Community-based participatory research is growing in popularity as a research strategy to engage communities affected by health issues. Although much has been written about the benefits of using CBPR with diverse groups, this research has usually taken place in community-based organizations which offer social services and programs. The purpose of this article is to explore the opportunities and challenges encountered during a CBPR project conducted in a small hospital serving people living with HIV and addictions issues. The structure of hospital-based (...) care delivery required the team to account for participants’ health-related limitations, including adopting recruitment strategies built on clinical care, and modifying the original research design to better protect participant confidentiality in a small space. Although CBPR offers an important strategy for researching with members of hospitalized communities, it requires research teams to develop context-relevant approaches to ethically engaging community members that recognize the ways clinical space mediates the research process. (shrink)

Background Policy instruments based on the working of markets have been introduced to empower consumers of healthcare. However, it is still not easy to become a critical consumer of healthcare. Objectives The aim of this study is to analyse the possibilities of the state to strengthen the position of patients with the aid of a new financial regime, such as personal health budgets. Methods Data were collected through in-depth interviews with executives, managers, professionals and client representatives of six long-term care (...) institutions. Results With the introduction of individual budgets the responsibility for budgetary control has shifted from the organisational level to the individual level in the caregiver-client relationship. Having more luxurious care on offer necessitates a stronger demarcation of regular care because organisations cannot simultaneously offer extra care as part of the standard care package. New financial instruments have an impact on the culture of receiving and giving care. Distributive justice takes on new meaning with the introduction of financial market mechanisms in healthcare; the distributing principle of ‘need’ is transformed into the principle of ‘economic demand’. Conclusion Financial instruments not only act as a countervailing power against providers insufficiently client-oriented, but are also used by providers to reinforce their own positions vis-à-vis demanding clients. Tailor-made finance is not the same as tailor-made care. (shrink)

BackgroundThe emphasis on impact factors and the quantity of publications intensifies competition between researchers. This competition was traditionally considered an incentive to produce high-quality work, but there are unwanted side-effects of this competition like publication pressure. To measure the effect of publication pressure on researchers, the Publication Pressure Questionnaire (PPQ) was developed. Upon using the PPQ, some issues came to light that motivated a revision.MethodWe constructed two new subscales based on work stress models using the facet method. We administered the (...) revised PPQ (PPQr) to a convenience sample together with the Maslach Burnout Inventory (MBI) and the Work Design Questionnaire (WDQ). To assess which items best measured publication pressure, we carried out a principal component analysis (PCA). Reliability was sufficient when Cronbach’s alpha > 0.7. Finally, we administered the PPQr in a larger, independent sample of researchers to check the reliability of the revised version.ResultsThree components were identified as ‘stress’, ‘attitude’, and ‘resources’. We selected 3 × 6 = 18 items with high loadings in the three-component solution. Based on the convenience sample, Cronbach’s alphas were 0.83 for stress, 0.80 for attitude, and 0.76 for resources. We checked the validity of the PPQr by inspecting the correlations with the MBI and the WDQ. Stress correlated 0.62 with MBI’s emotional exhaustion. Resources correlated 0.50 with relevant WDQ subscales. To assess the internal structure of the PPQr in the independent reliability sample, we conducted the principal component analysis. The three-component solution explains 50% of the variance. Cronbach’s alphas were 0.80, 0.78, and 0.75 for stress, attitude, and resources, respectively.ConclusionWe conclude that the PPQr is a valid and reliable instrument to measure publication pressure in academic researchers from all disciplinary fields. The PPQr strongly relates to burnout and could also be beneficial for policy makers and research institutions to assess the degree of publication pressure in their institute. (shrink)

Over the past decades, science funding shows a shift from recurrent block funding towards project funding mechanisms. However, our knowledge of how project funding arrangements influence the organizational and epistemic properties of research is limited. To study this relation, a bridge between science policy studies and science studies is necessary. Recent studies have analyzed the relation between the affordances and constraints of project grants and the epistemic properties of research. However, the potentially very different affordances and constraints of funding arrangements (...) such as awards, prizes and fellowships, have not yet been taken into account. Drawing on eight case studies of funding arrangements in high performing Dutch research groups, this study compares the institutional affordances and constraints of prizes with those of project grants and their effects on organizational and epistemic properties of research. We argue that the prize case studies diverge from project-funded research in three ways: 1) a more flexible use, and adaptation of use, of funds during the research process compared to project grants; 2) investments in the larger organization which have effects beyond the research project itself; and 3), closely related, greater deviation from epistemic and organizational standards. The increasing dominance of project funding arrangements in Western science systems is therefore argued to be problematic in light of epistemic and organizational innovation. Funding arrangements that offer funding without scholars having to submit a project-proposal remain crucial to support researchers and research groups to deviate from epistemic and organizational standards. (shrink)

