BlOMQVIST K, THEANDER E, MOWIDE I and LARSSON V. Nursing Inquiry 2010; 17: 317–323 What happens when you involve patients as experts? a participatory action research project at a renal failure unitAlthough there is a trend towards developing health care in a patient‐centred direction, changes are usually planned by the professionals without involving the patients. This paper presents an ongoing participatory action research project where patients with chronic renal failure, nurses at a specialist renal failure unit, a hospital manager (...) and a researcher worked together to develop patient‐centred care. The project combined the expertise of patients in their own experiences of living with a chronic condition with the professional expertise of nurses, the manager and the researcher. As the workload on the unit was uneven, the development work needed to be low in intensity but long‐term. Based on a number of dialogues in focus groups, four main development areas were identified; access to test results, prerequisites for postponing the progress of the illness, general awareness and understanding of living with chronic renal failure, and family‐focused care. A number of changes have been planned or implemented, such as developing a prototype for a web‐based feed‐back system, expanding patient education to newly diagnosed patients, steering the nurses' role towards a guiding and family‐focused function, and planning a digital story‐telling workshop. Involving committed people who have the mandate to change practices were prerequisites for success. (shrink)

Deep brain stimulation (DBS) is a developing technology. New generations of DBS technology are already in the pipeline, yet this particular fact has been largely ignored among ethicists interested in DBS. Focusing only on ethical concerns raised by the current DBS technology is, albeit necessary, not sufficient. Since current bioethical concerns raised by a specific technology could be quite different from the concerns it will raise a couple of years ahead, an ethical analysis should be sensitive to such alterations, or (...) it could end up with results that soon become dated. The goal of this analysis is to address these changing bioethical concerns, to think ahead on upcoming and future DBS concerns both in terms of a changing technology and changing moral attitudes. By employing the distinction between inherent and noninherent bioethical concerns we identify and make explicit the particular limits and potentials for change within each category, respectively, including how present and upcoming bioethical concerns regarding DBS emerge and become obsolete. Many of the currently identified ethical problems with DBS, such as stimulation-induced mania, are a result of suboptimal technology. These challenges could be addressed by technical advances, while for instance perceptions of an altered body image caused by the mere awareness of having an implant may not. Other concerns will not emerge until the technology has become sophisticated enough for new uses to be realized, such as concerns on DBS for enhancement purposes. As a part of the present analysis, concerns regarding authenticity are used as an example. (shrink)

Let [Formula: see text] be an integer. We show that the set of real numbers that are Poisson generic in base [Formula: see text] is [Formula: see text]-complete in the Borel hierarchy of subsets of the real line. Furthermore, the set of real numbers that are Borel normal in base [Formula: see text] and not Poisson generic in base [Formula: see text] is complete for the class given by the differences between [Formula: see text] sets. We also show that the (...) effective versions of these results hold in the effective Borel hierarchy. (shrink)

Un invito a vedere nella vita e nelle opere di don Sturzo delle risposte alle difficoltà del mondo attuale, approfondendo le ragioni di un impegno cristiano per il recupero della dimensione etica dell’economia, della politica e delle istituzioni.

At the outset of an ethnographic inquiry, we navigated national and international resources to search for theoretical and practical guidance on obtaining parents and children’s informed consent/assent. While much theoretical guidance debating ethical issues to children’s participation in research was found, a paucity of published papers offering practical guidance on assent processes and/or visual representations of child assent forms and information sheets was discovered. The purpose of this article is to describe our experiences, both theoretically and practically, of negotiating the (...) process of obtaining informed consent and assent with parents and children for a non-therapeutic qualitative research study. We hope this article instigates a platform for others to explicate their experience and contributes to the construction of a coherent body of knowledge which will clearly delineate important elements that must be considered when negotiating children’s agreement to participate in research. (shrink)

In this paper, we examine the scientific, legal, and ethical foundations for inclusion of transgender women athletes in competitive sport, drawing on IOC principles and relevant Court of Arbitration for Sport decisions. We argue that the inclusion of trans athletes in competition commensurate with their legal gender is the most consistent position with these principles of fair and equitable sport. Biological restrictions, such as endogenous testosterone limits, are not consistent with IOC and CAS principles. We explore the implications for recognizing (...) that endogenous testosterone values are a ‘natural physical trait’ and that excluding legally recognized women for high endogenous testosterone values constitutes discrimination on the basis of a natural physical trait. We suggest that the justificatory burden for such prima facie discrimination is unlikely to be met. Thus, in place of a limit on endogenous testosterone for women, we argue that ‘legally recognized gender’ is most fully in line with IOC and CAS principles. (shrink)

