer the system define, measure and evaluate emergency care processes, and then use this information for restructuring. Managerial targets and thinking not only dominate the way emergency work is understood, determined, and controlled but also subsume the actual work of health‐care providers in spaces called ‘wait times’, where it is systematically rendered ‘unknowable’. The analysis is supported with evidence from an extensive institutional ethnography that shows what nurses actually do to manage the safe passage of patients through their emergency care process starting with the work of triage nurses. (shrink)

Previous studies suggest that social class, class background, and social mobility have important consequences for family life. Exploring hypotheses derived from these studies, as well as the literature on intergenerational relations, the authors focus on one key aspect of family relations: adult daughters' ties to their mothers. Analyzing data from the National Survey of Families and Households, the authors explore how employed women's relations with their mothers are shaped by race, social class memberships and backgrounds, and family arrangements. Their results (...) suggest that social class and mobility exert powerful effects on women's sense of their relations with their mothers, especially among Whites. In addition, however, it is shown that mother-daughter ties among African American and White women are also influenced by family arrangements that operate somewhat independently of social class and mobility. (shrink)

Historical accounts of sickle cell disease tend to emphasize either its theoretical role in catalyzing the field of medical genetics or its clinical and social significance in representing the health-care disparities experienced by African Americans. This essay bridges these narratives by focusing on the discovery of sickle cells in marginalized Arabic-speaking communities of Yemen and Turkey in the 1950s. As in North America, sickle cell research in the Middle East unfolded along the social fractures of race. The essay analyzes how (...) British, Turkish, and Arab geneticists attempted to create evolutionary hypotheses that reconciled historical and sociological boundaries between white and African, Arab and Turk. As the parameters of Turkish and Arab nationalism shifted in the Cold War–era Middle East, so did the favored explanatory narratives for the presence of sickle cells in different communities, which assigned different degrees of importance to African ancestry, socially enforced endogamy, and evolutionary adaptations to malaria. (shrink)

In most other nations, insurance for medical care is called sickness insurance, and it covers sick people. In the United States, we have “health insurance,” and its major carriers — commercial insurers, large employers, and increasingly government programs — strive to avoid sick people and cover only the healthy. This perverse logic at the heart of the American health insurance system is the key to reform debates.Focusing on sick people versus healthy people might seem a strange way to view the (...) coverage issue. Most discussions of insurance categorize people into other groupings: the insured versus the uninsured; Caucasian whites versus other racial and ethnic groups; men versus women; poor and low-income people versus everybody else; children, adults, and the elderly; or citizens versus immigrants and undocumented aliens. More recently, health researchers have begun talking about “vulnerable populations,” using most of the same demographic groupings and adding other illness-inducing factors such as social isolation, stress, and impoverished neighborhoods. But as I will show, insurance plans now use premiums, cost-sharing, and other design features in ways that indirectly divide each of these groups into the sick and the healthy, to the detriment of the sick. By shifting the costs of illness onto people who use medical care — that is, sick people — market-oriented reforms of the last few decades have eroded insurance in the name of strengthening it. (shrink)

This article explores female religious interaction in racially divided ‘colonial’ South Africa through the lives of five unmarried Anglican women missionaries who worked in and around Johannesburg between 1907 and 1960. It particularly analyses the quality of their personal relationships with African women converts, colleagues and students. Deaconess Julia Gilpin, in the imperial, anglicizing post-Boer War years, encouraged devout, respectable wifehood on the mine compounds, contributing to the corporate solidarity of praying mothers as a deeply entrenched feature of most black (...) churches. Dora Earthy interacted in a warmer, more egalitarian way with black churchwomen. Her transfer to Mozambique led not only to evangelistic building on African cultural traditions and pioneering anthropological research but also to the protection and validation of Christian widows’ autonomy against coerced remarriage. Frances Chilton and Dorothy Maud, despite sharply contrasting class origins, struggled to connect with more assertive networks of married women in the segregationist 1920s and 1930s, devoting their energies rather to guiding and enhancing African girlhood and youth. Hannah Stanton, in the more politically fraught 1950s, recognized the necessary independence of African actors and the limitations of outdated white liberal advocacy. Her training of African women promised new theological and organizational maturity, a potential collegiality, cut short by her detention in the 1960 State of Emergency and subsequent expulsion. The historical sweep of this survey suggests which personal and political conjunctures opened up or closed down meaningful interaction between colonized and colonizing women. It also offers a more positive evaluation of the intersection of race and religion as not invariably a ‘fatal combination’. The politics of the personal in women's joint educational, mission and social welfare ventures across the racial divide helped keep alive the idea of a single society and thus aided the surprisingly peaceful transition to democracy in South Africa in 1994. (shrink)

