The purpose of this study was to compare breast cancer patients' perceived partici pation in their own care with nurses' perceptions of such participation. Both groups reported that patients are able and willing to take part in their own care more actively than allowed under the present health care system. Nurses also reported that they do provide patients with opportunities for participation.

t. 1. Dialog s V. V. Davydovym -- t. 2. Nereshennye problemy razvivai︠u︡shchego obrazovanii︠a︡.

Standard models of adolescent risk taking posit that the cognitive abilities of adolescents and adults are equivalent, and that increases in risk taking that occur during adolescence are the result of socio emotional differences in impulsivity, sensation seeking, and lack of self-control. Fuzzy-trace theory incorporates these socio emotional differences. However, it predicts that there are also cognitive differences between adolescents and adults, specifically that there are developmental increases in gist-based intuition that reflects understanding. Gist understanding, as opposed to verbatim-based analysis, (...) generally has been hypothesized to have a protective effect on risk taking in adolescence. Gist understanding is also an essential element of informed consent regarding risks in medical decision- making. Evidence thus supports the argument that adolescents’ status as mature minors should be treated as an exception rather than a presumption, because accuracy in verbatim analysis is not mature gist understanding. Use of the exception should be accompanied by medical experts’ input on the bottom-line gist of risks involved in treatment. (shrink)

This study in the context of short-stay surgery is based on a definition according to which informed consent consists of five elements: consent, voluntariness, disclosure of information, understanding and competence. The data were collected in four district hospitals in southern Finland by using a structured questionnaire. The population consisted of short-stay and one-day surgery patients (n = 107). Data analysis was based on statistical methods. The results indicated some problems in the realization of informed consent. Most commonly, consent was expressed (...) by voluntary admission. Most patients had indicated their voluntary consent by making their decision independently. There were also certain problems with information. The respondents were least well informed about the drawbacks of anaesthesia and about alternative forms of treatment. The patients had not understood all the information they had received; problems of understanding were greatest with information about the advantages and disadvantages of anaesthesia. Problems were also reported with competence. These patients had the most difficulty in assessing the advantages and drawbacks of different treatments and anaesthesia. (shrink)

The purpose. Critical social philosophy of education strives to provide a radical critique of existing models of education in the so-called Western models of democracy, creating progressive alternative models. In this context, the proposed integrative metatheory, which is based on classical and modern sources, concepts, aims for a comprehensive understanding and reconstruction of the phenomenon of education. One of the main tasks in the sphere of education’s democratization today, therefore, is to bring to education the results of restructuring and democratization (...) of the society, to reflect changes in conditions of life and thinking, experience and transformation of subjectivity in the context of the technological revolution and globalization. Methodology. The critical social theory, which developed in the framework of contemporary neo-Marxism, indicates the need for a thorough analysis of society, however, unlike other theoretical concepts and research programs in order to analyze not a fixation and a statement of the existing social givens. On the contrary, critical analysis of society involves the identification of existing antagonistic, alienating factors that distort public communication.The subject of social analysis is the whole sphere of human and non-human nature, which interacts a person depend on it, the whole system of relations between society and nature, society and man, which is covered by the historical practice of conscious – "praxis". The representative of "pure science" isn't the learning, research subject. He is a public a person, which is the totality of all social definitions included in society and its constituent individuals. For such a "total subject" Object of interest is not something external; on the contrary, the latter appears as a product of his own activity. The scientific novelty examines trends in educational institutions and models of globalizing society in the context of our particular relationship of education and society, man and the state, and processes. The research and systematic analysis of neoliberal reforms at the level of society in general and education in particular are conducted. It examines substantive, structural and functional characteristics of the concept of «critical social philosophy of education» in the context of institutional tendencies of social life, as well as forms and possibilities of its methodological application. It consider a model of «critical social philosophy of education», as embodied in the programs of social development and learning, which are primarily designed to teach people how to lead an independent and original research themselves, society and knowledge systems. However, it is proved that the models and programs should not be cut off from any individual and the collective system of moral and social values, theoretical and applied training, nor from further use of the acquired values, norms and skills in everyday life, science, or in production, sphere of all social institutions. Conclusions. Critical philosophical, educational, pedagogical-psychological surprisingly theory, its models and concepts seek to redefine public and private and the public mind. Based on these grounds, in the future, it allows philosophy of education to develop a more inclusive philosophical vision of education, to apply directly to the problems of democratization and changes in social relations in the direction of equality and social justice in the field of education. The point of view of socio-philosophical and philosophical-еducational, pedagogical-psychological, normative understanding and social critics also requires the use of active efforts in the reconstruuction of education and society, the social vision of what education and human life can be and what their specific limitations in existing societies. (shrink)