As críticas de Newton e Voltaire endereçadas à negação do vazio por parte de Descartes compartilham uma estrutura básica: ambos parecem concordar que tal tese cartesiana conduz a implicações indesejáveis tanto no campo da mecânica, quanto no que diz respeito à teologia. Entretanto, embora Newton admita as implicações teológicas da negação do vazio, elas não constituem o fim último de sua crítica, o que parece ocorrer na crítica de Voltaire. Ao contrário, os argumentos newtonianos para assumir o vazioencontram na mecânica (...) não apenas um campo de prova; eles constituem uma parte importante da fundamentação de um dos pilares do newtonianismo: o espaço absoluto. (shrink)

Este artigo visa introduzir a noção de dramatização em Gilles Deleuze. Trata-se da subversão das clássicas perguntas metafísicas que justificam as essências e as idéias. Uma distribuição de diferenças determina a atualização das idéias. O método de dramatização envolve processos de diferenciação. Diferenças internas, relativas a blocos de espaço-tempo criam condições para os conceitos. Um campo intensivo e diferencial de forças faz emergir um teatro especial de virtualidades e uma expressividade das idéias. A realidade não é dada , mas dramatizada (...) por forças não individuais e subjetividades larvares. O método de dramatização está aquém do conhecimento e até mesmo de toda consolidação que a filosofia ganha com os conceitos. O artigo procurará ainda indicar os vínculos da dramatização com os mundos incompossíveis de Leibniz e com o cinema de David Lynch. (shrink)

many symbols. We define o, as the probability that an arbitrary machine be circular and we prove that o, is a random number that goes beyond..

It is commonly thought that that the best system account of lawhood ((Mill (1843), Ramsey (1978)[fp. 1928], Lewis (1973)) makes available a nice explanation for why laws are ‘distinctively appropriate targets of scientific inquiry’ (Hall, 2015). The explanation takes the following general form: laws are especially valuable for agents like us because they efficiently encode a lot of valuable (non-nomic) information in a tractable format. The goal of this paper is to challenge this style of explanation: I argue that the (...) general principle it presupposes is in conflict with our best account of practical rationality. After considering and rejecting a number of proposals for dissolving the tension, I conclude that BSA proponents may need to scale back the explanatory ambitions of their theory; in particular, they may need to give up the hope of non-circular explanations of the value of nomic information. I end by outlining some challenges for the humean world-view that results after this shift. (shrink)

The paper describes a methodology to be used for analysis and design of human activity systems. The methodology is based on an analysis of the decision settings whereas most other decision analysis methodologies are analysing the process. The decision concept is analysed and discussed. A distinction between programmed and programmable as well as non-programmed and non-programmable decisions is proposed. A classification of different information types for decision making is presented. A methodology based on a systemic and systematic analysis of the (...) information requirements of an organization is proposed. This methodology also indicates organizational discrepancies and information imbalances. The methodology focuses the settings of the decisions on all levels of organizations. The methodology can be regarded as a dynamic, learning system. The author proposes further research on the individuals decision making abilities. (shrink)

Machine generated contents note: Chapter 1 -- The Prison of the Known -- Chapter 2 -- Can We Live without Conflict? -- Chapter 3 -- The Meaning of Dialogue -- Chapter 4 -- Practice and Solidarity: We Are the World -- Chapter 5 -- Science and the Religious Mind -- Chapter 6 -- A Call for Active Being: Being at Home in the World.

We live in dangerous times, ruled by the imperatives of what Hannah Arendt calls “the catastrophic interiority of the selfish I” 1 which threatens the planet and the survival of humanity. But I believe, nevertheless, that it is possible to reinvent the world since, by and large, it is evident that its shape reflects our notions of reality and value, the way we weave together the various strands of existence. Antonio Gramsci may have had something like this in mind when (...) he wrote that it is only by “the conquest of greater consciousness” that we will be able to bring a different kind of culture into being because, “man is above all spirit,” a creature, that is, with imagina- tion, the ability to reconfigure the way we see ourselves and the world. Just as importantly, he argues that this may mean returning to some things we once knew but have now forgotten or ignored. Poetry or, to be more accurate, poetic ways of seeing, may be one of these things, to the extent that it generates ways of seeing beyond the merely rational. In this essay I therefore want to explore the work of Judith Wright and the ways in which it explores the possibilities of being ‘true to the earth’. 2. (shrink)

This paper deals with epistemological and methodological complexities in gender studies, when applied to the social movements of indigenous and peasant women in rural Mexico. Their problems, actions, achievements, projects and utopia, allow the appropriation and redefinition of concepts from local ..

