The purpose of this article is to re-examine an ethic of care as the main ethical approach to nursing practice in light of past and present developments in nursing ethics, and to briefly speculate whether or not it will survive within nursing in the future. Overall, it is maintained throughout that the terms ?caring?, ?nursing? and an ?ethic of care? are inextricably linked. This is because, it is argued, professionally focused nursing practices are based predominantly on a well-recognised moral commitment (...) to deliver expert care, and that a care-based ethic is the major factor in the construction and maintenance of these practices. Subsequently, the influences and developments of a caring ethic in nursing are firstly re-examined, and the discussion is supported by evidence from more recent nursing research and theoretical developments. Consideration is given to the philosophical underpinnings of both care theory and caring ethics, and the fundamental importance of caring in nursing, as an interpersonal relationship and as an appropriate ethical response, is made transparent. Finally, an outline of the future possibilities that may affect an ethic of care in nursing is offered. (shrink)

While outcomes for children with T-cell acute lymphoblastic leukemia have improved dramatically, survival rates for patients with relapsed/refractory disease remain dismal. Prior studies indicate that glucocorticoid resistance is more common than resistance to other chemotherapies at relapse. In addition, failure to clear peripheral blasts during a prednisone prophase correlates with an elevated risk of relapse in newly diagnosed patients. Here we show that intrinsic GC resistance is present at diagnosis in early thymic precursor T-ALLs as well as in a subset (...) of non-ETP T-ALLs. GC-resistant non-ETP T-ALLs are characterized by strong induction of JAK/STAT signaling in response to interleukin-7 stimulation. Removing IL7 or inhibiting JAK/STAT signaling sensitizes these T-ALLs, and a subset of ETP T-ALLs, to GCs. The combination of the GC dexamethasone and the JAK1/2 inhibitor ruxolitinib altered the balance between pro- and anti-apoptotic factors in samples with IL7-dependent GC resistance, but not in samples with IL7-independent GC resistance. Together, these data suggest that the addition of ruxolitinib or other inhibitors of IL7 receptor/JAK/STAT signaling may enhance the efficacy of GCs in a biologically defined subset of T-ALL.Leukemia advance online publication, 30 May 2017; doi:10.1038/leu.2017.136. (shrink)

This study investigated students’ perceptions following a prepared, common presentation regarding academic integrity provided by their residence dons. This peer instruction study utilized both quantitative and qualitative analyses of survey data within a pre-test post-test design. Overall, students reported gains in knowledge, as well as confidence in their knowledge of academic integrity. Notably, students reported increases in their personal value for academic integrity after participating in the presentations. Overall, the quality and content of the presentations were judged positively, and participants’ (...) ratings of the presentation were predictive of increases in personal value of academic integrity, as well as self-reported knowledge and confidence gains. Qualitative analyses supported that the key ideas in the presentation served as the focal material for discussion, but also introduced specific topics that students wanted to explore in greater depth. (shrink)

Background:Acting ethically, in accordance with professional and personal moral values, lies at the heart of nursing practice. However, contextual factors, or obstacles within the work environment, can constrain nurses in their ethical practice – hence the importance of the workplace ethical climate. Interest in nurse workplace ethical climates has snowballed in recent years because the ethical climate has emerged as a key variable in the experience of nurse moral distress. Significantly, this study appears to be the first of its kind (...) carried out in New Zealand.Aim/objective:The purpose of this study was to explore and describe how registered nurses working on a medical ward in a New Zealand hospital perceive their workplace ethical climate.Research design/participants/context:This was a small, qualitative descriptive study. Seven registered nurses were interviewed in two focus group meetings. An inductive method of thematic data analysis was used for this research.Ethical considerations:Ethics approval for this study was granted by the New Zealand Ministry of Health’s Central Regional Health and Disability Ethics Committee on 14 June 2012.Findings:The themes identified in the data centred on three dominant elements that – together – shaped the prevailing ethical climate: staffing levels, patient throughput and the attitude of some managers towards nursing staff.Discussion:While findings from this study regarding staffing levels and the power dynamics between nurses and managers support those from other ethical climate studies, of note is the impact of patient throughput on local nurses’ ethical practice. This issue has not been singled out as having a detrimental influence on ethical climates elsewhere.Conclusion:Moral distress is inevitable in an ethical climate where the organisation’s main priorities are perceived by nursing staff to be budget and patient throughput, rather than patient safety and care. (shrink)

