The aim of this study was to explore patients’ experiences of using the Integrated Palliative care Outcome Scale (IPOS) during specialized palliative home care. The study adopted a qualitative approach with an interpretive descriptive design. Interviews were performed with 10 patients, of whom a majority were diagnosed with incurable cancer. Our findings suggest that the use of IPOS as a basis for conversation promotes safe care by making the patients feel confident that the care provided was adapted to them which (...) gives them a sense of safety. IPOS facilitated discussions between patients and nurses about care needs. The patients believed that using IPOS enabled reflection on their well‐being and life situation. In conclusion, the study finds that using IPOS is beneficial and provide ways to enable person‐centered care and with advantage could be used in specialized palliative home care. The results may help overcome barriers and facilitate the use of patient‐reported outcome measures (PROMs). To enable the use of PROMs such as IPOS in palliative home care, nurses need education and opportunities to develop routines that enable patients’ voice to be heard and thereby compose a basis for care. (shrink)

The ageing population is increasing worldwide with an increase in chronic disorders. At the same time, person‐centred care has become a policy within both health and social care. To facilitate coordination and collaboration and integrate the older adult's perspective in the decision‐making process the collaborative care planning process with the development of a written care plan can be used. In this study, the result of an interpreted analysis of four empirical studies of the collaborative care planning as a person‐centred practice (...) will be discussed and reflected on. A framework based on the French philosopher Paul Ricoeur's little ethics was used in the synthesis of the studies. The findings revealed two common threads: personhood and power asymmetry. Both challenges in achieving a person‐centred collaborative care planning. Ricoeur's dialogical thinking and description of a person served as an underpinning in discussing and reflecting upon the findings of the interpreted synthesis. Collaborative care planning is a complex process. However, Ricoeur's philosophy contributed to a greater understanding of the collaborative care planning as a person‐centred practice and accentuated that ethics, human values, and the older adults and care partners perspectives need to be given the same importance and considerations as the medical and social sciences perspectives for the collaborative care planning process to truly become person‐centred. (shrink)

The nature of nursing has been the subject of discussion for the last 10–15 years. One reason is that in many countries the education of nurses has moved from teaching hospitals to the academies. This move has given rise to the question of the scientific basis for nursing knowledge.Lately, the content of nursing knowledge has become a principal focus in the work on developing expert systems for nursing. Thus theories of knowledge and the nature of new technology are of great (...) concern to the future of the nursing profession. The basic assumptions underlying a chosen theory of knowledge will determine the development and use of advanced technology in the future. (shrink)

Based on calls to an outsourced call centre in Moldova, where the agents have received training in Swedish, this article deals with some cases when agents are attributed categorical belonging associated with the issue of outsourcing. The aim of the study is to examine how these challenges are handled within interaction. The analysis is implemented by a combination of conversation analysis and membership categorization analysis, primarily through the notion of omnirelevance, used to demonstrate the participants’ orientation to social contexts. A (...) main result is the subtle forms of resistance that agents exhibit when they respond to various category-based compliments, oriented to the location and language skills of the agent. One form of resistance is giving minimal responses and another is to return to the transactional procedure. The calls are part of a corpus of 800 calls. A comparative analysis also includes a call to a centre in Sweden. (shrink)

_ Source: _Volume 40, Issue 1, pp 1 - 31 This anthropologically informed study explores descriptions of communication with invisible, superhuman agents in high functioning young adults on the autism spectrum. Based on material from interviews, two hypotheses are formulated. First, autistic individuals may experience communication with bodiless agents as less complex than interaction with peers, since it is unrestricted by multisensory input, such as body language, facial expressions, and intonation. Second, descriptions of how participants absorb into “imaginary realities” suggest (...) that such mental states are desirable due to qualities that facilitate social cognition: While the empirical world comes through as fragmented and incoherent, imaginary worlds offer predictability, emotional coherence, and benevolent minds. These results do not conform to popular expectations that autistic minds are less adapted to experience supernatural agents, and it is instead argued that imaginative, autistic individuals may embrace religious and fictive agents in search for socially and emotionally comprehensible interaction. (shrink)

Perceptual experience supports the assignment of confidences in belief – doxastic confidences. To explain this fact, many philosophers appeal to Perceptual Indeterminacy, which holds that perceptual content can be more or less determinate. Others instead appeal to Perceptual Confidence, which says that perceptual experience supports doxastic confidences because it assigns confidences too. Morrison argues that a primary reason to favour Perceptual Confidence is that it is uniquely capable of accounting for bell-shaped doxastic confidence distributions; we call this the bell curve (...) objection to Perceptual Indeterminacy. Here we show that two recent defences of Perceptual Indeterminacy, due to Nanay and Raleigh and Vindrola, fail to adequately address the bell curve objection. But we also argue that all is not lost for proponents of Perceptual Indeterminacy. They can counter the bell curve objection by embracing a third view, which we call Perceptual Noise. (shrink)

Interview of Katrin Flikschuh, Rainer Forst and Darrel Moellendorf by Valentin Beck and Julian Culp for Global Justice: Theory Practice Rhetoric.