It’s relatively easy to say that the debates about whether trans and intersex women athletes deserve full and equal inclusion in women’s sport is a contentious contemporary issue. I’ve already argued for the legal, ethical, and scientific basis for full and equal inclusion of trans and intersex women in women’s sport. In this paper, I want to analyze what I take to be a representative selection of recent arguments against full and equal inclusion of trans and intersex women in women’s (...) sport. In short, these arguments tend to be based on mere assumption, unsupported “common sense,” straw arguments, fallacious question begging, and a number of hypotheticals and unsupported counterfactuals rather than established fact. Essentially, they’re based on a lot of “ifs.”. (shrink)

Background:Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty.Objectives:The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi.Methodology:A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 clinical nurses. Data were (...) collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0.Ethical consideration:The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi.Results:The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings.Conclusion:The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

Abstract:Brain–computer interfaces (BCIs) can enable communication for persons in severe paralysis including locked-in syndrome (LIS); that is, being unable to move or speak while aware. In cases of complete loss of muscle control, termed “complete locked-in syndrome,” a BCI may be the only viable solution to restore communication. However, a widespread ignorance regarding quality of life in LIS, current BCIs, and their potential as an assistive technology for persons in LIS, needlessly causes a harmful situation for this cohort. In addition (...) to their medical condition, these persons also face social barriers often perceived as more impairing than their physical condition. Through social exclusion, stigmatization, and frequently being underestimated in their abilities, these persons are being locked out in addition to being locked-in. In this article, we (1) show how persons in LIS are being locked out, including how key issues addressed in the existing literature on ethics, LIS, and BCIs for communication, such as autonomy, quality of life, and advance directives, may reinforce these confinements; (2) show how these practices violate the United Nations Convention on the Rights of Persons with Disabilities, and suggest that we have a moral responsibility to prevent and stop this exclusion; and (3) discuss the role of BCIs for communication as one means to this end and suggest that a novel approach to BCI research is necessary to acknowledge the moral responsibility toward the end users and avoid violating the human rights of persons in LIS. (shrink)

The introduction of new medical treatments based on invasive technologies has often been surrounded by both hopes and fears. Hope, since a new intervention can create new opportunities either in terms of providing a cure for the disease or impairment at hand; or as alleviation of symptoms. Fear, since an invasive treatment involving implanting a medical device can result in unknown complications such as hardware failure and undesirable medical consequences. However, hopes and fears may also arise due to the cultural (...) embeddedness of technology, where a therapy due to ethical, social, political and religious concerns could be perceived as either a blessing or a threat. While Deep Brain Stimulation (DBS) for treatment resistant depression (TRD) is still in its cradle, it is important to be proactive and try to scrutinize both surfacing hopes and fears. Patients will not benefit if a promising treatment is banned or avoided due to unfounded fears, nor will they benefit if DBS is used without scrutinizing the arguments which call for caution. Hence blind optimism is equally troublesome. We suggest that specificity, both in terms of a detailed account of relevant scientific concerns as well as ethical considerations, could be a way to analyse expressed concerns regarding DBS for TRD. This approach is particularly fruitful when applied to hopes and fears evoked by DBS for TRD, since it can reveal if our comprehension of DBS for TRD suffer from various biases which may remain unnoticed at first glance. We suggest that such biases exist, albeit a further analysis is needed to explore this issue in full. (shrink)

La 4e de couverture indique : "Du Mutterrecht, l'oeuvre majeure de Bachofen, Walter Benjamin écrivait qu'il s'agissait d'une « prophétie scientifique ». De prime abord, il s'agit là d'une étrange définition pour un ouvrage qui, loin de se tourner vers l'avenir et d'en délinéer les formes, explore les confins du passé pour esquisser, par le biais de l'étude des mythes, le contour de l'origine de nos sociétés. La pensée de Bachofen est prophétique car révolutionnaire, et par là même porteuse de (...) fruits pour l'avenir. Il a en effet avancé une thèse bouleversante : les premières sociétés humaines auraient été régies par un droit maternel, l'organisation patriarcale n'étant qu'une forme plus avancée, certes, mais plus tardive de l'évolution spirituelle et sociale de l'humanité. Sa pensée permet ainsi de réfléchir à la prégnance de l'opposition masculin/féminin, maternel/paternel dans les fondements mêmes de nos sociétés, mais aussi de considérer l'importance que la notion d'origine, et la représentation, pour erronée qu'elle soit, qui en est faite, revêt pour la construction et le maintien de la société et de ses structures. C'est bien là une réflexion avec laquelle, aux dires de Bachofen lui-même, « on n'est pas prêt d'en finir ».". (shrink)