The ability to memorize changes in the environment is present at all biological levels, from social groups and individuals, down to single cells. Trans‐generational memory is embedded subcellularly through genetic and epigenetic mechanisms. Evidence that cells process and remember features of the immediate environment using protein sensors is reviewed. It is argued that this mnemonic ability is encapsulated within the protein conformational space and lasts throughout its lifetime, which can overlap with the lifespan of the organism. Means to determine diachronic (...) changes in protein activity are presented. (shrink)

The analysis of the measurement of gravitational fields leads to the Rosenfeld inequalities. They say that, as an implication of the equivalence of the inertial and passive gravitational masses of the test body, the metric cannot be attributed to an operator that is defined in the frame of a local canonical quantum field theory. This is true for any theory containing a metric, independently of the geometric framework under consideration and the way one introduces the metric in it. Thus, to (...) establish a local quantum field theory of gravity one has to transit to non-Riemann geometry that contains (beside or instead of the metric) other geometric quantities. From this view, we discuss a Riemann–Cartan and an affine model of gravity and show them to be promising candidates of a theory of canonical quantum gravity. (shrink)

The analysis of the measurement of gravitational fields leads to the Rosenfeld inequalities. They say that, as an implication of the equivalence of the inertial and passive gravitational masses of the test body, the metric cannot be attributed to an operator that is defined in the frame of a local canonical quantum field theory. This is true for any theory containing a metric, independently of the geometric framework under consideration and the way one introduces the metric in it. Thus, to (...) establish a local quantum field theory of gravity one has to transit to non-Riemann geometry that contains (beside or instead of the metric) other geometric quantities. From this view, we discuss a Riemann–Cartan and an affine model of gravity and show them to be promising candidates of a theory of canonical quantum gravity. (shrink)

Since the early 1980’s, with the clinical advent of in vitro fertilization resulting in so-called “test tube babies,” a wide array of ethical considerations and concerns regarding artificial womb technology (AWT) have been described. Recent breakthroughs in the development of extracorporeal neonatal life support by means of AWT have reinitiated ethical interest about this topic with a sense of urgency. Most of the recent ethical literature on the topic, however, pertains not to the more imminent scenario of a physiologically improved (...) method of neonatal care through AWT, but instead to the remote scenario of “complete ectogenesis” that imagines human gestation occurring entirely outside of the womb. This scoping review of the ethical literature on AWT spans from more abstract concerns about complete ectogenesis to more immediate concerns about the soon-to-be-expected clinical life support of what we term the fetal neonate or fetonate. Within an organizing framework of different stages of human gestational development, from conception to the viable premature infant, we discuss both already identified and newly emerging ethical considerations and concerns regarding AWT and the care of the fetonate. (shrink)

We invite systematic consideration of the metaphors of cycles and circulation as a long-term theme in the history of the life and environmental sciences and medicine. Ubiquitous in ancient religious and philosophical traditions, especially in representing the seasons and the motions of celestial bodies, circles once symbolized perfection. Over the centuries cyclic images in western medicine, natural philosophy, natural history and eventually biology gained independence from cosmology and theology and came to depend less on strictly circular forms. As potent ‘canonical (...) icons’, cycles also interacted with representations of linear and irreversible change, including arrows, arcs, scales, series and trees, as in theories of the Earth and of evolution. In modern times life cycles and reproductive cycles have often been held to characterize life, in some cases especially female life, while human efforts selectively to foster and disrupt these cycles have harnessed their productivity in medicine and agriculture. But strong cyclic metaphors have continued to link physiology and climatology, medicine and economics, and biology and manufacturing, notably through the relations between land, food and population. From the grand nineteenth-century transformations of matter to systems ecology, the circulation of molecules through organic and inorganic compartments has posed the problem of maintaining identity in the face of flux and highlights the seductive ability of cyclic schemes to imply closure where no original state was in fact restored. More concerted attention to cycles and circulation will enrich analyses of the power of metaphors to naturalize understandings of life and their shaping by practical interests and political imaginations. (shrink)

In welchem Verhaltnis steht die Seelenlehre zur Kosmologie in Platons Phaidon?