In lieu of an abstract, here is a brief excerpt of the content: Five Poems DEBORAH WARREN Bugonia hic vero subitum dictu mirabile monstrum aspiciunt, liquefacta boum per viscera toto stridere apes utero et ruptis effervere costis. —Vergil, Georgics IV The covert’s dark, but Aristaeus sees —beyond it, in the oleandered meadow, walking to her wedding with her maids— Eurydice, as sweet as early windfall apples to the gods of the bitter dead. She runs, from shifting shade to sun (...) to shade until, in a shock of sudden sun, she sways, blinded, blundering into an adder’s kiss, and while the bridegroom waits by the bridal bed, she waits to be undressed by worms instead. But Aristaeus pays for the assault. The mead-gods visit on his apiaries wax-moth, mites, foulbrood and chalk-disease until an oracle orders a hekatomb: after nine days the myrtle-nymphs perform a miracle, and out of the carcases crawl fat new sun-furred drones to work the comb, a gift of the mead-gods who, with the poet, praise the teams of bright collaborating bees as little Romans—parvos Quirites. arion 27.1 spring/summer 2019 And what about Eurydice? The swarm goes humming on, a small Rome in a hive. The story’s not about Eurydice’s second chance, or whether she’ll survive. Eurydice’s a minor character; she’s only one girl, sui generis. Besides, no cattle-trick exists for her. The gods can let the apiaries thrive and armies—even empires—endure; one girl’s more complicated to replace. 44 five poems The Tithonus Club We can begin our visit with the Day Room where, in wheelchairs, some with canes or walkers, members sit: a fraternity so ancient that the confrères mostly ignore each other (club tradition). The dues are paid in decades; no one has an outstanding balance—Sir? Whoa, steady, there! Sit down... yes. Here’s your blanket. The badge of membership—the club regalia? Laminated ceremonial bracelets bear the motto Do Not Resuscitate (legend which, in practice, is seldom honored). Eleven-thirty, gentlemen; lunch is served, and now a little toast while the television mesmerizes the aides: Messieurs, your health! Deborah Warren 45 Aphrodite at the Old-Age Home —for Aphrodite Kalogeris “Honey,” the night nurse said to Aphrodite, “let me fix your bib. Look, Aphrodite! Here’s your juice and crackers, Aphrodite! “She doesn’t speak a blessed word of English,” the night nurse told us, “but she understands as good as if we spoke to her in Greek.” Aphrodite’s ears were as grotesque as the pore-coarse nose that bloomed across her face, but she heard her name: When Aphrodite rose and, beatific, dreamed across the room, traversing a happiness none of us could hear, she spoke a language older than herself but still her own—a dialect of beauty able to translate the fetid air. 46 five poems Climbing Etna We’d see the lava, nights, from the town square, as if the sun—an egg of fire—broke at dusk, threading its incandescent yolk down a mountain hanging in black air. Every night we’d scan the dark horizon looking for those streaks, and every night they took a while to find, however bright: Etna, it seemed, had spent the evening rising off the earth, to hover even higher, as if the mountain meant not to be found. And then, today, we ran the flows to ground, climbing up to the rolling burns of fire— closer, into the shimmering air and hiss that glanced up from the thick and red-flecked river —until our soles were smoking. But the lava sang, inside the mountain: Come, discover the fire’s origin and genesis; more—the heart of the world, in its enceinte of blind white heat. Seeing the lava course wasn’t enough, or watching the rock decant the sun; what brought us up here was the force— the hot loins—of a lightning god as dark as thunder; and, like Eve, like Semele, we wanted to approach. But there’s a spark, a jewel older than geology: stop shy of it—of finding the fire’s source, of closing in on what you shouldn’t see. Deborah Warren 47 Human Sucking strength... (shrink)