The purpose. Critical social philosophy of education strives to provide a radical critique of existing models of education in the so-called Western models of democracy, creating progressive alternative models. In this context, the proposed integrative metatheory, which is based on classical and modern sources, concepts, aims for a comprehensive understanding and reconstruction of the phenomenon of education. One of the main tasks in the sphere of education’s democratization today, therefore, is to bring to education the results of restructuring and democratization (...) of the society, to reflect changes in conditions of life and thinking, experience and transformation of subjectivity in the context of the technological revolution and globalization. Methodology. The critical social theory, which developed in the framework of contemporary neo-Marxism, indicates the need for a thorough analysis of society, however, unlike other theoretical concepts and research programs in order to analyze not a fixation and a statement of the existing social givens. On the contrary, critical analysis of society involves the identification of existing antagonistic, alienating factors that distort public communication.The subject of social analysis is the whole sphere of human and non-human nature, which interacts a person depend on it, the whole system of relations between society and nature, society and man, which is covered by the historical practice of conscious – "praxis". The representative of "pure science" isn't the learning, research subject. He is a public a person, which is the totality of all social definitions included in society and its constituent individuals. For such a "total subject" Object of interest is not something external; on the contrary, the latter appears as a product of his own activity. The scientific novelty examines trends in educational institutions and models of globalizing society in the context of our particular relationship of education and society, man and the state, and processes. The research and systematic analysis of neoliberal reforms at the level of society in general and education in particular are conducted. It examines substantive, structural and functional characteristics of the concept of «critical social philosophy of education» in the context of institutional tendencies of social life, as well as forms and possibilities of its methodological application. It consider a model of «critical social philosophy of education», as embodied in the programs of social development and learning, which are primarily designed to teach people how to lead an independent and original research themselves, society and knowledge systems. However, it is proved that the models and programs should not be cut off from any individual and the collective system of moral and social values, theoretical and applied training, nor from further use of the acquired values, norms and skills in everyday life, science, or in production, sphere of all social institutions. Conclusions. Critical philosophical, educational, pedagogical-psychological surprisingly theory, its models and concepts seek to redefine public and private and the public mind. Based on these grounds, in the future, it allows philosophy of education to develop a more inclusive philosophical vision of education, to apply directly to the problems of democratization and changes in social relations in the direction of equality and social justice in the field of education. The point of view of socio-philosophical and philosophical-еducational, pedagogical-psychological, normative understanding and social critics also requires the use of active efforts in the reconstruuction of education and society, the social vision of what education and human life can be and what their specific limitations in existing societies. (shrink)

"This book is an augmented and updated translation by the author of Theorie des Subjekts: Subjectiviteat und Identiteat zwischen Moderne und Postmoderne, Teubingen, Francke-UTB, 2010 (3rd ed.)"--Title page verso.

In nursing, the concept of advocacy is often understood in terms of reactive or proactive action aimed at protecting patients' legal or moral rights. However, advocacy activities have not often been researched in the context of everyday clinical nursing practice, at least from patients' point of view. This study investigated the implementation of nursing advocacy in the context of procedural pain care from the perspectives of both patients and nurses. The cross-sectional study was conducted on a cluster sample of surgical (...) otolaryngology patients (n = 405) and nurses (n = 118) from 12 hospital units in Finland. The data were obtained using an instrument specially designed for this purpose, and analysed statistically by descriptive and non-parametric methods. According to the results, patients and nurses have slightly different views about which dimensions of advocacy are implemented in procedural pain care. It seems that advocacy acts are chosen and implemented rather haphazardly, depending partly on how active patients are in expressing their wishes and interests and partly on nurses' empowerment. (shrink)

Today, monitoring of patient complaints in healthcare services is being used as a tool for quality assurance systems and in the future development of services. This nationwide register study describes the number of all complaints processed, number of complaints between different state provinces, healthcare services and healthcare professionals, and outcomes of complaints in Finland during the period 2000–2004. All complaints processed at the State Provincial Offices and the National Authority for Medicolegal Affairs were analysed by statistical methods. Complaints about mental (...) healthcare were explored in greater detail. The analysis showed that the number of patient complaints increased considerably during the study period. There were changes in the number of complaints between study years in different provinces. Out of different healthcare services, an especially marked increase was seen in private healthcare. Nearly all complaints were lodged against physicians, and over half of the complaints were made because of medical error. In mental health care, patients more often complained about unsatisfactory certificates and statements and the use of compulsory hospital care. An analysis of the outcomes revealed that in mental health care complaints more seldom led to consequences. The results need to be utilised when planning interventions for advanced supervision, prevention of adverse events and patient safety in healthcare, and especially in mental health care. From the patients’ perspective, it is important to create a culture where most problem situations are handled where the treatment was provided, thus avoiding a complex complaints process. (shrink)