Conflict can profoundly affect individuals and their groups. Oftentimes, conflict involves a clash between one side seeking change and increased gains through victory and the other side defending the status quo and protecting against loss and defeat. However, theory and empirical research largely neglected these conflicts between attackers and defenders, and the strategic, social, and psychological consequences of attack and defense remain poorly understood. To fill this void, we model (1) the clashing of attack and defense as games of strategy (...) and reveal that (2) attack benefits from mismatching its target's level of defense, whereas defense benefits from matching the attacker's competitiveness. This suggests that (3) attack recruits neuroendocrine pathways underlying behavioral activation and overconfidence, whereas defense invokes neural networks for behavioral inhibition, vigilant scanning, and hostile attributions; and that (4) people invest less in attack than defense, and attack often fails. Finally, we propose that (5) in intergroup conflict, out-group attack needs institutional arrangements that motivate and coordinate collective action, whereas in-group defense benefits from endogenously emerging in-group identification. We discuss how games of attack and defense may have shaped human capacities for prosociality and aggression, and how third parties can regulate such conflicts and reduce their waste. (shrink)

Direct-to-consumer advertising (DTCA) of prescription drugs has been a heavily contested issue over the past decade, touching on several issues of responsibility facing the pharmaceutical industry. Much research has been conducted on DTCA, but hardly any studies have discussed this topic from a corporate social responsibility (CSR) perspective. In this article, we use several elements of CSR, emphasising consumer autonomy and safety, to analyse differences in DTCA practices within two different policy contexts, the United States of America and the European (...) Union (EU). Doing so results in an alternative analysis of the struggle between proponents and opponents of DTCA from a CSR perspective, adding an alternative view on this debate. (shrink)

Background In the ethical and clinical literature, cases of parents who want treatment for their child to be withdrawn against the views of the medical team have not received much attention. Yet resolution of such conflicts demands much effort of both the medical team and parents. Objective To discuss who can best protect a child9s interests, which often becomes a central issue, putting considerable pressure on mutual trust and partnership. Methods We describe the case of a 3-year-old boy with acquired (...) brain damage due to autoimmune-mediated encephalitis whose parents wanted to stop treatment. By comparing this case with relevant literature, we systematically explored the pros and cons of sharing end-of-life decisions with parents in cases where treatment is considered futile by parents and not (yet) by physicians. Conclusions Sharing end-of-life decisions with parents is a more important duty for physicians than protecting parents from guilt or doubt. Moreover, a request from parents on behalf of their child to discontinue treatment is, and should be, hard to over-rule in cases with significant prognostic uncertainty and/or in cases with divergent opinions within the medical team. (shrink)

Compared to approach motivation, avoidance motivation evokes vigilance, attention to detail, systematic information processing, and the recruitment of cognitive resources. From a conservation of energy perspective it follows that people would be reluctant to engage in the kind of effortful cognitive processing evoked by avoidance motivation, unless the benefits of expending this energy outweigh the costs. We put forward three empirically testable propositions concerning approach and avoidance motivation, investment of energy, and the consequences of such investments. Specifically, we propose that (...) compared to approach-motivated people, avoidance-motivated people (a) carefully select situations in which they exert such cognitive effort, (b) only perform well in the absence of distracters that occupy cognitive resources, and (c) become depleted after exerting such cognitive effort. (shrink)

Historical case studies of scientific concepts are a useful medium for showing how scientific ideas originate and how they change over time. They are thus a useful tool for conveying knowledge about the nature of science. This paper focuses on the concepts of heat and temperature and discusses some issues related to choosing the content for a historical case study which incorporates not only nature of science perspectives but understandings related to what we know about the teaching and learning of (...) these concepts. The case study is designed for first-year university chemistry students as an introduction to their study of thermodynamics. The paper includes a general chemistry textbook analysis of the heat and temperature concepts and a discussion of the caloric theory of heat, thermometry, and a brief survey of how the energy concept transformed our understanding of heat and temperature. (shrink)