Dans la pensée de Walter Benjamin, le mythe est-il seulement une source de danger et de séduction contre laquelle l'homme moderne devrait se protéger à tout prix? Par une approche qui convoque la philosophie, l'anthropologie et la sociologie, ce livre montre que la réponse à cette question est loin d'être tranchée. Le diagnostic que, au fil de ses oeuvres, Benjamin dresse sur l'appauvrissement de l'expérience moderne est de fait indissociable du problème posé par le mythe, en tant que porteur d'un (...) savoir que la modernité ne sait plus reconnaître et encore moins accepter. La confrontation avec Scholem et Kafka indique que, pour Benjamin, ce savoir relève du langage et participe de ce récit grâce auquel l'individu peut penser son existence au sein d'une histoire commune, d'une tradition avec laquelle la modernité semble toutefois vouloir en finir. (shrink)

The article discusses a relatively obscure but significant aspect of work of the Russian and Soviet thinker Alexander Bogdanov—his science fiction novels. The author points out that, using the form...

O objetivo deste artigo é apresentar uma argumentação sobre a possibilidade de se pensar a justiça como uma experiência do i m possível. Parte-se da distinção derridiana entre justiça e direito. Essa distinção trará algumas implicações no que tradicionalmente é entendido como ética. Partindo do jogo ou da différance marcada entre a presença/ausência, pretende-se estabelecer um ponto de diálogo entre Derrida e Levinas. O ponto de aproximação é a questão do terceiro na relação do face a face. Nesse sentido, problematiza-se (...) se a desconstrução pode ser adotada como um possível modo filosófico que fundamente a compreensão da justiça. (shrink)

We obtain a large class of significant examples of n-random reals (i.e., Martin-Löf random in oracle $\varphi ^{(n - 1)} $ ) à la Chaitin. Any such real is defined as the probability that a universal monotone Turing machine performing possibly infinite computations on infinite (resp. finite large enough, resp. finite self-delimited) inputs produces an output in a given set O ⊆(ℕ). In particular, we develop methods to transfer $\Sigma _n^0 $ or $\Pi _n^0 $ or many-one completeness results of (...) index sets to n-randomness of associated probabilities. (shrink)

Play and games are among the basic means of expression in intelligent communication, influenced by the relevant cultural environment. Games have found a natural expression in the contemporary computer era in which communications are increasingly mediated by computing technology. The widespread use of e-games results in conceptual and policy vacuums that must be examined and understood. Humans involved in design-ing, administering, selling, playing etc. computer games encounter new situations in which good and bad, right and wrong, are not defined by (...) the experience of previous generations. This article gives an account of the historical necessity of games, the development of e-games, their pros- and cons, threats and promises, focusing on the ethical awareness and attitudes of game developers. (shrink)

Body representations are known to be dynamically modulated or extended through tool use. Here, we review findings that demonstrate the importance of a user's tool experience or expertise for successful tool embodiment. Examining expert tool users, such as individuals who use tools in professional sports, people who use chopsticks at every meal, or spinal injury patients who use a wheelchair daily, offers new insights into the role of expertise in tool embodiment: Not only does tool embodiment differ between novices and (...) experts, but experts may experience enhanced changes to their body representation when interacting with their own, personal tool. The findings reviewed herein reveal the importance of assessing tool skill in future studies of tool embodiment. (shrink)

We study probabilistic logic under the viewpoint of the coherence principle of de Finetti. In detail, we explore how probabilistic reasoning under coherence is related to model- theoretic probabilistic reasoning and to default reasoning in System . In particular, we show that the notions of g-coherence and of g-coherent entailment can be expressed by combining notions in model-theoretic probabilistic logic with concepts from default reasoning. Moreover, we show that probabilistic reasoning under coherence is a generalization of default reasoning in System (...) . That is, we provide a new probabilistic semantics for System , which neither uses infinitesimal probabilities nor atomic bound (or big-stepped) probabilities. These results also provide new algorithms for probabilistic reasoning under coherence and for default reasoning in System , and they give new insight into default reasoning with conditional objects. (shrink)