The vast majority of research in nursing ethics over the last decade indicates that nurses may not be fully prepared to ‘deliver the good’ for their patients, or to contribute appropriately in the wider current health care climate. When suitable research projects were evaluated for this article, one key question emerged: if nurses are educationally better prepared than ever before to exercise their ethical decision-making skills, why does research still indicate that the expected practice-based improvements remain elusive? Hence, a number (...) of ideas gleaned from recent research about the current nature of nursing ethics, and especially teaching nursing ethics to student nurses, are analysed and critiqued in this article, which concludes with a cluster of ideas and conclusions based on that analysis. It is hoped that such a review may serve as a catalyst for nurse educators to re-examine their teaching practices with a view to enhancing good nursing practice through educational means. (shrink)

Nursing acts occur in thousands of instances daily, being a major component of professional health care delivery in institutions, communities and homes. It follows that the ethical practice of most nurses is put to the test on an everyday rather than an occasional basis. Hence, within nursing practice there must be a rich and deep seam of reflective interpretation and practical wisdom that is ‘embedded’ within the experiences of every experienced nurse. This article presents discussion on some of the main (...) findings of a recently completed study on nursing ethics in New Zealand. An interpretation of a nurse’s story taken from the study is offered and suggestions are made for nursing ethics education. (shrink)

This article explores the social and ethical elements of cultural safety and combines them in a model of culturally safe practice that should be of interest and relevance for nurses, nurse educators and nurse ethicists in other cultures. To achieve this, the article briefly reviews and critiques the main underpinnings of the concept from its origins and development in New Zealand, describes its sociocultural and sociopolitical elements, and provides an in-depth exploration of the key socioethical elements. Finally, a model is (...) presented to illustrate the strong connection between the social and ethical components of cultural safety that combine to produce culturally safe practice through the activities of a ‘socioethical’ nurse. (shrink)

Abstract In the last few decades, a growing number of commentators have questioned the appropriateness of the 'justice view' of ethics as a suitable approach in health care ethics, and most certainly in nursing. Essentially, in their ethical deliberations, it is argued that nurses do not readily adopt the high degree of impartiality and objectivity that is associated with a justice view; instead their moral practices are more accurately reflected through the use of alternative approaches such as relational or care-based (...) ethics. Yet, it has also been argued that this viewpoint does not necessarily 'do justice' to the broader moral responsibilities of nurses towards humanity in general, i.e. to the wider socio-cultural and socio-political issues in society, and to the concept of social justice in particular. This criticism has triggered a much closer examination of relational and care-based ethics in nursing at levels beyond individual responsiveness within relationships and brought into the spotlight the need for a more ethically refined nursing response to an increasingly complex set of socio-cultural inequalities. This article explores a relational ethic within nursing practices with contemporary ideas regarding social justice. In particular, it is argued that the synergy between the two actually produces an ethic that is capable of not only challenging the continuing predominance of justice-based ethics within health care, but of replacing it. Subsequently, in the discussion that follows, it is suggested that a combined social justice and relational care-based approach, as a social ethic, should guide the moral deliberations and actions of nurses. It is maintained that such an approach is not only possible, but crucial if nurses are to realize their full potential as ethical agents for individual and social good. © 2011 Blackwell Publishing Ltd. (shrink)

Various scholars defend the idea that leadership is something accomplished between the leader and the led, rather than something that coincides with the role of an individual manager. Even so, we argue that shared leadership implies a relational ontology grasping leadership as an ever-changing series of events that is thoroughly processual in nature. Supplementing existing analyses and expanding the possibilities for relational leadership research, we propose a view from the perspective ofprocess philosophy, in which relations determine individual leaders and followers, (...) and not the reverse. The process perspective invites us to see and to feel leadership subjectively within ourselves, instead of simply looking at it objectively from the outside. Understanding leadership in this way, as an internally related complex occasion of experience, has implications for expanding the possibilities for what is known in management as relational leadership research. (shrink)

Contemporary epidemiological methods testing the associations between green space and psychological well-being treat all vegetation cover as equal. However, there is very good reason to expect that variations in ecological "quality" (number of species, integrity of ecological processes) may influence the link between access to green space and benefits to human health and well-being. We test the relationship between green space quality and restorative benefit in an inner city urban population in Bradford, UK. We selected 12 urban parks for study (...) where we carried out botanical and faunal surveys to quantify biodiversity and assessed the site facilities of the green space (cleanliness, provision of amenities). We also conducted 128 surveys with park users to quantify psychological restoration based on four self-reported measure of general restoration, attention-grabbing distractions, being away from everyday life, and site preference. We present three key results. First, there is a positive association between site facilities and biodiversity. Second, restorative benefit is predicted by biodiversity, which explained 43% of the variance in restorative benefit across the parks, with minimal input from other variables. Third, the benefits accrued through access to green space were unrelated to age, gender, and ethnic background. The results add to a small but growing body of evidence that emphasise the role of nature in contributing to the well-being of urban populations and, hence, the need to consider biodiversity in the design of landscapes that enhance multiple ecosystem services. (shrink)

ABSTRACTRecognising a facial expression is more difficult when the expresser's body conveys incongruent affect. Existing research has documented such interference for universally recognisable bodil...