“Ignorance” is receiving an increased amount of philosophical attention. The study of it even has its own name, “agnotology.” Some ignorance remains simply a case of not having enough information, but increasingly philosophers are recognizing a whole other type of ignorance, one that is socially constructed and often actively promoted. In the first section of this paper I examine perhaps the best known type of socially constructed ignorance, “white ignorance.” White ignorance reflects a lack of genuine understanding of (...) the social realities of others and it creates injustice. In the second section of the paper, I consider what it means to “genuinely understand,” arguing that when it comes to issues of justice those with epistemic power have a moral obligation to at least attempt to understand others’ social realities. (shrink)

This book considers whether we can be epistemically responsible for undesirable beliefs, such as racist and sexist ones. The problem with holding people responsible for their undesirable beliefs is: first, what constitutes an “undesirable belief” will differ among various epistemic communities; second, it is not clear what responsibility we have for beliefs simpliciter; and third, inherent in discussions of socially constructed ignorance (like white ignorance) is the idea that society is structured in such a way that white people (...) are made deliberately unaware of their ignorance, which suggests their racial beliefs are not epistemically blameworthy. This book explores each of these topics with the aim of establishing the nature of undesirable beliefs and our responsibility for these beliefs with the understanding that there may well be (rare) occasions when undesirable beliefs are not epistemically culpable. (shrink)

Heikes challenges Enlightenment rationality's tendency to be an achievement concept which excludes non-whites and non-males. She examines post-Cartesian criticisms of modernism, and pre-modern efforts to address the functional diversity of human cognition, arguing that such approaches offer a rationality that is diverse and morally substantive.

Deborah is a thirty-three-year-old who presented to labor and delivery at thirty-seven weeks gestation with complaints of contractions. Upon arrival, she explained that her fetus, Nathan, had been diagnosed with a “lethal” condition by her primary obstetrician. At twenty-two weeks gestation, an amniocentesis confirmed trisomy 13, a chromosomal abnormality leading to miscarriage or stillbirth in nearly one-half of affected pregnancies. During the admission process, Deborah voices the worry that due to Nathan's brain and heart structure, vaginal delivery could (...) be traumatic and cause him to suffer. Deborah wishes for him to have as painless and as dignified a death as possible; cesarean section, she feels, will achieve this. Yet with her history of three prior vaginal deliveries, normally progressing labor, and poor fetal prognosis that is unlikely to improve with cesarean delivery, there is no maternal or fetal indication for a cesarean section. Should the obstetrician proceed with a cesarean delivery despite knowing that it would expose the mother to surgical risks with little or no corresponding fetal or neonatal benefit? (shrink)

Pre-reading language skills develop rapidly in early childhood and are related to brain structure and functional architecture in young children prior to formal education. However, the early neurobiological development that supports these skills is not well understood. Here we acquired anatomical, diffusion tensor imaging and resting state functional MRI from 35 children at 3.5 years of age. Children were assessed for pre-reading abilities using the NEPSY-II subtests 1 year later. We applied a data-driven linked independent component analysis to explore the (...) shared co-variation of gray and white matter measures. Two sources of structural variation at 3.5 years of age demonstrated relationships with Speeded Naming scores at 4.5 years of age. The first imaging component involved volumetric variability in reading-related cortical regions alongside microstructural features of the superior longitudinal fasciculus. The second component was dominated by cortical volumetric variations within the cerebellum and visual association area. In a subset of children with rs-fMRI data, we evaluated the inter-network functional connectivity of the left-lateralized fronto-parietal language network and its relationship with pre-reading measures. Higher functional connectivity between the FPL and the default mode and visual networks at 3.5 years significantly predicted better Phonological Processing scores at 4.5 years. Together, these results suggest that the integration of functional networks, as well as the co-development of white and gray matter brain structures in early childhood, support the emergence of pre-reading measures in preschool children. (shrink)

This article presents narratives from 13 Indigenous early career academics (ECAs) at one university in Auckland, New Zealand. These experiences are likely to represent those of Indigenous Māori and Pasifika ECAs nationally, given the small, centralised nature of the national academy of Aotearoa New Zealand. The narratives contain testimony, fictionalised vignettes of experience, and poetic expressions. Meeting the demands of an academic role in one’s first years of working at a university is a big deal for anyone; the extra pressures (...) and challenges for Indigenous Māori and Pacific staff are immense, yet little understood by White ‘others.’ A writing workshop was the initial catalyst of this collective writing project. Through these insider narratives, this article presents a collective description of, and response to, the experience of Māori and Pasifika early career academics. (shrink)