Palliative care is provided at a certain timepoint, both in a person's life and in a societal context. What is considered to be a good death can therefore vary over time depending on prevailing social values and norms, and the person's own view and interpretation of life. This means that there are many interpretations of what a good death can actually mean for an individual. On a more general level, research in palliative care shows that individuals have basic common needs, (...) for example physical, mental, social and spiritual well‐being. Therefore, in today's pluralistic Western society, it becomes important that palliative care is person centred to enable individuals to receive, as far as can be achieved, care that promotes as good a life as possible based on the person's own needs and preferences, and in accordance with evidence and current laws. For many years a research group, consisting nurse researchers together with nurses working in palliative care, has developed a model for person‐centred palliative care, the 6S‐model. The model's central concept is Self‐image, where the starting point is the patient as a person and their own experience of the situation. The other concepts: Self‐determination, Symptom relief, Social relationships, Synthesis and Strategies are all related to the patient's self‐image, and often to each other. The model's development, value base and starting assumptions are reported here, as are examples of how the model is applied in palliative care in Sweden. The model has been, and still is, constantly evolving in a collaboration between researchers and clinically active nurses, and in recent years also with patients and close relatives. (shrink)

Nowadays it is increasingly common that the patients in the end of life phase choose to be cared for in their own home. Therefore it is vital to identify significant factors in order to prevent unnecessary suffering for dying patients and their families in end-of-life homecare. This study aimed to describe 10 nurses’ perceptions of significant factors that contribute to good end-of-life care in the patients own home. The transcribed texts from the interviews’ were analyzed using phenomenological hermeneutical method, which (...) focuses on the life-world of human beings. The results demonstrate that good end-of-life care presupposes that the aim of the caring staff is to provide safety, autonomy and integrity for the patient and family in order to create the respect required for as good and dignified a death as possible. (shrink)

sirThe recent article by Evans in the journal on the single blind placebo in drug research is timely and its conclusions were persuasive. The basic premiss that single blind placebo “washout” periods are ethically specious was well argued and I agree that from a scientific point of view they have no valid justification. The real reasons ….

Attachment theory ( Bowlby, 1969/1982 ) posits the existence of internal working models as a foundational feature of human bonds. Radical embodied approaches instead suggest that cognition requires no computation or representation, favoring a cognition situated in a body in an environmental context with affordances for action ( Chemero, 2009 ; Barrett, 2011 ; Wilson and Golonka, 2013 ; Casasanto and Lupyan, 2015 ). We explore whether embodied approaches to social soothing, interpersonal warmth, separation distress, and support seeking could replace (...) representational constructs such as internal working models with a view of relationship cognition anchored in the resources afforded to the individual by their brain, body, and environment in interaction. We review the neurobiological bases for social attachments and relationships and attempt to delineate how these systems overlap or don’t with more basic physiological systems in ways that support or contradict a radical embodied explanation. We suggest that many effects might be the result of the fact that relationship cognition depends on and emerges out of the action of neural systems that regulate several clearly physically grounded systems. For example, the neuropeptide oxytocin appears to be central to attachment and pair-bond behavior ( Carter and Keverne, 2002 ) and is implicated in social thermoregulation more broadly, being necessary for maintaining a warm body temperature (for a review, see IJzerman et al., 2015b ). Finally, we discuss the most challenging issues around taking a radically embodied perspective on social relationships. We find the most crucial challenge in individual differences in support seeking and responses to social contact, which have long been thought to be a function of representational structures in the mind (e.g., Baldwin, 1995 ). Together we entertain the thought to explain such individual differences without mediating representations or computations, but in the end propose a hybrid model of radical embodiment and internal representations. (shrink)