Power is a matter of authority and control. It can be wielded either consciously or unconsciously, and it can be either overt or latent. Using a structured questionnaire, this study set out to describe nurses’ opinions about the exercise of power in basic care situations in both acute and long-term care. The questionnaire was organized into four categories in which items concerned: power in obligatory daily activities; power in activities necessitated by obligatory activities; power in voluntary activities; and power in (...) activities that take into account the patient’s characteristics. The samples consisted of 228 nurses from five medical and surgical wards of district hospitals, and 233 nurses from five geriatric units of a community health centre and from one nursing home in Finland. The final response rate was 65% (acute care 76%; long-term care 55%). Data analysis was based on statistical methods. The results showed that, in the nurses’ own opinion, negative power is exercised only in certain situations and in the patient’s best interest, when for instance there are concerns that something may happen to the patient. (shrink)

Moral philosophers have often felt the need of a concept which would cover all those cases where we are prevented from achieving our ends through no fault of our own: a criterion for saying when failure is not blameworthy. The deontologists thought we were not to blame for actions done in genuine ignorance of the facts. Kant declared in a famous passage that we were not morally responsible for failures due to the “niggardliness of stepmother nature.” In this article I (...) want to introduce into moral philosophy a new concept for clarifying the failures for which we are not to blame: the notion of scarcity, taken from economic theory. (shrink)

This study aims to describe and compare nurses' willingness to provide care for patients with HIV/AIDS and factors associated with this in three countries. An international cross-sectional survey was conducted among nurses working in medical, surgical and gynaecology units in Finland (n =427), Estonia (n =221) and Lithuania ( n =185) in early 2006. The response rates were 75% (n = 322) in Finland, 54% (n =119) in Estonia and 86% (n = 160) in Lithuania. A modified version of a (...) scale developed in 1994 by Dubbert et al. was applied. Our findings showed a general willingness of the nurse participants to provide care for patients with HIV/AIDS. However, this willingness varied both among and within countries and was also related to specific nursing interventions. The results underline the importance of providing education on ethical issues related to HIV/AIDS care in Europe and tailoring the content of this education to meet nurses' national educational needs. (shrink)

The importance of communities in strengthening the ethics of international collaborative research is increasingly highlighted, but there has been much debate about the meaning of the term ‘community’ and its specific normative contribution. We argue that ‘community’ is a contingent concept that plays an important normative role in research through the existence of morally significant interplay between notions of community and individuality. We draw on experience of community engagement in rural Kenya to illustrate two aspects of this interplay: (i) that (...) taking individual informed consent seriously involves understanding and addressing the influence of communities in which individuals’ lives are embedded; (ii) that individual participation can generate risks and benefits for communities as part of the wider implications of research. We further argue that the contingent nature of a community means that defining boundaries is generally a normative process itself, with ethical implications. Community engagement supports the enactment of normative roles; building mutual understanding and trust between researchers and community members have been important goals in Kilifi, requiring a broad range of approaches. Ethical dilemmas are continuously generated as part of these engagement activities, including the risks of perverse outcomes related to existing social relations in communities and conditions of ‘half knowing’ intrinsic to processes of developing new understandings. (shrink)

George V. Walsh examines the differences and similarities between Immanuel Kant and Ayn Rand in the area of metaphysics. He presents Kant's premises and conclusions on the major issues and provides a detailed discussion of Rand's criticisms of Kant. Walsh argues that Rand has seriously misread Kant on several points. Her interpretation—that Kant saw our sensory grasp of the world as "delusion," rather than knowledge—resembles that of Arthur Schopenhauer, except that the latter declares Kant's doctrine worthy of praise instead of (...) condemnation. (shrink)

We introduce proof nets and sequent calculus for the multiplicative fragment of non-commutative logic, which is an extension of both linear logic and cyclic linear logic. The two main technical novelties are a third switching position for the non-commutative disjunction, and the structure of order variety.