In South Africa, race has been subverted by the fall of official apartheid. Specifically, the “invisibilization” of black others is overturned and white-black relationality problematized, thereby deeply troubling whiteness. However, the logic of race continues to reverberate through social relations against a global backdrop in which this category proves remarkably adaptable as purveyor of inequality. The end of official apartheid is not the end of the power effects of the apartheid discourse. The postapartheid field is a site of contestation (...) over previously normalized hierarchies, including over gender and class. Applying a discourse analysis to texts generated in research interviews with respondents who self-identified as women, white, Afrikaans-speaking, and middle class, this study finds attempts at re-securing race. First, the strategy of “elision and misattribution” seeks to recuperate apartheid's racial binaries to bolster present-day whiteness. Second, “intersectional shifting” of social markers aims at ameliorating the secondary status of femininity through the wielding of whiteness and middle classness. These strategies are complicated by affective practices. Particularly the social emotion shame holds transformative potential, but with a caveat. Shame brings self into relation with the other and the social and can usher white subjects into an expanded conception of being human, but only if acknowledged. (shrink)

In a recent poem, Vom Schnee, oder Descartes in Deutschland, German writer Durs Grünbein suggests that a snowy, white landscape inspired the young René Descartes to theoretically define nature. Indeed, Descartes's reduction of nature to extended matter composed of particles in movement and abiding by the laws of nature entails a reduction of all bodies' diversity to a mechanistic system in which all secondary qualities are mathematically framed. The description of colors in the Regulae ad directionem ingenii exemplifies this (...) reduction of nature to a geometrical grid with no differences—Jean-Luc Marion (Sur... (shrink)

Abstract:In Red Skin, White Masks: Rejecting the Colonial Politics of Recognition, Glen Coulthard argues that since 1969, colonial power relations in Canada have shifted from an unconcealed structure of domination to a mode of colonial governance that operates through state recognition and accommodation. He instead looks to identify a type of recognition based on self-affirmation and self-recognition rather than state acceptance. Following Coulthard, I examine movements created to affirm oppressed groups in the context of anti-Semitism and anti-Blackness in the (...) mid-twentieth century and explore possible limitations of such movements, including the erasure or elision of complex intersections of identity. I then draw upon self-compassion, a mental health and wellness approach, as a potential framework for the affirmative politics Coulthard theorizes. Subsequently, I consider whether such a framework offers a mechanism to provide the self-affirmation and recognition that Coulthard identifies as vital to resisting oppression. I ultimately explore how understanding music as cultural production in music education might engender this affirmative politics to facilitate rich affirmation and validation of students and educators to musically imagine different possible futures. (shrink)

This text provides a critique of the subjective Bayesian view of statistical inference, and proposes the author's own error-statistical approach as an alternative framework for the epistemology of experiment. It seeks to address the needs of researchers who work with statistical analysis.