In recent years, increasing pressures have been brought to bear upon nurses and others more closely to inform, involve and support the rights of parents or guardians when crucial ‘life and death’ ethical decisions are made on behalf of their seriously ill child. Such decisions can be very painful for all involved, and may easily become deadlocked when there is an apparent clash of moral ideals or values between the medical team and the parents or guardians. This article examines a (...) growing number of such cases in New Zealand and analyses the moral parameters, processes, outcomes and ethical responses that must be considered when life and death ethical decisions involving children are made. The article concludes with a recommendation that nurses should be recognized as perhaps the most suitable of all health care personnel when careful mediation is needed to produce an acceptable moral outcome in difficult ethical situations. (shrink)

Process theories of leadership emphasize its relational nature but lack a substantial method of analysis. We offer an account of leadership as a language-game, employing the concepts of opaque context and propositional attitudes. Using established methods of linguistic analysis, we reformulate Weber’s understanding of charismatic leadership. A by-product of this approach is to limit the epistemological role of individual psychology in leadership studies, and to increase the relevance of linguistic and semantic conventions.

In [6] Messmer and Wood proved quantifier elimination for separably closed fields of finite Ershov invariant e equipped with a (certain) Hasse derivation. We propose a variant of their theory, using a sequence of e commuting Hasse derivations. In contrast to [6] our Hasse derivations are iterative.

Pacific Philosophical Quarterly, March 2006. Significant effort has been devoted to locating a good argument for Kant ’s Formula of Humanity. In this paper, I contrast two arguments, based on Kant ’s text, for the Formula of Humanity. The first, which I call the “Valued Ends” argument, is an influential and appealing argument developed most notably by Christine Korsgaard and Allen Wood. Notwithstanding the appeal and influence of this argument, it ultimately fails on several counts. I therefore present as (...) an alternative the “Autonomy” argument, which is largely inspired by the failings of the Valued Ends argument. (shrink)

At the turn of the century Martin Buber arrived on the philosophic scene... The path to his maturity was one long struggle with the problem of unity- in particular with the problem of the unity of spirit and life; and he saw the problem itself to be rooted in the supposition of the primacy of the subject-object relation, with subjects "over here," objects "over there," and their relation a matter of subjects "taking in" objects or, alternatively, constituting them. But (...) Buber moved into a position which undercuts the subject-object dichotomy and initiates a second "Copernican revolution" in philosophical thought. (shrink)

Interpretation of the classics in political theory seems to go in waves. For a while we had John Locke, the bourgeois thinker. Now we seem to be in a Locke-as-radical-democrat phase. Locke-the-bourgeois had problems of its own, but a radically democratic Locke -- not just the old Locke as liberal democrat but Locke as quasi-Leveller -- strains the interpretative imagination more than most; yet in recent years, several different kinds of argument have been advanced in support of it, both textual (...) and contextual. The most effective argument has proceeded by situating Locke in the context of radical Whig politics in the 1670s and '80s, the struggles over religious toleration and the royal succession, in particular the �Exclusion Crisis� of 1679-81. This contextual argument has been accompanied by various textual interpretations having to do with Locke's conceptions of property, consent, representation, the right of revolution and natural law. Among other things, these are supposed to show that while Locke had nothing explicit to say about the extent of the franchise, the weight of evidence suggests that he would have supported a fairly wide franchise, perhaps even something like the (almost) manhood suffrage advocated by the Levellers (at least according to some, and probably the most convincing, interpretations of their ideas). Most recently, in these pages, Martin Hughes, building on the work of James Tully and Richard Ashcraft in particular, has pushed the argument as far as it can probably go. His argument on taxation and suffrage has provided a motivation here for a wider exploration of Locke's views on representation, consent and the franchise. (shrink)

My thesis is that there is a deep, intractable difference, not between history and science per se, but between paradigmatically central kinds of historical interpretations-call them humanistic historical interpretations-and theories of any sort that are characteristic of the physical sciences. The difference is that unlike theories in the physical sciences, good humanistic historical interpretations reveal subjectivity, agency, and meaning. I use the controversy provoked by Gordon Wood's recent reinterpretation of the American Revolution to illustrate and substantiate this thesis. I (...) also use it to support the claim that unless one attends to the ways in which humanistic historical interpretations reveal subjectivity, agency, and meaning one has no hope whatsoever of getting the epistemology of historical studies right. (shrink)