Background: Older, frail patients with multimorbidity are at an especially high risk for disease severity and death from COVID-19. The social restrictions proved challenging for the residents, their relatives, and the care staff. While these restrictions clearly impacted daily life in Norwegian nursing homes, knowledge about how the pandemic influenced nursing practice is sparse. Aim: The aim of the study was to illuminate ethical difficult situations experienced by Norwegian nurses working in nursing homes during the COVID-19 pandemic. Research design and (...) participants: The research design involved semistructured individual interviews conducted with 15 nurses working in 8 nursing homes in 3 health regions in Norway, within both urban and rural areas. Ethical considerations: Oral and written information about the study was provided before the participants gave their written consent. The transcribed interviews were de-identified. The study was approved by the Norwegian Centre for Research Data. Findings: Four ethical difficult situations were identified: (a) turning the nursing home into a prison; (b) using medication to maintain peace and order; (c) being left alone with the responsibility; and (d) s. impact on decision-making. Conclusions: The nurses’ ethical challenges were intertwined with external factors, such as national and local guidelines, and the nurses’ own internalized factors, which were connected to their subjective professionality. This duality inflicted emotional distress and gave nurses few opportunities to perform nursing in a professionally sound and safe manner. (shrink)

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:René Girard and the Rhetoric of ConsumptionKathleen M. Vandenberg (bio)The work of René Girard, so productively applied in so many different fields—in theology, in anthropology, in literature, to name a few—has yet to be recognized or applied in the field of rhetorical studies. Yet there exists, I argue, a need precisely for Girard's theories as the over 2000 year-old discipline enters the twenty-first century.Girard's theory of mimetic or triangular (...) desire can be used as a model for understanding persuasion, because it is, among other things, an "expression of a basic set of ideas on... the dynamics of the self and human relations" (1996, vii). Girard's concern is with human relationships and, in a sense, with how individuals in these relationships act rhetorically upon themselves and others. Girard's mimetic theory hinges on the dynamics of imitation and explains how individuals relate through both the conscious and the unconscious sharing of behaviors, attitudes, and beliefs in certain situations. These situations are clearly rhetorical, as can be seen by examining the definition of the "rhetorical situation" set forth by Lloyd Bitzer, in his seminal 1968 article, "The Rhetorical Situation." Bitzer proposes three conditions that must be met for a rhetorical situation to exist: an exigency or imperfection marked by urgency; a rhetorical audience or an audience that can act; and constraints, or elements that have the power to constrain the decision and action needed to modify the exigency (7). In mass-mediated modern rhetoric, I argue that the exigencies exist externally (in the culture) and internally, the audience is both others and self, and the constraints are the alienation, mystification, and desire generated by hierarchies. Twentieth-century rhetorical theorist Kenneth Burke advises that "we must often think of rhetoric not in terms of some one particular address, but as a general body of identifications that owe their convincingness much more to trivial repetition and dull daily reënforcement than to exceptional rhetorical skill" (1950, 26). Such is the case with this particular form of rhetoric, which is generated and propagated by mimetic contagion and thus is best more narrowly defined as sociological propaganda, a type of propaganda [End Page 259] theorized by Jacques Ellul in Propaganda: The Formation of Men's Attitudes (1975).Ellul, the first to distinguish between political propaganda and sociological propaganda, proposes that the latter encompasses social behaviors "much more vast and less certain" than those of political propaganda (1975, 62). These social behaviors permit the penetration of an ideology in a society, a penetration that is achieved through the active participation of the masses. Sociological propaganda, as Ellul describes it, works from within; it is dependent on the individual's willingness and ability to persuade him- or herself and others. Sociological propaganda, Ellul posits, is created when members of a group behave in such a way as to influence the attitudes, actions, and lifestyles of others; often this behavior is unconscious, unintentional, and spontaneous.In these ways, the rhetoric of sociological propaganda operates in a markedly different fashion than more "traditional" rhetoric, which is largely understood to operate as a unilateral transaction in which an individual orator actively, openly, and orally works to move a relatively passive but physically present audience to act in accordance with the orator's own beliefs through a formally delivered speech. In its reliance on the interaction and cooperation of the many rather than the centrality and dominance of one speaker, in its acceptance of unintentional, spontaneous, and unconscious persuasion, in its dependence on the modern mass media, and in the limitless and nebulous nature of its boundaries in time and space, sociological propaganda constitutes a type of rhetoric heretofore insufficiently addressed by rhetorical studies. Although existing perspectives in rhetorical criticism have certainly addressed some aspects of this rhetoric, sociological propaganda is not easily explained with the terminology of traditional rhetorical criticism or easily approached from traditional rhetorical perspectives.This article asserts that the best way to approach and understand such propaganda is through the perspective of René Girard. Approaching this propaganda from a Girardian perspective permits us to look beyond the symbols of sociological propaganda and analyze our own responsibility in rhetorical... (shrink)