In lieu of an abstract, here is a brief excerpt of the content:diacritics 30.1 (2000) 106-123 [Access article in PDF] The (Mis)Uses of Cannibalism in Contemporary Cultural Critique C. Richard King At least since 1979, when W. Arens demystified what he termed "the man-eating myth," cannibalism, once a fundamental feature of the anthropological imagination and a primary trope for interpreting cultural difference, has become subject to serious debate and lingering doubt [see Osborne]. Even as some anthropologists have sought to recuperate (...) anthropophagy as a tangible symbolic, ideological, and ritual complex [Brown and Tuzin; Conklin, "'Thus are our Bodies'"; Forsyth; Harris, Good to Eat 199-234; Sanday], a constellation of scholarly projects and popular works has complicated cannibalism by relocating it in the West. Perhaps most visibly, Hollywood cinema has reclaimed cannibalism. Although a handful of films have revived well-worn clichés of dark-skinned savages preparing to consume Westerners, as in King Solomon's Mines and Crocodile Dundee, others have cast the Western subject as cannibal to grapple with the horrors of reluctant cannibalism, as in Alive! [see Fiddes 121-31], to work through the transgressive and terrifying desires associated with psychopathic cannibalism, as in The Silence of the Lambs [Fuss; Halberstam], and importantly to parody the normative beliefs and behaviors of white, middle-class, heterosexual EuroAmericans, as in Eating Raoul and Parents. At the same time, an array of scholars, artists, and activists have invoked cannibalism to fashion critical perspectives on Western cultural practices. In his film Cannibal Tours (1987), Dennis O'Rourke encourages his audiences to think critically about tourists who travel to the Sepik River Valley to encounter reformed cannibals, asking implicitly who the cannibals are, the Melanesians who formerly (were thought to/claim to have) practiced anthropophagy or the tourists who travel to New Guinea to consume them [see Bruner]. Others have pushed the metaphor. Michael Ames, borrowing explicitly from O'Rourke, uses the cannibal to reframe ethnographic museums and their practices. Similarly, Jane Tompkins asserts that "Museums are a form of cannibalism made safe for polite society" [533]. More generally, Crystal Bartolovich playfully glosses consumerism as the cultural logic of the late cannibalism; bell hooks speaks of the EuroAmerican desires for and incorporation of things ethnic as "eating the other"; and Rosalind Morris suggests that cannibalism is the essential metaphor for late capitalism. More telling, however, are a set of overlapping critical projects that offer detailed theorizations [End Page 106] [Begin Page 108] of contemporary anthropophagy. Here, I will examine three that have had an important impact on discussions of tourism, museums, cultural appropriation, and consumption. Dean MacCannell, in an exciting exploratory review of the documentary Cannibal Tours, makes explicit what O'Rourke left unsaid: we are cannibals, and contemporary capitalism is neocannibalism. Perhaps more radically, Jack Forbes argues that Western civilization fosters cannibalism as an embodied, psychosocial condition or psychosis rooted in exploitation and consumption. Inspired at least in part by Forbes, Deborah Root rethinks Western civilization as cannibal culture.Although I am terribly sympathetic with these perspectives, particularly their political commitments and theoretical creativity, I am disturbed by the practices and effects that animate them. Indeed, as powerful as this critical field promises to be, it is at the same time troubling and dangerous. Although it defamiliarizes practices of cultural production and consumption, it does not enhance understanding of the contexts in which individuals and institutions deploy them and does less to effectively challenge or undermine them. In reframing beliefs and behaviors to accentuate productivity and power, it reinstates and reaffirms binaries and, worse, often turns on the same forms of appropriation.* * *Arguably, flesh eating has always promoted the elaborations of differences. Works central to the Western canon mobilize cannibalism to make (sense of) the world. Herodotus offers an early anthropophagic distinction:These Scythian husbandmen then occupy the country eastward for three days' journey.... Beyond this region the country is desert for a great distance; and beyond the desert Androphagi dwell.... The Androphagi have the most savage customs of all men; they pay no regard to justice, nor make use of any established law. They are nomads and wear a dress like a Scythian; they... (shrink)

Experience and expression are orthogonal emotion dimensions: we do not always show what we feel, nor do we always feel what we show. However, the experience and expression dimensions of emotion are rarely considered simultaneously. We propose a model outlining the intersection of goals for emotion experience and expression. We suggest that these goals may be aligned or misaligned. Our model posits these states can be separated into goals to experience and express, experience but not express, express but not experience, (...) or neither experience nor express positive and negative emotion. We contend that considering intersections between experience and expression goals will advance understanding of emotion regulation choice and success. (shrink)

While many philosophers of science have accorded special evidential significance to tests whose results are "novel facts", there continues to be disagreement over both the definition of novelty and why it should matter. The view of novelty favored by Giere, Lakatos, Worrall and many others is that of use-novelty: An accordance between evidence e and hypothesis h provides a genuine test of h only if e is not used in h's construction. I argue that what lies behind the intuition that (...) novelty matters is the deeper intuition that severe tests matter. I set out a criterion of severity akin to the notion of a test's power in Neyman-Pearson statistics. I argue that tests which are use-novel may fail to be severe, and tests that are severe may fail to be use-novel. I discuss the 1919 eclipse data as a severe test of Einstein's law of gravity. (shrink)