Im diesem Aufsatz nehme ich die Popularität des Verantwortungsbegriffs in der Alltagssprache zum Anlass, um seinem Verhältnis zum Pflichtbegriff auf den Grund zu gehen. Dabei unterziehe ich den Verantwortungsbegriff zunächst einer allgemeinen Analyse. Anschließend diskutiere ich in Gestalt von Indeterminismus, Amoralismus und Interaktionismus drei Modi der missbräuchlichen Verwendung dieses Begriffs. Dabei handelt es sich jedoch bei genauerer Betrachtung um allgemeine rhetorische Verschleierungsstrategien, die nicht an die Verwendung des Verantwortungsbegriffs gebunden sind, sondern in der kommunikativen Bezugnahme auf moralische Forderungen generell auftreten (...) können. Dies verdeutlicht auch die anschließende Analyse des Pflichtbegriffs, der einige grundlegende Ähnlichkeiten zum Verantwortungsbegriff aufweist. Ex negativo zeigt sich so jedoch, wie ein nicht missbräuchlicher Rekurs auf beide philosophischen Grundbegriffe möglich ist. Darüber hinaus werden auch die Unterschiede dieser Termini deutlich. Der Pflichtbegriff ist trotz einiger wesentlicher Gemeinsamkeiten weniger vielseitig als der Verantwortungsbegriff und daher zumindest in der Auseinandersetzung mit einigen Themen der praktischen Philosophie weniger gut als Grundbegriff geeignet. Gleichwohl zeigt sich, dass die Frage „Verantwortung oder Pflicht?“ uns vor eine falsche Alternative stellt, wenn sie im ausschließenden Sinn verstanden wird. (shrink)

Medical-legal partnerships connect legal advocates to healthcare providers and settings. Maintaining effectiveness of medical-legal partnerships and consistently identifying opportunities for innovation and adaptation takes intentionality and effort. In this paper, we discuss ways in which our use of data and quality improvement methods have facilitated advocacy at both patient (client) and population levels as we collectively pursue better, more equitable outcomes.

This study argues both that the proofs are ultimately unconvincing and that Plato was aware of the problems. The Phaedo is shown as a truly dialectical philosophical conversation about the immortality of the soul.

Tarihte herhalde çok az soru Tanrı’nın varlığı sorusu kadar sık sorulmuş, çok yanıtlanmış ve verilen birbirinden farklı onca yanıta rağmen kesin bir sonuca ulaştırılamayıp tartışılmaya devam etmiştir. Yine de geçmişe dönüp baktığımızda bu soruya verilen farklı yanıtların farklı uygarlıkların inşa edilmesine, bazılarının yıkılmasına, acımasız çatışmalara ve her şeye rağmen kucaklaşmalara da vesile olduğunu görüyoruz. Tanrı var mı? Varsa onu nasıl bilebiliriz? Tanrı yoksa her şey mubah mı? İnsan aklı ilahi olanı kavrayabilir mi? Tanrı’nın varlığı ahlaklı olmanın şartı mı? Evren akıllı (...) bir tasarımcının imzasını taşıyor mu? Bu kitapta felsefeci William David Beck, bu sorulara tarihte verilen yanıtları ve bu konudaki tartışmaları ele alarak meselenin genel ve tarihsel bir tablosunu bize sunuyor. Platon, Aristoteles, Marcus Aurelius gibi Eski Yunan ve Roma düşünürlerinden Anselmus, Thomas Aquinas, Augustinus ve Yahudi-Hıristiyan geleneğine, Doğu’nun bilgelerine, İbni Rüşd, Fârâbî ve Gazzâlî gibi İslam düşünürlerinden Alvin Plantinga, Graham Oppy, Sam Harris, Richard Dawkins, Max Tegmark gibi Batılı modern ilahiyatçılara, bilim insanlarına ve Yeni Ateizm hareketine kadar uzanan bir çizgide “Tanrı var mı?” sorusuna verilen çeşitli yanıtları ve bu yanıtlara sunulan akılcı gerekçeleri ortaya koyarak soruya felsefece bir yanıt vermenin nasıl bir iş olduğunu da gösteriyor. (shrink)

In large-scale assessments, disengaged participants might rapidly guess on items or skip items, which can affect the score interpretation’s validity. This study analyzes data from a linear computer-based assessment to evaluate a micro-intervention that blocked the possibility to respond for 2 s. The blocked response was implemented to prevent participants from accidental navigation and as a naive attempt to prevent rapid guesses and rapid omissions. The response process was analyzed by interpreting log event sequences within a finite-state machine approach. Responses (...) were assigned to different response classes based on the event sequence. Additionally, post hoc methods for detecting rapid responses based on response time thresholds were applied to validate the classification. Rapid guesses and rapid omissions could be distinguished from accidental clicks by the log events following the micro-intervention. Results showed that the blocked response interfered with rapid responses but hardly led to behavioral changes. However, the blocked response could improve the post hoc detection of rapid responding by identifying responses that narrowly exceed time-bound thresholds. In an assessment context, it is desirable to prevent participants from accidentally skipping items, which in itself may lead to an increasing popularity of initially blocking responses. If, however, data from those assessments is analyzed for rapid responses, additional log data information should be considered. (shrink)

The thought-experiment presented by Bernard Williams in 'The self and the future' continues to draw the attention of writers in the debate about personal identity. While few of them agree on what implications it has for the debate, almost all agree that those implications are significant ones. Some have even claimed that it has consequences not only for personal identity, but also concerning the viability of thought-experiment as a method. This paper surveys what these consequences might be at both levels (...) - as a substantive contribution to the debate on identity, and as to what it shows about the usefulness of thought-experiments. It argues ultimately that thought-experiments like Williams's do provide a useful philosophical tool as long as we temper our expectations of them, and that it offers some support to a view of personal identity but one which is at odds with Williams's own view. (shrink)