The use of platelet rich plasma as a novel treatment is discussed in the context of a qualitative research study comprising 38 interviews with sports medicine practitioners and other stakeholders working within the English Premier League during the 2013–16 seasons. Analysis of the data produced several overarching themes: conservatism versus experimentalism in medical attitudes; therapy perspectives divergence; conflicting versions of appropriate evidence; subcultures; community beliefs/practices; and negotiation of medical decision-making. The contested evidence base for the efficacy of PRP is presented (...) in the context of a broader professional shift towards evidence based medicine within sports medicine. Many of the participants while accepting this shift are still committed to casuistic practices where clinical judgment is flexible and does not recognize a context-free hierarchy of evidentiary standards to ethically justifiable practice. We also discuss a tendency in the data collected to consider the use of deceptive, placebo-like, practices among the clinician participants that challenge dominant understandings of informed consent in medical ethics. We conclude that the complex relation between evidence and ethics requires greater critical scrutiny for this emerging specialism within the medical community. (shrink)

In Subjects That Matter, Namita Goswami attends to philosophy’s institutional and disciplinary failures to reconcile its identitarian claims to universality and reason with the feminist and postcolonial modes of thinking it traditionally keeps at bay. This essay places Goswami’s critique within a context of “the thought from outside,” which, beginning with Foucault’s reading of Blanchot, continuing through the geopolitics of Dussel’s philosophy of liberation, and prominent in Catherine Malabou’s conceptualization of plasticity, demonstrates how political critiques of philosophical hegemony contain an (...) implicit theorization of “literature.” If “literature” gives voice to the thought from outside, does it in turn “decolonize” philosophy? If so, what itinerary of thought ought to follow the relationship between this literary decolonization of philosophy and its imbrication within the fold of philosophical thought? How to conceptualize the plastic relation between inside and outside, between center and periphery, without subordinating the latter to the hegemony of the former? This essay argues for a coherence between Goswami’s and Malabou’s materialist understandings of difference and a conceptualization of literature as an “outside” to philosophy that operates “excentrically” “inside” philosophy. (shrink)

This paper examines the reasons for the high level of unmet needfor contraception in rural Egypt, using data from the individual survey andservice availability module of the 1988Ð89 Egypt Demographic and HealthSurvey. Two broad sets of potential factors are considered: characteristics ofa woman which influence her desire for children and thus her propensity touse contraception, and factors relating to the family planning serviceenvironment in which she lives. The results from a multivariate analysis showthat certain individual characteristics, such as family composition (...) andeducation, have a strong impact on the level of contraceptive use and on theproportion of total demand for spacing or limiting childbearing that is metby use of family planning. Unmet need, however, remains fairly constantacross demographic and socioeconomic subgroups of the population. Thelargest variations in unmet need are regional, but elements of the familyplanning services, namely the provision of a community-based nurse whodistributes family planning and female doctors at clinics, also play animportant role. (shrink)

Das Grab des Königs Ninetjer in Saqqara: Architektonische Entwicklung frühzeitlicher Grabanlagen in Ägypten. By Claudia M. Lacher-Raschdorff. Deutsches Archäologisches Institut Kairo, Archäologische Veröffentlichungen, vol. 125. Wiesbaden: Harrassowitz Verlag, 2014. Pp. 295, 44 pls., plans. €247.

Для широкого круга читателей (слушателей, аспирантов, преподавателей) интересующихся данной проблемой.

Rescued in 1972 from a storeroom in which rats and seeping water had severely damaged the fifty-year-old manuscript, this text is the earliest major work (1919-1921) of the great Russian philosopher M. M. Bakhtin. Toward a Philosophy of the Act contains the first occurrences of themes that occupied Bakhtin throughout his long career. The topics of authoring, responsibility, self and other, the moral significance of "outsideness," participatory thinking, the implications for the individual subject of having "no-alibi in existence," the difference (...) between the world as experienced in actions and the world as represented in discourse--all are broached here in the heat of discovery. This is the "heart of the heart" of Bakhtin, the center of the dialogue between being and language, the world and mind, "the given" and "the created" that forms the core of Bakhtin's distinctive dialogism. A special feature of this work is Bakhtin's struggle with the philosophy of Immanuel Kant. Put very simply, this text is an attempt to go beyond Kant's formulation of the ethical imperative. Toward a Philosophy of the Act will be important for scholars across the humanities as they grapple with the increasingly vexed relationship between aesthetics and ethics. (shrink)