The body is a rich object for aesthetic inquiry. We aesthetically assess both our own bodies and those of others, and our felt bodily experiences have aesthetic qualities. The body features centrally in aesthetic experiences of visual art, theatre, dance and sports. It is also deeply intertwined with one's identity and sense of self. Artistic and media representations shape how we see and engage with bodies, with consequences both personal and political. This volume contains sixteen original essays by contributors in (...) philosophy, sociology, dance, disability theory, critical race studies, feminist theory, medicine, and law. They explore bodily beauty, sexual attractiveness, the role of images in power relations, the distinct aesthetics of disabled bodies, the construction of national identity, the creation of compassion through bodily presence, the role of bodily style in moral comportment, and the somatic aesthetics of racialized police violence. -/- Contents: Maria del Guadalupe Davidson, "Black Silhouettes on White Walls: Kara Walker’s Magic Lantern"; A. W. Eaton, "Taste in Bodies and Fat Oppression"; C. Winter Han, "From 'Little Brown Brothers' to 'Queer Asian Wives': Constructing the Asian Male Body"; Deborah L. Rhode, "Appearance as a Feminist Issue"; Shirley Anne Tate, "A Tale of Two Olympians—Beauty, 'Race,' Nation"; Glenn Parsons, "The Merrickites"; Stephen Davies, "And Everything Nice"; Tobin Siebers, "In/Visible: Disability on the Stage"; Jill Sigman, "Live, Body-Based Performance: An Account from the Field"; Barbara Gail Montero, "Aesthetic Effortlessness"; Peg Brand Weiser and Edward B. Weiser, "Misleading Aesthetic Norms of Beauty: Perceptual Sexism in Elite Women's Sports"; Yuriko Saito, "Body Aesthetics and the Cultivation of Moral Virtues"; George Yancy, "White Embodied Gazing, the Black Body as Disgust, and the Aesthetics of Un-Suturing"; Richard Shusterman, "Somaesthetics and the Fine Art of Eating"; Ann J. Cahill, "Sexual Desire, Inequality, and the Possibility of Transformation"; Sheila Lintott and Sherri Irvin, "Sex Objects and Sexy Subjects: A Feminist Reclamation of Sexiness" -/- . (shrink)

Although both philosophers and scientists are interested in how to obtain reliable knowledge in the face of error, there is a gap between their perspectives that has been an obstacle to progress. By means of a series of exchanges between the editors and leaders from the philosophy of science, statistics and economics, this volume offers a cumulative introduction connecting problems of traditional philosophy of science to problems of inference in statistical and empirical modelling practice. Philosophers of science and scientific practitioners (...) are challenged to reevaluate the assumptions of their own theories - philosophical or methodological. Practitioners may better appreciate the foundational issues around which their questions revolve and thereby become better 'applied philosophers'. Conversely, new avenues emerge for finally solving recalcitrant philosophical problems of induction, explanation and theory testing. (shrink)

Corporate social responsibility (CSR) has repeatedly been described as an “essentially contested concept,” which means that its signification is subject to continuous struggle. We argue that the “CSR institution” (CSRI; i.e., the set of standards and rules regulating corporate conduct under the banner of CSR) is legitimized by narratives which “decontest” the underlying concept of CSR in a manner that safeguards the CSRI from calls for alternative institutional arrangements. Examining several such narratives from a structuralist perspective, we find them to (...) be permeated with six recurrent ambiguities that we show to be reflective of three deep-set taboos: the taboo of the noncongruency between corporate profit objectives and societal needs, the taboo of multinational firms’ continued contribution to the emergence of global socioenvironmental issues, and the taboo of the CSRI’s moderate results in solving these problems. We contend that the perpetuation of these taboos contributes to inhibiting substantial change in the way of doing business, and we sketch out possibilities for initiating a “recontestation” of CSR’s meaning. (shrink)

Background:Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress.Objectives:The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs’ experiences of ethical issues.Methods:Using a systematic (...) approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home.Findings:The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work.Conclusions:The review highlighted a need for improved ethics education for care-providers. (shrink)

The growing availability of computer power and statistical software has greatly increased the ease with which practitioners apply statistical methods, but this has not been accompanied by attention to checking the assumptions on which these methods are based. At the same time, disagreements about inferences based on statistical research frequently revolve around whether the assumptions are actually met in the studies available, e.g., in psychology, ecology, biology, risk assessment. Philosophical scrutiny can help disentangle 'practical' problems of model validation, and conversely, (...) a methodology of statistical model validation can shed light on a number of issues of interest to philosophers of science. (shrink)