This paper investigates the semantics of adverbials like ‘page by page’ and ‘stone upon stone’. An analysis is developed in which sentences containing such adverbials have a pluractional semantics; that is, pluralization affects simultaneously the event- and the individual-argument slot of a predicate. Sternefeld's system of plural operators is used and extended for this purpose. The adverbial constrains the relation that is pluralized and makes visible a higher plural operator. In the case of ‘page by page’-type adverbials, this is a (...) fairly standard operator that leads to a simple divisional interpretation. In the case of ‘stone upon stone’-type adverbials, the operator has a stronger semantics that leads to a sequence interpretation. The generality of our theory permits straightforward extension to data like ‘she ran and ran’ and ‘she climbed higher and higher’, among others. Finally we propose that inclusive alternative ordering reciprocals have a pluractional sequence interpretation as well. (shrink)

Adverse health care events are a global public health issue despite major efforts, and they have been acknowledged as a complex concern. The aim of this study was to explore the construction of unsafe care using accounts of adverse events concerning the patient, as reported by patients, relatives, and health care professionals. Twenty‐nine adverse events reported in an acute care setting in a Swedish university hospital were analyzed through discourse analysis, where the construction of what was considered to be real (...) and true in the descriptions of unsafe care was analyzed. In the written reports about unsafe events, the patient was spoken of in three different ways: (a) the patient as a presentation of physical signs, (b) the patient as suffering and vulnerable, and (c) the patient as unpredictable. When the patient's voice was subordinate to physical signs, this was described as being something that conflicted with patient safety. The conclusion was that the patient's voice might be the only sign available in the early stages of adverse events. Therefore, it is crucial for health care professionals to give importance to the patient's voice to prevent patients from harm and not unilaterally act only upon abnormal physical signs. (shrink)

The topic of this paper is the semantic analysis of the sentences in (1). (1a,b) contain the adverbial modifiers 'one after the other' and 'dog after dog', respectively, which add to the simple (1') information on how the overall event of the dogs entering the room is to be divided into subevents based on a division of the group of dogs into individual dogs. We call these adverbials pluractional adverbials, following e.g. Lasersohn's (1995) use of the term pluractionality for the (...) division of larger eventualities into subeventualities. (shrink)

Do we need a right to mental privacy? In an era of increasing sophistication in recording, interpreting, and directly intervening on our neural activity – not to mention efforts at combining neural...

Because we humans speak a public language, there has always been a special reason to suppose that we have a language of thought. For nonhuman animals, this special reason is missing, and the issue is less straightforward. On the one hand, there is evidence of various types of nonlinguistic representations, such as analog magnitude representations, which can explain many types of intelligent behavior. But on the other hand, the mere fact that some aspects of animal cognition can be explained by (...) nonlinguistic representations hardly suffices to show that animal minds are bereft of any sentence-like representations. This paper explores these complexities and argues that empirical research into the logical abilities of nonhuman animals provides a more direct way of evaluating whether they have a language of thought. Along the way, I offer a novel suggestion of how the hypothesis that animals draw disjunctive syllogisms can be empirically distinguished from the hypothesis, defended by Michael Rescorla, that animals reason probabilistically in accordance with Bayes’ Law. (shrink)

Severe obesity has been associated with reduced performance on tests of verbal memory in bariatric surgery candidates. There is also some evidence that bariatric surgery leads to improved verbal memory, yet these findings need further elucidation. Little is known regarding postoperative memory changes in the visual domain and how patients subjectively experience their everyday memory after surgery. The aim of the current study was to repeat and extend prior findings on postoperative memory by investigating visual, verbal, and self-reported everyday memory (...) following surgery, and to examine whether weight loss and somatic comorbidity predict memory performance. The study was a prospective, observational study in which participants underwent cognitive testing at baseline, 1 and 2 years after bariatric surgery. Repeated measures analyses of variance revealed significantly poorer visual and verbal memory performance at the 1-year follow-up, with performance subsequently returning to baseline levels after 2 years. Verbal learning and self-reported everyday memory did not show significant postoperative changes. Memory performance at 1 year was not significantly predicted by weight loss, changes in C-reactive protein levels or postoperative somatic comorbidity. The study demonstrated poorer visual and verbal memory performance at 1-year follow-up that returned to baseline levels after 2 years. These findings are in contrast to most previous studies and require further replication, however, the results indicate that postoperative memory improvements following bariatric surgery are not universal. Findings suggest that treatment providers should also be aware of patients potentially having poorer memory at 1 year following surgery. (shrink)