The key problem in the controversy over group selection is that of defining a criterion of group selection that identifies a distinct causal process that is irreducible to the causal process of individual selection. We aim to clarify this problem and to formulate an adequate model of irreducible group selection. We distinguish two types of group selection models, labeling them type I and type II models. Type I models are invoked to explain differences among groups in their respective rates of (...) production of contained individuals. Type II models are invoked to explain differences among groups in their respective rates of production of distinct new groups. Taking Elliott Sober's model as an exemplar, we argue that although type I models have some biological importance--they force biologists to consider the role of group properties in influencing the fitness of organisms--they fail to identify a distinct group-level causal selection process. Type II models if properly framed, however, do identify a group-level causal selection process that is not reducible to individual selection. We propose such a type II model and apply it to some of the major candidates for group selection. (shrink)

The ArgumentThis paper sets out a framework for understanding how the scientific community constructs computer simulation as an epistemically and pragmatically useful methodology. The framework is based on comparisons between simulation and the loosely-defined categories of “theoretical work” and “experimental work.” Within that framework, the epistemological adequacy of simulation arises from its role as a mathematical manipulation of a complex, abstract theoretical model. To establish that adequacy demands a detailed “theoretical” grasp of the internal structure of the computer program. Simultaneously, (...) the pragmatic usefulness of simulation arises from its role as a “virtual laboratory.” That role is made possible by black-boxing the internal structure of the program, such that the scientist can interact with the computer in an intuitive, “experimental” manner. Thus simulation is rendered authoritative, opening up encoded theories to a novel, “experimental” type of manipulation. (shrink)

Community engagement to protect and empower participating individuals and communities is an ethical requirement in research. There is however limited evidence on effectiveness or relevance of some of the approaches used to improve ethical practice. We conducted a study to understand the rationale, relevance and benefits of community engagement in health research. This paper draws from this wider study and focuses on factors that shaped Community Advisory Group members’ selection processes and functions in Malawi. A qualitative research design was used; (...) two participatory workshops were conducted with CAG members to understand their roles in research. Workshop findings were triangulated with insights from ethnographic field notes, key informant interviews with stakeholders, focus group discussions with community members and document reviews. Data were coded manually and thematic content analysis was used to identify main issues. Results have shown that democratic selection of CAG members presented challenges in both urban and rural settings. We also noted that CAG members perceived their role as a form of employment which potentially led to ineffective representation of community interests. We conclude that democratic voting is not enough to ensure effective representation of community's interests of ethical relevance. CAG members’ abilities to understand research ethics, identify potential harms to community and communicate feedback to researchers is critical to optimise engagement of lay community and avoid tokenistic engagement. (shrink)

Nous nous proposons dans le présent article de revenir sur l'enjeu de Über Gewissheit : doit-on lire cet ensemble de notes comme l'ultime réponse de Wittgenstein à l'idéalisme sceptique ou comme la réélaboration de nos catégories de connaissance (croire, savoir, être certain) ? La réponse à cette question passe tout d'abord par la prise en compte du dialogue avec Moore et en particulier par une réévaluation de sa défense du sens commun et de sa preuve du monde extérieur tout aussi (...) célèbre que controversée. Nous voudrions souligner les limites d'une interprétation purement dogmatique de ces textes en mettant en évidence le caractère problématique du dogmatisme mooréen, avant de revenir sur les deux critiques que Malcolm puis Wittgenstein en ont proposées. Un bref rappel de la critique de Malcolm nous permettra ensuite de saisir la singularité de la démarche de Wittgenstein qui consiste par l'analyse grammaticale des propositions « intéressantes » de Moore à renvoyer dos à dos les prétentions au savoir de Moore et les doutes sceptiques. (shrink)

In seeking general accounts of evidence, confirmation, or inference, philosophers have looked to logical relationships between evidence and hypotheses. Such logics of evidential relationship, whether hypothetico-deductive, Bayesian, or instantiationist fail to capture or be relevant to scientific practice. They require information that scientists do not generally have (e.g., an exhaustive set of hypotheses), while lacking slots within which to include considerations to which scientists regularly appeal (e.g., error probabilities). Building on my co-symposiasts contributions, I suggest some directions in which a (...) new and more adequate philosophy of evidence can move. (shrink)